The Ohio State University-College of Medicine

I was very excited about my prospects at OSU. Everyone I had interviewed with at the Ohio State University-College of Medicine had been very gracious and helpful. I was particularly impressed by a plastic surgeon, Dr. Robert Ruberg. He asked the right questions about where I wanted to be. He demonstrated that if I made the choice of Ohio
State, he would certainly be there to help. He was concerned about my family
and asked about my mother. He was concerned about me. He was there trying to
help me make a decision, not exclude me. I loved him from the start.

Ohio State took in a large number of medical students. There were about 160 my year. Of that, approximately 30 of us went into the independent study program. I chose the independent study program because it just seemed to be civilized. I couldn’t see me wasting time in lecture discussion classes having my mind roam as I sat there for hours. Independent study was much more suited to me. I could sit down with a very good book in a very quiet place and get it done.

The course workload was divided into modules. Modules were comprised of the material that needed to be learned in that particular subject. You progressed through the module at your own speed. When you had completed a module, you took an exam. If you passed the exam, you progressed to the next module. If you didn’t, then you had to see the professor
who wrote it. And frankly, that was something you never ever wanted to do.

The independent study program was run by Dr. Michael Altman, an internist, but the real backbones of the program were two women, Dee Eskin and Jodi Skinner, the administrators.

Dee was strictly “business” and expected you to do your best. In a sense she was a “mother figure”. She made sure that it got done. Jodi was simply our fantasy. She was about the same age as all of us and we all really looked at her as, hopefully, the next girl friend, and not the program administrator. She didn’t even know any of us were alive. It was hysterical, but it was how it was. They were the administrators with whom you interacted. The goal became to impress Jodi by passing all your tests. If you failed, she’d have to tell you those horrible words, “You need to see the professor.” No one wanted that.

The other students in the independent study program were, in fact, pretty “independent” themselves. Most were incredibly smart. Many already had advanced degrees. There were a couple of dentists, a pharmacist, and two engineers. Most were older, some of them
married, and so it just worked for their lives based on where they were at the
time.

My favorite subject was anatomy, and two of my favorite people were our anatomy instructors, both women. Martha Sucheston taught embryology, and Peg Hines taught gross anatomy. The part of anatomy that intrigued me most was embryology. Getting a look at how we develop amazed me. That anybody – and I mean anybody – was born normal was the exception, not he rule. There were so many things that could go wrong all along the way. I just marveled at that stuff. Imagine two microscopic cells
developing into a total person. The transformation was simply awesome.

About eight months into the program, and about a year before I was to complete the independent study program and head for the clinical wards at Ohio State Hospitals, I began to feel ill. I experienced a lot of chest pain and after having had a number of
episodes with associated nausea and dizziness, I decided to talk to one of my
instructors about it.

Of course, I went straight to Peg Hines one of my anatomy professors. I couldn’t pinpoint for you why it was her or why she took an interest in me. We were so different, but the fact is I liked her and trusted her judgment. She referred me to a cardiologist, Dr.
Donald Unverferth. She chose him because our backgrounds were similar, though
his was clearly more impressive than mine.

Donald Unverferth had grown up in Dayton, Ohio about 20 miles north of Middletown. He had played football at Ohio State, and in actuality had played quarterback during some of the glory years of Woody Hayes. Unverferth had been drafted by Vince Lombardi of the Green Bay Packers and chose not to go into the NFL. He chose to be a doctor. He was
impressive. He was 6’4” tall, still about 210 pounds, prematurely gray hair but
still looking all the part of the athlete. All the secretaries and all the
nurses loved him. It was amazing to watch them all swoon as he walked by,
oblivious to all of it. He simply loved taking care of people. I envied him
that. He was just so happy to be doing it. The process was his reward.

Donald ordered a lot of tests to examine my heart. It was all very confusing for me. I knew what each test was for but I was confused as to why he always seemed so solemn and serious. I had been referred to him because we were kindred spirits, but I couldn’t help but
feel some sadness when he was around, as if there was always something he
wasn’t telling me. I finally got my answer.

One day he came to me looking more serious than usual. We sat down, and he began to talk about what he thought was going on. His concern was not only the Wenckebach block (that had been discovered a few years earlier when I interviewed for the Naval Academy), but that I had developed a cardiomyopathy. My heart was getting larger and larger over time, becoming a more ineffective pump, and the heart rhythms were now becoming increasingly erratic.

He was worried and so I became worried too.

I also became incredibly sad and even angry following that conversation. Why was this happening to me?  I’m the athlete here. I’m the one running every day. I’m the one lifting weights. I’m the one eating right. And yet here I am, 24 years old, and essentially dying of heart disease.

Dr. Unverferth decided to place me in the hospital to run more tests. The first was an electrophysiology study, a very interesting (and new) test to undergo. I was completely awake for the entire process. Electrodes were placed in my groin and right arm through veins and pushed into my heart under x-ray guidance. Different medicines were infused
to stimulate my heart and the electrodes recorded the different rhythms. Part
of the test is diagnostic and part is therapeutic. The goal was to discover
what medicines serve to make the heart a more effective pump.

The cardiologists discovered that I had an ectopic focus of tissue near my sinoatrial node (another set of pacemaker tissue) and that this was most likely the reason for the Wenckebach block. In other words, there were two distinct set of cells fighting to control
the electrical activity, and hence the beating, of my heart. No wonder I had
become conscious of my heartbeat, something most of us never even think about.

The cardiomyopathy was viral in nature, and an echovirus was cultured. I spent the next 42 days in the cardiac intensive care unit. While the cardiologist figured out what medicines would make my heart a more effective pump, they also wanted to see my symptoms disappear. At the end of those 42 days, I was on Hydralazine, a vasodilator,
Digoxin to help the pump by increasing contractility, and Inderal to slow down
my heart rate.

The medicines initially made me a zombie. Oddly enough, one of the side effects of Inderal was to make me confused and it became more difficult to study. The hydralazine simply gave me the worst headache I had ever experienced (and it was constant). As a result I
took some time off from school. I spent the next few months at home resting in
bed, but eventually I did get my strength back. I came to understand that that
was a miracle. Most patients with a cardiomyopathy simply die.

I devoted myself to health and over the following three or four months became a gym rat. I execised constantly, in fact too much. A short time later, I began to experience
problems with my right knee and subsequently saw another Unverferth, Donald’s
brother, Jack.

Jack was the orthopedic surgeon in Columbus-he was team physician for the Ohio State Buckeyes- and it was funny to watch them joke with each other. They used me as a ball to play with. Donald showed up at the operation on my knee, a lateral meniscectomy, and was always present at my follow-up appointments. He didn’t have to do that, but it was always great to see his face.

Donald always suggested that I never go into surgery because I wasn’t quite dumb enough. Jack would always laugh and say that’s exactly why I should go into surgery, because I’m not quite dumb enough to be an internist.  They loved each other. I envied them that also.

The saddest conversation I’ve ever had with my mother came after her conversation with Dr. Unverferth. His fear was that this heart disease was progressive. He thought I’d be lucky to get to 44 years of age.

Sadly, Dr. Unverferth himself, who was born on exactly the same day as I (April 21) died a couple of years later at the age of 44.  He had developed a brain tumor. On the day I received that news, I simply cried. The world was worse for it. I felt sorry for us all.

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