Ep. 95 | Two Hearts Beat As One

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In the spring of 2016, an older woman lay in a bed in a cardiac ICU talking to her sister on the phone.

The woman had been in the hospital for three days.

She was still feeling weak, but her sister's call was a welcome distraction.

Their laughter filled the room as they relived some past past memories.

But then suddenly, the woman stopped laughing.

Pain began to creep around her back and then shot through her chest.

She took in a deep breath, but couldn't let it out again.

And then she couldn't take another one.

Her hands shook and she dropped the phone.

She could hear her sister calling her name over and over, but she couldn't answer.

Seconds later, a team of doctors and nurses surrounded her bed.

Bells rang and lights flashed around her.

She could hear a doctor calling her name, but she couldn't make out what he was saying.

And then everything began to fade away.

Her vision blurred and the loud beeps sounded distant.

And for a few peaceful seconds, all she could remember was being a little girl, laughing along with her sister.

Then everything went black.

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From Ballin Studios and Wondery, I'm Mr.

Ballin and this is Mr.

Ballin's Medical Mysteries, where every week we will explore a new, baffling mystery originating from the one place we all can't escape, our own bodies.

So if you like today's story, please ask the follow button if you can have a bite of their donut.

When they say yes, just stuff the whole thing in your mouth.

This episode is called Two Hearts Beat as One.

On a sunny spring afternoon in 2016, 67-year-old Denise Powell threw open a window to let some fresh air into her home in British Columbia.

Denise and her 66-year-old husband, Robert, had spent most of the day harvesting baby vegetables and spring flowers from their garden.

Now, with a vase of fresh flowers on their table, they were sitting down to enjoy a healthy salad for lunch.

A few years earlier, Denise had been diagnosed with high blood pressure and high cholesterol, which is having fat inside of your bloodstream.

For the moment, she wasn't on any prescription medication, but her doctor had recommended a heart-healthy diet.

emphasizing unprocessed food.

And so ever since then, Denise had tried to do that, doing her best to eat as many fresh fruits and vegetables as she could.

As Robert cracked a little salt and pepper over their bowls, Denise added a splash of red wine to each of their glasses.

Then, after making a toast to celebrate their unusually warm spring, the two of them dug into their delicious lunch.

Denise was born in China, and so she combined Western medicine with traditional Eastern practices to try to keep herself healthy.

After lunch, she took her usual supplements of vitamin B12 along with traditional Chinese herbs.

Twenty minutes later, she put on some sunscreen, grabbed a hat, and headed out for her daily walk.

But when she got back home, Denise felt more tired than usual.

So she laid down to take a quick nap on the couch, thinking maybe she'd spent too much time in the sun.

However, Denise slept right through her alarm and woke up hours later.

And also, she woke up with this terrible pain gripping her stomach.

Then these waves of nausea rolled through her body and she stumbled from the couch to the nearest bathroom just in time to vomit.

When she looked up, she saw Robert looking very concerned standing in the doorway.

She would cling to him over the next few hours as he helped her go back and forth, back and forth from the bathroom to the bed.

And then eventually, she just stopped going back to the couch and just laid down in the bathroom.

And as she laid in the bathroom, she noticed that it was not just nausea she was feeling.

Also, her chest felt really tight.

At this point, Robert asked Denise if she wanted to go to the hospital.

but she said no, she didn't, at least not yet.

So Robert began to wonder aloud if maybe this was just a bad case of food poisoning.

But Denise shook her head and said they had both eaten the same thing that day and Robert was fine.

She figured what was going on here was just a stomach bug and she'd likely feel better after some sleep.

So she had Robert help her up and she crawled into bed, hoping that in the morning she would feel better.

Three days later, Denise lay curled up on the couch, still feeling pretty dizzy and nauseated.

She looked at her watch right as Robert came in from his daily bike ride.

She saw that a whole hour had passed since her last episode of vomiting, and so maybe she was on the mend.

Robert walked over and handed her a few of her favorite roses, which he had just picked from their garden.

Denise took the flowers with a smile and held them to her nose.

But even the flower's mild fragrance suddenly made her feel nauseous.

And so Denise quickly handed the flowers back to Robert and got up and hobbled over to the bathroom.

After emptying her stomach yet again, Denise collapsed back on the sofa.

Robert had turned on their favorite show, but Denise barely had enough energy to focus on the TV.

In fact, she found herself squinting against the brightness of the screen.

And then, as she was squinting, she sat up and peered right at the television more closely.

Something was very odd.

Rings of bright yellow light circled the screen.

She blinked and blinked, but these lights didn't go away.

In fact, soon, the yellow lights surrounded everything she focused on.

Her hand, a doorknob, a picture over the fireplace.

These rings were all around them.

She asked Robert sort of desperately, like, hey, do you see yellow rings around everything?

But he looked at her and he just said, no, I don't.

At this point, Denise wasn't sure what scared her more.

The very concerned look on Robert's face as she was asking him this question?

Or the bright yellow halo that surrounded his head?

Denise couldn't deny it anymore.

She had to go to the hospital right now.

Two hours later, inside the emergency room of the local hospital, Dr.

Carmen Oliver wrapped two fingers around Denise's arm.

She could barely feel the woman's pulse.

which registered at only 53 beats per minute, very slow.

Dr.

Oliver could see that her new patient was totally exhausted and dehydrated from days of vomiting.

But even more concerning was that Denise was reporting tightness in her chest.

These issues, combined with her age, convinced Dr.

Oliver that she was looking at more than just a run-of-the-mill case of the flu.

Denise and her husband began to rattle off Denise's medical history.

Dr.

Oliver learned that Denise had a history of high blood pressure, high cholesterol, an inner ear disorder called Minier's disease, and asthma.

Dr.

Oliver was not that surprised when Denise asked her if, you know, what she had just experienced was maybe a heart attack, given her high risk factors for heart disease.

That was actually Dr.

Oliver's concern, too, that this was a heart attack.

So she ordered blood work, a chest x-ray, and an electrocardiogram, which is a test that shows a graph of how your heart is beating.

Then she had Denise placed in a cubicle within steps of the nurse's station, just in case something happened.

A little while later, after all the testing was done, Dr.

Oliver met with Denise to go over her results.

Dr.

Oliver shared that Denise's blood work and chest x-ray were normal, which seemed to rule out a heart attack along with an infection or a stroke.

However, Dr.

Oliver said they were not out of the woods yet.

She turned her data screen around to actually show Denise and Robert the full results of the ECG, and it was clear by their very worried expressions that they knew what they were looking looking at.

Robert immediately pointed to a flat line between the two peaks of the heartbeat spike on Denise's graph.

He knew the space between the peaks was supposed to be consistent, but here the spaces were variable.

Dr.

Oliver nodded, confirming that the graph showed a one to two second delay between Denise's heartbeats.

That irregular heart rhythm was dangerous.

It meant she was susceptible to a heart attack or stroke at any moment.

Just then, Dr.

Oliver's pager beeped and a nurse appeared at the doorway.

One of the doctor's other patients needed their attention right now.

But before she moved down the hall to this next emergency, Dr.

Oliver told Denise that she wouldn't be sending her home until they found out what was wrong with her heart.

She assured her the cardiology team was already reviewing her case.

A few hours later, Denise woke up from a nap, and for a moment, she had no idea where she was.

Everywhere she looked, she just saw these swirling yellow halos and flashing lights.

But the IV lines in her arms, the pads on her chest, and the monitors beeping around her bed reminded her she was still inside of the hospital.

At the foot of her bed, she saw Robert speaking in hushed tones with a man she didn't recognize.

Judging by the man's white coat and the concerned look on his face, Denise decided this must be her new doctor.

When Robert noticed Denise was awake and he looked at her, she saw he also looked very concerned.

At this point, the man in the white coat introduced himself.

He said he was Dr.

Arthur Hammond, and he was the head of cardiology at the hospital.

Denise asked him if that should make her feel better or worse, that he, you know, was here to talk to her about her case.

And he jokingly admitted that he wasn't sure.

He told her that he knew what was going wrong with her heart, but he didn't know why.

He told Denise that what she was experiencing was something called a total heart block.

Denise looked over at Robert, and she could tell he was just as confused as she was.

Even with all her previous heart issues, they'd never heard of anything like this before.

Dr.

Hammond explained that a heart block was when the natural pacemaker in the heart stopped working correctly.

In Denise's case, the little group of cells that sent electrical signals to regulate the rhythm of the heart weren't sending the messages fast enough, or at all, which created a high risk that blood flow to her heart would just stop.

the true definition of a heart attack.

And the way her heart appeared to be beating, it could happen at any moment.

After that, Dr.

Hammond very gently told her that she was going to be admitted to the cardiac intensive care unit, where she could be closely watched and undergo more testing.

Denise felt Robert squeeze her hand and then he stepped away as nurses moved around her bed, unhooking her from all the lines and monitors.

As they began to roll her out of the room, Denise lay there in stunned silence, and everywhere she looked, all she saw were bright yellow halos.

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Three days later, Dr.

Hammond gave a soft knock at the entrance to Denise's ICU cubicle.

And as he entered, he immediately noticed that Denise was alone.

Every other time he had made his rounds, Robert had been by her side.

Denise remarked she actually hadn't heard from Robert all morning, to which Dr.

Hammond smiled and told her he was glad Robert was getting some much needed rest.

Over the last few days, Dr.

Hammond had run advanced heart function tests on Denise, and now he wanted to go over the results with her.

He pulled the data screen close to her bedside and clicked on an animated version of her echocardiogram, which is different than the electrocardiogram she'd had previously.

Echocardiogram is a test that uses sound waves to create an image of the heart as it pumps.

The screen filled with various angles of the inside of her heart beating and pumping blood.

Dr.

Hammond pointed out all the structures and clicked on the animation loop over and over.

Then, Dr.

Hammond switched the screen to show Denise a video of her angiogram, which is a medical imaging test that uses x-rays along with a special dye to visualize blood vessels and their function.

And so as they watched his video, it showed the dark dye progressing through her veins.

The good news, he said, was that all these tests showed that there weren't any severe blockages or problems with the structure of her heart.

But then he paused and said, unfortunately, there was some bad news too.

He told Denise it was clear she was still very sick.

There was nothing wrong with her heart structurally, but it was operating too slowly and not at the correct rhythm.

And so she was still very much in danger of having a serious heart episode.

Dr.

Hammond could see Denise's face fall, but he assured her that all was not lost.

There were some very good options for her care, and he wanted to go over them with her.

At this point, it didn't surprise him when Denise said she actually wanted her husband to be a part of this conversation.

So, the doctor nodded and gave her some room while she picked up her phone to call Robert.

At the same time, Dr.

Hammond's pager beeped, calling him back to the emergency room.

He promised Denise he'd be back as soon as he could.

He left the room as Denise began leaving a voicemail for her husband.

As Dr.

Hammond walked into the busy ER, a nurse handed him a chart for a new cardiac patient.

She pointed over to the older man who was laying on his side on the gurney facing away from them.

Dr.

Hammond glanced at the monitors and saw the man's heartbeat was extremely low.

Also, as Dr.

Hammond read the electrocardiogram, it showed strange patterns in the electrical signals of the man's heart.

Dr.

Hammond paused for a moment, shocked that this patient was basically showing the exact same symptoms that Denise had.

And then, when Dr.

Hammond took a look at the name on the patient's chart, his jaw dropped.

The new patient was Denise's husband, Robert.

Dr.

Hammond immediately ordered Robert an IV trip just to be on the safe side, and then also began reviewing the notes from the ambulance drivers who had brought him in.

And what he read shocked him.

In addition to the nausea and chest pain, Robert had told the EMTs he was seeing yellow and red halos everywhere.

Dr.

Hammond remembered Denise talking about all these bright yellow halos everywhere when he first took her case, but he had no idea what to make of that.

And so the mystery was only deepening here.

Dr.

Hammond now had two patients suffering from basically the exact same combination of symptoms, which was of course very rare.

And so as a result of that, he knew that the odds were that whatever was wrong with Robert and Denise probably had very little to do with heart disease because they didn't share the same heart here.

Like what were the odds that they both had the exact same heart disease and they both developed these symptoms identically at the same time?

Like that's not going to happen.

But regardless of how this came to be, both of their hearts were in peril here.

Either one of them could still suffer a heart attack at any moment.

So there was no time to lose.

Later that night, Dr.

Hammond was back at the nurse's station of the Cardiac ICU.

He could see both Denise and Robert, who were now resting comfortably in beds right next to each other.

Robert was reading, and Denise chatted quietly on her cell phone.

Dr.

Hammond pulled up both of their health histories to look them over side by side.

Their record showed that they both had some level of cardiac disease that was typical for people their age.

But high blood pressure and high cholesterol didn't explain what was happening to them now.

And so this only added to his suspicion that their heart troubles were simply a symptom of a very different, larger problem.

And so he started making a list of questions about their lifestyle and their environment that he intended to ask them both in the morning.

But then as he was doing that, suddenly alarms began to sound from Denise's cubicle.

And so he ran to Denise's bed with nurses right behind him, and he took one look at the monitors and he could see that Denise's heart had gone into a deadly rhythm called ventricular tachycardia.

The lower chamber of her heart was beating too fast to pump blood correctly.

He could see Denise's eyes fluttering as she slid out of consciousness.

Dr.

Hammond knew he would have to act fast.

If Denise's heart kept going like this for more than maybe 30 seconds, it could become starved of oxygen and just stop.

Denise already had defibrillator pads applied to her chest for this kind of emergency.

A defibrillator is a device that delivers a controlled electrical pulse that can shock the heart back into the correct rhythm.

Years of experience kicked in and Dr.

Hammond stepped calmly to the control button of the device.

He had to watch the electrocardiogram graph for the exact moment to deliver the electrical pulse.

If he fired the defibrillator at the wrong time, he could actually put her heart into another cycle of the wrong rhythm.

But just as suddenly as this episode began, it was over.

Denise's eyes opened wide and she started to breathe normally again.

The monitor showed her heart had shifted back into the correct rhythm, apparently on its own.

The doctor could see Denise clearly felt uncomfortable, but for now, she was out of danger.

However, without knowing what had caused this episode, Dr.

Hammond feared it could happen again at any moment.

He left Denise's side as the staff took over to watch her recovery, and he went over to Robert.

He knew Robert, for a host of reasons, would be petrified, not only because it was his wife, but also he had the same issues his wife did, so that could happen to him too.

Dr.

Hammond reassured Robert that Denise was fine for now, but the last episode was a sign that things were still very dangerous and unstable.

As tears began to roll down Robert's face, Dr.

Hammond handed him a cup of water and began speaking to him in very calming tones as he kept one eye on the blood pressure monitor.

He didn't want Robert's anxiety to trigger any changes in his own heart rhythm.

Now, ordinarily, Dr.

Hammond would have put off asking Robert a whole bunch of questions at a time like this.

But with Denise in such a dire situation, he knew there was no time to waste here.

Once Robert's blood pressure appeared steady, Dr.

Hammond stood behind the workstation screen and began taking notes.

He gently guided Robert into a a conversation about the day his wife first got sick.

Dr.

Hammond was hoping that maybe Robert might have a fresh detail or another memory, anything that could point to what happened that day that caused all this.

But Robert told the same story Dr.

Hammond had already heard about the sunny day a week ago where the couple worked in the garden and ate the salad of freshly picked vegetables.

He heard how Denise got sick a couple hours later and Three days after that, she was in the hospital.

But then, Dr.

Hammond asked Robert to describe how he had gotten sick.

Robert said he had felt fine until yesterday.

He had gotten up and taken an early bike ride, and then picked some kale from their garden and made an omelette with the fresh vegetables.

And then a few hours later, he felt so ill he could barely drive himself to the emergency room.

Dr.

Hammond's ears perked up the moment Robert mentioned adding the plants from their garden into his breakfast.

He asked if the vegetables Robert ate were the same ones that he and his wife had eaten together a week earlier when Denise had gotten sick, and Robert said yes.

And so now the whole thing had Dr.

Hammond totally confused.

He wondered how two people could eat the same thing at the same time, but get sick a week apart.

Dr.

Hammond thanked Robert and began to leave the room, but then Robert called him back over to say he actually remembered one more thing.

He told him that the greens he ate that morning, right before he got sick, were definitely a little bitter.

Robert Robert also recalled that on the day Denise got sick, she had said her salad had tasted very bitter as well.

But he, a week ago, had not noticed that in his own salad.

At this, Dr.

Hammond knew he finally had something that stood out.

He told Robert he would need to run some new blood tests, but hopefully, those tests would get them the answers they needed.

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Early the next morning, Dr.

Hammond was in his office when his inbox pinged.

The results of Robert and Denise's new blood tests were in, and they were shocking.

Both blood samples contained high levels of a cardiac medication known as digoxin.

Dr.

Hammond couldn't believe that both Denise and Robert could forget something this important, and so he wondered if maybe there was some piece of their medical history that had slipped through the cracks.

Dr.

Hammond walked into Denise's room and he asked her about taking digoxin.

But Denise told him, no, she's not taking that and had never even heard of it.

The doctor even showed her pictures of what the medication looked like, but Denise swore she was not taking it and never had.

After that, the doctor crossed the hallway into Robert's room, but he would get the same blank look and firm no from Robert about digoxin.

Apparently, neither of them were taking it.

But Dr.

Hammond felt like this couldn't be a mistake.

I mean, the digoxin chemicals were clearly in their blood.

They'd gotten there somehow.

At this point, the doctor began to think, like, how else could the digoxin get into their bloodstream?

And that's when he had an idea.

He mentioned this idea to Denise, who immediately picked up her phone and called her sister.

A few hours later, Denise's sister arrived and she handed Dr.

Hammond a basket of fresh produce from Denise in Richard's garden.

The doctor put on a pair of gloves and began sifting through the carrots and tomatoes until he came across the kale.

Because Robert had told him that before Denise got sick, she had claimed the kale was bitter, even though Robert had tasted the kale and it wasn't bitter to him.

But then a week later, when Robert said the kale tasted bitter, he got sick.

And as Dr.

Hammond stared at this kale, he realized what was wrong.

Denise and Robert had been poisoned.

It would turn out, Denise and Robert's garden was full of vegetables, fruits, and flowers that were all all in early stages of growth.

Some of the kale leaves that the doctor were looking at were in fact kale, but mixed in with the kale were leaves of a different plant called foxglove.

As young plants, kale and foxglove look very similar.

While kale is perfectly safe and healthy to eat, foxglove is not.

In fact, it is highly toxic.

Foxglove contains digitalis, a compound used in heart medications like digoxin.

In precise doses, digoxin can help regulate heart rhythm, but too much can be fatal.

It can also lead to visual hallucinations like the ones that Denise and Robert had experienced, where they saw all those bright colored halos around everything.

It's not exactly clear why Denise got so sick so quickly on the same day that she and Robert both ate the same type of salad.

It's possible that Denise got most of the bitter foxglove leaves on her plate and Robert ate mostly kale.

Or maybe Robert simply ate fewer of the poisonous leaves, or he ate smaller ones, which had less of the chemical.

Whatever the reason, on the day Robert did finally get sick, he just must have eaten more of the foxglove leaves instead of the kale.

Ultimately, both Robert and Denise had eaten enough of this foxglove to put them both on the brink of death.

As soon as Dr.

Hammond realized what was going on, he immediately gave Denise and Robert the antidote for digoxin poisoning, poisoning, a medication called digoxin fab.

And within an hour, they were both feeling remarkably better.

Denise and Robert were both well enough to go home within days, and as soon as they got home, they made sure to remove every foxglove plant from their garden.

And also the kale, just to be safe.

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From Balin Studios and Wondry, this is Mr.

Balin's Medical Mysteries, hosted by me, Mr.

Balin.

A quick note about our stories.

They're all inspired by true events, but we sometimes use pseudonyms to protect the people involved, and some details are fictionalized for dramatic purposes.

And a reminder, the content in this episode is not intended to be a substitute for professional medical advice, diagnosis, or treatment.

This episode was written by Alison Taylor.

Our editor is Heather Dundas.

Sound design is by Andre Plus.

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