A Dangerous Instrument

Fig Newton?”

I was peeling the lid from a coffee cup. I told Pam’s mother No, thanks.

We were on a bench in the hall right outside the ICU. There wasn’t much to say, so we fell into a trance watching the doors on elevators open and close. Sometimes people got out, sometimes they didn’t. Sometimes there were no people.

Hugh Calkins appeared, all lab coat and glasses — a timid presence.

He carried a medical instrument. He sat down next to Pam’s mother, Jackie. He was terribly sorry about what happened.

He said this to her:

“What happened was I was trying to reposition the catheter. I was going to ablate four areas. I got two done and I wanted to switch catheter sheaths. I turned away for a second and the mapping catheter – just like this one here – see how it’s coiled up there at the end like a lasso? And that’s what they call it, a Lasso catheter.

“Well, while I was moving the catheter, working toward the third area, I turned away because I wanted to use a different sheath, and the catheter went down into the mitral valve muscles.

“The mitral valve muscles, they’re like parachute strings. And you see how this catheter loop sort of coils up? When we retract it, it’s supposed to straighten out and it should have just slid off  those muscles when we retracted it, but this catheter, you know, is a mapping catheter, which, they have these little electrodes on them.”

He held the tip of the catheter up and ran the thin wire straight through his finger tips before it snapped back to a curl. “Now this one, this mapping catheter is a new design. It has TWENTY sensors – electrodes. So what I think is… is that the extra sensors kept us from retracting the catheter. The electrodes of this catheter got snagged on these parachute string muscles of the mitral valve.

“This catheter,” said Hugh Calkins, “is a dangerous instrument.”

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