Polite Dissent

Batman is shot point blank in the chest by the mysterious “Third Batman” (a police officer once trained to take Batman’s place if he were to die), which causes his heart to stop. Batman collapses, but is later revived when the Third Batman shocks his heart back into a normal rhythm. At this point, Batman exclaims: “My God — I had a heart attack — on the roof of the GCPD — “

There are a handful of problems with this scenario:

#1. There is a difference between a cardiac arrest and a heart attack. A cardiac arrest occurs, as the name suggests, when the heart (cardiac) stops beating (arrest). Cardiac arrest can be caused by several different conditions, including a heart attack, an abnormal heart rhythm, trauma, and electrolyte abnormalities.

A heart attack (”myocardial infarction” in medical-ese) occurs when one or more of the small arteries supplying the heart with blood are suddenly blocked and the heart can no longer obtain the oxygenated blood it needs to survive. The affected part of the heart muscle (myocardium) then dies (infarcts). If a large enough part of the heart dies, it can lead to a cardiac arrest and death, but it is certainly possible to have a heart attack without suffering a cardiac arrest.

In the story, despite what he says, Batman suffered a cardiac arrest, not a heart attack. He developed an abnormal heart rhythm that degenerated into asystole (a flatline). This abnormal rhythm was brought about by direct trauma to the chest, a kind of commotio cordis (a condition which occurs when a blunt trauma to the chest happens at just the right instant in the heart cycle to disrupt the normal heart rhythm and cause a fatal arrhythmia and cardiac arrest. It is most common in children, and is thought to kills several Little Leaguers struck in the chest by baseballs every year. There have also been recorded cases of commotio cordis occurring in adults struck by a bullet who were wearing body armor, much like Batman in this situation).

#2. After Batman slipped into asystole, he was brought back by the Third Batman using a defibrillator. I know I’ve covered this many time before, so everyone repeat after me: you don’t shock a flatline. It’s a bad idea — especially after several minutes of asystole have elapsed, as in this case. (Though Morrison is right that brain damage after a cardiac arrest starts at the five minute mark.)

#3. The Third Batman appears to have defibrillated Batman through his uniform, which I always understood to be insulated. Or else he defibrillated him through the hole blown in his uniform, which would put the paddles in the wrong position to work. The art in the book actually suggests he defibrillated the right side of the chest (the wrong side), so I’m giving Daniels the benefit of the doubt and assuming he’s showing the moments leading up the actual defibrillation, as the Third Batman moves the paddles into position.