Polite Dissent

Superman #701 “Grounded, Part One”
J. Michael Straczynski, writer
Eddy Barrows, artist

Kevin does a good job discussing the meat of Superman #701. There’s not much that I can add, other than to take a more in depth look at one particular scene — you know which one I’m talking about — from a medical perspective.

One of three things is likely going on with the elderly gentleman:

1. The gentleman is suffering from angina (severely decreased blood flow to the heart due to narrowed or blocked arteries) or an early heart attack (a complete blockage of blood flow in one or more of the arteries supplying the heart). The pain and the man’s slumped position in the chair fit this diagnosis, but Superman’s comment doesn’t.

2. The gentleman has a dangerously irregular heart rhythm. Brief episodes of an irregular rhythm are fairly common — everybody has them — and generally nothing to worry about. But when you combine an irregular rhythm with chest pain, then there is something more serious going on (ventricular tachycardia or an advanced heart block would be my guess).

3. A combination of 1. and 2. An irregular rhythm could be cutting blood flow to the heart, leading to angina or a heart attack.

In any case, all of these situations qualify as a medical emergency — as in call 911 or proceed immediately to the nearest emergency room. Do not pass Go. Do not collect $200. This is not the time for you to scrounge for the doctor’s phone number; this is when you need to be calling 911. Or better yet, Superman could spend 2-3 minutes flying you to the emergency room. If he has several hours to spend talking a suicidal girl off a ledge, he can spend a few minutes saving an old man’s life (remember, not saving a man’s life is what led Superman into this predicament in the first place.)

And if it is angina or a heart attack, the last thing Superman needs to due is give the guy an adrenalin rush, increasing the blood requirements of the heart even more. Nice going, Superman.

As I discussed last time, while Superman has the ability to detect medical abnormalities, I am not convinced he has the skill to be able to interpret what he finds. It’s easy to misread heart rhythms, for better or for worse. If you haven’t had appropriate medical training, it’s also easy to miss the potential complications of certain diagnosis. For instance, Superman might diagnose the man with atrial fibrillation — a type of abnormal heart rhythm — but due to his inexperience, he wouldn’t know to look for a blood clot in the heart, a potentially fatal complication of atrial fibrillation.

True story: I had a case a few weeks ago, where a patient of mine was in a minor fender bender. The EMTs at the scene ran a rhythm strip and told him that he had an irregular heart beat and needed to see his doctor right away. First thing the next morning, the patient was in to see me, panicked, rhythm strip clutched tightly in his hand. He was convinced something was seriously wrong with his heart. A brief look at the rhythm strip quickly showed nothing was wrong. He had respiratory sinus arrhythmia, which means that the heart speeds up and slows down as the patient breathes in and out. It’s a completely normal finding and is nothing to worry about at all; the poor patient had been panicked, and undoubtedly lost a night’s sleep, for no reason. Thankfully, this story had a happy ending, but it shows that having the ability to check the heart rhythm is not the same thing as knowing what it means.