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February 21, 2012

Mortality


Interesting insight into the death of one of Hollywood’s great stars emerged in a medical journal article I read recently.

The information has to do with a set of heart attacks that killed Clark Gable in November 1960. The article in question has a very long title and summarizes the history of coronary care in America. The article was published in a 2011 issue of Circulation, the journal of the American Heart Association.

I was reading the article for a story I was writing, but the topic of coronary care has personal interest.. In October, I learned that I have a heart condition. I have an irregular heart beat that one Sunday afternoon caused my heart to stop beating several times. I spent the night in John Muir Medical Center’s cardiac care unit before undergoing surgery to receive a pacemaker.

Clark Gable was 59 when he died. The Circulation article focuses on the care he received between two heart attacks he suffered 10 days apart. Gable received the best, top of the line care possible for 1960. The “king” of Hollywood consulted with the most renown cardiologists in Los Angeles. Nonetheless, he suffered his second attack, which was fatal, after he left the hospital and was recovering at home.

 “The recent death of a prominent motion picture performer, whose medical management was of unqualified excellence, precipitated nationwide headlines in the lay press and created a public  awareness that, even with optimum care and smooth convalescence, recovery was not assured.”

This statement came from Morris Wilburne, a Los Angeles cardiologist, who was speaking at the American Medical Association’s annual conference in 1962. Wilburne, who was on the faculty at the University of Southern California, was one of the first doctors to publish articles describing the concept of a special hospital unit designed to treat patients with heart attacks and other heart conditions.

Gable sounds like he was a heart attack waiting to happen. He was always a heavy drinker and smoker, according to the Hollywood history website, Findadeath.com. As he entered his 50s, the one-time MGM box office champion put on weight, ballooning from 190 to 235 pounds. When a movie role came along, he would quickly shed pounds by crash dieting and consuming tons of diet pills.

The film he was making right before his death was the modern-day cowboy drama The Misfits, co-starring two other ill-fated legends, Marilyn Monroe and Montgomery Clift. Much has been written about the stressful, physically demanding shoot. Maybe he-man Gable did his own lassoing stunts, though others doubt that a studio insurance company would allow a 59-year-old star to do such strenuous work. There was also gossip about how Monroe’s  famous insecurities, lateness and “semi-comatose appearances” wore Gable out.

On Friday, November 4, 1960, Gable didn’t feel well as he finished shooting a close-up shot with Monroe at Paramount studios. The next day, he doubled over with severe chest pains while changing a tire on his jeep at his Encino  home.  He and his wife couldn’t call 911 because 911 didn’t exist at the time. Not sufficiently aware that chest pains signaled a life-threatening emergency, they also didn’t think to call a doctor or take Gable to the hospital. Instead, Gable ate an early dinner and went to bed. A bad headache kept him awake much of the night. Finally at 7:15 a.m. Sunday, the chest pains returned, Gable collapsed, and his wife called the local fire department and his doctor.

An ambulance sped him to Hollywood Presbyterian Hospital, where tests confirmed Gable had a heart attack. Bypass surgery was a procedure of the future. Gable’s state-of-the-art treatment consisted of sedatives, anti-coagulants and rest. “The only hint of future treatment was a large machine called a pacemaker brought into his room,” Findadeath.com said.

The Circulation article explains that up until the early 1960s heart patients convalesced in wards or standard hospital rooms with little or no monitoring by staff trained to respond immediately to cardiac arrest.

Gable’s recovery was “uneventful,” the Circulation article said. He stayed in the hospital 10 days. “It was reported that he was looking his old self again, and his color had returned. He was chatting to the nurses and sitting up in bed reading – and probably smoking as well,” Findadeath.com said.

On the evening of Friday, November 16, Gable was back at home. Just before 11 p.m. Gable was in bed looking through a magazine when he lay his head back on a pillow and died.

A remarkable woman introduced me to the Circulation article. This woman, Kathleen Dracup, became a nurse in the mid-1960s and found her calling caring for patients recovering from heart attacks. I was assigned to write a profie on Dracup, the former dean of UC San Francisco’s School of Nursing and one of nursing’s most important pioneers. As I learned during my research, Dracaup has become internationally renowned for her clinical and research work on patients recovering from heart attacks and living with heart disease.

Dracup began caring for heart attack patients at the time hospitals were establishing the first departments dedicated to their treatment. As I wrote in my profile, the invention of ECG machines, external defibrillators and cardiopulmonary resuscitation in the early 1960s gave doctors and nurses the the tools to set up coronary care units where staff could employ life-saving measures within minutes. 

Dracup’s research over the years has focused on the emotional needs of heart patients and their families, She became interested in finding ways to help these patients get well and stay out of the hospital.

Dracup explained to me how medical advances, including diagnostic tools and prevention strategies, have shifted the emphasis of care from people dying of heart attacks to people learning to live with a chronic heart condition. She said that people don’t die from heart attacks with the same frequency as they once did in, say, Clark Gable’s day.  Also, the typical heart patient is no longer a man in his 50s,  like Gable, but someone who 20 years older.

Good follow-up and outpatient, preventive care is key, Dracup’s research shows. The follow-up includes counseling and education for patients and families about life-style changes, managing medications, identifying symptoms and responding to emergencies.

That kind of counseling, education and follow up care was not available to Clark Gable and his wife, who was pregnant with his son. 

In photos, 59-year-old Clark Gable looks, well, old. Today’s top movie idols, upon entering their 50s – Harrison Ford, George Clooney, Brad Pitt, Tom Cruise -- generally look younger and healthier. These guys seem too secure in their fame to rely on plastic surgery – at least in any overt way. They look like they take good care of themselves -- not like they drink heavily and smoke three packs a day.

I think that’s true of men and women in general these days. We know better. We take care of ourselves. We go in for regular physicals where doctors check for heart-problem warning signs such as high cholesterol or high blood pressure. We learn to eat better, exercise more, give up smoking if we haven’t already.

Fifty-nine doesn’t seem so old anymore. That’s only 10 years older than me. Fortunately, my “heart condition” doesn’t constitute a chronic condition for which I must take medication to preserve what healthy heart tissue I have left. Aside from some faulty electrical circuitry, my heart is in good shape. 

So, I don't feel old -- not like Gable looked old in his final decade. But maybe I'm in denial.

4 comments:

Andre' Gensburger said...

Great post and observations about how things changed. Also glad that your pacemaker has solved your immediate issues.

Martha Ross, AKA Soccer Mom said...

Thanks Andre! My doctor told me that I could compete in ironman triathlons if I wanted to. I don't want to. But it's nice that I've been able to get back into running (well, I actually more job), and it feels like at a higher level than before. As in more distance.

Indeed, it was fascinating to find out how things have changed, and the changes in cardiac care also created changes in health care overall. And in the nursing profession. Nurses gained lots more autonomy in cardiac care units. They were making decisions about life-saving measures that had previously been left to doctors.

And, of course, I had fun learning a bit more Hollywood trivia.

ames said...

Interesting blog Martha! Reminded me also of Peter Sellers, who died at 54 of a heart attack.

Anna, The Lemon Lady said...

This is a very interesting story you have written.

My husband was only 43 when he had his heart attack. Like you, we have a personal interest in heart health. We are grateful to live near a renowned medical facility such as John Muir.

Mechanically, the doctors can do fine work. Nutritionally, the patient must help themselves to live and eat better.

One thing that really hurts most people these days is the processed, high sugar, high fat foods. Even with advanced medical care, the poor quality food continues to be a source of problems. It is not difficult to eat healthy, it simply has to be a choice not to eat the processed foods.

I wonder if the cholesterol was such a problem in Gable's day and age?