Narrating and imaging an aortic dissection

Robert Kaiser, a distinguished reporter and editor at the Washington Post, describes his aortic dissection here.

To see the spiral CT scan animation and still-land drawings of the operation, go to the Interactive Graphic box, “My Telltale Heart.” Watch the animation several times, after studying the last frame, to see the dynamics of the dissection. Or, for the images, read the article.

To read the entire article without having to go through all 5 page links, just go to “print this article” which puts all the pages onto one continuous page (and does not cause your computer to print the article).

Now and then, this personal narrative leaves the case-study (n = 1) mode and provides some general context. For example: “Unless repaired, dissections of the ascending aorta kill most of the people who have them, instantly or eventually. The risk of death for those who survive the dissection itself rises sharply as time passes — about 1 percent per hour for 48 hours.” The report also illustrates the great importance of good imaging, which is usually non-invasive, in preparation for the often-invasive treatment. And also the statistical lesson in medical care: always ask how many times the surgeon has done the proposed procedure (in this case 200 times), since, as in so many things, rehearsal improves performance.

By tracing out in detail the months-long events, Kaiser’s report is helpful to those facing such difficulties. It also illustrates what optimal care looks like, thereby providing a basis for comparison for less privileged patients.

Finally, in case studies, the question is always “Compared to what?” Robert Kaiser fortunately survived to write this riveting account. If not, no story.