First of all, we’ve been using the wrong word all these years. It means without rhythm. The only arrhythmia is asystole, I tell my students. That’s the flat line accompanied by the clang of alarms in all the television dramas. There’s not much you can do about it; the patient is dead and usually stays dead. The correct word to describe all the ways a heart can dance and die is dysrhythmia, which means a disordered rhythm. There’s the soldiered march of ventricular tachycardia or the pirouette twirl of Torsades. Ventricular fibrillation simply quivers on the monitor. When these rhythms occur, the patient is pulseless and sometimes you give magnesium, usually shock, and always pump their chest to the beat of whatever song lives in your head. Once I was speaking with a man who stopped in the middle of a word, and I watched the rhythm on the monitor change. When I didn’t feel a pulse, I started CPR, and then we placed the paddles on his chest and shouted, Clear, just like in the movies. And it worked. He opened his eyes and looked at me and said, I don’t feel good. And I said, It’s okay, I’m going to get you better and smoothed the fair from his forehead, but then the alarms blared and the V tach returned, and we did it all over again—the drugs and compressions and shocks, and his eyes opened one more time and he mouthed I’m scared around the tube I’d placed in his throat, and I said, I’m here with you. But that was the last time he said anything. We didn’t stop for thirty minutes or more. He’d waved to his family when the medics loaded him into the ambulance with just a little chest pain, so they were shocked when I entered the small consult room to tell them he had died. His teenage son collapsed and landed on his knees and punched the ground and said, But we were fighting, and I think the last thing I said was I hate you.

All I’m trying to say is that it’s really important to use the right words.