The death of Bill Eden: Betting on the cold

By Tim Madigan

tmadigan@star-telegram.com

Second of three parts

When awakened in her Washington, D.C., apartment, Ashley Eden saw that it was 3 a.m., a time when news is never good. Her mother, calling from Texas, was almost hysterical on the other end of the line. Something about Ashley's father. A heart attack at home. The doctor said they had gotten Bill Eden back, but maybe not for long. The doctor said Ashley needed to come home right now.

This isn't happening, Ashley thought that early morning last April. Dad is only 57. It's a dream. But then she called her younger sister, Megan, who lived in Dallas. Megan was on her way to the hospital. She said she didn't know much, other than it was really bad. Ashley's fingers trembled so badly that a roommate had to help her make plane reservations on her computer. She went through her closet to pack, and saw two black dresses hanging there. She pulled them down and threw them into her luggage because she wouldn't have a chance to come back east if there was a funeral.

Ashley was 27, Megan three years younger. Both were as close to their father as daughters could be. They usually talked to him every day on the phone, and now that they were older, he was more friend than parent. But Megan was like her mother, more outwardly emotional and nurturing. Ashley, on the other hand, had heard from the time she was a little girl how much she was like her dad. The same droll sense of humor. Same happy-go-lucky demeanor that masked something deeper. The same love of politics.

Like her father had been decades before at the University of Texas at Arlington, Ashley had been active in student government at the University of Arizona. She interned for an Arizona congressman as an undergrad. After graduation, she worked as a healthcare consultant and fitness trainer in Washington, D.C., until she landed a job on the staff of Sen. Edward Kennedy. When Kennedy died, she went to work for Sen. Tom Harkin of Iowa.

On his regular visits to Washington, Bill and Ashley would share a bottle of wine and talk public policy. Theirs was a shared idealism, a desire to speak for those without a voice. Bill had served a term on the Southlake school board, but his real dream was to run for Congress. It wasn't the right time, he always told her. Someday.

But now?

Her flight for Dallas left at 6:30 a.m., connecting in Atlanta. Before that morning, Ashley had openly wept maybe twice in her life. But she cried all the way to Atlanta, cried during her hourlong layover, and cried all the way to Dallas. People around her were uncomfortable, but she couldn't have cared less.

He can't die. Neither one of us are married. My dad loves parties. He loves to give speeches. Who is going to give the speech at my wedding?

Megan picked her up at the airport. As they drove to Baylor Regional Medical Center at Grapevine, Megan tried to explain the hypothermia treatment being administered to their father. It would lower their dad's body temperature for a day to try to reduce damage to the brain from the lack of oxygen after cardiac arrest. Otherwise, the sisters rode in shocked, exhausted silence.

In a room of the third-floor intensive-care unit, Ashley's comatose father was barely recognizable, swollen, a breathing tube protruding from his mouth, covered in cooling blankets from head to toe.

"Dad, what the hell!" Ashley said. "You need to go on a diet. Are these things fingers or are they sausages? You need to get out of bed."

If her father was somewhere in there, he would hear what she was saying, and it would make him happy. His way of handling trouble was to make light, crack a joke. That was Ashley's way, too. He would be happy that Ashley was there and doing it for him.

But it was hard to find any light in this situation. Cathy Eden could scarcely bring herself to enter her husband's room in the ICU.

"That's my buddy, that's my friend," she said at one point, weeping. "We hang out every night on the couch. What's my life without that?"

Later that day, Megan drove Ashley to the home in Southlake where they'd grown up and helped her older sister unpack. Megan saw the two black dresses and became angry.

"Ash," she said, "what the hell?"

A man with a big heart

When Dr. David Scherer had arrived at the hospital early that Wednesday morning, April 13, Bill Eden's condition could scarcely have been more dire.

Scherer, a veteran cardiologist, had first met Eden several years earlier after he had showed up at a suburban emergency room suffering from symptoms of an enlarged heart. The strapping ex-jock in his 50s, a guy with a devil-may-care demeanor, was the kind of patient doctors and nurses tended to remember. Untreated, Eden's heart condition could kill him, but he seemed unfazed.

"I thought a big heart was a good thing," he had quipped.

With a regimen of drugs, diet and exercise, Scherer helped Eden restore his heart to its normal, healthy size, but then hadn't seen him for a couple of years. Their next meeting was that morning in April when Scherer found his patient unconscious in the Baylor ICU.

The doctor studied results of ultrasound imaging of Eden's heart, which seemed to confirm Scherer's suspicions. Not only had the organ become re-enlarged and weakened, it was in worse shape than when Scherer had first seen him. Most likely, the catastrophic event had not been caused by a blocked artery, but by the swollen heart.

"When the heart swells up for whatever reason, it stretches electrical fibers and they become more likely to short-circuit," Scherer explained later. "That's what it is. You short-circuit into rhythms that aren't compatible with life."

The results of another diagnostic measure, called an ejection fraction, were similarly dismal. A healthy heart fills up with blood, then pumps out about two-thirds of the blood with each beat. Eden's ejection fraction that morning was 10 to 15 percent, meaning he had lost most of the heart's functional capacity.

Eden was heavily sedated during the hypothermia treatment, in an induced coma, so there was no way to assess the neurological damage he had suffered. His wife had called 911 as soon as he had lost consciousness at home, and the emergency response time had been good. But the survival rate of people who suffered cardiac arrest away from a hospital was only 1 in 20. Odds of patients who lived long enough to be treated with hypothermia were significantly better, but still only 1 in 5.

Many who survived were neurologically compromised, some in a vegetative state. That was the worst, Scherer thought.

"With the majority of those cases, you end up withdrawing [life] support down the road at the request of the family or you try to respect the wishes of the patient," Scherer said later. "I wasn't real hopeful for him. My conversations with the family were, 'We're going to do everything we can with this protocol for 48 hours, and we're going to hope for the best.'"

The basketball crowd

The calls began to swamp the Baylor switchboard. The ICU waiting room overflowed. The Southlake firefighters who had rushed to Eden's home the night before were among the visitors, as was the emergency-room doctor who had helped save his life. Many others were middle-aged men who, for the past quarter-century, had met at lunchtime on the basketball court at Fort Worth's downtown YMCA.

The pickup games were often heated, and Bill Eden, a monster of a guy and superb athlete, often irritated his teammates with his nonchalant play. But that was Bill, forever laid back. Only once did anyone remember another side of him surfacing, when a player took a cheap shot against one of the old guys who still played.

Bill pinned the offender against the wall by the neck. There were no more cheap shots.

Thousands of pickup games. Beers at Angelo's afterward. Marriages and divorces, children and grandchildren. Ups and downs in careers. A death here or there. But Bill Eden? He always seemed larger than life, indestructible. On that Wednesday morning at Baylor, for his shocked buddies from the Y, there were thoughts of being pallbearers.

Jess Cole would have been one, if it came to that. He had played golf with Bill that Tuesday, when he seemed absolutely fine. The next day, Cole couldn't bear to go into the room in the ICU to see him. He wanted to remember him as that guy on the basketball court.

Rob Frye met Bill at the Y in the early 1980s and became like an uncle to Bill's two girls. That Wednesday, Frye went into Bill's room, kissed his big head and began to sob. Frye told his friend goodbye. He left the hospital to play nine holes of golf, trying to get his mind off what had happened. That didn't work. Frye later sat in a corner at his favorite hangout, Railhead Smokehouse in Fort Worth. Other guys left him alone as he sat and wept some more. He left for home and forgot to pay his tab.

Prayers and MP3s

Megan Eden was the only member of her family who was conventionally religious. While in high school, she joined a youth group at White's Chapel United Methodist Church in Southlake, and the hope of Christianity took hold deep in her heart. She turned to prayer almost the moment she heard about her dad's condition. She prayed for her mother at the hospital as Cathy Eden trembled in her daughter's arms.

And she prayed that Wednesday, during the hours she spent at her father's bedside, holding his hand. Ashley had assumed the role of note taker, the organizer. Megan was the caretaker, the one who made sure someone was always with their father. But it was weird, Megan thought. The swollen person beneath all those blankets, the breathing tube, in the middle of all that medical equipment, that wasn't him.

She kept photographs of her dad on her phone, Bill making stupid faces for the camera. Megan showed them to a nurse in the ICU who wanted to see what Bill looked like in happier times. That goofy face on the phone, that was her dad.

Megan's favorite songs were also on her phone. She and her dad were musical soul mates, so in the room at Baylor, she played the tunes they both loved. Sitting on the Dock of the Bay by Otis Redding. Billy Joel's We Didn't Start the Fire. Norah Jones. Alicia Keys. Imagine, by John Lennon.

The big freeze

There were a few funny times, too, like when a doctor explained the hypothermia protocol. Bill's body temperature would be lowered to 32 degrees. For his daughters, that inspired the image of their dad frozen like an ice cube, some sort of cryogenics. Someone finally explained that the target temperature was 32 degrees Celsius, about 89 degrees Fahrenheit. Megan laughed when she heard that, which made a little more sense.

With the cooling blankets and IVs of chilled saline, Bill's body temperature was lowered one degree every four hours until reaching the target temperature. The heavy sedation was in part to ensure that the patient did not become chilled. His pulse held at around 40 beats per minute. A nurse was devoted to Bill's care around the clock, one-on-one.

So Wednesday was a day of waiting, like suspended animation. The truth of Bill's condition would not be known until the next day, when the medical team would slowly begin to bring his body temperature back to normal. He would be weaned from the sedation, and he would either wake up or he wouldn't. There was a much better chance that he wouldn't.

And if he did regain consciousness, how much of the old Bill Eden would remain?

Tim Madigan, 817-390-7544

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