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Philip Roth and Heart Failure

Philip RothThe noted novelist Philip Roth has died at age 85 of heart failure, even though he had changed many of his lifestyle risk factors that caused him to suffer a heart attack at the very young age of 56, which required bypass surgery of all five arteries leading to his heart. 
 
He wrote more than 30 books, mostly fiction about his own experiences and those of his friends, male sexuality and life as a Jew in America.  He won two National Book Awards, two National Book Critics Circle awards, three PEN/Faulkner Awards, a Pulitzer Prize, the Man Booker International Prize, the United Kingdom's WH Smith Literary Award for the best book of the year and the inaugural Franz Kafka Prize.  Many of you will never forget three of his characters: the teenager, Alexander Portnoy, who was so driven by his libido that he had sex with his baseball mitt and his family dinner; professor David Kepesh, who became a woman's voluptuous 155-pound breast; and Nathan Zuckerman, the nearly autobiographical narrator of nine of his novels.  Roth spent much of his later life alone in his Connecticut farmhouse that was built near the time of the American revolution.
 
Early Life and Writing 
Roth was born in Newark, New Jersey in 1933 during the Great Depression.  His parents were second-generation Jewish Americans and his grandparents had immigrated from Russia.  Roth's father worked in a low-level job at the Metropolitan Life Insurance Company and felt that he was denied promotions because he was Jewish.  Roth was a good student in high school and was graduated from Bucknell, magna cum laude in English and Phi Beta Kappa. He received his masters degree from the University of Chicago in 1955. He enlisted in the army but injured his back during training and received a medical discharge.    
 
His first book, a collection of the novella Goodbye, Columbus and five short stories, won the National Book Award in 1960 when he was only 27 years old.  Rabbis hated it because the stories were unflattering to the Jewish community; one of them described a Jewish army sergeant who complained about Jewish draftees who were not fit to be in the army.  At age 36, Roth published his fourth book, Portnoy’s Complaint, that infuriated the rabbis even more because it was about a neurotic young Jewish man trying to break free of his suffocating parents.  Roth was on the front pages of almost every American newspaper for the most uses of the word "masturbation" in any book, and for his graphic descriptions of the overpowering effect of sex on the behavior of an adolescent Jewish male.   
 
Roth was incredibly disciplined in his writing, starting early in the morning, taking a break for lunch and then returning to his studio to write until seven in the evening.  He had a book published nearly every year until he retired from writing in 2012.  His main characters, such as David Kepesh, Nathan Zuckerman and a fictional Philip Roth, who narrate many of his novels, are thinly disguised versions of Philip Roth himself: an idealistic son of Jewish parents who attempts to ignore Jewish customs and traditions, in spite of pressure from his parents, rabbis and the community.  In 2004, at age 71, he wrote The Plot Against America in which aviator-hero and isolationist, Charles Lindbergh, a noted anti-semite, is elected U.S. president in 1940, and the U.S. does not interfere with Hitler's killing of Jews in Germany and has its own version of Europe's anti-semitism. 
 

His Two Marriages
At age 23, while he was a student at the University of Chicago, he went out to dinner and was served by waitress, Margaret Martinson Williams, a divorced mother of two children.   They lived together for three years and then he claims that she used someone else’s urine sample to persuade him that she was pregnant to trick him into marrying her.  After four years of marriage they separated, but argued frequently until she died in a car crash four years later in 1968.  She had a tremendous effect on him and he featured her in When She Was Good, which was based on her life and family.  She was also portrayed as Josie Jensen in The Facts, Maureen Tarnopol in My Life as a Man, and The Monkey in Portnoy’s Complaint
 
In 1976, at age 43, he started spending half the year in London with English actress Claire Bloom.  After fourteen years he married her and at age 61, he left her.  When he was 63, she wrote Leaving a Doll's House, in which she described what a lousy husband he was.   She wrote that he hated women and wanted to control everything that they did.  She said that he refused to let her daughter, from her marriage to the actor Rod Steiger, live with them because he was bored by her.  Presumably he responded to her book by featuring her and her daughter in his next unflattering book, "I Married a Communist".  
 

His Medical History
After a knee operation at age 54, he suffered from dependence on the drug, Triazolam, given to him to treat his inability to stay asleep at night.  At age 56, he suffered a major heart attack and had emergency quintuple bypass surgery for all five severely blocked arteries leading to his heart.  At age 60, he described his drug dependence in Operation Shylock, which was published in 1993.  At age 72, he had successful back surgery. 
 
How His Heart Attack at Age 56 Killed Him 30 Years Later 
A faulty diet is the main reason that plaques form in arteries.  However, a heart attack is not caused just by arteries narrowed by plaques.  Usually, heart attacks are caused by: 
• a sudden breaking off of a plaque from the inner lining of an artery, 
• extensive bleeding, and 
• the formation of clots that suddenly completely block off all blood flow to a part of the heart muscle.
The part of the heart muscle that completely lacks oxygen dies within about three hours. 
 
Prior to his first heart attack, he ate an unhealthful diet with lots of meat and sugar and low in plants, did not exercise and had a protruding belly with very small buttocks, suggestive of diabetes.  However, after his heart attack, he changed his lifestyle dramatically.  He avoided red meat, ate large amounts of Great Grains cereal and exercised regularly.  He used his experience of having a heart attack in Everyman, (2006), where the main character says, "Old age isn't a battle . . . Old age is a massacre." 
 
Strong data show that a person can get rid of plaque in his arteries by adopting a healthful lifestyle, but you cannot bring dead heart muscle back to life.  When a person survives a heart attack, the major problem is that part of the heart muscle has died, so anyone who has had a real heart attack has part of his heart muscle replaced by scar tissue that cannot contract to push blood through the body.  After his heart attack at age 56, Roth had lost a lot of functioning heart muscle.   With aging, everyone progressively loses muscle, including heart muscle, so his heart got progressively weaker over the years until it eventually became too weak to pump blood through his body. Thirty years after his heart attack, he died of heart failure, because his heart was not strong enough to pump adequate amounts of oxygen to his brain and other organs. 
 

March 19, 1933 – May 22, 2018
June 3rd, 2018
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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