240 beats


By Bernard Witholt, PhD with Roger M. Mills, MD

Available on Amazon


“Ever wanted to continue a conversation with a lifelong friend who has died? Impossible, you say! Not for cardiologist and author Roger Mills and his Amherst College classmate and rowing partner from fifty years ago—the accomplished European research biologist Bernard Witholt. This book was born two years after Witholt’s death, when his widow shared his journal about living with an “unruly heart” (that occasionally raced at 240 beats per minute) with Mills. 240 Beats per Minute recounts an extraordinary conversation—the combination of Bernie’s journal and Roger’s commentary. It’s a read of such continuing surprise, discovery, triumph, and, in the end, mutual understanding and respect, that we readers become the luckiest of eavesdroppers: Long after we finish Life with an Unruly Heart, Bernie and Roger’s conversation will live in our minds.”
—PAUL DIMOND, lawyer and author of The Belle of Two Arbors and
Beyond Busing, winner of the Ralph J. Bunche Book of the Year Award

“This absorbing, ambitious blend of memoir, science, and friendship traces in two voices the journey of Bernard Witholt, an eminent Dutch biologist with a diseased heart and his lifelong friend, cardiologist Roger Mills. Witholt grapples—sometimes unconventionally—with years of tachycardia while stubbornly attempting to sustain a vigorous life. One cannot reflect on this compelling account without saying that it has heart in more ways than one. Witholt brings a scientist’s curiosity into how the heart works to his problems, while Mills’ interspersed, accessible reflections on his friend’s journal entries are fascinating, compassionate, and clear. This book is a gift to healthcare professionals treating heart patients, to patients facing their own conditions, and to readers open to a story about resilience in the face of challenge, about the mechanisms of an “unruly” heart, about the power of friendship even after death, and about the dignity of a life well-lived.”
— JAN WORTH -NELSON, Editor, East Village Magazine, poet, author, and lecturer emerita, University of Michigan, Flint

“Kudos to Drs. Witholt and Mills for bringing to light one of the most important issues in contemporary medicine: the psychological impact of sophisticated medical treatments. This book is a must-read for those of us who practice high tech medicine and for our patients who spend their (remaining) lives on the cutting edge.”
— PETER KOWEY, MD, FACC, FAHA, FHRS, Emeritus Chair, Cardiology, Lankenau Heart Institute, William Wikoff Smith Chair, Cardiovascular Research, Lankenau Institute of Medical Research, Professor of Medicine and Pharmacology, Jefferson Medical College

A Note From Roger Mills, MD:

In 1999, my close friend, the Dutch scientist Bernie Witholt, received a device, an implantable cardioverter defibrillator (ICD), to control ventricular tachycardia, a potentially fatal heart rhythm problem. I had completed my formal training as a cardiologist at Harvard’s Peter Bent Brigham Hospital in 1975 and had spent three decades working with seriously ill patients. As I watched Bernie living with his ICD, I realized that no one really understood how patients adjusted to these devices. Cardiologists implanted the devices and said, “There, that’s fixed. Next.”

Bernie quickly realized that his problem was not “fixed.” With his ICD, he had just traded one very serious problem for a new one (also serious but less likely to be fatal).

Today, almost twenty years later, there’s growing medical literature on the quality of life for patients with implanted cardiac devices. A consensus has emerged that depression and anxiety are common problems in patients who’ve received an ICD. Nonetheless,
this literature inevitably reflects a medical viewpoint, not the patients’. Bernie was a scientist and teacher; he wanted to share his thoughts about his heart and his ICD with others. He wrote extensively over several years, with every intention of putting his thoughts together into a book. He did not have the opportunity to do that, but his wife has allowed me to edit and arrange what he wrote.

Bernie had a PhD in biology and achieved great success in research and teaching, but when he wrote about circulatory physiology (how the heart works) and, most notably, his speculations on his arrhythmia’s origin and regulation of body temperature,
his ideas did not always follow currently accepted medical understanding. I have made some corrections to his notes, but they are minimal. First, because he was very smart and doctors are not always right, and second, because the critical purpose of this book is to recount how one particular patient dealt with his illness over fifteen years. This is not a physiology text.

I attempted to structure Bernie’s book as a continuation of a conversation that we carried on over decades. That conversation began at Amherst College, so some background about the college in the 1960s is important. I have also added some technical information and, from time to time, made comments when, based on my thirty years of clinical practice, some particular understanding of the doctor–patient relationship is important.