Jared's email

I don't think Jared will mind me posting this. (If you do, let me know, and I'll take it down.) He's right of course, it doesn't change anything. But I thought it was really kind of him to write and it somehow made me feel better...

Michael-
the following is some basic pathophysiologic stuff about the heart that won't make you feel any better. Even if you learn why, she is still gone. As your brother I ache for you, as a doctor (and for only six months besides) here's what I can piece together 3rd hand from this side of the ocean:
So far the report doesn't really tell you much of anything other than that her heart stopped beating. They will likely never know why it stopped, it'd be pretty hard to figure out why after the heart stopped in her case, since she had no symptoms previously. It's likely not something obvious to the naked eye, like a big clot in the vessels that feed the heart itself causing a big heart attack (even if she smoked a lot and took birth control pills this would still be unlikely in a young healthy woman) or something structural like HOCM (http://en.wikipedia.org/wiki/HOCM).
Any one of a number of cardiac arrhythmia could have caused it (long QT, Wolf-Parkinson-White, etc). Whichever one did, the likely endpoint is that her heart rhythm degenerated into ventricular fibrillation. The electrical activity (and thus the activity of the individual heart cells) becomes extremely disorganized. The ventricles stop beating in a coordinated way and become so inefficient in their movement that no blood actually moves anywhere. After a couple minutes without blood flow... death.
The rest is more a less a generic description of what happened to her body after her heart stopped beating.
High potassium can cause fatal arrhythmias but the body has exquisite machinery to VERY closely regulate the blood levels of potassium. They don't get out of a range of 3.5-5.5 unless something is seriously wrong. At death all the cells (which are full of potassium, lots more than is in the blood) burst and release their potassium. Most likely the high potassium was something that was a result, not a cause, of death.
Like I said, this doesn't really help. And it's total armchair quarterbacking. I can't imagine the numbing shock of it. Seeing a someone, especially a young person, who has died lying in bed is so... mind numbingly wrong and outrageous. It's not supposed to end like that. You shouldn't have had to see that, I have felt it a little (the outrage) for people I don't even know from outside the hospital. I can't imagine seeing someone I love looking like they were sleeping but knowing they are gone. See, I'm not a cold heartless surgeon, I'm almost crying for a girl I never met. But more I'm crying for you, and all the broken promises/dreams. I am so sorry.