A Shadow Across Generations

For me the search for family history began as a search for medical history — as it probably does for a lot of people. So I was fascinated by this ABC News story about a medical condition that has stalked a family for four generations.

Reading about Lisa Salberg’s struggles for answers about hypertrophic cardiomyopathy reawakens my respect for what family history can reveal about our health — as well as the limitations of those revelations. Her family’s terrible dance with the condition goes back at least a century to a great-great uncle, an Irish immigrant who died suddenly in a New Jersey mine at the age of 19. As the story points out, there is a strong genetic component in hypertrophic cardiomyopathy, which affects the muscles of the heart and, left undetected, can result in sudden cardiac arrest in otherwise healthy young people.

But there’s no simple, smoking-gun clue to who is most vulnerable — there are over 1,000 genes associated with cardiomyopathy. For this reason, many experts do not consider genetic testing an effective screening tactic. Apparently it yields false positives as well as negatives.

Although this condition isn’t in my own family, as far as I know, it was my father’s fatal heart attack at age 59 that eventually got me going seriously about my genealogy. Looking back, I began with a pretty simplistic assumption. I knew my father, and both his parents, had died before age 60 of heart attacks. (My grandfather was 49 when he died.) When I began going back further than that, I thought I would find a string of similar deaths. But instead, I found a cluster of ancestors, including my great-great-grandfather, who lived into their eighties and beyond. Unsurprisingly, I also found a lot of people who died from things we can treat today — tuberculosis, pneumonia and the like. The picture, in short, was a lot muddier than I’d imagined.

So reading today’s story reawakened my respect for the mysteries we can encounter at the intersection of genealogy and genetics. The connections are a lot more intricate than I naively assumed when I began studying my family years ago.