Three Strikes

A queer sound in the night woke Mrs. Clarice Singer, and dread drove her to the room of Susan, 3. The child stood on tiptoe in the dark against a closet door, arms thrust stiffly overhead. Moments later she heaved a great sigh. Mrs. Singer screamed for her husband, but both knew that nothing could be done. Susan was dead.

A pretty, bright, seemingly healthy child, Susan had never been sick. Yet for the Singer family of Bellingham, Wash., this tragedy a fortnight ago was not entirely unexpected. Susan was the third Singer child in five years to die, without warning, in the same way. In 1953 there was Barbara, a normal, vivacious girl of nearly ten. She was on her way to school when a neighbor saw her rise on her toes, stretch her arms and drop to the sidewalk, dead. In 1956 there was Billy, a strong, spirited boy of two. He was heard to sigh in bed one night and next morning was found dead. Of the four children born to Clarice and Edward Singer (a prosperous plumbing supply dealer), only Steven, 16, is living.

Why? The answer is endocardial fibro-elastosis, a peculiar hardening of the inner lining of the heart, which has no known cause. The trouble is a growth of white fibrous tissue, which may reach a point where the heart is suddenly shut off. Adult victims usually have a history of congestive heart failure; children may have no symptoms at all. Though the disease seems to be rare, it is being recognized more and more--but still only after death. When Barbara was six, her pediatrician found a slightly enlarged heart. It was not unusual, nor was the small heart murmur that another doctor found in Billy in infancy. Susan was also thought to have a minor heart enlargement, but all the children were healthy, energetic specimens. Their hearts seemed near normal, at least, and they suffered no undue strain or emotional upset. Their X rays and cardiograms were all "nonspecific."

The Singers are the first reported family in the world with three children so afflicted--which may be the most important clue yet to endocardial fibro-elastosis. One theory so far: it begins developing in the fetus, though nobody knows why. The Singer family recurrence, says Dr. Bernard M. Wagner, a top Seattle heart specialist, "suggests lethal genes, a genetic mutant. This may be a key family in our study." For the stricken Singers last week, it was little comfort, but all they had.

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