In our latest Notable Narrative “What Broke My Father’s Heart,” from The New York Times Magazine, the broken heart that reporter Katy Butler writes about is both emotional and literal. Her father’s slow heartbeat leads to the insertion of a pacemaker, which at the end of his life prolongs an increasingly debilitated existence.

Butler describes the way “my mother and I had come to long for the machine in my father’s chest to fail.” The trio of full-fledged characters enters our minds early on:

I don’t like describing what dementia did to my father — and indirectly to my mother — without telling you first that my parents loved each other, and I loved them. That my mother, Valerie, could stain a deck and sew an evening dress from a photo in Vogue and thought of my father as her best friend. That my father had never given up easily on anything.

Born in South Africa, he lost his left arm in World War II, but built floor-to-ceiling bookcases for our living room; earned a Ph.D. from Oxford; coached rugby; and with my two brothers as crew, sailed his beloved Rhodes 19 on Long Island Sound.

In Butler’s powerful portrait of her family, her mother and her father make two different decisions about medical intervention. One choice brings mercy to the family; the other, misery. Small wonder that she emerges with strong opinions.

She uses her parents’ experiences to take on big issues, delving into the failure of the system to fully inform patients about treatments and of individual practitioners to coordinate care for patients. Butler’s examination is a classic first-person narrative made richer by her research and even more complex by reader comments that offer counter-narratives from doctors and patients who have faced similar choices.

[For more, read our interview with Butler, in which she discusses reader comments, pulling off a story in which things go from bad to worse, and engaging readers in the lives of the elderly, who seem to have “lost their civil rights in our hearts and our minds.”]

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