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She was hypertensive so that was pretty clear what types of meds that required but the type and variety of meds increased as the years progressed. My first hints that her health was a daily battle was a year I came home for Christmas during winter break from graduate school. She and I were set to do an ambitious day of shopping in downtown Philadelphia as we had in the past at other malls in California and Illinois.

Such combinations of drugs can lead to high levels of serotonin in the blood, a condition that has previously been shown to damage blood vessels and produce heart valve defects, said Dr. Richard J. Wurtman, director of MIT’s Clinical Research Center.