photo by Adam Kubalica

“It’s the little things,” people will sometimes say, “that make the difference.” Do you know what I mean?

For instance, you’ll remember a momentous occasion (be it tragedy or celebration), but you will also remember some seemingly insignificant or off-the-wall details surrounding that occasion, embedded in your mind. The macro and the micro.

It reminds me of the little bit of rock climbing I did when I was 15 and 16 years old. The smooth face of a mountainside can only be scaled with the use of numerous tiny hand and foot holds. From one vantage point they seem insignificant and small. But while you cling to them on the face of the rock . . . they appear as dear as life itself.

My memories of the heart attack are like that, too.

I asked the cadre of nurses and firemen in the OR (operating room): “Would you be doing this for me if you weren’t getting paid?” One sweet nurse said, “Of course!” One realistic fireman said, “No, I’d be at home in bed!” I am always looking for a laugh, you know. Especially when I am in a dire personal situation.

In the OR, in semi-consciousness, I recall hearing the cath lab nurse (Christie) saying to the cardiologist (Dr. P), “I’m going to give him 5,000 units of heparin.” To which the cardiologist responded, “No, give him 8,000!”

Of course, heparin is an oft used anticoagulant (approved in 1939), usually coming in increments of 5,000 units/ml. My memory of the doctor’s request for an odd number of units is puzzling. All I recall is a burning sensation in my left hand, and I suspect it was the heparin. I do recall asking for something for the pain in my left arm, but I don’t yet know what they might have given me (versed, perhaps?).

Then the man working on my right wrist (it must have been the cardiologist preparing to enter the radial artery) said, “Now I’m going to give you some novacaine right here.” I said to him, “Novacaine? Really? Like the dentists used to use? I thought they stopped using that years ago!” To which he said, “Well, really it’s lidocaine, but nobody ever knows what that is!” I said, “Well I certainly do!”

While this was going on with me in the OR, my wife and daughters were trying to enter the waiting room, but found it locked. Security was called and a key was produced. But when the door was opened by the hospital staff they found it had been barricaded by a young homeless man who had stashed all his earthly goods in the way. He quickly left once they discovered he was not an employee, etc.

Once in the ICU room I was attached to a monitor that annoyed me no end! The blood pressure cuff was placed around my left bicep (the one place where I had experienced my only heart attack symptom); the monitor was set to beep obnoxiously every few seconds, and the BP cuff would inflate every 5 minutes, squeezing the arm that had been getting my attention with pain every since 2:30 that morning.

I was almost afraid to tell the nurses that my left arm still hurt, but finally I mentioned it since I thought it would be silly for me to fail to disclose this. The nurse (Phuong) asked me to squeeze her hand with my left hand, and I was able to do so without any problem; this seemed to satisfy her. She said I might be feeling some residual discomfort in that arm, or that the increased blood flow there might be paining me as well. She shifted the cuff to my forearm to relieve my upper arm. There are sometimes so few definitive answers in medicine, it seems.

The nursing care I received was first rate, I think. Thanks to nurses Jasmine and Gwen, especially, my short time there was beneficial. I got no sleep as usual (you know you just can’t sleep in the hospital) in the place where of all places you need rest. And thanks, too, to the nameless nurse in solid blue who wiped my derriere with baby wipes after my one final successful poop into a bedpan (my oh my, it was gross, too).

There is no shame in the ICU. I had been shaved in the OR in places that I didn’t even know were places!

Finally, at 10:30 PM on Wed. night, Oct. 5 we were home; only about 43 hours had passed. But immediately upon entering the house I got the chills. I went to bed sweating and shivering, wondering if something else was going wrong, and that this unwelcome drama was going to continue. No one had warned me that night sweats and a low grade fever were natural results after what I’d been through.

Now I am over 2 weeks away from what could have been my last breaths on this earth. Do I worry about it? Truthfully, yes. Whenever I feel a pain in an arm, or notice a flutter in my chest, I wonder if it’s a sign that something is awry. But one can’t live in that fear! Not well, anyway.

I did wake up last week thinking to myself,

“I could be 10 days dead, today.”

The thought was ominous. And I considered how life would have gone right on without me, relegating me to a mere footnote in the lives of those around me. A significant footnote, mind you. Like the ones I used to use in my graduate school papers, citing “original sources” whenever possible. But . . . a footnote, nonetheless.

One of the most interesting details I will retain from the whole ordeal is one I would not have known about had my wife and daughter not told it to me. It was a detail I guess I hadn’t considered before, but the absence of this insight in life’s hardest dramas could be devastating. It was when the firemen told my wife and daughter, “Don’t try to follow us! Follow the normal traffic laws no matter what we do in the ambulance.”

Of course! Good advice. And thanks for taking the time to relay that little, all-important, less-than-self-evident detail. I don’t know if it’s Fire & Rescue protocol to address this with citizens or not, but it sure is important to say to clear the air of any uncertainty.

All in all, I’d say this is the BEST heart attack I’ve had yet!

And the worst.

I don’t yet know the quality of life on the other side of it.

But I know this! Whatever it is . . . it will be – good life!