“Lord save us from old age and broken health and a hope tree that has lost the faculty of putting out blossoms.”---Mark Twain
Ah, that’s the thing, the magic amulet that carries us over swollen rivers, through raging forest fires, gives us wings to soar past the abyss and light down in green meadows—Hope. When our bodies are bent and withered by the ravages of time, when our minds are rattled by images of impending disaster, when our allies are few and the invaders are many, Hope is there, spear in hand. Were it not for Hope, we would have long ago ceded the castle, packed our bags and made off for The Land of Nobody Knows. Hope is our constant companion, our beacon on murky seas, our call to battle, our last resort. And when it is gone, for all purposes, so are we. Cling to Hope. Don’t let it out of your sight. With Hope, you are saved. Without it, you are nothing.
Attack Of The Plaque Monster
Sometimes, the enemies come in swarms and it’s difficult to determine one from the other. And so it was last Friday, when I headed for the gym, my second day back after the placement of a new pacemaker lead. In the last few days, I had experienced a new welling up in my chest every now and then, usually accompanied by light-headedness. Certainly nothing approaching pain or pressure, but an annoying curiosity that made breathing just slightly more challenging, though not difficult. I put in a call to Beau Caruthers, my caretaker at the Asthma and Allergy Center to discuss the issue, since I was unable to discern whether it was a heart or lung problem. Just before I got a return call, I had a particularly strong surge and became almost dizzy. I pulled over and parked. Since this issue was new, the culprit almost had to be the new pacemaker lead; either it was dislodged, misfiring or required fine-tuning. The woman at The Cardiac and Vascular Institute in Gainesville advised me to get to an emergency room. North Florida Regional Hospital, where I had the stent inserted, was 30 minutes away but the Advent Hospital next to my gym in Ocala was a 10-minute drive. I waited a few minutes for the storm to abate and headed there. You can’t beat it, they have free valet parking.
The medicos were quick to get an evaluation. A chest X-ray and a CT scan testified only to the fact that “You have long lungs, Mr. Killeen.” Maybe I should have been in the St. Patrick’s Church Boys Choir after all. An echocardiogram was equally unhelpful. Blood markers established that I was in no immediate danger of a heart attack, although one of the numbers seemed a poser. My hospital cardiologist, the inimitable Doctor Hima Mikkilineni, finally agreed with me that the pacemaker must be the issue. A technician from the pacer manufacturer, Boston Scientific, finally arrived at 9 p.m. and after a thorough check declared the pacemaker was operating perfectly. Thanks for that, I was less than thrilled at the prospect of a redo. Alas, we were back where we started. Then Dr. Mikkilineni, still up and prowling about at 10 p.m., called to report we were having an angiogram done in the morning. You remember those fun events, where they run a line from your groin to your heart to search for stowaways. Well, they found one.
Dr. Edward Santoian, a brusque and authoritative man who last smiled in 1982, gave me the rundown, his crew rolled me into the Hall of Horrors and the line was implanted. They gave me some sort of pacifying drug so I was awake for the procedure and could actually talk to the doctor. Santoian allowed Siobhan to watch from a viewing area where another doctor described what was going on, not that she needed the help. She watched the adept cardiologist push a new stent through the occluded 14-year-old model in the left anterior descending artery, dislodging the evil block, then placing it below the first stent, the site of another occlusion. Dr. Santoian said the rest of my arteries were fine as frog hair. Then he called in a prescription for Plavix, everyman’s blood-thinner and Lipitor, a statin. I never saw the man again. Nor Dr. Mikkilineni, who rode off into the sunset.
Captain Whiz-Bang’s Magic Belt
Everybody has a notion of what’s a good idea. Not everyone agrees, of course. The standard of care at Advent Hospital requires that a patient in my circumstances leave swaddled in an octopus belt called a Zoll Life Vest. The purpose of the ZLV is to zap your heart back to work in case it decides to take an extra-long lunch break. The life vest is a Rube Goldbergian device full of wires and little wonder-parts which wraps tightly around your chest and is attached to a battery that feels as heavy as your blacksmith’s anvil. You wear this because Medicare, in its infinite wisdom, will not let you have a defibrillator lead added to your pacemaker for three months unless your ejection fraction falls below 30. And wouldn’t you know it—mine was on the way up. It’s always something.
The Zoll rep, a very large man named Costello (I don’t think it was Lou), arrived early Saturday evening, replete with equipment. He took 90 minutes to explain the arcane workings of his product, a neverending recital which left me glassy-eyed and forced Siobhan to flee with a case of terminal boredom. Among many other things, Costello advised me that should the belt find any heart irregularities, an extremely loud siren would go off, alerting anyone within 50 miles, before zapping me back into consciousness. When I eventually went home and started mixing feed for the horses, the alarm errantly let loose, causing extreme concern in the horse and goat communities. Fortunately, I was able to push the cease-and-desist button before it blasted me into the middle of next week and/or caused picketing by neighbors with delicate eardrums.
Melancholy Baby
When you have already exceeded the average life span of the American male and are closeted in a hospital cardiac ward attached to numberless mysterious machines in the dead of night, several things come to mind. You lie in bed considering your prospects. How many more orbits of the sun will I see? How many Cedar Key sunsets remain, how many Grand Canyon moments, how many times watching the fans mill around outside Fenway before the game? Will there be another drive through Big Sur, one more ferry ride from Sausalito to San Francisco, will I walk on another glacier, will I finally see Paris in the summer when it sizzles?
Time and tide wait for no man. When you are 79 years old, the Grim Reaper is driving the hearse your way. Some folks, beaten and bloodied by life, unhappy, devoid of hope, are waiting at the bus stop with their bags packed. I am not one of those folks. Life has been good to me. I have steered my own ship, enjoyed the companionship of sterling friends and priceless women and have somehow discovered the perfect wife. When I leave this blue orb, it will be kicking and screaming, demanding a recount, on the cell phone with a battery of lawyers.
Ten years ago, when I was lying nauseated and semi-conscious on a bed in the ER at North Florida Regional Hospital with a heart rate of 20, I remember thinking---just for a second, mind you—oh, what the hell, is it all that terrible to just slide away? I mentally slapped myself upside the head immediately. This could be the reason some people live while others die, I thought, concession rather than resistance. I thought about leaving Siobhan alone in the wilderness. I thought about the many things left for me to see and do. And I thought about all the world’s dramas, large and small; I wanted to see how everything turned out. A few minutes later, my doctors gave up on medication and implanted a pacemaker and the sun slowly rose in the East.
Back In The Saddle Again
On Monday, I visited CVI in Gainesville for a talk with Dr. Roja Pondicherry, a man of good humor, not enured to many clients like Bill and Siobhan. I had earlier sent the medical records from Advent Hospital and carried with me a disk of my procedure, while Siobhan had prepared bound booklets with a variety of information, including a lengthy list of questions and several reviews of the wonderful Zoll Life Vest. The reviews were less than luke-warm, but when we asked him whether Bill should slog around in it for three months, Pondicherry dutifully said that we should follow Dr. Santoian’s discharge instructions. Since the reviews seemed to indicate the vest might be more appropriate for customers in more dire circumstances, I was mildly surprised and disappointed. I temporarily forgot, it’s all in how you put the question. Siobhan did not forget.
“Let me rephrase,” she said. “Would YOU recommend that a person in Bill’s condition wear the vest?” Pondicherry cracked a smile. “No,” he answered. “That is not our standard of care here. We use medication.” I looked at Siobhan. Siobhan looked at me. “Good enough for us!” we replied, almost in unison. The doctor gave us an additional prescription and sent us on our way.
We drove back across Paine’s Prairie, which never looked as nice, and discussed the future in optimistic terms. I decided to travel to Laguna this summer to visit my oldest friend, Jack Gordon, then up to Santa Monica to see my sister, Alice (the Republican). After that, up to Big Sur, on to San Francisco for the round trip ferry ride and over to Yosemite to visit my other old friend, Half Dome. I won’t be climbing it again this year, but that’s okay. Finally, across Death Valley for a final sneer at the afterlife and on to Vegas and home. What you most ponder when you may be dying is what you should definitely be doing while you’re still alive.
Salud!
When I’m visiting others or just driving by the hospital, I wonder when I’ll next be inside looking out. It’s only a matter of time, after all. Despite the miseries inherent in being there, what would we do without these places and the people who man the parapets? So thanks to Keri, the best nurse on Advent’s observation floor, and the rest of her comrades in the cardiac unit. Also to Dr. Mikkilineni, who discovered the answer to the riddle and Dr. Santoian, who put an end to the problem. And thanks for all the cards and letters, you folks in the hills and dales of the amorphous Facebook Land. I hope you’ll continue to join me in The Battle of Hanging Around. And always make a point of remembering the immortal words of the great A.P. Carter:
Oh, the storm and it’s fury broke today,
Crushing hopes that we cherish so dear;
Clouds and storms will in time pass away,
The sun again will shine bright and clear.
Keep on the sunny side, always on the sunny side,
Keep on the sunny side of life.
It will help us every day, it will brighten all the way
If we keep on the sunny side of life.
That’s not all, folks….
bill.killeen094@gmail.com
