This Week in Doom: Appointment at Sentara

That-Was-The-Week-That-W-That-Was-The-Week-473964Off the keyboard of Surly1

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Originally published on the Doomstead Diner on July 19, 2014

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death cheated


“There was a merchant in Baghdad who sent his servant to market to buy provisions and in a little while the servant came back, white and trembling, and said, Master, just now when I was in the marketplace I was jostled by a woman in the crowd and when I turned I saw it was Death that jostled me. She looked at me and made a threatening gesture; now, lend me your horse, and I will ride away from this city and avoid my fate. I will go to Samarra and there Death will not find me. The merchant lent him his horse, and the servant mounted it, and he dug his spurs in its flanks and as fast as the horse could gallop he went. Then the merchant went down to the market-place and he saw me standing in the crowd and he came to me and said, ‘Why did you make a threatening gesture to my servant when you saw him this morning?’ ‘That was not a threatening gesture,’ I said, ‘it was only a start of surprise. I was astonished to see him in Baghdad, for I had an appointment with him tonight in Samarra.'”

― ancient Middle eastern tale retold by W. Somerset Maugham

Anyone reading this space on a semi regular basis knows that it is devoted to poking and sifting through the abundant scat left by doom as it slithers its way through the postindustrial economy and neoliberal politics. This week, “doom” dropped a load closer to home, and of a much more personal nature.

At about 9:30 last Sunday morning, I was working at the computer and found myself getting lightheaded, images swimming front of my eyes. Nausea rose, and with it cold sweating, which was curious because the room was reasonably warm. I immediately went to the bedroom to lay down. Contrary, usually hard to arouse and who could probably sleep through percussion grenades detonated in front of the house, cracked one eye open and immediately sat straight up. “What’s wrong with you?” she asked. Because of hardwired habits of mind, and because I’m an idiot, I replied, “Absolutely nothing, I’m just a little dizzy, and I am going to lie here for a little bit.”

She importuned me to go immediately to the hospital. I brushed her concerns aside, and muttered dark oaths. By family example, long-standing habits of mind, and a flinty Pittsburgh upbringing, my reflexive response to injury is along the lines of, “Rub some mud on it.” I was certain I would feel better shortly. After a shower, I joined my daughter and some friends for brunch. I found that I couldn’t eat anything, and found myself sweating through a shirt in a well-air conditioned room. Contrary watched this scene unfold with increasing agitation, but didn’t say anything until our guests left. As the door closed, she turned to me and said, “Are you going to the hospital or do I have to cut you?”

I’ve seen that expression on her face before. When it appears, she means business. This time it was tempered with evident worry, which struck something in the recesses of my mind where empathy lives in sullen exile, like Napoleon on Elba, and I went without more of bitching.

We checked in to the emergency room of our local Sentara hospital complex where, having presented with cardiac symptoms, they saw me reasonably quickly. An intake nurse hooked me up for an EKG. Dropping the various wires on my chest she said, “Excuse my castanets.” I asked, “Does dancing come with an EKG? ” She smiled and quipped, “Yeah, the Dance of the Seven Flails.” That I was in the hands of a clever nurse with a good sense of humor made a fortunate omen. After six hours of monitoring, they admitted me.

After apparently finding my insurance card still carried some headroom, the following day they ran me through every EKG, CT scan, sonogram, echocardiogram, ultrasound and stress test available. (Without doubt the hospital system will make their third-quarter based on this run of diagnostics.) Apparently I have an arrhythmia, and the chambers of my heart are not beating in sync. When I was young and got a pro-forma physical for the junior high school football team, the doctor observed that I had a “heart murmur.” These are apparently pretty common, and certainly had had no practical impact on my life until this moment. But it certainly had claimed my attention now.

The cardiologist assigned to my case, having reviewed the welter of evidence from the tests, suggested an ablation, which is a procedure similar to a cardiac catheterization, in which they Roto-Rooter a garden hose up your femoral artery into your heart, where a tiny laser actually cauterizes the parts of the heart sending aberrant signals. He said that they have 85 per cent success with this procedure, but that it was not without risks. Fortunately for me, the previous evening I have exchanged some personal messages with agelbert, who had also gone through his own rounds of cardiac testing and procedures. AG exhorted me to resist an ablation should it be proffered, and to ask what other options might exist on the continuum of care. Now regular readers of the Diner Forum know AG’s work, and his propensity for tireless research. Plus he’d already gone through many of these procedures himself and was decent enough to share what he knew. Thus armed, when the cardiologist proposed ablation, I asked him if there were not more moderate steps we could take before rushing to do something permanent and irrevocable. He affirmed that there were, and agreed to try another higher-level beta blocker to get my rhythm back in order.

The medical teams are very good at knowing “what,” and even work at “why.” In my case, blood testing ruled out some mineral deficiency as a proximate cause. Of course in my case, the “why” probably centers on years of dissolute, then sedentary living. But here we are.

So they switched my meds and kept me for observation. That evening, Contrary and I went for a walk after dinner down to a station where they have all those cardiac care on monitors. There I was able to see a visual display of my louche heartbeat. Now I’m as competent to read the signals as a plumber, but both sets of signals looked far more synchronous than they had the last couple days. Contrary described it best: she said that by top chamber had been going “Ka-boom, Ka-boom,” while the bottom chamber was going, “Boom-shaka-lacka-lacka, Boom-shaka-lacka-lacka.” Now they were more uniform, with my renegade ventricles tossing off fewer PVCs. But then I’ve always had rhythm.

I remained on low-calorie house arrest for another couple of days tethered to a heart monitor, having my blood pressure and my EKG regularly assessed, and cutting up with the nurses assigned me. And here I would be remiss if I didn’t call out those nurses, as well as all members of the care team, for their professionalism, expertise and good humor. I found them remarkable. The story ends on an up note, in that the hero doesn’t die at the end, but learns on the fourth day of his medical incarceration that the cardiologist says he is stable and good to go home and resume regular life.

This experience has been pretty challenging, as it tests my usual cynicism about what Diner Lucid Dreams, a former EMT with abundant firsthand experience with Big Med, calls the “wealth care system.” Certainly plenty of cynicism is warranted at all times about the interlocking cartel of health insurers and hospital systems, not to mention Big Pharma, at it is with every vertical of crony capitalism. Yet when one’s own health is swinging in the balance, one’s habitual cynicism is directly challenged. Which is quite where I find myself now. During the entire process, was very grateful for the fact that I had employer-provided health insurance. And I wondered what my prospects would be if, like so many others in this toxic economy, I were unemployed and without such insurance. As I’m too young for Medicare, they would be grim, and the Reaper herself might be waiting for me at Samarra.

As you might imagine, friends of long-standing and those more recently acquired, especially via Occupy, have checked for the latest news. For this I am most grateful. One conversation I had is worth repeating.

A friend of extremely long-standing who I have known from third grade, a man in otherwise superb physical condition, found himself with a bout of tachycardia this last August. He felt faint and nearly passed out. His wife implored him to go to the hospital as well. He was initially resistant, but found that he was glad he did. They put in a pacemaker, had a good recovery and now feels like a milk fed athlete. He will retire from his university career this coming fall, and in considering next steps had an epiphany. He realized he might think about it differently: what if, on that day in Augest, he had not gone to the hospital but had died instead? (The doctors told him that it was indeed fortunate that he came in when he did, else he would have been at grave risk.) So he posited: what if you died, but the Great Scorer reviewed the replay and overturned the ref’s call, and gave you a new lease on life, for a to-be-determined term: what would you do with that “bonus time?” How would you live? He certainly considers his pacemaker as providing that new lease on life. And 100 years ago, his story would have ended differently. One of the interesting implications of high-tech medical science.

It’s a provocative question, and a refreshing way to look at the time we have remaining. Every day we spend on this side of the dirt is “bonus time.” Precious, worthy of a sense of gratitude and wonder.

Many years ago I read a little book by Baba Ram Dass entitled, “Be Here Now.” It opened my mind to the importance of living in the present and seizing the moment, but I spent a great deal of that awareness in hedonistic pursuits. There are, in fact, worse ways to spend your time, but it’s not a path to enlightenment, whatever that is. (What is it the Buddhists say – ” Before enlightenment: chop wood, carry water; after enlightenment, chop wood, carry water?”) It’s not until the last dozen years or so that I’ve actually put into practice the discipline of reminding myself to be aware, to be mindful, to be fully present and in the moment, at many different points during any given day, and to cultivate a sense of gratitude for the life I have and the people in it. Sometimes easier said than done.

Whenever we brush up against intimations of our own mortality, we tend to think about Big Questions, Legacies, and other ephemera that day-to-day living pushes out of our minds when avoidance is not completely up to the task. I am untroubled by such thoughts. If I kicked today, I would leave behind a remarkable daughter with an active mind and a preturnatural capacity for making good decisions, as well as one discomfited Contrary, as well as a handful of friends and family who would tell funny stories about me at my wake. Legacies are much overblown because at the end of the day, none of this lasts aside from the memories we create and the decency we show others along the way. Long time Diner PB Shelley said it best:

I met a traveller from an antique land
Who said: “Two vast and trunkless legs of stone
Stand in the desert. Near them, on the sand,
Half sunk, a shattered visage lies, whose frown,
And wrinkled lip, and sneer of cold command,
Tell that its sculptor well those passions read
Which yet survive, stamped on these lifeless things,
The hand that mocked them and the heart that fed:
And on the pedestal these words appear:
‘My name is Ozymandias, king of kings:
Look on my works, ye Mighty, and despair!’
Nothing beside remains. Round the decay
Of that colossal wreck, boundless and bare
The lone and level sands stretch far away.”

As the many Tyler Durdens say over at ZeroHedge, “On a long enough timeline, the survival rate for everyone drops to zero.” So the only question that really matters is, “What are you going to do with your time today?” That’s a question worth considering whether you’re on a gurney or at a keyboard. As for me, I’m on “bonus time.”



Surly1 is an administrator and contributing author to Doomstead Diner. He is the author of numerous rants, articles and spittle-flecked invective on this site, and has been active in the Occupy movement. He shares a home in Southeastern Virginia with Contrary and is delighted this week didn’t end in a dirt nap.




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