Look in Your Heart

I’m fine, but . . .

I spent nearly 21 hours in an emergency room from Thursday into Friday. For the past three or four weeks, I’ve been experiencing these symptoms occasionally: a fluttering in my heart, a feeling of pressure (not painful) in my chest, or pressing down in my diaphragm, an inability to get a really deep breath, like when you yawn but it’s not quite enough and you need to yawn again. The symptoms rarely occurred while I was out walking the dogs on their two-a-day 1-mile loops around our neighborhood; they were more likely to happen while I was sitting at my desk or driving.

Now, before I get into the wacky and rambling story, I will reiterate: I’m fine. the doctors and nurses did not find anything that could be causing my symptoms, and I plan on going to a cardiologist to get a more in-depth examination and see if it’s anything more than my neuroses run wild.

Now that that’s out of the way, here’s what happened.

I attributed all these symptoms to stress/anxiety from my conference and my magazine. But that ended a week ago, and they kept occurring. So, after shul yesterday (and right after I wrote The Birthday of the World post), I called my doctor to make an appointment and get it checked out. I did not have any severe episodes and there was no dramatic trigger that led me to make this decision. I was simply not feeling right and figured it was best to get this looked at since

• I’m 40,
• my dad required a quintuple bypass in his 60s,
• my brother nearly died from a heart issue a few years ago,
• one of my best pals dropped dead at 42 of a heart attack (he was a smoker and a diabetic, but still), and
• one of my pals in Spokane died last March from heart failure (but got better).

Apparently, symptoms like that aren’t the things one goes to a doctor for. His receptionist wigged out and insisted I go to an emergency room right away. I kept telling her that I was not experiencing chest pains, nor the numbness in the arm or shoulder pain or lightheadedness or other symptoms of an impending heart attack. She wouldn’t have any of it, and kept telling me to get to a hospital immediately. She put my doctor on for a second, and he echoed that sentiment. To be fair, I understood where he was coming from; if I’d gone in to his office for an EKG, looked fine, and then dropped dead from a heart ailment a week later, he’d be facing some malpractice-y problems.

After calling my wife to tell her about my symptoms and my doctor call, I drove down to the hospital that treated my dad for his quintuple bypass in 2005. No, I hadn’t told Amy about any of this stuff previously. Mainly because I didn’t consider the symptoms to be very serious, but also for the same reason I didn’t tell anyone else about them: because, just like Shaun’s mum in Shaun of the Dead, “I didn’t want to be a bother.” She wasn’t happy to learn about things so late, but she knows it’s Not About Her and that I really am trying not to be this bad.

I parked in the daily garage and walked to the ER at 1:30 in my Rosh Hashana finery: summer-weight khaki chinos, blue sportcoat, white oxford. Once she heard “chest” in my symptoms, the triage nurse processed me quickly. Early in the process, someone wrote “chest pains” on my file, which may have facilitated my treatment, but was, I repeat, not accurate. I guess “existential void” or “vague unsettledness” weren’t categories in their system.

So I was given a bed, I gowned up, and the wait for treatment began in the carnival sideshow of the ER. I had multiple EKGs and blood-drawings to check out my enzyme levels over time. They set me up for a stress-test set the next morning, which was their way of telling me that I was not leaving the hospital that night.

I had the good fortune of having my laptop with me, since I’d planned on writing for a while after shul on Thursday. The hospital had great wifi service, allowing me to write to my family much more quickly and comprehensively than I would’ve done with my iPhone, and without any funny autocorrects. I hadn’t brought my charger, but the Air has great battery life, and Amy would come by with that stuff later in the evening, if she didn’t get lost trying to find the hospital.

Seeing that I was in for the relatively long haul, I convinced my doctor that a small coffee at 4:30 p.m. would be less deleterious to the results of the stress test than the monster who would be unleashed if I had to go 24 hours without caffeine. (I was smart enough not to have my afternoon coffee before checking in, but once I was in the gown, that kinda precluded my getting up and hitting the coffeeshop in the hospital lobby.) Plus, it was National Coffee Day, and I’d be damned if I didn’t have at least one afternoon dose of the stuff.

I took a picture of the lunch tray and posted it on Facebook, with the caption, “Hospital food: am I right? (#notnecessarilyhavingaheartattack)”. This led to dozens of messages from friends, checking to see what was going on and whether I really should have mentioned a heart attack when one wasn’t taking place. I was touched by the well-wishes and concern.

Left to my own devices, I briefly worried that the tests would find something that would require immediate surgery. And, of course, it would go wrong. I thought about the early morning before my dad’s bypass surgery, when we had a heart-to-heart conversation in his hospital room about how to reset the servers at his girlfriend’s offices. I also thought about Everyman, and how the last thing I wrote would be the post about haras olam and potential vs. being.

But I didn’t dwell on these thoughts too much, in large part because of the craziness of the ER. I was entertained by the old man (dislocated shoulder) to my left, who didn’t have his hearing aids in and was clearly trying to fake his way through any and all conversations.

The bed to my right was empty when I arrived, but was soon occupied by a 60-year-old woman who had cracked her face on a sidewalk. She had no recollection of the accident, had a blood alcohol content high enough that the nurse asked her how much she drinks every morning, wore no underwear and refused to put on a gown so they could take her out to have a CAT scan, declaring, “I’m one Puerto Rican who actually has pride!”, and peed her bed.

Also, after being told that she had multiple facial fractures and bleeding in her brain, she asked what time she’d be able to leave that night.

I give all the staff credit for not laughing, nor contradicting her severely enough to set her off. I’d be terrible at that.

For my part, I was pretty easy with the doctor, nurse and orderlies. I tried not to be very demanding or impatient, and prefaced any requests with, “I know you’ve got a ton to do, but if you have a minute . . .” I grew a little peeved when the wait for a space in the observation ward stretched on for hours, but I dealt with it and just read and wrote for a few hours.

My dad and Amy came around 9:00 p.m. She brought along all the items from the long list of overnight stuff I’d sent her:

• Laptop charger
• iPhone charger
• Kindle
• Contact lenses
• Glasses
• Toothbrush
• Underwear
• Socks
• T-shirt
• and my copy of The Leopard

and she even decided to pack toothpaste for me, because she’s the best. She took this picture, which got some funny comments on her Facebook page:

They stayed for an hour or so, during which time Dad complained about Michael Jackson’s doctor. This wasn’t quite on the level of sending me plane-crash jokes before one of my flights, but still involved talking about medical incompetence while his son’s in the hospital. And you wonder why I make inappropriate jokes.

Once they left the ER, I asked my nurse again about the timeframe for getting me up to the observation ward. He admitted that it probably wasn’t going to happen, and that I’d be sleeping in the brightly lit, noisy ER overnight.

“If that’s the case, then I’ll need some Xanax or Ambien. And some gin.”

“We can get you the Xanax or Ambien. What’s your poison?”

The P(ee)R lady got moved out after a second CAT scan to determine if she had an aneurysm that led to the fall, as opposed to the fall causing the intracranial bleeding. They moved in an older black lady who had lost most of her eyesight pretty rapidly. The doctors were trying to discern whether it was a visual migraine or a variety of stroke that had an awesome name I’m forgetting now. I felt like it was an episode of House, except for when the lady’s husband asked, “So she has to stay overnight? That means we can leave her here?” and split.

I lay back on the bed that I’d spent 10 hours on (minus a couple of pee-breaks, for which I had to disconnect three separate sets of wires and tubes) and finished reading The Leopard, which remains fantastic and which I’m mad you haven’t read yet.

Around 11:30, a new nurse brought me a 0.5 dose of Xanax, and I tried to sleep. It turned out to be impossible, from the light, the noise, and the fact that my blood-pressure cuff was set to take a reading every 15 minutes. I asked them to reset it for hourly readings, but the nurse decided it needed to stay at 15. So the few times I started to drift off, I was woken by a loud pumping noise and a constriction on my arm. Joy.

Around 1:45 a.m., the nurse decided to move me to another room nearby, an expasion of the ER, “because it’s quieter.”

Except when you’re put next to an 86-year old German woman who’s losing her mind and keeps insisting to the hospital aide that they call her husband right away. I covered my eyes and ears with the T-shirt Amy brought and tried to ignore her, but the aide decided that engaging her in conversation would help mellow her out. It didn’t, but I noticed that the aide only spoke to her in very limited questions that probably would have gotten him nailed as a chatbot if someone had transcribed the conversation and submitted it to a Turing panel. Which is kinda sad, considering the other person in the conversation likely had Alzheimer’s.

Anyway, I managed about half an hour of sleep, which I felt might wreak havoc on the stress-test, but I figured they account for that.

With the morning, I had a really great nurse, who turned out to live in my town. She told me that, due to HIPAA regs, she’d pretend not to know me if we bumped into each other at the farmer’s market or Stop & Shop. I told her that, because of lack of sleep and caffeine, I might not remember anything from this whole experience.

She was good and straightforward about the potential delays with getting me upstairs for a stress-test, but contended that if it went well, they’d be able to discharge me right away. A slot opened up for the exam pretty quickly, so I was shuttled upstairs with all my stuff. On the ride through the ER, I had to remind myself, “Never look to the sides.” I’m very visually inquisitive, even if that doesn’t come out in my descriptions of settings, but looking into someone’s room/space is real no-no. All those faces: pain, puzzlement, anger, impatience, pleading, dying. You can’t intrude on them like that, in those moments. Or maybe I’m just too sensitive to other people’s suffering.

Anyway, up in the room for the stress test, a tech who looked like a skanky, young Marisa Tomei shaved part of my chest, hooked up some electrodes, and told me about a Hasidic father of two who was hitting on her a few weeks ago.

Soon after, another tech and the doctor arrived. Tech #2 performed a sonogram of my heart (they keep the gel cold for guys, too), and then I got on the treadmill. I found the pace and incline ridiculously easy, and the doctor noticed that I was barely increasing my heart rate.

I told her, “I walk my dogs on 1-mile loops up and down hills twice a day, so this is pretty mild.”

She asked what sort of dogs I had, and when I told her about Ru & Otis, she was happy to find out that they were rescues. She went on to (slightly tearfully) tell me about the pregnant dog she rescued from Jamaica after a trip there in 2007. It involved all manner of machinations, and the dog gave birth to a litter of seven a mere 2 hours after landing in the U.S., but she got five of the pups adopted out and has kept two and their mom ever since. After the exam, we got our phones out and showed off doggie pictures.

The exam itself went fine. They got me to break a slight sweat eventually, then had me lie down for another sonogram. Neither that tech nor the doctor noticed anything awry. In a worst-case scenario, they’d have had to send me for an angiogram immediately. I thought back to Dad’s experience with that, when a doctor walked out of the examination to tell me and Dad’s girlfriend, “He has 100% occlusion in three major arteries, so he’s going to need bypass surgery immediately. Have a good day!”

All I got was, “You’re all good! We’ll send you downstairs and get your discharge papers going,” from Marisa. My symptoms were still coming and going, but the tests I’d undergone — multiple EKGs, blood work and a stress test — showed no signs of danger. I waited back in the ER for an hour to get processed and go.

During that time, an orderly brought me my breakfast tray. It had a small cup of oatmeal so hot that it threatened to combust, a cup of decent coffee, some juice and milk (“I only drink three things: water, black coffee and gin”), a piece of bread, and a big plate with a thermal dome over it. I figured there’d be some good breakfast under the lid; I took it off to discover . . . one scrambled egg. I ate it in three bites, drank the coffee, and left the rest.

And then I was done. My cool nurse reiterated that I need to find a cardiologist (she’s barred from making recommendations) and might be told that I have to cut out coffee. I mean, I think she said that. I was too busy covering my ears and going, “LALALAICAN’THEARYOU.”

Outside the building, walking back to my car, I realized how disoriented I was from the lack of sleep and the overall strain of the past 21 hours. It didn’t stop me from driving a 3,000-lb. car along busy NJ highways, but at least I was aware of my impairment.

So now I’m home with a glass of red wine, my laptop, my doggies, a rained-out Yankees game, and a wife who deserves to know more about the little things that I keep inside. Even though I don’t want to be a bother.