10/06/2024
Dateline: 6/5/2024. La Jolla, California, Scripps Memorial Hospital Prebys Cardiovascular Center
“For long months of days and weeks Ahab and anguish lay stretched together in one hammock rounding in mid-winter that dreary, howling Patagonia cape; then it was that his torn body and gashed soul bled into one another,”
H. Melville, Moby Dick or the Whale
The thing about hospitals is few of us want to enter them. But if you are a patient in need of serious healthcare and are interned for a few days or a week or more, you are afraid of leaving them.
When I landed in the ICU the afternoon of my surgical aorta and aortic valve replacement (SAVR-only the military has more acronyms), I counted 16 tubes and wires somehow connected to me. Some went to veins, some plugged into arteries, two went into my lungs. There were iPod-sized boxes with wires that had a direct pathway to my heart. I looked like one of those experimental versions of a human robot but couldn’t move quite as well.
And the best part was a secondary wrist band next the one that held an inclusive bar code indicating my 6th grade Biology test scores was a bright yellow loop with the words “FALL RISK” emboldened in black. As of this post 6 days later, most of the tubes and wires have left my side but I’m hoping to keep my Fall Risk band until next winter’s big surf season.
If you’ve never vacationed in an ICU, I have one suggestion. Don’t. But if you have the fortune and are of even of questionable faculties, look around, feel the energy, awe at the technology, know there is a reason the staff wake you every 15 minutes to take vitals, draw blood, push meds. Docs, nurses, and staff are not there to make you comfortable; they are there to keep you alive.
According to my surgeon, Dr. Sam Baradarian, the procedure went well. He and his team successfully paused my heart, replaced the torn and tattered parts, restarted the engine, and told me, “now, it’s up to you.” Which sounds a bit dramatic so I take it back. But during those dark and lonely hours, usually late at night when you can’t sleep, you can’t dream…all you can do is take a breath in and then let it out. And if in those unconscionable hours, you begin to appreciate the people who gave you the gift of life—no, I mean it—it’s a fukin’ gift because they’ve sacrificed and learned and followed their warrior’s heart path down a rabbit hole that has become a morass of healthcare obstacles. These are the frontline fighters of disease and pathologies and every example of trauma from a childhood boo-boo to a decapitation. They are giving you another chance. And our society does what for these natural born and trained healers? Enough schools and certified institutions of learning? Nope. Pay them well for their on-average 30 years of schooling? Nope. Instead we shackle the docs with 5 and 6 figure insurance premiums and ask them to work 80 hour weeks, much of which is spent filling out reports.
You want to do something very risky and exciting? Go on a trip to a developing country and end up with staff infection. Many times, your return ticket can only be punched by fortitude, luck, and divine intervention. The world may be full of healers but when you are very, very sick, would you rather have advanced robotics curving out your tumor or an ageless psychic anointing you with elderberry garlic paste?
And if you can finally end up back in an American hospital that saves your life, think in Emersonian fashion about the facts shot through with spirit. That is just one thought that rolled around my pain-ridden mind those first few days.
A lot of patients end up loving their surgeon; the savior that returned them to life. Any why wouldn’t you? I didn’t fall in love with Dr. Baradarian. No, I went one better: I respected him. I know that’s one of my essential flaws as a human—this lack of respect for some (well, actually most). I know it’s awkward and perhaps not completely fair but I make people earn my respect. And if you make the list, I have a kidney for you if you need one.
After I was transferred to a regular floor and room, I began to meet the most amazing patients and staff. On one of my first forays outside to my room, I had my wife, my nurse, and a nurse’s aide riding shotgun on my walker-assisted jaunt across at least 20 yards of tiled hallway. Feeling like a 16th Century Spanish Explorer, I stop at a 7th story window and gaze out on a world that I hoped would accept me back, even make me better for my Ahabian suffering. A fellow heart surgery patient saddled up next to me.
“You ever gonna take that for granted?”
“If I do, it will only land me back here again.”
Reduced to the common denominators in life, we speak in levels--pain, mobility, family, and deviance—speaking across a narrow dark space, it seems odd to me that I am having this kind of conversation with a person I just met and will never see again. He’s a strong guy, almost mountain-manish. If we were in a war together, he’d have my back. And I’d buy him strong drink.
In the afternoon, the room is quiet. Outside it is cool, almost winterish for a San Diego June. My healing nurse moves my bed next to the window, brings in pain pills, fresh pillows, and a menu. The coastal marine layer has darkened the sky and for the moment, the halls are still. I lie there and think again, the bone-level pain moved just out of center for the time. When did you do that last—just lie on a floor and let your mind wander? Ideas might start out in the world, get filtered through reading and research, maybe even put into play. But they are catalyzed in the rare quietude of the cool afternoons of our lives; those soft moments when we allow ourselves to be taken down and taught by some teacher who waifs across the room, the sound of her steps imperceptible. The white noise of modernity stands as aural barrier to what potential lies inside. There is a time for rock and a time for Bach but what is missing is what exists in the rents and seams of our nervous days—reflection.
The thing with open heart surgery is that, as much science and training and preparation goes into having your chest cracked and your heart stopped in hopes of fixing the broken parts in and around this amazing piece of God’s engineering…you never know the end results. People have spoken of changes in personality, taste buds, and choices between Ford and Chevy trucks. And there are setbacks.
My only other major surgeries were replacing my worn-out hips; mostly linear procedures relative to the ship-in-a-bottle procedures required when you are dealing with the heart. My first setback happened when I went back into a-fib on day 3 post op. As an athlete, you identify your enemy, know his strengths and weaknesses, study the rules, and go into battle. Going back into a-fib, for me, and even though it happens at least 30% of the time in my type of surgery, was like having some kid from Europe beat me in the Ironman because he’d taken illegal and undetectable drugs. No respect there.
The following days, things became more stable. I was becoming more accepting and a part of me and I didn’t know what to do with. I’d always wanted to be that Marlon Brandon character from the 1953 film, The Wild One. Brando, as motorcycle rebel, Johnny Strabler, is asked by the town sheriff what he and his marauding gang are rebelling against as they take over the Northern California town of Hollister.
Stabler replies, “What you got?”
I didn’t want to come through this thing without an edge.
