Monday, March 25, 2013

Don't get lost in the details

For 2 years in a row, the date March 9 has brought me face-to-face with the frailty of the human body.

This normally inconspicuous date has also held for me interesting coincidences.

On March 9, 2012, I awoke shortly after midnight with a splitting headache. It was the worst headache I ever had in my life. It was as though a large Bowie knife had been shoved through my skull. My vision was distorted by shimmering lights, like an aura. Because I had lived with migraines most of my life, I deduced it was just an exceptionally bad migraine. I took some Excedrin and went back to sleep.

Later that morning the headache persisted. I stayed at home and worked, but the throbbing pain in my skull was getting to me. I took a handful of aspirin later in the afternoon. The pain diminished slightly. I was beginning to notice that I had lost vision in my left peripheral field. It was the normal blind spot I get when having a migraine, so I thought.

The next day, the headache and the blind spot were still there. Perhaps this was not a migraine. I called one of those "phone a nurse" lines and described my symptoms. It was suggested that I get to an emergency room. I drove myself there. They did a CT scan. They told me I had a stroke.

On March 9, 2013, I woke up feeling fine. I went to make the coffee. I returned to my room and started my laptop, started to look through my email. When I heard the coffee had stopped brewing, I went and got a cup. I poured the soy creamer into the mug and then added the coffee like I always do every morning. I took the mug of coffee back to my room, took a sip, set the mug on the side table, then sat in the chair to resume web surfing.

Suddenly there was an intense pain in my chest. It was as if a giant hand wearing one of those metal medieval jousting gloves had gripped my chest all about the left breast and was squeezing with the pressure of an hydraulic vice. The pain radiated to my left arm, went under through the arm pit, then down my arm to my fingers. This intense pain went up the left side of my neck as well to my jaw. My breathing became shallow, I felt clammy.

I knew what was happening. I stood up, went to my medicine cabinet, grabbed an adult aspirin and chewed it. I returned to my chair and focused my mind on the pain, on my heart, on the blood vessel that was shutting down. I waited a few moments, but the pain was not subsiding. It was steady; a black knight had me in his grip and he was not letting go. Mara be damned. I was going to have to go to the emergency room. Again.

I told my roommate what I thought was happening and he and his boyfriend drove me to the emergency room. I never felt like I was going to die. But I was thinking about the irony.

Two hugely significant medical emergencies in my life, both occurring on March 9. In both incidents, I had Phô for dinner the night before. In both situations I had recently picked up my friend Curt at the airport upon his return from Malaysia where he had spent three months. And on both occasions, Curt returned from Malaysia with some type of lung infection.

Coincidences. Silly facts to mess with your mind.

At the emergency room, it had been at least an hour since the symptoms first showed and my chest was still gripped with pain. This is not a hackneyed metaphor. It literally felt as though my chest was caught in some giant vice. My blood pressure upon arrival was 188/107. They gave me a nitro. A swelling headache developed, but the chest pain had only slightly subsided. Morphine was next. At last, the pain was receding.

They drew blood to see if the tell-tale enzymes would show up indicating a heart attack. It could be severe angina or some other less serious event. These enzymes show up when there is heart tissue damage, and the only thing that causes that type of damage is a heart attack. The first draw was necessarily zero, but it would be the second draw that would reveal all.

Nammo tassa bhagavato arahato samma sambuddhasa. Say it three times. Say it six times. Say it a hundred times. I wasn't afraid. I knew I wasn't going to die. But I was embarrassed. And I was confused. I don't follow the best diet, but I eat reasonably well and I exercise a lot. My cholesterol numbers are fabulous. My EKGs have been normal. I have never felt chest pain while exercising or exerting myself. All I did was sit down after getting my coffee. Now I was annoyed. They told me I would be spending the night for observation in a regular room. Dennis and Stephen went home to get me some things.

Then the first enzyme test came back. They were canceling my room. They were sending me to ICU. The enzymes were there. I was 54 years old and I had a heart attack. My father was 58 when he had his first one. My brother was 62 I think when he had his, one that required a quad-bypass. But this couldn't be. I knew I didn't have blocked arteries. I just knew it! But what was happening?

An angiogram done two days later confirmed my belief; there was no arterial blockage. They started talking about a spasm, like a cramp in the artery that caused it to pinch shut, blocking the blood flow just as effectively if it had been blocked with plaque. But there was a problem with this diagnosis. Had it been plaque in the artery, they would cite a source, whether it was my diet or something else leading to the plaque buildup. There were procedures for this, whether surgery or angioplasty, doesn't matter - there was a protocol with that scenario.

Without the plaque, well now, they couldn't tell me what caused the spasm. And without knowing what caused the spasm, they couldn't very well tell me what to do or not do to prevent it from happening again.

It was like the stroke all over again. The stroke was caused by a blood clot - at least that's what they tell me - but they could never identify the source of the clot.

My roommate Stephen said it best: "You are a medical mystery."

Fuck that.

But now, when I chant the Five Remembrances, the significance is hard to ignore. I got things to do. And not silly things. Now the Bhaddekaratta Sutta has meaning unlike anything its held before. And yet I am still the same person. I'm not quite acting differently, not yet. But I am looking at others much differently. And I'm looking for opportunities. Opportunities to help. Opportunities to be kind. Opportunities to smile. And most important of all, opportunities to be present.

Expect some more of the same, but a little bit different.