I.

IN THE HEART, IN THE SOUL

or, 

On Becoming (Well,
Not Quite!) Posthumous

(July 29-31 et seqq., 2003)


In the end, almost as an afterthought, each of us must confront his or her own mortality. We think, even those who believe in some after-existence, some transcendence of death, we believe, deep within our heart of hearts, in our personal immortality. Death comes only to other folks—it will never, ever actually transgress upon our own doors, and we will never let it in. It will turn away at the last moment. We will continue onward, ever onward, till the sun finally sets in the west, and somehow our lives will be subsumed in that extinction of light. The arrogance of the self demands that this be so.
Until....
At seven o’clock on the evening of Tuesday, July 29, 2003, I had just plopped my much-fattened ass in front of the computer to begin an evening’s work. I was preparing to issue a series of contracts on behalf of my new editorial assignment with Wildside Press, to whom we had sold the remnants of Borgo Press just a few months earlier, for the grand total of one American dollar.
The first of the agreements, the pattern document, had been printed out the night before, and then dropped in the mail on Tuesday morning. I was ready to proceed with about forty others, having made preliminary contact with the authors during the preceding weeks. God or the devil or perhaps fate, depending on one’s view, had other plans.
Without warning, without any precursor whatsoever, I felt a pressure building at the center of my chest. I thought of indigestion, since I have always been prone to such ills, but this was something different, very different, unlike anything I had ever previously experienced. I shut down the computer, grabbed the dogs, and went next door to our house.
“My heart!” I managed to gasp to Mary. “We really need to go to the hospital.”
“We’re calling 9-1-1,” she immediately responded, and she was right, of course, as she usually is. Thank God for her practicality and levelheadedness and steadiness.
In the meantime, folks, I was now sweating profusely and having problems breathing, while still trying to shoo away the little monster sitting upon my chest. He wouldn’t leave. Mary sat me down on the couch, and then opened the front door to allow access by the emergency personnel.
Within five minutes, a fire engine and ambulance rolled up, their lights splashing red dots all over the neighboring houses, announcing to the world that the Prince of Fools resided within. Of course, by then my symptoms were rapidly diminishing, but I made (with Mary’s help) the one sensible decision that was possible that awful night: I let them take me away.
I was deposited forthwith at St. Bernardine’s Hospital in San Bernardino, less than a mile from our home.
I felt just fine. This had all been a fluke! I wasn’t sick! Not me! Not me!
Of course, out of courtesy (and since I was already there) I let them poke and prod me in Emergency for a few hours, and take their measurements and draw their samples of blood, and conveniently forgot about what had just happened.
About three in the morning on July 30th, they transferred me by ambulance to the Kaiser Permanente Hospital in Fontana, some twenty miles distant, where I was placed in an observation ward. “Additional tests would be forthcoming the following day,” I was promised.
I felt fine! I felt great! Whatever small discomfiture this represented, well, it could be fixed. I’d certainly caught it in time. I congratulated myself. Meanwhile, I was enjoying watching everyone scurrying around on my behalf. Fascinating stuff!
Mary finally went home and I managed to catch a few hours of rest before the morning routine started up again (and it begins very, very early in a hospital). Mary returned soon thereafter, but I was fine, still feeling great, not a trouble in the world. About ten-thirty or eleven o’clock I had another small, transient episode, but it passed! I was OK! I was just fine! I told Mary to go home for lunch, and come back in the afternoon for my expected barrage of tests.
Perhaps a half hour after she departed the pressure within my chest abruptly returned, much worse this time, and I finally rang for the nurse. They gave me a nitro tablet, but it didn’t help. They gave me another, and called for the doctors. The second didn’t help. They gave me a third. The third didn’t help. By this time a pair of interns had suddenly appeared, fresh as friggin’ daisies in their white coats, and they reassured me that everything was under control. “You’re just fine,” they said, more to satisfy themselves than to comfort me. “I think you’d better do something,” I managed to respond.
I have this vision—this actually happened—of the two neophyte physicians paging through a manual, trying to figure out just what to do. They’d tried their standard three tabs of nitro, and they knew that a trio of these suckers was all that was allowed. They kept looking and looking through this damned loose-leaf book, while I was gasping for air and telling them that they had better do something real, real soon now, because I was definitely NOT getting any better. I wasn’t fine! Not in the slightest. In fact, I was dying.
Finally, somewhere out of the mists of this supremely horrific period of time, a cardiologist named Dr. Carmela Leonora appeared, a middle-aged angel of mercy clad all in white, who took one look at my suffering body and ordered me transferred FOB and PDQ to ICU.
She started me on injections of morphine, eight or nine of them in a row, and I started sliding downhill towards that precipice that marks the boundary betwixt life and death. For five hours they worked on me. Someone contacted Mary, and she returned almost immediately. I remember flashes through my drug-state of everything that happened to me. I began vomiting on the seemingly endless trek to the Emergency Room, coughing out my insides until there was nothing left to give but bile and eventually blood, great gobs of my life fluids flowing wantonly into a steel pan.
I remember experiencing gut-wrenching convulsions, one after another. I remember being questioned by the medical personnel about the pressure in my chest (it was never pain, always an ever-present pressure, intent on choking out my life). I remember, finally, the pressure easing. I had no time to worry about the great questions of philosophy and religion. I had no time even to worry about myself. I spent five hours reacting to my body’s sudden and almost complete failure to sustain itself. And I worried what would happen to Mary if I suddenly went away.
But the little man did finally wander off somewhere. Unbeknownst to me, ambulance attendants had literally been arrayed like mourners at the foot of my cot. They immediately grabbed my worn-out bod, rushed it into a waiting vehicle, and dragged me back to St. Bernardine’s for the second time in a day. St. B’s specializes (among others) in problems relating to a failure of the heart, and I had failed big-time this time, no question.
What followed had a surrealistic aura about it that was almost amusing. I found myself laid out in a room filled with looming machines arrayed on tables as far as I could see. They had no function that I could readily discern. I was placed on a flat metal bed cool to the touch, underneath one of these steel behemoths. Two gentlemen in green coats sat themselves down next to my recumbent body, and started a strange conversation with me (and themselves) that continued for the next hour. They gave me a local anesthetic, and cut a small incision into my groin.
The man nearest to me looked like a refugee from the Sixties, with a bushy beard not unlike mine, and a rather laconic air; the other bore upon his features an indeterminate (from what I could discern) but rather definite heritage from the Far East. “Look at this,” one of them would say, but of course I couldn’t see anything of what they could see. Occasionally Dr. X or Dr. Y would swing around to me and say: “You might wish to turn your head to the left,” and then a giant robotic arm would loom over me, maybe two inches from my skull.
“Did I have a heart attack?” I gasped at one point.
The pair looked at each other rather strangely. “I think you could say that,” one of them responded, with the pervasive vagueness that seems generic to the medical profession, and the other nodded his agreement. “There’s a 90% blockage of the artery supplying blood to the heart,” came a subsequent comment, apparently directed at no one. “Diabetic damage,” was another observation.
Oh, shit! Oh, shit! My diabetes, from which I had suffered for over a decade, was supposedly under control. There was no damage of which I was aware. I was fine! But I wasn’t fine anymore. I wouldn’t ever be fine in quite that sense again, and I knew it.
So we had a very pleasant discourse, I and my two new-found friends. They did an angiogram and angioplasty and inserted two metal stents, whilst musing about this and that and the other; and they finished up their work in that almost wholly deserted hall of robots at about seven o’clock in the evening. And I was safe again! Wasn’t I?
I was moved into a private room in the Cardiac Care Unit at St. B’s. I know Mary was there, but my body was so filled with drugs at this point that I drifted in and out of hallucinogenic dreams that were peopled with bizarre geometrical shapes and colors and an ongoing science-fiction story about “Dal Assante and the Galactic Privateers.” Oh, yes!
And I nearly shuffled off this mortal coil once again.
Because, dear friends, my poor, beat-up internal pump, or rather that remnant that was left after being starved nearly to death of oxygen for five hours, decided it had had quite enough of all this crap, and started shutting down for good by the early morning hours of the 31st. End of month, end of show, end of life! That’s how the old drama closes!
So when Dr. Ashis Mukherjee first appeared at my door early the next day, he was not happy with what he saw. Without even moving me from my hospital bed, he called a half dozen nurses and other medical personnel into my crowded room, reopened the incision in my groin, and inserted a balloon pump to assist my heart in doing its vital work. As soon as it was activated, I could hear and feel deep within me the “chug-chug-chug” of my life coming back again.
“Oh,” the good doctor mentioned. “You can’t move your right leg. Not at all. You have to lie on your back and remain absolutely still until we take this thing out again. The pump is very sensitive. If it stops, you might die before we get it going again.”
Ah, what a confidence-booster! They posted my own private nurse, my very own guardian angel, right at the entrance to my door, twenty-four hours a day. She was there for one reason only: if the pump dared to stop, she had to call in the troops right away.
Meanwhile, ole Dal Assante and his Privateers kept on rumbling through my brain in their interminable travels in Trapezoid Land. I couldn’t sleep without injections of morphine, because my back started hurting within hours of the surgery, and never stopped until that damned chugalug was finally removed.
My daughter Louise flew out from Maryland within the day. She and Mary were allowed to see me every few hours for five minutes at a time, no more. I looked, they later said, like a piece of dead meat, my flesh completely gray, bruised, lifeless, limp, covered with IVs. Not a pretty sight, I’m sure. I was often overheated, and insisted that they bring a fan into my room. I usually wore no more than a small cloth draped across my midsection. I was one sick critter.
But after four days, during which Dr. M gradually reduced the beats of the balloon pump, I was strong enough to dispense with it for good. My brother Steve visited with me briefly on Saturday, August 2, and I was finally able to eat something more than just a bite or two, or a sip or two. I had no appetite, and I knew I was losing weight steadily, but I tried. Soon, Mary and Louise were feeding me.
A week later, I was transferred to an intermediate care facility at St. B’s, and then released from the hospital (oh, glorious day!) on Friday, August 8th. Louise had returned home a day or two earlier. Her presence, together with Mary’s, had been for me a shining light guiding me through the darkest days of my life.
But my hard-won freedom didn’t last. Over the weekend, I started getting severely fatigued again. I was coughing constantly, and I had fluid building up in my lungs. By Monday, August 11, I couldn’t fight it any longer. I told Mary that she had to take me back, this time to Fontana. I was hospitalized in Intensive Care for another ten days, while they tried to bleed me of my fluids, and I lived on the few glasses of water that they would allow me each day.
Meanwhile, my diabetes, which had been lurking just around the corner, came back with a vengeance, reaching into the 200-300s for the first time in my life. No one seemed much concerned about this development: they had other priorities to treat first. I received my first-ever injections of insulin during this period.
I was finally released again on Wednesday, August 20th, but I had relapses due to fluid accumulation on the 30th (one day only), and again on September 8-9, just after our guest house burned down in 100º+ heat, taking our power lines with it. I was being dragged down by my damaged heart’s own incapacity.
During my first hospital stay, my ejection fraction (a measurement of the heart’s pumping efficiency) was pegged at 20-23, a very low figure. It had recovered to about 30 by the end of my second hospitalization. A normal number for most non-aliens is somewhere around 60; major marathoners may get their levels up to 80 or more.
Alas, I was heading for a third post-release stint in ICU when I confronted my family practitioner here in San Bernardino, and pointed out that during each of these hospital sessions my blood tests noted severely low potassium levels. He increased my dosage of potassium, and added a water pill to my pharmacopeia (by this time I was gulping down over twenty pills daily). Almost overnight, my fluid problems dissipated, and have never returned since.
But I was very, very weak for weeks on end, and despaired at times of ever getting back to a “normal” existence, whatever that was and is (it’s different now than before, I can testify at least to that much). Gradually, though, I regained some strength. The six-week physical rehab program helped, as did returning to work at Cal State at the end of September.
Now, I suppose that you are looking for some profound pronunciamento, some great insight gained from my life-and-death tussle with the Grim Reaper. I’m minded, of course, of the classic scene of Death playing chess with the medieval knight in Ingmar Bergman’s The Seventh Seal. But I’m not a knight, even in modern form, and I don’t believe in a personification of Old Blacky.
I lived. Others died, including some better than me. I don’t know why. I do feel that I’ve been given a second chance to make something better of my life, but not by any Supreme Entity or High Mojo-Dojo. The dice rolled, and it wasn’t my time, not yet. That time will come, of course, as it will for all of us.
I try these days to find a little more joy in my life, to live a better existence with Mary and Louise and my friends and colleagues. I try very hard to accomplish positive things and set positive goals. I’m not sure what else I can do. I hope to write a few more books and to say something in them that other individuals might find interesting or amusing or at least worth their time. I try not to be so judgmental or harsh or unkind, and I have done too many of these things in the past.
I try mostly to be a better man. Some days I succeed better than others. I have learned one thing, though: it’s marvelous to be alive! It’s really, really great to be able to write these words down, and to know that I haven’t lost everything that I hold dear, even if I have missed part of my core.
In my heart, in my soul, I seek to find some modicum of understanding, perhaps even a little measure of wisdom, if I’m lucky, and to communicate that insight, whatever it is, to a few others.
Just a few will be enough.

Postscript, October 2005

As it happened, within a week of writing these words in November of 2003, I came down with a cold, and it just wouldn’t go away. A bug that would have taken me a week to shake in earlier years hung on for almost two months. When it finally started to ease in January, I promptly got a bad case of bronchitis. These respiratory ailments plagued me throughout the winter and spring of 2004, and greatly retarded my recovery. I was tired all the time and pale of hue, and I despaired of ever getting back my strength again. I didn’t feel at all “normal” physically until that summer, but I’ve been much better ever since. I’ve managed to avoid catching anything else until now, my color has been consistently good, and I seem to be able to walk and act without significant shortness of breath.
My ejection fraction was measured again in July of 2004, but it hadn’t improved any. I’m still hovering around 25 percent. The difference appears to be my body’s ability to handle that level, which has certainly grown over the past year and a half. Some of this is due to the medications that I take. My diabetes continues to be a problem, although I’ve almost never gone past the magic 200 level since my time in the hospital. I avoid sugar in all of its overt forms.
I’ve gained back some of the forty pounds I lost—not good!—and I’m not exercising enough, to be sure. But I’m writing again, I’m productive, and I’ll continue to accomplish as much as I can with the renewed energy I’ve found, until I finally resume that game with Old Blacky again.