Reports of My Demise
Most recipients of this message will know that I have been held in durance vile, for the past six days, as a prisoner of the International Medical-Industrial Complex. Yesterday after the lunch I did not eat, I returned home from Swedish-American Hospital. Please no jokes about “Da Swedish Surgeon.” Miracle of miracles I am walking—slowly and briefly— around the ground floor of the house, using only walker or cane. I even ate a breakfast of one half an English muffin, with yoghurt cheese, a glass of grapefruit juice, a small fruit cup, and my first cup of coffee since last Wednesday.
Is anyone old enough to remember the time when men, if they suffered illness, injury, or misfortune did not immediately wonder how, in the words of a recent martyr to police brutality, they could “make some money” out of their misery? I do, and it is with considerable reluctance that I embark on this narrative. Back in the 80’s, everyone used to say, “fish gotta swim, birds gotta fly.” It’s what they do, as my friend Mark Atkins would say. True enough, but one has to add, “writers gotta write.” Some bits of the following brief narrative are extracted from one or two emails I sent friends who were checking out the rumors of my imminent demise.
It all started on the last day—or rather night—of January. Gail and I were visiting our daughter and son, who live in Chapel Hill, NC, where we had met about 1969. We had had a nice dinner with red wine, preceded by an excellent Martini. After supper, I mentioned that I had brought with us some pretty good Italian red wine, and under very little pressure, I decided to go out in a dark and rainy night to get a bottle from the car. Eleanor’s yard has a stone walkway, uneven and canted to the left, and just as I was making up my mind to return to the house to turn on a light or get my iPhone, I went flying through the air, banging my knee quite sharply on a stone. As I lay there in the rain, I had enough time to realize where I had gone wrong. There are no do-overs or take-backs in life.
Although my right leg was useless, I determined it was not broken, and in the morning we set off for Sullivan’s Island, where Carl Mixon had generously loaned us his beach house for a month. I couldn’t walk, much less drive, and it took ten minutes to drag myself into a Chick-Fillet for lunch. You know you’re back in the South, when strangers react to misery with friendly compassion instead of “Who’s this gimp getting my way?” While we were at Carl’s place, I was mostly confined to the house, since going up and down the stairs from the driveway to the entry way was an ordeal.
I did get to the point that I could walk a half mile in an hour. I should have bought a cane, but I own two, and did not discover, until we were unpacking upon our return to Rockford, that one of them was in the trunk of the car the whole time. Although Mark Beesley had urged me to go to a doctor in Charleston, I could not be bothered. The other option was to leave for home immediately, but then Gail would have to drive a thousand miles. We stayd most of the month and actually had a good time seeing friends like Jeff and Becky Calcutt, Donny and Marie Livingston, Vince Graham, and Kirk Kilpatrick, David Mills, and Jack Trotter.
On the way back, I was able to drive an hour at a time in several shifts, and we got home at the end of February, I was urged to see a doctor, but the knee, the still a mess, was improving and in a few weeks, I could walk a slow mile on level ground with no incline. I was finally bullied into seeing my primary care physician, who arranged an x-ray that revealed nothing. She suggested an MRI, but this was near the peak of the COVID panic, and I decided to wait. Finally, in early summer, I went to an orthopedic surgeon, and the MRI revealed a torn quadriceps tendon that controls the functioning of my right knee. He gave me the choice of therapy, which would give some improvement but not restoration of functionality, or an operation.
This is where the fun begins. When I decided finally to have the torn quadriceps tendon restitched, the orthopedic surgeon required a routine physical, although I had had one as recently as November. I had nothing to worry about, since apart from the game knee and a certain proneness to fatigue after lunch, I’m in pretty good shape for a man of 75. We were back to walking three miles a day, albeit at a slower pace, and I felt better than I ever expected to feel at this age.
I had little comparative information, since both my mother and father had died of heart attacks at about the age of 70. My father’s father had been murdered when my father was about 13, which would mean that my paternal grandfather would not have reached the age of 40. Ordinarily, one would say that a murder victim and a heart attack victim have nothing in common, but from what I have heard of my paternal ancestors, they were self-willed, prone to fits of temper, which were exacerbated by whiskey—not just alcohol, but whiskey. My father once told me that when he was quite young, and the family was waiting for his father to return home, his grandfather put him on his knee and instructed the lad: “Albert, there was never a Fleming who was not born one drink behind and trying to catch up. Imagine the fate of such a person in Chicago politics!
Turning to my mother’s family provided little reassurance. My mother had died, in her sleep, of a heart attack, and her father had died of a long-deteriorating heart condition before I was born. Her mother did live into her 80’s, fat and on the whole happy, but from my own personal experience of the good-hearted lady and from what my mother and other relatives told me of her, she was a hard and self-centered woman who cared most about her own comforts--in other words, one of life’s winners if you're a Randian or a Libertarian capitalist.
I took the physical and the EKG turned up a disturbingly regular arrhythmia. This was not particularly alarming, since no previous EKG had turned up anything to note. Nonetheless, the kind APN, Jane Steffen, irritated (to say the least) me by announcing, “A cardiologist is going to see about this. I’m sending the results immediately, and they’ll call to arrange an appointment.”
My lord, it was like being sent to the principal’s office by an offended teacher. The fact that my worst symptoms were afternoon fatigue and a minor ache in the chest, which I have always put down to my esophageal ulcers impressed no one. My hackles were raised, and I said something about this being my decision to make. All I had came for was a little work on the knee. She said, of course, but what she saw on the KGG could mean I was liable to keel over with heart attack or stroke any day, and I should feel grateful to have advanced warning. I had a few choice words with her and with other nurses who called in the following days, but I reluctantly agreed to go to the cardiologist.
After two stress tests, a dozen blood tests, x rays, the cardiologist gave me the choice of a cat scan or a much more intrusive angiogram. The evidence was clear that something was wrong, but in the case of a man who walks three miles a day on a ruined knee, the tests were probably inconclusive. He urged me to do the angiogram, because he could at the same time perform angioplasty to restore what seemed like several blocked sections of the coronary artery.
I opted for the cat scan, which only confirmed all the other evidence, and so I agreed with great reluctance to the angiogram/angioplasty. After a day or two I even looked forward to the procedure, which often restores mental and physical energies. They dripped euphoriants into my body, and, as my mind floated on a sea of contentment, I was happy to have done “the right thing” for a change.
I was a shock to be awakened from my pipe dream by the cardiologist, who told me through his mask and in an almost unintelligible accent (thus I am guessing at the words), “I’m sorry, but your condition is too serious for stents. I am calling in a thoracic surgeon, who will explain to you about the bypass operation you need.”
Doped up as I was, I understood all too well what the surgeon meant, when, as he drew a picture on the window, he talked of this area as having !00% blockage, this one is 85%, a third major blockage, as well as others he might be able to repair.
I should not neglect to say a few words about the thoracic surgeon, Dr. HT. I was astonished to be dealing, first with an American, second with a civilized rather “preppy” American, who speaks correct English and is not without a sense of humor. When he first visited me, after the aborted angiogram/angioplasty, he had already looked over their records which records level of education. Virtually the second thing he asked me was,
“What did you get your PhD in?”
I answered “Classics” and, fearing I’d be misconstrued to be some kind of humanities guru, added: “Greek and Latin.”
His response startled me: “Latin AND Greek? I’m only a Latin man myself. At my office visit, he did the 19th century bit with a stethoscope, which I always find reassuring, then sat in a chair and asked casually, “What would you like to chat about?”
I made some kind of wisecrack and suggested he give me some idea of the odds I was facing. His answer was refreshingly straightforward. He gave the general statistics, and then, correcting for the good condition of the heart and the fact that even with the bum knee, I was walking 3 miles a day, he concluded that he would put me at the bottom of the standard risk category. Then with no transition, he told me about an article he’d read in the New York Times in which he had learned that there were more “Homeric poems” than the Iliad and the Odyssey.” I gave him the five minute version of what the “epic cycle” consisted of, and his interest appeared unfeigned. Usually I find it better not to disturb the ignorance of my fellow-citizens on any topic. As he got up he said,
“When this is all over, perhaps you can recommend a book of two on the subject.”
When I reported this amazing tale to Jim Easton, he pointed out a deeper significance in the remark:
“That’s better than if he said, ‘Everything’s going to be just find, but could you give me that recommendation before the operation?”
I am in no better a position to evaluate Dr HT’s competence than he is to evaluate mine, but it was very really quite reassuring to realize I was dealing with an intelligent and self-controlled surgeon. The surgeons I have known in the past 50 years had their merits, but their overwhelming arrogance was hard to deal with. Easton likes to tell the joke: Suppose you needed help with your investments, would you go to a financial advisor? No, you’d go to a surgeon. Want help with your golf game? Would you go to a golf pro? No, you’d go to a surgeon. Surgeons know everything.
I don’t take offense at their arrogance. A day or two before I went into the hospital, my wife was picking up a dress from her seamstress. While she was there, the seamstress alluded to the arrogance of President Trump, whom she, nonetheless, supported. Another customer on hand commented, “My husband is an airline pilot, and he is more arrogant than man I have ever met—apart from other airline pilots. They are impatient with incompetence, because the lives of hundreds of human beings are in their hands, and they have no toleration for mistakes.”
In dealing with nurses and hospital staff, the surgeon was affable and calm, and when he mildly criticized something that had been done, he passed it off with a joke. After he left, I made Easton’s little jokes about surgeons and went on to praise Dr. HT. The staff person thought for a moment before saying,
“I wouldn’t hesitate to send one of my own relatives to him.”
High praise, indeed.
In the next few days of hectic meetings at labs and the hospital, doctors and nurses assured me my heart itself was actually in quite good shape—it is only the artery that is blocked—and predicted success with low possibility of complications (such as atrial fibrillation). There was some sign of a leaking aortal valve, which he might be able to fix, but it was bueter to leave it alone, if the problem was not serious.
The procedure is complicated, but for any grillmasters out there, it is like spatchcocking a chicken, except in this case it is the sternum and not the backbone that is slit. The heart is then stopped, and the blood kept circulating by a mechanical pump that the body seems to resent and in revenge produces excessive glucose. He then cuts out of chest and leg snippets of veins that he sews in to bypass the probably fatal traffic congestion.
Throughout this process before the open-heart surgery, every nurse asked about pain, fainting spells, etc, and the poor dears seem disappointed at my fairly robust condition. To keep them from falling into depression, I find myself making jokes and cutting the fool. As I explained to my children, my life’s mission has been to make other people happy. When they laugh at this, of course, they are only proving my contention.
The last time I saw my father alive, he was all tubes and blinking lights after a bypass from which he never recovered either sanity or health and died a few months later, but they’ve come along way in 40 years.
I’ll spare details, but in the end the surgeon was able to arrange four bypasses, and after five and a half days, I was able to go home.
My children have asked me if the whole experience was better or worse than I had been led to imagine. With two exceptions, I’d have to say it was far worse, a physical counterpart to the last six months at the magazine and institute I once headed, though the kindness and help I received from all the doctors, nurses, assistants, and students was in stark contrast with most previous institutional experiences.
The second exception to the general horror I underwent is my complete ignorance of the operation. Waking up about eight hours after surgery, I was not a man but a helpless creature tortured in Dr. Moreau’s House of Pain. If the doctors and nurses had been less creatively vague about the process and the aftermath, my answer would have been, I don’t mind limping my way through a slow-paced life in Italy or Greece or on the Montenegrin coast. I don’t say they lied, but, as Huck Finn would say, they told some stretchers. I don’t at all fault them for their discretion. I don't like discomfort, and being tied down and unable to move without assistance is my worst nightmare.
In Dr. Moreau’s House of Pain, I am quite sure, his victims got more nearly edible food. At Swedes, the food ranges from a top occupied by bad commercial products—“Greek” yoghurt, salt-free V-8 Juice, salt-free crackers—and fresh fruit cup with pineapple, grapes, and unripe melon, to sandwiches with deli meats that one can still get down the throat, to several dishes, such as grilled chicken with lemon and rosemary, that began with a bad piece of chicken and flavored by some magic salt-substitute mixture that, I am guessing, is made of iodine, asafetida, camel feces, and something unidentifiable but far worse than the rest. Perhaps a bouquet of rue and hellebore. The room stank of the filth for 12 hours. The very sweet food service young lady brought me some chicken gravy, saying “The chicken’s a little dry,” and laughed indulgently the way so many gentle black women do.
I know one is not to supposed to mention race, and I suppose I should revise my statement to say she was “African-American,” and so unfailingly cheerful she laughed at all my jokes. She always asked about my glucose scores, and as they get better and better, she wondered, “How did you do that?” “Clean living,“ I replied, explaining that I had given up drinking.
“Really how long has it been?”
“Since eleven o’clock the night before surgery.”
I must have had more than a dozen tubes and wires that caused a battery of monitors to blink, beep, chortle, and break wind. I’m not making that up. It was like camping out with 12 year boys who consumed, each of them, a can of beans.
In short, as Frodo Baggins says, “I’m back.” The tubes are out, the many wounds look clean, and last night I slept, albeit not exactly pain-free, for over six hours, which is about all I got in total in the hospital. With and without cane, I am walking around, though I cannot raise my hands above my head, bend over, or carry anything weighing more than 10 pounds.
At check-out, the only really odious person of the whole ordeal—a young aftercare advisor—warned me against mood swings and depression. Assuming the privilege of age, I informed him, that physical inactivity and pain were not sufficient to depress the spirits of a mature human being. Hell is not having your chest chopped open by Leatherface with an MD. Hell truly is the awareness, growing every day, of the invincible herd mentality of modern man.