Anniversary of an Infarction

Blog Song for the Moment

"Condition of the Heart," Prince, Around the World in a Day, 1985

January 16th, 2006, Martin Luther King Day.  One of the worst years of my life had just ended--a year of a series of family and financial crises, capped by the termination of my visiting appointment at Wabash College.  Wabash did the right thing, I knew even then.  While I learned a great deal about teaching (and being a full-time academic) from my fellow faculty and many fine students, I'd become increasingly unhappy working with the cultists of all-male education, and their unspoken rule: If you can't praise the Wabash mission to the high hills, then keep your trap shut.  Still, I felt burned.  The college had used my work with students to raise money from alums, and I had done a lot of other service.  It was my bad though, not Wabash's, that I'd done so much service instead of doing what I should have done--research, writing, and finding another job.  Fortunately, a good friend from grad school days plucked me up and eased me into a visiting position at Albion College.

So on that day I was house-sitting for an Albion professor on sabbatical, in a place just a few blocks from the Albion campus.  Around two or three am, I woke up from a terrible dream.  My bedroom was upstairs, and I was there in the dream, but the room was now huge.  I lay on my bed in the middle of it, and I could see a dark doorway between my feet.  I heard a steady rhythm of booms downstairs, as if someone were pounding away on a timpani in the basement.  Then I noticed my chest was opened, as if it were a cardboard box, and when I looked over the one flap underneath my chin, I saw two arms trying to line my empty chest cavity with a white kitchen garbage bag.  They were making a hash of it, and I was irritated, and that drum downstairs kept banging away, and I hissed "Here, let me do it," and I grabbed the bag.  Then I woke up.

It seems so obvious now that some sort of myocardial event had just occurred, but I don't know if I had just experienced an infarction, or if it was yet to come (I love that word, infarction; the OED defines it as the "action of stuffing up or condition of being stuffed up," but for me it's a rude-sounding word that would likely make my grandkids giggle, a healthy giggle over a life-changing, or life-ending, event). I wandered around the house for a few hours, discombobulated.  I couldn't focus on anything, couldn't shake the dream from my head, nor the vague sense of dread--as if I were playing the Sesame Street game of "One of these things/is not like the other," and my life depended on it, yet unable to find the damn thing that didn't belong.

I ended up sitting on the back porch in the hushed, early morning dark, with a cup of coffee and a cigarette (I know, I know).  Finally, I decided to go to my office.  Work might erase the dream and the dread.  I remember bitter cold on that walk, though according to the Farmer's Almanac, even with wind chill, the temperature would have been the high teens or low twenties, which hardly qualifies as bitter to me.  About halfway there I suddenly felt as if I were walking in icy quicksand.  I felt no pain, no shortness of breath.  I just couldn't get my body to move.  I thought about sitting down on the curb, just rest a bit, but by then I must have been suspecting something was really wrong, I was beginning to get an idea of which thing that was not like the other.  I talked my body into moving again, and slowly crossed the short distance to my building, made it to my office, got online, and checked a website that gave a list of symptoms for heart attacks.

I knew I was at risk.  My two grandfathers had died in their 40s of heart disease.  Both my parents had high blood pressure, and so did I.  I smoked, and recently experienced a great deal of stress.  But I dithered.  I didn't want all the fuss of going to the hospital--I didn't want to appear a hypochondriac.  It may have been around eight am when I called a friend, and described what had happened.  He said get myself to an emergency room, call 911.  But this friend, god love him, tends to be an alarmist at times, and his anxiousness on my behalf only seemed to make me sink further into lassitude.  I didn't want the drama; I'd had enough of it already.

But after mulling it over a while longer, I thought, "Crap, let's just get this out of the way." I shuffled back to my house, got in the jeep, and drove to the emergency room in nearby Jackson.  Here my memory gets even more sketchy.  After describing my moment of quicksand to a nurse, there was a flurry of questions, blood drawn, an EKG, and then suddenly I was on a gurney getting shoved into an ambulance.  I woke up the next morning not knowing why I was in the hospital, or how I had gotten there.  Apparently the anesthesia they gave me had amnestic side effects, and I must have been on some sort of narcotic because when a doctor came in and told me that he had cleaned out the 99% blockage and placed a stent in my left descending artery--the widowmaker--I thought, "Well, how very interesting."  A bit later, or maybe it was before, a nurse checked the dressing over the plug in my groin, sealing the entrance point for the catheter.  If it opened, I might bleed to death in a couple of minutes.  As she checked me she asked me to warn her if I was going to cough or sneeze, and told me not to laugh, which, of course, I started to do.  I cannot remember what started me off, perhaps the bit of repartee we fell into while discussing my condition?  Or was it the absurdity of this rather attractive woman with her hands near my privates in a most unerotic tableaux?  Or it was the drugs still at work?  Whichever, her stern order to stop laughing worked.

Curiously, I did not know until my discharge that I had suffered a myocardial infarction, and it wasn't until a follow-up appointment with the cardiologist that I found out that the heart attack had left no permanent damage.  So I was fortunate (or blessed, depending on your views of providence) on a number of counts--1) walking into frigid air makes the heart work ever so much harder, and I made it to and from my office, and to the hospital, after two myocardial episodes; 2) that I even survived the heart attack(s?); and 3) no permanent damage.  We can add another.  According to my most recent stress test, my heart is in excellent condition.

I still often think of that dream, especially around MLK day.  I've done a little poking around in healthcare and medical journals, but can't seem to locate any studies the association between heart attacks and dream states and dread.  I don't think the dream caused the heart attack, of course, or that it predicted one, though it may have been my body, working through my subconscious, trying to tell me "Hey, Andy, we've got a problem."

An initial foray via Google brought me this tidbit from an Australian online health magazine:

Thomas Luscher told the annual meeting of the European Society of Cardiology in Vienna that, although heart attacks occurred throughout the day, their incidence increased after midnight, and peaked between 3am and 5am.
"What's interesting is that this is when dreams become more frequent and vivid," said Dr Luscher, a cardiologist at the Zurich University Hospital.
"Maybe there's a link which should be investigated."

'Well, how very interesting,' but if important, why only one guy in Austria raising this issue and whose words get picked up by some Ezine for senior citizens in Australia?  

A longer search with academic search engines did not give me much more.  There's lots of stuff on connections between mental and emotional states and heart conditions--there's a US News and World Report article that sums this research up nicely, saying, for example, "It's long been known that acute emotional states--like rage, fear, or panic--can trigger cardiac events that literally 'scare you to death.'"  But this is still treating the mind and emotions as causal factors of a physical trauma.  I'm more interested in what the mind and heart are doing in response to such a trauma.

I'm sure there must be more work out there that my inexpert searches did not locate. If any of the two or three of you that happen to read this blog know of some leads, I'd welcome them.

And a belated happy Martin Luther King Day to you all.  My drama isn't comparable to the national trauma he lived, faced, and which killed him.

Stress and Snails

I have been incredibly stressed these past few months for a variety of the usual reasons--conflict at work, worries about family, aging, blah, blah, blah. . .


I had a routine stress test with my cardiologist last August, and she said, looking at the pictures of my heart at work, that she wouldn't have known from the evidence that I had suffered a heart attack.  Good news, she said, but added that I had to learn how to manage stress better--though I'd said little about that to her.  I guess she reads minds as well as hearts.


So I've been doing a few things to try to reduce stress.  Conveniently, reconstructive knee surgery in late July means I've been going to rehab twice a week, where the PTs work me over pretty well--the exercise has felt good.  And I try to get in for a massage session once a week.  My wife tells me that recent reports show that massage lowers blood pressure, and that, combined with increased exercise and quitting smoking (umm, well until last week), must explain the lowest blood pressure reading I've had in a long time at my recent doctor's visit, 118/60 (by the way, my family doctor, John Duhn, is the greatest; he listens well, explains well, and is fellow fan of universal, single payer healthcare).


Another thing I've started just recently is to sit down with a book of poetry while I eat breakfast.  I read this one a couple of days ago, in a collection that might make the more sophisticated poetry readers cringe, Garrison Keillor's Good Poems for Hard Times.  It's called "For a Five-Year-Old," by Fleur Adock, a New Zealander who ended up in England.  Turns out she was born the same year as my father, 1934.  Knowing that makes me read it as both the child and the parent.

A snail is climbing up the window-sill
into your room, after a night of rain.
You call me in to see, and I explain
that it would be unkind to leave it there:
it might crawl to the floor, we must take care
that no one squashes it. You understand,
and carry it outside, with careful hand,
to eat a daffodil. 

I see, then, that a kind of faith prevails:
your gentleness is moulded still by words
from me, who have trapped mice and shot wild birds,
from me, who drowned your kittens, who betrayed
your closest relatives, and who purveyed
the harshest kind of truth to many another.
But that is how things are: I am your mother,
and we are kind to snails.

I had those snail moments, too, as a child: We are not the kind that hits others.  We are people for whom silliness is a virtue.  We are not to cheat at games, or throw tantrums when we lose.  We believe music to be beautiful and essential, along with wandering through forests, climbing mountains, and sleeping by rivers.  We absolutely do not, whether angry or not, call our best friend, a Japanese-American, a nip.


As a parent and grandparent, and watching my daughter raise two of her own, I am fully aware of the baggage we bring to raising children, and the detritus of daily life that swirls around our answers to a child's question, worry, or upset.  Lord knows I have had, and have, my inconsistencies--the little rages hovering around my moments of gentleness--and that I have betrayed and displayed my harsh edge, yet "that is how things are."  Or as Bruce Cockburn sings, "that's the burden of the angel-beast."


I treasure those childhood lessons, and that gives me hope that some of that treasure has been passed on despite myself.