2005-05-13 / Columnists

The Rockaway Irregular

Life, Death And Everything
by Stuart W. Mirsky

On May 1st I nearly died. Home alone and feeling the need to get in a little exercise, I undertook a familiar workout routine that I’d done, on and off, for years. Unfortunately, it had become more “off” than “on” over the past decade and, since I took early retirement about two and a half years ago, barely “on” at all. So I was feeling the creeping effects of the sedentary lifestyle I’d allowed myself to slip into. That morning I decided to address the problem.

About twenty minutes into my workout, barely having begun the second of the routine’s three parts, I suddenly found myself with a relentless pressure in my chest and an inability to catch my breath. I wasn’t out of breath so much as I was unable to ease the pressure I felt each time I breathed. I stopped the routine at once and stood quietly. Then I tried walking around, to cool down. But it didn’t help. No fool me, I thought this could be the beginning of a heart attack, and so, after sitting and then lying down on a nearby couch, I dragged myself to the bathroom, opened the medicine chest and popped an aspirin. Still no relief, though. I decided I’d better call it quits for the day and took myself upstairs to take a shower. But things didn’t get better in the shower so I cut that short, too, hastily dried myself off and went into my bedroom to lie down. Oblivious to the dampness of my flesh on the sheets, I lay there, shifting about uncomfortably. I tried sitting up again but the pressure that hit me, with each breath I took, failed to dissipate. Lying down yet again didn’t make things any better either.

At last I reached for the phone on my wife’s side of the bed and dialed 911. My conversation with the 911 operator was something of a blur but I managed to explain, somewhat breathlessly, that I thought I was having a “heart event”. She referred me at once to the Emergency Medical Service and the new person on the phone made me go through the explanation one more time. “Can the EMS technicians gain access to your house?” the person on the other end asked me. “I’ll go downstairs and let them in,” I croaked.

I pulled on a pair of pants and made my way unsteadily down the steps, plopping myself on the living room couch. Only then did I realize I’d forgotten to take a shirt or to unlock the front door. I wasn’t going back upstairs for a shirt but I made my way to the door and unbolted it. Then I struggled back to the couch and collapsed. In a short time (probably no more than ten minutes, though it may have been less) I heard sirens outside. Then banging on the door and the doorbell ringing. Weakly I called out that the door was unlocked. But they didn’t hear me. They just kept knocking and asking if anyone was home. Unsteadily I got to my feet again and went to the door. There were four or five of them and they swept in, asking if someone had called about a heart attack. When I said yes, they asked me what was wrong. I went through the whole thing still another time and stumbled back to the couch where I collapsed again.

In a swirl of activity, they took my pressure and pulse, discussed my symptoms and administered a nitroglycerin spray under the tongue. They did an EKG on the spot, too, I think. Then they were lifting me onto a mobile seat, wrapping me in a blanket, connecting me to a gazillion tubes and carrying me outside. All I could think of was that no one had locked the door and that my family wouldn’t realize what had happened when they got home. In the street, a number of my neighbors stared in mute astonishment. A couple of them spoke to me, asked what they could do. “Lock the door,” I struggled to speak, “tell my wife . . .” Then I was in the ambulance and someone was laying me down, adjusting the oxygen mask over my face.

My wife and kids made it home just as the ambulance was ready to go and my wife got in, visibly shaken. “I thought you broke your leg when I saw them,” she muttered, referring to the EMT vehicles, wishing a broken leg was all that was wrong. I just rolled my head, said the oxygen mask was slipping, and then we were off. Riding in an ambulance in that condition is no picnic. The bumps in Rockaway’s roads penetrated right through the wheels of the ambulance to the gurney on which I lay. The sirens, which I’m used to hearing on the streets, sounded eerily distant now, and yet followed me all the way.

At the emergency room in Peninsula Hospital they struggled to get the nitroglycerin drip going to stabilize me but the unit’s intravenous pump failed. After gamely fighting to make it work, they called for another. But they couldn’t get that one going either. Finally one of the technicians said, “maybe we need a vent to make it work.” They sent for a vent and the attending resident told my wife I had a 50-50 shot. He didn’t seem very upbeat, though, my wife confided afterwards. The hospital’s cardiologist arrived around this time and I heard them talking about administering an anti-clotting agent. But they needed to stabilize me first they said. The problem was, they couldn’t get me stabilized and the lack of a working nitro drip was acting against their efforts to do it.

As I lay there, the pressure on my chest became immeasurably worse. It wasn’t pain, as I told anyone afterwards who asked, just pressure . . . an unceasing, cold relentless squeezing with each breath I tried to take. The only relief I could get was by moving myself about on the bed. I tried breathing more rapidly as my wife had done when she gave birth. It helped a little. I remember opening my eyes at one point and seeing my wife and newly arrived son (he’d followed the ambulance in the family car) hugging each other, eyes red-rimmed and wet. “What can I do for you?” my wife whispered when she saw me looking at her. “Kill me,” I said. “Just get it over with . . .”

In the end the hospital staff gave up trying to get the nitro drip working, after laboring over two pumps and unsuccessfully adding the newly delivered vent, and just administered the anti-clotting agent (TPA, I think they called it). Stable or not, they’d finally decided they had to do something to save my life. They gave me morphine, too, and I was soon asking for more of the stuff. At least the morphine cut me off from what was going on, made the pressure bearable. Afterwards, when they finally transferred me to the Coronary Care Unit at Long Island Jewish Hospital on the same day, the doctors said the TPA had probably saved my life. By the time I arrived at LIJ my heart’s main artery, which had been 100% blocked at the earlier hospital, had been reopened by about 18%.

That evening they did an emergency angioplasty to widen the walls of my constricted artery and placed a couple of stents in it to keep it open for the long term. I threw up all the way back from the operating room as the ceiling sped by above my groggy eyes. I was on a ship trapped in stormy seas. Then I lay like a stuck pig in a three walled fishbowl of a room, under the scrutiny of the nursing staff and physicians bustling all about me. It wasn’t until two days later that I began to have a real sense of my surroundings at all. And it took at least three days for me to finally smell the awful mess I had become in my sweat and urine soaked bed clothes, dried blood and the strong scent of alcohol and other disinfecting agents on my arms where the needles pierced me.

My wife and other family members and a few friends were in and out as I slipped fitfully between sleeping and wakefulness. The nurses were kind and solicitous for the most part, but imperious in their demands. The interns, residents and fellows were tyrannical in their questioning and in poking my flesh. They roused me each morning for the rounds. Sometimes I’d only pretend to be sleeping so I could hear them discussing my case outside the curtained cubicle in which I lay. The numbers and phrases that obsessed them held no meaning to

my untrained ears so I strained to

listen to their tones of voice, to the indications of concern or uncertainty their words betokened. I was coming around.

On the fourth day I got up after my first full night’s sleep (they had disconnected me from the fixed monitors the day before) and I asked the nurses, busy with other patients, for some washing material and for fresh bedclothes and gowns. Glad they no longer had to see to these things for me, one of them graciously offered what I needed and I pulled the flimsy curtains shut, stripped myself down and gave myself a sponge bath. Looking at my flesh, I was horrified at the bruises, the wounds, and the softness of my muscles as I struggled to hold myself erect. I only knew one thing: I didn’t want to get back into that bed, even if it meant clinging tremulously to the side of the nearby sink and so I redoubled my efforts and cleaned myself off.

They tell me I nearly died that Sunday and I believe them. At the least I have a better sense now of what it’ll be like when I really do. It’s unlikely to be any easier . . . and will probably be worse. I’ve seen people die in my time, as most who’ve lived out more than half their lives, have. I suppose it’s rarely easy and sometimes quite a bit harder than what happened to me. As I lay there, coming back to myself, I found myself wondering if I’d be any different as a result of what I’d gone through, if nearly dying had changed me in some way? But the truth is I never felt like I was dying, never quite believed it, even while it was happening. Even when I looked up and saw my wife in tears, burrowing her head in my son’s shoulder, when I told her, “just kill me,” even then I didn’t believe my own words. I wanted the distress I was in to end but I didn’t believe it would end in my death. And didn’t want it to. 

They say a brush with death is life changing and years ago, when I was held up and nearly shot to death, it did indeed change me. Everything seemed different after that event, at least for a little while. But that was only afterwards. I hadn’t thought I would die as it was happening then either, even while my assailant was aiming his gun at my head and pulling the trigger. Only afterwards, in the luxury of retrospection, had I realized just how close I’d come and then everything else seemed to fade into insignificance.

But this time, facing a more ordinary mode of extinction, realizing that some day in some form this very sort of thing is just what will be waiting, this time I learned a somewhat different lesson: that life is good while you have it and that it matters when there are family and friends around who care. Condemned now to a lifetime of medication and special care, I’m glad to be back and more sensitive to the vulnerabilities of living. When we’re young we tend to feel immortal, if we’re lucky enough to have our health, and maybe we always feel immortal as long as we’re alive. It’s hard to imagine not being. But a brush with the limitations of life can’t help but enlighten us in one form or other. Things like politics and business lose some of their luster. Still, you can’t help wanting to get a few things done before you go. I’m not glad I went through what I did. But it could have been worse. I could have gone through it without feeling a thing. rockirreg@aol.com

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