Monday, January 30, 2012

Heart Attack Part II

The story they tell on the island is that after I had my heart attack, I drove the Ayala across Raccoon Strait, dropped Suzette off, and came back with Paloma and then drove myself to the hospital.  The way I heard it later, it sounded stupidly macho.  It’s true I did have a heart attack and it’s true afterwards I drove a 30 ton crew boat back and forth to Tiburon, and it’s true I drove myself to the doctor that afternoon.  In my defense I didn’t know I had had a heart attack.  Later when I knew what happened I just felt really lucky. 
That morning of my heart attack, I took the boat across the strait and with Paloma, my 7 month old daughter,  I came back.  We left the boat at the dock and drove back up to the house.  She had a cold and we were keeping her home from daycare that day.  Going up the stairs to our second floor I felt tired and took it slowly.  I made up my mind to call Kaiser and see someone.  I thought I had pneumonia.  Even after I got my breath back on the boat that morning, breathing wasn’t that easy.  I felt like I had weights on my chest and there wasn’t enough oxygen in the air
I called the advice nurse and she made me an appointment for 3:15 in the afternoon.  I took it easy that day.  I think Paloma and I were both under the weather and rested together.  She didn’t give me a bad time.  She had an appointment to see the pediatrician for Wednesday.  After I called the nurse, I thought maybe I would stack my appointment with hers.  I didn’t feel like making the trek to the mainland that day driving up and down the 101 freeway.  But then I thought about it and her appointment would be at the medical center in Terra Linda and mine was in the downtown San Rafael medical office.  By the time I schlepped between the two I’d be frazzled.  It was probably easier just to go for my appointment the nurse made for me in the afternoon.   
I look back on that day and think how close I came to just not going.  Thank god my heart attack wasn’t as serious as it could have been, I didn’t die.  But who knows if I had stayed home I might have had another heart attack.  I don’t know if I would have survived the second one.     
So I trekked down to the ferry dock, took the ferry to Tiburon, walked to the parking lot and drove to San Rafael all carrying Paloma and a bag of her supplies.  I found a parking space in the basement and went upstairs to wait for my appointment. 
The receptionist offered us a conference room to wait in so Paloma didn’t have to be exposed to whatever was in the waiting room.  It seemed like a parade of Kaiser people came in to see the baby.   Paloma by this time was feeling herself, very charming and very cute. 
We went in to see Dr. Pont, a young woman with long blond hair.  She did a physical exam, listened to my story and then my lungs.  She left the room and came back.  She was very interested to know what I had been doing and asked me if I had been travelling.  She made sure I hadn’t been flying at all or a long time waiting somewhere.  She said I didn’t have pneumonia, my lungs were clear, but she thought I might have had a heart attack. 
Some time ago I had described my heart burn to my doctor then using a clenched fist near my chest.  I had to go for a series of tests after that.  I learned later that a pain described with a clenched fist to the chest is a common symptom of a heart attack.  This time I didn’t need to clench my fist to describe my pain.  I didn’t have any pain.  I just couldn’t breathe.
Dr. Pont said she wanted me to go to the Emergency Room in Terra Linda.  I said I could do that and take Paloma along.  She said, no I should call Suzette, and she would arrange for a ride.   Suzette works 35 miles away in San Lorenzo in the East Bay; in mid-afternoon probably a two hour drive. 
A nurse came in and gave me aspirin and they might have given me nitroglycerin.  We waited, Paloma and I, and maybe I took some more aspirin.  Time passed.  And then I heard a siren.
A nurse came in and said, “Your ride’s here.” 
I spent six hours in the emergency room with a nurse.  Somewhere between the ambulance and my cubicle someone was taking care of Paloma until Suzette arrived.  The nurse kept coming back to me and checking my pain.  Ask me enough times and I could feel something in my chest, tightness or something.  I got nitroglycerin and morphine though the morphine seemed unnecessary and I was mildly disappointed I didn’t even get a high from my medical narcotic.
After hours in the emergency room, the results came back from my blood test and showed I had troponin in my blood.  Troponin is an enzyme produced by dying heart muscle.  It was a very small amount indicating very little damage but it was there.  Results in, they sent me upstairs and I got to go to sleep. 
The next day they told me I would have an angioplasty to see what my arteries looked like.  In the early afternoon I went into surgery at Terra Linda.  From that surgery I was taken directly by ambulance across the Golden Gate Bridge to Kaiser’s Cardiac Unit in San Francisco.  From the ambulance they wheeled me down another hallway.    
Laying on the gurney I looked up at the ceiling.  They were doing some sort of repair work and acoustic tiles were missing with electric wires sticking out.  All along I had been trying to hold on to the normal. No one around me was treating me normally but I wanted to say, it’s me, I’m here.  I’m just a regular guy, not just a cardiac emergency.  I make jokes when I’m nervous.   I told someone that I had expected a long white hallway but I had imagined the ceiling would be in better shape.  I either didn’t get it out very well or that person had no sense of humor.  I was disappointed when I got no reaction. 
I went into surgery, there were a whole group of people there, and another catheter was inserted into my femoral artery.  “You’ll be awake, but don’t worry,” they said.  After what seemed a long time I had a panic attack.  I wanted to get out of there.  I was afraid if I moved I would damage my own heart and the next few minutes were excruciating and then they were done. 
The next day a physical therapist came to help me walk around the ward.  A nurse from the surgery told me I had six stents; I had had 90% blockage in both my right and left coronary arteries.   She gave me a prescription to have filled.  That was it, they were done.  Suzette came, we went to the pharmacy downstairs and walked slowly to her car and went home. 
It was like I had been the center of attention for a lot of very humorless people for two days; humorless but warm, capable and efficient.  Just about the time it had sunk in, that I had had a heart attack and everyone around me had been watching me to keep me alive, I was told to go home.  It was all over.   I was OK. 
Heart Attack?  Even two years later it’s still hard to say the words without a feeling of unreality and gratitude that the heart attack was so minor, the people at Kaiser so good and that I am alive.      

Monday, January 23, 2012

Heart Attack

If I had imagined having a heart attack, it wouldn’t have happened at 5:30 a.m. on a Monday morning on Angel Island.  I wasn’t thinking heart attacks at all, of course.  I had been a Park Ranger for the last 5 years.  I made it through a physically demanding Academy and kept myself in pretty good condition after that.  I wasn’t overweight or much overweight, a few pounds more than the Academy.  Sure I had higher than normal cholesterol, but not too high and a few years before my blood pressure had climbed to 145 or so, but it wasn’t too bad.  I had regular checkups and my nurse practitioner didn’t seem worried about it.  Being a cardiac risk was not part of my self image.  

Angel Island is a special place, maybe not so good for a heart attack.  Getting on and off the island is no easy task and even harder if you’re trying to make a mainland schedule.  The Angel Island Ferry runs on an island schedule and the State boat runs on the island’s time as well.  I liked living on the island, an 800 acre State Park, 25 of us, employees and our families, in the middle of the San Francisco Bay within sight of downtown San Francisco.  When the visitors leave, it is a ghostly Army post closed for over 65 years.  The interior of the island is wonderful California coastal oak and chaparral.  During the summer a few thousand visitors come on the weekends, fewer during the week and off season.  They come late and leave early.  It is a very quiet and isolated place within sight of nearly 7 million people.       
What I don’t like about the island is that going anywhere requires a boat trip across Raccoon Strait followed by a four block walk to the parking lot where we park our cars.  Ferry schedules are based on visitors’ needs and during the winter severely curtailed.  We have two State Park boats, a big 50 foot crew boat and a 5 meter inflatable with a 90 horsepower engine on the back of it.   It had taken me a year with island politics and a difficult learning curve to get to drive the crew boat.  Convincing Suzette to move to the island with her 15 year old son had required that I commit to a 5:30 a.m. run to the mainland every weekday morning to get Arom to school and Suzette to work.

There I was one more time at 5:30 on a Monday morning on Angel Island getting the Ayala ready to go for a run.  I had gone below decks, down a ladder to the engine compartment and switched on the power before firing up the two diesel engines.  I climbed back up and went forward to the pilot house to turn on the electronics.  In the pilot house suddenly I couldn’t breathe.  I bent over trying to get a breath, I rested my right hand against the instrument panel and I tried to will myself to breathe.  I was frozen; I couldn’t even make an effort to breathe.   
The moments tick slowly when you can’t breathe and each tick is a step further from the ordinary.   My lungs wouldn’t work, I couldn’t pull the air in, I stood there waiting for it to be over, hoping it would be over.  I wasn’t panicked, I just couldn’t breathe.  Somewhere in the back of my mind it occurred to me if I didn’t breathe soon, it would be the end of me.  I just needed to take a breath.  I knew whatever was going on was serious.  I had never been like this before, short of breath yes, but not like this.   I just couldn’t breathe.
And then I could.  I took air in like a drowning man.   I was relieved.  Suzette was beside me asking what was wrong.  Finally I was able to say, nothing, I’m OK, I just couldn’t breathe for a moment. 
In the following weeks I thought about how these moments could have been my last in this world, how inconsequential it had seemed, no warning, something as simple as breathing.  I thought about how things had gone on around me; how Suzette, Paloma, the whole world seemed alive.  I was frozen for those few moments between them and nothing.   I couldn’t move, I couldn’t breathe, I couldn’t say anything.  I was walled off from everyone and for those few moments time stopped.  And then it started again.    

Monday, January 9, 2012

A Posting

It was my intention to post weekly.  And here it is Monday and I am posting.  I had an essay ready to post, one I wrote on my heart attack that occurred nearly two years ago.  I liked it.  I gave it to Suzette to read.  Suzette  has a degree in English Literature from UC Berkeley or Cal as they call it up here and an MFA from the New School in San Francisco.  Like a musician who can read and write music, she knows what makes good literature and when she performs herself, she writes poems, it is beautiful.  And she’s willing to read what I write and say positive things about it. 

She read my piece; she said she liked it but that it’s too factual, not enough narrative, it doesn’t feel like I’m telling a story.  I have a degree in English Literature from UCLA.  But my degree unlike Suzette’s  was the last step to a course that started when I was in the first reading group in primary school.  For me it was less a degree in Literature than it was a degree in Reading.  I never quite understood threads, arcs, themes, leitmotifs and all that stuff.  I just like reading and I wish I could write. 

My writing doesn’t satisfy me.  It’s not the story telling I enjoy reading, it doesn’t have the artistry I admire. But I think of myself as being good at taking direction.  I’m willing to try something new and see if it works.  I’ve learned a lot of things I didn’t expect to be able to do with that attitude.  So if Suzette is willing to suggest I’m willing to listen though I'm feeling stumped on how to add that sense of narrative to my writing.    

I was trained to write police reports: I saw, he said, this happened, this time, this place, only the facts, no opinion, no conclusions.  I have to admit it didn’t take a lot of effort to train me to be pedestrian, calm, and factual.  It suits me.  It seems like it ought to be good writing, but it isn’t.  Too dry.  What did you think?  How did it feel?  What was going on with you?  Explain this. 

So I’m trying to incorporate these suggestions into my essays.  I’m trying something different, learning a new step, a new skill.   I have the phrase in my head, “ Writers write, good writers revise.”  So I’m revising my essay. 

In the meantime I’ll share something I heard on the radio last Friday.  Garrison Keillor on his radio program Writers Alamanac talked about E.L. Doctorow and said, “E.L. Doctorow once asked about his writing routine, said here’s how it goes.  I’m up at the stroke of 10 or 10:30.  I have breakfast and read the papers and then it’s lunch time.  Then maybe a little nap after lunch, and out to the gym, and before I know it it’s time to have a drink.”   

Tuesday, January 3, 2012

Daddy at 65

“Your granddaughter is so cute.”  Or sometimes people ask, “Is that your granddaughter or your daughter?”  It’s my daughter.  At age of 65 I find both situations a little uncomfortable.  Early on I decided to be directly honest about it and not let it go.  I don’t want my daughter to ever hear me equivocate on whether she is mine.  I have to admit I’m still a little sensitive to the question.  Yes, I am 65 years old and I have a two year old daughter. 

I think my problem is that my own judgments on elderly daddies were not all that kind.  On the other hand, I have Paloma and she is the gift of my life.  She is the most incredible person I know and I am the luckiest guy in the world to be her Daddy. 

In the 4, 000 year old epic, the goddess tells Gilgamesh:

When the gods created man they allotted to him death, but life they retained in their own keeping. As for you, Gilgamesh, fill your belly with good things; day and night, night and day, dance and be merry, feast and rejoice. Let your clothes be fresh, bathe yourself in water, cherish the little child that holds your hand, and make your wife happy in your embrace; for this too is the lot of man.

I am a fortunate man, though I have to admit one of Paloma’s quirks is she doesn’t like to hold hands.  She strains against it to maintain her freedom.  That’s my daughter.  I do get the same or better feeling with her arms around my neck when she asks to be carried, something she frequently does.  I have been fortunate to feel that love and trust from a small child four times now.  My three sons range in age from 42 to 36 and it was a long time ago with them, but a feeling I still cherish in my heart. 
Back in the sixties I heard the arguments for ZPG, zero population growth, two children is enough for anyone.  Intellectually I agree, but circumstances gave me three sons.  And now I have a daughter.  The feeling I have is this side of embarrassment.  I haven’t acted exactly according to my beliefs, but it wasn’t a conscious decision.  Thank God, I don’t have full control of everything that happens in my life.  Before Paloma I judged older men with small children harshly.  I think children are for young people and I love and enjoy the children of my sons, but I have a daughter. 

I remind myself that Picasso and Chaplin had daughters late in life who have been a blessing on everyone, beautiful gifted children.  I am still judgmental, but my judgments are tempered by the results.  The world is fortunate for the lives of Paloma Picasso and Geraldine Chaplin.  And the world and I are fortunate for the existence of Paloma Ida Duggan.