They Tore Out My Heart and Stomped That Sucker Flat Read online

  “Hmmmmm,” said the doctor, moving his stethoscope to another position.

  I didn’t know it at the time, but a patient can learn a great deal about his condition simply by listening to the sounds the doctor makes while he conducts his examination.

  “Hmmmmm” means there is something very interesting going on inside you. A policeman makes the same sound when he pulls you over and there is an empty bottle of Gallo Thunderbird wine on the seat next to you.

  “Ahhhhhh” means he just remembered the last time he heard something going on inside you. It was back in medical school the day he was assigned his first cadaver.

  “Oooooh” means that, compared to you, the cadaver was in good health.

  “What is the problem, doctor?” I asked.

  “Heart murmur,” he answered.

  “Nothing to worry about,” he said. “You’ll probably grow right out of it.”

  I didn’t worry about it. I went right along with the normal life of the next demented child. I played sports throughout high school. I went off to college and took up drinking beer and smoking cigarettes. I had other physicals.

  “Hmmmm” is the sound doctors would always make when they listened to my heart.

  The diagnosis was always “heart murmur. Nothing to worry about. You’ll probably outgrow it.”

  I didn’t outgrow it. Came time for me to leave college. It was 1968. Recall the unpleasantness in Vietnam that was raging at the time? The government was insistent I go and take a part. I had another physical.

  “Oooooh,” said the doctor.

  I didn’t have a heart murmur any more. The murmur, or strange sound emanating from my heart, turned out to be something else.

  I was twenty-one. The diagnosis was aortic insufficiency. Doctors can spend hours explaining. I can do it much more quickly.

  In the normal heart, the aortic valve—from which blood leaves the heart and goes out into the rest of the body—contains three leaflets, or cusps, which open when the blood is forced out and then close tightly together so that none of the blood can leak back inside the heart.

  The doctor’s diagnosis was that I had been born with only TWO leaflets in my aortic valve. I was born in 1946, right after the Big War. Perhaps there was a shortage of aortic leaflets.

  Regardless, each time my heart pumped blood out, some of the blood would seep back into my heart, causing the “murmur” sound. On the next beat, my heart would have to pump that much harder.

  “It’s like taking three steps and then falling back two to make one,” the doctor explained.

  I was frightened of course.

  “You can forget the service,” said the doctor. “They’ll never let you in with an aortic insufficiency.”

  I wasn’t frightened after he said that. Better an aortic insufficiency than a bullet from a Russian-made AK-47 right between my eyes, I figured.

  The doctor made it quite clear to me. No big problem at the moment, he said. A young heart can withstand a great deal.

  “But someday,” said the doctor, “someday, you will have to have that valve replaced.”

  Someday. To a young man who has fallen in love in a motel utility room in Myrtle Beach, South Carolina, who has practiced-kissed Phi Mu’s, and who has just been given a reprieve from the mud and blood of Vietnam, someday never comes.

  2

  ‘This Might Sting a Little’

  I avoided any big deal concerning the malfunction with my heart for the next fourteen years. The fact I had been diagnosed as having this “aortic insufficiency” caused a problem here and there with life insurance rates, but other than that, it was nothing more than a slight nuisance in the back of my head. Something to worry about only if I didn’t have anything else better to worry about.

  I took up tennis when I was twenty-three and quickly shed the fifty pounds I had gained eating my first wife’s cooking. I could play three sets of hard singles in the hot sun, drink a half-case of beer, and still manage to dance an evening away, even if somebody else usually had to drive me home.

  Symptoms of a problem with my heart? What symptoms? Someday, the doctor had said . . .

  “Quit shaking the bed,” my third wife said to me one night. It was late January 1982.

  “I’m not shaking the bed,” I answered.

  “You’re shaking it,” she insisted.

  “Go to sleep,” I said.

  “How can I sleep with the bed shaking like this?” my wife demanded.

  The bed was shaking. I looked under the bed. There used to be things that slept under my bed when I was a kid. Godzilla. Zombies.

  There was nothing under my bed but the banana sandwich I hadn’t finished the night before. Godzilla wouldn’t eat a day-old, half-eaten banana sandwich.

  “I think it’s your heartbeat,” my wife said. “Your heart is beating so hard, it’s shaking the bed.”

  That’s nonsense. There I was, lying quietly in my bed. How could my heart be beating hard enough to shake the bed?

  “You had better go to the doctor and get that checked,” my wife said.

  I had learned to all but avoid doctors since I was twenty-one. I had gone in for a few routine physicals, but there had been no new developments regarding the fact my aortic valve leaked.

  Someday . . .

  “Do you really think it’s my heartbeat that is shaking the bed?” I asked my wife again.

  “I don’t remember installing a Magic Fingers system in the mattress,” she said. “Go to the doctor.”

  I made an appointment at 3 PM with my doctor. I also made a date for a tennis match at 5 PM.

  I packed my tennis gear in the back of my car. Two racquets. After you have played tennis for at least ten years, you can carry around two racquets. I drove away from my house, headed for my doctor’s office. My greatest concern was whether I’d be able to get in and out of the doctor’s office in time to make my five o’clock tennis match. Women. Sometimes you have to humor them.

  I knew something was wrong when my doctor’s nurse complimented me on the shirt I was wearing soon after I had been given a chest X-ray.

  “Hey,” she said, “that’s a sharp shirt you’re wearing.”

  The shirt wasn’t sharp at all. It was an ugly, green shirt I had won in a tennis tournament. Actually, I hadn’t won the shirt at all. They gave everybody who played in the tournament a shirt and all the reds and blues were gone when I went to pick out my shirt.

  “I really enjoyed your last book,” the nurse continued.

  How long did I have, I wondered? Six months tops? They’re never this nice to you in a doctor’s office unless they know something you don’t.

  My doctor is a quiet man. He’s never ruffled.

  “OH, MY GOD!” I heard him scream from the X-ray room.

  I said a prayer. Lord, I said, don’t make me suffer for long.

  My doctor came back into the room where I was waiting in my ugly, green shirt.

  “Hey,” he said, “that’s a sharp shirt you’re wearing.”

  “Give it to me straight doc,” I demanded.

  “Come with me,” he said.

  My heart was pounding hard enough to shake an entire Holiday Inn.

  He put two X-rays up on the screen. One was the X-ray that had been taken of my heart two years previous. The other was an X-ray that had been taken of my heart in the previous twenty minutes.

  “This is your heart two years ago,” said my doctor, “and this is your heart now. Notice how much larger your heart is today than it was two years ago.”

  I can explain that, I said. I quit smoking and I’ve been getting plenty of exercise. That would certainly account for why I now have a big, healthy heart, rather than the undersized little fellow I had two years ago.

 
“I’m afraid you don’t understand,” said the doctor. “Your heart has enlarged. I would say about a sixth. This is quite dangerous.”

  He explained further.

  The aortic valves leaks. Blood seeps back in. The heart is then filled above capacity. It must pump harder to rid itself of the blood. But it is fighting a losing battle. The leak is apparently bigger now than ever. The heart is pumping harder than ever. The heart is a muscle. The harder it works, the larger it becomes. The heart becomes too large, it can’t function.

  “And?” I asked.

  “And you suffer heart failure and you die,” said my doctor.

  I asked for a couch and a six-pack. I settled for a hard chair and a glass of water.

  My doctor explained some more:

  The pounding heartbeat that had shaken the bed was classic for my condition.

  “Cross your legs,” my doctor said.

  I crossed my legs, right over left. My right leg bounced up and down with my pulse.

  “Look at the pulse in your neck,” he said.

  Bam! Bam! Bam! The arteries pounded out of my skin. They call that “pistol pulse.”

  My blood pressure. The range was wide. Again, classic for my condition.

  Still, I had suffered no shortages of breath. No chest pains. No dizziness when I was sober.

  “That will come,” the doctor said.

  I didn’t want to ask the question, but I asked it anyway.

  “What can you do to repair this?”

  “In a word?” the doctor asked back.

  “Keep it as simple as you can,” I said.

  “Surgery,” he answered.

  There would have to be more tests, he said. He even suggested, if I so desired, that I get a second opinion. He also said the situation wasn’t critical . . . yet.

  “You might be able to avoid surgery for a time, with some help from drugs and a change in your lifestyle,” he went on, “but there’s no doubt you’re going to have to have a new valve eventually.”

  Change in lifestyle. No tennis?

  “I wouldn’t recommend you play tennis until we know more,” he said.

  I asked if I could use his phone. I called my opponent I had scheduled for five o’clock.

  “I can’t make tennis today,” I said.

  “How about tomorrow?”

  “I can’t make that, either.”

  “How about next week?”

  “Nope.”

  I was fighting back the tears.

  “So when can you play?”

  “God knows.”

  “You okay?”

  “Nope.”

  “What’s the matter?”

  “Someday.”

  “Huh?”

  “Someday. It finally came.”

  My doctor sent me to another doctor, and that doctor listened and felt and poked and prodded and ordered more tests. I took the standard EKG and then I took something called an Echocardiogram where they send sound waves into your heart, and when they had done all that, they still didn’t know much more than they had known before, so they scheduled me for a cardiac catheterization.

  I didn’t know what cardiac catheterization was, so I had to be a smart aleck and ask.

  “Before we perform the new heart surgery in this country,” one of the doctors explained, “we first put the patient through cardiac catheterization. It is the best diagnostic tool we have available to us.

  “We will insert catheters—little tubes—into an artery and a vein, and we will send them into your heart. We will inject dyes through the catheters so that we can take movies of the heart and of the arteries around your heart so that we can determine whether or not there is any blockage.

  “This way, we can determine exactly what is your problem, we can see exactly how your heart is functioning, and we can tell if there are any hidden problems we didn’t already know about.”

  That didn’t sound so terrible, but doctors tend to leave out details when they are explaining things.

  Friend of mine called me a few days before I was to have the catheterization.

  “Had it myself a couple of years ago,” he said.

  “How bad is it?” I asked.

  “Not too bad,” he said. “First, they whack open your arm and start shoving all these tubes up in you. When they get the tubes in, they shoot in the dye.

  “The doctor will say, ‘This is going to burn a little.’ What he doesn’t say is where it burns.”

  I never learn my lesson. I had to ask where it burns.

  “Your testicles,” he said. “The dye goes from your heart to your bladder and burns your testicles. You’ll think your testicles are going to burn right off. But try not to think about it before you go in there.”

  As my wife was driving me to the hospital to have my catheterization, she asked, “Something’s been on your mind for days. What is it?”

  I thought it best not to tell her.

  Aside from the evening I was born, I had never been a hospital patient before. First, they make you put on one of those silly gowns with no back. Those gowns have no backs so it is easier for the nurses to slip up behind you and give you a shot in your hip.

  “This is going to make your mouth very dry,” said the nurse as she gave me a shot in my hip. A lot of things puzzle me about medicine. One is, if they want to make my mouth dry, then why do they give me a shot in my hip?

  Next, you have to sign a release saying it is okay for your doctor to do this cardiac catheterization thing to you.

  “Just sign it,” said the nurse.

  “But I think I should read the release first,” I said.

  “Just sign it,” said the nurse.

  Like I said, I never learn. I read the release, all the way down to the part where it said, in large letters, that cardiac catheterization includes “the ultimate risk of death.”

  “Nobody said anything about dying from this,” I said to the nurse.

  “It’s just a routine release,” said the nurse. “I told you not to read it.”

  I asked for the number of the nearest cab service.

  “You can’t leave now,” the nurse insisted. “I’ve already given you a shot. What are you afraid of?”

  “I’m afraid my testicles will get burned off and I will die,” I said.

  Before I could get out of my hospital gown and back into my clothes—you wouldn’t have much luck hailing a cab with a bare bottom, I decided—they came to take me away for the catheterization.

  They were bringing in another victim as I left the prep room. A nurse handed him his release.

  “Just sign it,” I said to him.

  “But shouldn’t I read it first?” he asked.

  “Not unless you think you can catch a cab half-naked,” I said, as they rolled me away.

  The first thing I asked the doctor, once I had been strapped down on the platform that poses for a bed in the catheterization room was, “How much is this going to hurt?”

  “You are hardly going to feel a thing,” he answered.

  The next thing I asked the doctor was, “Have you ever undergone this procedure yourself?”

  “No,” he answered.

  Just as I thought. He’s going to cut open my arm on the other side of my elbow, stick tubes into my heart, inject dyes that will burn my testicles, and I am hardly going to feel a thing.

  There is, in fact, this awesome communications gap between the medical profession and its patients when it comes to pain.

  I happen to be an expert on pain. I can get hurt pouring a glass of milk.

  To me, pain is anything even slightly uncomfortable that is caused by somebody other than myself poking, picking, sticking, or jabbing me.

 
Pain to the medical profession probably would be something like cutting off your left foot without first giving you an aspirin.

  The next time you’re having something done to your body by a doctor, ask him, “Is this going to hurt?”

  He will likely answer, “It might sting a little.”

  Sting is a word they use a lot in medicine. Sting, to me, means a slight pain, a level or two under a mosquito bite.

  When a doctor says, “This might sting a little,” he really means, “Have you ever been bitten by a large animal with very sharp teeth?”

  Here are some other phrases to be careful of the next time you go to the doctor or spend any time in the hospital:

  — “You might feel a little pressure here.” This means the brakes on the delivery truck full of frozen pudding that is unloading in front of the hospital are about to give way and the truck, all ten tons of it, is going to roll over you. That’s the “little pressure” you’re going to feel.

  — “This might pull a little.” They used to say the very same thing to enemies of the state just before they put them on the rack. If a doctor says, “This might pull a little,” prepare for your kidneys to be yanked up to your throat. I’m no expert on the anatomy, but your kidneys have no business in your throat.

  If you happen to be in the hospital or at your doctor’s office and somebody mentions something about something “pulling a little,” run as fast as you can for the nearest bus, even if you are half-naked.

  — “I did this same thing to a seven-year-old boy this morning, and he didn’t even whimper.” Had the child been conscious, however . . .

  — “Now that wasn’t so bad, was it?” Not if you’re used to finishing third in ax fights, no.

  — “Very few of my other patients even complain about this procedure.” That doesn’t surprise me at all, Dr. Quincy.

  — “This may tingle a bit when the needle goes through the nerve.” Look around for a soft place to land.

  — “I think the anesthetic has had plenty of time to take effect.” Couldn’t we wait just six more weeks to be sure?

  — “If you will just relax, this will be over before you know it.” Be especially careful of this one. The doctor is just trying to buy time before you start trying to hurt him back. What he really means is that the British fleet can turn around and sail all the way back home from the Falkland Islands and this tube will still be stuck straight up Argentina.