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

  One thing I made certain of in my will. Nobody got my red coat in case I bought the farm during my heart surgery. I left strict instructions I be buried in it.

  My minister and I were alone in the hospital room. I was stretched out on the bed. He pulled his chair alongside me. A good preacher has a way about him, a way that calms.

  First, we had a long discussion about hell. Hell has always confused me. Who goes to hell? Hitler, of course. Bonnie and Clyde must be there. There was a man in my hometown who shot at dogs for sport. My cousin had a fluffy little dog named Snowball and the man shot my cousin’s dog dead.

  “I hope he burns in hell for shooting my dog,” said my cousin.

  “On the same spit with Hitler and Bonnie and Clyde,” I added.

  As a kid, I always wondered exactly where hell was. Heaven is up; hell is down. But down where?

  I used to wonder if you could dig your way to hell. I asked my minister about it.

  “You probably can,” he agreed. “But there are quicker ways to get there.”

  That brought up the current state of my status with the Lord.

  “I haven’t exactly been faithful,” I said.

  “None of us have,” said my minister.

  “I don’t think you understand,” I went on. “At last count, I had violated eight of the original Ten Commandments and had strongly considered the other two.”

  My preacher talked about forgiveness. He talked about it for a long time. Brother Roy Dodd couldn’t have explained it any better. I listened closely. When he finished, I said, “Then you think if I don’t make it through the operation tomorrow, there’s still time for me to be forgiven for all the things I’ve done wrong?”

  He looked at his watch.

  “There’s still time,” he said, “but I’d get on it right away.”

  We prayed together before he left. He asked God to watch over me during the operation. I wanted him to ask God to have a sense of humor when he looked over my past life, but he didn’t ask that.

  I got out of my bed as the preacher began to leave. Family and friends were outside waiting.

  First, I shook his hand. Then, I reached my arms around him, and he reached his arms around me.

  Compared to the comfort and assurance of resting in the loving arms of a man of God for a few moments, Valium is child’s play.

  7

  Adventures in ICU

  The head nurse came into the room at ten o’clock and asked everyone to leave. Everyone except me, of course. This was the part of the pre-surgery period I had dreaded the most. I said my goodbyes.

  “You’re sure about your red coat?” asked my friend, the Shriner.

  “Positive,” I said.

  My stepfather was there. He’s a good man who married my mother when I was ten and who had looked after her all these years and who is solid in situations like these. My mother’s own health problems had kept her from being with me.

  “Tell Mother I love her,” I said to my stepfather.

  “I’ll tell her,” he said.

  We shook hands. If I had it all to do over again, I would have hugged his neck.

  I kissed my wife. I wanted to say something poetic, like if I didn’t make it, I’d meet her just beyond the moon. I heard that line in a Tex Ritter song, believe it or not.

  All I could say to her was, “Thanks for bringing the chili dogs.” I guess I’m no Tex Ritter.

  The nurse gave me another sleeping pill and turned out my light. It was dark. I was alone. The buses had stopped running at ten. I prayed one last time. All I could do now was let the drugs take my dreams and what was left of my fear.

  At six in the morning, another nurse brought me out of what had actually been a restful sleep with a gentle tug on my arm. She even had the morning newspaper. I read the sports section first. North Carolina was storming toward the collegiate basketball championship. There was a story about how lousy the Chicago Cubs were looking in spring practice.

  That reminded me to look in my little bag I had brought with me from home. Something else I put in there I forgot to mention. I put in my lucky Chicago Cubs baseball cap I bought one day when I lived in Chicago and used to walk up to Addison and Clark Streets to Wrigley Field to watch the Cubs mostly lose.

  The reason I figure a Chicago Cubs baseball cap is lucky is this: The Cubs haven’t won a pennant since 1945. Season after season, they are a terrible disappointment to their followers. Yet, no Cub has ever been seriously injured by an irate fan, which is a minor miracle. Maybe, I concluded, it was the caps that kept the players from harm.

  I put on my Cubs cap while the nurse scurried around my bed, taking my temperature and checking my blood pressure.

  “What are you doing with that hat on?” she asked.

  “It’s not a hat,” I replied. “It’s a cap. Don’t you know anything about baseball?”

  “I don’t care what it is,” the nurse replied, “but you’ll have to take it off when we take you out.”

  I hadn’t counted on this.

  “What’s wrong with me wearing a cap when you take me out?” I inquired, a bit indignantly.

  “You can’t wear something like that into surgery because it can’t be sterilized,” she said.

  Once a guy sitting behind me at Wrigley Field had tried for a foul ball and spilled his beer on my cap, but other than that, it was perfectly clean.

  “I’m wearing my cap,” I said.

  “You want another enema?” asked the nurse.

  I put my cap back in my bag and went into the bathroom to take my shower.

  They give you a brush and medicated soap for your pre-op shower. The soap is yellow. Actually, it’s caramel colored. Actually, it was the color of that lotion they came out with years ago called “Q. T.” for “quick tan.” The idea was to spread it over your body and it would give you an instant tan without you ever having to set foot into the hot sun. The problem, of course, was that it was impossible to spread the lotion over your body evenly, so you wound up looking like a pinto pony.

  What you are supposed to do is scrub that soap all over your body with the brush. The brush has very brittle teeth, and your body, having been shaved the night before, is very tender. When I finished my shower, my body felt like the entire Chicago Cubs infield had just walked across it wearing their cleats.

  There was something that had been worrying me about this particular moment. I did not relish the idea of being conscious when they rolled me into the operating room. I didn’t want to see it. I didn’t want to see the table. I didn’t want to see the operating team. I didn’t want to see the table of instruments. I was also afraid they might have the little pig in there who was donating the valve. I didn’t want to come face to face with the pig, either.

  No problem. The nurse gave me another Valium, a whammo dosage. I began to drift off. I barely remember what came next. What came next was a shot in my rear to take me ever farther out.

  I have no recollection whatsoever of leaving my hospital room. As a matter of fact, I have no recollection whatsoever of the next eight or so hours. I can reconstruct it here only through later conversations with those involved in my operation and in my immediate post-operative care.

  At 6:45 AM, they wheeled me out of my hospital room toward the surgical unit. I was carrying on, they said, but nobody was exactly certain what I was carrying on about. Everything was normal so far.

  Before entering the operating room, I was taken to what is called a holding room. It was 7:15. Further preparation was made for the surgery. EKG leads were put into place. Small lines were placed in various arteries for measuring pressures.

  At 8 AM, I was taken into the operating room. More lines and tubes. One anesthetic ended my senseless carrying-on and put me even farther out. Another blocked nerves in ord
er to relax my body. More tubes, including the one tube I had worried about the most. The one to my bladder.

  “We always wait until the patient is all the way under before we put in that catheter,” a doctor told me later. I would like to go on record as thanking the medical profession for that concession to the comfort of their patients.

  There were eight other people in the room besides the one sound asleep with the bladder catheter in him. Three on the surgical team, two anesthesiologists, a nurse assisting, a nurse circulating, and two to run the heart-lung machine.

  My body was covered with sterile drapes. The lines and tubes were in place. The surgeon took his scalpel and made the initial incision into my skin. He started just below the base of my neck and went just below my sternum, four inches above my navel. Something to know about having heart surgery. Very little muscle tissue is cut when the incision is made. That cuts down on painful muscle spasms that cause so much discomfort following surgery to other parts of the body.

  This is the part that still gives me the creeps: After the skin incision is made, the surgeon takes in hand what is known as a Stryker saw. It is an oscillating saw that cuts through the breastbone. I was told it cuts through the bone very cleanly and doesn’t make a lot of noise, so do not think about the movie The Texas Chain Saw Massacre as you read this.

  Once they had cut through my breastbone, a chest retractor was used to open a large area in my chest in order to give the surgeons room to work. My ribs buckled in the process. This creates a great deal of discomfort following surgery, but at least the doctors have room to use both hands.

  Then came the stickiest part of the procedure. The reason it is possible to make necessary repairs to the heart today, is the development of the heart-lung machine. They explained to me the details of how it works, but here is about all I understood.

  The heart must be stopped so the surgeon can do his work. The heart is stopped by cooling it. The entire body of the patient is cooled to twenty-eight degrees centigrade (eighty-two, fahrenheit), as a matter of fact, which reduces the metabolism of the heart and also reduces the amount of oxygen it needs, a safeguard against further damage to the heart muscle during the surgery.

  A tube is inserted into the aorta on the left side of the heart, and then two more tubes are inserted into the right side. Blood then actually bypasses the heart through the tubes and flows into the heart-lung machine, which oxygenates it and filters it and circulates it throughout the body.

  The heart is not beating. It is clear of blood. But the surgeon is able to work on a live patient because of that marvelous machine that is taking the place of the patient’s heart and lungs.

  A clamp was placed on my aorta, the artery leading from the left ventricle of my heart. My aorta was then opened and the surgeons looked in at the valve for the first time.

  The leaflets of my valve, I was told later, were elongated and thin from overwork and were falling back into my heart chamber.

  The leaflets of my original valve were taken out. Fifteen sutures went in to hold the new valve, which had arrived in the operating room without its original owner, I was assured later.

  I received a twenty-seven millimeter Carpentier tissue valve, produced by American Edwards Laboratories, Model No. 2625, Serial No. AB0574. (I never did get the hog’s name.) The valve I received was comparatively large. The larger the better. The problem with tissue valves is if and when they begin to deteriorate, they also begin to shrink. Larger valves have farther to shrink before there is trouble and blood leakage begins all over again.

  One other note. No incisions were actually made into the muscle of my heart. The work was done on the outside where the valve meets the aorta. I did not then undergo “open heart surgery” and neither do most other heart surgery patients. Coronary bypass surgery, the most common sort of heart surgery today, for instance, requires no entrance into the heart chamber itself. “Open heart surgery” is what the guy down the street always thinks you had. So let him think that. It sounds more exotic than just heart surgery, anyway.

  Once the valve is in place, the heart is warmed again and all electrical activity re-starts. The patient comes off the bypass of the heart-lung machine, the most critical period is over. What is left to do is put his chest back together again.

  The sternum is closed with heavy stainless steel wire that grows into the core of the bone. This causes no pain afterwards, but when you have chest X-rays taken later, it looks like you swallowed a box of paper clips.

  As far as putting the skin back together, I got lucky. My surgeon practices a method whereby the sutures run underneath the skin surface so your chest doesn’t look like a football. My scar, as a matter of fact, looks like I was stealing eggs and the chicken scratched me. Nobody who sees my scar is the slightest bit repulsed by its appearance, not even strangers I stop on the street.

  The actual procedure of opening my chest, diverting my blood to the heart-lung machine, replacing my valve, taking me off bypass, and closing my chest back again took fifty-one minutes.

  There were no problems. No complications. Damn good surgical team.

  There is nothing for family and friends to do but wait. The hospital was kind enough to provide a private waiting area. They wouldn’t allow the two witch doctors in, however. I paid two witch doctors fifty bucks each to dance and chase away any evil heart-surgery spirits that might have been lurking within a twenty-five-mile radius of DeKalb County, Georgia. They also made the girls’ drum and bugle corps I had hired wait in the parking lot. They were to hit it when the word came I had survived the operation. You cover all the bases in a situation like this.

  My senior cardiologist, a learned and kind and gentle man, kept those who love me most posted on my progress.

  He told them when I went on the bypass machine. He told them when the surgery was over. I understand the subsequent celebration set no records, but the girls’ drum and bugle corps was well into their third number in the parking lot before somebody called the cops.

  My secretary waited in my office. She was given the word the surgery had been a success. She was to pass it on the thousands who would be calling in.

  I asked her later how many people actually called.

  “Two,” she said.

  “Two thousand?”

  “No, two, period. One was from an old friend calling long distance. He wanted to know if you had lived.”

  “And what did you tell him?”

  “I told him you were alive, but you didn’t know it yet.”

  “Who else called?”

  “The captain of your league tennis team.”

  “What did he say?”

  “Well, after I told him you were okay, he said, ‘Now what in the hell am I going to do with a dozen black armbands?’”

  After the surgery was completed, I was taken to the Coronary Intensive Care Unit where a tube was inserted into my throat and down into my lungs. This is called a respirator tube. It does your breathing for you until your lungs can shake off the effects of the anesthetic and the effect of inactivity while the patient is on the heart-lung machine. It is during this period the lungs fill with fluids.

  My family and friends were allowed into my room in the Intensive Care Unit soon after I arrived there.

  “I thought you were dead,” my wife told me later.

  “You were cold and white as a sheet,” said my stepfather.

  “I’ve seen you look worse only one other time,” said one of my friends.

  When I had the Asian flu and was in bed for a week?

  “No, the morning after you drank the bottle of tequila at the beach and ate the three dozen raw oysters and we found you asleep with your head in the john.”

  I remember that. I was so sick I wanted to drown myself, but I knew I could never make it to the ocean, so I tried the nearest available body
of water.

  Let’s go back to the respirator tube. They had told me about the respirator tube the day before my surgery.

  “We will put in a respirator tube following the surgery. When you first awaken, there will be some discomfort. We will have to restrain your arms because some patients have been known to attempt to remove their respirator tubes.”

  The first thing I did when I regained consciousness following my surgery was to attempt to remove my respirator tube. There’s that medical understatement again. “Some discomfort.” Sheer terror.

  I opened my eyes and I tried to do something very simple like take a breath. I couldn’t take a breath. I tried to take another breath. Nothing. I panicked. I was very much aware of the respirator tube. This, I reasoned, was what was responsible for my inability to breathe.

  I tried to reach to my mouth and pull the respirator tube out of my body and throw it at whomever was responsible for putting it there. I had forgotten the part about my arms being restrained.

  I looked around me. One of my friends was standing to the left of me. Thank God, I thought. He will get this thing out of my throat so I can breathe. I tried to say, “Get this thing out of my throat so I can breathe!” to my friend.

  Something else they had told me that I had forgotten. You can’t talk with a respirator tube in your throat because they shove it down through your voice box. I made a mental note to discuss this with my witch doctors later, in the event I managed to somehow survive this obvious attempt to kill me. Somebody was going to by-God pay for this little trick.

  Then I remembered they had also told me if I wanted to communicate during the time the respirator tube was in my throat, there would be a tablet and pencil near my right hand and I could write out what I wanted to say.

  I felt for the tablet and pencil. Nothing. I had one last chance. I reached my right hand as high as it would reach with the straps around my arm and I tried to write out certain words in the air.