Halloween 2011: I require no elaborate costume or ghoulish prosthetic make-up to join in this year's festivities. I simply need to remove my shirt, revealing the gruesome surgical scar usually concealed from the eyes of polite society. Just watch those greedy trick-or-treaters run off screaming into the night.
"Don't go to the house at the end of the street whatever you do," they will whisper to one another. "He's a real live topless Frankenstein's monster, and he's only got soy Oreos and fish oil candy. It's truly terrifying."
To be honest, I had hoped that the scar would be paler by now, but five months after my operation it still resembles a vertical line scrawled on my chest with a bright red sharpie. I still feel the occasional pull, ache and twinge, too, briefly forcing my mouth into a poorly-carved pumpkin-head grimace; and I sometimes stagger around like a dizzy zombie if I forget to eat before taking my beta-blockers.
All these side-effects: a little bit of trick still left in the treat of recovery, and all perfectly acceptable ready-made Halloween costumes.
Me and Them
These days, aside from the inadequately illuminated exteriors of nightclubs and bars, the ever-diminishing socio-economic group known as of smokers can mostly be found loitering outside hospitals and college campuses, or just about anywhere at all during the very early hours of the morning. I mention this observation, not because I begrudge or wish to prohibit people's pleasure in tobacco, but because at the moment I happen to spend a great deal of my time outside hospitals and college campuses during the very early hours of the morning, so I'm in a good position to know.
The smokers huddle around concrete, institutional ashtrays like vagrants around a makeshift brazier. Occasionally they embark upon random circumnavigations of the paving slabs, or make brief spitting expeditions to the edge of the sidewalk, trailing ephemeral jet-streams of nicotine in their wake. They glower down the street at nothing in particular, then return to the communal hearth to discuss the daily injustices encountered by their kind.
For some reason, there is always a preponderance of pale blue jeans and weather-beaten, brown leather jackets with over-sized shoulders amongst this group of puffing exiles. You could be forgiven for thinking you're walking past an historical reenactment of the 1980s, co-sponsored by Marlboro Lights and some anger management guru. I suppose these must be the loyalist smokers: the hardcore inhalers who refuse to quit despite lungs festooned with and blood vessels that are hardening into strands of pure crystalline plaque.
I, on the other hand, smartly turned out and wearing Clarks suede shoes, like the fresh-faced new boy at school, am extremely early for my first appointment with Cardio-Rehab. The doors don't open for another twenty minutes, so I'm forced to hang around in the cold morning air, pretending to find interest in the Brutalist architecture and freight delivery instructions. I almost wonder if the smoking gang will beat me up before I can escape inside.
I don't consider myself to be superior to them, of course. God knows I have my own fair share of stubborn blind-spots and idiotic misconceptions. It's just that I trust in medical science and they put their faith in the fact their best friend's uncle knew a guy who sucked down three packs a day, unfiltered, and lived to be a hundred-and-five. We have fundamentally different creeds, the smokers and me. I'll soon be running on a nurse monitored treadmill while they're only running out of cigarettes. Perhaps my efforts will all be in vain, but I'd rather try than stare at the floor with black lungs full of tar clouds.
The smokers huddle around concrete, institutional ashtrays like vagrants around a makeshift brazier. Occasionally they embark upon random circumnavigations of the paving slabs, or make brief spitting expeditions to the edge of the sidewalk, trailing ephemeral jet-streams of nicotine in their wake. They glower down the street at nothing in particular, then return to the communal hearth to discuss the daily injustices encountered by their kind.
For some reason, there is always a preponderance of pale blue jeans and weather-beaten, brown leather jackets with over-sized shoulders amongst this group of puffing exiles. You could be forgiven for thinking you're walking past an historical reenactment of the 1980s, co-sponsored by Marlboro Lights and some anger management guru. I suppose these must be the loyalist smokers: the hardcore inhalers who refuse to quit despite lungs festooned with and blood vessels that are hardening into strands of pure crystalline plaque.
I, on the other hand, smartly turned out and wearing Clarks suede shoes, like the fresh-faced new boy at school, am extremely early for my first appointment with Cardio-Rehab. The doors don't open for another twenty minutes, so I'm forced to hang around in the cold morning air, pretending to find interest in the Brutalist architecture and freight delivery instructions. I almost wonder if the smoking gang will beat me up before I can escape inside.
I don't consider myself to be superior to them, of course. God knows I have my own fair share of stubborn blind-spots and idiotic misconceptions. It's just that I trust in medical science and they put their faith in the fact their best friend's uncle knew a guy who sucked down three packs a day, unfiltered, and lived to be a hundred-and-five. We have fundamentally different creeds, the smokers and me. I'll soon be running on a nurse monitored treadmill while they're only running out of cigarettes. Perhaps my efforts will all be in vain, but I'd rather try than stare at the floor with black lungs full of tar clouds.
A Brief Excursion Into The Caves of Self-Justification
Like many writers, I keep a journal beside my bed - not that I actually write anything in mine, of course, but I do keep one all the same. There is a pen, too, although I doubt that any ink runs through its veins. These valuable and venerable tools have been spurned in favor of the smart-phone notepad and its stylus. After all, those digital words are actually readable by their own author; whereas that smudgy, wayward scribble on lined paper, well, just take a look for yourself: Is that blot an f or an s? Does that scrawl say burritos or buttocks? Who the Hell knows? Not I. And it's my handwriting.
Alas, inspiration most often strikes me when I'm taking a shower, a location perhaps unequaled for inconvenience when it comes to writing ideas down quickly, unless you're especially skilled at forming letters in soap scum with the business end of a loofah. And so my most fertile ideas just disappear down the drain, hitching a ride with all those emancipated hairs from my balding head. Gurgle, gurgle, there goes the plot of a best-selling novel and the outline of blockbuster screenplay. Oh well, at least I remembered to wash behind my ears.
Of course, good writing is, like Thomas Edison's famous formula for success, mostly the reward of perspiration rather than inspiration. So I suppose the preceding paragraphs are a scant excuse for lack of quality or quantity on my part. After all, I am not the sort of diligent, industrious writer who drips with sweat and elbow grease after an eight hour shift at his desk. But then I'm cursed with the existential concerns and tedious labors of a proper job, squatting on my brain like a killjoy gang of lugubrious toads and obstructing progress on more interesting and amusing projects.
This blog, for instance. True, it is perhaps the world's least informative coronary artery disease resource, and rarely makes a serious point that isn't blunted by some degree of facetiousness, but at least it's written with some degree of verve whenever I actually find the time to record my experiences, even if they are a shamefully thin gruel compared to the soul-searching tales of triumph over adversity recollected by other bypass "survivors".
Alas, inspiration most often strikes me when I'm taking a shower, a location perhaps unequaled for inconvenience when it comes to writing ideas down quickly, unless you're especially skilled at forming letters in soap scum with the business end of a loofah. And so my most fertile ideas just disappear down the drain, hitching a ride with all those emancipated hairs from my balding head. Gurgle, gurgle, there goes the plot of a best-selling novel and the outline of blockbuster screenplay. Oh well, at least I remembered to wash behind my ears.
Of course, good writing is, like Thomas Edison's famous formula for success, mostly the reward of perspiration rather than inspiration. So I suppose the preceding paragraphs are a scant excuse for lack of quality or quantity on my part. After all, I am not the sort of diligent, industrious writer who drips with sweat and elbow grease after an eight hour shift at his desk. But then I'm cursed with the existential concerns and tedious labors of a proper job, squatting on my brain like a killjoy gang of lugubrious toads and obstructing progress on more interesting and amusing projects.
This blog, for instance. True, it is perhaps the world's least informative coronary artery disease resource, and rarely makes a serious point that isn't blunted by some degree of facetiousness, but at least it's written with some degree of verve whenever I actually find the time to record my experiences, even if they are a shamefully thin gruel compared to the soul-searching tales of triumph over adversity recollected by other bypass "survivors".
The Greek Way
In ancient Greek myth, the Gods always punish the human crime of hubris with all manner of grisly fates: getting turned into a spider or a weeping stone; suffering for eternity with an unquenchable thirst; being chained to a rock while an eagle devours your liver; and, although there's no specific mention of heart disease in any myth I'm aware of, it's surely possible that Nemesis also clogged the arteries of arrogant Athenians with divinely vengeful cholesterol and plaque. Imagine, if you will, a shepherd from about three thousand years ago, perhaps someone not entirely unlike me, wandering happily on the sun-kissed plains of Attica telling everyone that he feels as fit as Zeus, only to be suddenly struck down with stabbing chest pains and rushed to the nearest Asclepieion. Such were my thoughts, anyway, as we boarded the British Airways flight to Eleftherios Venizelos Airport.
We had booked the Greek trip many months before I had felt even the slightest twinge of a chest pain, back when the idea of undergoing heart bypass surgery seemed as unlikely as me diving into a large vat of Tzatziki sauce; and so at certain low moments during my hospitalization I doubted whether I'd actually ever make it there; not because I thought I might die or anything quite as grim as that, but because I knew that the extensive physical recovery required might put island hopping with luggage well beyond my puny, convalescent reach. And to be sure, there was a period when I would have encountered almost insurmountable difficulty crawling to the Greek restaurant at the end of the road, never mind jetting off to Athens and points Aegean. Fortunately, the human body brushes aside its traumas much faster than you might expect, and I was able to pack my guidebooks and collect my boarding pass after all.
Having said that, the conclusions of Socratic method, Aristotelian logic, and even a brief appeal to simple common sense would all advocate against climbing the Acropolis - 500 feet above sea level - in my delicate condition; yet I staggered up to the top anyway. Call it Byronic whim (Robert Byron), but making an ascent had seemed like the thing to do when staring at the Parthenon from our hotel window. And also I feel a great affinity for this ancient temple, since its creaky columns are currently held together with iron scaffolding, much like my breastbone is held together with tiny sternal wires.
After all, if the Parthenon is still standing after three thousand years, despite the attentions of Turks, tourists and Lord Elgin, then I suppose I can survive to a venerable age also, providing the Greek gods and their Furies don't read this blog, obviously.
We had booked the Greek trip many months before I had felt even the slightest twinge of a chest pain, back when the idea of undergoing heart bypass surgery seemed as unlikely as me diving into a large vat of Tzatziki sauce; and so at certain low moments during my hospitalization I doubted whether I'd actually ever make it there; not because I thought I might die or anything quite as grim as that, but because I knew that the extensive physical recovery required might put island hopping with luggage well beyond my puny, convalescent reach. And to be sure, there was a period when I would have encountered almost insurmountable difficulty crawling to the Greek restaurant at the end of the road, never mind jetting off to Athens and points Aegean. Fortunately, the human body brushes aside its traumas much faster than you might expect, and I was able to pack my guidebooks and collect my boarding pass after all.
Having said that, the conclusions of Socratic method, Aristotelian logic, and even a brief appeal to simple common sense would all advocate against climbing the Acropolis - 500 feet above sea level - in my delicate condition; yet I staggered up to the top anyway. Call it Byronic whim (Robert Byron), but making an ascent had seemed like the thing to do when staring at the Parthenon from our hotel window. And also I feel a great affinity for this ancient temple, since its creaky columns are currently held together with iron scaffolding, much like my breastbone is held together with tiny sternal wires.
After all, if the Parthenon is still standing after three thousand years, despite the attentions of Turks, tourists and Lord Elgin, then I suppose I can survive to a venerable age also, providing the Greek gods and their Furies don't read this blog, obviously.
Perihelion
A new brand of toilet paper has made itself at home in our bathroom. It's called "Quilted Northern," as if it were especially designed for camping trips during the freezing rains and howling gales of late November in New England; just another item to add to the list of seasonal chores to be completed before winter arrives:
1. Retrieve woolens and heavy coats from storage.
2. Insulate the windows with thermo-seal.
3. Chop firewood.
4. Buy a family pack of Quilted Northern.
And, alas, winter is nearly upon us. Persephone has packed her bags and is preparing to make her way to Hades for half the year. Which is why, having missed most of the summer with my heart surgery, I'm going to recreate June by seeking the sun wherever it still shines.
So next week, rather than traipse around to the cardiologist's office or the rehabilitation center as usual, I thought I'd make an excursion to the Greek islands instead. After all, what can be better for your heart than tramping up and down zillions of steps as you attempt to find your hotel in a maze of whitewashed buildings clinging to the cliff side, especially after a grueling, stressful flight from Boston via London and Athens. Still, there will be a healthy Aegean meal of fish heads in sour yogurt and squid ink waiting for me, along with a glass of that Santorini wine they ferment from strange grapes that grow on circular vines in the volcanic ground.
Interestingly, toilet paper looms large in the legend of Greek vacations, although I'm sure they don't sell black market Quilted Northern at the local Agora. Toilet paper, it seems, cannot be flushed down the toilet, and must be placed in appropriate receptacles instead. Beware of Greeks bearing plumbing supplies, apparently! How odd that Athenian engineers could master the Doric column but not the plastic u-bend pipe.
Nevertheless, I refuse to allow such hygienic inconveniences to ruin my delayed summertime. I shall be soaking up the rays and sampling the moussaka regardless. And, obviously, I will not be too concerned with updating this blog for the duration of my vacation, either. So do not worry if nothing more appears here until October the tenth or so. I am not dead, but merely wondering what happens if you drink ouzo and then swallow a dose of Crestor on an empty stomach.
1. Retrieve woolens and heavy coats from storage.
2. Insulate the windows with thermo-seal.
3. Chop firewood.
4. Buy a family pack of Quilted Northern.
And, alas, winter is nearly upon us. Persephone has packed her bags and is preparing to make her way to Hades for half the year. Which is why, having missed most of the summer with my heart surgery, I'm going to recreate June by seeking the sun wherever it still shines.
So next week, rather than traipse around to the cardiologist's office or the rehabilitation center as usual, I thought I'd make an excursion to the Greek islands instead. After all, what can be better for your heart than tramping up and down zillions of steps as you attempt to find your hotel in a maze of whitewashed buildings clinging to the cliff side, especially after a grueling, stressful flight from Boston via London and Athens. Still, there will be a healthy Aegean meal of fish heads in sour yogurt and squid ink waiting for me, along with a glass of that Santorini wine they ferment from strange grapes that grow on circular vines in the volcanic ground.
Interestingly, toilet paper looms large in the legend of Greek vacations, although I'm sure they don't sell black market Quilted Northern at the local Agora. Toilet paper, it seems, cannot be flushed down the toilet, and must be placed in appropriate receptacles instead. Beware of Greeks bearing plumbing supplies, apparently! How odd that Athenian engineers could master the Doric column but not the plastic u-bend pipe.
Nevertheless, I refuse to allow such hygienic inconveniences to ruin my delayed summertime. I shall be soaking up the rays and sampling the moussaka regardless. And, obviously, I will not be too concerned with updating this blog for the duration of my vacation, either. So do not worry if nothing more appears here until October the tenth or so. I am not dead, but merely wondering what happens if you drink ouzo and then swallow a dose of Crestor on an empty stomach.
Hospital Nostalgia
Listening to a sample of patients outline their experience of our health care system, each account being uncompromisingly different than the others, I recalled the old Hindu parable about six blind men describing an elephant resulting in six descriptions of six very different beasts. Here was a menagerie of opinions: some friendly, some not so friendly, and some that were downright poisonous. Alas, since these various opposing viewpoints are so divided and dogmatic, any public discussion of the subject eventually descends into a cacophony of incoherent yelling that sounds more like feeding time at the zoo than a serious debate.
My own experience, by comparison, has been reasonably peaceful: a docile panda quietly chewing on a bamboo shoot in its Qinling cave. But then I have extensive health insurance, so I suppose I can afford to be philosophical. In fact, as post-operative time goes by, it might even be suggested that I've developed hospital nostalgia.
Whenever I'm passing Massachusetts General Hospital, for instance, I always feel compelled to stop in and say hello. It seems absolutely necessary that I should stay in touch with the place, as if the hospital were an old comrade whom I fought beside in a long and bitter war. I miss that satisfying degree of excusable self-importance and deep sense of personal value that invasive surgery confers. I miss the doting nurses, confident doctors and reassuring specialists in their white coats and pastel scrubs. I miss the spirit of purpose and determination that glides along the spotless corridors. But most of all I miss the science-fiction sights and sounds of modern bio-technology in motion. Anyone might imagine that an omniscient and infallible computer-brain was supervising every bed, supported by an ultra-serene, dome-headed staff wearing silver togas and hover-sandals.
M. G. H. certainly radiates an aura of a World's Fair "City of the Future": a perfectly landscaped amalgamation of international hotel, travel node, unisex spa and shopping mall, all connected by a gleaming spider's web of glass-covered sky-walks leading to an endless array of color-coded lobbies, vestibules and mezzanines. Consequently, visiting the hospital feels rather like a lengthy layover at Frankfurt airport (although they don't slice your chest open and fiddle around with your heart at Frankfurt airport, well, at least not anymore). But I'm sure that many malcontents simply consider the place to be a grubby bunker full of creaking wheelchairs and stone-faced staff. Some people are never happy, even if their health care is paid for with someone else's taxes or covered by a fully contributing company insurance plan. Personally, I'm just filled with gratitude that I'm still alive, so I don't complain.
My own experience, by comparison, has been reasonably peaceful: a docile panda quietly chewing on a bamboo shoot in its Qinling cave. But then I have extensive health insurance, so I suppose I can afford to be philosophical. In fact, as post-operative time goes by, it might even be suggested that I've developed hospital nostalgia.
Whenever I'm passing Massachusetts General Hospital, for instance, I always feel compelled to stop in and say hello. It seems absolutely necessary that I should stay in touch with the place, as if the hospital were an old comrade whom I fought beside in a long and bitter war. I miss that satisfying degree of excusable self-importance and deep sense of personal value that invasive surgery confers. I miss the doting nurses, confident doctors and reassuring specialists in their white coats and pastel scrubs. I miss the spirit of purpose and determination that glides along the spotless corridors. But most of all I miss the science-fiction sights and sounds of modern bio-technology in motion. Anyone might imagine that an omniscient and infallible computer-brain was supervising every bed, supported by an ultra-serene, dome-headed staff wearing silver togas and hover-sandals.
M. G. H. certainly radiates an aura of a World's Fair "City of the Future": a perfectly landscaped amalgamation of international hotel, travel node, unisex spa and shopping mall, all connected by a gleaming spider's web of glass-covered sky-walks leading to an endless array of color-coded lobbies, vestibules and mezzanines. Consequently, visiting the hospital feels rather like a lengthy layover at Frankfurt airport (although they don't slice your chest open and fiddle around with your heart at Frankfurt airport, well, at least not anymore). But I'm sure that many malcontents simply consider the place to be a grubby bunker full of creaking wheelchairs and stone-faced staff. Some people are never happy, even if their health care is paid for with someone else's taxes or covered by a fully contributing company insurance plan. Personally, I'm just filled with gratitude that I'm still alive, so I don't complain.
Lessons from the Past
It is never wise to investigate your own psychological quirks, but I have always struggled with a mysterious compulsion to save and collect cardboard tubes. The flimsy infrastructure of a roll of paper towels, for instance; even the little ones inside toilet rolls; and especially the sturdier variety of tube used to transport unfoldable posters and parchment through the postal system. I feel the pressing need to hoard them all. For some misbegotten reason, my mind seems to stubbornly maintain the childish notion that I could make something interesting out of them. But what?
The fuselage of a model rocket ship is pretty much the only object that suggests itself, and even then only after the cardboard tube has been wrapped in silver foil. But at my age I really can't imagine running around the living room, a home-made model rocket ship held in the air, shouting "zoom, zoom" and requesting permission to land on the sofa.
So I guess this cardboard tube obsession must be a memory trigger from days at kindergarten, when collecting cardboard tubes was essential for all boy's craft projects because rocket ships were the only things we made.
"What are you making today Stephen?"
"I'm making a rocket ship out of a cardboard tube."
"But didn't you make a rocket ship out of a cardboard tube last week?"
"Yes, but that was only a toilet roll tube. This one's made out of the sturdier variety of tube used to transport unfoldable posters and parchment, which means it can go to Mars."
Apparently a ghost synapse from my five-year-old self still wanders through my brain looking for things to do: a ghost synapse summoned back from its cellular grave by the sight of a cardboard tube. It could be worse, I suppose. It could be a memory trigger from childhood that involves urinating in public pools, for example. Not that I go swimming in public these days; not with a grievous and angry incision scar like mine.
But let us not dwell on the distant echoes of yesteryear. To paraphrase Saint Paul's famous epistle to the Corinthians: "When I was a child, I spake as a child, I understood as a child, I thought as a child: but when I became a man, I put away childish things, and then one day I needed to have heart surgery." Indeed, and no doubt you are wondering what possible connection could exist between cardboard tubes and coronary artery bypass surgery. After all, it's not as if I am going to manufacture a larger than life model of my heart using cardboard tubes as the arteries, is it?
Or is it? I discovered this small model of a heart in an examination room while waiting for my cardiologist to arrive. Although intriguing enough to look at and photograph, it was a solid lump of plastic lacking any interactive elements; about as useful as a Mr Potato Head missing its stick-on facial features. What a pity, I thought, that its various components cannot be removed and reattached in order to demonstrate the ins and outs of specific surgical procedures. I could make a superior model, I decided, with a bucketful of papier-mâché, spirit gum, and several detachable cardboard tubes of assorted lengths and diameters.
When completed, and after being painted an appropriate shade of Valentine red, my lightweight plug-and-play model heart would be a perfect teaching tool: "To replace a defective artery with a new, disease-free artery you simply pull the old tube out and then fold tab A of the new tube into corresponding slot A of the new tube, and repeat the process with tab B and slot B, etc. Of course, you'll be working with real arteries so it will be a bit messier than this, but you get the general idea. Ooops. Oh no. My thumb has just accidentally crushed the left ventricle."
I'm not proposing that my cardboard tube model heart should be employed in an actual medical school, obviously, but for today's super-fat kids in kindergarten, well, it might give them some idea of what's in store for their cholesterol-soaked organs at some point in the future. How I wish I had been taught such important lessons when I was their age, instead of making stupid rocket ships.
The fuselage of a model rocket ship is pretty much the only object that suggests itself, and even then only after the cardboard tube has been wrapped in silver foil. But at my age I really can't imagine running around the living room, a home-made model rocket ship held in the air, shouting "zoom, zoom" and requesting permission to land on the sofa.
So I guess this cardboard tube obsession must be a memory trigger from days at kindergarten, when collecting cardboard tubes was essential for all boy's craft projects because rocket ships were the only things we made.
"What are you making today Stephen?"
"I'm making a rocket ship out of a cardboard tube."
"But didn't you make a rocket ship out of a cardboard tube last week?"
"Yes, but that was only a toilet roll tube. This one's made out of the sturdier variety of tube used to transport unfoldable posters and parchment, which means it can go to Mars."
Apparently a ghost synapse from my five-year-old self still wanders through my brain looking for things to do: a ghost synapse summoned back from its cellular grave by the sight of a cardboard tube. It could be worse, I suppose. It could be a memory trigger from childhood that involves urinating in public pools, for example. Not that I go swimming in public these days; not with a grievous and angry incision scar like mine.
But let us not dwell on the distant echoes of yesteryear. To paraphrase Saint Paul's famous epistle to the Corinthians: "When I was a child, I spake as a child, I understood as a child, I thought as a child: but when I became a man, I put away childish things, and then one day I needed to have heart surgery." Indeed, and no doubt you are wondering what possible connection could exist between cardboard tubes and coronary artery bypass surgery. After all, it's not as if I am going to manufacture a larger than life model of my heart using cardboard tubes as the arteries, is it?
Or is it? I discovered this small model of a heart in an examination room while waiting for my cardiologist to arrive. Although intriguing enough to look at and photograph, it was a solid lump of plastic lacking any interactive elements; about as useful as a Mr Potato Head missing its stick-on facial features. What a pity, I thought, that its various components cannot be removed and reattached in order to demonstrate the ins and outs of specific surgical procedures. I could make a superior model, I decided, with a bucketful of papier-mâché, spirit gum, and several detachable cardboard tubes of assorted lengths and diameters.When completed, and after being painted an appropriate shade of Valentine red, my lightweight plug-and-play model heart would be a perfect teaching tool: "To replace a defective artery with a new, disease-free artery you simply pull the old tube out and then fold tab A of the new tube into corresponding slot A of the new tube, and repeat the process with tab B and slot B, etc. Of course, you'll be working with real arteries so it will be a bit messier than this, but you get the general idea. Ooops. Oh no. My thumb has just accidentally crushed the left ventricle."
I'm not proposing that my cardboard tube model heart should be employed in an actual medical school, obviously, but for today's super-fat kids in kindergarten, well, it might give them some idea of what's in store for their cholesterol-soaked organs at some point in the future. How I wish I had been taught such important lessons when I was their age, instead of making stupid rocket ships.
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