The Heart of the Matter

“EKG done, the triage nurse takes over, checks your blood pressure (high), your oxygen intake (decent, but lower than usual), temperature (normal). She looks more closely at the computer, then at you, ‘Wow. I’d never guess your age by looking at you,’ she smiles, means it as a compliment.” —Helen Noakes

Waking Point

By Helen Noakes

“If my doctor told me I had only six minutes to live, I wouldn’t brood. I’d type a little faster.” —Isaac Asimov

SAN FRANCISCO California—(Weekly Hubris) —7/6/2015—You go to the UCSF Clinic with an issue you think will be easily resolved.

“My lungs feel tight,” you say to a doctor with a benevolent smile. “My sinuses are blocked. It’s difficult to breathe. It feels like a weight on my lungs, here.” You point to the center of your upper chest, hope that you are conveying your symptoms precisely, realizing that physical symptoms are as difficult to put into words as deep emotions, fear, epiphanies. You add, “It’s my allergies. An inhaler would probably do the trick.”

He says the words you dread, “It might be your heart.” You’ve failed to persuade. You, who are in love with words, who use them daily to tell stories, drive away demons, heal—you have failed. His words, though anticipated, jolt you, bring up a litany of objections, tears. He gives you a choice, but urges that you go to the ER.

“I understand,” you say. And you do, but you don’t want to. “Hearts are complex things,” you comment, and wonder why.

You agree to do as he says, but reject the hospital protocol to have an ambulance drive you from the clinic to the ER across the street. You try to find humor in the protocol, but mirth eludes you. It’s the certainty that checking into the ER at 6:30 in the evening means you won’t be out until 3 in the morning. You know whereof you think, recall the hell of the waiting room with its babbling television, the exhaustion of dealing with a parent whose range of emotions (from whining to fury) would suck the life out of you for eight, twelve hours, and you wonder what they’ll find, what will happen next.

The doctor won’t hear of your walking across the street by yourself, insists on taking you there. In his offer, you see the wonder of this man, his sensitivity and gentleness. You are grateful to him, to the destiny that steered you to him, and you are almost undone by emotion. Almost.

As you pass the larger-than-life-sized statue of Hippocrates at the hospital entrance, you recall your mother proudly saying to anyone who would listen, “He was Greek, you know,” every time you’d take her to her numerous doctors’ appointments; every time.

During the short walk, the doctor tries to distract you, asks about your writing. Aware of what he’s doing, you smile at him, silently shower blessings on his kind heart. After explaining why you’re there to the nurse, he hugs you and reassures you. “It’s only a precaution,” he smiles. Now, you are undone.

The brief embrace, that act of empathy, means more to you than you can quite explain. “Every bed is taken,” the nurse tells you. “We’re doing our best.” A little shakily, you find a seat in the bright waiting room.

The television transmits the constant chatter of a sports channel. You look away, try to block it out, but snippets about a deflated ball scandal intrude. You look up to see Tom Brady’s slick smile. Go away: I don’t give a damn about your balls.

A Hispanic woman who was there when you arrived sits next to a man and whimpers. He stares stoically into space, paying her no attention. She gets up and walks to the other side of the room, as if to get away from what ails her, and wails.

A middle-aged man is chatting with a young man sitting a seat away from him. They’re comparing electronic devices. A young woman with badly bruised knees sits glowering across from the older man. Every so often, he looks at her, tries to persuade her to be patient.

A young Asian man opens the inner door, calls your name. You know this doesn’t mean you’re getting a bed. Triage? No. He’ll be doing your EKG. As he puts the stickers on your body, wires you up, you recall the innumerable times you’ve watched this done to your mother, and feel a little nauseated. He checks the computer. “Are you really that old? I don’t believe it!” he exclaims incredulously and takes a second look at you.

“Neither do I,” you reply, feeling like a disgruntled cyborg.

EKG done, the triage nurse takes over, checks your blood pressure (high), your oxygen intake (decent, but lower than usual), temperature (normal). She looks more closely at the computer, then at you, “Wow. I’d never guess your age by looking at you,” she smiles, means it as a compliment.

“You should see me when I don’t look like the wrath of God.” She chuckles, sends you back out into the waiting room.

The Hispanic lady is now surrounded by five people. She’s wailing in pain.

You find a seat across from the two Apple-happy men, who are engrossed in their tablets, pull out the paperback you brought with you in expectation of a long wait at the clinic (Edna O’Brien’s A House of Splendid Isolation), try to read.

The Hispanic woman is now kneeling on the floor behind you, screaming, encircled by four women. Six more people arrive to attend her. You want to help, but something cautions you not to. You pity her; wish a bed would become available for her soon. You marvel at the strength of these families, their concern for one another. You’re here alone and vaguely wish that someone were with you, but then decide it’s best not to bother anyone. You’d be imposing.

The sports channel is grating, loud; excited voices spout gibberish. You glare up at the screen, wishing the TV an instant death. The middle-aged man across from you notices, asks, “You don’t like sports?”

“Why do they have to be so loud?” you respond.

He takes it as an invitation to sit next to you. “I don’t like sports, either,” he smiles broadly at you and starts a conversation. You try to be polite. The young woman angrily demands to leave. Again he coaxes her to stay. “Bay To Breakers,” he explains. “My daughter fell.” You nod. He continues talking about this and that. The daughter grouses again. Dad cajoles. It’s a pattern with these two. You return to your book. In your peripheral vision you notice he’s gazing at you. Really? I should look like hell more often, you think, don’t acknowledge him, preferring your splendid isolation. But you’re neither isolated nor feeling particularly splendid. He returns to his previous seat.

At 8:20, they call the Hispanic woman’s name and she’s admitted. I’m glad for her. Her wails and screams had escalated. The girl with the bruised knees follows. At 8:30, you’re taken to a small, quiet room, newly painted, equipment gleaming. You know what comes next, have seen the procedure often enough, and are oddly calm as you remove clothes, get into a gown, lie down.

The young woman who inserts the IV needle finally finds a good vein. It’s almost painless. She checks the computer, tells you they’re going to do a blood test called troponin, which requires two blood draws six hours apart. You do a quick calculation. It’s almost 9 when she draws your blood, the second draw will be at 3, and then the lab work. You almost groan, but know it won’t do any good. She taps something into the computer, turns to you with a smile, “You look so young for your age?” You should be flattered but all you can think is I’ll be out of here at 4 a.m.! You manage a wan smile.

The duty nurse comes in, hooks you up to monitors that take you back into cyborg mode. She has a soft Irish lilt to her voice, sees your Edna O’Brien, examines it, chit-chats, looks at the computer. “I’d never have guessed your age. What’s your secret?”

“Being born Greek,” you tell her and wonder what all this fuss about your age is about. America! We’re a youth culture, you conclude.

She leaves you to your book, to the monitor’s beeps and whirrs, to the vice-like grip of the blood pressure cuff. You look at the reading, 174/85, and resolve to do something about it. You take a few breaths, do some Reiki on yourself. A doctor enters, checks your vitals, compliments you on your foresight in bringing a book, checks the computer screen, and yes, you guessed it, says: “You look so young!”

“You should see me when I’m tricked out,” you tell her. She chuckles, tells you the cardiologist will be checking you in a while, leaves. I’m running out of wisecracks, you think as your blood pressure is taken again. It’s dropped by 20 points.

You do a little more Reiki, the cardiologist enters after you’ve been working on yourself for half an hour. Your blood pressure has dropped another 20 points. He listens to your heart, looks at you closely, asks, “Is your resting heart rate always at 50?” You don’t know.

“Is that bad?” you ask.

“No, it’s a perfect resting rate.” You nod, “I was working on myself before you came in. Yoga breaths; that sort of thing.”

“That’s impressive,” he remarks. You ask about your blood test. It’s negative, but they have to do the second draw to confirm.

A new nurse shows up, takes the second blood draw, suggests you sleep. You close your eyes, drift, empty your mind, decide all you can do now is wait. Finally, the nurse comes back, checks the computer, tells you that the second test is negative. You sigh, relieved. “How will you get home?” he asks. You went to the clinic in a streetcar, you explain.

“Would someone please call a cab?”

Just as you finish dressing and think you’re home free, another doctor arrives to tell you that you’ll need a stress test, just to be sure. Damn! You know what happens when they start saying “Let’s rule it out.” You’ve been there, done that with your mom: interminable tests, doctors’ visits.

The cab driver holds the door for you, treats you kindly. I must look like the walking dead. He tells you how much he likes the night shift, how glad he is that he didn’t pick up the crazy kind of patients he picks up at San Francisco General. He tells you of one patient who got up on the back seat and started to dance.

“I won’t dance; don’t make me,” you quip.

He laughs, says, “You be Ginger; I’ll be Fred.”

You smile, say, “I love San Francisco.”

Note: The heart image used to illustrate this column derives from Jessica Lloyd-Jones.