It’s been lurking over my head like the Sword of Damocles for years. It started in 1966, just an ordinary day when I was a junior in high school. I was in a study hall in the cafeteria with a friend, when another kid, clearly a messenger type, came over:
“Mr. West wants to see you.”
My friend laughed. “Oh. Oh. You’re in trouble!” Mr. West was the principal.
But I wasn’t in trouble. At least not the disciplinary kind that usually led to an “audience” with the principal. No. Mr. West asked me to sit down. Then he told me that my father, a history teacher in the school, had a heart attack while teaching. I learned later that Mr. West had given him mouth to mouth resuscitation.
The changes in my family life were swift after his heart attack. The cigarette smell in the house disappeared. And all these years later, what really sticks in my mind is how our time-honored early Sunday afternoon Italian dinner changed instantly. It became a shell of what it once was: Most of the ingredients that gave my mother’s mouth-watering tomato sauce its flavor disappeared: Gone were the meatballs, the sausage, the pork, the hardboiled eggs, the salt. We all adjusted to the forced changes in our world. Except for my father. I believe his heart attack was the last straw: Between my first and eleventh years on Earth, he suffered five operations for kidney stones. After this heart attack, he seemed to become a shell of the laughing, joyful father I used to know.
Five years later, he underwent coronary bypass surgery to save his life at Columbia Presbyterian Hospital in New York City. It did…temporarily. Four years later, at fifty-four, I found him dead of a massive heart attack on his favorite chair. “Your father lived a life of hell,” my father’s doctor said to me after he died. The sword of Damocles dangled over my head just a little more.
It was harder this time; but my mother, my brother and I adjusted again. Taking care of my father had been my mother’s life. Now she was alone. She had her job; but could find no real purpose. And then she got sick. A diabetic, she suffered a stroke when she was sixty. Ten years later, she started to feel pain in her jaw and right shoulder and underwent a cardiac catheterization, after which her doctor told me “Your mother is in grave danger.” They took her by ambulance to a hospital from our local hospital to Beth Israel in Newark, New Jersey that night, where she underwent surgery the next morning to save her from the same fate as my father. It didn’t. She survived the surgery; but not the infection that consumed her. I’m not sure I ever felt more helpless as I sat day after day next to her bed as she languished on a ventilator. I don’t remember what made me think of it, but I came back one day with a recorder and played Frank Sinatra music for her. And in one of those musical moments in her room, lit only by the dim lights from the hallway, I was sitting next to her, staring at her beautiful face, and I still swear I saw her eyes smile.
When the brutal truth that she wouldn’t survive hit us, my brother and I got a chance to say goodbye alone. I didn’t plan on it; but I recounted my life with her, and told her I was sorry for anything I had done that hurt her, and asked her forgiveness. And when she immediately shook her head yes, which I knew she would do, I was her baby, she always protected me. And even then, in the few remaining moments before the end of her, she still protected me. She died an hour later, as my brother and I stared at the monitor’s flat line of extinction. And I remember thinking the machine would have gone on forever telling us she was dead, if the nurse hadn’t finally shut it off. And the sword…
I told one of my doctor about ten years ago that I didn’t smoke three packs a day or eat salami sandwiches at two in the morning like my father so I believed I could avoid his fate. But he said “I know. But you still have those genes.” I knew he was right. It would be my turn someday, I imagined.
Today, I live with my wife Alexis as vegetarians and I exercise strenuously at a gym five days a week. Fear, for me, has been a great motivator. A few weeks ago, I started going to a new doctor and when I told him about my family history, he said “you have a lot going on with those genes” and ordered some tests. One was a CT Scan with Calcium Scoring. When the results came in, he told me that I was a high risk for a heart attack, and that I had significant calcium buildup in the left anterior descending artery. The slang for that artery is crushing: “The widow maker.” I was in shock for two days. I lived under a dark cloud. Yet it confirmed what the cynical part of me seemed to know, that no matter what I did or how well I took care of myself, that the death sentence my mother and family had was coming for me, that my family history had finally come home to roost.
That night, I woke up at four in the morning and was alone in the cavernous space inside my head, even though my wife Alexis and our dog Sophia were on the same bed. My anxiety soared like a Saturn rocket. For the first time in my life, I saw my death not as some abstract future event but as a reality staring me in the face. I felt mentally naked. Helpless against this invisible killer. My life was in the hands of some mysterious bodily process, devoid of human empathy, a droning workmanlike march that would lead to my extinction. In my ruminating that night, I had no control of my mind, as it wandered in the dark and quiet of the night, ravaging me with all of my failures and regrets. I didn’t need a near-death experience to see my life flashing in front of me. It came at me like a meteor shower. Somewhere in the midst of my anguish, I saw my father lying dead in his favorite chair and my mother dead with the ventilator still lodged in her mouth and the monitor flat lining. Where would I be when it happened? When would I feel the shortness of breath, the radiating pain in my left arm, the crushing pressure on my chest, and what would the last few seconds of consciousness be like, when the horror strikes that you can no longer breath? My impending death that night seemed inevitable. I hoped it would be quick for me as I hoped it had been for my father. It hadn’t been for my mother.
“Is this reversible?” I asked my new doctor after we talked about the calcium scan results. He just shook his head no: “This is sixty-eight years of buildup.” I had an immediate image of my arteries stockpiling dangerous calcium deposits while I cavorted through life, and when he explained the different risks of the hard and soft plaque, I understood why they could unleash a catastrophe inside me. At any time.
There is something hard to explain about how I felt with the sudden realization that I could die at any moment from a heart attack. Insignificant events seemed important, as if they were magnified under a microscope. I actually felt more alive. Each moment seemed precious. While at the same time, even the most joyous events were tarnished. And so these days I find myself hugging Alexis more. And I worry about leaving her alone after I’m gone.
“I know you’re going to be alright,” She tells me over and over. There is a certainty in her voice that makes me want to believe her with all my heart. Her optimism consumes me and lifts my spirits. And I feel great physically, regardless of this invisible threat. Two mornings later, her optimism was in my thoughts as I fearfully stepped foot into the gym for the first time since I found out. I’m not sure when it happened or why; but I felt an urge to take charge. I couldn’t accept this threat passively while I was sitting on an elliptical trainer. It was the place I really pushed myself. As I started to warm up, the fear subsided and I began to push myself harder. And harder. Before long, my heart was pumping over 140 for each 30-second interval. I pushed like this during my entire 30-minute workout. At one point, I thought about what my new doctor had said about exercising: “Just don’t push yourself too much until we find out more.”
Fuck it, I thought. If I’m gonna’ die of a sudden heart attack, at least this gives me some control over where and when. Let me induce this fucker, challenge it, look it right in its coronary eye and push my heart into overdrive, get the blood flowing like a tidal surge after a hurricane, crashing through plaque, cholesterol and anything else. I’ve been pushing every day since, and I feel a thousand times better about my condition.
So in a few days, I’m going for that Coronary CTA scan to find out the percentage of blockage in my major arteries. I got a call from a nurse to ask me some questions and to tell me how to prepare:
“Do you have any chest pain or shortness of breath?”
“Have you ever had a heart attack?”
“Have you ever had angioplasty?”
“Have you ever had a stent?”
“Have you ever had cardiac surgery?”
“Do you have diabetes?”
“Do you have high blood pressure?”
“Have you ever had a stroke.”
“May I ask why your doctor ordered this scan. Usually people have some symptoms.”
“Family history,” I said.
“Oh. Okay. You have to come two hours early because we will put you on an I.V. Then they will inject you with iodine. You’ll feel a bit warm after this.”
During that first sleepless night, I wrote a last will and testament so Alexis would know, above all else, that during my cremation funeral service I wanted just three things: A Philip Glass musical piece called “Facades;” my guitarist friend Ed playing Neil Young’s “Old Man;” and absolutely no sign of anything religious. While I really did want those things, I had to inject some humor, because it was the only way to relieve the anxiety.
I’m ready for this new scan. I approach it with confidence. But even if there is another shock in store for me, if after the scan they tell me that I have major blockages in my coronary arteries, and that I’m in grave danger as others told my mother years ago, here’s what I’ll say:
“Fuck it. I’m going to the gym right now.” I ain’t going under the knife while I feel so good. Instead, I’ll keep facing it down at the gym.