“The Kind that Takes Care of Hearts”

Being an account of the events of week-before-last in e-pistolary form.

Hello all~

A few hours ago Tom had some minor chest pain accompanied by some left arm strangeness. Rather than wait for [our son] to tell us to go to the hospital, we called 911 (hey, at least I thought of it this time!). They came, and though most of his vitals were okay, his EKG was abnormal -- but as they put it, it could be "normal" for him now that he's got the stent. They suggested the hospital, so away they went in the ambulance, [Cute Bear] and I following close behind.

The ER doctor felt that the best course of action was to call his cardiologist and see what he wants to do. The two choices are either a stress test (please keep your fingers crossed) or another angiogram, to see if the stent has either been dislodged or clogged, or something else we don't want. It's also possible that he will suggest something that the ER doctor wouldn't know about. Given how recently the stent was put in (about 5 weeks ago), and the fact that he's been on his meds, watching his diet, and began exercising, it's unlikely that there's any problem with the stent. However, sometimes the body rejects the foreign object despite the meds and problems happen.

We're hoping that it was a big fat nothing, and that Tom and I were overreacting due to the seriousness of the last event. Best case scenario, he stays in the hospital . . . for 24 hours for observation.

So in the meantime I need 3 things:
1. Prayers, good intentions, or whatever spiritual thing you do that will send positive and healing vibes to us all.
2. Help with childcare. I still need to work, and I would really love to visit Tom (he doesn't do well in hospitals alone).
3. Visit Tom at the hospital. As of this moment (3:53am) he's not yet in a room, but that should happen within the next hour or two. He does have his cell, but I don't know how accessible it is to him -- what with all the wires and such.

Again, help with [CB] is critically important right now. If you have some time you can come over, PLLLLEEEEEAAAASE let me know. Help is greatly appreciated.

Thanks a million~
Much love~

Jenny


Hello everyone~

Well, thanks to your thoughts, prayers, and good intentions, Tom pulled through the heart cath this morning with flying colors. I haven't spoken with the doctor yet, but my mother-in-law did and she told me that there was nothing new (bad) going on, and some minor adjustments in Tom's meds should do the trick. Likely the cause of the pain was triggered by anxiety (who knew?) and being that he'd just had a balloon and a piece of metal in that part of his body, it's the weakest link in his system so logically would be affected.

Anyway, I think he comes home from the hospital (Florida South) tomorrow sometime (but in hospital time that means this year... maybe).

This has been incredibly stressful for [our son] and me as well. Thank you to everyone who's helped locally, and from afar. I . . . we couldn't have done this without your love and support.

Much love~

Jenny


Hello everyone again~

I'm delighted to let you all know that Tom came home from the hospital yesterday afternoon (Thursday). He's been feeling significantly better, especially compared to how he felt after the episode six weeks ago.

The heart cath revealed that there was no problem with the stent, no additional blockage, calcification, clots, narrowing, or any other icky thing that could have gone wrong. In essence, what he felt in his chest and arm was a normal result of the procedure. The thing that triggered it was 2-fold: 1. stress (Really?!! Us?!?!?!? NO WAY!!!), and 2. He had stopped a medication (the doc said he could) that would have made those sensations unnoticeable. He's now back on it.

And now we know: we know that's he's fine, that the stent held, and that no further complications are developing. So now we move on to the stress-less lives we are creating for ourselves.

Again, we couldn't have made it through this ordeal (or the one six weeks ago) if it were not for you, and so many others not on this email list. Thank you for your loving thoughts, prayers, and good intentions. It all matters. YOU matter. And thank you everyone for help with childcare, or for your offers to help. He seemed to have escaped this with as little stress as possible. As a matter of record, just now when Tom and I were tucking him in, we had the following conversation:

Jenny Daddy is so grateful to be home and do bedtime with you, instead of being in
the hospital.

CB But I LOVE hospitals!

Jenny Well then, maybe, when you grow up, you could be a doctor and work in a hospital.

CB Ok.

Jenny What kind of doctor would you like to be?

CB I want to be the kind of doctor that takes care of hearts.

Jenny That kind of doctor is called a cardiologist.

CB Car...di...o..lo...gist.

Much love to all~

Jenny

From Tom: Thanks to everyone who pitched in. Feeling MUCH better now. The Young Doctor and I went on another field trip yesterday, just to prove it. Trains were ridden. Monorails too.

I promise some non-health related posts in the coming weeks.

Field Trip

My son and I went on a field trip last Wednesday to a cucumber and corn farm north of Orlando.

When the possibility came up a couple of weeks earlier, Jenny and I had talked about it and decided that I should go along for some father-and-son time. I’d started talking to him about us going together almost immediately and he seemed to be looking forward to it. And so, last week, my darling four year-old boy and I walked a cornstalk maze with his classmates and teachers.

With his red hair shining on a coolish (by Florida standards) and cloudy day, his cheeks bright pink from his exertions, we took a hayride through the corn and cucumber fields. He ate an orange slice, watched the tractor tires churn through the mud as I took pictures.

We even caught a close-up glimpse of tons of cukes being washed and processed for market. This involved a smallish conveyor belt poking high out of a wall high on one side of a metal "barn," a huge hose, troughs, a wider conveyor belt and a bunch of other people and machines we couldn’t get very close to. Pretty much a little boy’s definition of heaven: lots of big, clank-y machines doing things in and to Mother Nature.

I'm guessing this doesn't sound all that thrilling to most of you, but the farm field trip is a rite of passage this time of year and lots of parents and teachers trek dutifully among the corn, pumpkins, and hay bales, kids in tow, seeking some kind of communion with our agrarian past.*

I imagine we’ll do something similar with our little guy next year and for the next few years, until he becomes far too sophisticated for the tradition. But this particular October field trip will always stick in my mind as the most precious one not because it was the first, but because I almost didn’t get to go at all.

Now that I’ve brought you in near the end of the story, in the fashion of a good Aaron Sorkin plot, let’s flash back a bit.

Saturday morning about three, I woke with tightness in my chest and in my left armpit. For a few minutes, I shifted and rolled around, trying to relieve the pressure. Jenny and the Cute Bear were already awake. (Not a big sleeper, our little boy. He’s frequently up in the middle of the night).

After my maneuvers failed to bring relief, I told Jenny what I was experiencing. This initiated the start of a conversation that probably went on for the next hour: should we go to the emergency room? I floated some really masterful rationalizations for not going: it’s just something skeletal; my neck is really out of alignment; it’s some kind of upper respiratory thing. Jenny, meanwhile, was alternating between insisting that we go and running to the bathroom. Stress, apparently, produces active bowels and bladders in some people.

CB, on the other hand, set forth his opinion clearly. “We need to take Daddy to the doctor right now so he can take me on my field trip on Wednesday.” Over the course of the next half hour, as Jenny wavered in her determination to get me to the ER immediately (using my rationalizations to support her own, I suppose), I continued to try and relieve the discomfort and deny that it was anything serious. Meanwhile, our little boy repeated his assertion several times.

Finally, we decided to go with his instincts. First off, he’s proven to be very in tune with his environment in the past in some unexpected ways. Psychic? Maybe. Certainly aware and willing to just say what is going on for him without all the filters that grown-ups have. Further, we reasoned, his minority shouldn’t deny him a vote. It’s his life and he needs his parents, whole and healthy, if he’s going to get the most out of it so, when it comes to a situation like this, the kid's opinion gets taken into consideration.

“We need to take Daddy to the doctor right now so he can take me on my field trip on Wednesday."

Jenny’s reasoning to me finally penetrated my cloud of denial, too: “If we go and it’s nothing, then we know that it was nothing and can stop worrying about it. If we don’t go and it’s something, especially something (God forbid) serious. . . “

. . . the people paying for that mistake could be the people I love most in the world.

And, besides: “We need to take Daddy to the doctor right now so he can take me on my field trip on Wednesday.”

It took us a few minutes to get dressed, pack a few essentials and just-in-cases and head for the hospital, by which time I was fully convinced (but not so much) that it was nothing. The tightness and discomfort had subsided, but there was a little voice in the back of my head saying, "This is not good. Go. Now."

A word of advice to those of you who may experience something similar in the future: When it goes away, be prepared to accept that it may just be hiding.

We got to the ER around 5 AM.

Five in the morning is, by the way, apparently the time to have a medical emergency. A few weeks before, we’d taken the Cute Bear to this very ER for an early morning ear infection and zipped right in for treatment with no wait whatsoever.

Though it didn't really seem like it at the time, things started moving very fast.

I’m on an EKG monitor within ten minutes of walking in the door and see the ER doc within thirty minutes. The IV goes in moments after he leaves the curtained room. The Bear is, however, fading fast, as is Jenny, who has been up with him since before my waking up that night. She calls a friend to come hang with me and they head home around 7 AM.

The tightness starts to return shortly after they leave and our friend, Andy, arrives. Things get a little fuzzy from here. I have another conversation with the ER doc: Kruger, I think, or Krugman . . . nice guy. Lousy golfer, we establish, which is why he’s on shift on Saturday morning and not on the golf course – although it’s raining this morning and not good golf weather anyway. There’s a second and then a third EKG, my very first ever dose of nitroglycerin (expands the veins and arteries, as I understand it, increasing blood flow – just don’t jostle the patient!) and, next thing I know, Dr. K, in consultation with the cardiologist at a nearby affiliated hospital with more comprehensive cardio facilities, decides that it’s time for me to go. The only way to know what’s really going on is to get me to the Cath Lab for a heart catheterization procedure and the Cath Lab is at a different hospital.

By 9 AM, I’m talking to the helicopter guys. They have come to move me, briskly and with no nonsense, to that other hospital. In less than five minutes I'm on a new gurney and rolling. We emerge from the building into a light drizzle, wheel quickly to the helipad, then into the chopper. My first helicopter ride is over in three minutes. (Really looking forward to the bill for that). I’m seven or eight city miles away at the hospital where our son was born, being given into the care of an equally bustling, efficient group of doctors in the Cath Lab.

There’s something about the speed and precision of the whole business that is deeply reassuring and also fully convinces me of the seriousness of the situation. The chopper team is gone. Dr. Shah (the cardiologist I’m calling My New BFF) leans over me and explains what’s about to happen. They’re going to give me something to relax me, but not knock me out, and then a local in my groin area. They’ll then make an incision into a major artery and run wires up there to drop some dye into my heart at which point . . . I don’t recall.

Frankly, I don’t really want to know. I'm the guy who can hardly watch the surgery scenes in shows like House or Grey’s Anatomy. Forget ER. As far as I’m concerned, they take magic lantern pictures or sling some goat entrails around and, poof, they can see what’s going on. He doesn’t think, based on the EKG’s that I’m having a heart attack, but the only way to know for sure is this thing he’s about to do. He tells me he’s really good, that he’s done this a thousand times and that I’ve got nothing to worry about. And then he rattles off the risk factors – statistics that I would probably remember more clearly and are, as I do recall, quite sobering EXCEPT in light of the alternative. And that alternative seems like a very real possibility in that moment.

I am then – yes, it’s inevitable – given some consent forms to sign. I’m flat on my back. I’m apparently suffering some dire cardiac event and about to undergo a more serious medical procedure than anything I’ve ever experienced in my forty-nine previous years on this planet. I’m scared poopless, surrounded by people in gowns, masks, goggles (!), and little paper hats of the surgical variety, all of whom are eminently professional -- though they have what seems to me an odd insistence on introducing themselves as they are doing things to my body: at one point a young lady tells me her name is “Amber” while shaving me in places that no one but my wife has had access to for many years. And yet, through all of this, it remains to feed the bureaucratic beast. Two scraggly signatures are duly obtained by a gentleman who, I'm sure, told me his name as he held the clipboard for me.

I fade out a bit after that. The effect, no doubt, of some really excellent anesthesia that gives me a safe, zone-y space to hang in without really knocking me out. I hear the cath team talking – lots of numbers being thrown about, mostly – and feel some mild pressures on my right leg. I start to come up out of it at some point and think, “I should ask them how it’s going. I bet that would blow their minds! Maybe I’ll just wait a bit then, when they’re done, say something funny.”

A bit later, I say something. Can’t recall what, but I don’t think it was all that funny. In response, I hear someone (Dr. Shah?) say, “Give him another 50 of gobbledygook.” I don’t go too far away, but far enough. There is more pleasant banter as they wrap up and I am left in the hands of the clean-up team. We joke. We bond. I think they have faces.

And then I am transported by . . . gurney? Magic carpet? Transporter beam? (the memory gaps creep up on you. I’m just now discovering this one.) to the Cardio-Respiratory Care Unit or Cardiac Progressive Care, deep in the bowels of Florida Hospital South.

Dr. Shah comes into my room later that day and, aside from acknowledging that the blood work proves it was, indeed, a heart attack, says reassuring things. Apparently I'm a case study for how EKG's don't always tell you what's really going on, but he went with the fact that I was still experiencing chest pain and his own gut to make the call to do the catheterization. He's just so confident and upbeat about the whole thing. He uses the phrase "totally manageable condition," and tells me he’d see me in his office in a week’s time. The fact that he’s a) expecting to see me in a week and, b) going out of town to a seminar are good things. Surely he wouldn’t a) tell me he’d see me in a week and/or b) leave town if he were at all concerned about prospects for my recovery, right? (This is my new BFF, remember.)

And now that the urgent narrative voice is no longer necessary, we will return to the more contemplative tones of the past tense.

I spent two days in the hospital as they monitored things like cardiac enzymes and BP and such. Watched way too much stupid TV between visitors (plenty of the latter, thank you all very much for coming!), but I didn’t really have the energy for much else. The hospital bed earned me what felt like a permanent, radical, not-at-all-welcome realignment in my neck and upper spine. Everyone on the hospital staff was patient, generous with their care and attention and generally great. The food . . . eh . . . not so much. But the fact that I had an appetite at all by the end of the first day was a surprise.

I’ve been home a week now and am taking a raft of drugs that have what the medical pros call “proven mortality benefits.” Proof that the AMA needs the same language consultants that the Republicans have been using, ‘cause no heart patient wants to hear the word “mortality” in the context of his treatment options, even when it’s spun as a “benefit."

Jenny is dealing. I think she was so much in survival mode for the first week that she forgot, for the most part, that she was allowed to have feelings. That emotional paralysis seems to be receding and she's a lot more like herself this week. The ice really seemed to break last Monday, after we met with Dr. Shah outside the hospital. The prognosis is good and, based on the tests he’s seen so far, the damage seems minimal. We may know more in a few months, with some additional tests.

Jenny and I were all about lifestyle changes, but I gather that he’s used to patients who aren’t really willing to change much and so he sticks with the data: this is what the heart cath and the stent do, this is what the drugs will do, if you take them. If you lose weight/exercise it will help, but there’s no way to measure how much. Talk to your GP about what you can do there.

Roger to that.

As a not so subtle message to people who may read this and think, “Yeah, but it would never happen to me!” I want to assure you that this is not a place I ever expected to find myself -- a real testament to the power of Rationalization and Denial. I am well aware of the facts concerning heart problems for guys in my demographic with my lifestyle and family history. I am a reasonably smart guy with multiple letters after my name. I read the New York Times and even buy the books they review sometimes. I listen to NPR more often than a Baptist goes to church. I do not religiously follow health-related news, but I don't tune it out, either. I have a wife in the health-care field. As previously mentioned, I watch House and . . . well, Grey's Anatomy doesn't really count, but we like Bailey, Izzy, George and Callie. I used to watch ER. Hell, we even own the first season DVD set for St. Elsewhere (still the best prime-time hospital drama EVER). I am, in other words, the kind of guy who Should Know Better than to be cavalier about health issues. And yet . . .

And even if you aren’t cavalier about health issues and in the best shape of your life right now, it couldn’t hurt anything to go have a check-up now, could it?

Finally, after all that’s happened in the last week or so, I actually feel pretty good. My color is better than it has been in a while, I’m told. Not so bright pink. My energy is decent, considering I just had a major medical procedure. I have a bruise the size of a Buick on my inner thigh, but it's getting better. My sleep has actually improved.

My wife and I are processing some pretty powerful emotions as, I suspect, are a few of our friends. Nothing like someone you know, someone roughly your own age, having a heart attack to get you thinking about your own health. Once again: since I wouldn’t wish a similar experience on anyone, I hope you'll listen to that little voice that always tells you the truth, even when you don't like what it says. If you hear it say, "Make an appointment with your doctor," please listen.

CB is doing well. Jenny did an amazing job of keeping his life relatively normal while I was in the hospital. We’ve done everything we can to normalize since I got home, though we’ve called in lots of help and will probably continue to do so. The house remains a mess, the bills remain a concern, my job hunt continues . . . and right now, none of it seems so all-fired important. More than anything else, I’m looking for ways to hold on to the sense of God’s grace that comes with surviving something like this.

To me, that grace is summed up in what we keep coming back to when we tell this story: our son, his eyes serious, his voice high and sweet and ever-so earnest and insistent in the wee hours saying, “We need to take Daddy to the doctor right now so he can take me on my field trip on Wednesday.”

That’s what got us out the door. That’s why I’m here, writing this, and looking across the desk into his beautiful, smiling face.

I went on a field trip with my son last Wednesday. We saw pumpkins and a walking scarecrow. We saw a cucumber-packing operation in action. We walked a cornstalk maze and took a hayride. We ran through a huge, concrete pipe buried in the dirt like a tunnel and heard our voices and footsteps echo. He pulled a wagon full of pumpkins and a bushel of corn across a dirt parking lot pretty much single-handed.

In the grand scheme, it was not a particularly remarkable day. Just a little field trip. We’ll probably do something much like it next year and the year after that.

But this particular field trip . . . this one was the best.


__________________________________________________________________
* I heard Princeton economist Paul Krugman say, last Sunday morning on TV, that there are more World of Warcraft players in this country than there are farmers. A sobering thought.

Much ado about not so much or “What’s all this brouhaha?”

There’s already too much. Too many things to buy, shows to watch, stuff to do, books to read, music to listen to and, above and beyond all of that, too many blogs and websites.

Why (oh, why?!!) add to it, then? A fair question:

Reason #1: Because a few people have asked me to. Although it's been awhile, I have written things to send out to the long-suffering folks on my e-mail list. Recipients have sometimes responded with the suggestion that I start a blog. Some percentage of them, I'm sure, meant it. I suspect others were actually saying, "Please stop. My in-box is quite cluttered enough, thank you." Nevertheless, friends, family and the occasional random searcher through the blogs of strangers will, I presume, make up the bulk of The Brouhaha's readership until I decide whether to promote it more broadly.

Reason #2: Because, damn it, I'm a writer. This simple fact puts me at odds with any pretense to modesty. As one of that self-obsessed breed who are incapable of keeping their fingers off keyboards, their pens off paper, or their thoughts to themselves, I like people to actually READ what I write. Furthermore, if I don't write on a regular basis, I can't legitimately call myself a writer, but I find it ever so much easier to write when I have an audience. Even an imaginary one. Blogging at least offers a forum and a reason to write, though no promise of an audience. One thing at a time.

Reason #3: Because I used to write letters, but the fine art of letter writing is dead and e-mail just does not fill the gap.

Reason #4: Because I finally have a bit of time to devote to a project like this. As blogging has become a widespread practice over the last few years, I've been immersed in completing my dissertation. The degree is done. (That chorus of angels you hear is actually just my wife, singing and dancing like Gene Kelly on a rain-drenched Hollywood backlot). I'll be working to turn The Big D into a book now, but that feels like a different kind of commitment than writing for the Ph.D. I may find out I'm deceiving myself there, but we'll see.

Reason #5: Because it is there. To stretch the analogy: much as Mt. Everest is a geographic imperative that compels certain overachievers with a knack for impossible exertions in inhospitable conditions to scale it, so the existence of even-a-yokel-can-do-it blogging technology demands that a certain type of person (see Reason #2) dive in and give it a whirl. The blog is a (relatively) new form, the relevance and durability of which remain a subject for much analysis and speculation. One cannot help but notice, however, that much of that analysis and speculation is undertaken in blog form.

Reason #6: It seems kind of cool and cruel at the same time. An irresistible combination to anyone masochistic enough to be call himself/herself a writer. (See Reason #2).

By "cruel" I'm acknowledging that a truly interesting and relevant blog is a beast that demands feeding. Content (the newfangled word for the writing I am promising to undertake in service to the hungry blog) translates into time. We'll see how that works out.

By "cool," I mean by my admittedly low standards for trendiness. For a little while longer at least, only a small percentage of the population will roll its eyes at you if you say you have a blog. These are folks who navigate the cultural currents with a deft attention to what is In and what is Out. In the words of "I'm Hip," the great Blossom Dearie song, "when it was hip to be hep [they were] hep" but now they have Moved On. Soon, more and more will adopt that pose as blogging becomes as old hat as the phrase "old hat" and the Newest, Hottest, Latest . . . in other words "Coolest" is something -- absolutely anything -- that isn't a blog.

The opinions of the Hipper-Than-Thou set can't really matter to a late-adopter like me nor will they matter much to the people likely to read me. Having a blog is still "cool" in my corner of the universe because, out here, far from the Cutting Edge, we know naught of MySpace and Facebook. My four year-old son (see above) navigates YouTube with more facility than I. Heck, proper nouns with capital letters sticking out of their middles still look strange to me.

And so . . . Being new to the blogosphere, I can’t tell you what the mix of topics in The Brouhaha will be. I need the room to experiment and grow as I go. I can promise there will be loads of pop culture commentary, notes on what I'm reading, watching, working on, and observing in the surrounding cultural commotion and kerfuffle.

Beyond that, I'm sure I will find plenty of fodder in politics. Every once in a while – probably more so when we get closer to the '08 election – I’ll embark on the genre of blogpost known as The Rant. Certainly plenty of fuel for that fire these days. Imperial imbroglios like those in which our nation finds itself caught up overseas, as well as the teapot tempests and under-card dust-ups posing as championship bouts that constitute our popular and political culture, will all make an appearance here.

In shuffling through the day-to-day stuff that bewitches, bothers, and bewilders I am, like most of us, always in search of connections to What Really Matters. With that in mind, another category for posts in The Brouhaha will be those little Moments of Bliss that sometimes come out of the alarms and excursions of daily life. As the parent of a young child, a lot of these entries will likely be of the "sweet parenting moment" variety which those of you with no interest in the sweetness (or the horrific realities) of parenting have my permission to skip. Your loss.

Most of the time, I’ll shoot for a light and entertaining tone, strive for relevance and work to connect each piece to the broader themes implied by the blog's title and the definition provided for it in the header.

Now, about that title. I’m a great lover of language in general and slang in particular. Nothing makes my ear perk up like a great turn of phrase, an intriguing combination of syllables, or the deployment of old words in new contexts. Not being as erudite on the subject as William Safire, I probably won’t be digging into the origins of words or phrases too often in these pages, but I bring it up because the title of this blog is one of those slang terms that deserves more currency, particularly when it seems to define so much of what passes for turn-of-the-twenty-first-century culture.

What else is the 24/7 babble of infotainment that passes for a "national dialogue" these days but a brouhaha? Otherwise it's all just a collection of tales told by idiots, full of sound and fury signifying . . . well, to say "nothing" is to surrender to cynicism. So, not nothing — but amid all the buzz and flutter, all the burble and blather, intuiting something about What's Really Going On is, to put it mildly, a challenge.

Every once in a while, I sense a pattern in the cacophony. Like a good academic, I like to take the insight and work through it to arrive at a conclusion. You might find my reasoning compelling or the way I write about the issue engaging -- or you might decide that all I've done is beat something about the ears with an overworked thesis and pelted it with over-ripe prose until it keeled over.

You'll have ample opportunity to judge for yourself if you keep coming back.

-- Tj