The Silent Heart

It’s 7:15 in the morning at a place where time begins and ends. I’d rather not be here, but this morning I told my wife, Sue, “I need to go.” The drive took only five minutes. Now I sit here in a wheelchair.

I’m pushed into an emergency room examination area while Sue gives my name and address to the receptionist. People in white move around me like the gears of a clock, ticking steadily. There’s no rushing, no signs of alarm—just efficient, continuous movement. Sticky plastic disks are pressed to my chest and legs while questions fill the air. “Where is the pain? Is it sharp or dull? When did it start? Are you taking any medications?” I glance around, as if the answers are hidden somewhere in the room. All I can see are white tiles, white curtains, and faces on heads sticking out of white smocks. More questions. I hope I’m answering these correctly. There’s no telling what these people will do if they catch me lying.

I’m asked to remain still while the electrocardiograph does its work. This routine is familiar, since doctors administered an EKG to me four months ago in San Antonio as part of a periodic physical examination with the army. The EKG was normal then, as were my lipid panels, good cholesterol, bad cholesterol, blood pressure, and triglycerides. Everything was A-okay. A woman—presumably an emergency physician—inspects my new EKG results. She looks at me calmly and says, “Mr. Matthews, you’re having a heart attack.” Sue must have finished her business with the receptionist because she’s at the foot of my gurney. We exchange a bewildered look.

This makes no sense. I took an army physical training test last summer and achieved a personal best in the two-and-a-half-mile walk. I have no family history of heart problems and none of the traditional risk factors, other than smoking. Don’t tell me smoking alone can cause a heart attack.

A nurse hands me a tiny, white tablet and tells me, “Place it under your tongue.”

I do as I’m told, and the discomfort in my chest seems to be subsiding. Yes, I feel better. Thank God. Someone must have started an IV and injected medication. I recognize the sensation—those few seconds before a general anesthetic takes effect when you are asked to count backward from one hundred. You start with one hundred. Your fingers and toes tingle. By ninety-nine the tingling spreads up your arms, and by ninety-eight your entire body is …

I don’t know how long the dream lasted, and I don’t recall the details. I only know it was a very pleasant dream, and I’m perturbed now that someone is yelling, “Larry, Larry!” I’d like to finish my dream, but instead my eyes open. A bright, round, white light shines above me. Someone starts in with the questions again. These are easier. “What is your name? Do you know where you are? What day is it?” No way am I answering any of these questions wrong. Someone—maybe that ER doctor—is kind enough to inform me, “Your heart stopped.” The words don’t make any sense. My heart stopped? I thought I was sleeping, dreaming. Sue is among the strangers who have gathered around. She wears a look of fear.

More white appears. It’s the white hair of a man leaning over me. He introduces himself as Dr. Something or Other. He operates with Swiss-clock efficiency as he holds a clipboard in my line of vision and clicks through the dangers inherent in the procedure I’m about to undergo.

“Do you understand?” asks the man with white hair.

I must have said yes convincingly enough, because he hands me a pen. Is this what is meant by the phrase “signing your life away”? The pen slices across the Ts in my name as the gurney begins to move. Someone is at my head, someone else at my feet, swiftly guiding the way through a double door and down the hallway. Sue rushes to keep up, an unexpected participant in this race for life. When we arrive at the doorway to the cath lab, she says good-bye with a touch.

The lab might be nicely decorated, but I’m in no position to appreciate it. I’m on my back, staring at more lights. What is it with all of these lights? I sense the people around me, but I can only catch an occasional glimpse of a hand, an arm, or the side of a head. They move quickly in here. The clock is ticking faster. While they work, they rattle off fragments of sentences, telling me what they are doing in a kind of abbreviated hospital-speak. It reminds me of the patter of a magician as the trick is being performed.

Are their words intended to distract me? If so, they don’t succeed. I feel the blade tugging at the hair on my thigh. Liquid evaporates into cold as the area is wiped clean, and then I feel the stick of a needle. This isn’t so bad. I hear the words, “Relax and breathe deeply. You’re going to feel a little discomfort.” Relax, my ass! It’s not humanly possible to relax when a knitting needle is being driven up your femoral artery. A severe, shooting pain in my groin area causes my core muscles to contract. It’s an automatic response. Then, as quickly as it began, the pain subsides. The needle must be in. I try my best to breathe deeply and relax.

Someone says, “You’re going to feel a slight burning sensation as the angiogram dye is injected.”

The sensation is more than slight, but it’s not altogether unpleasant. It is in fact a rush of heat into my chest that dissipates as it pushes out to my limbs. The people around me are quiet as they continue their work, or maybe they’ve added something to my vein—something to obscure time, cloud my thoughts. I recall being told to direct my attention to the monitor for a look at the arteries in my heart. I want to say, “No thanks. No television right now. Can’t you see I’m a little busy?” But the words never come out. This doesn’t seem to be a good time to risk irritating these people.

They appear to be finished, and it seems like they just got started. The gurney moves again. It is not a race this time, just a casual push out of the cath lab, down the hall, and into a recovery room. I see new faces here. Smiling people greet me like long-lost family members at a wedding reception. They fiddle with the lines sticking into my body, with the dials, and with the monitors attached to me.

Sue appears and takes my hand. She looks dazed. The clock on the stark, white wall behind her reads 9:00 a.m. We have spent less than two hours in this place, and time begins again for me.