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My heart attack began at 4:30 a.m. on Thursday, May 22, 1997.
F. Scott Fitzgerald wrote, "In a real dark night of the soul it is always three o'clock in the morning."
For me it will always be 4:30 in the morning.
I woke up startled because it seemed as if I had a very heavy rock in my chest; it had jagged edges and was causing me sharp pains. Sleepily, I placed my right hand on my chest to make the rock disappear, but it didn't. Must be those tacos and hot sauce I ate for dinner was my immediate thought.
I glanced at the illuminated clock dial that read 4:30 a.m., still dark outside on a typically mild California morning, a time when all I could hear around me was the deep silence and the heavy sleep of my husband, who was unaware I awoke. I didn't want to disturb him, since it was nothing to worry anyone about-just heartburn that some Maalox would instantly cure. With that thought in mind, I walked slowly into my bathroom, which now seemed like a ten-mile safari although it was only a few yards from my bed. I swallowed the Maalox and concentrated on walking back to the bedroom feeling shaky and exhausted, with the rock in my chest-oh, so heavy!-and sweat on my face and body, and nausea overwhelming me. I struggled to sit upright on the side of our bed. The Maalox was not working. Why doesn't it work now when it has always worked before? I was too weak to lie down again and cover myself, which I needed to do because an icy chill was enveloping me. Instead, I slid off the bed and stretched out on the floor, feeling I was about to faint and maybe that could cure what I still believed was heartburn. I did not pass out, and the pain, the nausea, the heavy feeling in my chest and my feeling like ice continued unabated.
I tried to get up from the floor, but could only remain kneeling with my hands on the side of the bed. I had no energy left and it was then that I semi-shouted, "Mel, Mel, please wake up, I feel so sick." Mel awoke and looked alarmed. He asked, "What's the matter, Pat? Why are you on the floor? What's happening?"
I said it was only a severe case of heartburn and that the Maalox I took wasn't helping. I did not share any other detail. Mel wanted to know more, but I kept repeating, "It's nothing, nothing, it's heartburn and it's just taking longer to go away, that's all." Mel lifted me into our bed and covered me. But this had little effect on my feeling better: I still felt I was at the North Pole in a nightgown. However, I told Mel, "Thanks for the help but I'll be my own self again shortly, so why don't you go back to sleep?"
The reason I can write this book is that Mel refused to go back to bed. He once told me jokingly that, when it came to acknowledging I was ill, I was Cleopatra. Why? I asked him. He answered, "Well, you are the Queen of Denial!" A good joke, I thought, but did it really apply to me? It certainly did on that May night.
"Don't call 911!" I screamed when I saw Mel walk out of the room to get to the telephone, for he was concerned, anxious and disturbed over my behavior. He saw the blood drained from my face, the sweat, the grimaces of pain, and questioned whether or not I really had heartburn. But as he told me later, he had no idea I was having a heart attack. After all, I never had such an attack in all my life. I prided myself on being as healthy as a horse. Heart trouble did not run in my family; I had no genetic susceptibility regarding heart disease. So, of course, I kept insisting all I had was heartburn.
I was angry but too weak to resist the call Mel made to 911. (I learned later it was very fortunate Mel called so quickly, because people with a heart attack can die if not taken to the hospital within the first four hours.) I heard him say, "Hurry, please. . . . It's an emergency. . . . Send an ambulance. . . . My wife is very ill. . . . It's her heart."
I was still denying anything was seriously wrong when Mel returned. The last thing in the world I wanted was an ambulance with a screaming siren. Too much commotion for me in my quiet neighborhood. My two Maltese dogs would get upset and start barking like crazy and madly run around the house. I didn't want the neighbors to know I was ill, because it would be very embarrassing.
A terrible fear of hospitals had always been a nightmare of mine, and now the nightmare would become a reality: I was going to a place that would kill me. This belief was imprinted in me in the earliest years of my life. I grew up in a family where money was scarce. My parents couldn't afford to pay for regular doctor visits and checkups. My older sister Peggy and I were supposed to not complain when we were sick, just stay home and go to bed until we felt better. Doctor bills had to be avoided. A hospital stay was out of the question for it would cost a fortune. I knew that our relatives (who also were poor) only went to a hospital when they were ready to die from an illness they experienced without medical care.
My first remembrance of fearing hospitals occurred when I actually stayed in one, my first and only time. I was four years old and my parents felt they had no choice. I came down with scarlet fever, and it was thought I might have diphtheria, too: a life-and-death situation for a girl of four. Even today I have vivid memories of a few flashes from that time. I remember how fearful I was, asking my parents, "Am I going to die now that I'm in a hospital?" I remember looking up at a strange lady near my hospital bed. She was dressed all in white. Was she the angel of death? I remember the way she opened and closed my hospital door without touching the knob and the white rubber gloves she wore to avoid infecting me. She smiled at me-a nice smile-when she bent down to pick up my Mickey Mouse toy that had fallen off my bed and then brought it back to me the next day all washed and disinfected, but the doll didn't seem to look like the one that had fallen on the floor.
It turned out I only had scarlet fever rather than a lethal combination with another disease. A narrow escape. Never again-no more hospitals for me!
(It is no accident I became a psychologist rather than a medical doctor. I have been a specialist in dealing with the psychological problems of my many clients over the past fifteen years. I delight in my work, and nothing makes me feel happier than to help people overcome their problems in interpersonal relationships. But when it comes to physical illnesses, I have always felt helpless. I have always seen myself as a psychologist who heals the psychological, not physical, wounds of others.)
Since the mind is a wild monkey, I once again became that frightened four-year-old girl as I worried about the ambulance arriving with its screaming siren. Lord, Lord, I hope it doesn't come, maybe they made a mistake about my address. . . .
However, the ambulance did arrive despite my prayer to the contrary. At first it didn't seem so. I heard a car grinding to a halt; I heard no siren, though, so perhaps it wasn't the ambulance. But it was. (Why no siren? was my first thought). Then suddenly I saw three men hastily coming toward me after Mel had pointed the way. They had arrived quickly, just about ten minutes after the 911 call. Mention "heart trouble" and the ambulance service always responds in my city like it is a fire alarm. It was 5:00 a.m. now, and a pleasant-looking man in his late thirties, who said his name was Ted, kept asking me questions: Did I have any pain? When did this start? Any history of heart problems? He had a kind voice and gentle manner as he took my pulse and blood pressure and felt the sweat on my forehead. I found it hard to talk because I could barely breathe. The pain was so acute, and I told him so. Soon I began to feel better as the pain subsided. (I learned later that Ted and his helpers had given me oxygen, nitroglycerin and some morphine to assuage my pain and the heavy-rock pressure in my chest; he also checked for any changes in my heart rhythm, which would indicate I was having a heart attack. Ted was a paramedic trained in emergency medical procedures, and he could make a basic assessment of a person's illness.)
Since I felt somewhat better, I thought it was the Maalox that was finally working. I then kept repeating, like a mantra, that there really was nothing very wrong with me, just heartburn that was going away. But I remember Ted shaking his head and saying softly, "We can't leave you here, you'll need further checking out at the hospital. It's best for you."
Too weak to protest any further, I suddenly found myself lifted out of our bed and put on a board by the three men present, and then, feeling like a slab of meat, placed in the cavern-like ambulance compartment that was filled with (as I was told later) all kinds of sophisticated equipment: a heart monitor, gel pads for electrodes to be attached to my chest, a blood-pressure cuff attached to my right arm, a nasal prong for oxygen administration, an IV catheter for morphine and nitroglycerin use, and a radio for contact with the hospital. What was being applied to me in the ambulance seemed like a blur at the time. All I remember was that the ride to the hospital was bumpy and that I was viewing everything backward as I lay in the ambulance. Looking through the back-door window I could see dawn emerging and people in their cars beginning their long commutes. As I looked at the cars, I kept thinking enviously: Here I am going to a hospital while you're going to work. You may hate your job and growl over having to get up so early, but let me tell you I'd rather be in your shoes anytime than in the place where I'm going.
Seeing everything backwards in the ambulance made things look unfamiliar, and now I was being taken to the most unfamiliar place of all.
The ambulance surprised me by suddenly stopping. The ride was too short, couldn't it take longer? Must I be taken into the hospital so soon?
To no avail. The sign said Emergency Entrance, the notice that THE HOSPITAL, like a great beast, was ready to pounce on me. But the morphine was working, diminishing the fear that would have escalated otherwise. Experienced hands quickly liberated me from the jail-like quarters of the ambulance, and soon I was in what looked to me like a larger jail, the hospital's emergency room. I was surrounded by a sudden sea of people in a blur of blue clothing. All I wanted to do was fly away, far away from where I was now, lying on a gurney. Doctors, nurses and technicians seemed to be doing things to me that felt strange and intimidating. All the gadgets they placed on me felt threatening. (I found out later I was on a heart monitor, an EKG to determine my heart elevation, IV catheter, nasal prongs, oxygen mask and morphine.) Why are they doing this to me? Can't they see I'm getting over my heartburn? The rock in my chest had disappeared, my breathing felt normal. So please let me go home! Right now! (I did not know it was the morphine, nitroglycerin and oxygen that had made me feel better.)
I must have been shouting because the next thing I remember was the up-close face of a doctor, earnestly looking into my eyes as he held my face very gently. In a quiet, firm way he said, "Don't say you have heartburn, dear, you are having a heart attack right now. We see it on the monitor near you. We need all your help to make you better. Are you going to help us?" I said, "Yes," and he said, "Fine."
That moment was the first time I acknowledged the reality of my condition-I never mentioned the word "heartburn" again. Moments later a silent scream of horror reverberated in my head. When I told the doctor, "Yes, I am going to help," I had only half believed it. The little four-year-old girl inside me was crying. You were lucky when you had scarlet fever, she was tearfully saying, but now you are going to die; a hospital is the place where you die, remember that!
But the little girl was wrong, although I did not know it then. The hospital would in future weeks become the birthplace of my new beginning rather than my end. Yes, I would have died if I had not arrived at the hospital, been diagnosed and operated on within hours of my heart attack. The hospital was not the villain; staying home would have been my killer.
A few minutes later my doctor's voice and the little girl's shock of terror faded away and my eyes felt like lead. The morphine was doing its work and I blanked out. . . .
My longest journey into the country of healing and self-renewal began with a single step, which was my recognition that I had survived a very serious heart attack. No longer could I delude myself that it was anything less than that. No longer could I believe, as I had always believed, that women were immune to heart disease, unless they were born with a damaged heart. It was a men-only disease, as so many of my friends who had husbands with damaged hearts also believed.
Letting go of this misconception would enable me to enter the dark forest of the unknown, where my odyssey to survive and discover a new sense of myself would begin. . . .
(c)1999. All rights reserved. Reprinted from The Heart of a Woman by Pat Biondi Krantzler and Mel Krantzler.