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Prologue

Statistics are aerial photographs. The photographer in the airplane circling high above us looks for the big picture -- where land gives way to water, where mountains rise, where the desert begins. There is nothing to distract him from the landscape, no movement telling of life below the treetops. Yet we are there nonetheless, waving, waving, each with our own story, each with a heart whose beat gives us life and makes love a possibility.

The aerial photograph of cardiovascular disease shows that sixty million Americans suffer from it. That's one out of every five, making it the number-one killer in this country. Cardiovascular disease is also the number-one killer of American women, afflicting one out of every two. Each year 2.5 million women are hospitalized for it and about five-hundred thousand die. That's more women than died from all other causes combined, including lung, breast, ovarian, and uterine cancer.

Unlike men, most women who die suddenly from heart attacks don't have any previous symptoms. And even though more women die of cardiovascular disease than men, many doctors still do not prepare women to recognize the signals of a heart attack -- certainly not young women in good health with no risk factors. This is tragic. According to a 2001 report from the Centers for Disease Control and Prevention, of the leading causes of death among women ages twenty-five to forty-four, heart disease is significantly ahead of breast cancer, and ranks second only to accidents and other adverse events.

When death came for me on May 12, 1997, I was a healthy forty-four-year-old with no family history of heart disease; in fact, one grand-aunt had lived to a hundred and six. My annual physical had just confirmed my usual low blood pressure and low cholesterol. I'd never touched a cigarette, let alone smoked one. I was slender, exercised regularly, and ate all my vegetables. I even made whole-grain bread each week. I was certainly not a candidate for a massive, near-fatal heart attack, emergency open-heart surgery, and ventricular tachycardia (a deadly malfunctioning of the heart's electrical system). Neither would I have believed that I could be unconscious for eight days of my life. And I certainly never dreamed that a heart transplant would be in my future. I was in my prime, assuming my American birthright in grabbing cash from the ATM machine, throwing toothpaste and tomato paste into the market basket, and driving to work. Besides, I am a woman; I thought that in the matter of my heart's health, my gender would protect me. Wrong.

A year and a half after my heart attack and surgery, on a flight to Anchorage, I met a cardiac surgeon from the Southwest who was recovering from open-heart surgery himself. I told him that I was drafting this book, and he said, "Even as a doctor who's prepared and operated on hundreds of patients in all circumstances, I had no idea what I was facing. Write your book for all of us. We need to understand more about what the patient goes through, from the patient's point of view."

And so I did. But my book is as much for families, friends, and people who deliver hospital breakfast trays and home heating oil as it is for patients and medical professionals. Matters of the heart cannot be separated from the muscle, I've discovered, so every person has an impact on the cardiac patient, who now believes that every moment is her last.

Each year nearly eleven times more women die of heart disease or stroke than of breast cancer. Yet there are virtually no memoirs about cardiovascular disease on the bookshelves. During my critical first year after being discharged from Massachusetts General Hospital in Boston, I found only a couple of books that offered the companionship and guidance I craved. There are plenty of books about fighting heart disease with diet and exercise, meditation and medication, but I wanted to know: Is anyone in the universe like me -- young, fit, female, shocked? What did you feel like? What happened to your life, to the lives of others close to you? How did you change, or did you not? In the end, I've written the book that I searched for about heart disease. But it is also a book about facing catastrophic change of any kind and doing the work required for true healing.

As happens with most people who find themselves suddenly in what writer Susan Sontag calls the "kingdom of the ill," I grappled with cosmic questions after I had sought medical explanations. Why me? Why my heart and not my toe? What could I have done to prevent this? Who is at fault? My year's stay in the monastery of illness -- a peculiar place of both confinement and release -- took me deep into my past and I discovered that, as intuitive healer Caroline Myss writes, "Your biography can become your biology." While my biography is certainly not yours, perhaps like me you gain more from being swept up by the story of a real person's life than by a river of statistics.

The first year following a heart attack is the most critical period of recovery, a time when in closing your eyes at night, you can't trust that you will be there in the morning. Doctors struggle to prepare patients for this uncertainty, but there is no experience like personal experience. I have stuck strictly to that year and tried to be unflinching in my descriptions of the devastation, terror, joy, setbacks, insights, and unbelievable humor that accompany dying and returning to life again.

So come with me through five seasons in western Maine, where I recovered my body and soul. The first spring lasted only a month, yet I dwell on it the longest because after being given back life I observed it as fixedly as a child observes a bug. As the seasons progress, my descriptions of them shorten, reflecting my gradual return to healthy-people time -- a time when a lemon drop no longer demands full attention until completely dissolved. We cannot meet our worldly responsibilities, which I did not for more than a year, while paying rapt attention to every raindrop on the windshield.

Simply by slowing us down, disease can tell us what our souls need to know. It becomes a diagnostic tool for the spirit. Difficult as that year was, I miss the languorous pace enforced by confinement. Driving thirty miles an hour no longer feels like speeding to me; I make lists of things to do and feel a tug if the day doesn't give me time to complete them; I occasionally walk by a flower without peering into it. But I doubt I will ever be truly inattentive again. I emerged from that monastery seeing my broken heart in a whole new light -- as a metaphor. It's ironic that a devastating attack on my literal heart brought healing to my spirit-heart. I now understand that healing and curing are two very different things.

My doctors told me that by the time I reached the one-year anniversary of my heart attack I would feel strong and confident again. And they were right. But I didn't believe them for even one minute, not when the act of eating a chunk of fruit took centuries as the sun rose in a chilly hospital room.

Ultimately, this book is not about heart disease at all, but about digesting that fruit.

Copyright © 2002 by Deborah Daw Heffernan