At the age of 42, my father died of a massive coronary—hardening of the arteries aggravate by a thyroid condition. I was 14 years old. His ghost continually haunts me, but usually only as a trace on my personal palimpsest of mortality.
We are so good at denial of death.
That changed a few years ago when I had what was supposed to be a “routine” surgical procedure: the implantation of a pacemaker. For years, I had alarmed doctors and nurses with a freakishly low resting heart rate, which resulted in a weird EKG.
“Either you have the heart of Lance Armstrong or you are dead,” one doctor told me.
As I neared my mid-sixties—despite far surpassing my father’s fate—I decided to err on the side of caution. I told no one I was having the procedure, other than my friend Bryan, since I was advised to have somebody pick me upon my release. It would probably be the same day.
The morning of my surgery, I was wheeled into the operating arena, attended by three nurses, the surgeon, and an assistant doctor. They fed me anesthetic intravenously and the procedure began. I would be conscious as the doctor worked.
Immediately, I became frightened by a tightening of my throat. I struggled to catch my breath. When I expressed my alarm to the nurses and doctors, they reassured me that everything was okay.
“Do you think it could be a bad reaction to the anesthetic?” I asked.
“No,” came the answer.
The monitors, which clocked my vital signs, were in eyesight. In my growing panic, it appeared I was flatlining. Why was nobody noticing?
I remained wide awake as the doctor cut slightly into the upper right of my chest in order to place a half-dollar-size metal pacemaker just below the skin. He went about the task of feeding the electrode-laden wires emanating from the pacemaker into veins that led to the heart.
The operation was supposed to take 90 minutes. Mine lasted nearly four hours.
At the time, I was unaware of the specifics that more than doubled my time in surgery. I was too busy asking the nurses to allay my anxieties that I was about to asphyxiate. What further unnerved me were the tense, whispered conversations between the doctor and his assistant. I suddenly heard the doctor demand another surgeon.
“Is anything wrong?” I asked.
“No,” he said. Everything was going according to plan.
The assistant came back to say that doctor so-and-so was busy.
“I don’t care what he’s doing!” the doctor yelled. “Tell him to come here now!”
“Am I going to die?” I asked.
“You sound panicked.”
“This is the way I always sound.”
I looked at the monitors. I was flatlining. I was sure of it. Now, not only was my throat tightening but my legs started to shake violently.
“Doctor, why are my legs shaking?”
He didn’t answer.
“I’m going to die,” I told the nurse. “Look at the monitors.”
I heard the doctor tell the nurse to increase the dosage of anesthesia and move the monitors out of my sight. I fought consciousness. I wanted to stay awake, convinced that if I fell asleep, I’d never wake up. The nurse, a sweet Jamaican woman, took my hand to soothe me. I was having none of it.
I always thought, or hoped, I would have a good death, addressing the Godhead: “Father, into your hands I commend my spirit.” I would think of those who I loved most dearly, the many I would miss. I would expire in a benediction of love, understanding, peace and gratitude for the life I had been given.
No. Freaking. Way.
My first reaction was total surprise. “I’m going to pull an Andy Warhol,” I thought.
People don’t even know I’m here. You go in for a routine operation and come out a corpse.
My second reaction was sheer, abject terror. Fear beyond anything I’d ever experienced before.
The third reaction was esthetic. I looked up into the lights and the spare institutional walls and thought, “This is going to be the last thing I see and it’s so depressingly ugly.”
I wasn’t thinking about anything I expected—not friends, family, or God—nothing except to stay awake and not give into the dark.
I had had a preamble to this reaction to impending death not long before when I was forced to put to sleep my beloved Clementine, a German shepherd who’d grown old and arthritic.
“It’s time,” the vet had said.
Sorrowfully, I agreed. I didn’t want her to die in a vet’s office, so some friends had arranged for the vet to come to my house in upstate New York, where Clementine and I had spent so much happy time together. With dread, I prepared the living room, putting on some soothing music and placing Clementine’s favorite blanket in front of the wood-burning stove.
She seemed unusually agitated. It took a long time to get her to rest on the blanket. However, the minute the vet entered the room, she shot up as though she’d seen the Messenger of Death. She tried to escape my arms. I had to hold her down, but she struggled mightily. She never let up. For a minute, I thought of canceling the whole thing. Clementine fought with every last breath to escape what was happening to her, crying pitifully and howling. I sobbed uncontrollably until she went limp in my arms.
That same animal instinct kept me fighting to stay awake in the surgery room.
Finally, against my will, I succumbed to the blackness. When I awoke in the recovery room, I was ecstatic, relieved—and embarrassed. I felt like a fool and a coward to have faced the situation with such a lack of grace.
The doctor came to check on me and explained why the operation had taken so long. One of the leads emanating from the pacemaker went into the first vein well enough. However, the installation of the second wire went awry because of irregularities in the chosen vein. After three more tries, another vein had to be found.
“Was there ever a moment when I was close to death?“ I asked.
“Why were my legs shaking so violently?”
“You’ve heard of knee-knocking fear?”
“Then I’m just a big chicken,” I said.
“You sure do talk a lot,” he laughed. “We could knock out a horse with what we fed into you to make you shut up.”
They kept me overnight and released me in the morning. “We wouldn’t release you if anything had gone completely haywire,” the doctor said.
Haywire. Good word for it.
The next day, I packed up my things having slept remarkably well. I actually felt great, even if it was odd to have a piece of metal protruding just under the skin. A pacemaker. That’s sounded so, well, old. I thanked the nurses. A couple of days later, I returned to give each of them a gift.
As I left, memories of my only other hospital experiences came flooding back. During the AIDS epidemic, I had become familiar with hospitals: the fluorescent lighting, the subdued chatter at the nurse’s station, the muted and indistinguishable sounds of TVs, the antiseptic cleaning solutions barely masking the smell of bodily fluids. As a volunteer for the Gay Men’s Health Crisis, I visited many dying young men, brought them food, held their hands, kissed their emaciated foreheads and commiserated, blindly. Then I would wave goodbye at the door of their room on my way to the gym, or to the theater or to meet friends for dinner, leaving them alone with their suffering and terror—a fraction of which I had just tasted. I felt I owed them an apology in some way.
Thoughts of all the lost friends from those AIDS-ravaged years and their beautiful souls swarmed around me as I walked down the hospital halls and out into a sunny July day. I breathed deeply of the sweet hot air. I thought also of a baby one nurse had told me about. She was only three months old and was in the pediatric ward to have a pacemaker implanted.
The tiniest little mechanism to send off the tiniest of electrical charges to coax the tiniest little heart to keep beating—until God knows when.
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