I have pondered for more than a week whether or not to tell this tale, and to be honest I don’t know at the moment that I am scratching out a first draft with pen and paper if I will actually complete it. If I end up doing so I will then have to decide if I will publish it. This may not be a story for all readers. My good friends, wonderful people all of them, may feel uncomfortable reading about this experience which I am about to share. If that is the case, please don’t read this. My sole intent is to share information in the hope that anyone who reads this will take precautions to prevent a severely painful situation which I experienced from happening to them, but I value my friends above most things in life and would never want them to feel uncomfortable reading anything that I write.

I never want to publish a story simply to shock, and the story that I have now set out to tell consists of details unsavory enough to shock and gross out many people. I suppose the trick will be to see if my writing skills are adequate to deal with the topic in a way that gives objective information of a deeply personal story in a way that the unpleasantness of the topic doesn’t detract from the point. I will assess upon completion of my first draft whether or not I have achieved my goal. Only then will I push the ‘Publish’ button and send this out to a world which may not even be interested in it at all. We shall see. (author’s note: I obviously assessed this story and decided that it should be sent. As I wrote a moment ago, we shall see).

The title of this tale is simply “Constipation” and, not surprisingly, that is also the topic. And it is a topic that many people do not consider to be serious; the butt (forgive the pun) of an inferior comedian’s potty humor or something that old people in the retirement home speak about often. But when constipation, and I mean real constipation, hits you all of the jokes and laughter fall away and you find yourself praying for some kind, any kind, of relief. Most people can avoid constipation by eating a balanced diet, remaining active, and staying hydrated. Surgery changes all of that however, and it is in the context of a recent major surgery which I underwent that this story is being written.

I recently suffered a heart attack and had to submit to bypass surgery to enable my heart to receive an adequate supply of blood. I was under general anesthesia for over three hours and then given regular doses of a narcotic pain medication for the next five or six days on a regular basis. I tapered off of the narcotics over the next two weeks but still needed them sometimes in order to quell the ache in my chest so that I could sleep. A side effect of the anesthesia and narcotics is that they interfere greatly with normal bowel function, and part of my daily post-surgical physical examination was to listen for the sounds that normal, healthy intestines make. Mine were obviously making normal sounds, so other than a stool softening pill given to me once a day I received no other attention to this potential problem. That would come back to haunt me.

In addition to the effects of the drugs that I was now taking, the other three components of healthy elimination were removed. I was very restricted in my walking around or doing any other exercise by the fact that my split chest was now held together with wires and stitches, and the heart medications given to me made me very light-headed and therefore unable to walk very far or very safely. My appetite vanished after the surgery and even if it had not done so the diet was virtually devoid of fiber, and they wanted me to lose some of my body fluids for reasons I don’t understand so I was put on a diuretic. The result of this perfect intestinal storm was that by the time I was released to go home I had had one small bowel movement and that was all. I was told to be conscious to avoid constipation but not given a plan to do so which fit my new situation.

Returning home was a wonderful thing. I now had the foods which I like to eat and my appetite slowly returned. I ate a lot of salads and other greens, and drank a great deal of water too. I hoped that this would do the trick, but nothing came of it. By day three I began to suspect that I was in trouble, but my preoccupation with safely rehabilitating with my light headedness and healing chest wound, plus the effects of all of the drugs that I was taking, diverted my attention from what should have been a priority. On day four the degree to which it should have been a priority burst upon me with a pain that one could hardly imagine unless one experiences it firsthand, and experience it i did.

I could tell when I arose that morning that things were moving to a conclusion. I tried a couple of times to eliminate but the bolus of stool reached the last centimeter of my digestive tract and then refused to budge any further. I gave up after a while and arose to return to my place on the sofa, but the stool was far enough down to be painful. I hobbled gingerly back to the sofa and sat/lay in a position that caused the least discomfort and waited for something good to happen. Nothing good happened. This was at about ten in the morning.

After a couple of tries I had moved things along another millimeter or two, which only sufficed to lodge a bigger chunk of clay-like stool right at the porthole of freedom, where it was as painful as it could possibly be. It was like having the gnarled, knobby end of an Irish walking stick or the spiked ball of a medieval mace stuck in my rear end. After a few more tries I sent my wife to the store to purchase a laxative, which is precisely what I should have done four days earlier and would have it I had been properly (in my opinion) counseled upon discharge. The bad news, I later learned, was that the laxative was great for future bowel movements but would be of no use for the problem at hand.

Time after time I returned to the toilet, and each time the pain increased but no relief was obtained. I was beginning to get desperate. The pain was intense and offered no prospect of diminishing anytime soon. My wive later told me that she was approaching the point of taking me back to the Emergency Room, such was my physical discomfort and her emotional anguish from watching as I suffered. I finally found myself praying to God for relief, even though I suspected that God is not in the business of giving colonics. I knew that God, when He was with us on Earth, suffered greatly too and that He understood my pain, and that gave me some comfort although I confess that it wasn’t much.

By four thirty in the afternoon I clutched at my final straw. I asked my wife to go to the store and purchase an enema. When I was a kid we had one of those in the house, although I cannot remember ever seeing or hearing of it being used. I didn’t even know if they made the things anymore but as luck would have it, they do. My wife returned with my last best hope, and after about twenty minutes of assembly and test runs, we put this final plan into action.

At this point I will cease with close descriptions of this drama. They are gross and embarrassing. The procedure itself was painful in the extreme and not immediately successful. Repeated attempts, each one introducing a little more of the warm water which I hoped would loosen things up, resulted in having to clear and clean the nozzle while I waited in almost breathtaking pain so that I could try again. Finally, after the third attempt, while the nozzle was once again being cleaned and prepared for use, all hell broke loose.

I could hardly believe that my ordeal was over. I simply said to my wife “it’s out”, but she could scarcely believe it either. She continued to clean the nozzle and I repeated “it’s over. I got it out.” Finally she allowed herself to believe it, and we just looked at each other; her standing by the sink and me sitting there doing my own interpretation of “Game of Thrones”. The relief washed over both of us and we went about the business of cleaning me and the bathroom up.

I returned to my sofa, but this time in considerably less pain. It would still be the next day before the fire down below was finally extinguished. At this point I began to take the laxative, drink glasses of prune juice, and a glass of water containing a tablespoon of psyllium seed husks every day, plus up the fiber in my diet even higher. It was and continues to be my intention to never go through that again.

If anyone is still reading this tale of my scatological nightmare I would like to reiterate why I wrote it. I did not expect to need bypass surgery. We never know when such things will overtake us. Anyone reading this may find themselves tomorrow faced with a difficult and painful surgery in their immediate future and if, heaven forbid, that is the case you might find yourself in the same position that I was. If I have properly utilized this opportunity to tell one person this messy and embarrassing tale, and if it in turn results in that person avoiding the dreadful situation that I endured, then I will understand why I had to endure it at all and will celebrate that I was able to help that one person avoid the pain.

There is my story. I urge you, reader, to take it to heart and make of it what you will.

A Memorable Day With My Friend Clay

The year 1971 is a year that was nearly lost to me. I grew up in a very authoritarian family, and upon reaching eighteen years of age in 1966 joining the Army, even in the middle of a way, was like liberation to me. My father was raised in a strict rural Georgia family and spent twenty years in the Navy where he flourished in the military environment. It was natural then that Dad modeled that regimented style into his parenting.

Being in the Army was, as I said, like liberation. After basic and advanced training I found the Army to be a routine which left me more or less alone for a good piece of the day, with large amounts of free time of which I could dispose pretty much as I wished. I know that this will sound odd to a lot of people, especially those who have also served in the military, but that is the way it was. My first real duty station was a supply company in name only. We didn’t supply anyone with anything. After breakfast we were supposed to return to our barracks and wait for the First Sergeant to come and select us to perform menial labor around the fort where I was stationed. Most of us elected not to hang around the barracks, and our sergeant became very good at finding us in the snack bars, the PX, the post swimming pool and so on. I don’t think Sarge was much of a reader however. I mostly hid in a branch of the post library not two blocks from our company area and Sarge never looked for me there. He really hated me for hiding so efficiently from him.

When my name was called and orders arrived for Vietnam I was glad to go. I had had enough of Texas and needed some newer scenery. I arrived in country and soon was working twelve hours on, twelve hours off, with every fourteenth day a day of rest for me. I found a surprising amount of free time within that schedule as well and, in the absence of all of the spit and polish that is common to the military life outside of a combat zone, I actually felt free and mostly left alone except for the inevitable annoyance which comes with being in a place where people are trying to kill you.

When I left the Army after three years I was now free of my father’s close supervision, free of the regimentation under which I had lived in the Army, and free of any kind of good sense. All of this took place in the late 1960’s and as most people know the late 1960’s were a time when, for many people, moderation and restraint were ripped out of our lifestyles and thrown into the ash bin of history.

Being ungrounded in any spiritual or moral framework I embraced a lifestyle of radical personal freedom that was visceral and not philosophical. If I wanted to do something and it seemed like I could probably get away with it, I did it. I was neither nihilist nor anarchist; I just wanted to do what I wanted to do and mostly did it. All of which is to say that I was stoned a lot on recreational drugs in those days and don’t remember a lot, and that is why there are big parts of 1971 that I do not remember so well. On the other hand there are parts which I remember quite vividly, and this is a story of one such event which stands out clearly in my otherwise foggy memory.

I loved to travel then, even as I still love to travel now, and when one of the guys in the group of students and ex-military guys with whom I was hanging out returned to the San Francisco Bay Area to become involved in his father’s large construction company, this gave me all the excuse I needed to pay a visit to that magnificent part of the country. My main traveling partner in those days was Joe Medina. Joe had been in the Air Force with Clay Wistler, the recently moved friend, and we all met at college. Joe and I needed almost no excuse to drop whatever we were doing and go backpacking in the Sierra Nevada mountains in California or just putt around the state visiting his friends and/or mine. Joe and I would throw a few items into his Volkswagon bus (yes, when you were stuck on a two lane road going uphill in a string of 200 cars behind a chugging VW bus, that very well might have been us) and roll down the roads and highways of California stoned and happy.

We would camp near Lake Tahoe, stop in for a few days in Sacramento to visit his friends Mike and Yoko, or drive over to Petaluma to see my friends Lara and Sherry, whom I met on a camping trip in my teens in the Laguna Mountains behind San Diego. A couple of times we stopped in Yosemite, parking in the public areas and then hiking way back up the east end of the valley where it begins to climb up into the Sierras. That was some of the most beautiful country that I have ever beheld.

On one trip however we went specifically to visit our friend Clay. Clay was now driving a cement truck for his father’s construction company when he worked at all, which was not very often. One can sometimes get away with a certain amount of laxity when one is the only son of a wealthy businessman. Most of the time Clay spent loafing on a twenty-six foot sloop which he tied up to a buoy thirty yards or so off the dock in Sausalito Harbor on the north side of the Bay. Clay had a six foot boat called a dinghy tied up to the back of his sloop, and when he wanted or needed to go ashore he would cast off in that little boat and putt into the dock. This guaranteed Clay a certain amount of privacy, a situation which Clay valued greatly.

Joe and I arrived at the dock and locked up his VW. We walked to the end of the dock and Joe took out of his pocket a little compressed air horn, such as people use at sporting events to make a loud, annoying noise. This horn was Clay’s doorbell. Joe pointed it at the sloop and gave it three short blasts. Shortly after that Clay’s head appeared over the side of the boat, or the gunnel, I think nautical types call it. Clay waved back to us, mounted his dinghy, and putt-putted his way to the dock to pick us up.

Clay’s boat was surprisingly comfortable for the three of us, with room for three sleeping bags, a galley, a head, and room to lounge on outside on the deck. We relaxed from our long drive, smoking a joint or two and sharing a six pack of Budweiser that we brought out to the sloop with us. At length however the sun began it’s descent in the sky above and we decided to go into Sausalito and eat rather than cook in the small galley. We climbed into Clay’s dinghy and he navigated it over to the dock, where we tied the dinghy’s rope to a piling and climbed up a ladder to the surface of the dock, and then walked a short distance to the No Name Bar.

That was not really the bar’s name. In fact, the bar had no name. There was no sign on the front identifying the establishment as a bar. Only a sign in the front door window alerting people under the age of twenty one that their presence was not welcome gave any indication whatsoever of what to expect upon entering that establishment. If you lived there however you knew exactly what you would find there; excellent mixed drinks if your preference ran to that (mine didn’t), great wines, cold beer, and pub grub that bordered upon gourmet.

We sat at a table, ordered our food and some beers, and spent quite a while at the No Name. I don’t really know how long because time was not something that I cared about all that much and so I usually chose to ignore it. However long we were there, it was quite dark when we exited the building and began to wobble back across the street and along the dock to where we had tied up earlier. When we returned to the dinghy we learned that time might be a concept of little consequence to us but tide was a much more substantial and pressing issue.

The tide may have been coming in when we tied up in the afternoon or it could have been at low tide, but one thing was abundantly clear; it was certainly coming in now. The point on the piling at which we had tied up the dinghy was several feet below the surface of the bay now and the rear of the dinghy was being raised out of the water as the bow of it was being pulled down by the taut rope. Clay cursed his stupidity and began to peel off his shirt and shoes. He extracted a knife from his pants pocket and slipped into the water, submerging near the piling and slicing through the rope as close to the piling as he could. The rear of the dinghy slapped back down as the rope gave way and Clay broke through the surface of the water, still fuming about his rope and unschedule dip in the water.

We climbed into the dinghy and made the short trip back to the sloop, where Clay toweled off and changed his clothes. His shower facilities were on land and so he would have to wait until the next morning to wash off the salt water from his swim in the Bay. We smoked another couple of joints and then turned in to sleep to the rocking and rolling rhythms of the swells on the Bay. It was a relaxing motion and I slept like a baby.

The next morning Clay got up early to shower and pick up some supplies at a store. By the time Joe and I awoke Clay was back with bacon and eggs cooking in the galley and a couple of six packs in the cooler. We had decided the evening before to cast off from the buoy and take a ride out on the Bay in Clay’s sloop, and although we had slept late it didn’t take us long to eat and clean up, and soon Clay was navigating his sloop out of the harbor and onto the broad expanse of San Francisco Bay.

If you have ever been there you know that the Bay is one of the most beautiful places on Planet Earth, and this day was one of the finest and most clear that I had ever seen. The massive yet graceful span of the Golden Gate Bridge stood out in its red/orange glory against the indescribable blue of the sky over the Pacific Ocean. Alcatraz Island slipped past and behind us as we slid effortlessly across the slight chop of the untroubled surface of the Bay. Sipping our beers, sharing joints and gliding like a phantom over the waters I felt as free as I ever had. Out in the middle of the Bay there were no rules, no expectations, no timetables to be met. This was exactly where my radically individualistic, unmoored soul longed to be. Nothing could touch me here. Nothing could make me dance to its tune. Nothing except—.

AHHHWOOOOOO! The deep roar of a ship’s horn brought the three of us out of our stoned reveries. The Gate we had seen. Alcatraz we had seen too. But somehow the gigantic oil tanker that was now bearing down upon us had eluded our attention. “Holy Shit!” we bellowed in unison, and Clay instantly maneuvered the sail and tiller so that we would catch the maximum amount of wind to push his sloop out from in front of the black behemoth which was looming up over us already. Joe and I leaned far over the port (left) side of the boat as the starboard (right) edge dug deep into the water after Clay’s maneuver. From that position I could see the top of the ship’s bow which was pressing relentlessly straight towards us. Some Asian crewmen were looking down at us, probably certain that we would be run down and killed beneath the hull of their great ship.

Somehow, that didn’t happen. Clay’s quick action and a good breeze propelled us like a shot across the water and we looked back with relief as the tanker, with a huge “Phillips 66” emblem painted on the side, plowed irresistibly past us. Clay backed off on the sail and we slowed down to a more measured pace. For a minute we just looked at each other, too shaken to say anything. Joe had peed his pants, and I have no idea why I had not done so too. Then we began to laugh so hard that piloting the boat became impossible, We lay more or less dead in the water while we laughed away the terror which had so recently owned us. Joe peeled off his soiled pants and underwear and gave them a good wash in the Bay. He got some fresh clothes out of his pack which was stowed in the sleeping area below deck and we proceeded to continue our tour of the Bay.

On the way back we stopped in Tiburon to pick up a case of beer and then returned to the safety and calm of the buoy in Sausalito Harbor. After tying up the sails, I think that may be called “reefing” them but I am not sure, and immobilizing the tiller we climbed into the dinghy to go get showers and a meal somewhere that was a little less expensive than the No Name Bar. That night we slept the peaceful sleep that God grants to drunkards and fools before arising the next day and continuing with our journey to wherever we went next (I’ve forgotten that part), blissfully unconcerned with how close we came to a watery death the day before on the beautiful but sometimes dangerous waters of San Francisco Bay.

The Tale of Captain Henry Kershaw

“You never can tell who’s hiding in the woodpile.” That was my mother’s way of saying that we cannot help who our relations are or who our ancestors were, and you cannot always be sure about who you’re even related to. It was funny to me that Mom would actually have such a saying when for most of the years that I knew her she never showed very much interest in who her own distant family members were or might have been, and none at all about my father’s. That familial and generational ambivalence seemed to change a bit as she grew older and moved back to her home state of Kentucky in her retirement years, and on one visit I found myself one morning in a car headed east on the Bluegrass Parkway towards Lexington and the mountains further east of there.

Most of Mom’s immediate relatives had settled in Louisville Kentucky or across the Ohio River in New Albany, Indiana. She grew up however in the coal mining mountain counties of Eastern Kentucky. To be exact, a large part of her childhood was spent in and just outside of Hazzard, Kentucky. Mom used to laugh when we would watch the television show “The Dukes of Hazzard.” She called that show “The Dukes of Riverside” because the terrain in the television show looked a lot more like Southern California than Eastern Kentucky. I later found out just how right she was about that.

On this clear, warm Kentucky day we took the Parkway through low hills and broad fields of corn and tobacco and in an hour or two arrived on the outskirts of Lexington, where grand farms raising some of the finest horses in the world lined the road which narrowed as it neared the center of town. I don’t care much about horses one way or the other but I have to admit that the sight of a group of three or four of them standing regally under the shade of an oak or elm tree, with the white rail fences and ever-present arena and track, did stir the Kentuckian blood which runs through my veins.

We threaded our way through downtown Lexington, picked up the Bert T. Combs Mountain Parkway, and headed east. The flat farmland continued for about a half hour and then the road began to rise and twist through low hills that bunched together closer and higher until we knew that we were officially in the Appalachian Mountains of Eastern Kentucky. A bit further on we found the turnoff to State Route 30 which led to the town of Jackson, the seat of Breathitt County. After another half hour we pulled into Jackson, a picturesque mountain town with a downtown that seemed to be right out of the late nineteenth and early twentiety centuries. There was a lot of stone and brick, with diagonal parking in the street in front of the hardware store, the drug store, the dress store and so on. Jackson looked like the set of a movie and I would have probably not believed it to be real if it was not so much like Campbellsville, Lebanon, Bardstown and a host of other small Kentucky towns that I had already visited.

I parked our car in one of the diagonal slots in front of a large stone and brick building which housed the Breathitt County Library. My mother had a list of relatives whom she wanted to research and I was mostly along for the ride. We exited the car and walked up a short flight of stairs to the front door, which we found locked and sporting a sign which gave some reason or other why the building would not be opened that day until one in the afternoon. It was now barely ten thirty, and so Mom and I went back to the car to decide what to do next.

“We’ve already eaten breakfast” I said. “Do you want to walk around Jackson?” “No” she replied. “I don’t have any close connections here.” “Oh, really? I thought your family was from around here and that’s why you are using the library to look up some genealogies” “Some of them, yes, but only the more distant ones. I grew up in Hazzard, in the next county east.” I pulled out our Rand McNally atlas and saw that indeed, less than a hour further down the highway was Hazzard, Kentucky. “You want to go there?” Mom’s eyes lit up just a little but she said “I don’t know anyone there anymore.” “So what?” in asked. “We could just go and take a look.” Mom thought about that for just a minute and then nodded her assent. I backed out of the parking slot, nosed the care back onto U.S. Route 30, and we were quickly on our way to Hazzard.

As we drove deeper into the mountains I began to understand why Mom used to laugh at the television show. Breathitt and neighboring Perry County, of which Hazzard is the seat, are very vertical places. Steep, forested hillsides and deep valleys through which tumbled swift creeks and narrow, twisting roads were the order of the day in this broken, irregular landscape. The long, straight country roads that the Dukes piloted their muscle car down bore no resemblance whatsoever to the serpentine roads in this vertical land.

Mom and I pulled into Hazzard and quickly found ourselves in an older part of town. “Park here” said Mom, and I rolled slowly up against the curb. We exited the car and began to walk along the sidewalk in front of a row of usable but sad looking and run down buildings, some of which still contained struggling businesses but many of which were empty. Across the street was an old wooden pedestrian bridge which spanned two hills between which a narrow road came into town. “I used to walk on that bridge when I came into town as a girl” Mom said. “My best friend, Etta Boggs, and I would go to school or I would go to buy some small thing for my mother, and I would cross over that bridge. It came down to town just around the side of that hill”

I instantly became interested in this girl, Etta Boggs. What would she look like today? ¬†What would she be like? Did they play with dolls, even if only paper ones? Did they fix each other’s hair and talk about boys? Could they ever see each other again? I asked Mom if she ever tried to find Etta Boggs. “No. I wouldn’t even know how to start looking for her. Etta married young to a man who worked at the mine office. He had a good job, as those things went back then. One day there was an explosion at the office; gas or coal dust, I don’t know what caused it. The explosion blew the office safe into the air and it landed on Etta’s husband. Squished him good. I left right after that and lived with the Browns in Newport News Virginia and never saw her again.”

This was a time before Google searches and the ancestry web sites, and I knew that Mom was right. It would require a laborious search of genealogy libraries with follow-ups of birth certificates, marriage licenses, birth announcements and perhaps a death record to hunt down the mysterious Etta Boggs. Mom didn’t seem interested enough to do the legwork to find Etta’s trail and so I let the topic drop.

We continued walking the sidewalks of old Hazzard, Mom pointing out where stores and homes and schools used to be when she was a little girl and I felt the mixed emotions of imagining her when she was very young in the 1920’s in a bustling town, and comparing that vision with the old, tired, down-at-the-mouth town through which we were walking. It seemed like Mom wore her years much as the town was wearing its own. We soon felt like we had killed enough time in Hazzard and reentered our car to begin the return trip back to Jackson. Mom was hungry but we decided that the fare in Hazzard did not look too tempting, so we gassed up and made our return to Jackson. To be fair to Hazzard, we did not go into the newer areas to the east of the old downtown. It might be a much more attractive place than what we saw. I also think that there may have been a ghost or two pestering Mom there; the boyfriend who didn’t work out, the cousin who drowned in the creek, poor old Etta’s squished husband and so on. In any case, we were soon heading west, slowly losing elevation as we rolled back down the road to Jackson.

In Jackson we stopped at a drug store which had a lunch counter that offered the usual southern fare. Burgers and fries, bologna and macaroni and cheese, or fried anything. We ate and left a tip which Mom thought was too generous and returned to our parking slot which was still available in front of of the big stone building. We were five minutes early and waited in the car until we saw the sign come out of the window and the doors open up. We slipped out of the car, made our way up the stairs, and then plunged into the cool confines of the library. We found the genealogy section right away and I left Mom to her research while I went throughout the library savoring its look and smell and feel, and daydreaming about the generations who had passed down those aisles and past those stacks of books, sat at the tables and perhaps flirted over by the section housing the history of the Roman Empire.

Mom was having success with her search and called me over to see what she had found. Mom’s maiden name was Cooper and her mother’s name had been Kershaw. She had always heard that a great great uncle, Captain Henry Kershaw, had been a bit of a rogue and had even seen him mentioned in an article in “Kentucky Magazine.” Mom was on a mission to set the record straight about her distant uncle. She had found a wealth of records including microfilm and microfiche which contained photos of news clippings, court entrees, sheriff’s warrants and the like and as we worked together the picture of that distant relative began to come into a sharper focus.

Captain Henry Kershaw, or “Cap’n Hank” as he was called, enlisted in the Army on the Federal side in the Civil War. Through his own skill, luck, and ¬†attrition he rose to the rank of Captain by the end of the war. After Appomattox Cap’n Hank returned to his home near Jackson and began to farm and mine a type of near-surface coal, which gave him the funds to enlarge his land holdings. Kentucky had been a border state however, and the Confederate Army also drew units from that state. After Appomattox those soldiers went home too. This was not a good mix.

Amos Riesen had never liked the Kershaws anyway, and when Cap’n Hank bought the land next door trouble was inevitable. Cap’n Hank had a nice herd of swine and when he noticed that he was missing quite a few shoats, or juvenile pigs, he was certain that he knew who the culprits were so he set a trap. Cap’n Hank was waiting early one morning when the Riesens came to plunder his stock again and put a well-placed bullet through the heart of Cletus Riesen, Amos’ oldest boy. The other Riesens exchanged fire with Cap’n Hank and then fled, leaving the body of Cletus where it lay. Cap’n Hank secured the body to his horse and brought it to the sheriff in Jackson, who declared the homicide to be justified but would not swear out a warrant for Amos. That rascal would only deny that he had been there and in the end it wouldn’t be worth the effort.

As I suggested earlier, there were families and clans which aligned with either Federal or Confederate sympathies. The Federals were known as the Red Strings and the Confederates as – and I am not making this up – the Ku Kluxers. Naturally, Amos Riesen was a Ku Kluxer and Cap’n Hank was a Red String. So Amos gathered a few cousins and his remaining offspring and encircled the cabin of Cap’n Hank one dark night. When dawn came they opened fire on Cap’n Hank, and he and his wife and his young son were pinned down in the cabin.

After three days, his food and ammunition running low, Cap’n Hank crept out at night and put his young son on a horse and sent him for help. The boy got through and soon a dozen or so Red Strings were riding to the rescue. The relief column showed up and took the Riesens completely by surprise, killing three of them while the others took to their heels and fled into the forest. Cap’n Hank then led his men to the Riesen homestead, sent the women and children to walk to Jackson, killed all of the livestock and burned down every building on the farm to the ground. That was enough for the Riesens. Amos took his immediate family and moved to Tennessee, while the remaining family members gave Cap’n Hank a wide berth ever after.

For his remaining years Cap’n Hank was a peaceful man, more or less. His association with the Red String bunch placed him at odds with the Ku Kluxers, and from time to time and there were reports, unsubstantiated of course, of him being involved with assaults and shootings in connection with the feuds which wracked the county. But Cap’n Hank worked hard, increased his holdings and made a large family before one morning, when riding back with his youngest son from an inspection of some of his more distant property, he was ambushed and killed. The boy got away to report the event but nobody was ever charged or arrested. It was just not healthy for a sheriff to take a side in those feuds until well into the early twentieth century.

Mom and I were lost in time for almost three hours in that library, and when we were finished we looked up and saw that it was later than we had planned to stay. Dad was going to be cranky because we would not return home until nearly sundown, and he liked to eat earlier than that. We called him to let him know the situation and then hit the road west towards their home in central Kentucky. We chatted almost non-stop about all of the people and events that we learned about on that trip and made our plans to do it again soon. Those plans didn’t work out, but I at least have that one memory or Mom and her crazy Appalachian, feuding family. It is enough for me.

Serious As A Heart Attack: Epilogue

Home at last. Home, where I can lie in my own bed, eat food of my liking, sleep in front of my cheesy old movies and relax while my body knits itself back together. At last I can truly heal, because I am home. At least that is what I thought. The reality however is that I have never before had my chest split open and sewn back up and been put on blood pressure and antiarrhythmic medications, so I really had no basis for expecting anything. And the unexpected is exactly what I got.

My appetite and enjoyment of the taste of food did not return right away, and although I ate much more than I did while in the hospital, and ate much better stuff, there was little joy in it. A persistent light headedness continued and continues to make walking difficult, and the slightest hill of any sort will exhaust me almost instantly. The combination of less food and a lower sodium intake than before my surgery, plus my various medicines, led to dehydration which for one night put me back into the hospital. What a scare that was, as one of the possible causes of my problem could have led me back into the operating room to be opened up again. I think I would have preferred to slip into God’s arms rather than to do that. Fortunately for me, my problem did not need to be addressed in that manner, and I will always be grateful for that fact.

One thing that I mentioned earlier was the threat of constipation, the result of anesthesia plus pain medication plus heart medications. I ate salads and veggies galore and other high fiber foods, drank a lot of water, and still fell afoul of constipation. To a great many people that seems like a minor problem, a humorous side-note, a potty joke. It was none of those things. Constipation is a vastly painful condition which is exacerbated when in the context of major surgery, which left me in agony for at least six hours and almost sent me back to the Emergency Department, so awful was it. I feel constrained not to describe my pain or the difficult and messy manner by which my constipation was resolved because I believe that the story should be told in detail with proper prefaces so that the reader will understand from the very beginning that there is nothing in that story meant to be funny or gross or shocking or anything else. If I ever write that story it will be because I hope that at least one person will read it and take it to heart so that they never have to go through what I went through that day.

And then there’s the sweating. I would wake up in the middle of the night with bedclothes, sheets and pillows drenched in a cold sweat. I assume all of the medications I had taken plus the anesthesia had to work their way out of me, and also my improved eating which replaced what was already a fairly good diet was probably liberating toxins stored up in fat cells which were now melting away. I have lost nearly fifteen pounds since my surgery and the junk stored in those fat cells has to get out one way or another. My wife was kept busy washing clothes and sheets and pillow covers every morning for much of the first week that I was home. This has now subsided and I hope is at an end, although I deep protective coverings over my bed just in case.

Still, there have been many things at home that have lived up to my hopes. I cannot go into my garden but I can see it from the deck or a window, and I can eat out of it. I would love to pull the weeds creeping amongst my rows and beds and lift the drooping tomato plant branches and support them with cloth slings tied to wooden frames that I have build around the plants, but that is not to be for now. Instead I can watch my wife and my son water and tend and harvest my vegetables, and that counts for a lot.

So it’s been two steps forward and one step back; one step forward and one step back, and so on. My recovery is very likely to take the whole three months that I have been given off from work, and I still wonder if I will have the energy to return to what can be a physically demanding job. I’m not overly concerned about that as we could probably do all right if I was to retire, but I did not want to do that yet and it would be a hardship of sorts if I should have to. I will continue to pray for healing and be comforted to know that I have family and many good friends praying for that end as well.

Now it’s time to tell other tales and lighten the mood. No matter what happens from this point on, my life has still been an interesting one, to me at least, with many stories to write and hopefully many laughs to share with my readers. And from now on when I am tempted to respond to somebody’s question of ‘seriously?’ by saying “I’m serious as a heart attack”, I believe that I will catch myself and ask “was I really that serious?” My guess is that the answer will be that I am not quite that serious after all.

Serious As A Heart Attack, Part VI

“Good morning Glenn. How are you feeling today?” Kim, my new daytime nurse, was smiling and active, even perky. Nothing could have been more diametrically opposite of how I felt. I had been awakened two or three times the night before by a nurse taking vital signs or a phlebotomist drawing blood or somebody sticking a needle into my belly injecting something, insulin I think. I still felt light headed, as I had since I awoke from surgery, and I was still without any appetite at all.

“Today we are going to walk a little, and if you want you can take a shower. Your urinal is in the bathroom; if you need it, call and we’ll help you walk to it. Your breakfast will be here in a few minutes. Is there anything else I can do for you now?” I assured Kim that I was all right for the moment and she left to perform other duties, leaving me in bed to ponder my new stage of recovery. I did not feel at all like eating OR walking, and even though I knew that both would be good for me my body recoiled at the thought of it. As Kim had promised, my breakfast did arrive within minutes of her departure.

Diane, a nurse assistant, brought in my breakfast tray and set it on a bedside table. “Come on, Mr. Durden. It’s time to get into the chair.” I grudgingly complied, grasping a pillow against my sundered sternum and allowing Diane to get her arms around me so that she could help me up to a sitting position on the side of the bed. Using my own arms to push myself upright was forbidden, as the muscles of the arms are leveraged against the muscles of the chest which attach, among other places, to the sternum. I did not need the muscles attached to either side of my sternum pulling in opposite directions, separating that bone which was now cut into two pieces and wired back together. One surgery was enough; I had no need of another to rewire my sternum.

“Up we go.” And up we went. I sat on the edge of the bed for a minute or two, getting my balance, and then stood up, once again using my legs instead of my arms to push me erect. The chair was only a few steps away and I carefully sat down in it, still pressing my stiff pillow tightly against my chest. “There you go” said Diane. “Now lets see what we have for breakfast.” What we had was oatmeal with raisins, a small fruit bowl, a cup of cranberry juice and something else, the memory of which escapes me now. I looked upon my feast with a relish approaching that with which a taxpayer looks upon the approach of an IRS auditor.

“You have to eat to get your strength Mr. Durden” said Diane, and I knew that she was right. So I lifted my spoon and began first to work on the chunks of canned peach and pear and a few bits of melon which might have been fresh, and washed it down with my juice. That didn’t amount to much but it added up to more than I really wanted. Now I dipped my spoon into the oatmeal and began to mechanically chew. It was like asking a T-Rex to eat tofu. I rolled each spoonful from one side of my mouth to another, chewing and chewing and finally swallowing, just to get rid of the noisome stuff. I probably ate no more than a quarter of the bowl and then pushed the button that would alert my caregiver that I was finished. Diane quickly arrived and swept away my tray.

“I’d like to get back into bed now” I said. “Since you’re already up, why don’t we get your weight and take a little walk” Diane replied. I groaned but nodded my approval. Clutching my pillow I once again arose and walked unsteadily about ten feet to where a large scales awaited me. I stepped onto it, Diane recorded my weight, and then we headed out of the doorway and into the hall. I really didn’t want to do this and so I set out to get it done as quickly as possible. I probably went thirty feet down the hall, and at a faster rate than I should. I turned around to make my return trip and the distance to my room looked like miles to me, so I quickly pushed on, wanting to get this ordeal over with and back into my bed.

At last I did get to my bed and carefully fell back into it. I could feel my heart pounding with the exertion and my nurse quickly made an appearance. Kim took my vital signs, felt pulses, listened to heart and lungs and then disappeared for a few minutes. When she returned she injected a medication into the central line that was still in my neck. It turned out that the exertion caused my heart rhythm to go into atrial fibrillation, and the result of that was a new medication taken each day to ensure that my heart stayed in what is called a ‘normal sinus rhythm’. I still take that pill every day and will probably continue to do so for another month or two to come.

This pattern of activity dominated the rest of that day and the next two and a half days to come. I finally got my shower the next day, and not a minute too soon. I had worked and hurt and sweat for four days by then and I could draw my fingernails across the back of my neck and scrape up an opaque bit of dirty oil underneath them. A chair was placed in the shower and I sat on it while I sprayed myself with a hand held shower nozzle. I have never felt better than when I emerged from that shower.

Thursday and Friday were a monotonous progression of walks and meals (which nearly made me throw up) and blood draws and finger pricks and belly injections and attempts to have a bowel movement. Anesthesia, pain medication, and even some of the heart meds that I was taking have the unpleasant side effect of causing constipation, and when you have had your chest cloven in two any sort of straining is to be discouraged. My central line was removed from my neck (a very strange sensation if I do say so myself) and a final few wires in my chest were extracted. It felt good to finally be free of all technologies which had invaded my badly beaten-up body. Friday was proposed for my discharge, but my doctors, nurse, and ultimately I felt like one more day would do the trick.

Saturday arrived and I initiated my final round of unappealing meals and walks around the hallways of the sixth floor. I took another shower and brushed my hair, and for the first time in a week and a half put my baseball cap on my head. My wife appeared at about ten thirty and we waited as a depressing series of doctors and pharmacists and dietitians made their final interviews with me. Finally a cardiologist cam into my room, spoke with me for a few minutes, and pronounced me ready to go home.

Words are inadequate to express how I felt as I rode in my wheelchair down that elevator to the first floor. My wife had moved our car to the front entrance and we rolled out to it. I rose up out of my chair, sat carefully in the back seat, said my goodbye to Diane, and my wife fired the car up and rolled away from the hospital and out onto the street. I relished seeing the blue sky and the familiar houses as we crossed the five blocks or so which separate my house from the hospital. People were out working in their yards and at one house a small child played at it’s dad’s feet while dad puttered around the garage. The beauty and rhythm of the life I watched as we drove home were healing medicines all by themselves.

In a very few minutes we rolled in front of our house. My wife pulled slowly up the driveway and I looked out of the window at the abelia and hyssop that I had planted years ago. I saw that the white, pink and coral flowers were crawling with bees, and it looked good and natural. I also saw that the hyssop needed water. Hyssop has more shallow roots than abelia and must be watered more frequently. “That’s OK” I said to myself. “It’s all right now. Daddy’s home.”

Serious As A Heart Attack, Part V

Day number three after open heart surgery dawned in a fog, much as day number two had ended. My nurse had configured my bed in such a way that I was semi-upright all night, and for some reason that helped to control the pain which had run riot in my body the day before. As always I slept most soundly in the later morning period, so I slumbered pretty much right up until breakfast arrived. I was transferred to my chair and waited for my breakfast tray to be brought over to me.

I don’t remember what it was that was brought to me for breakfast but I do remember my response; I grabbed the nearest plastic bucket – they kept one within my reach at all times – and threw up explosively into it. I had hardly anything in my stomach so the volume was low, and I felt a good deal better when that was done. I had no interest in breakfast however and asked them to remove it from me. It would be several days before I would have any desire to eat again.

Nobody had arrived to visit with me yet and so I remained in my chair for a while with my eyes aimed in the direction of the television screen but with no real recognition of what channel it was on or what they were saying. Time passed in this manner as people slipped into and out of my room, some to draw blood from the central line in my neck, others to poke my fingers to monitor sugar, and still others to give me some kind of injection into the fat around my belly. Most merciful was the nurse who came in to push another syringe full of Dilaudid into my central line. More than that is only a blur and I would not be able to accurately describe it.

As the morning wore on the various doctors taking care of me stopped in to check on me. First was the Family Medicine general practitioners, usually consisting a trio of Dr. Manning and two residents who are not yet licensed to practice on their own. Dr. Manning and I have known each other for years and he is a lover of history as I am, so we usually ended his visits by giving each other a history challenge question. “What was the Beatles’ album which changed the course of rock music?” (Answer: Sergeant Pepper’s Lonely Hearts Club Band), or “Which WW II battle took place in May of 1942 and changed the course of the war?” (Answer: Battle of Midway), and so on. On this day I was in no kind of shape for such banter and Dr. Manning could sense that. A brief examination by the residents ensued and I was returned to my bed because my exhaustion was now becoming more of an issue than the pain.

My wife appeared at this point and took up her position by the bed, stroking my forehead or brushing my shoulder, completely unable to reduce the pain but communicating clearly that she would do anything in the world if she could to take it away, and there was comfort in that. We passed an hour or so I think in that way until the next group of doctors made their appearance.

Dr. Willis is with the surgical group of which Dr. Grossing, my surgeon, is a partner. He was checking on me that day along with Rachel Lenz, the physician’s assistant who was involved with my actual surgery. They examined the incision site on my chest and declared it to be infection free so far and healing nicely, and then they knelt down by the bubbling canister at the foot of my bed. “Take a breath and bear down on it Mr. Durden” said Ms. Lenz. I drew a breath and bore down on it as much as my stoned stomach muscles and screaming chest would allow. “That looks good Mr. Durden. How would you like to have your chest tubes out?”

I had been told that the tubes draining grunk from my chest could be a major source of the pain I had been experiencing for the last day and half so I jumped at the opportunity. In a flash the tubes were gone and after a little puttering around on my chest, which probably represented suturing the holes where the tubes had been, I was finally free of the tubes and the urinary catheter which they removed at the same time.

The improvement in my pain situation was almost instantaneous. There was still pain aplenty but the Dilaudid was more than adequate to keep that down to an acceptable level. I could finally lie in my bed and enjoy my wife and son, who appeared a short time after one in the afternoon, and carry on a conversation with them between naps which tended to remain on point more or less. I would describe that afternoon as pleasant, at least as pleasant as one could expect it to be under the circumstances.

A big change occurred at about five o’clock however. A gurney appeared and it was time for me to leave the CVICU and transfer to the sixth floor where less critical patients continued their recovery. I knew right away that I would miss the staff in CVICU. They had been very kind and attentive and I felt very well taken care of. I want to visit them very much when the time comes that I can walk and move about with more ease than is currently the case.

The sixth floor was an entirely different place with an entirely different mission. Once deposited (lovingly) like a sack of potatoes in my bed in room 6102 I was in the care of people who’s mission was to get me ready to function at home again. Because I arrived in the afternoon, rather close to shift change, I had a grace period where I could lie quietly in bed with my thoughts and narcotic dreams. My new nurse and her team of two assistants introduced themselves and then that was all that I saw of them that night unless somebody had to take vitals, take blood, give me pain meds or empty my urinal. The evening was passed in broken sleep, but the morning came soon enough and my new recovery plan took off in a big way.

Serious As A Heart Attack Part IV

The second day of recovery began when I emerged lazily and with some difficulty out of a fog of anesthesia, narcotic pain killers and sleep. My wife was beside me, as she almost always was, and as the fog cleared she was asking if I wanted to sip some chicken broth. The doctors had explained that it was important that I resume eating and drinking in order to speed up my recovery. There was nothing I wanted more than a speedy recovery, so I was eager to comply.

The broth was listed as low fat, low sodium. I guess that this is standard for hypertensive cardiac patients, but I thought that low taste, low interest would have been a good deal more accurate. Still, an order is an order, so down the hatch it went. I drank a cup of cranberry juice as a chaser and relaxed back into my bed to continue my nascent healing process.

I knew that my urine was draining out from my bladder through a catheter and found the convenience of that arrangement comforting. All of the peeing in a urinal that I had been doing before my surgery had now been taken out of the picture, and I didn’t miss it. I was actually mildly disappointed when the catheter was removed the next day, which will illustrate as clearly as possible what a lazy man I truly am. I also had one or two surgical tubes protruding from my chest and coursing into a bubbling container. Why the container bubbled is a mystery to me. Those tubes were draining blood or air or anything else which might be in my chest post-surgically but didn’t belong there. I was practically unaware of those tubes at first, but that would change.

My nurse, who was one more wonderful person in a parade of wonderful people, was constantly flitting in and out of my room taking vital signs, checking IV fluids, and generally making me feel as comfortable as possible, and the latter duty involved administering periodic doses of a pain killer called Dilaudid. The dose was prescribed to be given every three hours as needed through a catheter threaded into a vein in my right neck.

My son made his first post-surgical appearance that day and I greatly enjoyed chatting with him, although the pain killer had the exceedingly weird effect of loosening my grip on reality. I have an active if somewhat shallow mind and it is not at all difficult for me to slip in and out of a daydream at any time. Under the deluge of Dilauded which was pouring down my central line I was no longer slipping into daydreams; I was now jack booting down the door and commandeering the residence.

A conversation might go something like this. WILL: “I’m going to go to the house tomorrow and water your garden. Are there any special instructions that you have for me?” ME: “Yes. Use the sprinkler on the onions and just lay the hose at the base of the tomatoes. Don’t worry about the dog (author’s note: I don’t have a dog), he stays in the shade and will fix the bicycle tire himself if you have a…. Wait a minute, that didn’t make sense, did it?” WILL: “Some of it, Dad. You told me to sprinkle the onions and just put the hose in the tomato beds.” ME: “Yes, that will work. Do the same with the cucumbers and squash and don’t worry about the asparagus because they take care of themselves since they moved out of the house and haven’t had much trouble except that one time that the police….” It was like that all day.

As morning moved into noon the pain in my belly began to grow and by lunch had come to dominate my consciousness. Hospitals like to use a pain scale of zero to ten, with zero being no pain and ten being agony. Those scales are highly subjective of course, and for me skinning my right foot and plunging the raw flesh into salt would be about a three. By noon I was at five or six. I sat up in my chair and tried to eat, and the pain seemed to subside a bit, but I was not able to eat much and soon returned to my bed.

The pain began again to cresendo and soon I was begging for more of the pain medications with the result that I became even more stoned but not one bit less in pain. I had maxed out my Dilauded dose and still I was crawling up to an eight-and-a-half. My nurse was truly sorry for my pain and tried anything she could think of to bring it down, including exchanging morphine for Dilaudid a couple of times, but nothing worked.

The nurse’s instructions were to get me up in a chair as much as possible so that the changed position would keep fluids moving and allow me to inhale as deeply as I could on a device designed to help me gain greater expansion of my lungs. I groused about having to move in my pain but complied. It slowly began to register with me that I really did feel somewhat pain-diminished when I was sitting up. Not pain free by any stretch of the imagination, but pain-tolerable. My nurse noticed this as well, and I stayed in my chair until it was time for visitors to go home and for me to try to get some sleep.

“There’s no way that I will be able to sleep if I lay down” I told my nurse. “I know” she replied. “That’s why I’m going to turn your bed into more of a chair.” With that she began to fiddle with buttons and my bed began to move like a Transformer. The head began to raise up almost like the back of a chair and the foot of the bed dropped down towards the floor, leaving me a shelf to be seated on with feet dependent and head upright, then she tilted the whole thing back so that I was reasonably in a kick-back mode. In that bed I passed through the night. The pain level stayed down at a four or so and sleep, with the help of the Dilauded and a benedryl capsule, stole over me and I enjoyed something which approached acceptable comfort the rest of the night.

That second day was one of the worst of my life. I have suffered physical and emotional pain before and this day stands out from all of the others by a long shot. The pain in my belly felt like the larval stage of “The Alien” was eating his way up from my intestines through my liver and diaphragn and into my chest. It was hard to breathe and I performed very poorly on the device through which I inhaled in order to expand my lungs. The pain was almost like a physical entity; a beaked, taloned and tentacled monster from one of the ‘B’ sci fi movies of the 19650’s that I loved so much as a kid

Only there was no love here on this day. The tentacles embraced me with a power which refused my lungs the ability to inflate. The talons dug into my flesh and denied me the opportunity to shake my monster off in any way. The beak ripped and tore through bone and cartilage and muscle to feast on the crying organs at my core. This monster came to stay, and none of the tricks and devices which became available at the end of the ‘B’ movies to enable the humans threatened with destruction to escape the final victory of the monster was becoming available to me. I was the captive of PAIN. I would remain that way. Tough luck, Kiddo.

The pain meds, which no doubt prevented me from shrieking at the top of my under inflated lungs even if they seemed to not be working at all, also kept my mind in the fog that I mentioned earlier. It was a humorous side note to the day when I would prattle on to my family and then stop, both of us knowing that I was not speaking of anything real at all. But there were those times when I was not speaking, when I stared vacantly at the television or at the ceiling or simply into the pain which gnawed at my belly, and they were not humorous. They were dead, or at least deadening. They robbed me of what is peculiarly me and replaced my me-ness with a stoned, mentally wandering imitation of me.

I am not a narcissist by any measure, but I have grown over the years to like myself. I am glad to know that I have some good points and I can clearly see the bad ones and work towards their correction without self-loathing. I have managed with the help of God to be a blessing – a mixed one to be sure – to a wife of thirty seven years, two children whom I adore and three grandchildren. I short, as the saying goes, I’m ‘comfortable being in my skin’. The drugs blurred my self awareness and I became ever so slightly not me. The sensation lasted most of a day and a half and never came to wholly dominate the real me. It tried however and it was not pleasant, and I was eager to cut down on the narcotics as quickly as the pain would let me, which I am told was a great deal more quickly than most people who have undergone my surgery have done. That process would become easier by the events of the next day, which will have to wait for my next post.

Serious As A Heart Attack, Part III

“Good morning, time to get up.” Sandra, my nurse for the Big Morning, had actually let me sleep for a half hour longer than the plan had called for, but now it was time to get the ball rolling and she was all business. My surgery was the first case of the day and if anything delayed me, the whole rest of the day would be thrown off as well. “Let’s get you unplugged and into the shower.”

Sandra removed my IV lines and covered both sites with plastic to keep them dry, and snatched off a half dozen EKG patches, removing a little bit more of what hair I had left. She then led me to a large shower where I scrubbed down from head to toe with some kind of special soap. After toweling off and re-gowning I was led back to my bed where more blood was drawn, more pinpricks were made in my fingertips to assess glucose, and both IV sites were declared to be too old to risk going to surgery with. I did not realize that IV sites had a useful lifespan, but it turnes out that they do and mine had outlived theirs thanks to my prolonged wait through the Forth of July holiday. In a flash both of those sites were removed and a new plastic needle, but thankfully only one of them, was inserted into one of the few veins on my arms that remained at that point untouched.

That accomplished, my new site was again covered with plastic and once again I was in the shower scrubbing myself down with the anti-microbial soap. And once again I was toweled off and re-gowned and led back to my room to await the transporters who would move me to the Operating Room. The wait wasn’t long. After double and triple checking of my name and surgical procedure I slid sideways from my bed onto the gurney.

I can’t really tell you what I thought as I rolled through those unfamiliar halls. Wait a minute: Unfamiliar? How could that be? For 26 years I had passed through those halls, looking at the linoleum or carpet, the artwork on the walls, the co-workers whom I would pass and acknowledge. This time however it was very different. This time I was looking up at the sound-deadening ceiling tiles interspersed with banks of florescent lights that passed monotonously by my vision. I probably thought of the life that I had lived up to this point, the highs and the lows, and I probably thought about what life would be like afterward, although I had no way of knowing what life would be like afterward and I knew it. One thing was clear. I have assisted with open heart surgery before and I knew exactly what that would be like, and therefore made the choice to not think about that at all.

We entered the O.R. and I did a repeat of what I had done in the cath lab four days earlier. Same freezing room, same process of identification of patient and procedure, same slide onto a hard table and same wraith-like gowned, masked, and hatted doctors and nurses and techs puttering around the room preparing their instruments and equipment for the surgery that was imminent. Soon the anesthesiologist was injecting some fluid into my IV and soon I was once again somewhere out in deep space. Somebody else was occupying that space between Alpha and Proxima Centauri so I sped by them to take a gander at what was happening out near Sirius.

My next twelve hours are pretty much lost. Surgery lasted about three hours and at some point I was rolled into my new room with my breathing still controlled by a respirator and with more tubes and hoses sticking out of me than an automobile engine. I remember very little of the rest of that day, but two events stand out. With a big, fat tube running into my lungs communication became a challenge, but I still wanted to express myself to my wife and there were several instances when I successfully did that. Two occasions which I actually remember of accomplishing that feat went this way. By engaging in creative hand signs I asked my wife not to cry, and later asked her to pray for me which she did. Shortly after that event my body remembered how to breath on its own and that really nasty tube was removed from down my throat.

The rest of the evening I can barely remember. My wife was there the whole time and my daughter arrived at near 7 PM. I don’t remember the daughter’s visit more than as a shadow but I do remember the visit by her husband which followed. He had been reading about the early Christian Church leaders and their relationship with the Roman Empire. He rattled on about Ambrose of Milan in the West and John Chrysostom in the East, and their beef with the Emperor Theodocius and so on. This is the stuff we both like to talk about, but my participation this evening was sketchy at best. I was later told that I would drift off, then return with a comment which was actually pertinent to the topic, and then drift off again. The presence of my son in law and wife, and their familiar chatter, were immensely comforting and it was around 11 PM that they left and I finally lapsed into an exhaustion and drug assisted sleep.

This concludes Part III of my story. It is a short segment because there was so little that I was consciously aware of. There has been much told to me which would flesh out my story but my interest here is to record my own sensations and perceptions. I did not live the other stuff, even if I was involved in it. My true recovery did not begin until the next day, and that tale deserves a Part IV all by itself.

Serious As A Heart Attack, Part II

“Good morning Mr. Durd— oh, Glenn! What are you doing here?” Serena was in my room to pick up the next patient for the cardiovascular catheterization Lab and had no idea that the patient in question was me. We had worked in close proximity for years and were friends, but she had never learned my last name. It’s all right, really. I don’t know her last name either. “I was bored so I thought I’d come visit you guys” I replied, and after being disconnected from my bedside I.V. and monitors. I climbed aboard the gurney where I was reattached to portable monitors and was whisked away to the prep area in the Cardiovascular Observation Unit.

Prep for a catheterization procedure, or simply a ‘cath’ as we medical types call it, does not permit a patient any modesty. Human hair is about as dirty an item as one can get and the prevention of infection will be almost obsessive-compulsive in any hospital worth going to. Therefore, the hair had to go and Serena, with a coolness and professionalism that helped to diminish the awkwardness of the moment, exposed my altogether naked groin and gave the family jewels a buzz cut. The duration of my stay in CVO was short and I was glad that I had no visitors. Because of the Privacy Act hospital workers must be very careful to respect the privacy of patients, and since I have worked at the same hospital which was now taking care of me for 26 years I know almost everyone there at least a little. The close association and familiarity bred comfort and discomfort in equal measures, and I was glad to be left alone while I awaited my procedure.

I did not have to wait for long. Hardly a few minutes passed by before my escorts reappeared to roll me into the cath lab itself. I noted instantly as I rolled into the room that it was cold as a tomb. Hospitals usually seem cold but I went from snug to shiver in about 30 seconds. After exchanging greetings with the staff I slid over onto the table and issued my first complaint as a patient about how cold it was. I knew that my complaint would do no good but it seemed obligatory that I should register it, and so register it I did. A technologist placed a thin drape over me and the anesthesiologist injected a fluid into my IV. I felt nothing different and in a moment the cardiologist appeared and briefly reaffirmed what she would try to do; an angiogram, of course, and a stent if the problem was found and could be repaired in that manner. I agreed once again and the masked, hatted face of the anesthesiologist reappeared. With what seemed to be wrinkles of smile about the corners of his eyes he said “goodbye”.

Goodbye wasn’t the half of it. “Enjoy your de-existence” or “happy annihilation” would have been closer to the truth. In what seemed like an instant of time a catheter was inserted into my right femoral artery, threaded through my heart, and to the origins of the arteries which supply blood to the heart muscle itself. The dye was injected, the narrowing was found, the possibility of a stent rejected and the catheter withdrawn, all while I blissfully spun somewhere out between Alpha and Proxima Centauri. At some point I awoke sufficiently for the cardiologist to show me the images and explain that surgery would be needed, and then I was rolled back to CVICU to await my date with the knife.

This is the point at which my timing comes seriously into question. I had my heart attack on Tuesday July 1, went to the ER Wednesday July 2, and had my cath on Thursday July 3. Can you guess what comes next? July 4! National holiday! Emergency procedures only. My condition was very emergent to me but in the grand scheme of things I was considered stable. I couldn’t go home I was told but instead would await the next normal working day for my surgery, and that day was four long days in the future. I asked my wife to bring me books and writing utensils, and settled in to wait out what, except for the four-a-day blood draws, was one of the most boring 96 hours of my life.

Of course I got a lot of reading done, wrote several letters (I love snail mail) and wrote the vast majority of “Serious As A Heart Attack, Part I”. I also entertained visitors. I especially enjoyed the latter. All of my nearby family came and stayed for hours at a time with me, as did friends from church and work and a reading group of which we’ve been a part for 15 years. I loved those visits and, although there are people who would rather not be bothered with excessive human contact if they were in the same position as I was, I think that visiting friends who are confined in the hospital is one of the kindest things that a person can do.

I did have one scare during my wait for surgery. On the day after my angio I got tired of using a plastic urinal while lying in bed and asked if I could walk into the bathroom and pee like a normal man. It was more than 24 hours after my procedure and all looked well so Nick, my nurse for that day, agreed to affix all of my medical accoutrement to a mobile IV pole so that I could accomplish that task. The first effort went flawlessly and I shortly arose to do it again. While I was standing before the toilet in midstream however I began to feel a twinge in my right groin which grew rapidly into a nice burn. I instantly knew what that could possibly be and hobbled back to my bed so that I could call Nick. Upon his arrival he immediately put pressure on the bulge which had popped up under the bandage over the site where the catheter had been inserted the day before.

What I had feared is called a pseudo aneurysm. When an artery is punctured it is necessary to put a great deal of pressure at the puncture site for a good long time to be sure that the small hole left behind clots off. Doctors and technologists and nurses are good at making this happen but sometimes the hole in the artery wall pops open again and blood flows out of a narrow channel through the muscle tissue, forced by the pressure of arterial blood, and ends in a sort of pouch or balloon farther out in that same muscle tissue. These hurt very much and usually are repaired by advancing a needle under ultrasound guidance into the neck of the pseudo aneurysm and injecting a substance to cause the blood swirling in the pouch to clot off. The trick or course is to place the needle in the pseudo aneurysm and not in the femoral artery, as injecting the clotting agent into the main artery of one’s leg, well, isn’t usually regarded as a good thing. I have guided many of these procedures myself and had no interest in being on the receiving end of one, and the prompt intervention of my nurse prevented what was almost certainly the beginning of a pseudo aneurysm from happening. I spent the rest of that day and all of the next two flat upon my back, gratefully peeing in the plastic urinal and counting my blessings.

At last the final visitor who was probably my wife, an angle sent to this planet solely for the purpose of getting me through this ordeal (and helping me make a couple of wonderful kids and a few other things too), kissed me good night and it became time to prep me for the next day’s surgery. The surgeon had earlier counseled me that I might want to shorten my beard as it drooped down into the area that soon would be open like the hatch on the old space shuttle. It seemed as if he had gotten resistance on this idea from previous patients but I told him “It’s not spiritual, Doc. It’s a beard. Whup it off”. The idea of an infection in an incision extending from the surface of my chest to my very heart was entirely without appeal to me, so off it came and off I went to sleep until they would come for me at five thirty AM the next morning to begin my march to the next leg of this medical drama.

Serious as a heart attack, Part I

“Mr. Durden, you’ve had a heart attack”. Dr. Stone, whom I had known for decades, gave me the fish eye as he shared this little item of information with me. Part of me was stunned as I received this verdict but part of me was not. I had been dealing with chest pain for years and now, at last, I knew why. That might sound odd to a rational person; three years of chest pain which came on with exertion should be enough to alert anyone to a cardiac problem. The problem with that analysis however is that A. None of us, or at least very, very few of us are entirely rational, and B. Human bodies are just not at all as predictable as we would like to believe. But let me begin at the beginning.

Three years ago, while helping friends move from their condominium to a rental house where they would live while looking for a house to buy, I felt great as I hauled tables and lamps and boxes of all sizes down a flight of stairs and loaded them into a truck. I was happy and perhaps a little bit proud to be able to hold my own at 63 years of age with guys half that old. We emptied the condo and unloaded our cargo into a storage unit where it would rest for a few weeks until the rental was clean and empty and ready to be reoccupied. When those few weeks were up the call came to reverse the process and move my friends into their new nest. A crowd of us duly showed up and the work of transferring the household goods back into trucks and then into the new house began in earnest.

But something was different this time. After carrying, or helping to carry, several items I felt a distinctly uncomfortable pressure in my chest. I tried to ignore it, but the pressure was not to be ignored and so I sat down several times to let it subside before resuming my labors. At the end of the day I forgot about it and proceeded to go on with my life as I always had done before. But the intermittent pressure was not interested in going away. Climbing stairs, walking up a hill or carrying heavy loads would trigger the pressure which I was finally beginning to call pain, and at last I went to see my naturopath.

My naturopath, Dr. Marsh, is a very smart guy. He knows that there is much that can mimic heart disease and conducted or ordered tests to evaluate for food allergies and sensitivities, a chest x-ray, and ultrasound of the gallbladder and a few more diagnostics and concluded that he could not rule out a cardiac problem. I was then referred to a naturopathic cardiologist who ordered a stress EKG. That test came up positive for the heart as a likely source of the problem. The doctor suggested that I get an angiogram to confirm that I had a blockage or one or more of my coronary arteries before proceeding to fix the problem with surgery.

I didn’t like that news at all. Other than minor dental work I have never had surgery of any type and had no interest in doing so now. Also, the thought of doctors threading a catheter up an artery from my groin into my heart and squirting dye into my coronary arteries to make them light up under X-ray to demonstrate a blockage did not sound like a stroll in the part either, so I began looking around for an alternative and found it in the form of a Thallium Stress Test. This test is performed by injecting into a vein a radioactive isotope which likes to find it’s way into heart muscle, and then walking the patient at a nice clip on a treadmill to get the heart pumping at a higher rate than usual. Then, after resting for a while to allow the isotope to settle in the heart muscle I was laid on a table under a very special camera which detects that isotope. The result: no defect in perfusion of my heart muscle with the blood it needs to remain healthy.

A clean bill of heart health was exactly what I wanted to hear, and I concluded that whatever my problem was it was not heart and I would just have to work through it, so I took long walks, climbed hills, and tried to condition myself so that I could shake the uncomfortable pressure out of my life and get on with being a senior citizen superman. The plan worked, sort of but during the last year some other changes began to show up, and even though I continued to refuse to add two and two together the signs were there if I had chosen to read them.

First and most significantly, my energy level began to drop. I have always been an active guy and the barest hint of some activity to engage in with friends was all that I needed to launch me full tilt into chopping wood or playing frisbee or hauling sound equipment at my church from the theater where we meet to an upstairs office down the street where it rested during the week. A bad shoulder which is the result of thirty years of performing ultrasound exams was the primary indicator which ended my church tear down activities but I certainly didn’t mind avoiding the chest pain which inevitably accompanied that activity as well. Slowly I came to accept that there were activities that I simply could no longer do, ascribed it to my age, and settled down to learn to live with it.

More worrisome to me than my decrease in energy was my decrease in interest. I still continued to read and walk and meet with friends, but the verve was greatly diminished. Walking three or four miles in Hawai’i on a vacation was still a pleasure, but walking the same distance on the familiar streets of my own hometown was no longer tempting enough to draw me out of my chair and onto the pavement. There was always a good excuse; the weather was bad, work had been tough that day, or I had already done enough extracurricular activities that week. But the weather was no different than it had been the previous thirty years that I had lived here, my work was in fact easier than it had ever been, and my other extracurricular activities had never slowed me down before. Slowly I came to enjoy sitting in my chair reading a book on history or theology or philosophy more than sitting in a chair at a pub discussing those topics with friends.

This progression of changes finally came to a head on a Wednesday a little less than one week ago as I write these words. I had eaten on Tuesday night at about seven and after finishing dinner went outside to water the front lawn and pull some weeds in my vegetable garden in the back. Upon returning to the house I felt the old familiar pressure and expected it to quickly go away.

Throughout the night I would awaken and go to the bathroom or get a drink of water and it would not go away. Upon rising in the morning I got dressed and walked to work, and it did not go away. I came home and helped prepare to go to a picnic with friends and it did not go away. While chatting with those friends I was invited to throw a football, fling a frisbee, roll some lawn bowling balls but I declined; I just didn’t feel like doing any kind of activity and the pressure would not go away. At one point several people walked up a hill at about a 20% incline to a field above us and I looked at that small hill with the absolute certainty that I could make it up there but had no interest whatever in paying the price in pain that it would require to do it. Turning to my wife I said “I’m tired, let’s go home so that I can get some sleep.” And still the pressure would not go away.

We arrived home and I brought in a few items from the picnic. I began to walk down the hallway towards the bedroom and bathroom and the realization hit me all at once: I was not going to lie in bed one more night with my chest hurting. Halfway down the hall I wheeled around and said “I think you had better take me to the E.R.” “Would you rather go to an urgency care clinic” asked my wife who knows how little I like being a patient. “No”, I replied, “I know that they would just send me to the E.R. (probably in an ambulance I thought, but didn’t articulate that vision). Let’s just cut to the chase”. I grabbed a book and put a few supplies in my book bag and we rolled down the driveway and up the street towards the hospital only a few locks away.

When we arrived at the Emergency Department main entrance we could see that the little parking lot was full. My wife let me out and went to park somewhere further away. There was a small line of people in front of me who presented with a variety of issues. They were asked all the right questions and were duly processed and went to take a seat in the waiting room where they would await their turn to be seen. At last I stood in front of the open window. “What’s going on with you tonight sir?” asked the the young woman sitting behind the counter. “Chest Pain” I replied, and before another sixty seconds passed I was ordered – and I do mean ordered – to sit in a wheelchair which almost magically appeared behind me. Sixty more seconds and I had a blood pressure cuff inflating on my arm and an EKG tech awaiting his turn at me.

In ten minutes’ time I was lying on a bed in room 71 hooked up to a variety of monitors with a phlebotomist waiting her turn to draw a few tubes of blood. The blood draw completed I now had two needles the caliber of the Alaska pipeline inserted into my veins, one in each arm. What followed was a ritual dance of X-rays, more blood work, and waiting while calls were made, and finally Dr. Stone appeared from behind a curtain and said to me “Mr. Durden, you’ve had a heart attack. It was a small one, the EKG was read by the machine as normal but some of the waves just don’t look right to me. And the blood test confirms it. The cardiac enzymes level indicates that you’ve had a small heart attack. You’re going to be going to the cardiovascular intensive care unit tonight, and then tomorrow morning you will have an angiogram. If they find the problem perhaps they can put a stent in the vessel to open it up and you can go home. We can hope so anyway.”

After a gathering up of stuff I was rolled out of Room 71 on a gurney and taken to the fourth floor where a big, soft bed and a bank of glittering and beeping monitoring devices awaited me. I made the transfer to my new bed, was introduced the the night RN, George, and soon was alone in a darkened room with a couple of IV pumps pushing fluids and medicines into my veins and wondering how in hell I ever got here and where my life would lead next.