Almost next

My dad, James, died at 62. He was a heavy smoker and even when death gave him the “your cigarettes or your life” ultimatum, he, like so many others chose the cigs.

I was 26 then and my brother, Jim, 32. We gave no heed to my dad’s age of death. He smoked. We didn’t. That wasn’t going to happen to us. Simple as that.

Jim died at 63, of pancreatic cancer, lasting about 12 months longer than our dad. For both men, the last months of their lives wasn’t what anyone could describe as living. My father withered away, suffering a heart attack and just as he’d regain enough strength to feel human, a stroke would set him back. His heart just flaked apart. I had trained like crazy to be a high finisher in the Chicago Marathon that October. A competitive long-distance runner, I was in the shape of my life and my father planned to be there as he’d been for most of my big races. A few nights before, he called to say he couldn’t make it. I didn’t ask why, but I knew something was wrong. A few days later severe angina landed him in the hospital, a few days after that, his heart attack. Four weeks after that he was gone, never leaving the hospital. One of us, my mom, me, either of my two sisters — at least one of us — was by his side the entire time. The nurses said they’d never seen a family such as ours. The hospital was more than an hour’s drive for my mom and sisters from the south and west, and for me from the north. Jim was stationed in California and he couldn’t be there as often but came as much as he could. We all became familiar faces with the workers and regulars at the Denny’s around the corner. After it was all over, I took my mom to a service the hospital performed for the families of loved ones who died in its care the previous month. We had gotten to know the cardiac ICU nurse team pretty well. I’d asked my mom, Dottie Jean, if she’d like to go up the few floors once more “just to say ‘hi’” and thank them again for all they had done. My dad had died late in the night when few of them were around. The nurses spotted us as we entered the reception/waiting area and all were smiles and bright faces. The local paper had published a letter I’d written in praise of the nurses, the gist of it read, “it goes without saying that a nurse’s job is to care for a patient, but they don’t have to care about them. Ours did.” It had meant a lot to them, just as they’d meant a lot to us.

I receievd a diagnosis about the same time my brother received his. I had prostate cancer, the “good one.” I kept the news from my brother and from my sisters for a while. He didn’t need the worry. It’s hard to imagine feeling lucky about having cancer, but compared to the likely death sentence my brother had gotten, I felt just that way. And I felt guilt about being the lucky one. My brother had a family and an important career. I was single and self-employed. Somehow I concluded that his life had more importance. He didn’t deserve it, not that cancer cares.

My brother died of sepsis, his body too weakened by the surgery to ward off what came after him months later, almost on the same November date as our dad. He actually beat the cancer, one of the 5% who become cancer free. He was well enough to attend his youngest son’s wedding that summer, although he had to return home during the reception gathering. A career Air Force man, he’d climbed to lieutenant colonel before retiring. He’d been a part of the START treaty team and understood his mission well, making sure the Soviets were detonating the warheads they’d promised to destroy and not a facsimili. His assignment took him to Siberia. And he liked it there. He really did. After retiring, he joined the NSA, and at the end his sense of duty kept calling him to work. He had a project he wanted to see through. And there was only so much laying in bed he could stand. On his last day, he refused the morphine drip. He chose to be lucid at the end, and when it was time somehow he knew. As was their custom when he’d say goodbye to his wife, Joan, he gave her an affectionate peck on the nose, said he loved her, and slipped away. A greater moment of courage, self awareness and affection I can’t imagine ever being equal to.

After the funeral my oldest sister, Jean, asked how I felt. She already suspected what the answer would be when I said, “I feel like I’m next.” That seemed to be the theme of a lot of my conversations the next year or so. All the signs pointed to it. No male on my dad’s side of the family tree had longevity. My paternal grandparents were gone before I was even born. The confidence I shared with my brother about blowing way past dad’s age of 62? That was gone.

My prostate was removed 18 months later and my general nonchalance returned. So when I turned 62 and supposedly entered my valley of the shadow of death, I was looking very much toward retiring with my wife and setting out to see the world and enjoy family time. Marsha and I planned a trip to Norway to make good on a promise to friends Walter and Lena, a couple from Bergen who had visited me in Phoenix 25 years earlier. Marsha had never met them and there’d been anxiety over spending 5 days at their house. I knew Walter and that he’d be trying to reassure Lena just as I was with Marsha. We had a grand time, of course. When it was time to leave them, there wasn’t a dry eye among us.

We’d begun the trip in Iceland, seeing the wonders of the country and surviving the sticker shock over the cost of everything. After our time with Walter and Lena, we took a merchant ship through the fjords and into king crab country near the Russian border above the Arctic circle, then to Oslo before arriving to New York, then LA and finally back to Phoenix. The reason for listing the itinerary is we had two suitcases, each weighing about 44 lbs. So, I’m lugging 88 lbs. of luggage plus the backpacks with books, snacks and what not. To max out on the unusally sun shiny September days and indescribable beauty, we took many short but strenuous hikes. It didn’t seem to me like the valley of the shadow of death.

However, my first day back at work as a landscaper, I was finding myself sweating much more than usual and having shortness of breath, all while guiding a self-propelled mower. Basically all I’m doing is walking behind it. I call it a day, then call up a cardiologist, who gets me right in. He reads the EKG, declares there’s no need for a stress test. I’d need a triple bypass and there was something else going on, for my aorta was dilated to a concerning degree.

There was no sense of urgency to anything, as far as the medical staff was concerned. They set the operation for two weeks out. “Just look at him,” the surgeon told my wife, pointing at me. “He looks fine.” That was a long two weeks, let me tell you.

The surgeon cuts my chest open, finds an aneurism in my ascending aorta, repairs that, and then completes a triple bypass. During my week of recovery, six or seven different surgeons looked in on me. Each would enter, check my my chart, look again, peering a bit more intensely, then give this “do you know how lucky you are!” look. One of them did that and actually said it. You may have had this aneurism for years, he said, as I thought about my lugging all that shit around two countries 4,000 miles away just two weeks before. That, and that I had indeed been next, or would have been.

In the recovery room, my wife and her sons were by my side, expecting a fuzzy awakening and a roomful of gratefulness. But no, something goes wrong. Still unconscious, I bolt upright, thrash to try and free myself of the tubes and wires. From nothing boredom to all panic and all right now. The room cleared, I’m stabilized and soon I come out of it unaware anything had heppened. But my wife’s eyes were all puffy and red, as were her sons. I asked, “What’s the matter? Did something happen to somebody else?”

They explained what had happened. I don’t remember much more, except that I’d have given anything to have spared them the memory of those moments. Whenever I reach for a cookie or an extra helping of something, Marsha gives me “the treatment.” So I put it back.

Things can go wrong that can’t be explained. Three nights into my recovery during a routine checkup, I’m hit with a pain I can only try to describe as the cramp that just won’t let up, except it’s your heart, or somewhere in there. The pain has me standing stock still, managing only puffs of air. My god, how much worse can this get and how much longer can it go on? My nurse calls for an aide to get what she needs to settle me down. “RUN!,” she commands. Off he goes and they give me a shot and the next thing I know is it’s morning. A month later we meet with my cardiologist. My wife tries to pin him down about what could have happened in the recovery room, what about a second EKG that came up “different,” and why was I in the ICU for so long. “It could have been anything, maybe even a heart attack.” he shrugged. “It doesn’t matter. He’s OK now and anyway we couldn’t have gone back in. He wouldn’t have survived it.”

Geez.

New Year’s passed and we were all so happy for 2019 to be over with, how much worse could 2020 be? Marsha and I went for a 40-minute hike. I was moving too slow so Marsha went ahead. About 10 minutes from the end I’m sensing some serious signals. The air feels caustic, I’m short of breath, fatigued, my feet feel like lead and my wife is hundreds of yards ahead of me. I make it home and the next day or so I’m set up for a stress test. I last about 20 seconds. Eventually it’s discovered that my two of my bypasses have failed. I go in for an angioplasty, 90 minutes on the table only to have the surgeon give up. He couldn’t access the blocked area and is talking about cutting me open. I find another surgeon to talk to. He assures me he can reopen the vein grafts. He failed, too.

After that we are sent to a third surgeon. Young, bright, confident and very at ease with my situation. He explained that my bypasses failed and the other two procedures failed because they were performed by “minor leaguers.” He was upset that another hospital would be practicing trial and error on a heart patient. I gave him the history of the events that led up to this point. He nodded his head, understanding my symptoms as I go along. The caustic feeling I had was an angina attack.

“Doc,” I said, “I was having those symptoms on training runs I had more than 20 years ago!”

“Well, you’re a lucky man then.”

He said we needed to coil off the vein grafts and reopen my native arteries, one now and another in a few months. He had broken his left wrist playing cricket. He said he could do the procedure with one hand. We laughed, but we opted to wait. He picked March 20, a day when a convention of surgeons would gather. He wanted to live-stream my procedure to a conference, show the surgeons there how to perform the operation, and share my story. I should never have had to go through two failed procedures, he said. If you can’t do it, hand the patient off to someone who can, but I was seen as a cash cow. When the day came Covid had shut down everything in Arizona so the live-stream was off. He handled the procedure in two hours or so, much longer than the 45 minutes he predicted it would take. Even he described it as “complicated.” Four hours later I was whisked out and having pizza with Marsha. 10 weeks after that he reopened the other artery. I wasn’t as good as new, but he said I’d never have to worry about having a heart attack.

What a relief. The second failed angioplasty attempt left me bewildered. Was there anything anyone can do for me? Was I out of options? Was I just going to another guy who says he can but can’t do it either? I was 64 now, you know. I was afraid I was at the end of my road. That I was next.