A few nights ago I was listening to BBC World Service Radio. Broadcast from the UK, of course. And then relayed to me through a satellite radio service. This was while driving a Korean-made car through Nashville, heart of the bible belt, on my way to a Zen Buddhist service inherited from Japanese traditions.
Afterwards I joined a few friends at a locally-owned eatery, had pita bread and hummus (both of Middle Eastern origin), and an oatmeal stout from a North Carolina brewery. Oatmeal stouts are a style of beer that, like the BBC, originate from the UK. Only a good bit further back in time.
On the drive home I was able to queue up, on demand, Brian Eno’s Ambient 1: Music for Airports, originally released in 1978. This took no more effort than finding music released last year or last month.
None of this was due to any great effort on my part. It was possible simply because I am alive now, at this time.
We have increasingly connected, immediate-access, globally-sourced lives. There has been much critique and concern over the effect this is having in terms of quality-of-life, attention spans, competition for resources, etc. Where this is ultimately taking us remains to be seen. But in the moments when we can stop and notice how amazing it is, a feeling of ‘wow’ becomes undeniable. We are living in the future.
It’s been some time since I’ve checked in on this topic, but it turns out that recovery as in life is back to normal isn’t the same thing as we are fully finished gathering data from a medical perspective. In other words, I wasn’t quite done yet.
Just this past week that data gathering is complete, and other than yearly checkups (something that everyone over 30 should do anyway) this process that began 7 months ago is now complete.
I’ve finished the cardiac rehab classes, a kind of monitored exercise program, and passed that with flying colors. On a scale of cardiovascular exercise capacity called “MET” there is a specific value they want you to reach by the time you’re done, and I went well past it. I also maxed out my stress test (which despite how it sounds, does not mean that I have maximum stress), with a result that was above the highest end of the scale for my age group.
None of this is for bragging rights- If there’s anything that I hope you take away from this, it should be the value of sticking with or getting on some kind of regular exercise routine. I did that before my surgery, got back to a minimal version of it as soon as I could afterwards, and have been ramping up to a healthy, not-overdoing-it amount ever since. At least 30 minutes a day, every day. You don’t have to set a new 5K personal best. Just go for a walk. Please. Your ancestors and mine didn’t have to make this a part of their routine, because they lived it. We have our desk jobs and iPhone apps and an overflowing Netflix queue to keep us busy mentally while we do very little physically, and it takes a concious effort to add that missing activity back in. Your body is built for movement, so move it already!
Here’s a bonus- it’s good for you mentally too (any kind of movement, not just the dance floor)
The other good news – back in part 1 of this saga I mentioned that one of the reasons for having my surgery was that the increasingly misbehaving valve was causing part of the heart to enlarge as it compensated. I heard a number of opinions from people with various degrees of medical experience that after the valve repair, it would shrink back down. Or it might shrink. Or it probably wouldn’t at all. My regular cardiologist was optimistic that it would, and not only was he right, he was more right than he knew. I had the impression that it would shrink to normal size but might take awhile, maybe a year or two. Something gradual. Imagine my surprise when after having an echocardiogram 4 months after the surgery, he informs me that not only had it already shrunk, but it was firmly back in the normal range. As I told him at the time, “I love being a success story!”
In regards to that success, I stick to my earlier story that I’m just really lucky. One person who was in the cardiac rehab program when I got there is still there. They’ve worked at just as hard as I have, but a few persistent issues that they ultimately can’t control have kept them in the program. Similarly, I have no control over what other issues I have, or in this case didn’t have. I can only control my own behavior and how much work I put into it. Which is why, again, I’m urging you all to get out there, do something daily, do something in the one area where you can. You can’t change your genetic predisposition or your family history. But if those things are stacked against you, it’s all the more reason to get moving on the things you can do something about. You can get a new pair of sneakers and put a lot of mileage on them. You can get to a point where if you miss a day of exercise, you’re out of sorts and eager to get back to it. You may find that the stress of the day is evaporated more quickly after a 20 minute jog than 2 hours in front of the TV. You might even find, as I have, serenity in walking outside in a rain parka on quiet mornings during weather that’s only fit for a duck. Making that connection with the wind and the rain is like listening to the world breathe, and coming back in to the warm and dry makes that first cup of coffee that much sweeter.
I closed my last post with a mention of the “three treasures” from the Tao Te Ching. They could just as easily be called virtues, qualities, or characteristics. My own valuation of these three is not because of the book in which they are found; one could find these three things in any list of worthy attributes. But after a lot of reflection, I agree with the author that it’s hard to think of any that are greater. From these, every other worthy thing follows…
Patience
Healing is hard. Not necessarily as in hard work (although it certainly can be depending on what you’re healing from) but more in the way of giving oneself the time and space in which to do it. I’m finding out that I’m… not very good at it.
This is odd, because I was told I was a great patient at Vanderbilt. Then I got home, and have been going a little stir crazy. I had a list of things I was going to do while at home, ways to relax I haven’t done in a while. Old TV shows queued up on Netflix to watch, books to read, giving myself time to just do nothing and take what would actually be the longest “vacation” of my adult life. But that’s not what happened. Old TV shows aren’t nearly as good as you remember them to be (I got 2/3 of the way through one Mission:Impossible episode and decided I didn’t care how it ended) and I’ve only managed to read a bit more in one book I had started weeks ago. It’s not that I didn’t get anything done, it’s that I haven’t relaxed in any of the ways I thought I would. Which is a bummer (especially the lack of reading) because the time at home recuperating is just about up. But I suppose that’s not the point. The time was spent how it was spent, and I’m recovering well. One of my discharge instructions was to work up to walking a mile a day. I started with a mile and a half and am now easily doing three. That’s a much more meaningful goal than progress made in front of a television.
If there’s a lesson to be had here, at least for me, it’s that patience is needed with oneself most of all. And it’s that much harder to be patient with others if you don’t start there first.
Simplicity
One thing I did get done, one of my while-you-were-out projects, was further streamlining of my desk. In a previous post I had managed to get from this…
…to this.
Now it’s down to this…
One laptop to rule them all. And killer headphones.
Clicking on any picture will give you a larger version, if you’re into that sort of thing and/or morbidly curious
Of course, simplicity is about more than the number of things on your desk or the clutter in your closet. Simplicity of mind (NOT to be confused with anti-intellectualism) means to be just as diligent in regard to the quantity and quality of things that end up between your ears. Judicious use of that space leaves it more open for yourself and for others.
Compassion
Plato once said-
Be kind, for everyone you meet is fighting a hard battle.
This quote has slowly sunk in over the past few months. I’m not entirely sure how much my surgery has to do with that. But there is something about lying in a hospital bed with all kinds of activity going on around you that gives you an eye-of-the-storm perspective. You can see everyone’s worries and concerns. You can tell what kind of day the nurse or CP who has just come on shift has had, even if they aren’t intentionally broadcasting it.
It also helps to understand that what may seem like tension on the part of your loved ones is really concern for you, mixed in with all the other things they may be worried about.
Compassion, then, becomes a very useful attribute. Not from others, but from the person who you’d think would need it most from others. And just as with patience, compassion towards oneself is sometimes needed most of all; do not underestimate your own hard battles.
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In terms of “how things went” the surgery was a great success. Dr. Petracek was able to repair my mitral valve, which is quite a feat as it was in even worse shape than expected. He told Lynn that I “would not have done well for very much longer.” Which to me is perfect timing, and exactly the same way I treat car ownership: drive it until the wheels fall off. Of course, it helps that he is one of the top 2 or 3 surgeons in the world at valve repair. The amount of flow in the wrong direction is now zero, demonstrating that in some situations, nothing is the best result of all.
Thank you for reading. Thank you for being here. You are wonderful.
Today is the day. By the time you read this, I will be somewhere along the process that I’ve been living in constant anticipation of for almost 2 months. I’m either being prepped, being sedated, being fixed, or recovering. Even though this was written many hours in advance, I can include recovering in that list for one simple reason:
I am a very lucky man.
The odds are highly in my favor. This particular procedure is frequently performed on patients decades older than me, and in much worse shape. It would not be an exaggeration to say that I place myself at greater risk simply driving to the hospital. And there is the obvious, yet easy-to-miss fact that I am lucky to be alive at this time. Had I been in my mid-40s in 1912 instead of 2012, it would be a very different story. The first surgical heart valve repair was reported in 1923, and the current state-of-the-art in minimally invasive techniques has only been around since about 2005. One of the pioneers of those techniques just happens to be the doctor who will be working on mine.
Could I be any luckier than this? Sure, I could not have the genetic defect that brought this problem about, but then I would arguably be a different person anyway. You can’t really separate one aspect of it out from the other. We have no more control over when we are born than we do the various conditions we are born with, whether it’s a heart valve or your eye color. My good fortune comes not from what might have been, but from the fact that I live now, when what we know about medical science far outshines the tens of thousands of years when we knew nothing at all. Or perhaps worse, had medical opinions that were dangerously stupid. Leeches and bloodletting, anyone? How about the fact that it was only in the early 20th century that we finally quit prescribing mercury as a treatment for a variety of ailments? They don’t even use that stuff to make batteries anymore.
The medical knowledge we are fortunate enough to have today has come at a high price. Much of that has been paid by the suffering of untold hundreds of millions of people because we had not yet figured out what to do, or had some really bad ideas. Some has been paid by people who we have known that couldn’t be saved because we still don’t know enough. The rest has been paid by thousands, perhaps tens of thousands, of researchers and medical pioneers who pushed the envelope of what was possible.
This gradually ascending curve of knowledge and effort leads to an inescapable observation: As much as we may be to blame for getting it wrong in the too-long and very dark ages of leeches and mercury treatments, we are also deserving of the credit for finally starting to get it right. The credit is ours alone, because on the subject of medical knowledge, the gods have been mute. I say gods, plural, because nowhere in the scriptures of any tradition can be found even basic medical or physiological knowledge. Does the Bhagavad Gita tell us what the pancreas does, or even that it exists? Does the Torah describe the proper functioning of a mitral valve? Can any version of the Bible provide insight into the thyroid? Does the Koran have anything to say about blood type compatibility? While many people in medicine are adherents to a faith, it’s not the source of their knowledge and skill. If we are the product of divine intention, we have been left to figure these things out gradually, painstakingly, and entirely on our own.
To understand what compels me to make this point (besides the obvious fact of my impending surgery), allow me to share two separate conversations I’ve had recently.
One is with a doctor I’ve talked to, who said “For some reason, the lord decided to give you this condition.”
The other is from a good friend, who said “I am praying that our lord guides the hands of the doctor.”
What does one make of this apparent contradiction of intention? If we are to take both statements as being true, it would be the equivalent of a husband coming home and breaking his wife’s favorite heirloom, so that he could guide his son in the fine art of super-gluing things back together again. We would have choice words to describe such an individual, ’deranged’ perhaps the most polite that I can type here.
This is not to suggest that the lord they refer to is deranged. It is only to point out that a lot of people have a lot of ideas about what God will or will not do, has or has not done. One interpretation that I’ve heard is that both statements are true and that they fit- You were given this condition precisely so that the surgeon could fix it, so it would be a testament to benevolence and would strengthen faith. I have heard this kind of explanation offered for all kinds of inconvenient circumstances. But I have no idea how to respond to a claim that the fate of humans is intentionally architected in such a perverse and manipulative way. Because what does one then make of the fates of countless people before me, before our current medical skill, who were no doubt “given” this condition or numerous others, and had no possible help at all? What does one make of the conditions that people have or contract today that we have no cure for? This illustrates the problem with trying to assign intention or ultimate meaning to the things that happen to us.
One answer is not to read too much into conflicting statements like those, or to take them as literal truths about the nature of reality. That’s not the point (although it would be interesting to get them in a room together and hear them work it out). In the case of the doctor, he was expressing his consolation and a kind of surrender at things we have no initial control over, but can now do something about. In the case of my friend, he was expressing the hope that doing something about it will go as well as possible.
For myself, there is only one response to this combination of my initial condition and the possible fixes: for my condition I cast no blame or responsibility, and for the fact that it is repairable, I am extremely grateful. I do not think “why me?” but instead “lucky me.” We know that evolution is an inherently experimental process- 98% of the species that have ever lived are now extinct. We are part of that process, and that makes it no surprise that things don’t always work right. So it’s quite difficult to be mad at anyone or anything for a malfunctioning valve or a receding hairline. It is in equal measure easy to be appreciative that I happen to live where I do and at the time I do, and that other members of the human race have worked diligently to make my prognosis what it is.
I am also very thankful for all of you. My family, my friends, people I know only as a thumbnail picture on Facebook and people I only know by name are praying for my recovery. While you and I may have different opinions on prayer, it at least means that you are wishing me well and hoping for the best. That is the most I can ask of anyone not responsible for my care, and for that you have my heartfelt gratitude. You also have it for how much it means to Lynn. I think I worry about her worrying about me, just as much as she worries about me.
I am more thankful than I can put into words for two people in particular- my daughter Adrienne who has turned out to be a better and brighter person than I could have hoped for. She’s wiser at 21 than I was at 31. And my wife Lynn, who I can only describe as an absolute jewel. If I did not have her to accompany me through this, I would in all honesty rather go through it alone. You or nobody- I can’t think of a better indicator that one did not settle for less than what they wanted in a relationship.
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Hospitals always have that just-in-case paperwork ready to be signed, even for something as routine as my cardiac catherization last month. It’s the same reason we do living wills. It’s necessary because the odds, no matter how much in your favor, are never exactly zero.
So here is a just-in-case thought I want to leave you with, in the extremely rare chance that you don’t hear from me again. It’s from chapter 67 of the Tao Te Ching, the classic manual on “the art of living.”
I have just three things to teach. Patience, simplicity, and compassion. These three are your greatest treasures.
And so we don’t end this on such a dreadfully serious note, here’s something I received from my friend Will:
To which I quickly replied, “That’s funny, you bastard!”
