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.
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!”