Heart Attacks

by NotDownOrOut

Having told the story of the mammogram, I now feel it necessary to share the follow-up. My coworker with the pathological fear of cancer had to see a heart specialist after her physician observed an abnormality in her heart during a routine appointment. It turns out that undergoing a stress test is even more terrifying for her than a mammogram. The specialist wanted to put the woman through an actual stress test, but she refused. Many years ago the woman was in a serious car accident that shattered her ankle. She has undergone several surgeries since that time, none of which has helped for longer than a couple of years. She was certain that an actual stress test would induce heart failure due to fear that she would stumble and fall while walking on a treadmill without her cane.

The specialist explained that he could administer a drug that would put stress on her heart and simulate the conditions that would permit him to watch the muscle action of the heart using a sonogram.

My coworker, having no family in the area and no friends who would accompany her after they heard about the mammogram meltdown, asked me to accompany her and I decided that it could not possibly be tougher than a mammogram. That kind of optimism is what the mayor of New York City calls a 32 ounce serving of soda pop glass half overflowing. It should be taxed. It should be banned. It should be clear to any rational person that no good will come of it. I like a challenge.

We went back to the same hospital and went to another massive waiting room that we managed to clear in ten minutes of loud, angst-filled queries about the necessity of undergoing the test. My coworker was certain that she would die when they injected her with their liquid stress. She wanted a sedative, which was inconsistent with the notion of stress. Someone came out to usher us into a back room that was in the middle of renovation. Painters had paused in their work. Someone directed us to two chairs hastily dragged behind two sofas tipped up on their sides. Even the immense cushioning of two sofas did little to muffle the rising tone of hysteria my coworker gave off as the clock someone had rested on the floor clicked its way in circles from the corner.

“This way,” a nurse coaxed us down the hall to an examination room.

I would have liked to wait in the public area, but my coworker had bonded with my forearm like we had been dipped in Gorilla Glue. She dragged me with her. Once again I stood witness as she shimmied out of her clothing and into a hospital gown. I folded her garments and set them atop the bag of provisions that I had brought with me in case this, too, turned into an all-day event. I had some cookies, an apple juice box, and several business cards in case I needed to negotiate for my coworker’s release from psychiatric observation.

The doctor came in to explain the procedure. He assumed, as did everyone else in the room, that I was there in some very personal capacity, rather than as a coworker. He kept on reassuring my friend that many heart anomalies proved irrelevant to longevity. My friend would have none of it.

“What if I die while you’re making my heart race?” she asked.

The doctor, probably in his twenties, looked at me, possibly realizing for the first time that this was not going to be as stressful for the patient as it might be for him. I smiled. “She isn’t entirely rational. The last time she had a test we needed a psychiatric consult.” Then I scrunched up my nose like this was just a joke.

The doctor turned to a gowned nurse who had laid out a tray while we spoke.

“If I die I want you to have me revived,” my friend insisted while the nurse prepared to insert a port into her inner arm. Someone else began to lower the head of the hospital bed on which the patient was sitting. “Oww, oww,” moaning commenced as the core was engaged and the muscles of her back and abdomen began to clench.

“We haven’t begun the test yet,” the doctor said. He perched up on the ledge beside the window to make room for the sonogram technician as she prepared her equipment.

My friend was panting as the nurse introduced a needle into a vein. “Oww, oww.”

I took a half-step back, not certain what might happen next. My back hit the wall. No place to run. No place to hide. The nurse put a blood pressure cuff on my friend’s upper arm and proceeded to take some starting measurements. “One-forty-five over eighty,” she said. I don’t recall the heartbeat.

“Go ahead,” the doctor said.

As soon as the I.V. bottle began its drip there was such a clatter of arms against the sides of the hospital bed as to imply we were animating a wild animal. The technician, who had been standing by with her equipment, flinched. But she gamely proceeded to unsnap the gown at the shoulder and draw it down to uncover my friend’s chest. She attached some electrodes and spread a chilly gel over my friend’s chest. My friend reached out for me and got air. “Help,” she wailed.

I took her hand. The drug had started working. Heartbeat accelerated. An angry blush spread over my friend’s upper torso. I was prepared for great amounts of panicky anguish. My friend starting crying.

“We need her to turn onto her side, facing me,” the technician explained. The nurse joined me on my side of the bed.

“Try to roll over,” the nurse said.

“Rotator cuff, rotator cuff!”

The nurse handed me a pillow and took one for herself. The two of us worked in unison to roll my friend over onto her side while she huffed and puffed and cried like a baby. It took both of my hands and all the weight I carried to prop her up while the nurse shoved more flat little pillows into the crevice between back and bed. My friend reached back and tried to grab my arm but caught my right breast in her fist.

“Yikes,” I announced as I tried to back up some more while keeping my arms braced against her back.

No one heard me in the din my friend created. “That’s my boob, not my elbow,” I yelled.

She released me like I had sprayed her with a firehose. It would have been so much easier if she had just reached forward and wrapped her hands around the rails on the other side of her hospital bed, but this was not the time to expect an exercise of self control. The doctor had hopped down off of his ledge and stood by like he was examining a rare medical condition rather than a hysterical outburst worthy of a scene in The Exorcist. The sonogram technician was doing her best to get a reading from her instrument, which she had applied to a now smooshed cleavage heaving like a freight train.

The doctor looked at me. “It doesn’t hurt,” he said finally.

I nodded.

He reached for a hypodermic needle and an ampoule of some drug that might counter the stress effect if it became impossible to continue. My friend bucked like a bronco and kept on wailing insensibly. Someone knocked on the door and barged in to see what was going on. We had an audience now. More smocked doctors tried to enter the room.

I was tempted to start laughing, but the truth is that my friend was in great distress so I took over. “That’s enough crying,” I said firmly. I leaned over the bed and got close enough for her to see my face, for me to smell the fear emanating from her pores. “There’s nothing wrong with your heart. Look at the screen. It’s pumping just like it’s supposed to.”

“There’s a flutter there,” the doctor said, trying not to use a technical term that might elicit more terror in his patient.

I shot him a look meant to say, “Way to not help me calm the raging wave of panic that you had to shoot up with an artifically induced heart attack!” We might have gotten the desired effect with a placebo, but someone had to go giving her the real thing as some type of experiment.

There were enough hands on the patient to have subdued her, if she were a normal woman. Fear had galvanized superhuman strength and animal instinct for self-preservation into a cacophony of anguish and a hard to hold mass of pumping muscles.

I honestly can no longer recall how we finished the test. Sometimes memory fails us to prevent us from dwelling on things too painful to comprehend.

It turns out that my friend’s cardiac abnormality was much less dangerous than her general physician had feared. It also was much less dangerous than her reaction to an artifically induced stress test. “I’m going to tell your referring doctor that I would not advise repetition of this test . . . .”

“It would be helpful if you also ruled out the possibility of another mammogram,” I said it like he would know my friend’s entire medical history.

He blinked at me before proceeding to back out of the examination room. The nurse, whose gown looked like she had dragged it out of a hamper, smiled like she was getting blood flow to the arms again now that my friend had settled down. The technician was gathering a tape for her file. She seemed in a hurry to escape our company. I moved our stuff off of the chair and sat down to catch my breath.

“I think that went well,” my friend offered. She was not at all abashed by having inflicted on all of us a massive dose of insanity.

“You grabbed my boob and twisted it like wet laundry,” I offered.

She shrugged, then rubbed her own shoulder, as if it was the event’s most tragic casualty.

“The next time your doctor recommends you undergo a test I want you to decline it,” I said.

The technician tried to hide a smile.

“At least we’re getting out of here without having to speak with a psychiatrist,” I said.

My friend looked confused.

“Don’t tell me you’ve forgotten that the last time we were here they wanted to keep you for psychiatric observation.”

My friend buttoned her shirt. “No. I don’t recall that at all.”

“You also threatened the hospital staff with lawsuits for having scared you nearly to death.”

She shook her head. “I can’t remember any of that happening.”

Dementia is a tragedy. It deprives its victims and their families of memories and makes them strangers at a time when they want to cling to each other because time has become a shrinking commodity. Selective amnesia is a blessing. It is an antidote to stress that selectively permits us to escape memories so traumatic that were we to relive them we might want to kill someone. The fact that I cannot remember what happened during my friend’s stress test but can still recall learning that I had cancer suggests to me that there are things scarier than cancer. The next time I think I cannot handle my fear of it, I’m going to go into my storage room to look for the journal I kept during the year of the stress test and gain some perspective on what is scary and what is merely life threatening and scarring. I have to hope that those lost minutes spent subduing someone else’s greatest fears will help me master my own–or make me laugh so darn hard that I find the strength to soldier on.