A Short Story by Claude Pigeon

As soon as I was brought up to the cardiac I.C. unit, I was encouraged to walk, even use the stairs to whatever level I was comfortable with.  “Piece of cake”, I thought.  I felt great for a guy who had just suffered a major heart attack (myocardial infarction of the right ventricle in medicalese…)   As he sat at the foot of my bed, the doctor who had performed the procedure told me I was a very lucky man. “Yea sure, Doc” I replied.  “A hundred miles from home eating boiled chicken and vegetables in your hospital on Easter Sunday! Yes sir, I sure am lucky!”  “No seriously,” Doc said with a very grim look. ” Only 20% of men who have heart attacks before the age of 50 survive them.”  I considered those odds and suddenly felt VERY LUCKY!

Only a few hours before, I had been stranded at the edge of I-95 in Maine with a flat tire. It was a dreary April day that alternated between bouts of wet snow interspersed with moments of sunshine.   Lying with my back to the pavement at the road edge, every passing car, and there were many, sent a wave of cold wet slush over me as I tried to jack up my truck.   My fingers were so numb I was beating them bloody and didn’t even feel the pain.  It was so cold and damp; the shivering made the work near impossible.

When the tire of a Ford F-150 is fully deflated, there is only about 5 inches of clearance beneath the axle.  The bottle jack provided by Ford is about 10 inches long… not sure what the Ford engineers were thinking.  I was so upset that I have often said that if a kind little old lady had offered to hold an umbrella over me, I would probably beat her to death with it!   Between the physical exertion of trying to fit the jack under the axle, the rage and frustration with my predicament, and the near hypothermic state I was in, my heart couldn’t keep up with the demands I was placing upon it, and it punished me…

The first ambulance ride took me to Southern Maine Medical Center where they quickly and ineffectively injected me with a $1,700 clot buster, then determined that I needed to get back into the ambulance and move on to Maine Medical Center.   Fortunately for me, the chief of cardiology at SMC got into the ambulance with me and off we went.  We were hardly rolling when they administered the first dose of morphine.  After what seemed like a short amount of time, the doc asked me “How ya’ feeling, Claude?”  “Hurts like a muthafucker Doc,” I replied, so he instructed the EMT to give me another dose.  With lights a-flashing, the ambulance continued on its way north on I-95 and doc asked me again “now how’s it feel, Claude?”  I winced and answered “Hurts like a mothafucker, Doc!”  Once again, the EMT dosed me with some morphine.  This scene repeated itself a couple of more times as we drove towards Maine Medical Center.  As we approached the ambulance entrance, Doc asked me once again how I was feeling.  I answered “Hurts like a muthafucker, Doc, but I really don’t care anymore!”

*  *  *  *  *  *  *  *  *  *  *  *  *  *  *

*  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *

There is no shortage of good Samaritans in the state of Maine. At the onset of my heart attack, some very nice people had stopped to help me.  One fellow took control of the tire changing, another offered to bring the flat tire to a tire shop nearby.  As the job progressed, they could see that something was wrong with me.  I was embarrassed that I wasn’t pitching in, but as the pain in my chest grew, my interest in the truck and the tire changing diminished.  I guess I knew by then that I had bigger problems to deal with.  One very nice Samaritan offered to call AAA for me.  I told her I didn’t have an account so she offered to call it in on her’s.  Such a sweet gesture! With as much enthusiasm as I could muster, I thanked her for her kindness, explained that I was having a heart attack and asked her to call an ambulance instead.

For several weeks, I had been feeling niggling little pains in my chest, but I ignored them.  I was a walking time bomb.  I had a high stress job in an inherently high stress industry, I was a type A personality (volatile temper), and for years I had been smoking at least two packs a day of Marlboros… Welcome to Marlboro country! Patches, nicotine gums, hypnosis, I tried them all to no avail. I guess I had resigned myself to being one of those hopeless addicts who smokes through a tracheotomy…  The heart attack was no surprise, it had an open invitation and a red carpet arrival!

Even though I was completely doped into a morphine stupor, I was still fascinated by the procedure.   After wheeling me into the room, they transferred me onto the table, no mean task given my size.  They immediately went to work on accessing the major artery in my groin.  It seemed like 50 or 60 fingers were applying pressure to the area.  It wasn’t painful but it was unpleasant.  To my left was a big screen with a large heart rhythmically beating… my heart.  The heart was not whole, an entire quadrant was missing!  A young attendant, spiked hair, piercings, tattoos, was standing close by, compassionately offering words of encouragement and explaining the procedures in great detail. He was very calming and reassuring.   While pointing to the screen, he indicated that the unseen quadrant was missing because the blood flow had been blocked.  My blood had been injected with a radioactive isotope, that’s what showed on the screen, no blood flow, no picture.  As he spoke, they put the catheter into my port and slowly traveled the route to my heart.  I watched the device go into my heart and move towards the dark area.  The highly skilled surgeon knew precisely where the entrance to the invisible artery was.  No sooner had the little device opened its jaws then miraculously, the missing quadrant appeared on the screen!  At the same time, the crushing pain in my heart stopped.  I was so relieved.  I could breathe well, the pain had abated, I felt normal!

It didn’t take me long to bounce back.  I was able to handle two flights of stairs and walk the length of the ward immediately, a walk that took me to the sunroom where the “gray people” hung out.  As I walked into the room, I was immediately struck by the color and texture of their skins.  They looked like they were made from gray modeling clay, pasty, bluish-gray… lifeless.  As they stood around and made small talk, it became apparent that most of these folks were “old pros”. Some were in their third and fourth procedures!  Modern medical miracles!.. and yet, the invariable theme to their conversation was “Can’t wait ta’ git the fuckoutahea so I can go home and smoke a cigarette.”  Welcome to Marlboro country!

She was just about the homeliest woman I had ever seen.  Everything drooped, her eyes, her face, her breasts… everything had long ago surrendered to gravity.  Her hospital robes hung loosely and she made no effort to cover herself… unfortunately!  Her scraggly hair hadn’t been washed and had no color.  She had deep dark rings circling her dull gray eyes.  Most of her teeth had vacated her mouth long ago, and her lips were stained brown, the color of tobacco juice.    Another fellow had a tracheotomy. Shriveled and shrunken, one had to wonder how he could hang on. The muscle of his legs and arms had atrophied from disuse.  Everything was limp and gimpy.  His body hung from his frame like moss hangs from a tree.  Another fellow was attached to a variety of hanging bags.  He looked like another bag of fluid hanging from his chrome tree.  Oxygen tanks, I.V. trees, medical paraphernalia of unknown function… it was hard to tell who was connected to what. Their faces were gaunt and sallow.  Where once there had been living tissue, there were deep ruts and loose gray flesh.  Illuminated by the unflattering cool gray light from the fluorescent light fixtures, they passed their remaining time playing cards and endlessly complaining about everything. Damaged by their own self-abuse and further ravaged by bouts of chemo and radiation, their life force tanks were running on fumes. They were the “gray people”.

I was stunned!  Having just had a brush with my mortality, I knew with no equivocation that I wanted to live.  As I lay in the I.C.U. watching that little monitor on the wall as it beep, beep, beeped to the beat of my heart, I realized how tenuous anyone’s hold on life is.  One minor glitch and you flatline.  “Beep…Beep…Bee…  … ….. …. …. …..”  Life is a miracle, health an even greater one.  These people had been provided with many miracles and yet they were not going to change their headlong charges into oblivion.

Before they could discharge me from the hospital, I was required to complete three exit interviews.  The first was a smoking cessation session.  In that meeting, I was quite sure that I was never going to smoke again and I think I left no uncertainty in the therapist’s mind about the matter.  Without any doubt ,he was never going to see me again!

The second interview was with a dietician.  We discussed my dietary sins and he repeated the common litany of proper eating.  Blah, blah, blah… is anyone really not aware of this stuff?  We don’t eat poorly out of ignorance; we eat poorly out of choice!

The last interview was with a psychologist and we discussed the effects of stress and some ways to manage it.  Doc was cool.  He was from my era, a Vietnam vet who had lost both legs to a land mine.  He certainly knew something about stress!!!  We connected immediately.  As we talked about the stresses of modern living, I remarked “y’know Doc, I used to be one of the most laid back, easy going people you could ever meet.” Doc had a quizzed look on his face… “What happened to change that, Claude”?  “The price of weed went up, Doc!” I replied.

“Well we have to get you back to that frame of mind, Claude”.  “Fine, Doc, write me a script”  “…”without drugs” he shot back.  “Damn, you’re tough!”  I complained.  Fact was I had stopped smoking weed many years prior but I seriously doubt that my heart attack would have been averted if I was still smoking.

Doc suggested I remove myself mentally from work and imagine myself in places that would provide peace and tranquility… cool flowing trout stream, breezy mountaintop, misty waterfall or sitting in the wildflowers of an alpine meadow.  I was already hip to the Zen of his counsel and quite in agreement with his advice.  I certainly did not want to die from the stress of solving problems that were really not even my own.  All my stress was job related, not at all from MY OWN LIFE!  To this day, I routinely follow his advice.

Four days after my heart attack, I walked out of the hospital in a blue hospital gown and disposable slippers.  I had been irretrievably separated from my clothing, keys and wallet.  Fortunately I had planted a spare key on my truck.  When the taxi pulled alongside my Ford, I was grateful that the spare had held and even more grateful that there was enough gas to get me home.  I felt like smoking then and many times after, but every time I thought about having a cigarette, I remembered the “gray people” and the urge to smoke was suppressed.  All I had to do was remember those pallid, waxy complexions, the dead eyes and the words “can’t wait to git the fuckoutaheah” and I immediately found the will to resist the temptation.

Now many years Iater, I sometimes wonder about the gray people.  That was 12 years ago, I’m sure they’re all dead by now.  I can’t imagine their deaths were very pleasant.  It’s very painful to die of oxygen starvation.  Your organs slowly shut down, one by one. The pain is extreme as the body’s systems go out of balance.  You die in pieces, one cell at a time.   Nothing works and the pain mounts. Kidneys fail, fluids back up, the body screams for relief and air.  Muscles cramp and stiffen; fluid fills the lungs as the heart weakens.  Your final days are dulled with morphine to ease the agony.  Mercifully, a coma removes you from the final throws of death, but by that time, the suffering has been long and extreme.

I wasn’t like them.  Above all else, I wanted to live!