I was standing in the kitchen when it happened. I had just arisen on a workweek Monday and fed the kittens, grinning as they gnawed desperately at their wet food as if it were their last meal on Earth.
I stood there silently, my hands planted on the kitchen counter, my gaze turned toward the morning light streaming in through our living room windows. In that moment I was a 39-year-old who had never had a health problem, who had never had an awful thing happen to him, who had lived something near a charmed life.
That’s when my chest started on fire.
At first I thought it was heartburn, because I couldn’t believe, maybe refused to believe, what my body was telling me. But it got worse, and worse, until it felt like 50 pounds of weight pressed down directly onto my rib cage, until both my shoulders tingled and fiery little embers of pain shot down into my forearms.
I took some heartburn medication. I climbed back into bed. It kept getting worse.
We better go, I told Sarah. Something’s really wrong.
I have written so many stories and columns over the years about people facing all manner of trauma and tragedy.
I have listened to people describe how their lungs don’t work right, or why their legs no longer work at all, or how their spouses can no longer remember their names, or how their best friend died in the war, or how their children, their beautiful angels, have been taken from them by inexplicable disease or senseless violence.
I have sat close to them, and wrote their words in my notebook. I have tried very hard to understand what they were feeling. I did this because I wanted to take what I glimpsed and pass it on to you.
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But now I know that I never understood much about the fragility of life, how truly and almost comically fleeting our time here is. I didn’t truly understand that things can change as quickly as two ravenous kittens can snarf a half can of Purina.
Less than an hour later, I lay on an operating table, hooked up to an array of tubes and machines and surrounded by a platoon of doctors and nurses at the Nebraska Medical Center.
Through the painkiller fog, I marveled at their speed and efficiency, the clipped, code-like phrases they spoke, the purpose with which they moved, almost as if these movements were a matter of life and death.
But they weren’t. Were they? It felt like a TV drama. It felt like pretend. Except I had just asked a doctor, “What’s happening?” and he had met my gaze and said: “You’re having a heart attack.”
I had some follow-up questions, ones I didn’t get to ask until later.
“It’s very rare. I would say, in the span of a year, we see two guests in this age group we call young people, that’s people in their 30s or early 40s,” says Dr. Yiannis Chatzizisis, a med center cardiologist and also now my cardiologist.
“We don’t get those people coming in with heart attacks, really at all. And when it comes to the particular scenario, for your heart attack? It becomes even rarer.”
When Chatzizisis says my heart attack, he’s referring to what doctors saw when they used cutting-edge technology to get a fantastically high-definition view of my heart arteries.
What they saw: No plaque in my arteries. None of the usual markers that show up in 90% of heart attacks, the cardiologist says.
They saw a heart that looked pretty great, except for the fact that there was a heart attack going on inside of it.
After they got a good look at my heart, and realized I didn’t need a stent or other procedure as many heart attack patients do, the platoon of serious-looking medical professionals sort of melted away, leaving me in the care of a couple of kind, wisecracking nurses.
Unbeknownst to me, they called Chatzizisis, the on-call cardiologist, gathered with him in a nearby room and asked one another some more educated version of the following question:
What in the heck is going on in this 39-year-old dude’s heart?
What they guessed then, and what they still assume now, is that I hit the heart attack jackpot, some version of a bizarro coronary Powerball.
A blood clot formed in some other part of my body. Then a chunk of that clot, or maybe the whole thing, moved toward the heart and slipped inside it thanks to a conveniently located hole in my heart.
A small hole in the heart is common — roughly 1 in 4 people have one, and the vast majority will live and die never knowing it’s there, doctors have told me.
But what is highly uncommon is that a clot will weasel its way into the heart and cause a heart attack.
How uncommon? To give you some sense, Chatzizisis says he’s seen three heart attacks like this during his time as a cardiologist. Three. Including mine.
So that seems rather unlucky. I lay in my hospital bed for a day or so after the heart attack and dwelled on the unfairness of it all. I run regularly! I have low cholesterol! My blood pressure is great! I have no family history of heart trouble! I’m 39, for heaven’s sake!
But then, as I recovered and talked more to doctors, it began to occur to me that, after getting horribly unlucky, I had actually gotten wildly lucky, too.
The blood clot picked a relatively good spot inside the heart to detonate. If it had traveled elsewhere, or triggered a more severe heart attack, it could have badly damaged my heart.
Instead, my heart is basically undamaged, and my heart function is normal. This lack of damage also happened because I got from home to a world-class medical center in under an hour, and then they activated a huge platoon of doctors and nurses who moved at breakneck speed.
“Time is muscle. Time is heart muscle. Every minute and hour counts,” my cardiologist says.
And keep in mind: This rogue blood clot could have floated into my lungs or, God forbid, my brain. Then I might not be writing to you today.
If that doesn’t seem lucky enough, consider this: Chatzizisis told me that, in the 1990s, before a point when cardiologists could get a high-definition look at my heart, they likely would have placed a stent inside my heart.
If this had happened during the Bill Clinton presidency, I would have been a 39-year-old with an unnecessary stent in his heart for the rest of his life.
“Overall,” says my heart doctor, “you were on the lucky side.”
I left the hospital 36 hours after entering it. I write this 15 days after my heart attack. I feel remarkably normal.
Doctors are still working to try to figure out where the rogue blood clot originated, what caused it and whether my blood clots too much. I’m on three medications, but that number could be down to one — a blood thinner — as soon as August.
If I hide the bruises on my arms — the bruises left by various IVs and worsened by blood-thinning medication — you wouldn’t have any clue that I just survived a heart attack 10 months before my 40th birthday.
But here is the thing: I am not the same. I’m simply not.
My brush with mortality, my first true glimpse into the tenuous nature of this existence, has made me feel differently about this life in a way I can’t fully explain.
I find myself resorting to clichés: I realize what’s truly important now, and what isn’t. I appreciate things I used to ignore. The first shower I took after I got home from the hospital was the best shower I have ever taken, for example.
But none of that truly gets at the difference inside me since the moment my heart started on fire. It is a feeling that goes beyond my grasp of the English language.
The best way I know how to describe it is to describe to you how I ended my interview with my cardiologist, in fact the last interview I will do as a World-Herald columnist.
“Before we go, I just need to tell you one thing,” I say. It is a thing I’m saying more these days. It is a thing I want to say to you, too, to all the regular readers of my World-Herald stories and columns for the past 13 years.
“Thank you,” I say. “Thank you.”
I meant that. I mean it.
A roundup of inspirational stories from Midlanders with heart
There's the woman with MS who runs despite her diagnosis. The 7-year-old born without his left hand who plays baseball just like the other kids his age. The refugee who turned to Zumba to help her recover from cancer treatments. Check out their inspiring stories and others below.