Heart monitor
By Marcia Z. Nelson
“He’s all right,” was the first thing my husband’s
doctor said to me.
Why shouldn’t he be? I thought. I had been out walking
after lunch, having been confined to the cardiac catheter lab
waiting area since I said goodbye to my husband at 7:30 a.m. that
morning. He waved as he walked off to the inner part of the lab,
where he would have an hours-long demanding procedure to correct
a heart rhythm problem. I was about to say to the doctor: you’re
done earlier than I expected.
“There was a problem,” was the next thing he said
to me.
I stared at him. I listened as best as I could. I strained to
comprehend the complexities of heart physiology as the doctor
explained what had happened. The tiny catheter had punctured something,
causing bleeding around my husband’s heart so it couldn’t
beat. Doctors quickly stuck a tube in his chest; they’d
called a surgeon just in case. “He’s all right,”
the doctor said again. “You can see him before he goes upstairs.
Come on back.”
This complication – known as a tamponade, when the heart
can’t pump and the blood pressure drops to zero, like a
car with a flooded engine that won’t turn over – doesn’t
happen often, maybe one percent of the time. Ninety-nine other
patients wouldn’t have this experience. We were simply on
the bad side of the numbers. That’s what complication means.
You get the one short straw.
An attendant was pushing my husband’s gurney rather quickly.
My husband was shrouded in blankets. His skin was deathly pale.
He shivered almost convulsively. He saw me.
“They finished? They got it?” he said. His speech
was thick with anesthesia, with shivering. “You’re
fine, honey,” I said. “I’m glad to see you.”
His hands were cold. “Don’t talk,” I said. “You’re
all right.”
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Thus began the first lesson of a six-day intensive course in
Cardiology101. A well-intended medical procedure on which our
hopes had been riding led to free fall into anxiety and a six-day
hospitalization. During that period I had a lot of time on my
hands. Neither my husband nor I was going anywhere else. So I
learned how to read the cardiac monitor.
In the rooms of cardiac patients in a hospital, a heart monitor
is common equipment. It looks like a small TV; on it is playing
“The Heart Show,” a drama about life and death. The
monitor measures activity of the heart and other vital signs,
showing when they’re normal and when major deviation from
normal can bring staff hustling in.
The monitor rapidly became my focus of attention in the room.
Visiting people in hospitals can get boring. Not much is happening.
Worrying is exhausting. Rooms are sometimes small and always hot.
Equipment is hanging around everywhere. White dry- erase boards
tell you the staff’s names and other changeable information.
The heart monitor is a straightforward piece of equipment. Every
one tells a unique story, an adventure and mystery story. With
its constantly unfolding lines, the monitor screen conveys vital
information in bright, easy-to-read colors. The visitor’s
eye is seduced. Unrolling across the screen, squiggly lines are
news crawls: here’s the heart rate, here’s the respiration.
It’s happening right now, like reality TV, only real.
The undulating zig-zags on the monitor made me think of the nervous
modernist lines of the Spanish painter Miro. Sometimes I would
see the obvious: a stock ticker, roller-coastering along. Other
times, it was an icon inviting contemplation. Except when a patient
has visitors, or staff bustles around the bed for measurements
and ministrations, a hospital room can be a low-key place, making
it easier for the activity on the monitor to hold attention. It
shows that something is happening, even while a patient lies in
bed sleeping and healing.
I learned that any one individual number didn’t matter
as much as did the pattern of numbers: were they, on the whole,
average and relatively constant? Or were they widely changeable?
A body normally experiences a range, reflecting dynamic adjustment
to always-changing conditions: pump this much, now that much.
The range itself had a range: too fast, too slow, about where
it should be. Such constant fine-tuning prompted me to appreciate
in detail I’d never seen how carefully the human mechanism
is made.
A few rate numbers, as it happened, did matter more than others.
There were pauses: times when my husband’s heart stopped.
Stopped. Then started, again. The pauses were little flat lines
within lengthy constantly unfolding squiggles: that long flat
line represents a five-second-pause. Five seconds. My husband
described the pauses as “spooky.” I hoped his heart
was not deliberating: hmm, shall I push again? This ought to be
on auto-pilot. The process works by wiring, not willing. The heart
is engineered to do this: pump, pump, pump. In my husband’s
case, though, the pump is not working right. This standard-issue
piece of equipment is designed to work reliably for many years,
but as with other aging equipment, the warranty has expired, and
maintenance can get complicated.
As the hospital stay wore on, it became the longest time we had
ever slept apart in 22 years. Right after we first met, before
I went to sleep, I had to talk to him. I had to hear his voice.
He called around bedtime, when we were living our separate lives
before they flowed into our pooled common life. We would talk
late at night and the sound of his voice over the phone was an
embrace. Goodnight, honey.
We have been married 22 years, and still make it a point to bid
goodnight. Goodnight, sweety, I say. Goodnight, honey, he responds.
Lots of times over those years, those greetings are barely civil
grunts, an effort not to go to sleep with your brethren angry
at you. Sometimes even that effort was too much.
On the sixth night, I was awaiting his recovery from anesthesia
given for yet another procedure intended to normalize his heart
rhythm. I was sitting by a body in a bed, watching heart TV.
My husband stirred, opened his eyes.
“Marcia,” he said. He used my name, which was oddly
formal, since he usually calls me by a private nickname that no
one else knows or uses.
“I love you with my whole life.”
His first words.
“I have always loved you. I was looking for you. I was
born missing you, but then I found you because we were one to
begin with.”
The anesthesia had loosened his tongue and his inhibition. He
spoke in a dreamy, chatty voice. We sat in the room, holding hands.
His hand was cool, not cold. He was all right enough.
For a little while, the circle of light around his bed held anxiety
at bay. The poet Gary Snyder said of these rare junctions of perfect
peace and awareness: “All the junk of everyday living drops
away.” Yesterday’s disagreement has vanished; the
answer to the question “When will you be home?” has
not yet been determined. We are only right here right now. Just
this. Love, the life blood of relationship, is flowing. Love is
not measured on the heart monitor.
The mechanical heart monitor blabs the patient’s secrets.
Numbers flick and change – 80 beats, 89 – heartbeat
after beat. A heartbeat is a different measure of time than a
second, faster, more intimate. When the heart is ailing, its beat
can be a jumpy, skittery thing. Things can change in a heartbeat.
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