Flatliner

It’s 1994 and I’m lying on a cold, hard X-Ray table in the cardiac catheterization room of the Methodist Hospital in Houston. The nurse administers some Valium and Demerol IV to relax me while a cardiologist sticks needles in the right side of my groin, threading a wire catheter from my femoral artery to my heart. Meanwhile there is another cardiologist—an electrophysiologist—waiting to do a study that will use a computer to map “stimulation points” in my heart. Even though I was a practicing anesthesiologist in Manhattan, I was sent here so doctors could examine the genetics of my disease, hypertrophic obstructive cardiomyopathy. The process involves triggering sensitive parts of the heart to induce cardiac arrest—basically they bring you really close to death to see how much of a chance you have of dropping dead at a later time. How’s that for a paradox? The wire is now in my atrium, one of the two smaller upper chambers of the heart. The cardiologist says I’m in atrial fibrillation, meaning my heartbeat is rapid and irregular. My anxiety level starts to climb, but so far I’m handling it. Being a physician makes it twice as hard because I completely understand everything that’s going on. I’m thinking, “Jesus Christ they’re only in the atrium and I’m in trouble. I do the same thing to people in the operating room all the time and they don’t go into a-fib. What’s going to happen when they enter the ventricle, the main pump of the heart? Will I die? If I do, will they be able to bring me back?” Now he’s inside my ventricle stimulating some pre-marked places to determine not only if I’m inducible, but also if I’m “easily inducible.” I’m really terrified now, approaching the moment of truth, when suddenly I yell, “Something’s wrong” and try to sit up and stop them. There’s a wide belt around me and all these hands are pushing me down until I feel I’m losing it. Stark terror washes over every cell in my body. I know I’m dying. I don’t see any bright light. My life doesn’t pass before my eyes. All I can think about is the unfair level of pussy I’ve managed to accrue. And that was it. I was clinically dead. No thought. No feeling. I remember it. There was nothing there. Then all of a sudden a warm feeling takes hold and I think someone is calling me. I’m awake and see faces looking at me. I ask, “How long was I out?” “Three minutes.” I question where my consciousness went and how it returned. I now knew exactly what to expect in death. In fact, I was disappointed that I came back. One thing that remained unchanged was my thoughts on God. I’d long believed in a random universe and this more or less confirmed my suspicions. Then the EP guy says, “There’s a little problem. You’re still in a-fib. Do you want us to put you to sleep and shock you back, or do you just want to wait for it to go away?” What the hell? He’s asking a man who was just dead if he wants to go under. Nevertheless, I tell them to do it because you can easily have a stroke in a-fib. A few hours later the hospital’s chief cardiologist and EP guy came to my room and broke it to me: I am at risk of sudden death and they recommend getting an implantable cardioverter-defibrillator. It senses when your go into cardiac arrest and shocks by way of a wire literally screwed into the heart muscle. ICDs are common now, but in 1994 they were experimental. They also wanted to put a pacemaker in me as a backup in case the shock gives my heart a slow start. The next day they put the ICD in the left side of my beltline along with a cable under the skin that goes up to my collarbone where it’s spliced into another cable that leads to my heart. Imagine having to walk round with a permanent 16-ounce mass inside your waist. As a cherry on top, they sent in the most sadistic nurse on the planet to explain the different things that can fuck up the ICD’s signal. The list includes the electromagnetic field at Niagara Falls, airport metal detectors, and operating-room equipment. By the end of our conversation I was petrified of sitting in the wrong seat on my return flight, lest the plane’s engine do something screwy to my implant. Then she suggested wearing a jumpsuit to accommodate the lump. All I could think was, “Wow! Am I fucked or what? I could experience sudden death at any time and this thing in my side makes it impossible for me to go back to work in the OR.” *** Soon after my return I visited a cardiologist at St. Francis Hospital in Long Island for a check up. It was decided that the only way to determine if the ICD was working properly was to “put me to death.” I insisted on anesthesia this time so I wouldn’t feel the same terror as before. They dosed me up, I went to sleep, they put me down, and the ICD brought me back. Again, there was nothing. I never knew or sensed a thing. During my downtime I was offered a variety of positions in the medical field but they all paled in comparison to my previous career as a doctor. So I just decided fuck it, I’m moving to Florida. My wife begrudgingly agreed to go. We bought a place on the beach, made friends, got a boat, and my sons fell into their own niches. I was luxuriating in a life of leisure. At the time I was asymptomatic except for the side effects from my medicine, but I asked my doctor about my life expectancy and he answered me (and the insurance company) with a statement that basically said: “He has a normal life expectancy… with the exception of a risk of sudden death.” There were those words again. Still, I was thrilled with my situation for about two years. Eventually the boredom got to me and I hooked up with another anesthesiologist in Ft. Lauderdale who taught me how to “erase” spider veins on women’s legs. I also learned how to do facial peels with acid and eventually opened up a small cosmetic surgery practice in a shared office space with a gynecologist. A few years passed and it became time for yet another surgery. They told me I needed a new mitral valve, the flap between the left atrium and ventricle. Only two doctors in the country could do the procedure so I was sent to a hospital in Pennsylvania. The doctor spent the entire time arguing with me, even while they were catheterizing my heart. Afterward he told me I needed open-heart surgery and that, after all this time, I really didn’t have HOCM because of a bunch of nitpicky technical conditions that only an asshole would rely on in a diagnosis. Going in I had a bad feeling that I wouldn’t be coming out alive. Luckily, the surgeon was excellent and managed to repair the implant instead of replacing it. This procedure was supposed to finally take care of my a-fib but of course it didn’t. The surgery also required the use of a freezing solution with potassium that stops the heart. Again, I entered the great abyss and was brought back. After the operation another, more urgent problem popped up: I was having trouble with my balance. I kept falling on my face and tumbling down the stairs. I went to a few specialists. A couple thought it had something to do with my inner ear, while a neurologist who examined me claimed I had Parkinson’s disease due to a medication I had been taking over the last 30 years to help my digestion. I was a mess. I had all the symptoms of advanced Parkinson’s, and then I started having severe delusions and hallucinations. I wouldn’t sleep for two or three days at a time—all I did was sit at the computer. My sons would visit me and tell my wife that I wasn’t doing shit, but in my mind it was all very important “work.” I only remember a few things from this period. One night I woke my wife up at 4:30 AM, crying as I told her in all seriousness: “I can’t protect the family anymore. They threw me out of the Secret Service.” I also believed that a high school teacher who I knew had given me a CD of important information to get out on the web before he was brutally murdered by a gang from the school. Everybody tried to talk me out of this but I wouldn’t hear of it—I owed this man and now he was dead. So all day and all night for a week I was researching shit on the internet, but I have no idea what it was. There were also hallucinations—the “shadow people” who danced around on the wall at night while I worked. Another night my wife came into my home office before bed and I was shredding papers and destroying disks in a frenzy. I told her that the Feds were raiding the house in the morning and she asked me why. “I don’t know, but the IRS is coming to get me tomorrow.” That time she cooled me off easy by reminding me that my disability checks were exempt from taxes. My psychiatrist thought I was going down the tubes. I remember getting really angry with him and my wife when he said he wanted to hospitalize me so the doctors could regulate my medications. I thought they were going to commit me. Eventually they adjusted my meds and I gradually came back to normal (at least I think it did), except out of nowhere I was a talkative, affable, down to earth person instead of the miserable guy I had been for years. I was getting around with a walker until last year, but now I can get around the house without it. Life was hard but I went to a special “movement disorder” neurologist. He diagnosed me with both brain damage from going under during all the heart surgeries and vascular Parkinsonism, for which he gave me medications. They have helped a great deal and I feel better about life than I ever had. Still, it’d be nice knowing it wasn’t going to cut out at any minute. ANTHONY PERRICO, MD