This post will be a slight departure from the normal material you see on this website. As some of you may know, Uncle Jack has had some health problems of recent and when my parents relayed to me what was going on, I asked him to write a little piece on it for the website. He has some unique views on things and I think they are worthy of being voiced. I also think that those of you who are going to be future physicians and health professionals should take time to really sit and read this. It is not very often that we can truly get into the head of our patients and see what is important to them and discover how they truly feel about their health and their choices. If you are not in the health care field, I still think this whole story is worth your while. In addition, I have suspended voting on this post because frankly, I don't give a fuck what you think. If you like it, say so on the guestbook, if you don't, who cares.
Enjoy....
-- Citizen D
Most of you who read this are either in the beginning stages of your medical careers, in your twenties, or both. After Dallas's parents related my story to him he asked me to write about it, and he would post it on his website. Maybe it will have an impact on some of you, maybe not. I'll let you decide if it's a credible point of view overall, or personally unique. Dallas knows the history of my cardiac problems, he's visited me in the hospital enough, along with some of his buddies.
On July 20th, at around 7:45 a.m., I awoke from a mild dream and found I was sweating profusely. I keep my house cold with the air conditioning and ceiling fan over my bed. I thought, what the hell is going on? I sleep on my belly and just in a pair of briefs, and raised up on my elbows and literally watched sweat run off of me like water.
Then I noticed my chest. My heart wasn't beating, it was more like a rapid flutter.
I thought, well, shit, and got out of bed and grabbed a cigarette, lit it, and sat at my computer desk and said, "Come on, you son of a bitch, take me."The son of a bitch I was referring to was the Reaper, not the Almighty. I still hold Him in high regard.
I knew I was having some kind of cardiac arrhythmia and sat there watching my chest flutter. After a few more puffs on the cigarette, I didn't notice any measurable change in how I felt. I felt no pain, no other discomfort, and no panic.
After I finished the cigarette, and alternated my stares between the screen saver and a fluttering chest, I thought, if this is what dying is like, it isn't so bad. I have lost parents to a stroke and Lou Gerhig's Disease; a son who burned up in a car wreck, and an ex-wife to Hodgkin's Disease; the oldest of these family members, my parents, weren't even 68 years old; my son was the youngest, 23 at the time. All of these deaths had to be worse than what I was experiencing sitting at my desk. If I was going to die, this seemed like a piece of cake. I'm sure that 15 or 20 minutes had passed since the onset of this occurrence, and I still didn't feel like I was dying.
During this 20 minute period, I wish I could say that I contemplated profound and meaningful things, but I really didn't. I just sat here occasionally checking my fluttering chest and contemplated nothing. One would think I would have family and friends on my mind; my "war bride", Maria from England, or what kind of mess my meager estate will cause for those left behind. Nothing panicked me or caused me to want to get up from this chair and do something about my flutter.
Then all of a sudden, while staring at the screen saver, something inside flashed the 1961 Oldsmobile convertible into my mind. "You've got to finish it", I said to myself. A long time ago, at least ten years, a buddy of mine who is a pilot for United Airlines and I decided before we die, we were going to take a road trip down old Route 66 from its beginning in Chicago to the end at the pier in Santa Monica, California. In the years since that initial thought, I had purchased four Oldsmobiles, two hard tops and two convertibles, and since the fall of 1999, I've been making one good convertible out of the other three cars. It's almost finished. That's the car Terry, my friend, and I are going to take on this road trip.
So, I got out of the chair, slipped on a pair of shorts, a t-shirt, and sandals; grabbed my car keys and on the way out the patio door, I yelled at a friend of mine, Rich, who had spent the night in the back bedroom, that I was going to the hospital.That woke him from his sleep. He said, "What for?" I replied, "I don't know, something is going on with my heart." "Hang on, he said, you're not driving, let me get dressed and I'll take you." I sat on the steps of my deck waiting for him to get dressed.
By this time, I had felt a mounting change in my condition. My neck was beginning to feel funny. I had the sensation that it was warm and kind of tight, and I felt a little light headed.
Rich was dressed and keys in hand told me to get in his car. I did under my own power. I still felt like I could have driven myself. We tried to negotiate a route to the local hospital that would keep us off the main street, which ended up taking even more time than had we gone the direct route. I'm sure at least a half hour had passed since I was awakened by the sweating and fluttering before Rich pulled up in front of the emergency room door.
I got out under my own power and Rich opened the entrance door for me. There we were met by a receptionist, I think, and almost immediately, a male nurse or something. I knew them and they knew me. The nurse or something sat me in a wheel chair and we were off to the emergency room.
There he and I think someone else, inserted an IV and began pumping me with a drug that was suppose to kick my heart back into regularity. It didn't work, so they tried another drug. It didn't work, either. By this time I could see my read out on my EKG, and it looked like a 10.0 earthquake on the Richter scale. The emergency room doctor on call was there, too, by this time. I remember him saying something, but not sure what it was. I do remember them saying that along with these drugs, I was also getting a mild sedative.
I guess I was, because things were getting a little fuzzy by now. The next thing I remember were these two white paddles being held up in front of me, and then I don't remember anything until I looked at my chest and it seemed to be beating normally. The male nurse told me they had to bop me one time with a low dose of electricity, and my heart started beating normally again.
He also told me that I was extremely lucky, that only about one in one hundred survived what I had just gone through. He said, "someone must have a plan for you." All I could think of was that Route 66 road trip and the Oldsmobile convertible.
It was either him, or a male nurse at St. John's Hospital in Springfield who answered a question I had. I asked, "What would have happened if I had just sat there at the computer and kept waiting?" The reply was: "your heart was beating so fast, over 300 beats per minute, that it was churning your blood, not pumping it. Your brain would have eventually shut down because of lack of oxygen and you would have passed out, then died." I said, "Yeah, that's what I thought would happen." It all seemed a pretty peaceful way to go to me.
If I had been where I was suppose to be the Saturday and possibly Sunday morning of the "occurrence", I would have been with Dallas and his family and friends at Table Rock Lake helping him and his brother celebrate their birthdays. Instead, I had spent a hot Saturday afternoon working on that Oldsmobile and was too hot, tired and sweaty to make the trip to Shell Knob. I just showered and took a nap until Rich knocked on my bedroom window and wanted to go bar hopping. I did until about 10 Saturday night, then had him bring me home. I had three beers. I don't believe in fate, I believe in good or poor timing for events in our lives.
I had a major heart attack in June of 1993, about 3 months before my 50th birthday. That called for angioplasty; three arteries in my heart were between 80 and 95 per cent blocked. I had quadruple bypass surgery in July of 2000, and now this in July of 2003, about two and a half months before my 60th birthday.
I've had a tendency to approach my own mortality with a sense of humor and sarcasm. Dallas went with me once when I had a yearly appointment with my cardiologist in Springfield, who, incidentally, graduated from UKC Med School. Dallas saw my sarcasm and attempted wit with the cardiologist's beautiful physician's assistant, I think they are called. She left frustrated and sent in the cardiologist. Dallas got on me for trying to be funny. Dallas talked with Dr. C. for a while, and every time I see him, I now give him a report on Dallas's progress at UKC Med. He likes to talk about Dallas.
In Springfield after this event, and another angiogram which showed my arteries from the bypass were clean, my regular cardiologist told me, "I'm your plumber, your pipes are clean, I'm going to call in an electrician, the wiring in your heart has gone haywire." Now, I liked that. He approached my situation with a sense of humor. Shortly thereafter, a little black guy with a deformed spine, walked in and said, "Hi, I'm your new electrician." I liked that, too. It told me that these two busy guys had a sense of humor and had at least corroborated on my case. This black guy, I found out, was from a really poor family of eight in Louisiana, and had somehow managed to pull himself out of that situation and is regarded as the best electrocardiologist in Springfield by his peers and others in the health industry.
He told me what they thought went wrong and scheduled me for another invasion of my groin. This time they were going to go in through a vein next to the artery they had just violated the day or two before. I told him, "Jesus, can't you just use the same route Dr. C. used?" He laughed and said, "No, this is a little different."
After the results of that test, he came back and told me what they wanted to do. He had an option of treating it with medication, which he didn't want to do because of side effects, something about my eyes, or implanting a combination defibrillator -pacemaker. After explaining to me what it would do and where it would be implanted, I felt a little queasy about it all. It's called an "implantable cardioverter defibrillator" (AICD) system, made by Guidant. I told him to go ahead and do it, although I was beginning to feel a little like the Six Million Dollar Man, a TV series in the 70s.
He did it under a local anesthetic, and afterward he chuckled at what I was telling him throughout the insertion of the device. For some reason I thought I had a choice of which side of my upper chest I wanted it implanted. I kept telling him I hadn't decided which side I wanted. I was left handed, and thought it would be better on the right side, then would change my mind and say the left side because it's closer to my heart and the wires wouldn't have to be so long. He said I kept asking when he was going to start the procedure. It was already over. All I experienced was the feeling that he was making hamburger patties on my chest. I could feel him kneading the hamburger and then smacking them into patties, all on my chest. He said I kept asking him why he was making hamburger patties on my chest? We both had a laugh about it afterwards.
I had my three week post-event checkup this past Tuesday. A technician from Guidant pulled information out of this device that told him what all had happened since the implant. I had read in the manual that comes with it that it can be programmed with a device similar to a TV remote control. I asked him if he could program it to pick up the Cardinals games so I wouldn't miss them since I dropped my satellite service. He laughed. He said everything looked great� all the read outs were excellent or good. The little black doctor came in to follow up and said basically the same thing. I can't drive for six months because of Missouri law, but he said I could go back to my normal activities within reason, and made my day when he said I could take that Route 66 trip I had told him about. It's now scheduled for late next Spring when the temperatures in the desert areas of a lot of the old road's route are at their mildest.
Every story has to have a point, a moral, a climax.
I've smoked for 45 years. I can barely remember not smoking. I know that smoking has caused me to have all these heart problems. I don't recommend smoking for anybody.
Dallas's dad and I have known each other for almost 50 years. He never smoked that I know of. Smoking was as much a part of my life as eating and sleeping. It had become a part of my daily routine, and has been as vital to my brain's triggering mechanism as the ones that tell you when to eat and when to sleep. I can't imagine my life without nicotine in it. It's like any addictive drug, and worse than most, I'm told.
I grew up during a period of our history when TV programs and magazines carried cigarette commercials, the Fifties. One TV show even ended with the announcement that "gift cartons" of Camels were being sent this week to a designated military base for the soldiers to enjoy. My high school football coaches smoked in their offices in the gym. Teachers had a smoking lounge in the school building. Kids stood outside the school under an old oak tree and puffed away before, between, and after classes. Some people can quit cold turkey, some struggle, some agonize, some don't quit.
There are over six billion people on this planet. In less than 50 years there will be over seven billion. Doctors and scientists are now talking about extending the human life span to upwards of 500 years. Salt has been the number one seasoning for thousands of years. Now it causes high blood pressure. Tobacco has been smoked, chewed, snuffed, for hundreds if not a thousand years. Now it causes a multitude of diseases. Things in the environment, once thought harmless, now are found to cause the same multitude of illnesses. It goes on and on. Did anybody ever stop to think maybe these things are here for a reason? To help control population?
I read somewhere a few years back that the first commercially available health care insurance was offered by a Dallas newspaper back in the 1920s; the premium was, I believe, one dollar and fifty cents a year.
A hospital room in Aurora in the late 1960s was 18 dollars a day. An office visit to a doctor was about ten dollars. Even Barns hospital in St. Louis was only charging 40 dollars a day at that time.
This device I have implanted in me cost close to, or more than, 60 thousand dollars. I thought, before I knew what all it could do, that I could build one similar out of a Model T coil and a car battery, all for less than ten dollars. The week I spent in the hospital in 2000 for my bypass surgery was over 60 thousand dollars. My first hospital stay in 1993 for a week was over 25 thousand dollars. In 1969 and 1970, when my ex wife was first diagnosed with Hodgkin's Disease, the total hospital bills, from the week she spent here in the Aurora hospital, through the month she spent at St. John's in Springfield, and on to the month she spent at Barnes where they treated her as an in- patient for a month, and six months of outpatient radiation treatments totaled only a bit over 40 thousand dollars. I had insurance for that one and was out very little. When she died in 1999, almost 30 years after the remission of her Hodgkin's, and about 3 months in intensive care, her bill was well over one million dollars.
Forty million people in this country have no health insurance. Hospital stays now average about 5 to 7 days and cost as much or more than the 40 thousand dollars spent on my ex- wife for a nine month period of in-and out-patient care in 1969-70. None of these hospital figures include the cost of the doctors involved. I had no insurance then. I lost my business and went bankrupt from it. It isn't that people want to go without health insurance, rather it's a choice they make between trying to enjoy life and having some money to spend on frivolous things that make life a little more tolerable, than paying those few hundred dollars a month on health insurance. We take chances that we can beat the odds. Most of the time we don't.
If I hadn't had Medicare and another supplement, I would probably have gone ahead and sat here and died. I wouldn't want to go through the embarrassment of another bankruptcy and charity case.
A lot of you are going to be doctors. I recently read where 8,000 doctors were pushing for a national health care plan. I don't care how corrupt it becomes; like Medicare, abuse and waste runs amok, and a national health insurance plan probably will, too, but the average person just cares that they have some coverage that will stave off them losing everything.
I kid Dallas about becoming a plastic surgeon and making millions of bucks from the vanity of women and breast implants. Now men are doing the same thing. Cher can't have any more plastic surgery. She doesn't have enough loose skin left to even close her eyelids. Joan Rivers looks like an overstretched bongo drum. I don't think she could ratchet her eyes closed, or that silly smile on her face. All for the sake of vanity.
I hope Dallas changes his mind and becomes something useful, or keeps that career in mind and helps kids and adults who have been burned so bad they can't face society. Do something worthwhile. You will all be rich doctors no matter what field you go into.
Do on occasion what my first cardiologist did for me knowing I had no insurance. I know of at least 3 tests costing over 600 dollars apiece that never appeared on my bill. I don't know how he did it, but he did. Don't help keep people alive on life support systems in their 80s and 90s. I know that's out of your hands, but fight for some kind of legislation that would help you do that. Try to understand patients me who know their heart problems were caused by a life choice that could have been avoided, but smoke anyway. Sometimes I feel like doctors and nurses come in to the examining room like a bereaved member of the family viewing the corpse in the coffin. I know it's going to get me, but don't grieve for me yet.
Don�t treat smokers like the dumbest people on earth. We have now become the hated minority. I�ve seen anger in the eyes of doctors and nurses over smoking. These same people show sympathy and compassion for people with AIDS, another disease caused by life-style choices, but more politically correct to accept.
Try to have a little humor in your bedside manner. Don't look at your watch and think, geez...this asshole is sitting here telling me his life story and two thousand dollars worth of patients are still sitting in the waiting room.
You people are sacrificing a lot to become doctors. To you it seems like most of your life has been spent learning to be one. I have to admire you for your perseverance, but at the end of the day you are like anybody else, you will live, grow old and die. Try to empathize with your patients, you will learn something from them. You'll face your share of hypochondriacs and crybabies, but you'll deal with them. Just be human and realize someone has probably sacrificed a lot to get you where you are now.
As for me, I want to stick around to see Dallas and Guy in their careers and Larry to get a worthwhile career, too. I want to see Dallas's dad, Don, learn to slow down and enjoy life. Maybe I'll see all of this and maybe I won't.
I'm sure the Reaper will visit again, and I'll tell him the same thing, "Come on, you son of a bitch, take me." Maybe he will and maybe he won�t.
Dallas, I hope this is ok, it's from the heart.
Uncle Jack