Dodging Bullets

I was in San Francisco when it happened. It was Labor Day, early afternoon, and my sister-in-law, Beth, was driving me to the hospital while I sat calmly next to her and watched the cityscape sweep by. She seemed unruffled under the circumstances, though was clearly driving as fast as safety permitted. Luckily, traffic was light—or maybe, as a local, she just knew all the backstreets.

“Do you want me to call Terry?” she asked as she turned into the Emergency driveway.

“No. Not yet," I insisted. There was no need worrying my wife right now when she was four hundred miles away. I was holding to the notion that it was going to be no big deal. I’ve been to the ER plenty of times: kidney stones; broken hand; busted shoulder… You go to the ER, they fix you, then you go home. I knew the drill.

They were waiting for us when we walked into the lobby. Right away, we were whisked straight in; no paperwork; no showing my Kaiser card. There was a sensation of disconnect from my point of view, like all of this was happening to somebody else. I was merely a curious observer—or so it seemed at first. I was quickly ushered into an examination bay and instructed to lay down on the bed. A medical team crowded around me and began asking a lot of questions while IV stints were inserted into both arms and EKG leads were taped to my chest. More equipment was rolled in. More questions. Pretty soon, there were eight people jammed into the exam bay, two of them doctors, giving me their undivided attention. They even rolled a computer monitor to the foot of the bed, and a THIRD doctor joined the fray via Skype. He asked even more questions. Holy mole! 

When the frenzy had died down a bit, Beth poked her head around the curtain to see how things were going. 

“Okay, maybe you better call Terry now,” I said sheepishly.

She smiled. “I already did.”

That’s how fast the world can shift while you’re busy living your life. It’s like swimming in the ocean: Everything can be blissfully grand—if you don’t notice the shark’s fin slowly circling you. But allow me to back up a bit...

Four days earlier, I had embarked on what was supposed to have been a semi-solo road trip. My first stop was Beth and Tom’s place in San Francisco, where I picked Terry up at the airport the following day, which was a Friday. On Saturday, Ter and I drove up to the Sonoma wine country for a friend’s birthday bash, stopping off to hike Mount Tamalpais along the way. It was a beautiful, late-summer day. The birthday boy, Kevin—one of my cohorts on the Patagonia trip—was in his element playing drums in his band, performing three rollicking sets at the party. We then stayed the night in Healdsburg and spent most of Sunday at Kevin and Denise’s house; took a scenic hike along the Russian River. At the end of the day, we drove back to the city and I dropped Ter off at SFO for her flight home, capping off a wonderful weekend. I then went to Beth and Tom’s place for the night. They were out of town, so it was just me and the Italian Grand Prix on ESPN. During the race, I texted my climbing buddy, Paul, to verify that I would be staying at his Sacramento abode on Tuesday. We hadn’t seen each other in a dozen years and I was really looking forward to catching up.

Labor Day morning was damp and chilly. I called Ter and we chatted for a while. Then I hiked up to the lookout at Grandview Park. I was back before Beth and Tom got home around noon, their boys, Nick and Colby, scurrying downstairs with some of their school pals to play video games. Since a barbecue was planned for that evening, I helped Beth tidy up the patio deck while Tom went to the store. That’s when things began to get a little weird.

Beth and I were sitting at the kitchen table, conversing over cups of fresh-brewed coffee. She’s an interesting lady: super-mom; wife; avid skier and mountain biker; plays basketball and guitar, though not at the same time (but she's working on it). As we talked, I found my voice becoming a little hoarse. Crap. Ter had been complaining she was coming down with a sore throat, popping Zicam like candy all weekend. So when Beth asked if I was okay, I told her that I was coming down with Terry’s cold.

The parents of Nick and Colby’s pals soon arrived to pick them up, but before they departed, we visited on the backyard deck for thirty minutes, maybe longer. I was losing my voice, so I didn’t talk unless somebody asked me a question. Occasionally I’d stumble over a word. An alarm bell would sound in my head that something was wrong, but a quick, internal systems diagnostic concluded that I was coming down with my wife’s sore throat (even though my throat wasn’t sore!). One side of my brain was warning “Houston, we have a problem,” and the other side would respond “Relax, it’s nothing.” But as soon as the guests had left with their kids, Beth cornered me in the kitchen. She asked if I was aware of my slurring of words, and again, I told her I felt fine. But she was doggedly persistent and wouldn’t let it rest, and stepped closer for keener scrutiny.

“What day is it? Close your eyes and raise both arms in front of you. Stick out your tongue. Give me a big smile.”

Did I mention that she’s an ER doctor for Kaiser Permenente? I knew what she was doing: I was being given a cursory stroke test, which was absurd. I had no problem passing it. Or so I thought.

“Okay, we should get you to the hospital,” she said, already halfway across the kitchen to where her backpack/purse was sitting on the bar. 

“What?! Whoa, hold on a minute. I’m fine.”

I was finding all of this hard to process. Things were moving too fast. Tom came into the kitchen and Beth told him she wanted to take me down to Kaiser. Tom is like your cool, easy-going neighbor who is always there to lend a hand when you need it. He’s a doctor, too. He looked at Beth, and then he looked at me and said: “You know, I'd go have it checked out.”

I still balked.

“Go look in the hall mirror,” Beth suggested, “and give yourself a big smile.”

So, I went and looked in the mirror—and then I stopped arguing with her: My smile was lopsided, the right side of my mouth looking as though it had been shot up with Novocain.

The hospital where Beth works is only three miles away, so getting there didn’t take long. As Beth was driving, she called right into the ER center and gave them a heads-up. That’s why they were waiting for me when we arrived.

“It might’ve been a TIA,” the ER doc informed me after their examination and assessment was completed. Other than my speech impairment, I had aced the pop quiz and coordination tests. So, could I go home now?

Nope. They had more tests to run—and they wanted to keep me overnight for observation. A CAT scan was next up, followed by an echocardiogram of my heart. Then I was admitted to the hospital and wheeled up to a room on the top floor with a view of the clouds and drizzle. Beth had gone home by then, though she’d be back in a while to work the ER night shift. I called Terry and assured her that I was okay. She was taking a flight up in the morning. Then I called my daughters. Ter had already informed them, but I wanted to talk to them directly.

Every picture tells a story. This is one of the stroke tests given in the ER to quickly assess any compromise to cognitive thinking. I was asked to describe everything going on here.   

I was lying in bed watching TV, bored and forlorn, when it finally sunk in that my road trip was dead. Kaput. Up until then, I had remained optimistic that everything would get sorted out and I would move on. But no longer. I texted Paul and relayed the bad news that I wouldn’t be coming to Sacramento. And I informed my brother Jeff in Morro Bay that I’d have to cancel my stay there as well. This was the melancholy mood of things when I got the text message from Beth:

“Hungry?”

My angel. She breezed into my room before her shift started, wearing pale blue scrubs and toting a big bag of Thai cuisine in take-out cartons. No hospital food for me. I had my own private dinner and a movie, and then it was lights out—not that I got much sleep. The nurse came in to check on me every two hours, taking my BP and asking how I was doing. Between these drop-ins, I would lay and stare up at the ceiling and try to fall back asleep. I remember, more than once, thinking: How the hell did I end up here?

Sometime before dawn, I had to pay a visit to the toilet. I swung my legs around, stood up, and was halfway to the bathroom door when an alarm went off in my room. Frantically, I looked around in the dark, figuring I must’ve pulled some EKG wires loose when I stepped away from the bed, but nothing seemed amiss. The alarm kept beeping and I kept standing there perplexed. Soon, a nurse rushed in and turned on the lights.

“I didn’t do it!” That was my story and I was sticking to it.

She calmly went to the foot of the bed and flipped a switch that brought instant silence, explaining that they’d activated the bed alarm, just in case I fell out of it in the middle of the night. Hmmm. Or just in case I attempted an escape in the middle of the night.

Breakfast came around eight o’clock, but I’d already been up reading for hours and watching the news on TV... and fretting the next big test scheduled that morning: the MRI. There’s nothing like being inserted into a 28-inch diameter tube of coiled wires that are energized with thousands of watts of electricity to create powerful magnetic pulses that bend the hydrogen protons inside your head to the same magnetic axis, the machine buzzing and clanking and slicing and dicing until it has created a detailed, three-dimensional topography of your brain.

With the MRI out of the way, all that was left to do was wait. And wait. Terry and Beth arrived around noon with lunch, and as we ate in my room, I apprised them of the latest, even the errant bed alarm that woke up half the seventh floor. I was feeling good. I wanted to go home. Every so often I’d check my smile in the bathroom mirror. It looked close to normal to me, far better than twenty-four hours ago. Henceforth the swell of anticipation when Dr. Kimm, the neurologist on my case, arrived to talk with us. She was in her sixties, tall with short-cropped grey hair. I liked her sincere, quirky demeanor right away, and after introductions, she got right down to summarizing all the tests that had been conducted.

She started with the good news: I was in great shape for my age; all veins and arteries were clean with no blockages; I had “gorgeous carotids” (her words, not mine); my heart was functioning perfectly. Then came the bad news: This was NOT my first stroke. There had been others.

From the computer terminal in the room, Dr. Kimm queued up several MRI images of my brain. “Here’s the stroke you had yesterday,” she said, pointing to a small blemish. It was in the left hemisphere’s Broca’s area, which formulates speech. “And here’s an older one… And another one here...” She pointed to the other dark spots. One of them, she estimated, was only a few months old. It looked as though somebody was using my brain for target practice.

The room got awfully quiet after that bombshell. I was stunned. After a short pause, Dr. Kimm continued, expressing her suspicions on what had caused the strokes, even though she had no evidence, other than previous cases like mine.

“Random atrial fibrillations,” she said. And they had to be extremely random, because I had been hooked up to an EKG monitor for thirty hours, and not once did my heart utter a hiccup or flutter. And what about the other two strokes? Why couldn’t I recall anything weird happening during those events? So many questions with no answers.

“Consider yourself fortunate,” said Dr. Kimm. “It could’ve been much worse.”

Which was true. I felt as though I’d dodged a bullet—three of them, actually. She also pointed out that I was lucky it happened at Beth’s house, because she had detected it right away, rushed me to the hospital, and now I knew that I had a serious problem to address. Had it happened a little later, when I was no longer at Beth and Tom’s, I probably would’ve blamed my hoarse voice on a cold, and within forty-eight hours, all the symptoms would’ve gone away, long forgotten…. Until the next stroke.

I was released from the hospital that evening, and Terry drove us home the next day. Hard to believe that was two and a half months ago already. Time flies when you’re busy seeing doctors and having more tests run. I had a tiny EKG monitor taped to my chest for a month, 24/7, in an attempt at capturing an A-fib. And the results...(drum roll)… Four random events, the longest lasting about twenty heartbeats. That is only twenty seconds. But it’s enough to put me on an anti-coagulant drug to prevent my heart from causing another stroke. Life goes on.

Through September and October, I was restricted to walking the dog and taking out the trash. Doctors’ orders. “Take it easy,” they urged. If truth be told, I wasn’t up for much more anyway. I fatigued easily and took naps in the afternoon to recharge the brain, my neurologist assuring me that this was normal and would improve with time. To assuage my cabin fever, Terry “volunteered” me to be her traffic controller at her school in the morning when the kids get dropped off. That’s been a Carmageddon experience, but a traffic engineering problem that I think I’ve resolved.

Slow but sure, my stamina has been returning. The doctors lifted the draconian limits of what I could do—though they urged me to start off easy. A couple weekends ago, we put the mountain bikes on the camper van and drove up to Big Bear Lake. It felt good to be rolling down the trail again and gaze up at the stars at night with my sweetheart and sidekick poodle. Only now, everything seems richer and more precious.

On the trail near Big Bear Lake.