Saturday, July 26, 2008

Random thoughts on a heart attack


As you can imagine, my mind has been racing since my apparent heart attack last week. So many thoughts, so many concerns have been whirling in my head…

First there’s a sense of dread for what’s ahead. I hate being cast in the role of “patient.” I haven’t had much experience with that role, having only been in the hospital twice in my entire life, for the insignificant procedures of having my wisdom teeth extracted and having my tonsils taken out as an adult. I haven’t had very positive experiences with doctors, either, having been sexually harassed by two (at a time when I didn’t even recognize what sexual harassment was), mocked by another, and in general being consistently treated in a condescending manner by most. A couple of years ago my best friend was going through treatment for cancer, and all I could think was, “I’m not strong enough to endure something like that.” Right now I am desperately hoping that all I’ll need is an angioplasty and a stent, rather than a bypass. The one silver lining here is that the cardiologist I wound up with seems to be a good one who assured me that he would take care of me.

And of course the overwhelming concern is that I need to stick around as long as I can for my boys. When my mind dares to consider what will happen to Marcus, Gabriel, and Tevis when I’m gone, I almost go crazy. Yes, of course there are group homes, but I want to know that they will have someone who cares about them. In recent weeks, I have been doing a lot of reading about cohousing, and what I’d like to have in place at some point is to be part of a cohousing community, so that when I’m gone, the boys will be part of a community, with relationships that will support them. I want them to have people in their lives who aren’t paid to be there. Ideally, family would fill that role, but I have to be realistic and acknowledge that my family just won’t be there for the boys.

As always, money is a big worry. I’ve finally gotten my caseload up to an acceptable level, and my expense down, where I actually have a surplus at the end of the month. But I have very little PTO saved up, having used most of it when Marcus had his surgeries. Yes, I have short and long term disability coverage, but it only pays 60% of wages, and I was reading the policy last night and discovered that they go back 12 months to determine your wages. Well, that will take them back to include some lean months when the company wasn’t giving me enough patients, so the disability payments will be low if I have to be out for a considerable length of time. Then you add the additional financial burden of the medical bills, and it doesn’t look good. So there’s another good reason to desperately hope for an angioplasty over a bypass!

And then there are the thoughts of all the practical, nuts and bolts sort of things that need to be done…revising my will (just in case), getting in extra groceries and making sure the boys’ prescriptions are all filled, catching up on the laundry, getting the house presentable in case people are coming in to help the boys, etc.

Finally, even though I plan on hanging around a long, long time, an event like this does tend to hit you over the head with a sense of your mortality. I can’t help but start thinking of a “bucket list” of all the things I wanted to do and haven’t yet accomplished, and when I do that, I have a sense of regret. But something changed my perspective yesterday. I read about the death of Randy Pausch and have been listening to his “Last Lecture,” which I had not previously heard of. Hearing him talk of realizing his childhood dreams has led to me think of what I have accomplished, rather than of what I haven’t. But I guess I’ll explore that more fully in a future post.

So, enough of maudlin thoughts…time to get busy.

Thursday, July 24, 2008

Bummer!

I just got back from the cardiologist. He says I probably had a heart attack last week. And so it begins...

Blue genes


I remember a moment of dark humor amongst our family as we waited for my dad’s funeral to start. We were all gathering in an anteroom, greeting and visiting with family members some of us hadn’t seen in years. One of my cousins is an ophthalmologist in Dallas and several of us have taken him up on his offer to check our eyes or even to have Lasik surgery without charge. As some of us were making reference to his gracious offer, someone quipped, “Too bad you didn’t go into cardiology!”

No joke. My mother had a heart attack when I was in junior high, which would have been when she was in her mid-forties. One brother had an arterial bypass many, many years ago, and the other brother had a six way bypass a few years ago (I didn’t even know they did 6 way bypasses!). For too long, like an ostrich with its head in the sand, I have comforted myself with the fact that I haven’t had the problems my brothers have had, ignoring the possibility that avoiding doctors has enabled me to avoid a diagnosis.

Well, last week I had a rude awakening, as my blood pressure skyrocketed, accompanied by a headache that made the back of my head feel like it was being squeezed in a vise. I went to the doctor, who changed my blood pressure meds. (Thank god, she took me off the one that turned me into a lump, so tired and depressed I was barely functional.) Great! But on the way to my car, I had the worst chest pains, which finally forced me to do an about face, right back into the doc’s office. They did an EKG, which was OK, and sent me off with a prescription for nitroglycerin and an appointment with a cardiologist, which is tomorrow.

Ah, genetics! It sometimes seems that my genetic history is an inexorable force seeking to turn me into my mother, with a shoebox full of prescription bottles. Hypertension, diabetes, depression, poor eyesight, big ears…thanks, Mother and Dad! But I refuse to fill that shoebox, with one pill after another, many prescribed to offset the side effects of another. So I dusted off the exercise bike tonight…

Sunday, July 13, 2008

Getting it

I’m always frustrated when I’m in a situation where someone doesn’t “get it.” On a political level, we saw a prime example this week when John McCain’s chief economic advisor, Phil Gramm, informed us that, in this time of financial hardship for many folks, we are simply in a “mental recession” and that we have become a “nation of whiners.” While McCain was quick to distance himself from Gramm’s remarks, the fact remains that McCain himself has been slow to acknowledge, or even recognize, the seriousness of the current economic situation. Time after time, he has pronounced that the “fundamentals of the economy are strong,” seeming to believe that if he says it enough, it will be so. Are we surprised? Only 4 short months ago, our president was dumbfounded when a reported asked him about the prospect of $4 a gallon gas, responding, “Four dollars a gallon? That’s interesting. I hadn’t heard that.” These rich politicians who have very limited contact with us regular folks can’t imagine how we live. When Cindi McCain charges $750,000 in one month on her American Express cards, when she has a closet full of $3000 designer suits, when the McCains own eight expensive residences, I can see why it might be difficult to empathize with someone who lives from paycheck to paycheck, who can’t afford the health care they need, who has lost their home to foreclosure. It’s not just a failure of empathy. It’s a failure of what I like to call “empathic imagination.” These people, living in an insulated world with others like themselves, find it almost impossible to imagine what life is like for those who live in a much different world.

But this failure of empathic imagination isn’t only a fact of political life. I see it in my everyday life as well and I find it equally frustrating there. One recent experience at work immediately comes to mind because I was so upset about it at the time. Last month I had my annual performance review and received low scores on “Productivity” and “Absenteeism.” The supervisor assured me that the numbers were only based on the time period from October on, after my caseload picked up. Great. In that period of time, I have missed work for minor surgery on my feet, an emergency stress test, two MRIs, my sons’ two visits to the ER, my mother’s two trips to the ER by ambulance, Marcus’ two surgeries and follow-up care, my mother’s regularly scheduled doctor’s visits. I also had to take Gabriel to MHMR every two weeks, but usually managed to drop him off and see a patient or two while he waited. I reminded her that my absences were due to these circumstances and she sort of brushed my protest aside. (Later I checked with the head of HR and found out that I could have been using intermittent Family and Medical Leave Act time for these absences and they wouldn’t have counted against me…it would have been nice if someone had told me that!) Anyway, the supervisor was obviously trying not to seem uncaring and asked a bit about my mother, but what I find at work is that supervisors ask about things like that, but they don’t really want to listen to the answers. I explained that my mother is 89 and legally blind. A few minutes later the supervisor asks me, “Does she still drive?” Say what? Hello? I just said she was blind, plus if she could drive, WHY would I be taking her to her appointments? I also mentioned that one evening recently I tried to call my mother and didn’t get an answer over the course of an hour. My mother almost never leaves her apartment after supper, so I was in a panic. The supervisor laughed and said something like, “I guess you were wondering where she went off to!” I couldn’t believe she didn’t get it, that I was panicked because my first thought was that my mother was lying helpless on the floor after a stroke or heart attack. Naturally that would be my first thought, given her age and the fact that I lost my dad not so long ago. I see this as a failure of empathic imagination, something that I seem to encounter a lot as I am surrounded at work by 20- and 30-somethings, many of whom have responsibility for no one but themselves and have unlimited youthful energy and good health. They literally cannot imagine how life is for me. Maybe 20 or 30 years from now, they’ll understand how things change when you have to manage work while dealing with personal health problems, caring for elderly parents, etc.

Most people, I think, would agree that empathy is an important facet of emotional intelligence, but I would say that the first step of developing empathy is to develop the ability to imagine what another person might be experiencing. One has to be able, mentally, to walk a mile in someone else’s shoes.