Hill 1

Michael Hill

Professor Salter

ENG 101

31 March 2018

A Change of Heart

“This is what I learned at the hospital. You have to do everything you can, you have to work

your hardest, and if you do, if you stay positive, you have a shot at a silver lining.”

-Matthew Quick, 'The Silver Linings Playbook'

It's not an unfamiliar concept that there are occurrences in life that divide a person into two

parts; a before and after. Depending on the life, there might be three or four such divisions between the

cradle and the grave, which irrevocably change the patterns weaved into the tapestry of consciousness.

The usual process follows an invisibly slow and logical sequence, like the erosion of a canyon, but

every so often, the earth trembles in the wake of a violent realignment.

On a day like any other, my parents were huddled in a cardiologist's office. The doctor making

sure my mother had been taking the correct dosages of her medication, my father soaking in medical

jargon like a sponge to a mess. Weeks earlier, she had suffered a heart attack out of the blue at only

thirty-two years old, and was diagnosed with cardiomyopathy, a type of heart failure. With no familial

history of heart disease, or personal history of drug use, it was decided that her condition was simply

bad luck. A deafening noise drew the appointment to a close. In the hall, nurses crowded around a

television, hands over mouths. A plane had just hit the World Trade Center. Tension became panic when

the second plane hit. My parents joined the flood of people in the streets, many of them covered in ash.

There was a rumor going around that schools were going to be next, and as the train wasn't an option,

my parents walked across the Queensboro Bridge and all the way to Forest Hills. When they got there,
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they found me with a family friend, oblivious that anything had happened.

In the winter of 2012, snow battered the windows of the ICU, the freezing air of Westchester in

stark contrast to the humid heat I'd grown accustomed to in Tampa. I sat outside my mother's room, my

feelings of powerlessness tangible, my father down the hall with the same cardiologist whose office he

was in when the towers came down years earlier. My mother had suffered a stroke due to the

negligence of several nurses and doctors, and it wasn't expected that she would survive the weekend.

Several miles away, a 19 year old boy whose id said 'donor' on it was hit by a car. With mere hours to

spare, his heart was salvaged and transplanted into my mother.

In 2017, I was 21 years old, living in Salt Lake City, Utah, training to be a professional ballet

dancer. When not in class or rehearsal, I could be found in the gym, or working nights as a truck-

loader in the stagehand union. I crammed what little free time I had with as much partying as possible,

with the best friends I've ever had. The tribulations of familial health issues and adolescence were in

the past, and the insecurity of my teenage years had given way to the overconfidence of autonomy,

invincibility. I barely slept, living off of ramen noodles and candy, washed down by cheap beer and

cigarettes. The more invincible I felt, the more risk I was willing to take. Beer and weed were soon

joined by liquor and cocaine. I used adderall as a recreational drug, but also to stave off hangovers. And

while all of my peers remained impervious to the consequences of such indulgence, I was gambling

with a weak hand. I begin to feel drained, heavy, as if I wore Marley's chains around my neck. Stomach

cramps set in, defiant of ant-acids and laxatives, and I became so bloated that I looked pregnant, my

feet like puffy balloons. I stopped going to ballet or to the gym, and could soon no longer walk, eat, or

sleep due to the agony I was in. I later learned that my sleeplessness was caused by something called

sleep apnea, which is when your body thinks it's suffocating, and jerks you awake the moment before

you drift off. After a month of this hell, I told my father what was going on, and he drove up from LA.

By the time he arrived, I realized that I needed to go to the ER. He mentioned my mother's history to a
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nurse. They drained over a liter of fluid from my stomach and I was taken to the ICU.

I should mention here that an ejection fraction is a ratio which indicates the capacity of the

heart. An EF of 60% is healthy, my mother managed to get by at around 20%, and below 15% is

considered an existential threat. When I was checked into the ICU, mine was 9%.

I was diagnosed with cardiomyopathy, like my mother, my symptoms and physical reaction to

various medicines matching hers exactly. It's a testament to complacency that none of her many

cardiologists over the course of seventeen years ever thought to test me for her condition. If I hadn't

been fond of drugs that are notoriously harmful to the heart, as well as doing an enormous amount of

physical exercise, I may have also made it to my thirties without the surfacing of any symptoms. As

things were, they struck me younger and harder than they did my mother, and I can live with that. Once

admitted, I was in and out of the hospital with a frequency that blurs my memory. My father, and a

hospital renowned for heart transplants, both residing in LA, it made sense to come here, a milrinone

drip sitting on my lap in coach.

My longest stretch was approximately two months, a turn of phrase I use deliberately. What

most people don't know about hospitals is that there is a duality at work in the relationship between the

patient and everything else. On one hand, everyone around you is there working in shifts to keep you

alive and well, a team of people behind the scenes concocting treatment methods that I can't begin to

fathom. On the other hand, a hospital is like any institution, and you feel like something of a prisoner.

The staff sometimes border on apathetic, and tend to assume that they know more about your case than

you do, and this is simply not true. Often, the doctors and nurses on call on any given day or evening

have seen only the cliff notes of a patient's file. And, so, how the next twelve hours was going to go

was completely up to chance. A good nurse was like a brick wall on which to lean your utter

dependence, a bad nurse; a judge in a courtroom where you don't have a voice.

Psychologists and social workers interrogated me frequently, usually with a bias born in the
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'Just Say No' era. Blood samples were drawn so many times throughout the day and night that soon I

could give several viles without waking up. Through all of the ups and downs of my time in hospital,

my father was there with me. Having spent years as an active witness to my mother's case, he is better

versed in heart failure and it's treatments than several of the doctors I've seen, and his experience gave

me an edge in adapting to this new life. Perhaps more potent than the dramatic physical changes I'd

undergone is the shift that occurred within me.

One day, I am a careless, reckless child, quick to anger, judgment, or depression, operating out

of a resilient, athletic machine, thriving in spite of itself. Only weeks later, that machine had been

poured through a filter, leaving only the charred suggestion of it's previous features. I suddenly

occupied the body of an old man, translucent skin stretched tight across a feeble frame. The false

importance of insignificant hardships, the ability to take things for granted. These were burnt away on

a funeral pyre, and a new perspective arose like a phoenix from it's ashes. Thirty seconds of fresh air

became a precious commodity, ten minutes in the shower a luxury, walking a block a formidable and

punishing task. My standards for pleasure and it's opposite realigned.

Months passed, and things happened in what seems a haze now, though it was a tumultuous

disaster then. After a particularly long stretch in the heart disease unit, I was sent home with a life-vest,

something that looked like what kids wear in the pool, which had a defribulator sewn into it. The

doctors said most people don't wear it much because it's uncomfortable. Luckily, I was more diligent

than most. I got up one morning, went into the bathroom, and promptly collapsed, passing out. When I

came to, I'd already been screaming for awhile. Turns out, I had gone into cardiac arrest. After I'd been

clinically dead for thirty seconds, the life vest lived up to it's name, shocking me until my heart

restarted. I was taken back to the hospital, and soon had an internal defribulator installed in my chest,

which I still have. For weeks after the incident, I was so frightened of sudden cardiac arrest, and the

possible head trauma that collapsing could cause, that I wore a bicycle helmet around the house, aware
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that I looked like a mental patient. Eventually, such dramatic precautions fell away. At some point, you

have to understand that there is only so much you can do to avoid death.

Aside from shaping my appreciation of life's fragility, my perspective has also been broadened

in a way that I didn't expect. When I first re-entered the world, it quickly became apparent that to the

untrained eye, I looked more or less healthy. Walking across the street at a snail's pace was viewed as a

passive aggressive action, when in reality, it was my maximum effort. When I used an electric

wheelchair in grocery stores, people looked at me disapprovingly, unaware that I needed it. The lesson

from this is simple; none of us have enough information to judge others for things on sight. Perhaps

this seems obvious, but obvious lessons are not necessarily applied. The vulnerability I felt interacting

with my surroundings forced me to see things through more open-minded and empathetic eyes.

My behavior became motivated by a drill sergeant whose name was Death. If I smoked a

cigarette, if I ate more salt or drank more water than my doctors ordered, if I allowed anger to

overcome me, shouting and letting my blood rise, I would die. I have no advice to offer anyone trying

to overcome addiction, stick to a diet, control their feelings, have a more positive outlook, or generally

mature. I didn't have the discipline for any of those things without my drill sergeant.

As time has passed, my circumstances have improved, and some of the more drastic shifts in

my view slid ever so slightly closer to their original position. I'm once again guilty of taking showers

for granted, of not giving the sky it's proper due. As my tolerance to heart medications has grown, so

has my energy. Color crept back into my face, removing the gaunt, tired years that seemed to have

settled there. Climbing a flight of stairs still leaves me short of breath, but is now an obstacle which

can be overcome. The helicopter of my life is in a holding pattern, waiting for the call informing me

that a heart has come in. I could be waiting anywhere from one to five years. I can't tell you how that

will go, or what could happen in the meantime. All I know is that if you stay positive, you have a shot

at a silver lining.