Opening My Heart

by Tilda Shalof

  I’ve napped all day, but night comes and I’m exhausted.

  I sit up in bed. Something is wrong. I feel chilled. Ivan piles blankets on top of me but I can’t get warm. My teeth are chattering. I take my temperature: 37.1* Celsius, higher than my usual of 36.0.†

  A low-grade fever. My first thought – sepsis! Overwhelming infection! Bacterial endocarditis!

  A few minutes later I take my temperature again. It’s 37.5.‡ I call the cardiac hotline, which puts me through to the ward where I was a patient.

  “Is Melissa on? Ray? What about Yolanda?” “My” nurses, the ones who know me, the ones I knew and trusted are the ones I want.

  “They aren’t working tonight.”

  Ahh, the mystery of nurses’ schedules. Even Ivan hasn’t cracked the code of mine. They’re like Sudoku puzzles – endless configurations and combinations.

  “Could I speak with a nurse?”

  “I’m a nurse. Can I help you?”

  “I’m eight days post-op aortic valve replacement and I have a fever. What should I do?”

  “How high?”

  I’ve taken it again. “37.6.”§ Can she hear the barely contained hysteria in my voice?

  “You could take a Tylenol,” she suggests with a hardly concealed “d’oh” in hers.

  “Good idea.” I thank her with an imperceptible note of sarcasm in mine.

  But what did I expect? This is the correct response. Stay calm. Think it through. Monitor closely. Be a nurse.

  “A mild fever is common after surgery,” the nurse says. “Keep an eye on it. Call back if there are any further problems or if the fever persists. See how you feel tomorrow.”

  I knew that.

  Horrors! I have become one of those high-maintenance patients who always think the worst, whose anxiety is off the charts. I pop two Tylenols and one painkiller, then another. They get rid of pain and just about everything else, too. Such a sweet trip off to la-la land.

  I deserve it, don’t I?

  Soon, a wave of pleasure spreads through my body. I smile to myself.

  Ahh … this part I like. I could get used to this.

  * 98.8 °F

  † 96.8 °F

  ‡ 99.5 °F

  § 99.7 °F

  14

  SLOUCH ON THE COUCH

  My surgery was in August and I’ve spent most of September crashed on the recliner. I haven’t accomplished much. My email inbox and voicemail are full, untouched. Messages from friends, unanswered. My loving family has been waiting on me hand and foot. I feel stronger every day, my daily walks are getting easier. The only problem is a familiar one but hard to admit. I know exactly what it is.

  “I think I may be a little depressed,” I say to Ivan.

  His exasperation flares. “Tilda, you need to get a grip,” he says. “What do you have to be depressed about? The worst is over. It went well.”

  “I know it makes no sense …”

  “Have you gone for your walk today?” He looks out the window. For days it’s been hot and muggy and now the sky has turned dark and overcast. A late-summer storm looms, about to be unleashed on the city.

  “It looks like rain,” I say.

  “I’m sure it will pass.”

  The rain? Of course it will.

  Sitting in a fire truck … I accidentally release the emergency break … crash into cars that explode into flames … a bleak Chinese labour camp … I’ve been imprisoned for crimes unknown and am forced to turn tricks for a dirty peasant in a smoky opium den who comes after me in a rage with a knife when I try to escape from his clutches …

  Terrifying nightmares linger all morning, like a bad aftertaste. The beta blocker – along with every other “aol,” “ilol,” and “olol” – posts nightmares on “side-effects-may-include” list, yet millions of people use it without a problem. It is highly effective in controlling the heart rate and strengthening the heart’s contractions and decreasing its workload, but I wonder if it’s what’s disturbing my sleep.

  I spend the day suction-cupped onto the recliner, heavy-lidded and groggy from the narcotics. Lethargic and lazy like … well, a pig is purported to be. When I wake up three hours later it feels like three days have passed.

  The kids are back in school and the Jewish New Year approaches. Fall usually feels to me like an exciting beginning – but not this time. Prone on the recliner, I watch Ivan roasting a brisket, stirring chicken soup, rolling matzah balls, baking a honey cake. Only my thumb is moving as I channel-surf the TV. Not movies or sitcoms that require concentration, albeit minimal, only mindless reality shows about overweight brides who go off to boot camp so they can squeeze into their too-tight wedding dresses or cat-collecting hoarders living in misery and squalor.

  “Mom, these shows are sad,” Max says. “Why are you watching them? Are you a sad-ist?” He tries to change the channel, but I snap at him – just leave it.

  The smallest things irritate me and I lose my temper over nothing.

  “Looks like someone got up on the wrong side of the bed,” Max says when I scold him for a puddle of spilled milk on the counter. (At least I didn’t cry over it.)

  Harry and Max arrive home after the first day of grade six and grade nine respectively, noisy and eager to tell me about their day, but I have no patience to listen to tales of an already-lost brand-new pencil case or the strict math teacher, “who gave us homework on the first day of school. Can you believe it, Mom?” Max asks, incredulous. All I could think of is that I only hope they don’t notice that when they left for school in the morning, I was on the recliner and this is where they find me again in the afternoon. Phoebe, the cat, has had more exercise today than I have between stalking imaginary mice, grooming herself, and chasing her tail.

  I place a sandwich down in front of Max, who attacks it ravenously.

  “Don’t wolf it down … like a … wolf,” I say in annoyance.

  “Mom, you’re a writer. Can’t you come up with a better simile than that?”

  I retreat to the recliner, fuming.

  “Looks like someone got up on the wrong side of the oxygen mask,” Max says, laughing at his own joke, which, I have to admit, is pretty funny, but I can’t even fake a smile or a chuckle.

  Harry goes to his room and Max sits down to watch my shows with me but becomes distracted by my incision. He gazes at it, mesmerized, as if he’s trying to imagine what lies behind it.

  “Don’t stare,” I say, immediately regretting my impatience.

  I accomplished the impossible but now can’t handle everyday life. Even the electronic “nurse” gets on my nerves. If I punch in the “correct” answers, she moves on. If not, I am taken down a pathway of increasingly longer menu options. It infuriates me how the personal touch is becoming obsolete. One day robots will be caregivers for us baby boomers. But I have to admit, when friends come over to offer some of that human contact, I’m so irritable they probably wish they’d sent one of those robots instead.

  Visitors come bearing good wishes and thoughtful gifts – home-cooked meals, scented soaps, and the latest bestsellers. Joy brings me a plastic multicoloured ball that bounces off crazily in wobbly, unpredictable directions that in my slightly stoned state I find wildly amusing. But when friends ask, “How are you?” in their sincere and solicitous way, I spare them the details. The truth takes too much energy.

  “What were your symptoms?” the curious ask. “Was it a bypass? A heart attack? A murmur? I have a murmur, too! Why didn’t you tell us sooner?” Some ask too many personal questions or launch into accounts of their own medical woes or those of their cat. The worst is when they give advice. Don’t give me advice! No one really wants advice, especially unsolicited advice. I’ll never forget all the useless advice I received when I was a new mother, especially about breastfeeding. “Feed the baby!” “Don’t feed the baby too often!” “You aren’t producing enough milk – the baby is hungry!” The cacophony of advice was so loud, it drowned out own my inner voice tel
ling me how to care for my baby. The only thing worse than getting unwanted advice is receiving wrong advice. My friend’s mother was having bad headaches. “It’s because you wear your hair in a ponytail,” her bridge club friends told her. “Stop pulling back your hair so tight.” Meanwhile, she had a pituitary tumour. Luckily, her own intuition that something was wrong brought her to the doctor in time to have it successfully treated.

  No advice! No questions! Don’t offload onto me your own fears! Don’t pay me a visit if it is for you to perform a good deed or to fulfill a sense of obligation. Come if you’re not going to flinch or pity me or make it worse or harder for me. Just be with me, sit with me, I tell them and then doze off – or pretend to.

  Annie, a close nurse friend, knows how to visit. She makes one of her composed, signature salads with exotic greens, edamame, and toasted sesame seeds. She whips up another favourite with Asiago cheese, balsamic vinegar, apples, and figs. She then sweeps the kitchen floor and organizes my cupboards while I try to eat. Even this gourmet delight, so lovingly prepared just for me, is hard to get down. Nothing tastes delicious. I have lost my appetite for food – and life.

  Another friend asks me eagerly if I had a “near-death experience.”

  “Did you go to the other side? Was there a bright white light?”

  No, none of that, I’m sorry to disappoint.

  A third friend is angry at me and lets me have it.

  “I can’t stand the way you dealt with this,” she says straight out. “You kept it to yourself. You didn’t let anyone help you. I could have organized a car pool for your kids, meals for months. Why did you only tell us all at the last moment?”

  “I didn’t want to worry you. I could only tell nurses.”

  “What do they do differently than the rest of us?”

  “They knew how to help me in the way I needed. They listen but take a step back. Try it. Imagine you’re a nurse.”

  She pauses. “I get it. I’m listening to hear what you need, not what I think you need.”

  Exactly.

  Later in the afternoon, the doorbell rings, but I don’t answer it. I hide out on the recliner. Later, on the doorstep, I find a bag left there by another friend named Janet. Inside it are all the fixings for a Sabbath dinner – a pot of warm soup, perogen (a South African Jewish delicacy) and a braided challah. In a little box, there is a sparkly heart threaded on a silver chain.

  “We have wonderful friends,” Ivan says. “See how everyone cares about you.”

  I know this but can’t feel it. None of these kindnesses make me feel better, as they are all intended to do. I want to be left alone to feel sorry for myself in peace.

  In my case, is depression a passing emotion or a medical diagnosis? Is it negative thinking or a real illness? Of course I would acknowledge it in patients, but I can’t muster the same respect for the symptoms of depression in myself, especially when, as Ivan logically points out, there is no reason for it.

  The next day after Ivan has gone to work, the kids are at school, and I’m sucked into the recliner doing nothing, I suddenly start hearing my heart pounding madly in my chest. I start breathing faster, then faster, to keep up with it. My chest tightens. I have difficulty swallowing. Something is wrong. I call the cardiac hotline.

  “My heart is beating,” I tell a nurse, any nurse, in a rush.

  “That’s good. It’s reassuring, isn’t it?”

  “But I hear it beating. It’s eighty per minute.”

  “Help me understand,” she says, sounding puzzled. “Do you want to hear it beating or not?”

  “I just want to know if it’s normal to hear your own heart.”

  “Of course it is. You’re just aware of it. Maybe you’re having an anxiety attack?”

  “No, it’s not that,” I say. What a relief. My heart is okay. Maybe it’s like the new furnace we put in last winter. It made different noises, working in an unfamiliar way. Eventually I stopped noticing the sound, only that it kept the house warm.

  The next day Phoebe the cat has taken over my spot on the recliner so I move to the couch, but it’s not comfortable – too upright and hard with rough, sturdy fabric. We chose it for durability and economy. Who knew I’d need a cocoon to hibernate in, not a serviceable piece of furniture upon which to sit?

  The only company I can bear is the TV. In the morning, it’s fashion makeovers that make me dissatisfied with my clothes and want to trash my entire wardrobe. Home decorators ease me gently through the long afternoon.

  “I love beautifying other people’s houses,” one designer says, “but my own is a disaster.” He’s like me. I readily take care of others but learning to take care of myself, especially my emotional health, has been one of the biggest challenges of this whole experience. Self-care is the best care, but sometimes the hardest to accomplish.

  Then, Oprah’s exhortations to “keep a gratitude diary” and “be my best self,” which only make me feel even more inadequate, especially when I watch the example of Monica, a woman who developed a massive infection after childbirth and had to have her arms and legs amputated to save her life. Her uppermost thought was to make it home so that she could be a mother to her kids. “I was still here,” she said. “I can still love my children. I have a loving husband.” Now, that sounds like a woman who has conquered herself so that she could serve others. Normally, I would be inspired by the example of her courage, but now it only makes me ashamed for my lack of it.

  Similarly, I compare my problem to my patients’ battles with life and death. I try to draw strength from recalling the bravery and dignity of so many patients I’ve cared for over the years, but these comparisons also discourage me. It’s completely irrational to be weepy and tragic about my happy situation, but that’s what I feel. It makes no sense.

  In the evening, I chase the cat off the recliner and lie back on it to watch more newlyweds squabbling about their out-of-control spending habits and controlling mothers micro-managing their spoiled kids’ lives and planning over-the-top bar mitzvahs and sweet-sixteen parties for them. Then it’s time for two painkillers and off to bed.

  I fall back to sleep and enter straight into a nightmare of being nine months’ pregnant with a litter of puppies. The sound of them barking, clamouring inside me is what wakes me up.

  I get up and go into the bathroom to step on the scale and I see I’ve lost ten pounds.

  Lose weight the open-heart surgery way! The new diet sensation! Don’t try this one at home, folks!

  The next morning, when the phone rings at the set time, on an impulse, I decide to short-circuit the system by punching in the “correct” responses to each question, regardless of the real answer, thus officially bringing to an end my relationship with the “e-nurse.” Yay, I won!

  I return to the recliner. I’m supposed to walk, increasing the distance each day, but I’m afraid to leave the house. I want a cup of tea, but it’s too much effort to get up and boil the water. The phone rings unanswered. The TV screen goes blank. (The kids have shown me how to fix it, but I can’t be bothered.) I bounce the pretty rubber ball Joy gave me and watch it careen off in random directions.

  When Ivan gets home from work, he peppers me with questions. “How are you feeling? “How far did you walk?” “What did you eat today?” “What did you do today?”

  Bad.

  Not far.

  Nothing.

  What did I do today? I got up from the recliner to get the remote control where I’d put it on the kitchen table so I’d be able to report I’d done something.

  Even Phoebe looks at me in reproach, her whiskers twitching.

  “Are you having pain?” He holds out the bottle, poised to give me pills.

  Yes. Not really. Kinda-sorta. Okay, I’ll take a few of those puppies. I had open-heart surgery, didn’t I? I could get more of them if I wanted. What doctor wouldn’t renew this prescription? But am I on the road to drug addiction, an intervention, then packed off to “celebrity rehab”? I had a
neighbour once who had to go into detox to get off these painkillers. It could easily be me, too. I take two more and decide here and now to make these my last. Cold turkey. From now on, it’s over-the-counter painkillers only.

  “You have to force yourself to do more each day,” Ivan says.

  “I am trying.” I hate the whine of self-pity in my voice and hope he can’t hear it.

  “It would help if you would be more positive.”

  “I’m trying to be.”

  “There’s no trying. Just be positive. You have so much to be thankful for. Stop feeling sorry for yourself and obsessing about your heart.” He stands over me, looking down at me ensconced on the recliner. “There are other things going on in the world. Like your kids, for example.”

  Or his birthday a few days ago. Oh, by the way, Happy birthday, Ivan.

  “You’re dragging yourself around like an old lady. You’re a young, vibrant woman. Let’s go for a walk around the block. You’ll feel better.”

  I’m tired. It takes a lot of energy to feel this bad. I long for my bed. Is it time for bed yet? It’s only five-thirty in the afternoon.

  “I think I’m depressed,” I say, staring off miserably into space.

  “Oh no, not this again.” Ivan comes to sit beside me. “The problem with you is …”

  That gets my back up. I brace myself.

  “… that you can’t deal with discomfort.”

  Is that all you’ve got? “Actually, I have a very high pain tolerance.”

  “I’m not talking about pain. I said discomfort. You can take pain, you just can’t handle being uncomfortable. For you, that’s worse than pain.”

  Yes, and I’m uncomfortable in my body and in my mind. For some reason, I think of the kids at camp. To them, feeling healthy and happy every day is like a right, the natural order of things. When they’re faced with even minor physical challenges, they feel affronted. Even as adults, when we get a cold, many of us have such meagre resources to cope. I thought I’d feel great by now, three weeks after surgery. I certainly expected I would feel better than ever after surgery and hadn’t anticipated such a long and arduous recovery. Who knew? I certainly never thought I’d be thrown into this state of intense and debilitating discomfort – a sensation that feels lodged in my soul and weighs down my neck, my forehead, right down to my toes.