A Match to the Heart

by Gretel Ehrlich

  I stared blankly. “Could you repeat all that sometime when I’m feeling better?”

  “Don’t you trust me?” he said, laughing, then put his hand on my forehead and told me to rest.

  In the morning I noticed Blaine’s eyes had changed color: they had been brown and green and now they were gray and blue. My mind was mush. A tight band around my chest tightened and eased, depending on the threadiness of my blood pressure. Sometimes during rounds Blaine stopped to talk, and other times I heard him talking to nurses. My own hazy monologues continued: I wondered what the interior geography of my body looked like or if my insides could be read like illuminated manuscript.

  Between visits I wandered. The peregrinations felt inter-galactic. Fingering the color fold-outs of Gray’s Anatomy, I traced nervous systems, blood vessels, intestinal coils, musculature, spinal cords, and the convolutions of the brain. A body is a separate continent, a whole ecosystem, a secret spinning planet. The brain looks Vesuvian with its breaks and draws called “gyri” and “sulci,” its fissures and fjords. The large internal fold of the cortex is called an “insula,” and near the cerebral aqueduct dividing the midbrain grow stalks of neurons called “infundibulum.” There is a “vermis,” and “arbor vitae,” a “pons,” and the small swellings of the medulla are called “olives.” Who named these parts of the body? I asked Blaine. He didn’t know. I thought it must be a walker like Thoreau, or a mad geographer, an Arctic explorer, or someone making a miniature garden of the brain.

  “Look.” I showed him a picture. How the brain sits on its spindle, like a globe, the nodding head tilting on its axis, how the nervous system is a series of branches sprouting from that axis mundi, how each thought passing through is a separate ecosystem.

  “The brain has a hundred million nerve cells and is seventy-eight percent water,” he replied.

  More fog rolled through the window like reason, trying to hide things, smooth things over. The room was a skullcap. When Blaine returned in the afternoon, I asked, “How does it all work?”

  “What?”

  “The systems of the body.”

  “That would take years,” he said.

  “I don’t have years.”

  He gave me a surprised look.

  “Yes, you do,” he said.

  “Tell me anyway.”

  He thumbed backwards to a picture of the whole body. No one part functions as a separate entity: the brain does not coolly dispatch messages as a computer does, nor is the nervous system just a system of highways, he explained. It is the communicator inside us, at once both pathway and messenger, though, in my case, the pathway needed repaving and the messenger was dead.

  I smiled and he continued. The nervous system is composed of a network of cells that extends throughout the body, receiving information about the internal and external environments, assessing that information and then sending signals to organs that cause an appropriate response. It is a great branching tree dividing down into separate systems: the central and peripheral, of which the autonomic nervous system is a part. My autonomic nervous system had been damaged by lightning. Regulated by centers in the cerebral cortex, hypothalamus, and brain stem, it is divided further into two subdivisions that must constantly balance each other—the sympathetic nervous system, whose purpose is to stimulate activity in the heart, blood vessels, stomach, and sweat glands by releasing an excitatory chemical called norepinephrine, and the parasympathetic nervous system, which does the opposite, releasing an inhibitory chemical called acetylcholine, which slows things down.

  “Because your sympathetic nervous system got fried by the lightning, your vagus nerve has gone wild. There is nothing to tell it to stop sending its messages to slow everything down,” Blaine said. “It’s a big long nerve that innervates the lungs and heart, liver, stomach, pancreas, small intestine, and kidney. That’s why it’s called vagus. It wanders around in the body and tells your heart to slow down and your blood vessels to stop contracting until you have no blood pressure at all.”

  I have a wanderer inside me, a vagus nerve, a vagrant that does whatever it wants. Any time the fine balance of the body’s internal civilization is upset, the whole intricate communication breaks down: when the heart slows or stops, cells, synapses, and receptors become confused and leaderless. Where is that oxygen, they wonder, where are the nutrients that keep us alive? Homeostatic panic ensues. For a while the self-regulating universe of the body tries everything it can to compensate, but if that doesn’t work, then it’s good to have a doctor nearby.

  The next day I asked Blaine and Dr. Ilvento to explain what actually happened to brain and nervous system cells when a great deal of electricity passed through the body. Together, they speculated: “The mylenated sheaths—the fatty white matter that protects neurons—may have bubbled and melted; cells died and were sloughed off [there are cells in the body that do nothing but cart the dead ones away]; neurotransmitters with their excitatory chemicals dried up. The path taken by lightning inside the body became a desert.”

  I touched the place on my back where I had felt a burn after being struck. Blaine touched it. “Does it still hurt?” he asked. “It’s sore,” I told him.

  “This is your exit wound. It’s near the heart, right where the sympathetic nerves hook in,” he informed me.

  Blaine ordered new medicines and larger dosages. Norpace made my heart beat regularly no matter what messages it received from the brain, as well as working on the vagus nerve by blocking acetylcholine. The Florinef helped my body retain water. It was a simple gardener’s idea: watering a plant maintains the turgidity of a plant’s stem—in the human body, retention of water helps raise blood pressure. “Eat lots of salt and drink strong coffee,” Blaine said, laughing. “Can you believe a cardiologist is recommending these things? Also, stay cool, no Jacuzzis, or hot baths, no alcohol, and keep your feet up.”

  Two days later I was released. My father came for me. Leaning on his thin arm, I walked out of the cardiac care unit barely able to comprehend what was around me: waiting rooms full of strangers, miles of polished floors, then cars, sidewalks, palm trees and sycamores, and sea smell. It was all I could do to put one foot in front of the other.

  During the drive home the sides of the world heaved up and folded in on me, and the road was a concavity dropping out from under the car. With my seventy-five-year-old parents, I was still their child, dependent on them for shelter, food, rescue, and survival. Even their pace was too fast for me. “Now you know,” Blaine said, “why patients are called patients.”

  chapter 8

  I was once the young girl who wanted everything to be fast: horses, cars, wild and turbulent rides in my father’s small plane. My appetite for life was clamorous inside. Now even that din had been quelled. I doddered around the house, lay on the floor with my feet up in the air to get more blood into my head, and from time to time begged my mother for oxygen.

  Life consisted entirely of rest, round-the-clock pill taking, TV watching. Norpace blurred my vision, so reading was difficult, nor did I have the concentration for it. Someone else’s story was too big to swallow. All my wits and brain power went into maintaining my own life: I was the homeostatic engine trying to reestablish equilibrium in a body seriously off-kilter, which is another way of saying I stayed close to couch and bed. If I had any ideas about going out that first week, waves of low blood pressure knocked me back down.

  On my next checkup at Blaine’s office, I informed him that I was going to London in two weeks for the opening night of the ballet for which I had been writing a text all summer. Undaunted, he smiled, but I didn’t believe his casual air. “I’m not going to miss it,” I repeated, just so he knew I was serious, though down deep I couldn’t imagine how I would get myself there.

  During the second week I made a supreme effort to face the world. After all, if I was going to fly to London by myself I had to raise my energy level. On a good day my mother drove me to the beauty shop, whose atmosphere of care and sill
y gaiety cheered me. My singed hair was brittle as wire. A cheerful young woman cut and drenched it in conditioners to bring it back to life. Staying conscious during those visits was tricky enough, but I managed. Other days we went to lunch, always taking oxygen along. I had a craving for hamburgers, though a few bites filled me completely. It was only tastes of life that I wanted; biting in and chewing was still too much for me.

  One morning I visited a Chinese acupuncturist. He was horrified at the medicines I was taking. On the table, with needles sticking in my head and fingers, I nearly passed out. He immediately changed the placement of the needles and I came around quickly. He showed me a pressure point on my little finger to use if I started to black out while traveling.

  At the end of the week I lied to Blaine. Two weeks had elapsed and I was to fly to London the next day. Driving for the first time since getting out of the hospital, I had to pull off the freeway three times to keep from blacking out and lie down on the front seat with my feet pushed through the window. Figuring there was nothing to lose, I tried the acupressure point Dr. Wang had showed me and finally revived.

  In the parking lot behind Blaine’s office, I jumped up and down before going in. He took my pressure and sure enough it passed muster, though it was by no means normal. A little later, when he asked how I was feeling, I said, “Great.” My determination to get to London would get me there, I presumed, though I sensed Death had not forsaken me altogether. I knew how easy it was to die, and, by God, I was going to pack a few more things in before Death took me away.

  chapter 9

  My travel agent made sure I was booked on uncrowded flights, so I could lie down, three seats across. It was my only hope to keep from passing out. I wrapped my legs in Ace bandages to prevent blood from pooling in my feet and licked palmfuls of salt, chased with water. The trip to London was broken by an overnight stop in New York. My publisher and his wife picked me up at the airport and I spent the night in their Brooklyn home.

  In the morning, a driver took me to the airport and I had to lie flat in the back seat to stay conscious. The plane was like a drug that lifted me out of the human world with its sorrows and entanglements. I stretched out with pillows and blankets. In the past I had preferred sleeping on hard ground, gravel walkways, granite ledges in high mountains. Now the simple comfort of a soft seat was an unexpected gift. To surrender and sink and still be carried forward all night across the sea was trancelike, as if I had stumbled upon life beyond death that magically becomes life again. The Atlantic was a great river running north and south under me, a channel through which lightning sometimes pulsed, but I was shooting across it at right angles, far above, where lightning could not touch me.

  London cheered me as nothing else had for a long time. During the summer months of June and July, I had collaborated with a British choreographer, Siobhan Davies, on an evening-length ballet and had only gone home to the ranch in early August, to rest up, ride my colts, and help neighbors move cattle before returning to work with the company again—and that was when I was struck by lightning. Now opening night at Queen Elizabeth Hall in the South Bank Theatre complex was a day away. The dance, the music, and my text had been put together without me.

  I felt safe staying with my friends, Siobhan (“Sue”) Davies and David Buckland—who designs her sets—because he had a heart problem too. When an infection from an abcessed tooth traveled to his heart, David suffered from endocarditis—a fast-moving infection that caused nine cardiac arrests. He is now alive, thanks to a pacemaker and a mechanical mitral valve, whose ticking could be heard in the quiet theater when I stood next to him. His cardiologist lived nearby, and I knew David would understand when and if I needed help and how urgent that need can be.

  The next twenty-four hours were spent in the theater. I lounged in velvet-covered seats, legs propped up, amazed at the spectacle of our dance. All summer we had rehearsed in a crowded and unglamorous hall in a Soho synagogue. Now, for the first time, I saw the spectacle of our creation.

  The dance—choreographed from a poem cycle I wrote after being in the Canadian high Arctic—was both stark and sensual, fluid and athletic, graceful and erotic, with impossible contortions of male and female bodies that resolved into gestures of solitude or ardent embraces. Above them a single revolving light stood for the Arctic’s circling sun. The stage was blue: a blue backdrop with David’s sixty-foot-long painting of Sue’s body floating over the stage and a blue ground cloth nailed tight to the stage—the floor of the Arctic—from which dancers rose and into whose shadows they walked.

  The day of the performance was also the day of the company’s one and only technical rehearsal at Queen Elizabeth Hall. The two sixty-foot painted cloths were stretched and fastened, lighting cues were dictated, music was heard for the first time, and dancers struggled to get their timing just right. Peter Mumford, the lighting designer, had just flown in from St. Petersburg, where he had been working with the Kirov Ballet. When he saw the stage during the first run-through he decided the lights were all wrong and with five hours to go before the performance began he redesigned every cue.

  The ground cloth tore the dancers’ feet, and when they bled the canvas had to be retouched to cover the stains. There were blips and extra words no one had heard before in the music-and-text tape. I had recorded my poems in a studio and these had been cut into the electronic score. While the composer recut parts of the tape, we fiddled with sound levels, and it was the dancers who readjusted their timing—a process that wasn’t completed until a few moments before they went onstage.

  Soon enough ushers appeared holding programs, doors were opened, the stage lights dimmed. The last lighting cue had just been given moments before. Slowly the thousand-seat theater filled. I went to the lobby to greet two American friends. Outside on the terrace overlooking the Thames, the usual gray London sky had darkened with storm clouds. As the chimes rang, announcing the beginning of the performance, thunder clapped and lightning, rare in London, crackled over the river. David ran outside and grabbed me: “For God’s sake, get inside!” Just as I found my seat, the lights dimmed and the dance began.

  Seeing our collaborative work unfold on a large open stage—no proscenium, no rules by which we can declare what in our lives is fiction and what is “reality”—as if the two were different, as if it did not all come from the same imaginative source—was a gift, a new life, canceling out for a moment the huge and ungainly blank that lightning-induced amnesia had deposited in my private narrative of how things had been and, therefore, how things are now. The lines I had written for the dance seemed an echo: “You walk inside yourself on roads and ropes of blood vessels and tendons, you walk inside yourself and eat weather ...”

  Gladly I made for the shoreless shore of an open stage that stands for life with no boundaries, for the “bardo” of uncertainty and for whatever transpires inside the synaptic gap. I watched the line of my grappling hook play out, loose and shimmering in the dark until it came tight, fastening me to those elastic dancers, to David’s blue stage of shadow and memory ticking with his pacemaker’s time, and the moving planes of light that Peter had made, and together we jigged into the night.

  It was time to go home. I was desperately tired. The last leg of my journey began to feel Odyssean. Overestimating my resilience, I had planned, on my return home, to go on a sixteen-city book tour for my publisher to promote a new book. Ten minutes into the first of these readings I had to excuse myself and sit down before I fell. The next day I flew across the country. Just as my plane landed in San Francisco the flames of a fire that would blacken much of Oakland broke into view and while driving to Sausalito, white ash thickened on the windshield—some of which, I found out later, was the burning pages of other writers’ manuscripts.

  Flying from Portland to Seattle, I experienced what felt like a heart attack: deep anginal chest pain. When I got off the plane I was gray, sweating, breathless, and my left arm felt numb. My heart was trying to pump enough blood and oxyge
n to raise my blood pressure but couldn’t keep up with the demand. I rested for five days in a posh suite that previously had been inhabited, the maid informed me gushingly, by Jeff Bridges, a movie star. She seemed dismayed now that she’d have to bring coffee to an ordinary mortal with chest pains.

  The president of my publishing company faxed this message: “Stop the tour now. Go home immediately. A dead author does us no good.” But I had to rest another few days before I could travel.

  I finally boarded the plane that would take me to California. It was an airbus, large and completely full. Just before liftoff there was a loud explosion. The plane lurched, then the pilots slammed on the brakes so hard, people were thrown about. My forehead hit the seat in front of me and my heart seized up—pure stress—until I had trouble breathing.

  The plane came to a stop, then turned and taxied back to the terminal. No soothing words from the captain; no words from anyone. Just a stunned silence. I asked the young man next to me to press the buzzer. When the flight attendant came, I told her I thought I might be having a heart attack. She brought oxygen-though she looked as pale as I did. I popped nitroglycerin, and offered her some. She didn’t know if I was making a joke. The pain stopped, then after ten or fifteen minutes started again. I breathed in and tried to relax. This was beginning to get funny, except I was too tired to laugh. If only I could get home and lie down and not have to get up again.