What A Pain

My friend John spent New Year’s Eve this year in the cardiac unit at St. Joseph’s Hospital in Atlanta, while I was on a road trip. In light of the privacy issues involved I will call him “John Smith” for two reasons—to save him any embarrassment about the personal details I will be sharing, and because that is his name, John Smith. When I made it home and heard about his hospital stay, I called to see what had happened.

It all began when John ate a little too much and may have drunk a bit too much at a party the night after Christmas. He woke up at 3 AM with chest pains. He lay there for a while, he said to me later, “I was just laying there thinking that all this pain—just to let me know I had overdone it—is serving no purpose at all. I knew when I went to bed I had overdone it.”

John finally got up and spent the next 14 hours at a nearby hospital. The staff there found nothing wrong. When he left, they suggested he might want to follow up with a cardiologist. “I still see nothing for certain,” the cardiologist said after yet another battery of tests, “but just to make sure, why don’t I do a heart catheterization? Can you be at the hospital at 4:30 AM tomorrow?” Now, John’s a skeptic and his first thought was that this guy seemed in a hurry to make some money. He considered not doing it at all, but in the end he went ahead with the procedure.

I knew where this was going, and I was sure I’d be more than a little uncomfortable if I didn’t crack a joke or change the subject. Discussing events that remind me of my own mortality gives me the willies, it’s probably my age.

But a joke was out of the question, so I decided to share the story of my friend Adam, who works these days in Naples, Italy. He and John both knew a lot about two New Years things—being hospitalized this New Year’s Eve and fireworks. You see, John, when he’s not hospitalized on New Year’s Eve, by midnight has had a few too many and is happily shooting off fireworks out in front of his house. Adam knows about New Years fireworks from a different perspective.

In Naples, Adam decided to make some lasagna two days before New Year’s and cut off the end of his thumb. He was slicing onions, and he left a lot of his thumb on the cutting board in the kitchen as he ran for his phone. The paramedics took him and his thumb to the hospital. In the ER, they did what they usually do when you cut off that much of your thumb—they threw away the piece of thumb and told him he’d need skin graft surgery. Although they couldn’t perform the surgery until New Year’s Day, they admitted him right away. Adam said, “They told me at this time of year, you take the bed when you can get it and await your turn in surgery. If you don’t take the bed, by New Year’s Eve all the beds in the Hand Surgery Ward are filled up with young people who celebrated the New Year shooting off illegal fireworks.” The chief of surgery morbidly observed, “Dozens of them will blow their hands off at midnight.” Sure enough, Adam met some of them before he could get his turn in surgery.

Now that was a masterful job of brightening the mood, wasn’t it? John said, “Thanks for telling me about Adam. Now I know how it could have been worse, I could have blown off my hand shooting off fireworks, then had this problem. Now, will you let me finish my story?”

It gets worse. It seems that cardiac catheterizations are done with the patient fully conscious and following the process on TV monitors along with the doctor. What fun! Fifteen minutes into John’s session, the cardiologist has matter-of-factly showed John two blocked arteries, a nearly ruptured blood vessel, and indications of a problem with John’s right carotid artery. He wrapped things up early by saying, “I can’t finish this, I need to get you to surgery.” But he needed to look at those carotid arteries first, again with John conscious and observing the process. Less than 24 hours later, John had a new stent in his carotid artery, two new heart bypasses, a foot-long incision in his chest and piano wire wrapped around his sternum to hold him together.

OK, he’s gotten to me now—I am starting to feel pain in my chest, and I am standing stock still, petrified. “I could have died,” John told me, “but it was really odd, I wasn’t the least bit afraid—in fact I was fascinated with all of it.” My friend John Smith is now what they used to call “a little touched in the head.” The world is suddenly “fascinating” to him. He has had a guided tour of the inside of his chest, followed by an up close and personal look at the arteries supplying blood to his brain, and double bypass surgery. Fascinating, my foot.

Oh, and that pain he was bemoaning on the night after Christmas? It turns out the cardiologist calls John’s kind of problem “a widow-maker.” It often blows up with fatal consequences and no warning. That pain without a purpose? It saved his life.