The story of my heart begins with an earache in the night. The ear belongs to my eleven-year-old son, Max, who wakes me, head in his hands, tears welling up. Sleepy mom and hard-boiled nurse that I am, I dope him up with a slurp of purple painkiller syrup and send him back to bed. But in the morning his ear still hurts and he''s spiked a temperature, so I take him to the doctor. The waiting room is packed. How much longer until our turn? I pester the receptionist, but she''s too busy to answer. Hovering around the front desk, I scan the rack of doctors'' business cards. Three general practitioners and an asthma specialist share this office.
Oh, a cardiologist, too, and I pocket one of his cards. Some people collect stamps, antiques, or lovers. I collect cardiologists - a hobby of mine for years. Eventually, we get to see Dr. Ivor Teitelbaum. He''s my husband''s doctor, and Max and his older brother, Harry''s, doctor, but not mine. I don''t go to doctors. Ivor is a handsome, smartly dressed, young-looking middleaged guy with an old-school manner.
Always relaxed, he never rushes us along, despite the bustling waiting room. He examines Max, then offers me his otoscope so I can look into the ear canal myself and see the bulging, inflamed tympanic membrane, severe enough for Ivor to prescribe an antibiotic. We get up to go, but I pause. "This cardiologist" - I wave the card at Ivor - "is he any good?" "Very." He looks up from writing in Max''s chart. "Who needs a cardiologist?" I shoo Max back out to the waiting room, pull up my T-shirt, and nod at the stethoscope around Ivor''s neck to remind him of my secret. I''d had to tell him so that my children''s hearts could be checked for defects. Fortunately, neither inherited my heart problem.
It takes Ivor only a quick listen and then he looks up at me, hard, grips me by the shoulder, and steers me down the hall to the office of Dr. Milutin Drobac, the cardiologist. "She needs to be seen," he tells the secretary, "as soon as possible." "It''s your lucky day," she says. "I just got a cancellation. Tomorrow at 11:00?" "Sorry, I can''t make it," I say. "I''ve booked a haircut." She shoots me a glance.
What''ll it be, your hair or your heart? Okay, heart it is. At home I give Max the first dose of antibiotic and another dollop of grape-flavoured syrup. Soon he''s back to his usual cheery self, so I hustle him off to school, leaving me alone to muse on my funny-sounding heart. It''s only a murmur, I remind myself. What a cozy-sounding word. It almost sounds like a good thing to have. Who wouldn''t want one? Many people have murmurs and most are normal or "innocent." But not mine.
Murmur is a term that refers to any irregularity in the heart''s blood flow, and in my case it''s due to a serious heart defect - a faulty valve. It''s congenital, meaning I was born with it. As a child, I sensed something was wrong from the get-go. The heart specialists who spoke in solemn tones and the protective, cautious way my parents held me all conveyed the message: Fragile - Handle with care! Then, around the age of ten, on one of many days off from school, I sat in a pediatrician''s office and heard him say to my parents: "In time, her condition will worsen. One day she''ll need open-heart surgery." He probably assumed I wasn''t listening (a mistake many adults make around children) because my head was buried in a book. "No overexertion," he warned them, "and no sports or gym classes." For my parents, that was a perfect prescription.
It dovetailed with their need to keep me close, conveniently available to help my chronically ill and depressed mother. As far as they were concerned, school was optional. Don''t think I didn''t hear the doctor''s parting comment to my parents before he left the room: "A certain percentage of these children experience sudden death." That''s some experience, I thought and dove deeper into my book. I''ve always known my heart could stop suddenly, but I banished the thought. I accorded my heart no respect, never allowing myself to think I had any physical limitations. I avoided strenuous physical activities, but in my mind, I was swimming the English Channel, riding horses, even running a marathon. Meanwhile, my parents became preoccupied with their own health problems and I became a nurse so that I could focus on other people''s problems, not dare think of my own.
My mo has always been to fly low on the medical radar and hope that an apple a day would keep the doctor away. (I eat a lot of apples.) After a quiet, sedentary childhood, I threw caution to the wind and became a wild, adventurous teenager, then an active adult and energetic mother of two boys. I''ve always done whatever I wanted to do. That is, until recently. Lately, I haven''t been feeling my best. The next morning, I find myself where I always intended to never be - a cardiologist''s office. First, there''s the electrocardiogram (ecg) and an echocardiogram, tests I''ve helped many patients through, so I know the ropes.
I strip off my T-shirt and bra, don the blue paper gown, jump up on the table, and lie down on my back. As Cezar, a big, burly guy who''s Dr. Drobac''s technologist, does the ecg, I glimpse the tracing over his shoulder, noting that my heart is in a regular rate of sixty beats per minute. Normal sinus rhythm. So far so good. Cezar tears the printout off the machine and attaches it to my chart with a paper clip. For the echo, I flip to my left side so that he can obtain the best view. He glides the probe around my chest, digging it in at certain landmarks for a closer look, pausing, peering at the screen, then moving on.
While Cezar works, I take a look around the small room, dimly lit as a nightclub to enhance the clarity of the picture onscreen. In the corner there''s a treadmill for stress tests and a red "crash cart," equipped with defibrillator, pacemaker, and emergency drugs. "Ever had to use that?" I point at it. For a patient like me? "Yup." Cezar''s brow creases, his eyes widen then narrow, but he keeps them trained on the screen in front of him. The sound of the amplified beats of my heart fills the room. "See anything?" I inquire, well aware that he''s not supposed to divulge anything, but I''m quite sure Cezar knows a thing or two. "Don''t worry," I assure him.
"You can tell me. I''m a nurse - an icu nurse." He stays focused while I chatter on. "There''s a problem with the valve, isn''t there?" Cezar pauses his probe and looks at me. "Big-time." But I feel fine! Well, maybe not my best ."How bad is it?" "I''ll let Dr. Drobac speak with you about it.
" I get dressed and graduate to the office of Dr. Drobac, who greets me warmly. As he reviews my ecg and echo report, I check him out. He''s a tall, thin, elegant man who looks like he may have run a few marathons himself. "You''ll never see a fat cardiologist," my old nurse buddy Laura says. "Yet, there are many neurotic psychiatrists," she points out. Laura has developed extensive character profiles of every medical specialty. According to her, neurologists are precise and nerdy, gastroenterologists are messy and swear a lot - "think of what they do!" - and all ophthalmologists have small, legible handwriting.
Her theories have yet to be tested. Dr. Drobac introduces himself and we sit down opposite each other for the "functional inquiry," also known as the "patient interview." "How have you been feeling?" he starts off. "Great! No problem!" I say. "Asymptomatic," I feel compelled to add. "Any history of family illnesses?" "My mother had early onset Parkinson''s disease and manic depression. My father had type 2 diabetes and coronary artery disease.
" Died from it, too, but I keep that detail to myself so as not to prejudice my case. "Do you smoke?" "Never!" How virtuous am I? "Take any prescription drugs on a regular basis? "No." My body is a temple! "How about recreational drugs?" "No ." Well, not lately . "What about alcohol?" "Clearly, not enough." Now that gets a laugh out of him. "Are you a Muslim?" he asks, breaking from the script of a standard cardiac history to figure out who I am. He hasn''t quite got me pegged.
"No," I say. "Jewish. We like to eat. But I plan to start drinking more red wine as soon as possible. In moderation, of course. Strictly for the cardio-protective properties." Broccoli and dark chocolate, too. From now on, I''m going to do everything right.
My mouth is dry, my hands are beginning to shake. "I have a feeling you''re about to give me bad news." "No, I''m not." He smiles. "Not at all." Maybe it''s nothing. What am I worried about? I feel perfectly fine. "Any shortness of breath?" he continues.
"No . Not really." Well . maybe, a little, now that you mention it. "Chest pain ." "No, never!" "What about chest discomfort or tightness, or racing heartbeats? Have you had any dizziness, light-headedness, coughing, or fainting spells?" Now that you mention it . I swallow the lump in my throat and stifle the harsh, dry cough I''ve had for a few months. Sudde.