Open Hearts, Part Two

As promised, this piece continues the story begun last time in the blog Open Hearts as I prepared to undergo open heart bypass surgery. That name is somewhat of a misnomer. The chest, not the heart, is opened in order to give access to the heart and surrounding area. Often, it is referred to as CABG, which stands for Coronary Artery Bypass Graft. When pronounced, it sounds like we’re discussing a garden vegetable that is much less threatening and especially tasty as Cole slaw or sauerkraut. Trust me — the similarities end there!

My last memory prior to the surgery includes a stranger shaving my body. I’d liked to have had some input on the design. Perhaps we could go with the logo of a favorite sports team, or my wife Judi’s name shaved out in a tasteful place. Alas, this barber was more of the military caliber who offers no options, asks no questions, and buzzes close to the skin. I doubt I had been this smooth and hairless since the day I was born, and maybe not even then! About 11:00 a.m. the anesthesiologist introduced himself and provided a brief overview of what was next. In what can best be interpreted as an act of mercy, his capable implementation of those plans sent me to La La Land immediately. I was spared seeing and feeling the things they did to my body over the next four hours.

I resisted the temptation to search YouTube for “open heart surgery videos” prior to the date, thinking there was more to lose than to gain by seeing that in advance!  The surgeon informed me of the basics earlier in our consultation. After an incision into the chest, the team would saw my sternum into two, which frankly, just seems cruel in some respects! They would then pull it apart to allow access to the areas needing attention. Meanwhile, they’d harvest veins from my arm, chest, and as it turns out, my leg also. Apparently the blockages were longer than anticipated, meaning they needed more vein length than they’d expected. They would place me on a heart/lung machine to keep my body functioning while they worked. After grafting those veins into their new home and stitching them carefully into place, the team would close me up, using metal bands to help hold the sternum in place plus a combination of stitches and glue to seal the incisions. After that, it was off to recovery! All of this took approximately four hours. Quite a way to spend a Wednesday afternoon!

When I awoke early in the evening the endotracheal tube through which a ventilator assisted the breathing process during surgery was already removed, thankfully with no memory of the procedure itself. I asked for my phone – not to check news headlines or stock quotes, but to FaceTime with Judi. Thanks to COVID-19 restrictions, once we said good bye prior to the surgery, there could be no in-person visitation. We would next stand cheek to cheek in front of the hospital on the day of my release, estimated to be 5-7 days later. I will tell you now that when that moment finally arrived, it brought joyful tears to both of our eyes! But for now, thanks to the wonders of technology, it was a gift to see her face and be able to verify for her what the hospital staff had already communicated a few hours earlier. She could count me among the 99% for whom the surgery went well.

For those who may find themselves in a similar moment in the future, I would emphasize a couple of things. First, there is no memory of the surgery and the shock that it must cause to a body. We are long past the Wild West episodes where a swig of whiskey and a dirty rag to bite on are the best anesthesia available. Second, the pain after the surgery was less than anticipated. It was, indeed, one of those “Hey did anybody get the number of the truck that hit me?” kind of moments.  But it wasn’t as core rattling as the anticipation itself had been. If before the procedure the question was “How best to face my mortality?” the question afterward is more akin to “How shall I live now that I’ve survived?” The elation of seeing the other side of the surgery overrode much of the impact of being used as a real life version of the old game Operation. It was no picnic to be connected to monitors, drips, and catheters, but neither was it painful. No doubt that was in large part due to medication. I pushed a button that allowed me to self-medicate but by day two and three, the nurses noticed that I was dispensing less of the drugs than was typical and encouraged me to use it if I needed it. Perhaps I had a high tolerance to pain, they suggested. Maybe, but I doubt it. Perhaps it was the luck of the draw. Possibly it was one effect of the many prayers being offered for my recovery by the numerous friends who gladly offered their support in that manner. I can’t objectively verify which possible solution is the truth but if forced to choose, I’d opt for the latter.

After sleeping through the night, I was helped into a chair the next day to sit for a while. Later I was taken for a walk around the hallway. Though not as momentous as Neil Armstrong’s first steps on the moon, these might have been as significant as any steps I’d taken since learning to walk as an infant. I was on my feet, moving forward into recovery! With a physical therapist and an entourage of monitors and IV’s I paraded around the hallway some 200 feet or so, hospital gown waving like it was the Grand Marshal of a one person parade. I knew progress was being made the day I passed a person pushing a wheel chair in the hallway because, sort of like an Amish buggy on an Indiana country road, they were just traveling too slow.

Some people complain that hospitals rob them of their dignity. I wonder if that isn’t an incorrect word choice. Perhaps people feel denied the opportunity to preserve their modesty. Our own bodies are sacred vessels that are extremely personal to us as the physical manifestation of who we are; but to the medical staff, parts are parts and there are jobs to do in order to accomplish their number one objective: the return of your health. During a later lap around the facility, as I passed one room I heard the patient on the phone say, “Yeah, they’re coming back to wipe me off in a few minutes.” That made me laugh, and laughing isn’t easy when your chest is stitched down the middle. Whatever role a sponge and basin of warm water may have once played in hospital hygiene, the preferred option these days is a packet of antiseptic towelettes. Rip open the package and shake out the towel. What comes next does feel like a wipe down, as though you’re someone’s dirty countertop being cleaned of its crud and crumbs. Honestly, I felt dirtier afterwards than I did before, with a sticky residue film to verify that I was clean. I never thought I was being deprived of my dignity, but if I had any modesty when I arrived it was long gone by the time of the parade. Maybe that is why I was content, proud even, to let my robe wave to the bystanders as I passed through the halls.

The long term effects of the surgery to date are less about pain and more about energy and stamina. It is the kind of feeling where the phrase “That took the starch right out of me” is appropriate. The strong man that rolled into the OR hasn’t awakened just yet. When did it become such a task to walk across the room? For the first couple of days it seemed wise to pause and rest during a meal. When did chewing become such a chore? Granted, it has never been easy to eat broccoli, but not for reasons of fatigue! Recovery is made even more challenging by the instructions to not use the arms when standing from a sitting position so that stress isn’t put on the mending sternum. Don’t carry more than ten pounds. No overhead, big arm activities. Those are the rules for the first 4-6 weeks. Meanwhile, in the coming days, my starchless body will have to begin ironing out the wrinkles! I walk at home regularly, increasing the distance as the days pass by on the calendar. Starting in February I’ll begin visiting a rehab center three times per week. Hearing this from me may make no difference if such a moment comes for you, but I offer it just in case . . . Recovery to full strength doesn’t happen overnight. My sister-in-law gave me a jigsaw puzzle and wished me a speedy recovery; the fact that it has 2000 pieces makes me suspect she doubts it will be! However I can tell you the progress within just the first two weeks is pretty amazing. Patience and persistence are proving to be essential keys.

As a clearer mind returned during those first few days, it went to work processing the experience. The phrase “open hearts” rolled repeatedly in my mind. It is more than a description of an invasive surgery. It is also a phrase that some religious traditions use as code for a posture of submission to the divine or a willingness to be changed and made new. Through the prophet Ezekiel, God says, “I will give you a new heart and put a new spirit in you; I will remove from you your heart of stone and give you a heart of flesh.” (Eze 36:26). Psalm 51:10 sails close to the shoreline of this experience: “Create in me a clean heart, O God, and renew a right spirit within me.” Or from the old hymn Open my Eyes we find these words: “Open my heart and let me prepare love with thy children thus to share. Silently now I wait for thee, ready, my God, thy will to see. Open my heart, illumine me, Spirit divine!”  The verbs vary but the sentiment is related. There is work that can be done in the heart that changes the quality of life available.

Allowing the Spirit to work in our lives can create a newness that makes a deeper walk of faith possible. It cultivates a richer understanding of events that surround us. It reshapes perspectives that, in turn, influence how we view and interact with others. It sounds positive and inviting, with no pain included and no anesthesia required. Maybe the “painless” part is a misunderstanding. Early Quakers expected some degree of distress as the Light shown into their hearts, opening new Truths for them to consider. We may be guilty of toning down the demands of such experiences so that it is now mostly a feel-good opportunity to imagine opening the heart to the work of the Spirit. I’ll leave that for others to ponder. My point is that in this moment I was taken by the shared idea of opening the heart, or at least the chest, with a goal of creating a clean heart in a biological sense as well as a spiritual one. This quadruple bypass grafted new sections of vessels stripped from their original placement in a body and moved to a location of new service. As with the spiritual opening, the goal here is also to affect one’s quality of life. That seems related to the open heart or clean heart. The spiritual and physical are so closely intertwined I wonder why we draw such solid boundaries between them. One supports the other; each affects the other.

After learning how reduced the blood flow was for my heart and body prior to this procedure compared with now, I wonder what it is like for the various organs and muscles. On the one hand the bypasses are work arounds that detour the blockages and allow the flow to continue. But on the other hand, it may be like my body is leaving a depression era where resources were few and they all learned to survive on less; now it must learn how to behave in a resource-rich world of plenty.

As my heart enjoys this newfound abundance, I look forward to the next chapters of my life and am grateful to have this extended opportunity. To the talented surgeon and the excellent medical staff involved in my care, I offer my heartfelt thanks! As the saying goes, “I couldn’t have done it without you!”

Further Reading

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