Prologue: 1983
Michael Jackson and Roscoe Lee Browne are two voices I will never stop hearing in my imagination. For days, both were my two best companions, trading places in a battered cassette player with orange headphones as my older brother and I negotiated the real estate in the back of a blue Mercury Zephyr. Those square inches grew more precious as the miles crawled away from Baltimore to Orlando, and discussions (and gestures) often grew contentious.
Like many middle-class families of our time, we were making our first pilgrimage to Disney, to see the Magic Kingdom and the new EPCOT center. (It’s an acronym, you know: Experimental Prototype Community of Tomorrow.) If you ever have the opportunity to drive down the East coast, my advice: don’t. Our back-seat squabbling only accentuated the icy silence from the front.
Anyway, Michael and Roscoe. Michael needs no introduction, especially in the year “Thriller” was released. Roscoe was the scruffy English baritone narrator of “The Story of Star Wars,” basically a condensed audio of the movie, something pointless in the YouTube era. If you want a copy, it’s on eBay for $20.
Something kids in the 21st century will never understand is the sound of a cassette tape grinding to the end of its player’s battery life. The voices deepen and slow, and you keep hoping for one more verse, one more quip from Han Solo, one more piece of the story.
Upon our drive’s merciful conclusion, we checked in to our Motel in Kissimmee and - this is where memory is a bit fuzzy - took some sort of nearby tram to where all that magic happened. Picture an elevated platform with a station settled into a forest – at least that’s what my hard drive is returning back to me. We made our way to the top and waited for the next car - and I grew restless, as a ten year-old boy will. In my case, restless has a slightly higher bar. More on that later.
So unbeknownst to my family I found a railing and made myself a seat. Being ten and immortal, I felt no need to grip the sides with my hands, nor hook my feet into the bottom bars. I swung the cramps from driving out of my legs, looked over the sides to the forest below and daydreamed about Space Mountain. Nearby some parent yelled something in my direction (I’ll substitute my parent self at my current age: “holy shit, kid!”) and my mother not-so-gently yanked me from my perch.
Or something like that. This became something of a legend with my parents: in some retellings, I’m holding the railing; others, I’m swinging like a circus trapeze artist. Are they still making those? Are they still finding work?
What’s undeniably true: far from being the first boy to do so, I balanced myself between life and death without much thought in the matter. What if the railing was wet? Or it had been windy? Hell, what if I had been startled by a sound – you know, like “holy shit kid, you’re going to kill yourself” and had subsequently killed myself? If there is a multiverse, there must be a few versions of me lying at the bottom of a forest in Kissimmee.
What’s also undeniably true: If there is a multiverse, there are many versions of me dead right now.
Prologue: OHS-Day Minus 34
“You know when you're sitting on a chair and you lean back so you're just on two legs and you lean too far so you almost fall over but at the last second you catch yourself? I feel like that all the time.”
- Steven Wright, “I Have a Pony”
It’s late on a Saturday in February 2024, and my childhood family sleeps in different towns and different states now. My father rests in Darlington Cemetery; my mother in a mobile home in South Carolina. My brother is with his family in North Carolina. My wife and daughter are snug in their suburban beds, my son living the college life. Here I am, remembering, writing, and… processing new information.
In 34 days, I will be on an operating table for open heart surgery. Two weeks ago, I learned that my thoracic aortic aneurysm – or TAA – had begun to further weaken the valves that regulate the flow of blood through my heart. Some setting of terms are in order here. An aneurysm is a bulge in a blood vessel. Your thoracic aorta delivers oxygenated blood from the heart throughout the body, and in a healthy adult is about the width of a garden hose, or 3 cm. Mine is almost twice that diameter at a point just above where it connects to the top of the heart – hence, TAA.
I first learned of this in 2017, following a rather unsuccessful treadmill session that led to an accidental diagnosis. At the time, the diameter of the aneurysm was not considered wide enough for surgical intervention. What followed was medical management, and what the doctor folks call “watchful waiting.” Tests were completed, prescriptions filled, and data compiled. But the calculation followed was simple: did the diameter of the aneurysm present more of a risk with or without surgery? Fourteen days ago, I tipped over in the chart from “better to wait” into “better to operate.”
“Risk,” by the way, is a loaded word in such circumstances. Someone in my position carries every day significantly higher risk of heart attack or stroke. That comes in the basic living with TAA package. Risk can also mean experiencing a tear, or “dissection,” in the medical parlance. This wins you an emergency surgery, with an outcome that’s, um, iffy.
Or you can be someone like Grant Wahl.
Wahl, 49, was a reporter in the press box at the Qatar World Cup. He had felt for days like he had bronchitis, and saw a Qatari doctor, who prescribed decongestants. During a match, witnesses saw him collapse. His TAA – undiagnosed – ruptured. No amount of emergency measures would have saved him. All of the oxygenated blood from his heart, detached from the passage to deliver it to his body, simply pumped into his chest cavity until it was exhausted. He died within minutes, without the time or capacity to tell anyone he loved goodbye.
I think about Grant Wahl a great deal.
But, but, but – there are lots of differences between us. Obviously. Starting with they found mine before it killed me. Too many victims each year are diagnosed with an aortic aneurysm in an autopsy, not an ER.
Second, yet most important, is the fact that they are fixable, using a serious but increasingly routine open heart procedure. In my case, the preliminary plan is to use a Dacron graft that will stabilize the aortic wall and ease it back to a safe diameter. Surgeons will then attempt to fix my aortic valve; if unsuccessful, they’ll replace it with a bovine aortic valve, rendering me just a tiny bit of a cow. Pig valves are also used, a replacement some women I’ve dated in the past would find more appropriate. Some patients also choose an artificial valve, an option I have vetoed for multiple reasons. The survival rate of these procedures sits around 99%. All positives.
But the waiting. Jesus Christ on a popsicle stick, the waiting. I have the diagnosis, the tests, the plan – even a rock-star surgeon who’s performed this procedure literally 10,000 times, including on professional athletes and Olympians. Even so, today – right now – here I sit with an enlarged heart, two leaky valves, and an aorta that probably won’t blow on me. Today, absent intervention, I’m on a path with a short life span.
Today, I’m back on that railing, dangling my feet, staring into the forest of what’s to come, waiting to be taken to where the magic happens.
At ten years old, the realization that I had brushed against mortality was a vague notion. At almost 52? Nessa Coyle, a Nurse Practitioner quoted in an article forThe Atlantic, calls it “The Existential Slap:” a moment when one realizes, on a visceral level, what it means to be mortal.
Cicero’s Exercise
“that to study philosophy is nothing but to prepare one’s self to die.”
- Cicero
Precarious is a word that is never far from many of our minds these days. In retrospect, the sensation seems to be soaking through our pores since 2017. Precarious leadership, precarious leadership changes. Trump. COVID. Inflation. Chinese spy balloons (more inflation!) over oblivious octogenarians. If you’ve felt your world to be off balance, well… not to get into comparisons, but mine has been so in at least one more dimension.
As of today, this writing serves less as memoir – or God help us, a work of philosophy (like I could attempt that!) than it does therapy, insurance, artifact, and exercise.
As therapy, it’s helping me process the maelstrom of emotions that my change in diagnosis precipitated. As insurance… well, creating something that outlasts us is our only tangible form of immortality, right? What’s more precise for that job than the written word? As J.K. Rowling observed, words are “our purest form of magic.” Stephen King defined it in On Writing as telepathy. My techie-inclined brain regards it as making a backup copy of whatever might be interesting in me, to me. It’s ultimately your judgement that matters if it is.
Maybe that last sentence isn’t quite true. In some respects, I’m also writing this for whoever emerges from surgery on April 2nd. Technically speaking, I am preparing to spend a small amount of time in a state of clinical death. Your heart is stopped and cooled for repair, and your brain’s supply of oxygenated blood is maintained by what is known as a heart-lung bypass machine. Of course, medical miracles happen forthwith, and in the vast, vast, vast cases where surgeons do this, the heart resumes its job, oblivious to the forced pause. In hospital waiting rooms across the world, families anxiously watch monitors or smartphone apps for their loved one’s status to change to “Off Bypass,” indicating this has happened.
Here's my problem - problems. The odds of my heart remaining silent are not zero. Yes, they’re very close to zero. But would you play Russian roulette with a gun that had one hundred chambers, but only one bullet? Me neither.
The largest concern occupying me: holding on to my brain as it works today, in both clarity and mood. My most pleasant surprise arriving in my early fifties is that I have never felt mentally sharper – or calmer – than I do right now. Yet message boards abound with stories from open heart surgery survivors who persistently complain of not being able to think clearly. This is an expected complication following the operation, sometimes lasting several weeks – c’mon, folks, it’s major surgery with an insane amount of drugs, everyone’s eggs are gonna be scrambled for a while – but many believe they are simply never the same upstairs. The clinical term is Post-Operative Cognitive Decline, or POCD.
At my age, in my life, being mentally nimble with good recall isn’t just enjoyable – it’s essential. Not only will losing them put my career at risk, it will endanger my favorite hobby: messing around with words, particularly as an actor. I perform in local productions as much as time allows. Kinda need to be able to memorize lines and think on your feet when you do.
Even so, between clarity and mood, it’s still the lesser worry. Much like the odds of survival, the chances of avoiding long-term POCD are good, especially if you are younger than 65 and reasonably fit. I’m both. And hell, even if the odds of POCD were high, it would still be a decent tradeoff. You survived, after all. A sharp brain in a box is rather pointless.
But mood? Yeah. Mood’s the killer for me. Let’s see how succinctly I can explain this.
I am a part of a long family history of both diagnosed and undiagnosed instances of almost every mood disorder you hear about. In my case, I grew up a child with severe ADHD (the actual, diagnosed by professionals kind), anxiety and depression. Those last two don’t often rear their ugly heads, but when they do, they stop my life in its tracks, as I’ll explain.
So a man with my history, in an otherwise good frame of mind, facing a significant trauma is like someone in Miami with a nice house on the water in the direct path of a category 5. Time to fill the sandbags, get your house in order and make damn sure the insurance policies are correct.
As I said, it’s like trying to make a backup copy of myself, a la the villain in the second “Avatar” film. Maybe, just maybe, recording how I’m thinking, feeling, wording right now will give whoever comes home from surgery the proper kick in the ass needed to work hard to get back on the same road – or a better one.
So we begin Cicero’s exercise. As quickly as possible, I will try to put down whatever I think is worth leaving behind. Whatever the result, it will pale in comparison with those to whom I dedicate it: my wife and children, always and forever the best parts of me.