Didn't Get to See Fred

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Thomas Laver

Heart disease was never something I worried about much. Although both my great-grandfather and grandfather died at 74 from sudden cardiac arrests, I didn’t know them. Besides, their deaths happened in the kitchen, a room where I spent little time. However, when my father died at 72 during open-heart surgery, I became less cavalier and much more concerned about my own potential for a heart attack. In lighter moments, I saw these three as horsemen of the apocalypse riding toward me, wielding their swords of genetic menace. I was, nonetheless, determined that their fates would not become mine.

With that in mind, I set about building walls around my heart. When my “bad” cholesterol, which blocks coronary arteries, increased, I built the first wall: I renounced meat — sort of — reducing my intake of beef or pork to eight ounces daily. Cholesterol easily breached this barrier. Medication that lowers “bad” cholesterol levels was the second and better wall, sending the cholesterol into retreat. Red meat remained in my diet, but three-ounce servings, not eight.

Having beaten back that insidious enemy, I thought I would no longer be in danger of assault from my forebears’ cardiac problems. Not so, as I discovered during my annual checkup.

“You have a heart murmur,” the doctor said.

“What’s that?” My heart started galloping. Murmur didn’t sound too bad, but heart…?

He explained that my murmur was an unusual sound, indicating that I had a damaged aortic valve, which if not replaced, could someday cause my death. And not just in the kitchen.

As it didn’t seem like a pressing problem then, I decided to carry on with my usual activities, at least until the next annual medical exam. So I watched the cholesterol and continued to eat only inert meat and in quantities that didn’t tip the “too much” scale.

Breathing became more of a problem in the next few years. When I reached 70, climbing a small hill in the wilderness left me panting. Ascending the stairs in subway stations required several stops for breath and a tighter grip on the handrail to keep my balance. That valve needed to be replaced and soon!

The first step in the valve replacement process was a coronary angiogram, a special X-ray test to determine if any other problems, such as blocked coronary arteries, were present. At this point my fear level was low. A few days before I had this exam, I suspected that life-threatening cardiac surgery might be imminent, so I had a Catholic priest bless me. The blessing used to be called Extreme Unction, meaning “the last anointing,” but that always signaled the recipient was a dead guy for sure. It has been re-named The Anointing of the Sick. Good idea! After the blessing, and reading Stoic philosophy’s viewpoint on pain — get a grip, it only hurts if you let it — I was as ready as I could be for whatever might occur.

An angiogram usually proceeds without significant complications; mine did not. I experienced a major problem with my heart’s electrical system and immediately required a pacemaker to normalize my heartbeat. It was also discovered that three of my coronary arteries were obstructed and needed prompt surgical intervention. Valve? Pacemaker? Arteries? The horsemen hovered in the neighborhood.

The night before the surgery, I dreamed that I had died. I was struggling to escape from a stifling white cloud, which engulfed me like a terrified fish caught in a net. I awoke, paralyzed with fear. In the morning, after my chest hair was shaved, the possibility of my death gripped me more strongly than before: What if I die? What happens to my family? What’s next for me? Heaven? Hell? Reincarnation? And even more disturbing, What if there is no “next”? The religious anointing seemed far away and long ago and perhaps might indeed prove to be extreme. My friends, the Stoics, had left the building. I needed reinforcement.

On other occasions I had used music to reduce surgical anxiety. So in case I had to undergo an emergency cardiac procedure, I had loaded some songs onto my MP3 player. As I waited outside the operating theatre I turned it on. A young surgeon asked me, “Is that gangsta rap?” His amusing question and the music put me at ease. Later, it occurred to me that I could have answered him in rap:

When you come to your decision
How to make my chest division
I am sure that your incision
Will be done with great precision
With no need for a revision
On this body of mine!

At the time though, I didn’t feel quite that cool. Anyway, I wasn’t listening to gangsta rap. My choice of music was Fred Astaire’s 1948 film rendition of “Steppin’ Out with My Baby,” Irving Berlin’s composition about a guy heading out for a date with his best girl. My last memory was the sound of Fred’s lively singing and tap-dancing performance, and it accompanied me as I stepped out with my own partner — Death.

When I began to wake up 18 hours later, still in a semiconscious state, I asked my wife, “Did you call Fred?”

Neither of us knew anyone named Fred.

“Do you mean Fred Astaire?” she asked me in a hesitant voice.

“Yes,” I said.

I didn’t get to see Fred on this trip. Maybe I will — someday.

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