PAIN

Part Three

     The days before the operation blurred into one solid, multicolored mass with one notable exception and we’ll get to that very soon, I promise. The angiogram sticks out during that first week following the heart attacks, mostly because I’d been bracing myself for some serious discomfort and it was rather anticlimactic.

     It wasn’t uncomfortable at all. I could barely feel it because they had me loaded to the eyeballs on something very mellow indeed. With all the drugs I’ve been taking lately, it’s still problematic as to whether I’ll end as a junkie like Rush Limbaugh. But I can see how that fat bastard turned into one. I could easily go that direction. Vicodin is a truly mellow high. Four will toast you nicely; about equivalent to four stiff drinks. Oxycodone is pretty sweet too and takes even less to get the same effect: two at a time did it for me. I suspect I could have calmly attended my own hanging with enough Oxycodone coursing through my bloodstream.

     But, Dilaudid! Ah, that wonderful synthetic heroin analog, so richly praised by William Burroughs as Father Ted in Drugstore Cowboy! So beautifully smooth and easily accepted by the body as not so much a necessity as a part of life, like drinking water or breathing air. One milligram intravenously is what they gave me and that one milligram was like a blessing from above; a warm and fuzzy benediction that reassured me that all was well with the world inside my skin.

     It also gave me some of the worst and most vivid nightmares I’ve ever had. I still have about twenty of the tiny pills. I’m thinking about flushing them down the toilet, but I’m afraid of what it might do to the water table.

     The angiogram: a fat yellow tab of Valium put me in a nice, relaxed mood—but I was still hungry—and they wheeled me into a big room filled with folks in scrubs and masks. They all had cheerfully efficient demeanors. I was left with the impression that, not only were they very good at their jobs, they really enjoyed them, too. They certainly enjoyed me.

     “How we doin’ today, Michelle?” He learned over me: ruddy complexion, blue eyes and the faint impression of a beard behind his blue mask. He wore glasses. I think his first name was Peter. I dunno. By that point, I was pretty stoned.

     “Okay,” I mumbled. “Kinda cold.”

     “You want a warmed blanket?” One of the best ideas ever devised is the warmed thermal blanket hospital aides give you if you’re cold. I nodded and they tucked one around me. I was comfortable in a detached way, as if what was about to happen to me was actually supposed to happen to someone else, but I could watch closely if I wanted.

     I didn’t especially, but it was the only show on at the time, so I played along.

     “Thanks,” I murmured. “Hungry, too.”

     I think he was smiling. Who can say? “You can eat later. This shouldn’t take long.”

      “’Kay,” I murmured again and rolled my head to look at the clock. The last time I’d been this loaded on pharmaceuticals was when I’d had a ganglion cyst removed from my left wrist. (I was a pro musician then and it played hell with my performing and rehearsal schedule) Watching the clock, I’d noticed that I could see, with a little concentration, the actual movement of the minute hand. It was an interesting indication of how slowed and distorted my time tense had become under the influence of legal, mind-altering substances.

     It was kind of cool, back then. Not so much now.

     It was cool in the cath lab too, but I didn’t feel it much, even though my legs were spread wide and the knees elevated a trifle. One of the female nurses bustled up.

     “We have to shave your groin for this, dear. I hope you don’t mind, but we have to do it.” Her hands were motionless on the sheet, about four inches from my crotch. I gave her a sleepy grin.

     “I don’t think you’ll find much, ma’am.” My voice was ever so slightly slurred, as if I’d had a few too many at the tavern. “I kinda like it neat and clean down there.”

     She nodded and again I had the impression she was smiling. “Most people think so,” she declared, “But we usually find that they need a trim. Let me just take a look . . .” With that, she flipped the blanket aside. Her eyes widened and her left eyebrow shot straight up into her hair-cap. “Oh, my,” she muttered. Louder: “Nope, doesn’t need a shave!”

     If I hadn’t been so blitzed, I might have taken offense. Or maybe not, as it was one of those unique situations: I wanted go along with it just because it was an amusing little scenario and I was curious to see how it played out. I didn’t even mind that she’d had a good look at my inconsequential three-piece set. Nobody gets to see that, not even my beloved.

     Why? It’s not me, that’s why.

     I’d left most of my social force-fields down for this and not just because I was fried on a lot of narcotics. That morning, many odd things had happened in my room or perhaps merely in my head:

     I’d awakened and there were eight young women in my room: student nurses. I didn’t know what the hell they were at first; it seemed like an invasion of teenaged girls in scrubs. I blinked at two of them: a tall, rather muscular Afro-American apparently partnered with a petite Asian who was the spittin’ image of a beautiful kathoey from Thailand; the recent winner of the Miss Gay World beauty contest. I blinked again.

     The leader of this pack of nubile femininity was saying something to me, but I was at a loss as to what it was. I understood not a word. It seemed as if she was speaking a language I should have known, but was somehow emotionally incapable of understanding. There was something altogether feminine about the content, but I had no way to shape my mind around the thought she was trying to impart to me.

     I felt that, if I were somehow more female, I would know what it was she said to me and what it meant. As it was, I could only stare helplessly at her.

     They soon filed out, the supervisor leading the way. The tall Afro-American and the Asian were the last to leave. They lingered by the end of my bed as the others were leaving. The Afro-American looked down at me. Dismissal was in her eyes; dismissal and more than a little contempt. She grinned at her friend as she was turning to leave.

     “Looks like a hootchie t’me,” she drawled in a perfect ghetto accent. Her friend seemed to smile back uncertainly. I snorted because it was all I could think of at that moment. The black student nurse turned back to me. Her eyes were cold.

     “Whatchoo say t’me?” she said softly. My heart seemed to stop again. It certainly did a quick skip and a hop. I rolled my head on the pillow away from her.

     ‘Nuthin’,” I mumbled.

     “Thas’ good. Y’better not be sayin’ nuthin’ t’me.” She gave my foot a playful squeeze. Then they left. I went back to sleep, I think. The next time I opened my eyes, Tami was looking down at me.

     “How ya feelin’?” she inquired.

     “Okay. Are you really here?”

     Her look was quizzical. “What?”

      “Nothing.” I spread my arms for an embrace and she gave me a long hug. When we pulled apart, I peered past her and saw Jenn Burleton standing in the doorway. Her broad, motherly face was wreathed in a gentle, Buddha-like smile.

     “Hi,” she said tentatively. “I’m Jenn Burleton, from TransAction . . .”

     “We’ve met.” I motioned to her and she gave me a hug, too. “I was at the benefit you guys had at the Q-Center last year, with Mayor Adams.”

     “Oh, that’s right! We have met, haven’t we?” Gracious as always, she looked a trifle embarrassed for not recognizing me. I think she had good reasons. I was sporting two days growth of beard, my hair was limp and in need of shampoo, hair-pick and lots of product. I wore not a scrap of makeup. I must have looked like something the cat dragged in and then promptly abandoned because it smelled bad.

     “I had a talk with the nurses at the desk,” Jenn began. She had a comforting, gentle tone that told me she’d done this many times before. “I gave them a short course in Trans101 and I think they get it.”

     “Me, too,” Tami interjected. She waved a piece of paper. “I dropped this off with them. Wanna read it?”

     I put out my hand, took it, and tried to focus my eyes. It was one of my community’s identity manifestos, stating that gender and identity were separate, equal things and how identity as defined by self-perceived gender was so important and blah-blah, woof-woof. The usual stuff for the muggles; the straight folks who still think this is all about sex and the three P’s: promiscuity, pedophilia and pissing; lurking in bathrooms so we can listen to (real) women urinate.

     It’s a lot more complicated than that, of course, but we like our sound-bites in this wired world, don’t we?

     “Looks good, Tami.” Actually, it looked a little like Sanskrit at that point, but I could pick out a few words, here and there, so I could guess at the rest of the content. I handed it back to her. “Thanks.” I looked at Jenn. “You too, Jenn. I appreciate it. I know how busy your schedule is.”

     She parked herself on the end of the bed and grinned broadly at me. Her eyes twinkled. When she does that, she looks a bit like Mother Hubbard about to deliver the punch-line to an especially naughty joke. “Not at all. I do have to get back to the office, but I wanted to make sure that there will be no further trouble here. We were told that you had a bit of a problem last night. What happened?”

     Fumbling, I tried to recount the events of the previous evening and succeeded only in sounding incoherent. Jenn and Tami exchanged solemn glances.

     “That’s . . . unfortunate, Michelle. The nurse involved is still at home. I understand it was very traumatic for her. She’s never had a patient threaten her before.”

     “I did not . . .!” I swallowed what I was going to say and started over. “Right. You’re right. I need . . . need to apologize to her. In person, if possible.”

     “Well,” Tami commented, “That’s a start, but I doubt if it’s going to happen.”

     I glanced at the door. “Is that rent-a-cop still out there?”

     They both nodded soberly.

      “Damn. Is he going to stay there?”

      Tami shook her head. “I don’t think so. I think we’ve got them convinced that you’re okay now.” She eyed me with concern. “You are, aren’t you? ‘Cause if you act out like that again, they’ll use restraints. It’s the law.”

     I swallowed again: bitterness, suppressed anger, sadness, terrible regret, and that sinking feeling that comes with losing face when everyone expects you to set a great example just because. As nutritional breakfasts go, it was a bit less tasty than pureed Brussels sprouts.

     “I’m okay,” I muttered, my face hot. “I was having a heart attack, f’cryin’ out loud . . .!”

     “They took that into account,” Tami remarked. Her voice was peculiar and flat, as if it was hard for her to say it, too. With another burst of shame, I realized that she was embarrassed for me and our whole community. I’d put my foot in it, big time, and there was nothing to do now but own up to it and make damn sure it never happened again.

     “Okay, then.” I took a deep breath and looked up. “What do they want? Do I have to sign a non-violence contract or something?”

     They both grinned. Jenn stood up. “No, I don’t think that will be necessary,” she said. “Just let me or Tami know if anything like that happens again and we’ll take care of it.” Her look was inquisitive. “Has anything else like that happened?”

      I scowled at the ceiling. “I dunno. There was . . . something, this morning, I think.”

     Tami raised an eyebrow. “Like what?”

     I tried to explain the incident with the student nurses. Again, I sounded like a five year old trying to explain particle physics. By the time I’d fumbled through it, Tami and Jenn were exchanging raised eyebrows and worried looks.

     “Uh, you say this student nurse was black? Afro-American?” Jenn asked. There were two tiny vertical lines between her eyebrows and an ominous glint hovered in the back of her eyes; a storm-warning best heeded tout de suite.

     “Uh, yeah, but Jenn, it doesn’t matter . . .”

     “Yes, it does,” Tami said, a little grimly. She got up. “I think they need to hear from me again.” She left the room, leaving me with nothing more than the desire to go back to sleep and pretend that it was all a particularly unpleasant dream. Jenn gave me a hug and followed her. I rolled over and tried to ignore my grumbling belly, hoping that they would just get on with it.

     They got on with it. First a serious, bee-sting zap of anesthetic in an area best not discussed that left me with a feeling that was no feeling at all. The enormity of what they were about to do was finally penetrating my drug-soaked mind. I was trying really hard not to envision it, but my hyperactive imagination never sleeps and never stops running the projections that flicker behind my eyes like an endless kinescope.

     They were going to make an incision, enlarge it with clamps, find my femoral artery, puncture it, and then insert a metal catheter with a probe at the end about the size of a thin mechanical pencil through the resulting gash into the second largest artery in my body. (More clamps, of course, to keep me from bleeding to death) This snake-like contrivance would be pushed slowly up my femoral artery, into the aorta and then into my heart. The probe would inject an iodine-based dye (Remember what it felt like to smear iodine on a cut finger? Imagine that feeling inside) into my left ventricle and atrium and hopefully outline the functions (or lack thereof) of my mitral valve.

     They made a video of what played on the imaging screen over my head that morning. I still have it. It looked weird, alien. That wasn’t me on that monitor, not really. I am not a bag of skin filled with various pulsing fluids and meaty surfaces slapping against one another. I’m not!

     Am I?

     I don’t know what I am, but I am more than merely meat. I know this much is true.

     Removal of the catheter and probe felt like a release, a relief whose description is almost beyond me. It wasn’t rape, not by a light year at least, but I had no choice but to lay back and try to enjoy it. I didn’t, not at all, and I was light-headed with something suspiciously like joy when it was removed.

     They took me back upstairs. By that time, a lot of the drug effect was ebbing away and I was beginning to hurt. But I gritted my teeth, ordered a hearty lunch (Providence Hospital has a really great menu) and managed to talk them into another shot of morphine. Ah, enfold me, Great Mother M, and carry me off to the sweet lands of dream!
     Or, put simply: lemme get some sleep, willya? I may die in a few days.

PAIN

Part Two

     The second heart attack later the next evening was only the second of the many dishes of pain and fear that were served to me over the next few days. As an antipasto goes, it was a sour and bitter dish indeed, especially considering that I’d helped prepare it.

     I went home the next morning, AMA. That means Against Medical Advice. The staff at Providence was dumbfounded. “If you have another incident, it could be worse,” insisted one nurse. Michelle was livid. Her e-mail was brief, bitter and to the point: Way to go! You’re going to really love it if they stamp your file with a great big UNTREATABLE in red ink and send you off somewhere else!

     I should have listened. Why I did not remains a matter of conjecture, but I attribute it largely to one last gasp of my defiance; my denial; my refusal to accept the inevitable. That I was an idiot goes without saying, but I’ll say it anyway:

     I was an idiot.

     My teacher, mentor, and all-around wonderful human being, Maria Caruso, saved my stupid ass. She came by my apartment while I was trying to complete the rest of my homework. I would be roasted in Hell before I would let something as picayune as a heart attack keep me from another term of straight A’s, damn it!

     Yes, I really was thinking that way. Insane, isn’t it?

     She took one look at me when I opened the door and said, “What are you doing out of the hospital?” in a quiet, steely tone I’d never heard from her before.

     “Uh,” I said. “I’ve got homework due.”

     “Not in my class, you don’t,” she grimly. “I called Providence and they said you’d checked out. Are you out of your mind? You had a heart attack, woman!”

     “I have work to do,” I repeated, robot-like.

     “Michelle.” There was a metallic glint in her big brown eyes that I could not recall ever having seen before. “You look awful. Let me take you in.”

     “I have work . . .”

     “That can wait!” She was visibly angry and a little shaken, I think. “Your health is more important. If you die, you can’t do it anyway, can you?”

     I stared at her. “You have a point.”

     She took me back to the hospital. She told me not to worry about homework, that she’d speak to my counselors and advisers and help work something out. I don’t know what all she did behind the scenes, but for one exception, she was an enormous influence on events. I know she told the rest of my instructors. They responded with cards and flowers and personal visits, including Doctor Pryor, that wonderfully hobbit-like little genius who was my instructor for Mass Media. I have effectively zero interest in men, but in his case, I’d be honored to make an exception. My God, what a mind that man has! He’s wasted in a community college like PCC. He ought to be teaching at Stanford or even Harvard. He brought me a bouquet of lovely yellow mums that brightened my room considerably. (2G-24, the cardiac unit. Great view)

     But I digress, as always. The second heart attack happened later that evening, after Maria got me re-checked in and said goodbye.

     “You aren’t going to leave us again, are you, Michelle?” the resident ER doc said, rather irritably. He looked again at the EKG and shook his head, lips pursed. “If you do, we may think twice about taking you. You keep this up, we’ll be admitting you DOA, do you understand?”

     “I understand, doctor,” I muttered, a little irritable myself.

     “This is serious! I want you to consider the consequences if you try to check out again against medical advice.”

     “I got it already,” I growled. Shut the fuck up, doc! “I just wanted to try to finish this term. I’m due in New York on the twenty-sixth for . . .”

     “You need surgery. Immediately. So put all that out of your head. You aren’t going anywhere for at least a month. Is that clear?”

     There was a taste of lemon rind in the back of my throat that had nothing to do with the pills they’d given me. “Clear, doctor. You’re right. I’ll stay. Sufficient?”

     He flipped his stethoscope around his neck and left, shaking his head. I watched him go, thinking, Your bedside manner could use a little work, doctor.

     I relaxed, or tried to. My heart seemed okay, but I was terribly tired. After a while, the nurses came in and transported me up to the cardiac floor. I had the same room before and after my surgery, which was nice, except when the sinking sun was coming through the window and turned that tiny room into a greenhouse. I had some dinner while they continued my work-up and told me that they would be doing an angiogram within the next day or two.

     Wonderful, I thought. Now they’re going to pump dye into my heart through a tube inserted into my groin. Ought to be a really lovely scar. (In fact, you can’t see where they went in unless you look closely)

     I laid there and brooded. I watched TV or tried to: Weeds, with Mary Louise Parker and Elizabeth Perkins. Magnificent, both of them. But the eye-candy value was all but lost on me. I brooded instead.

     About nine pm, I began to feel distinctly uncomfortable. Not a racing heart this time, but there was an odd squeezing feeling in my chest, as if the gown I was wearing was too tight. Not bloody likely; the damn thing was as big as a pup tent.

     I twisted and turned, trying to get comfortable, but it didn’t seem to work, no matter how I was laying. I reached over to thumb the call button and it hit me again.

     An elephant stepped carefully onto my chest and settled his full weight upon me. I couldn’t breathe. My eyes crossed involuntarily and the lovely Miss Parker suddenly split into four people. (One was quite enough, thanks) I rammed my thumb into the call button and arched my back as a spasm jolted through my whole chest.

     “Uck,” I croaked. “Help.”

     There were heart monitors attached to me and attached in turn to a telemetric transmitter, a module about the size of a big smart-phone, but much thicker and heavier. I knew that it was probably ringing alarms down at the monitoring station, but what the flamin’ hell was taking them so long? “Help.” I croaked again. “Please.”

     She bustled into the room: young and slender, dark-haired and rather pretty in a nerdy sort of way. She wore glasses. Her hair was tucked into a neat ponytail.

     I never learned her name.

     “Are you all right, sir?” she asked, rather tentatively.

     “No.” The pronoun registered rather belatedly and I arched my back again as another spasm hit me. “Don’t call me sir!”

     She came to the side of the bed and tried to hold my shoulders down. The head of the bed was raised about twenty degrees. “Sorry, uh, sir. What do you want me to call you?” She peered at my wristband. “Mister Rosey?”

     Jesus H. Christ. I dropped the final ‘r’ off the end of my name to make it easier to pronounce and this little airhead mangles it anyway! “Not a mister!” I gasped. “Not a . . . man! Woman! I’m a transgender woman!”

     There was honest confusion on her face; confusion and alarm and genuine concern. Her brow wrinkled as she tried and failed to comprehend what I was saying.

     “Frankly, sir, I don’t know what you are. But you have to hold still. They’ll be in here soon. There’s another patient coding down the hall.” She glanced at her watch as she was trying to hold me down. “I’m just filling in while they care of that.”

     “Don’t care!” I almost shrieked. “Don’t call me sir! Not a man!”

     (I confess: I allowed myself to become shrill. But that ain’t all . . .)

     Her eyes widened as I grabbed the end of her stethoscope. Another chest spasm was arcing through me like sheet lightning. I can honestly say that I was not in my right mind. In fact, it might be said that I had no mind at all at that point.

     “You,” I croaked like Lon Chaney as Quasimodo, “Need to Google Trans101 and read everything on there. Now get the fuck out of my room!”

     Her eyes behind those nerdy glasses were bulging with shock and fear. I hope I never again see that look on another person’s face, for any reason.

     “Don’t you ever touch my stethoscope, sir!” she hissed.

     “Get out!” I shrieked hoarsely. “Out! Now!”

     She got. I writhed in pain. About three or four minutes passed, during which time I could hear her outside my room, sobbing. Another nurse poked her head in, one I recognized this time, thank God. “Michelle? Are you okay?”

     “No,” I managed to squeeze out. “Chest hurts.”

     “Okay.” She looked bewildered, but cautious. “Are you going to behave yourself?”

     “Gah.” I tried to breathe, but that elephant was bouncing playfully on my chest. Little bright lights were flickering in my field of vision. “Yuh. Help, please.”

     They hit me with a hypo of morphine and some other stuff. The tightness eased, the elephant reluctantly dismounted, and I could breathe again. While I was recovering my wits, the nurse told me quietly, with very little emphasis, that the youngster was a newbie on the floor, not briefed as to my situation and not particularly experienced.

     “But that doesn’t excuse your behavior, Michelle.” She said it without any accusing tone in her voice, but I’ve never before been so ashamed as I was in that moment.

     At that moment, a burly security guard poked his head in the door and eyed me. “This the one?” he asked.

     I met his measuring stare with one of my own. “Don’t tell me you’re going to stand guard over me now,” I rasped. “Gimme a break.”

     His gaze turned wary. “If I have to,” he said quietly and withdrew. There was a discussion going on outside the door that featured him, the newbie nurse, and two other voices I couldn’t identify. The nurse fussing over me said calmly. “It’s policy. When we have a patient that acts out like this, we have to take precautions for everyone’s safety. You understand?”

     “Yeah,” I said bleakly and began to cry. The owner of one of the voices I couldn’t identify entered the room. I did a slow, painful double-take and my tears dried up. “Howdy, Padre.”

     He was elderly, portly, and looked tired. But his eyes were sharp and his demeanor gentle. He looked me over and I could find only compassion in his gaze. “Howdy. You wanna talk about it?” he said, settling down in a chair.

     My strength was returning, so I waggled a finger at him. “You realize that your boss has condemned people like me, don’t you, Father? Have you read Benedict’s latest edict on trans folk? How we’re violations of nature?”

     “Big deal,” he grunted. “A lot of us don’t agree with what the Vatican has to say.”

     “Careful, Father. “ I waggled the finger again, mostly because it was all I could move at that point. “You risk excommunication with an attitude like that. Even your immortal soul.”

     “I’ll risk it,” he grunted again. “You wanna talk about what happened?”

     I took a breath and blessed the fact that I could. “Sure. She mis-gendered me. I told her to get out.”

     “Kinda rough on her, weren’t you?”

     I stared at him. Fatigue lined his face, but he wasn’t giving an inch. “Maybe.”

     “She didn’t mean it, you know.”

     The morphine was making me positively languid. Perhaps that was why I was so truthful. “She should have known better.”

     “Why?”

     He had me there. “Well, for . . . Jesus, Father! Oops, sorry. Who hasn’t heard of trans folk?”

     “Some of us haven’t,” he rumbled like a far-off roll of thunder. “Me, for example. I’ve heard of them, but I’ve never met one until now.”

     I raised an eyebrow. “You gotta be kiddin’.”

     “Nope.”

     “Well, howdy. My name is Michelle. I’m a trans woman.”

     He got up and shook my hand. “Nice to meet you, Michelle. Tell me about yourself.”

     But I couldn’t. The morphine was slowly dragging me down and I desperately wanted to sleep and put the day, the whole damn disaster behind me. But I couldn’t do that either. I was thinking they were going to cut me in a few days; open me like a defective doll, stop my heart, and slice out a valve. It was all I could think about.

     “Maybe later, Padre,” I said drowsily. “Tomorrow okay?”

     He nodded. “Sure,” he said in that rumbling voice. I’ll be around.” He got up again and speared me with one sharp eye. “Do I have your word that you won’t go after any more nurses?”

     I nodded slowly, as if it was an effort and it certainly was. “Yeah. You have my word. Just . . . tell them . . . would you? No more . . . wrong pronouns. It hurts.”

     He eyed me. “I get the picture, Michelle. I don’t think it’s gonna happen again.” The priest ambled out.

     I slept.

PAIN

     Come, let us discuss pain. I promise you that this will hurt.

     One of my major flaws as a writer is the assumption of too much knowledge on the part of my reader: I tend to think that the reader has already experienced what I have—my life is so boring, after all—and that he or she knows what I know; that their education is at least as good as mine. I once believed that it was an equitable if somewhat lazy form of egalitarianism; none of us are any better than the other, right?

     I did not factor in my natural contempt for those whose education isn’t as good as mine, through no fault or intent of their own. It took a long, weary time for me to recognize this despicable attribute within myself. It’s the sin of pride, folks: of course, they’re as smart as me! Anyone who reads what I write has to be at least as capable as me, right? Otherwise they wouldn’t be reading this!

     Uh, no. Not at all.

     I won’t go into reasons why this isn’t true. It’s obvious, I think. Logically, it’s impossible to conclude that anyone who reads what I wrote has to know how I feel. From a writer’s viewpoint, it shortchanges the reader. I didn’t tell the story in full.

     When I began this piece some days after I returned from the hospital, I made some erroneous conclusions that led straight to an essay bemoaning my own suffering and pain, without giving the reader the chance to find a bridge to join me on that little island of agony. It was, quite frankly, a piece of crap.

     So I scowled at it and wondered why it made me feel so crappy. It was the truth, wasn’t it? It was how I felt, wasn’t it? It touched on all the important points of my pain; the physical, the emotional and the spiritual, didn’t it?

     Yes, but it assumed so much. It assumed that anyone who read it would have experienced the agony of a heart attack and the subsequent necessary surgery; the terrible, yawing chasm of fear, the horrid loneliness and isolation of knowing that, in the final analysis, we are each all alone when facing our individual mortality. Finally, it assumed the reader would instinctively understand the gray bleakness that follows any such life-changing series of events; the depression that inevitably accompanies the realization that one’s life will never be the same as it once was, regardless of how well the recovery progresses.

     I cheated the reader, in other words, and it resulted in an arrogant piece of crap that made me want to slap myself upside of the head.

     So I begin again, gentle reader. I truly hope that you are gentle or that you find something within yourself that resembles gentleness when you read this. Let me help you find it. May I tell you what happened and how it felt?

      The facts are simple: April 25^th, 2011, I had a heart attack; what the doctors call “a significant cardiac event.” (Yeah, there’s an understatement for y’all!) It began as an enormous wave of dizziness and racing heartbeat while I was taking a shower, mid-afternoon, after a marathon six-hour session of schoolwork that featured no food and a lot of hot coffee and nicotine. It wouldn’t go away, even after I shut off the shower and managed to climb onto my bed in an attempt to relax and let it pass. A second attempt to finish my shower led to even more dizziness and that unshakable feeling: this is it. I retrieved the phone from its charging cradle and crawled back atop the bed. After some minutes of breathless agony and raw terror, I called my beloved Michelle in Montana.

     “Hey, hon?” I wheezed. “I think I’m having a heart attack.”

     Her voice was filled with terror too, but she’s better at handling this sort of thing than I. She is, after all, a nurse with over a quarter-century of experience.

     “Breathe deep,” she advised. “Slowly. Steadily. In through your nose. Hold it for a count of three. Let it out through your mouth.” Her voice was very soothing, but nothing could make me hold my breath for three seconds. I was slowly strangling, even though my lungs were hyper-inflated. 

     I didn’t know it at the time, but my mitral valve, the little rascal responsible for all this had all but given up and was flapping foolishly within my straining heart. The left atrium, one of the two upper chambers of my heart, was distorted with excess oxygenated blood that wasn’t getting to my extremities or internal organs, making me feel as though I was strangling. I was strangling! My poor ventricle, the chamber below my atrium and connected by that useless fuckin’ mitral valve, was not-so-quietly going berserk trying to pump the bright red blood to the farthest reaches of my body and failing miserably. It wasn’t designed for this!

     She kept at it for about forty minutes, as far as I could tell, later. (The paramedics were full of advice about that, nice fellows, even as I lay dying. “Next time,” one snapped, eyes wide in disbelief, “don’t wait so long.” Okay, it’s a deal) Finally, she said: “Michelle, you need to call 911. Now.”

     I did. I fumbled into a pair of lounging pants and a blouse, managed to get to the door to unlock it and collapsed on the couch. That was where they found me, ten minutes later: a whole football team of hunky, blue-clad paramedics, firefighters and a real doctor, no less. Eight enormously-muscled men carrying toolkits filled my front room and I was struck by how tiny my place really is.

      “You keep it kinda warm in here, sir,” one of them remarked as he opened his tool kit and started slapping electrode patches all over my bosom.

     “Ma’am.” I wheezed.

     “’Scuse me?” His attention was on the wires he was hooking up to the patches.

     “Ma’am,” I wheezed again. “I’m a transgender woman. My name is Michelle. Please address me as female.”

     “Ah, I see.” He eyed my breasts, about a B-cup, but rather shapely, I’m told. “Sorry, Michelle. I didn’t mean anything.”

     “S’all right,” I gasped. “I know I don’t look very female, right now, but I am. Legally. Honest.”

      “I believe you,” he reassured me. He and the rest of them were all doing something to me, at least those I could see inside of the rapidly narrowing cone of vision I had left.

      “SVT’s at about 200,” someone remarked with no particular emphasis, but every eye in the room swiveled toward the speaker. He was looking at a strip of paper extruding itself from a gadget that was hooked up to the wires sprouting from my chest. They all looked at the smallest of the bunch, a compact, modestly handsome fellow with pronounced Asian features. His right eyebrow was about to climb into his hairline.

     “Adenosine?” someone suggested.

     He nodded. “Six migs. Let’s get them onboard quickly.”

     Another firefighter crouched within my field of vision. He took my hands. His eyes were a direct, penetrating blue. “Michelle, we’re going to inject something into your bloodstream that might feel a little weird for a few minutes. It’s a naturally-produced chemical called adenosine that will reset your heart. It’s very benign and will dissipate in a few seconds . . . “

     “Enzyme,” I wheezed. “One of the four in DNA.”

     He grinned. “Very good. Yes, it’s part of everyone’s DNA, which is why it has no lasting effects . . .”

     Another paramedic bent and fitted a fat syringe into the catheter attached to my left arm. He pushed: injected it hard. I didn’t feel a thing except a momentary coolness in my forearm.

     “But I’m told it feels really weird, so hang onto my hands if you want.” He glanced up at his crew mates. “Anything?”

     The Asian fellow frowned, examining the strip of paper. “Hit him again.”

     “Her,” I whispered. My vision was beginning to go gray at the edges. “Her, damn it!”

     “Okay, Michelle,” the paramedic soothed. “He didn’t mean anything.” The Asian fellow looked up and smiled apologetically. As my vision grew grayer by the second, I wondered if his little half-smile, apologizing for the wrong pronoun, would be the last thing I would ever see in this world.  The fellow with the syringe hit me again and I suddenly knew it wouldn’t be, not this time around.

     It felt like my heart was simultaneously squeezed and torn in half. I could feel it stop. It went from two hundred beats a minute to zero, instantly. There was a space, a timeless time that couldn’t have been more than two seconds but seemed to stretch to the end of Eternity and back again when my heart did not beat. I felt aching emptiness, an odd and terrible hollowness within me as my heart imploded and waited to burst forth again. In those two seconds, I could feel and hear all that was within my dying body; the frail hanging scaffolds of flesh and bone that my life dangled from. It was as if someone had suddenly stopped the music at a loud, annoying party and the silence echoed within me, ringing against the columns and ladders of meat and rods of stiffened calcium and the fragile shreds of colloidal tissue hanging between; flags flapping slowly in the wind and subsiding as the breeze vanished.

     For a brief, bitter moment, I heard and felt the breeze of Eternity whisper within me and I knew, as all of us do when it is time, what that really meant and what I meant as a part of it: almost nothing. But the almost saved me, I think.

     My heart began to beat again. Such a simple, plain, unadorned statement! My heart began to beat again. Compare it to this: I began life again. Or: I was reborn. Or, yet again: time and life and the world I remembered began to flow about me once more.

     All are true. All are pitifully, painfully inadequate. My heart exploded. With a twisting wrench, it convulsed and began to beat. My eyes widened. My grip on the paramedic’s hand tightened. “Whoa . . . wow . . . oh my God!”

     He grinned at me. “Worked that time! Yeah, it’s weird, isn’t it?” He glanced up at the Asian fellow. “How’s she doin’, Doc?”

     The doctor smiled. “One hundred!” he announced cheerfully. “And dropping! Okay, guys, let’s transport!”

     The other paramedic didn’t let go of my hand. “You’re lucky we have one of the best field physicians in the Northwest with us today.”

     “Thanks,” I croaked. I had no idea what that meant, but I discovered later that all the major hospitals in the Portland area have this as part of their trauma training programs. He’s right. I was lucky.

     “No problem,” the doctor muttered absently. “Hey, I want you to see this,” he said to the paramedic holding my hand. He smiled down at me. “Sorry, Michelle. School’s in session.” He pointed to the strip of paper as the paramedic peered over his shoulder. “See that? Classic SVT. Those peaks can mean only one thing.” He glanced down at me again. “Michelle? Have you been having trouble with your mitral valve?”

     “Uh-huh,” I gasped. I could feel nothing now except utter relief and a bone-deep weariness. I wanted to fall asleep, right then and there. “Four years ago. Tried to beat it, get my degree and female surgeries . . . before . . .”

     “Uh-huh.” His face held nothing but compassion. For about three seconds, I wanted to put my face against his elegantly sculptured chest and bawl like a baby. “Well, plans have changed, young lady. It’s time.”

     They put me in a chair and carried me out. Apart from feeling utterly ridiculous and horribly embarrassed, I felt fine. I thought I could walk down those stairs, but I was recovering enough not to say that, considering how incredibly stupid it sounds in retrospect. I was so stupid with relief and temporary freedom from pain that I was ready to believe anything, including that.

     I’d called Marilyn, too, right before I called 911. I’d forgotten doing that. It’s another example of how disconnected I was and how fragmented parts of my mentality had become. She came in right on the heels of the paramedics and helped grab my purse and jacket when the time came to depart. She shut off all the lights and locked the door after they carried me down. Her friend and fellow Brody Players buddy Tamara was down in the parking lot with her and gave her a hug as I went by.

     “Hi, Tamara,” I croaked, I tried to wave, but managed only a finger. So much for walking down those stairs. Then I started to cry. I thought it was from humiliation at the time, but I know better, now.

     It was the beginning of the end for me, for that person I once was and can never be, ever again. I can never be that person who believed that her will could be forced upon a fixed, immutable Universe which has Laws, dang it, and if you cain’t abide by them laws, missy, you kin just plumb git outa town by sundown, hear?

     The sun was sinking as they took me away to the hospital, but that particular metaphor was lost on me at the time. I bless my incredible memory that allows me to recall these things and reconstruct them as best as I can. So far, I think I’m getting it right this time, gentle reader, so stick with me as we both find a bridge to the island. We can leave it later, but we must visit, you and I, and I hope you’ll forgive the pain of what’s to come.