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.