Chapter 5: Chapter Chapter IV

After all the morning’s excitement, I made it to the front desk.

“Hello, Mr. Stanford, what an unexpected surprise. Got someone on the chopping block today?”

Not humored, I told the receptionist Dr. Stewart had called ahead. She shuffled through some papers.

“I don’t see anything. Do you know who he talked to?”

“Gee whiz, Sara Ann, I’m not too sure. I wasn’t around when he made reservations.”

“What’s the problem, Tony? I hope you’re not sick. We have a crowd, and you might have to wait like the regular folk.”

On a side note, if you ever want to move to the head of the line, say these words at the emergency room: I have chest pain.

A nurse was summoned and came with a wheelchair.

“Hop on, Tony.”

“I can make it on my own.”

The polite request turned ugly.

“Sit in the damn chair, Tony, and shut up!”

Just like the character in ‘One Flew Over the Cuckoo’s’, , better known as Sarg around here, wheeled me back to one of the examination rooms. She started the standard procedures when they presume you’re having a heart attack or about to. After the ER doc reviewed the results of a few tests and blood work, he told me I hadn’t had a heart attack—yet. However, a debate ensued with my cardiologist and his junior partner over whether . I would have loved to have been a fly on the wall during that conversation, but both agreed further testing needed to be done. The ER doc urged me to stay the night for observation, and at the request of my cardiologist, do a few more tests in the morning. With some hesitation on my part, I agreed. They did another blood draw and kept me in the exam room while I waited for the results.

I grabbed a nurse and asked her who the guy was they just brought in. She told me she wasn’t sure, but said they were still working on him in the ER.

By now, it is late afternoon, and after hours of fidgeting and waiting, they moved me to a regular patient room. Bev had been in the lobby for most of the time and was finally allowed to see me. When she came into the room, I could tell she was upset.

I grinned at her from the armchair where I was watching TV. Why choose a bed that felt like a slab of stone when you could sit in a creaky armchair instead?

To try and calm her, I pointed to my tray and said, “I saved you my ice cream.”

“Thanks.”

She gave me a peck on the forehead, then swiped my ice cream.

“Are you OK?” she asked.

“Besides the Nazi nursing staff and my tray of gruel, I’m hunky-dory.”

The only decent thing on the plate had been my ice cream, and unfortunately, Bev took me up on my offer.

Bev removed the wrapper, and using a flat, wooden paddle deal, she starts chomping down on what used to be my frozen dessert.

Between bites, she says, “So far everything is still ticking. I talked to the doctor, and the good news is they don’t think you had a heart attack.”

“That is good news.”

Then, a bit aghast, I ask, “What do you mean, ?”

With a mouthful of ice cream, she is barely able to mutter, “Sorry. They said you

have a heart attack.”

Relieved by the sudden correction, I said, “Bev I wish you would improve on those communication skills of yours. There is a big difference between and “I’ll work on it.”

She went back to mauling the last few bites.

“The doctor says it may be stress. The tests in the morning will tell him more.”

Changing the subject, I asked, “How are the kids?”

“They’re all right. The boys are concerned about you, especially Jake. You know what a worrywart he is.”

“I’ll call them later and let them know everything is alright.”

She gobbled down the last bite, licked the spoon clean and tossed the empty cup onto the tray, followed by the wooden spoon which landed in the cup.

“Nice shot. The EMTs brought in some guy the same time I got here. They were in such a rush I didn’t get a close look. I swear I’ve seen him. I just couldn’t make out who he was.”

I’ve got enough on my mind, and Bev had been reluctant to break the news to me.

“Tony, it was Clark. He had a massive heart attack.”

Bev put her hand on mine and said he didn’t make it. I turned my head away from her and gazed out the window. An already cloudy day turned to rain. Clark had been a friend and colleague for many years. I became his partner not long after I graduated law school. A few years later, we went our separate ways. Clark quit the practice and gave it to me. He wanted to do volunteer work at our community legal aid office. He resigned from volunteering a little over a year ago to retire for good and do some traveling. I’ve been with Bev for a long time, and I know how she thinks. In her mind, she is comparing Clark’s plight to mine. The clue was when I noticed a tear flowing down her face after she told me about him. She wiped it away, hoping I didn’t notice. I reached over for her hand and looked into her eyes.

“I am going to be OK, Bev. There’s no need to worry yourself.”

My words were of little comfort. She hugged my neck so hard it felt like she was going to cut off the blood supply to my brain. Moments later, one of the entered the room to announce visitation hours were over.

We said our goodbyes, followed by another chokehold, and she whispered, “I’ll see you in the morning, and you’re right, everything is going to be OK.”

Bev tried to sound convincing, but her grip around my neck told me otherwise. Another little peck, this time on the cheek, then she left the room.

I’m not a big crier, but I did. I spent a while thinking about Clark, and how his poor wife gets to deal with all the “what-if’s,” except this time, they have turned into the “what now’s”?

At forty-one, I didn’t consider myself old enough to be a grumpy old man. Evidently, I’d already been tagged with being “that patient.” I didn’t like hospitals, and what’s worse was spending the night in one. All the smells of antiseptic cleaner in the air, moaning patients, and to top it off—that crap they called a meal. It’s enough to make you sick! I know these people had a job to do, but it didn’t mean I had to like it, and apparently it showed.

The cardiologist came to see me and begged me to stop tormenting his staff; then offered me a cigarette. I made the best of the rest of the evening. For the first time in recent memory, I got through an entire episode of without interruption. My nurse came into the room and told me it was bedtime. She also informed me the doctor wanted me to take a tablet after breakfast. He wanted me relaxed before the morning’s festivities. That’s fantastic! I have to get stoned before I got on a treadmill! The thought of an impending lawsuit entered my mind.

The next day arrived without any complications. If it weren’t for the intrusions every thirty minutes or so to take my vital signs, I might have slept through the entire night. The one vital sign they didn’t seem to care about was sleep-deprivation. In spite of the constant interruptions, I survived, and everything was still OK. So the day is off to a pleasant start except for my morning pile of garbage they called breakfast. My testing schedule was given to me, which they called “procedures.” First on the list, a treadmill procedure followed with a stress echocardiogram. Next in the lineup, a chest x-ray. And to round off this plethora of procedures, another invasive blood draw, only this time, I pleaded with them to leave me a little. I know I had an attitude—Bev reminded me all the time—but I hated this stuff! In my opinion, I was making the doctors rich and helping with the hospital’s bottom line. Wait a minute, I’m on the payroll and starting to sound like a real patient.

What made matters worse, all my procedures turned out great, and it was confirmed I have a heart attack. There was not a single detectable problem. I was fit as a fiddle, however, they were still studying the results of the echocardiogram. Cheapo me, compares going to the hospital is like going to an all-you-can-eat buffet. You have to load up at least a couple of plates of food so you think you got your money’s worth. Same thing applies here. I would have felt better if at least they’d found a wart! So it would appear this whole day and a half was shot all to hell and a big waste of time and cash. After this is over with, I’m launching an investigation.

But wait! They’re not done with me yet. Evidently, the echocardiogram did raise a few eyebrows. So it seems maybe I might get my money’s worth after all. The cardiologist told me to be sure as a result of the , he wanted to order a heart cath. This was the worst! It’s a relatively painless procedure, but daunting. They make an incision in your groin area, then run a catheter all the way up until the thing bumps into your heart. Then they inject some dye to light up all the little vessels and other things.

The nurse shot me up with what she called After she injected me, I was enough to ask for seconds. The drug didn’t take long for its effect. An aide helped “pour” me on the gurney and hauled me off to the Cath lab. The cardiologist was new at the hospital, and Bev hadn’t had the opportunity to meet him. She approached him in the cardio unit of the hospital. He remained seated in his chair, fine-tuning the monitor after he inserted the catheter and did another injection. No happy juice this time; medical dye.

Bev introduced herself and extended her hand.

“Hi, I’m Bev Stanford.”

He clutched hers, and in a thick Indian accent, said, “Nice to meet you. I’m Dr. Mukopadhyay, but everyone calls me Al.”

Impulsively she said, “No shit!”

“Excuse me?”

She was quick to rebound with, “I said, nice shirt.”

He went back to doing his job. I was knocked out, and Bev remained nearby; we were only separated by observation glass. I was on a gurney about ten feet away in the adjoining room when the cardiologist jumped to his feet.

“Thar she blows!”

Likely not a common expression in India, she thought. Dr. Al was as giddy as a schoolgirl. He grabbed her arm and jolted her to his side and said he found the problem. You would have thought he’d just won a car!

Bev didn’t know if she was supposed to be giddy as well or concerned.

“What is it, Dr. Al?”

“Check out the monitor, Bev.”

Using a pen as a pointer, he went over the images with her.

“You see the spaghetti-looking thingy next to that little flappy deal?”

She turned to him and gave him “that look.” His choice of medical lingo was questionable; however, it communicated.

“Bev, the bottom line is, Tony has two clogged arteries. One I’d say eighty percent,” — squinting his eyes, he studied the monitor a little closer — “the other, I’m guessing around ninety to ninety-five.”

Dr. Al points again with the pen and says, “That is the left anterior descending (LAD) coronary artery of the heart.”

With a concerned look, turned to her and said, “We call it the ”

Bev lowered her head as Dr. Al cuddled her arm.

“Bev, we’ve come a long way with this sort of thing, and Dr. Chopra is the best around.”

Cutter? So it’s down to this, she thinks in her head. Bev had been around the hospital for many years as a volunteer and served on several committees, and by osmosis, she learned enough to know this wasn’t great news.

“Dr. Al, I don’t understand. He doesn’t smoke and only has an occasional drink, and we eat reasonably healthy. Tony’s no Olympian, but he’s not a couch potato either.”

He responds, “I’ve seen his history, and all I can say, it is most likely genetic. It happens.”

Still under sedation, they rolled me into my room. When I regained consciousness, Bev was there waiting. As best I could, attempted to sit up. I struggled for a moment and gave up.

Still groggy, I asked, “Well, did I get an ‘A’?”

She didn’t say a word, and held back her emotions.

“What’s wrong, Bev? I’m still alive. That’s a good thing, isn’t it?”

I heard a couple of knocks at the door, then, this short, tiny little guy wearing surgical scrubs walked in. I immediately recognized him: it was Dr. Chopra, chief of thoracic surgery. A thoracic surgeon operates on everything in the chest area, including the heart. The best thing about Dr. Chopra, I could pronounce his name. The bad thing, I’m sure he didn’t stop by to say ‘hi.’

He approached me, said hello to Bev, and in a slow, stoic, and somewhat condescending tone begins the conversation.

“Well, Tony my boy, we have a problem.”

That’s the amusing part, “we” have a problem, as if “we” are going to equally share in whatever firestorm piece of information he is about to pass along.

Bev hadn’t told me a thing, so as expected, I was a little shocked at the news.

“OK, Doctor, what is problem?”

Dr. Chopra has been in the country long enough to detect sarcasm.

“Well, smart-ass,“—we’ve been friends for a while, so he can call me a smart-ass. “The problem,”—then pointing to me— “that have, in layman’s terms, is coronary artery disease.”

“I think I know what that sounds like, but would you be more specific?”

Now came the boring part. I wish I’d never asked.

As though he had a speech memorized, and in a single breath, here it came.

“Tony, it’s the narrowing or blockage of the coronary arteries caused by atherosclerosis, which is the buildup of fatty deposits and inflammatory cells called plaque on the inner walls of the arteries and restricts blood flow to the heart.”

He paused, took another long breath and continued.

“Without adequate blood flow, the heart becomes starved of oxygen and vital nutrients needed to work properly. And if we don’t do something soon, to put it bluntly, Bev can start dating again and gets to add a few zeros to her bank account.”

“Don’t hold back, Doc, give it to me straight.”

Then I asked, “So what’s the Again Dr. Chopra had no problem detecting the continued sarcasm and fired back with, “We’re going to open you up like a Christmas turkey and fix that mess!”

The skeptic in me always smells a rat. I knew this was an expensive operation and voiced my thoughts.

“So, Dr. Chopra, you got another kid off to college or do you need a new car?”

“Why, you’re right, Tony, and this little operation will pay for his first year at Duke. The last guy paid for my Cadillac. I appreciate the business—smart-ass.”

“No problem, Doc.”

I’ve never seen his serious side until now.

“I know we joke around, but Tony, this is no joke. Without the operation, you’ve got about three of four days.”

By sheer will and determination, I sat up. “For what?”

He just stared at me. I knew what he meant without him saying a word and fell back on the pillow.

Dr. Chopra tapped me on the leg.

“Don’t worry about it Tony, we’re going to fix you up.”

It was obvious he was having a slower day than normal and sat down on a guest chair next to Bev. She was given the run down earlier and had already dealt with the news of my scheduled surgery. She ignored the conversation and continued to read . Dr. Chopra reached for a copy of and started flipping its pages. Not reading a thing, he started talking again, and I pretended to pay attention. Still recovering from the drug, I nodded off. He slammed the magazine on the table and didn’t seem to care about waking me.

“You know what the worst part about my job is?”

My brief nap interrupted I asked, “What?”

“I’ve got one shot, if I’m lucky, at getting it right during surgery. And if I don’t, it’s off to the dirt farm!”

Dr. Chopra continued, only this time he was pissed!

“And what do most of these idiots do when I have performed such delicate work of artistic surgical genius?”

Not wanting to be, but now awake and sitting up, I said, “Not a clue.”

“They end up doing the same crap that got them here in the first place! When they leave the hospital, they go back to eating junk, not exercising and pick up a carton of on the way home! And you know what really stinks?”

“I haven’t the foggiest.”

Now I reached over and grabbed a magazine, and like him, flipped through the pages, still pretending to listen.

“Most of those dumb SOB’s don’t get a second chance— they just drop dead! Very frustrating.”

Dr. Chopra continued with his tirade.

“And when they do, here’s the depressing part. You know how much money I make when they bring in a dead guy who dropped like a fly because of a heart attack?”

“I don’t know, and it’s none of my business. How much?”

“Fifty measly bucks! And that’s only because I was lucky enough to be around to check for a pulse and pronounce him dead.”

Dr. Chopra settles down a bit and says, “My apologies, I’m being selfish. I should be thankful and take whatever bone they throw at me. But I don’t do car wrecks or anything else bloody. Too icky for me.”

Dr. Chopra reached for another magazine and flips through it as well, much the same as the last. Bev took a cue from me earlier and pretended to nod off.

“You know who has it made in the shade?”

“I give up, who?” I said, still flipping pages.

“Those oncology guys. They can hang on to a patient for months, sometimes years racking up cash the whole damn time and straight to the bank! Me? If your sorry ass drops dead, my income goes to zero!”

He continues thumbing through the pages then shakes his head.

“You heart patients are so unpredictable.”

“Very compassionate, Dr. Chopra.”

“We don’t have the luxury of stringing you along. Those oncology bastards can milk it forever, well at least for a long time. Most of the time, they can predict how long you got left. They get so close you could set your watch. Me, I’m screwed!”

Dr. Chopra tossed the magazine back on the table.

“Tony, I better move along and check on the , I mean make rounds.”

Dr. Chopra is from and educated in India like his colleague, Dr. Al, and received his advanced training in the United States. He is the only one I have ever met who converted from Hinduism to Judaism. I overheard him say to a new resident physician the Synagogue was a better networking opportunity and he should check it out. Before Dr. Chopra converted, he researched the heart attack rates between Jews and Hindus. Jews won hands down. To him, the Synagogue was a gold mine.

As Dr. Chopra left the room, he stuck his head back in and said, “I suppose you heard about Old Man Steinberg.”

“Yeah, I’ve been working on the case. Something about him owing the hospital a chunk of change.”

This time and uninvited, Dr. Chopra came back into my room and returned to my bedside with both hands clenched and shaking at his side.

“You damn right, a chunk of change! Most of it is supposed to go in my pocket, and the family stiffed me!”

As mournfully as I could, said, “If you recall, he did die.”

An agitated Dr. Chopra, with less clenching, raised both arms in the air in frustration.

“What’s your point? I did my part. You think your heart is a mess, — Steinberg’s looked like his was run through a meat grinder! The Steinberg’s should be thankful I gave him enough time to straighten some things out!”

He punched me on my arm then whispered, “And he had a lot of straightening out to do.”

Back to his griping, he finished with, “And that’s the thanks I get? The infamous Steinberg screwing!”

“Like I said, your compassion is overwhelming.”

“Hey, I’m a nice guy, I just want to be paid. You have a warranty on your car, not for my services.”

“I’ll take note and make sure you get your money, whether I make it or not.”

“Tony, I like you. You’re a man of your word and know how to take care of business. I’ll see you in the morning. Try to rest. You’re going to need it! Shalom.”

I shouldn’t have been nervous about him doing the surgery, he’s the best, but there is something a little discomforting having Dr. Chopra in charge of my fate. The reason I say this, only a few know of the secret little plaque hanging in his office, and I’m one of them.

and in small print, At the bottom of the plaque; a smiley face.

Bev raised her head a little from her fake nap and squinted through one eye.

“Is he gone?”

After I had announced the “all clear,” she came over to my bedside. She grabbed my hand and told me to take his advice and get some rest.

“I’ll see you before surgery.”

This time, she kissed me right on the mouth. I hated the thought my last memory of Bev was that she needed a .

The operation was scheduled for Thursday morning, and everything went without any problems, although it took a little longer than expected. Dr. Chopra wasn’t kidding when he commented about opening me up like a Christmas turkey. Rather than using veins from my leg, which is standard procedure, he used mammary vessels for the graft because of my age, thus having to “open me up” a little more. He said with younger patients, those veins were more durable and had less “wear and tear.” That was of little comfort; they sounded more like used car parts. Dr. Chopra told me it was worth the extra time and effort. Knowing him like I do, you can bet it also fattened his bank account a few more bucks.

When I woke up in the recovery room, the first thing I asked the nurse was, “Did Shorty use a stepladder or did he jump up and down?”

Not humored, she ran a catheter up my manliness.

After three days of recovery at Saint Grenadine’s, they decided to release me, and I did not want to stick around a second longer. I was already dressed and ready to go. I signed all the discharge papers, then waited for an aide to help load my belongings onto a cart and wheel me out of this hellhole. While waiting, I looked at some cards from well-wishers. One of them was especially touching. It was from the administrator I had to fire. It was a beautiful Hallmark card.

I read the printed inscription:

Underneath it, a handwritten message:

I laid it down with the rest of the pile. I checked my watch’s second hand spinning around and planned my escape if someone didn’t show up soon, and that time has now passed. I had the cart in the room, but no aide, so I took matters into my own. I loaded up my stuff and headed for the door.

Bev met me outside at the patient loading zone and was not amused.

“You had surgery three days ago, your moron! Why didn’t you wait for someone to help?”

“Because they were late, and I’m in a hurry.”

I tossed everything in the backseat, then hobbled to the passenger side and shouted, “Let’s make a run for it! Hit the gas!”

I spent the next several weeks resting and recovering at home. About the fourth week in, I was almost back to normal. I returned to work only to find mounds of paperwork overflowing on my desk. The first order of business, fire my secretary; the second, hire a new one.

As time went by, I felt great! I’d gone to see “Shorty” for a few postoperative visits and was given the all-clear. Teasing him, I asked what the “warranty” was for my operation. After all, nowadays a bypass operation is as routine as a tonsillectomy was fifty years ago. Dr. Chopra said the grafts should last a long time if I took care of myself, and with the right diet and exercise, I’d be around for a while. Sounded like a commercial to me.

Fast-forward two and a half years, which gets us pretty much current. I was out playing with my kids in our backyard when it hit me. Everything started spinning, followed with severe light-headedness. My neck tightened up so much, I thought it was going to pinch off my head! The pain in my neck was quickly redirected when it felt like someone just hit me in the chest with a baseball bat. On my way to the ground, I yelled at the kids to get their mother. I clutched my chest and collapsed right where I stood. As I mentioned earlier, they rushed me to the ER by ambulance. If not for the fact they were in a hurry to save me, I’d sue them for reckless endangerment, on the other hand, I still might. As it turns out, I might not have the chance. This is the part where we pick up on the On the trip to the hospital, I heard a beep coming from my phone. It was still tucked away in my shirt pocket. I regained a bit of consciousness and reached for it. With hardly any strength left, I managed to flip it open:

Seemed like an unusual message, and at the end of it there was no name, simply, . After reading it, I blanked out, but it got worse.

Let me recap up to this point: I’m dead.