Sweet Heart

Hello, friend. Thank you for joining me here.

In Minnesota, they say spring lasts two weeks tops. I always thought this was an exaggeration, but it turns out it’s really a statement of semantics. When you think of spring, what does it look like? OK, I’ll go : gentle rains, blooming trees, baby animals, and that particular shade of bright, life-saturated green…Sound about right? Spring is the start of growth, an awakening after hibernation, Beauty’s coming out party. All the new life of the season has such delicacy; the petals on an apple tree are a study in vulnerability. In a place where winter settles so deep, it is mind-bending to see the natural world do a 180. It felt, to me, like it took forever to get here, but once it arrived the changes multiplied exponentially on a daily basis. Indeed, we went from brown dirt to overgrown vegetation in two weeks flat. It isn’t that all of spring lasts a fortnight. It is that once she shows herself, Mother Nature goes on a bender. Life returns with abandon.

In preparation for spring, David has been working on the roof. We have people coming to install shingles on the porch addition soon, now that it’s warm enough, and he wanted to address the water issues before the roofers started. There was a weird bit of roofline over the Bilco basement doors, and we have had flooding down there in heavy storms. David decided that we will install half round gutters which should blend well with the decorative molding on the house. In order to prep for the new roof and the new gutters, he needed to remove the overhang of the current roof and add sub-fascia. This was not my favorite task he ever did. He would ask me to come outside, “just in case” he fell and no one could hear him scream. You know how you’re supposed to have the right tools for the job? Well, he had a straight ladder and a handheld power saw that were his whole strategy for cutting off the edge of the roof. He got up there and sat down, scooting along as he sliced. For someone who is herself afraid of heights, this was hard to watch. To his credit, it worked, and to my relief, he did not fall. It felt like forward movement on our long term goals to be ready for the new roof. Spring was bringing renewed energy to us all. 

Along with the blooming of our newly planted fruit trees, all sorts of surprises emerged on the farm in May. It turns out we have a bevy of Peonies, to my deep delight. We also have white, blush, and magenta Honeysuckle, Ornamental Plum, Primrose, Virginia Bluebells, Violets, and Lily of the Valley. An old tree, which we hadn’t known was an apple, errupted in perfect pink blossoms. At its base emerged a single, sweet Bleeding Heart plant, and I wondered to myself if the farm knew and echoed our politics. It started slowly, this abundance. Little shoots popped up here and there and we excitedly looked them up with the plant identifying app on my phone. It was thrilling, all that new life. One evening, David asked me to follow him outside for a minute. He walked me out to the edge of the Lilac thicket that boarders the road and, motioning for me to follow quietly, he entered the brush. A couple yards in, he stopped and I joined him—a little concerned about bugs (or worse). He pointed. There in a tiny circle among the leaves was a nest of baby bunnies. They were squirming together, their minky brown bodies so tender, the tips of their ears a transparent pink. David and I smiled so hard at each other, goofy with their sweetness. Less enchanting was the arrival of snakes, suddenly come out of brumation and ready to enjoy our farm as their own. Most are garter snakes: black with yellow stripes and utterly harmless. Bring them up to anyone who grew up on a farm and you will hear stories of “playing” with the snakes, accompanied by smiles and guilty laughter for surprising mothers with these little friends. I did not grow up on a farm, friend. I did not play with snakes, and I will not play with snakes, thank you very much. My compromise is to no longer scream when I see one—though much depends on exactly where they are in relation to my person. I am trying, is the point, to recognize that they do actually live here, too. That’s a big concession for me, you know. I never did like sharing. But, as David told me often when he was here, and I was still in NJ, this place is in the middle of nature. It’s wild. WE are the interlopers. I sort of scoffed at this from afar, but I see it now. Spring brings reminders that we are just one part of the much bigger world around us. It is the time of year when changes come whiplash fast, ready or not. And this Spring brought us something we never saw coming…

“I think we need to go to the hospital,” he said between heaves. I started packing a bag. I had this feeling that once he got there, they might make him stay. So I got his laptop and warm socks, his eye-mask and a magazine. We double checked that his insurance card was in his wallet, and I piled unread mail and a journal in my bag. When he felt like he wasn’t going to be sick anymore, we got in the car and I drove him to urgent care. I had towels, wipes and a Tupperware container he could throw up in if needed. Doctor Google said these were the choices: acid reflux, gallstones, cardiac arrest. Fun. We added to those our own guesses: food poisoning or vermiculite exposure. Equally delightful. For two days, following his roof work, David’s right shoulder had been achy, so much so that he couldn’t sleep comfortably if at all. With all the heavy work he did on the house and land, there followed many aches and pains, so this wasn’t terribly shocking. But now he was also on his second round of vomiting in 36 hours. What was so strange was that he did not feel nauseated, per se. He just felt like he “needed to throw up.” He also had weirdly loud belching, which he claimed relieved the other symptoms a bit. I had given him Tums the first go round and chalked it up to the McDonald’s drive thru he’d gotten after his Menards run for roof flashing. But there he was, the symptoms returning violently after having abated during the day in between bouts. 

We arrived at Urgent Care and gave David’s history to two nurses. To be safe, they ordered an EKG, but mostly they discussed acid reflux. We waited. At last, the doctor came in and asked what was going on. She said that the EKG was normal and that she’d read in the notes that he was complaining of gastrointestinal issues. He started at the beginning: shoulder pain, vomiting, burping, unable to sleep. She latched on to the pain part; where exactly was it, what was the quality of the pain, did it come and go? He responded: right shoulder and arm, achy, constant except for some improvement after vomiting. Then she asked if he had any feelings of heartburn and he said no. As he answered each question, her face clouded more deeply. She seemed kind of irritated. She said, “This is very different than what I heard from the nurses.” She listened to his heart. She listened to his lungs. She was not happy. She said, “You need to go to the Emergency Room. Right now. Do you know where it is?” And to me, “Are you driving him?” I said yes. She seemed to be rushing us. She said she could not be sure, but she believed this was heart related and she had none of the tests David needed next at the clinic. She said the ER had everything and only there could we figure this out. She said she’d call ahead and tell them we were coming.

It was strange to park in the “Reserved for Emergency” spots at the hospital. I mean, no one was bleeding out. It was all so odd. We checked in, answered our COVID screening questions and waited for someone to bring us back. In the exam room, there was a cheery tornado of activity. Again, two nurses worked together to take David’s history, but they also hooked him up to every type of monitor, IV and apparatus available. It was so fast and so friendly that I didn’t even realize the sum total of their work until later. We reported that we’d had a clear EKG already in Urgent Care and they called off the one they had already ordered. However, minutes later, after watching his vitals and hearing his symptoms, the EKG tech showed up anyway. She was the epitome of a Midwest Grandma. The word ‘kindly’ comes to mind. She stayed a while, chatting comfortably about gardening and kids. I am not sure if she talked this way in order to calm patients as their heartbeats were measured, or if she actually cared about these topics, but I call still recall her warm, crinkly-eyed smile. Finally, the on-call doctor came in. She actually sort of tripped as she sat on her rolling stool and noticed me noticing. We shared awkward half-smiles. She seemed equally klutzy at other times during the exam, and I felt vaguely as if the whole thing might secretly be a Saturday Night Live sketch. Even her face screwed up in exaggerated, comedienne furrows at David’s symptoms—and lack thereof. The photo on her name tag was quite glamorous, an image that seemed wholly unrelated to our masked and zany doc. She was stumped. She ordered a series of tests to rule things out. I guess that’s a useful way to find out medical answers: determine what it’s not. I can’t even recall now what all the test were, but I do remember one for blood clots and one for the heart. Apparently, there is an enzyme that is released if anything is wrong with your heart. If your levels are elevated, you have had a heart event of some kind. It is quite accurate. I think she also ordered a chest X-ray. It got a little blurry because I was distracted by the fact that I had to go soon to pick up our six year old from Kindergarten, even though I did not want to leave David. The doctor said they should have results back in an hour, so I should pick up Finley and come back. We were left alone for a minute as all the tests were prepped. I gave David his laptop, and tucked in his feet. He looked tanned, and tall, and a little silly in the patterned blue hospital gown. I left to get our child.

I hadn’t eaten yet, and it was now 2:15 PM. I stopped at a corner store near the hospital to grab something for each of us. I rushed through the aisles, grabbing I don’t even know what. Can you buy answers? I got cold waters, some oily pasta salad, and an ice cream sandwich. I made it to the school pick-up line and tried to focus on what to tell our girl. She got in, all smiles and six-year-old energy. I handed her the ice cream. Then, as we drove back to the ER, I told her that Daddy was at the doctor, and we were going to see him. I’m not sure if I said much else, just like I’m not sure how I drove from one place to the other. We did get there, but I was only partly present—my mind sort of checked out in order to keep going. As we entered his room, I saw the whole picture in a new way through our child’s eyes and realized that maybe I should have explained more. Her dad was hooked up to a lot of devices and somehow that dang blue gown made him appear unprotected—something about how it exposed his neck, I think. He gave her a big smile under his surgical mask and held out his arms for a hug. She went, but it was awkward with her height and the bed rails. I got her settled on my lap in the one plastic chair in the corner just as the doctor returned.

“You’re interesting,” she proclaimed with a wry smile, as if he’d just earned her respect in an unexpected show of complexity. She began to verbally sift through the test results thus far, commending him on his two perfect EKGs, his clear chest X-ray, and his no-show on the clot front. We nodded along with each piece of good news. Then she raised one eyebrow as she got to the point. “Your troponin was elevated, though, so something is going on there,” she said finally. Talk about burying the lead. Troponin was that telltale enzyme, the one that doesn’t lie. That elevation meant David had something wrong with his heart, despite all evidence to the contrary. By this point, Finley was squirming, asking when we could go home. Frankly, I was wondering the same. I was thinking we’d get medicine and an appointment with a specialist and be on our way. I was wrong. The doctor started explaining that there is not a Cath Lab, nor a Cardiology department at Lakeview Hospital where we were, but that David needed to go to Regions Hospital in Saint Paul. Like the Urgent Care physician before her, the ER doc pointed out that in the Emergency Room they did not have the tests he would need next. I was still thinking we’d go home and then follow up with the folks at Regions in the coming days. Finally, after an apologetic explanation of all the procedures she lacked on premises that might explain what was going on, she said he’d be transferred. That word stuck out. Transferred? I asked, “Do you mean his case gets transferred over there and we call them next?” She leveled me with a look under drawn brows, “No, we will transfer him now.” Oh, wait…transfer, like transport…like ambulance…She back-stepped a little and told us that once a patient shows an elevated troponin level, they can only be cleared by a Cardiologist. And since there were no Cardiologists there…the penny dropped. They could not let him go anywhere but to Regions. I asked if I could take him, and to her credit, she kept a straight face. “No.” It was the clearest, least funny she’d been. Throughout all of this, she kept looking at me. She went over all these results and explanations about David’s health while mostly staring into my eyes. It was unsettling. I had to look down sometimes, maybe to attempt to shake off the intensity. Even though she was still a bit kooky and her beat-around-the-bush style might have lead one to believe she was sort of unfocused, there was now something unspoken that she seemed to be trying to tell specifically to me. I did not understand. I asked when he would be “transferred,” and she said, “Within the next hour.” Oh. OK. That fast. That meant…She held my gaze as all that she had said started to sink in.

Once we were left alone for a moment, David and I looked at each other. Neither of us quite knew what to say or do. It turned out that Regions does not allow children to visit patients. We agreed that I needed to get Finley home and fed and that he would let me know ASAP when he’d arrived at Regions. Once he got there and was seen, we’d know more, and we’d figure out the next steps. It was awful to walk out of that room. I held Finley’s hand, but I kept turning back to look at him, wanting to do something, anything, to help. He was as relaxed as a person who has just been told he has a mysterious heart problem could be—or at least, that is how he appeared. I’m not sure what I would have done if he’d looked scared. He knew that. So, he did not. 

At home, I gave our girl dinner and got her to bed. I think I ate leftovers, and I know I had some Bourbon. David sent me his room number and said they might do more tests that night. It was 9 PM at that point, and I couldn’t imagine how anyone would have good test results so late at night after two days of little sleep. He also said that they told him it did not look like he had a heart problem, but that they needed to be sure. They would repeat the troponin test every few hours. We sent “I love yous,” and finally we both had to rest, but I left my phone on to hear any news. 

At 6 AM, I heard from David that they had bathed and dressed him in preparation for possible procedures. A little later, we spoke by phone and he said that the cardiology team had met about his case and decided they were going to proceed with an angiogram. I quickly googled that. An angiogram is where they inject dye through your groin or wrist into your vein and take a picture of your heart to see it the dye runs through it smoothly. It is considered low risk, and the patient is awake but lightly sedated. If there is blockage in any of the arteries that feed the heart, it will show up in this test. If that is what they discover, they can also do an angioplasty (which is basically the placement of a tiny balloon), and a put in a stent (which is a piece of mesh that holds everything in place), both through the same incision right then and there to immediately open the blockage. They were not sure if they would find anything since David had only one indicator, but they had to look. I took over the task of updating family members via various text threads. He sent a last message telling me they were heading down and saying he loved me. I told him I loved him most. And then, I held my breath.

Meanwhile, after her breakfast, I had let Finley watch Doc McStuffins in the parlor. She never gets TV before lunch, so this was a big deal. I could hear her, singing along with the theme song: “Do Do Do, You know it’s good for you, The doc is gonna help you feel better!” It was raining outside. It occurred to me that I hadn’t checked the basement for water. A few months before we had had some particularly bad flooding during one intense storm. David and I had worked furiously with two shop vacs to keep up, and even so, the water reached every corner. After that, David had hung a huge green tarp over the basement doors, set at an angle to get the run-off from the roof to slide away from the house. We knew that in addition the imminent roof work, we needed to re-grade the land and rebuild the foundation around the doors, but we had so much on our plates that it had to wait. The tarp, though exceedingly unattractive, had actually served us pretty well until David had removed it recently to prep the roof for the roofers. In fact, he’d been planning yesterday to rig something new for this very predicted weather front. As the sound of raindrops rose to compete with Doc McStuffins, I headed to the basement. As soon as I opened the door and looked down the stairs, all I saw was water. Damnit. I ran for my rubber boots on the porch and descended into the wet. Thankfully, one of the shop vacs was still right near the water’s entry point. I flipped it on and went to work. The powerful suction cleared things pretty quickly, and I thought my work was done, at least for a little while. However, things took a turn. All of a sudden, water was gushing in, as if a dam had been breeched somewhere above. There was no way I could keep up from below, so I threw on my rain jacket and hood, even though it was 80 degrees, and ran outside to inspect the situation. There was a huge, almost pond-sized puddle gathering beside the house, partially submerging the edge of the doors. No wonder the basement was flooding. I ran to the pumphouse and scrambled for a minnow bucket to bail out the doors. It was sticky hot, and pouring, and my rain hood stuck to my cheeks. Over and over I scooped water and heaved it aside. My aim was far from perfect. I was sweating. Steady streams of water were careening off the ripped off edge of the roofline above me. I remembered how David had been up on that roof just two days before. I added buckets underneath to catch the heaviest runoff. For a while it seemed I was making no progress at all because the rain was coming down so fast and so hard. The whole world felt relentless where I stood. David was in a hospital alone as his doctors searched for answers while I heaved buckets of water into the mud with rain falling on my face like tears, and Finley was watching a little girl fix broken toys with magic. Our little family at the center of a storm. 

At last, the clouds cleared; the rain slowed and my phone rang. It was the doctor. I ran up to our bedroom which has the clearest cell signal in the house. The doctor said, “I wanted to let you know that we just finished the procedure and everything went well. David did great and he is resting now.” I let out my breath. He continued, “When we looked at his heart, we found that the right and left arteries were fairly average for someone his age. However, the central artery had a 90 to 95% blockage.” I’m sorry, what??? I think I said, “Oh, my goodness!” He said, “Yeah. We were able to perform an angioplasty and put in a stent, and he should be fine now.” Wow. I sputtered, “Thank you…I’m…I’m just so grateful to you…and I’m also so, so shocked. A 95% blockage? That’s…that’s crazy…” He agreed, “Yes, it was a surprise and definitely not what we thought we’d find based on your husband’s symptoms. This was the real deal.” The real deal. That stopped me cold. I knew what he meant. David could have died at any moment from a blockage like that. If one step in the path to that stent had taken a little longer, or if any one of the doctors he saw hadn’t sent us to the next one, David might not be alive. He went on, “The good news is that the central artery in particular responds well to a stent, and your husband should recover well.” I thanked him again, shaking my head and staring into space. Then I said, “May I ask, how does a blockage that bad even happen? Is it gradual?” He replied, “Well, we don’t know for sure, but he should not have been able to walk around or function normally with a blockage that severe. So, I think it increased recently. Maybe he had a normal amount of blockage there, say 20-30% and then he had some kind of triggering event that caused a rupture or tear and that is when his symptoms started.” That made sense. All I could think of was David’s battle with the buckthorn and knot weed on our land, along with his roof work; I wondered if there was a single moment that pushed him too far? Goodness knows our renovations have been stressful, both psychologically and physically, but because David had been doing the same kind of heavy house work for over a year, the doctors did not think it was that. The doctor continued with what the next steps would be, most importantly a new regime of medication and instructions for David to avoid heavy lifting for one full week. I promised to enforce both and we hung up. I sat for a few minutes there on the floor, leaning against the end of our bed. At last, I cried. It all came out, the terror and the relief, in torrents like the rain. Finally, I went down to Finley and told her the doctors had fixed Daddy’s heart and he was going to be all better. I texted family to update them. I wanted to shout from the top of our unfinished rooftop: THANK YOU!!! I smiled recklessly for quite a while. 

The next morning, the day David came home, I awoke to more surprises. In the gardens, dozens of new plants had shot up overnight. The deep rains had wooed an entirely new crop of flowers and plants. Where there had been a pleasant, steady stream of spring growth, there was now a veritable jungle. Plants that had been a few inches had grown to knee high. Plants I’d never seen looked mature and established. That rainstorm had fast forwarded the season, and the whole landscape looked different. I went outside to check the tall buckets I had left to catch roof run-off. Both were spilling over. Happily, the little lake at the base of the doors was about where I’d left it, just shy of the threshold. I began to head inside when something caught my eye. Just past the spot where I’d thrown the buckets of water as I bailed out the basement, I noticed a new development. By the old apple tree, where there had only been one, there were now dozens and dozens of Bleeding Hearts. My hand flew to my mouth as I half gasped, half laughed aloud. Bleeding. Hearts. I knelt in front of the patch where they’d bloomed, and let my finger trace one of the perfect, heart-shaped blossoms. It swayed like a tiny bell, crystalline droplets shivering off the blooms in the morning light. I don’t believe in God really. I don’t think there’s a guy with a beard in the sky who runs the show. But, as I stood amidst those delicate heart flowers that had errupted overnight after my husband’s heart was mended, I believed in something. I always felt this place had magic, from the first day we visited here. Making the house our own and fixing it where it was broken has been hard. Maybe so hard that it gave David a heart attack. But now he was ok. And the farm filled herself with hearts for him. We are part of this place now, and it is a part of us. We are of each other and for each other, this land and us. I believe in that. In the very spot where I fought back the rising water of the storm and the rising panic of what would happen to David, the farm answered with love.

The night before his procedure, when David had just been transferred to the hospital and I was home alone with Finley, I was on exhausted autopilot. Everything sort of blended together into a sea of numbed-out anxiety. However, I do remember one thing clearly. There have been moments in the past year—a year that has included a pandemic, a long-distance move, endless and ongoing renovations, mouse infestations, and distance learning—that have truly tested our marriage. Handling the lack of a bathroom and a kitchen in particular have made me feel crazy at times. David and I do a lot of things differently. There have been moments when I’ve been stressed and angry that I’ve thought it would be easier to do all this alone, because then it could all be done my way. I’m not proud to admit that. Dark moments can bring dark thoughts. But, as I climbed the stairs of this old house on that night they moved him to the hospital alone, I had only one thought: without him, this whole dream we dreamed of a new life here would mean nothing. He is the dream. His tremendous heart beats out the bass line of our life. He is a man who works so hard he breaks himself. Granted, he needs to dial back on that going forward, but that is who he is. 

Today is David’s birthday. He is alive and well, thanks to some incredible doctors and nurses, and the miracles of modern medicine. He did not look or act like someone having cardiac arrest. He had no common symptoms. He could have died quite easily if the doctors we saw were less curious, less devoted to solving his case. It all happened so fast. That’s the thing about life and death, the difference between the two is less than a moment. The world can seem slow for a long time, and then suddenly it will take your breath away with its lightening speed. Spring does come fast in this part of the world. Flowers can emerge full-grown overnight, as if the fairies waved their wands and “poof,” the world was new. It takes a millisecond to meet the eyes of your lifetime love for the first time, and another millisecond for those eyes to close forever. When things happen that remind you of this, this fact of how fleeting our world really is and how fast it can change, it is a blessing. In one second of clarity you can know for certain what matters most. 

The heart of the matter is a matter of the heart.