TL;DR: I’m much better and enormously grateful.

As many of you know by now, I suffered a sudden cardiac arrest this summer. It’s been about five months since I was first discharged from the hospital after the “incident,” as I’ve elected to call it. Some survivors, I’m told, refer to such things as an “accident.” But my mother used to tell me accidents could be prevented—that’s what she said, at least, whenever I’d use the word as an excuse for something foolish—and nothing the doctors have said so far would indicate there’s much I could have done to prevent this. At any rate, “incident” is somewhat less cumbersome than “sudden cardiac arrest,” and, like accident, it still captures that felicitous sense of falling in its Latin root.

I have no memory of the incident, neither the fall itself nor the events of that morning. The last thing I remember is watching a movie the night before: the literally abysmal summer blockbuster 2012, if you must know. Since then, I’ve been able to piece together some of what happened from Pilar and my parents—as it happens, they and my brother had just arrived in Durham the previous day—but it’s all secondhand. Those moments are now theirs to bear and share as they choose. My memories resume, piecemeal, in the hospital. I remember a nurse asking if I knew where I was; I remember her telling me where I was. “Your wife saved you,” she added. The same has been true of every day since.

During that first stay at Duke Hospital, the doctors ordered a number of tests to determine the structural integrity of my heart. They found no underlying problems that might have caused such an “event,” as they call it. This was—and remains—good news. However much I’ve secretly come to resent hearing my doctors say I’m a “healthy young man,” it is nonetheless true that my body bears no signs of a pre-existing condition more serious than the “sudden death” my medical chart now lists under current health issues. Even so, I was strongly encouraged to have a subcutaneous implantable cardioverter defibrillator (ICD) installed before heading home; the device now protrudes from beneath the skin on my left side, patiently waiting to shock me should I slip into another “unsustainable” rhythm at some point. They discharged me on June 19, the Feast of the Sacred Heart of Jesus.

I was feeling stronger but still shaken at my follow-up appointment one month later. Prior to the incident itself, I’d begun attributing what felt like shortness of breath and occasional lightheadedness to a case of chronic anxiety. But an ECG now revealed an arrythmia whose pattern was consistent with the ventricular tachycardia (V-tach) that stopped my heart to begin with. For obvious reasons, the electrocardiologist advised an “aggressive” approach to these premature ventricular contractions (PVCs). Even if the extra beats weren’t doing immediate damage, the palpitations were certainly uncomfortable and increased the chance of another arrest. I was admitted to the hospital three days later for a cardiac ablation—a procedure that sends diagnostic catheters through blood vessels in the groin to map the electrical currents in the heart before burning the cells responsible for sending the faulty signals.

The first attempt at an ablation was not successful. For doctors to locate the aberrant cells, they must be misfiring during the procedure itself. Unfortunately, the mild anesthesia they administered ended up suppressing the PVCs almost entirely, severely lowering the procedure’s rate of success. The electrocardiologists were able to track the deviant signal to a specific section of the ventricles, but their ability to burn the precise cells in question was impaired by the lack of real-time data. I left the hospital with a couple of new prescriptions for antiarrhythmic medications, a wireless Holter monitor strapped to the middle of my chest, and a large dose of disappointment.

Over the next two months I struggled to acclimate to drugs that never quite worked as well as they should have, while we waited for a repeat ablation in early October. During the interim, days would pass with no PVCs only for them to return unexpectedly for days at a time. More often than not, the medications suppressed them in the morning hours but wore off by the late afternoon. We would have felt more frightened during those touch-and-go days had the ICD not given us assurance that even if the PVCs triggered another run of V-tach my heart could still be shocked back into a normal sinus rhythm without calling the paramedics. That sentence captures some of the strange new language we’ve been learning to speak to one another.

The second attempt at an ablation was not successful either. But this time I wasn’t even having enough extra beats on the morning of the procedure for them to take me back to the electrophysiology lab at all. My doctor had warned us of this possibility: better to minimize unnecessary risks like multiple IV lines and inserting the catheters themselves, he said, if the outcome would likely be the same. All they ended up doing that morning was taking a 12-lead ECG or two and monitoring my heart rhythm for a few hours in one of the pre-op holding rooms; I left the hospital with nothing but a shaved chest to show for my troubles.

So began another period of biding our time until the PVCs returned in full enough force to proceed with another ablation. Happily, the wait was not long. Two days before Halloween I called the cardiologist’s office to report an uptick in palpitations. They had only gotten worse, both in frequency and intensity, by the time they were able to fit me into the surgeon’s schedule a week later. The PVCs were now coming in couplets and triplets every third beat or so, making the heart monitor look like our toddler’s scribbles but increasing the chance of success with every new flutter. To ensure that sedation would not suppress the palpitations this time around, the doctor advised no general anesthesia. Which meant I was fully conscious for the entire four-and-a-half-hour procedure: from the threading of the catheters through the blood vessels in my groin to the actual burning of the defective cells in the bottom half of my heart, all of which I would describe as…unpleasant.

But it worked. Deo volente! It didn’t go quite as smoothly as we had hoped—the PVCs still slipped away halfway through the procedure, and not even the election coverage I requested they turn on the radio would make them return—but the doctor was “90-95% confident” that he was able to ablate the aberrant cells responsible for the arrhythmia. Among the reasons for his optimism was the fact that the culprit area they identified was a centimeter or so away from the spot the other team of electrocardiologists had ablated during the first attempt. I can’t say it was a comfort to learn the summer we suffered was a matter of ten millimeters. Nevertheless, the palpitations have been mostly absent since the procedure on November 5. One every now and then, to be sure, but they say this is fairly normal after a recent ablation. We’ll see what the various tests say at my return visit on December 4. For now, though, I’m focused on stringing together enough good days that I no longer wake up wondering when they’ll return.

+

The above is merely an outline of the ups and downs my health has taken over the last five months, and the various medical interventions that have delivered me, finally, to the tiny toddler’s table from which I now wrote this note. It says nothing whatever of the daily realities and routines that have actually seen me through: the love and sacrifice of a spouse who has suffered just as much as I have, in spite of every other calamity this year has wrought; the mostly oblivious (deo gratias!) eyes of two daughters, whose zeal for stories and playtime and leisurely strolls to the park has not been dampened (deo gratias!) by their father’s ailments; the unflagging care of two faithful parents, a loyal brother, and two beloved in-laws, all of whom have driven an obscene number of miles, changed more than their fair share of diapers, and cooked countless meals to assure us we were not alone during our darkest nights; the words of dear friends, which have offered near-constant and much-needed reminders that there is a world before and after all of this. Before blessings such as these, I have little to offer but the cliché that words fall short.

But I can say thank you. To everyone who’s texted, messaged, called, written, and carrier pigeoned over the last five months: thank you. To everyone who contributed to the meal train when we couldn’t find the strength to feed ourselves: thank you. To everyone who supported us financially through the GoFundMe campaign: thank you. Let me say that one again: thank you. Most of all, though, I’m grateful for the prayers: my mother’s, and those of the Virgin Mary; Pilar and Brigit’s, and the babblings of our little Pía; those of my friends, near and far and old and new; those of strangers, whoever they may be; those of the Spirit, who intercedes for us with sighs too deep for words. Thank you. 

Orate pro nobis.