A Match to the Heart (6 page)

It's not true that I wouldn't talk if tortured. As the black hood dropped over my thinking, I began to plead for a reprieve: “Please put me down, please ...” The instinct to lie flat was indomitable. It's the life-saving desire of the body to get more blood to the head. Quickly it became apparent to Ilvento that the “conductor disturbances” occurring in my body had to do with “vasovagal syncope”—the failure of the blood vessels to constrict. Blood and oxygen had drained into my feet and legs, and though I begged repeatedly and vehemently to be laid flat, they refused, simply watching my body go limp. I tried hard to hold out, to hang on to light and form and discursive thought, but the balloon burst and I was gone.

What is the architecture of a blank, and how long can it last? What happens to memory when one becomes unconscious, does the synaptic gap go dark? Do the neurotransmitters drift aimlessly?

 
 
Ahead of me it was dark but I could see the dogs' glistening fur. We were sledding in moonlight. A needle was slipped into my vein. Atropine. I slid from one black puddle to another on a road made of limitless gravity. The needle in the vein was like a needle in a haystack, a needle flying between galaxies. Blackness prevailed. The dogs who rescued me had dark fur. I foundered in a dream about horses whose back legs—hips, hocks, cannon bones, pasterns, hooves—were cut up and laid at odd angles in a wheelbarrow, to be carted away. The dogsled carried me back into the day.

 
 
I felt Dave's hand on mine. He was saying something to me but I couldn't answer. Ilvento was on the phone reporting to Blaine: “We got a positive result. She was out in fourteen minutes so this answers our questions. I think we can safely rule out most everything else. It's vasovagal.”

 
 
My face was gray and the back of my hospital gown dripped sweat. Almost unbelievably, they repeated the test after I had rested. “We won't let you go all the way out this time,” Ilvento promised, but I was skeptical. I felt like telling him I hated pizza. They tilted me up and quickly I felt faint. The black tunnel tightened around me—a noose—as if I had been sent to the gallows. Or was I being crucified again?

When they laid me down, atropine was started. It wasn't that I had suffered any pain, it was only discomforting. Later, dazed and unsteady, the nurses led me back to bed, like torturors leading the tortured.

You don't have to experience everything life can throw at you—torture or ecstasy—to fuel empathy; just a taste is enough. I vowed to send money to Amnesty International for victims of torture. When Blaine came by that afternoon his jauntiness rubbed me the wrong way for a moment. He sat on the bed and looked at me. My face was gray. It wasn't necessary to ask how I was feeling, but he did anyway.

“Everything is still dark,” I said. “I feel washed out... like I'm swimming and there's nothing to hang on to.”

“Here,” he said and held both my hands in his.

At the end of rounds he returned to my room. I was slightly more bright-eyed. He sat down and explained the findings of the tilt-table test. “You've suffered an electrical insult to your brain stem and have lost the ability to vasoconstrict. You have no vascular tone in the smooth muscles of your blood vessels. You've also lost the ability to increase your heart rate. The sympathetic and parasympathetic nervous systems usually counterbalance each other. When the heart and blood pressure get too high, a message goes through the parasympathetic nerves to the brain, which secretes an inhibitory chemical that slows the heart down. The sympathetic system does the opposite: it speeds things up. I think your sympathetic system was burned by the lightning, allowing the parasympathetic vagus nerve to take over and have its way. It keeps telling your heart to slow down, because no excitatory chemicals are being released.”

I stared blankly. “Could you repeat all that sometime when I'm feeling better?”

“Don't you trust me?” he said, laughing, then put his hand on my forehead and told me to rest.

 
 
In the morning I noticed Blaine's eyes had changed color: they had been brown and green and now they were gray and blue. My mind was mush. A tight band around my chest tightened and eased, depending on the threadiness of my blood pressure. Sometimes during rounds Blaine stopped to talk, and other times I heard him talking to nurses. My own hazy monologues continued: I wondered what the interior geography of my body looked like or if my insides could be read like illuminated manuscript.

Between visits I wandered. The peregrinations felt inter-galactic. Fingering the color fold-outs of Gray's Anatomy, I traced nervous systems, blood vessels, intestinal coils, musculature, spinal cords, and the convolutions of the brain. A body is a separate continent, a whole ecosystem, a secret spinning planet. The brain looks Vesuvian with its breaks and draws called “gyri” and “sulci,” its fissures and fjords. The large internal fold of the cortex is called an “insula,” and near the cerebral aqueduct dividing the midbrain grow stalks of neurons called “infundibulum.” There is a “vermis,” and “arbor vitae,” a “pons,” and the small swellings of the medulla are called “olives.” Who named these parts of the body? I asked Blaine. He didn't know. I thought it must be a walker like Thoreau, or a mad geographer, an Arctic explorer, or someone making a miniature garden of the brain.

“Look.” I showed him a picture. How the brain sits on its spindle, like a globe, the nodding head tilting on its axis, how the nervous system is a series of branches sprouting from that
axis mundi,
how each thought passing through is a separate ecosystem.

“The brain has a hundred million nerve cells and is seventy-eight percent water,” he replied.

 
 
More fog rolled through the window like reason, trying to hide things, smooth things over. The room was a skullcap. When Blaine returned in the afternoon, I asked, “How does it all work?”

“What?”

“The systems of the body.”

“That would take years,” he said.

“I don't have years.”

He gave me a surprised look.

“Yes, you do,” he said.

“Tell me anyway.”

 
 
He thumbed backwards to a picture of the whole body. No one part functions as a separate entity: the brain does not coolly dispatch messages as a computer does, nor is the nervous system just a system of highways, he explained. It is the communicator inside us, at once both pathway and messenger, though, in my case, the pathway needed repaving and the messenger was dead.

I smiled and he continued. The nervous system is composed of a network of cells that extends throughout the body, receiving information about the internal and external environments, assessing that information and then sending signals to organs that cause an appropriate response. It is a great branching tree dividing down into separate systems: the central and peripheral, of which the autonomic nervous system is a part. My autonomic nervous system had been damaged by lightning. Regulated by centers in the cerebral cortex, hypothalamus, and brain stem, it is divided further into two subdivisions that must constantly balance each other—the sympathetic nervous system, whose purpose is to stimulate activity in the heart, blood vessels, stomach, and sweat glands by releasing an excitatory chemical called norepinephrine, and the parasympathetic nervous system, which does the opposite, releasing an inhibitory chemical called acetylcholine, which slows things down.

“Because your sympathetic nervous system got fried by the lightning, your vagus nerve has gone wild. There is nothing to tell it to stop sending its messages to slow everything down,” Blaine said. “It's a big long nerve that innervates the lungs and heart, liver, stomach, pancreas, small intestine, and kidney. That's why it's called vagus. It wanders around in the body and tells your heart to slow down and your blood vessels to stop contracting until you have no blood pressure at all.”

I have a wanderer inside me, a vagus nerve, a vagrant that does whatever it wants. Any time the fine balance of the body's internal civilization is upset, the whole intricate communication breaks down: when the heart slows or stops, cells, synapses, and receptors become confused and leaderless. Where is that oxygen, they wonder, where are the nutrients that keep us alive? Homeostatic panic ensues. For a while the self-regulating universe of the body tries everything it can to compensate, but if that doesn't work, then it's good to have a doctor nearby.

The next day I asked Blaine and Dr. Ilvento to explain what actually happened to brain and nervous system cells when a great deal of electricity passed through the body. Together, they speculated: “The mylenated sheaths—the fatty white matter that protects neurons—may have bubbled and melted; cells died and were sloughed off [there are cells in the body that do nothing but cart the dead ones away]; neurotransmitters with their excitatory chemicals dried up. The path taken by lightning inside the body became a desert.”

I touched the place on my back where I had felt a burn after being struck. Blaine touched it. “Does it still hurt?” he asked. “It's sore,” I told him.

“This is your exit wound. It's near the heart, right where the sympathetic nerves hook in,” he informed me.

 
 
Blaine ordered new medicines and larger dosages. Norpace made my heart beat regularly no matter what messages it received from the brain, as well as working on the vagus nerve by blocking acetylcholine. The Florinef helped my body retain water. It was a simple gardener's idea: watering a plant maintains the turgidity of a plant's stem—in the human body, retention of water helps raise blood pressure. “Eat lots of salt and drink strong coffee,” Blaine said, laughing. “Can you believe a cardiologist is recommending these things? Also, stay cool, no Jacuzzis, or hot baths, no alcohol, and keep your feet up.”

Two days later I was released. My father came for me. Leaning on his thin arm, I walked out of the cardiac care unit barely able to comprehend what was around me: waiting rooms full of strangers, miles of polished floors, then cars, sidewalks, palm trees and sycamores, and sea smell. It was all I could do to put one foot in front of the other.

During the drive home the sides of the world heaved up and folded in on me, and the road was a concavity dropping out from under the car. With my seventy-five-year-old parents, I was still their child, dependent on them for shelter, food, rescue, and survival. Even their pace was too fast for me. “Now you know,” Blaine said, “why patients are called patients.”

I was once the young girl who wanted everything to be fast: horses, cars, wild and turbulent rides in my father's small plane. My appetite for life was clamorous inside. Now even that din had been quelled. I doddered around the house, lay on the floor with my feet up in the air to get more blood into my head, and from time to time begged my mother for oxygen.

Life consisted entirely of rest, round-the-clock pill taking, TV watching. Norpace blurred my vision, so reading was difficult, nor did I have the concentration for it. Someone else's story was too big to swallow. All my wits and brain power went into maintaining my own life: I was the homeostatic engine trying to reestablish equilibrium in a body seriously off-kilter, which is another way of saying I stayed close to couch and bed. If I had any ideas about going out that first week, waves of low blood pressure knocked me back down.

On my next checkup at Blaine's office, I informed him that I was going to London in two weeks for the opening night of the ballet for which I had been writing a text all summer. Undaunted, he smiled, but I didn't believe his casual air. “I'm not going to miss it,” I repeated, just so he knew I was serious, though down deep I couldn't imagine how I would get myself there.

 
 
During the second week I made a supreme effort to face the world. After all, if I was going to fly to London by myself I had to raise my energy level. On a good day my mother drove me to the beauty shop, whose atmosphere of care and silly gaiety cheered me. My singed hair was brittle as wire. A cheerful young woman cut and drenched it in conditioners to bring it back to life. Staying conscious during those visits was tricky enough, but I managed. Other days we went to lunch, always taking oxygen along. I had a craving for hamburgers, though a few bites filled me completely. It was only tastes of life that I wanted; biting in and chewing was still too much for me.

 
 
One morning I visited a Chinese acupuncturist. He was horrified at the medicines I was taking. On the table, with needles sticking in my head and fingers, I nearly passed out. He immediately changed the placement of the needles and I came around quickly. He showed me a pressure point on my little finger to use if I started to black out while traveling.

At the end of the week I lied to Blaine. Two weeks had elapsed and I was to fly to London the next day. Driving for the first time since getting out of the hospital, I had to pull off the freeway three times to keep from blacking out and lie down on the front seat with my feet pushed through the window. Figuring there was nothing to lose, I tried the acupressure point Dr. Wang had showed me and finally revived.

In the parking lot behind Blaine's office, I jumped up and down before going in. He took my pressure and sure enough it passed muster, though it was by no means normal. A little later, when he asked how I was feeling, I said, “Great.” My determination to get to London would get me there, I presumed, though I sensed Death had not forsaken me altogether. I knew how easy it was to die, and, by God, I was going to pack a few more things in before Death took me away.

chapter 9

My travel agent made sure I was booked on uncrowded flights, so I could lie down, three seats across. It was my only hope to keep from passing out. I wrapped my legs in Ace bandages to prevent blood from pooling in my feet and licked palmfuls of salt, chased with water. The trip to London was broken by an overnight stop in New York. My publisher and his wife picked me up at the airport and I spent the night in their Brooklyn home.