The scar, I was told, would be only a few inches long. After three weeks, I would feel well enough to take that trip to Madrid my family had planned. And when my surgeon, whom I adored, explained that he would just have to "stretch" my sternum to get to my heart, I never guessed that the stretching would be done with a saw, that the scar would measure 10 inches and that Spain would be out of the question.
Open-heart surgery at age 52 probably saved my life, but recovering from it was far more difficult than anyone had led me to believe. Everyone — especially those who should have known better — made it seem like a walk in the park. In the surgeon's waiting room, one guy coming back for a second round of heart surgery told me, "Don't worry. You'll be great." The last thing the social worker gave me was a white velour gym suit, as though I would be doing Pilates in days.
Instead, for months I couldn't get warm enough and shivered from a low-grade fever. My voice would go all wonky when I couldn't get a good breath. My heart made such a racket that it competed with the radio. An internal jumpiness lingered. For a long time, an alarm went off in my head when I tried to sleep: "Watch out! You don't want to do this. Remember what can happen when you lose consciousness." And more than two years later I am still missing some sensation in my little finger, where my hand was strapped to the operating table.
There has been a fair amount written about depression after open-heart surgery. There have also been studies about "pump head," a kind of cognitive impairment that may be related to being on the heart-lung machine. I don't think I had either, exactly. But it was a violent experience, one I hadn't really been prepared for, and I found myself thinking about death all the time. Once, I came home and said to my wife, "Do you know that when we die, we leave the kids forever?" "Yeah," she said. "It's tough, isn't it?" Another time I sat in a business meeting, looking around the table thinking, "Do all these people know they are going to die?"
Some of this was hard to talk about because I felt surrounded by a conspiracy of positivity. "You look great," someone would say. "Thanks, I'm feeling pretty good," I lied. A month later the same person would say, "You look so much better than you did a couple of weeks back. I thought you were a goner."
Shortly after surgery I went to a neighborhood party, and in a faltering voice I complained to one of my friends, a former nurse, about what I'd been through. "It's a tough recovery from what I understand," he admitted. "You're not going to feel well for a long time. Give it six months."
Six months? I was appalled. It had taken only a few hours for the doctors to open my chest, replace my aortic root, implant a bovine valve and stitch me up again — in essence, to save my life. But it took a full year before I felt as if I could really live that life. My heart was the least of my problems during those months; I was waiting on my mind and the rest of my body to recover.
I don't have a sure solution to offer. Get exercise. Hang out with family and friends. Read, sleep, pray. Give it time. But doctors, be realistic with your patients. Don't promise them Spain.
