Sunday, November 16, 2008
Sunday, March 25, 2007
This blog has been writing itself for the last forty days. I did not know what I would write from one day to the next, yet somehow the ideas and the words found themselves. This will be the last entry for a while.
On the anniversary of the heart attack last November, I asked my brother and sister-in-law to go do to dinner with me. My sister-in-law was adamant that she would not go to dinner to celebrate a heart attack. Instead, we went to dinner and celebrated what we called the Resurrection of the Heart. By some strange paradox, the wounding my heart has opened me up to the World.
When I began the first blog, I had no idea where it would lead, other than I slowly wanted to work through the drawings I had done after the heart attack. The drawings were done as a means of emotional relief; I had no idea at the time that they were also portraying an ancient underlying alchemical process of transformation. I have been amazed by the journey.
Before the heart attack, before the drawings, I was skeptical about people’s experience of God, and believed the World was only what we could perceive and describe in scientific terms.
Now, I know there is some mysterious, irrational presence in the Universe that influences us from a dimension that we do not have a direct perception of. Call it what you may: It is the Twilight Zone, the Spirit World, the Collective Unconscious, the Tao, the Un-Nameable.
Saturday, March 24, 2007
Since the heart attack, I experience more and more clearly and painfully that the institutions I work with on a daily basis with are not compassionate systems. The Court System is far more concerned with inflexible justice than with individual circumstances and mercy; the Correctional System similarly is overwhelmingly concerned about punishment rather than rehabilitation. The psychiatric unit at the hospital routinely drugs people having religious experiences.
What is missing from these systems is a sense of the Feminine and a sense of the Sacred; this is heart failure on a massive scale.
The whole planet is threatened by global warming, a reflection of the current state of unconsciousness. Perhaps this wound to the Earth, the sacred ground will live on, will bring about an awakening on a global scale.
Non nobis solum sed toti mundo nati.
Not for ourselves, but for the whole world we were born.
Friday, March 23, 2007
Know the active, the masculine
Yet keep to the passive, the feminine,
Being the entrance of the world
You embrace harmony
And become as a newborn.
.................................Tao to Ching Chapter 28
At the beginning of June, seven months after the heart attack, I essentially finished the last drawing in the series I had done after heart attack.
Through the process, I had found emotional release and comfort. I re-discovered the world of alchemy, which now seemed as if it had something very important and forgotten wisdom to convey. Similarly, the Tao Te Ching, an ancient Chinese book of wisdom, also connected with me on a much deeper level
The snow had melted in Fairbanks, the trees were green, and the outside world was beckoning. It was time to plant flowers, fix up the cave, walk the labyrinth.
The process was far from over, but now there were both masculine and feminine energy working together.
Thursday, March 22, 2007
The Valley Spirit never dies
It is named the Mysterious Female.
Her gateway is the root of heaven and earth.
It is like a veil barely seen. Use it; it will never fail.
.........................................Tao Te Ching, Chapter 6
When this drawing was completed, it suddenly reminded me of alchemy, of pictures I had seen of alchemical processes being contained in egg-shaped flasks. It was at this time that I started reading about psychological processes and alchemy.
In looking at it now from an alchemical perspective, something is cooking in front of the lunar light. Similar to the earlier drawing of the pelican on the red-hot buoy, the green forces were protecting and cooling the situation.
Jungians talk a lot about the Anima, the personification of the inner Feminine, the soul within the man. It is an “animating” force, the principle of receptivity, of relatedness, of compassion.
Was this Anima leaving my body, or was it manifesting itself?
Wednesday, March 21, 2007
..........Water gives life to the ten thousand things and does not strive.
..........It flows in places men reject and so is like the Tao.
..........In dwelling, be close to the land,
..........In meditation, go deep in the Heart.
....................Tao Te Ching Chapter 8
A friend looked at this drawing and said he felt sad for the person frozen in the ice.
I remember feeling some optimism when I made the image; to me, the person’s head was next to the Water of Life, and the process of thawing had begun. The river flowed out of a dark, mysterious place.
The alchemists talk about ”whitening”, a lunar process of purification, giving the body back its soul. Some of the alchemical writings eerily describe aspects of the drawing:
..........Take the whiteness and dismiss the darkness…
..........Until it looks like a naked sword, and make by whitening
Tuesday, March 20, 2007
Even though in May it was beginning to turn green in Alaska, I found my view of the external world blocked by the anxieties and images of the internal world. For the previous six months, I was much more fatigued and passive than I had ever been in my life; I looked forward every day to lying in bed.
My sister saw this drawing and feared I was lying in a coffin, preparing for death. Stan Marlan, the alchemical Jungian analyst mentioned earlier, looked at the image and saw the Black Sun, an archetypal symbol of darkness and transformation.
Monday, March 19, 2007
When I drew this landcape, I thought I was drawing an image of where I needed to go. It could just as well be an image of where I had been. Were those black shapes punctures of the body from the stent procedures?
With every surgery, I had to give up any sense of control over my fate. It was a humbling experience.
With the heart attack, I lost any sense of entitlement I had to life or to a future. At the same time, I gained a sense of deep gratitude for the life I still had.
Are those shark fins in the water?
Am I glad I am standing on the green earth!
Sunday, March 18, 2007
When our hearts are closed, we live within a shell. To extend the egg metaphor: the shell needs to be broken open if the life within it is to enter into full life. What we need is a "hatching of the heart” -- the opening of the self to God, the sacred….
Marcus J Borg, The Heart of Christianity
When my father died sixteen years ago, I went with a friend to a beach near San Francisco. It was very soothing to watch the pelicans as they glided right above the waves.
In my quest to understand these images, I talked last week with Stan Marlan, a Jungian analyst who writes about alchemy. He spoke of the pelican as an alchemical symbol of renewal, of the pelican's part in an alchemical stage having to do with breaking open the outer shell to reveal the inner person. In the times of alchemy, the pelican was seen as digging into its own heart to provide nourishment for the young, an act of self-sacrifice.
He also talked about how it was critically important for the alchemist to regulate the heat of the process. Clearly, this pelican was being heated; the green behind the pelican was cooling the process off, protecting him.
When I made the drawing, I was only thinking of how much I liked pelicans.
Saturday, March 17, 2007
Archives of Archetypal Symbolism, The God Thoth as an Ibis
This was the first drawing made with perspective: was I finally getting a perspective on things? Had my red tears from an earlier drawing turned into red eggs?
I continue to be surprised by at how helpful the alchemical viewpoint is in the way it adds the dimensions of history and mythology to psychological processes. I had never heard of the Great Cackler until yesterday, yet somehow hearing this myth about cosmic eggs laid in an immense ocean by a cackling goose makes me feel connected to something bigger, and makes me laugh at the same time.
Jungians and alchemists get excited about the symbolic nature of numbers. So why seven eggs? Seven days in a week? The moon, with four lunar cycles of seven days each? The seven islands of Atlantis? The seven chakras?
However you count them, there do seem be a lot of eggs. Perhaps something was about to hatch?
Friday, March 16, 2007
When I read this passage in Jung’s book last night, forty years after I bought it, it gave me goose bumps.
It doesn’t take an alchemist to recognize that the drawing an egg is a symbol of hope, of new beginnings. Somehow, though, Jung and the alchemists added an ancient dimension to the idea of the egg for me, one that deepened my sense of connection with them.
Thursday, March 15, 2007
To the extent that I managed to translate emotions into images – that is to say, the find the images which are concealed in the emotions – I was inwardly calmed and reassured.
Jung, in Memories, Dreams, and Reflections
Though I was calmer after making this drawing, I felt that I was in a precarious position and close to the Edge, that there was a question of whether my spirit would be rescued by the Pelican of Hope, or devoured by the Shark of Doom.
The alchemists would see this drawing in a little different light, that the image was dealing with the “Union of Opposites” and with the idea of finding the right balance. Problematic opposites included Water and Fire, Heaven and Earth, Masculine and Feminine, Spirit and Instinct. It was very important for these alchemists to obtain the right balance: unwary alchemists have been known to have been devoured by sharks.
A year later, as I look closely at the drawing, the pelican does seem to have an edge.
Wednesday, March 14, 2007
Miquel de Unamuno, The Tragic Sense of Life
(cited in The Black Sun, by Stanton Marlan)
When I returned home in late February, I received the report from the Mayo Clinic. I found out that I had “severe bi-atrial enlargement”, that two of the chambers of my heart were now more than twice as large as normal. This sounded ominous to me. Once again I was scared for my life.
I had never been able to find reassurance in optimistic clichés, such as “It is always darkest….. just before dawn.” This always seemed to me to be some kind of Pollyannish self-talk that denied reality.
No, better to look Reality in the face, and have no false expectations that things will get better:
It is always darkest…. just before it gets pitch black.
Tuesday, March 13, 2007
My wife tells me that it looks like the Eye of Ra, and that one does not want to Eye of God to look directly at you.
In ancient Egypt, the Eye of Ra was the eye of a peregrine falcon, both a symbol of safety and protection, and an image of a powerful destructive force linked with the fierce heat of the sun. Humanity was born of the tears of Ra:
Some kind of bird's eye had clearly been drawn. It evoked in me an intense feeling of scrutiny by some Being in another world. Is my Unconscious punningly alluding to some "Close Encounter of the Bird Kind?"
Or is this drawing about consciousness, about opening one's Eye to the World?
Monday, March 12, 2007
My heart is open
My heart is clear
My heart is full
My heart is strong
Adapted from The Four-Fold Way , by Angeles Arrien
The good news from the Mayo Clinic was that my “functional capacity”, the ability of the heart to pump blood, was excellent.
The bad news was that there was no improvement in the heart ejection fraction; the heart was still operating at half of its previous functioning.
I was able to focus on the good news. My mood was improving. I thought of home, and drew an EKG sunrise over the Tanana Valley and Alaska Range.
Unconsciously, once again, the theme of four and a circle emerged.
Sunday, March 11, 2007
Mithraic saying, 600 B.C.
In early February 2006, three months after the heart attack, I was scheduled to fly to the Mayo clinic in Minnesota; I was very concerned about the outcome of the testing that was to be done there. I didn’t know if I would need heart bypass surgery. I didn’t know if I was going into congestive heart failure. I didn’t know if I would return to Fairbanks.
After completing this drawing at the end of January, I feared it might be my last one. I thought, My light is fading.
Much later, as I tried to understand the symbolism of the drawing and came across this quotation about the Mithraic star, the Web told me that the Mithraic view preceded Christianity, that Mithras was said to have been born on December 25, and that the Vatican was built on a Mithraic site.
Instead of a fading light, I had drawn an ancient image of the Spirit, a Divine Spark within each of us.
Saturday, March 10, 2007
Several weeks after the heart attack, I took up meditation; I had difficult sitting still. I added chanting to the meditation, trying to resonate deep and healing sounds around my heart area. I worked at visualization, relaxing and seeing my heart as healthy and strong. I repeated over and over to myself, “My heart and arteries are soft and open.”
In late January, I sat down at the computer to draw and to my surprise, the image was a peaceful one.
Finally, the Drunken Monkey had calmed down.
Friday, March 9, 2007
One of Jung’s major discoveries is the psychological significance of the number four as it relates to the symbolism of psychic wholeness.... Images that emphasize a circle with the additional feature of a quaternity represent the Self.
Edward Edinger, Ego and Archetype
My wife returned, the days lengthened, the sun came out, and my spirits lifted. I vividly remember this day in mid-January, the first day when I felt some kind of hope:
A surprising sun
Rising in a cold blue sky
Lightens the birches
When I looked at the drawing I made, it was the first one that depicted an external reality, and I assumed that it meant I had finally been able to return more to the outside world.
Now, more than a year later, the drawing takes on an alchemical significance.
Out of the blue, I had chosen to draw four lines and a circle.
Thursday, March 8, 2007
The Red Sea is the totality of the psyche, the agent of solutio that the ego must encounter on the way to individuation.
Edward Edinger, Anatomy of the Psyche
I started feeling waves of sadness and grief when my wife had to leave Fairbanks for several days. The weather in Fairbanks in early January was well below zero, and it was still dark most of the time. It felt like Hell had frozen over.
When I started drawing, I started crying. I convinced myself that all was lost, that I had lost my health, my vitality, my future. It felt as if the waves of tears would never end.
When I made this drawing (and the others), I knew very little about the depths of alchemy; it seemed to me to be an obscure and confusing part of Jungian psychology.
I was drawing what wanted to be drawn, and assumed that the drawing was just a form of emotional release. Now, in reviewing these drawings more than a year later, I am amazed at the parallels between the drawings and the process of alchemical transformation.
Perhaps there is something to the Spirit World after all.
Wednesday, March 7, 2007
To this day "God" is the name by which I designate all things which cross my willful path violently and recklessly, all things which upset my subjective views, plans and intentions, and change the course of my life for better or for worse.
Carl Jung, 1955
There was nothing my will could do to stop the flow of despair that surrounded me after the heart attack.
I was told that as a result of damage to the heart, I had a 50% reduction in the capacity of my heart to pump blood efficiently, the “ejection fraction” of the heart. This resulted in frequent sensations of some kind of internal backflow in the heart, a very disquieting whooshing and swooshing. Similar to the perception of the PVC’s, these sensations triggered anxiety, and I assumed that another heart attack was imminent.
The only activity that brought relief was doing these drawings; after each completion of a drawing, I felt as if some burden had been lifted, something had been changed within. They didn’t do a hell of a lot for improving the ejection fraction, but they improved my spirits.
This is not what I had planned for my life.
Tuesday, March 6, 2007
This life of separateness may be compared to a dream, a phantasm, a bubble, a shadow, a drop of dew, a flash of lightning.
Buddha -480 B.C.
Of all the similes that convey the heart attack experience, to me it was what I imagined it would be like to be struck by lightning. It is sudden, it is intense, and it is absolutely frightening.
Being struck by the heart attack demolished any illusions that I was in control of my future, and provided overwhelming evidence that there were forces that could eradicate me in a flash. After the heart attack, I constantly missed the illusion that my future extended indefinitely, and the illusion that the world was a safe place.
The heart attack increased my feeling of separateness. I felt isolated; the rest of the world was going on as usual, and I was left lying in bed, looking out the window, trying to come to grips with what had happened. I could resign myself to my own death, but not to leaving my wife and child alone.
Trying to think that I was One with the Universe was no solace at all; this was just another philosophical Hakuna Matata: Don’t worry, be enlightened.
A flash of lightning split my Universe.
Monday, March 5, 2007
Isaiah I: 26
In alchemy, the fire purifies…
Carl Jung, in Psychology and Alchemy
Shortly after I finished this image that needed to be drawn, I interpreted the flames as trauma and anger, and the smoke as depression. Even with many years of psychological practice, I assumed that what needed to be healed was my body, and perhaps my emotions.
It is only in reviewing the images a year later that I understand that there was an intense psychological process going on, a transformational process.
After a dream in 1926, Jung had the brilliant recognition that alchemy was a metaphor for psychological and spiritual development. Alchemy, at the time he wrote about it, was regarded as a useless quest to turn base metal into gold; Jung saw alchemy as a parallel for turning the base metal of human existence into something more eternal and lasting.
While the heart attack burned me, dealing with its aftermath transformed me, purified me in some way. Afterwards, I was less caught up in the base life of my everyday existence; my attention turned much more frequently to spiritual matters, and at the same time I was on the road of being more understanding and compassionate for my fellow travelers in this life.
My ego was being burnt to a crisp, and something had to change..
Sunday, March 4, 2007
Rachel Naomi Remen
There are so many swirling emotions after surviving a heart attack:
.....................Relief at survival --
.....................Disbelief that it happened --
.....................Fear of the future --
.....................Grief for everything that was lost --
.................... Gratitude to those who helped --
.....................Vulnerability to the world--
There was no solid ground to stand on. I was weak from the injury; I didn’t know whether I would wake up each morning, I didn’t know if I would ever make it home.
It is as if I have crossed the River Styx to the Underworld, and have been temporarily allowed to return to the land of the living. While the journey has been Hellish, at the same time I have been given something important -- an increased compassion for the wounded, compassion for all those who have to cross the River Styx.
While the heart attack broken my heart, it has also opened my heart.
Saturday, March 3, 2007
My favorite activity in my youth was kayak surfing in the ocean. Being carried away by a wave is a wonderful feeling, an ecstatic letting go, a merging with the world.
After the heart attack, I was (metaphorically) kayak surfing in much bigger water. I was being overwhelmed by unconscious forces; I was in conditions way over my head. I felt I could be crushed at anytime, thrown into chaos, drowned.
The one time I kayaked in huge waves, I was scared to death. While my mind was racing with fear, my body instinctively kept the kayak stable and brought me safely home. It became a matter of trusting my instincts.
After the heart attack, I cried almost every day for months, caught in waves of despair, caught in overwhelming feelings of grief and loss. I somehow trusted that if I let my feelings be, let them into consciousness, that they would eventually right themselves.
There are still waves of emotions I have to ride, but they are usually not larger than the boat. .
Friday, March 2, 2007
Something about my heartbeat didn’t feel the same, didn’t feel right. When I attended the cardiac rehabilitation program at Fairbanks Memorial Hospital, the EKG monitor showed some marked downward spikes several times a minute, just after I felt some kind of missed drum beat in my heart. I had lain awake at night, worrying what these missed beats meant, waiting for the next one.
As a result of the changes in the heart, I now had frequent “pre-ventricular contractions” -–the heart rhythm was sometimes out of sequence, particularly when I exercised hard.
There is something about the heart beating irregularly that is a fragmenting experience, that throws one into a state of anxiety. Clearly, the anxious mind thinks, this skipping in my heart must mean I am about to die, or have another heart attack.
I was told by the cardiac nurse, who had never experienced PVCS, not to worry about them, that the electrical signal for the heart was finding a new path through the scarred tissue, and this was causing the pre-ventricular contractions. Right, Hakuna Matata... Don't worry, be happy. It took months to get used to this new off-beat rhythm in my heart.
Apparently though, irregular heartbeats don’t always mean that one is going to die. Hakuna Matata, indeed.
Thursday, March 1, 2007
........The force that through the green fuse drives the flower
........Drives my green age; that blasts the roots of trees
........Is my destroyer…
................Dylan Thomas, 1933
After a heart attack, the longer the heart muscle cells have been without oxygen, the more of them die. These cells do not regenerate; they form scar tissue in the heart and change the electrical pattern of the heartbeat. The heart enlarges, sometimes too much, in an attempt to compensate for the reduction in pumping efficiency. These changes are not something that can be reversed, that can be "cured."
Of all the books I read after the heart attack, the author that spoke the most clearly and compassionately to me was Dr. Rachel Naomi Remen, a physician who has survived Crohn’s Disease for fifty years and teaches other physicians about the emotional and spiritual side of healing:
Curing happens at the level of the body, and it requires expertise.
Healing is what happens at the level of the whole person.
Where do these drawings come from?
Where do these dreams come from?
Where does this healing come from?
The force that through the green fuse drives the flower
Wednesday, February 28, 2007
After I made the drawing, it felt like an image of high anxiety, of something dark and foreboding ominously hanging over the landscape.
An exact year after the heart attack, I consulted with psychotherapist James Nourse, another kind person helping me on my way. Of all the drawings I showed him, he was particularly struck by this one: he said he had seen similar images that were indicative of shamanic initiation experiences.
I was not particularly interested in having shamanic experiences; this seemed like another New Age fad, like walking labyrinths. I just wanted to get over the trauma and get back to normal.
Initiation experiences (which those shamans necessarily go through) always involve suffering; this was something I had no choice about, in the same way that anyone who is traumatized has no choice but to experience and re-experience over and over again what has happened to them.
The spiral maze is an image of the shaman’s path into the “other world”, a path that shows the way in and the way out. Trauma also throws one into another world, an internal world of fear and despair.
The spiral labyrinth is one of the oldest of symbols; it depicts the way to the unknown center of death and rebirth, the risk of the search, the danger of losing the way, the quest, the finding and the ability to return.
Edmond Whitmont, The Symbolic Quest
Tuesday, February 27, 2007
When I had the energy to work on the computer, I searched far and wide for help, both for information about what to do about preventing another heart attack and for people who could help me.
One kind person who responded immediately to my e-mails was Mala Cunningham, a cardiac psychologist working at the University of Virginia. Besides making sure I was breathing right to reduce my anxiety, she was adamant that I needed to find some kind of spiritual path to connect with.
Organized religion has never connected with me. As I child, I used to hide my good shoes on Sundays to try to avoid going to church. ("How can they make you go to church in bare feet?", the child was thinking.) In my view now, going to church barefoot might just be the simple, humble thing to do.
I have been attracted to those religions that believe that each person is capable of having a direct and personal experience of God. This is the Gnostic approach in Christianity, the Inner Light in the Quaker religion, the Atman as an animating force in Hinduism.
In Jungian psychology, the religious experience is the equivalent of the Self, the transcendent organizing principle of the human psyche.
The imminent possibility of death was precipitating a spiritual crisis.
Monday, February 26, 2007
In my work as a clinical psychologist, I often ask people who have experienced psychological trauma -- such a divorce – what kind of physical wound it most felt like. Often, they respond that it as if many bones in their body had been broken, or that they had a gut shot to the stomach. Yet, with these kinds of wounds, most people expect that they should be able to continue a normal life, as if their bones were not broken.
A heart attack is not a visible wound, yet it deeply impacts the physical and psychological body. After a body is wounded, it needs to rest; it often goes into a necessary state of depression to conserve energy so that more energy can be devoted to internal healing. A psychological wound is no different. A heart attack affects both the body and psyche; the psychological healing has been much more difficult for me than the physical healing.
To a large extent, I think these drawings are images of the state of the psychological body, in the same way that dreams are also images of the state of psyche. Similar to dreams, the drawings are done without conscious planning: they evolve, and they take on a life of their own.
So why I am drawing waves? What do you think?
Although the images speak for themselves, if I can find some words that also express what is going on with the images, so much the better.
(The title of this blog entry, Anatomy of the Psyche, is from a book by Edward Edinger, with the same title. Edinger is one of the most profound and original writers about Jungian psychology.)
Sunday, February 25, 2007
I felt as if my body had deeply betrayed me by having a heart attack. I didn't want to get out of bed.
When President Eisenhower had his first heart attack in 1955, the standard procedure was to commit people to bed rest for six months. (Eisenhower was playing golf and thought he was experiencing indigestion. His doctor misdiagnosed him as having a gastrointestinal disorder, give him morphine, and waited ten hours before sending him to the hospital.)
Hospitals now keep you only four or five days before sending you home after a heart attack. I would have preferred to stay in the hospital for several months, since it felt like the safest place to be and they could do something if my heart was attacked again. Another heart attack seemed imminent.
I felt as if my body were made of stone. If I didn’t feel my body, my body couldn’t hurt me. At home, I was most content watching DVDs of television shows, such as “24”, “Lost”, and “Desperate Housewives.” Each one of these complete seasons took occupied me for about twenty hours. Passing the time in a trance, without thinking about what had happened to me or what could happen to me, was a relief. It was good medicine.
After about three weeks of spending most of my time in bed and watching television, I started to feel as if I had some slight chance of living a little longer.
Saturday, February 24, 2007
Because of scarring to the heart, I am at risk for sudden cardiac arrest, where the rhythm that runs the heart goes haywire because the signal can’t take it’s normal path. (This is quite different than a heart attack, where the arteries are blocked. It is like the difference between the electrical system in the house and the plumbing in the house.) We bought a home defibrillator that I put next to the bed.
I also bought one of those blasting foghorns that boats use; I figured I had about six seconds to use it before I would lapse into unconsciousness if my heart went into ventricular fibrillation. I made sure that nitroglycerin tablets and aspirin were next to the bed, in my wallet, in the glove compartment, where I worked at the computer.
Although family and friends responded to the immediate crisis, within about three weeks the calls and concern dropped off; I had experienced this pattern before with the previous hospitalizations. I seemed to be better, I could walk, I could make jokes. For me, however, the crisis was still at an extreme level. Didn’t they understand I how much I needed their continuing support?
In retrospect, I think for several months I was at the emotional level of a two or three year old: I felt extremely vulnerable to a world that could smack me at anytime, I was anxious all the time if someone wasn’t near by, I could cry at anytime, I couldn’t put into words what was bothering me.
I had no previous experience with drawing, but felt that it might help to express what was happening, since talking about it wasn’t changing much. I found some computer drawing programs on the Internet, and began to draw whatever came into my mind.
The drawing at the beginning of this blog is the first drawing, done about a month after the heart attack.
Thursday, February 22, 2007
In spite of the technician’s subliminal suggestion about dying lke John Denver, the angiogram was successful. To the doctors’ surprise, I did not have any significant blockage in the problematic artery.
Apparently, I had had a large clot that blocked the blood flow in the artery. This was different than the problems with a narrowing artery that I had before; apparently some vulnerable plaque had ruptured and blocked the artery, most likely at the site of the stent.
In the coming months, news about problems with drug eluting stents started to surface: for about three percent of the population, drug-eluting stents greatly increase the risk of a fatal heart attack. The drugs on the stent made it difficult for the cell tissue to repair the damage at all, and the cells are left much more vulnerable to clotting and a heart attack.
At the time I had had the drug-eluting stent to put in, the recommendation was to use aspirin and Plavix, a medication that prevents the coagulation of blood, for six months after the stent was put in, a recommendation I had closely followed. The heart attack occurred fourteen months after the drug-eluting stent was placed. The current recommendation is to continue on aspirin and Plavix indefinitely. I take them, religiously.
Wednesday, February 21, 2007
After being evacuated from Fairbanks, I was now under observation at the intensive care unit at Providence Hospital in Anchorage. Several of the nurses kept commenting about how I had taken a “big hit”. I finally asked one of them what this meant. She said that she had been working there a number of years and this was the largest troponin level she had seen. (Troponin is a marker of cardiac muscle breakdown and cell death, and is one of the ways they test if a heart attack has occurred.) I am not sure I wanted to know this information.
After another day of recovery, young Dr. B. asked me what I would like to do next. The most likely explanation for what I had experienced was that my left arterial descending artery was permanently blocked and the surrounding heart tissue that it fed had been killed by lack of oxygen. He persuaded me to get another angiogram, just to check it out and see if perhaps something could be done. He said that he would play whatever music I wanted in the operating room. For whatever reasons, the idea of having music to listen to convinced me to try it.
Dr. B. started the angiogram procedure of trying to put a catheter into the femoral artery, but he was having trouble getting through because of the scar tissue. I asked about the music.
He asked one of the technicians in the operating room to play some music over the stereo system. John Denver began singing, “Take me Home…”, not exactly what I had in mind when I had been promised music. The technicians began to converse: “Didn’t John Denver die in an airplane crash?” the first one said.
This was not an auspicious start to the operation.
Tuesday, February 20, 2007
Drawing, February 20, 2007
Beginning at about one thirty in the afternoon on November 3, 2005, I felt a slight pain in my chest as I was sipping a cup of coffee and looking at the computer. About a half hour before, I had finished an hour of snow shoeing in zero degree temperatures.
The pain slowly increased, and I took it as some kind of heartburn from the coffee. The intensity continued to increase. I took some Tums: no effect. I lay down, and took some nitroglycerin. No effect. The pain continued to increase. I interrupted my wife at her work. She found some aspirin, and I swallowed what I could. I thought I was dealing with a bad case of indigestion. I was now bending over, having a hard time catching my breath.
My wife drove me to the hospital, thinking we could get there faster than an ambulance could arrive and take us there. (We should have called the ambulance; they could have alerted the hospital and started medications).
At the hospital, they immediately put in three IV’s and started administering blood thinners to try to break up the blood clot that was causing the heart attack. The chest pain continued to increase, as if the chest were being slowly squeezed, tighter and tighter. After about three hours from the start of the heart attack, my consciousness started fading, and I experienced that gray fog again, as I had five years earlier. I realized, dimly, that this could be the end of my life. I couldn’t believe it.
The order was given to evacuate me to Anchorage by emergency jet, since they did not have a cardiology unit in Fairbanks and they couldn’t do any surgical intervention. On the plane, I was strapped on a gurney, hooked up to EKG machine and oxygen, and was in the presence of my wife, two nurses, two pilots, and some strange dim red light that was always on in the cabin. I thought to myself, This is a new way to travel to Anchorage.
Somewhere on the plane ride the chest pain went away, and the gray fog lifted.
Monday, February 19, 2007
For whatever deep psychological reason, I like to play with stones. After walking the Grace Cathedral labyrinth in San Francisco, it was immediately obvious to me that I needed to build a stone labyrinth in the back yard.
Similar to building the cave, there was a lot more to it than I had considered when I had the idea. Once again I had gotten myself involved in a massive project that would overwhelm me. It took another ten truck loads of flat stones, and almost that much sand and gravel to make a level pad for the stones. Because of the slope of the land, I could only build it about two-thirds the size of the Chartes labyrinth, which meant the pathways were about one foot wide and the entire labyrinth was about twenty-four feet wide.
The labyrinth was oriented to the compass directions, keeping in mind the 27% declination that Fairbanks is from the North Pole; the entrance is from the North. It was a great laughing pleasure to put in the North and South poles that mark the labyrinth.
Arranging the countless stones in patterns to delineate the walk ways was sometimes quite difficult and it seemed like a never-ending task; sometimes it felt as if some kind of additional help was being given to me and the stones immediately and easily fell into the right place. The color, texture, and pattern of the stones add an additional dimenion to the walk. The ancient stones make it feel as if the labyrinth has been there for a thousand years.
Similar to the cave, the laybrinth was finished just about the time the snow fell in October. I swept the snow off the labyrinth for a couple of snowfalls, then yielded to the winter.
No matter how many times I walk this northern labyrinth, there is still a sense of relief and perspective when I reach the center. And, in latter difficult times to come, I would walk the labyrinth in my mind when I could not walk it in reality.
You can find a labyrinth in your neighborhood:
Sunday, February 18, 2007
Six months after the placement of the second stent, once again I experienced problems in exercising and breathing, with a slight uncomfortable feeling in my chest. Restenosis was happening, the biggest problem with stents. The artery was getting blocked from the scar tissue slowly surrounding the second stent.
I went back to San Francisco. I asked Dr. H. to run the catheter and angiogram through my wrist, as is frequently done in Europe. After three previous angiograms, there was scarring of my femoral arteries, and the last time there had been swelling the size of a grapefruit that made walking difficult for weeks.
He put a drug-eluting stent in, a fairly new product that was shown to greatly reduce the likelihood of restenosis. I wondered why this had not been done in Anchorage six months earlier.
Dr. H. as they say in cardiology parlance, “Is a good man with a wire”, and I had the easiest recovery I had ever had.
In San Francisco, my wife and I went to Grace Cathedral and walked the Labyrinth, a replica of the 12th century Chartes labyrinth that pilgrims walked as a spiritual and symbolic way of walking to Jerusalem. I have been very skeptical of such New Age California fads, and I was very surprised that it was quite a deep experience. Somehow, all the walking and turning changed my mental state, and I found myself quite thoughtful and grateful.
Saturday, February 17, 2007
Three ravens are picking away at pink insulation in my house.
This did not feel like a good dream. Something dark was eating at me, and something internal was exposed. I was having some difficulty recovering from exercising, and was walking less and less. This was similar to how I had felt in early January 2001, which I then first attributed to some trouble in my lungs with bronchitis.
Once again I went to the Alaska Heart Institute in Anchorage, where they have the closest cardiologists to Fairbanks. I passed twelve minutes on the on the thallium treadmill test; the technician told me that almost no one who can walk that fast and long has a problem. The doctor called me that afternoon and told me the test was “positive”, which was not positive for me.
After the placement of another stent, in a lower portion of the problematic left arterial descending artery, I felt relieved, in spite of intense chest pain that I was told was sometimes a by-product of the surgery and was expected to diminish. They kept asking me if I wanted more painkillers. “Sure”, I readily replied.
As I was talking to the nurse, the world suddenly started spinning very fast and I passed out. I woke up sometime later with the nurse shaking me, and at least seven nurses all looking at me in a concerned way. My heart had slowed down to about ten beats a minute, an emergency Code Red was called, and I was given two shots of epinephrine to restart my heart. The nurse told me this had never happened on her shift in twenty years after the placement of a stent.
The doctor was called, and once again I was headed back in surgery. This was not good, and it was feared there was blockage in the artery. My wife and I had one of those serious talks that couples facing unknown surgery have, and said good-bye.
The stent was re-positioned and I survived, to my surprise. No explanation was given to me why this had happened; my feeling is that I was given too much morphine. After several extra days in the hospital, I returned home to Fairbanks and forty degrees below zero. Next time, I vowed, I would go to Hawaii after any operation.
Friday, February 16, 2007
(Detail of East wall of cave)
For months after the stent was implanted I felt stunned, not knowing what to do with my life or how much life I had left. I felt only half in the world, half in some ethereal, other-worldly place. In August, six months after the emergency flight to San Francisco, I impulsively decided that it was time to build an underground room, a stone cave. I wanted a quiet, meditative place I could retreat to, out of the intense daylight of the Alaska summer and the noise of the every day world. Wounded creatures retreat to caves, I thought.
I called a friend who was a heavy equipment operator and suddenly, within four hours, there was a deep, gaping hole in what used to be the back yard.
The planned room was about ten feet by fifteen feet, half in a semi-circle. I had never built anything out of stone and concrete before. I had absolutely no idea what I was doing. My father-in-law, familiar with concrete from building in Poland, helped me pour the floor. I loaded and hauled twelve loads of rocks in a pick-up truck, and spent six weeks working with stone and mortar building the walls. Every morning I wondered what I had gotten myself into, and then worked each day until it was too dark to continue. It was close to the craziest thing I had ever done in my life, and it also felt like the right thing to do.
In mid-September, 2001, I went to Spenard Builders Supply, a local hardware store. Tom, one of the employees I knew there, was just shaking his head and talking about the events of September 11. “What are you going to do,” he said to me rhetorically, “Build a cave?”
We poured the concrete ceiling just before the snow came, in early October.
The friend and doctor who had suggested I come to San Francisco told me later that he was afraid that I was building a tomb. I didn’t think of it as a tomb, but I did see it as some kind of sacred project, something that was asking to be made from some deep part of me. The building of it got me back to being physically strong, grounded me in concrete reality, and brought me back to the world. It has been a very soothing and special place over the last years.
(Detail of East wall of cave)