Spiral Maze

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The spiral maze kept wanting to be drawn.


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.

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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

Egg

A three year old could have done the last drawing, and that is about the age I was.

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The heartbeat is the basic wave of the body; I certainly have been constantly concerned about whether it will keep going.


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.

Links


http://www.cardiacyoga.com

Waves

The psychological body is not visible.


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.)

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Betrayal of the Body

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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.

First Drawing

For months after the heart attack, I was afraid to go to sleep at night, thinking that I might not wake up in the morning. As long as I stayed awake, I figured I could watch to see whether my heart was going to be attacked.


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.

Drug Eluting Stents

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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.

The Big Hit

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.Drawing, February 21, 2007
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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.

Chest Pain

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Drawing, February 20, 2007
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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.
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Somewhere on the plane ride the chest pain went away, and the gray fog lifted.

The Labyrinth

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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.
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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.
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You can find a labyrinth in your neighborhood:
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http://ww11.veriditas.labyrinthsociety.org/

Golden Gate Stent

Drawing, February 18, 2007
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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.

Ravens

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_________DDrawing, February 17, 2007________

In January 2004, I dreamed

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.

The Cave

(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.

Surrender

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Drawing, February 15, 2007

The day after the operation, I dreamed,


I was on a peninsula called the Moulin Rouge. It was war time. I was hiding in a burned out room. The Germans were getting very near to where I was hiding; they were also about to discover my comrades. If I tried to warn my fellow soldiers, I would surely be killed; if I didn’t do something, my friends would be killed.

I stood up and shouted at the Germans, expecting to die immediately. To my surprise, they kept on going, almost as if I wasn’t there.

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This dream felt like a depiction of the battle in my heart, the moulin rouge, the "red windmill." The landscape had been devasted, but it was not my time to die. It was a relief for me to finally let go, to stop fighting, to surrender my self for the sake of something larger.


One of the problems with the placement of stents in the body is that the body treats them as a foreign invasion and creates scar tissue around them; if enough scar tissue builds up, then the artery becomes blocked. I hoped that this dream was a message that the body would not fight the invasion, to let it be.


As soon as I was able to walk around San Francisco, I went with my ten year old son to see the new movie the " X-Men," about mutant humans with special powers. I sure didn't feel as if I had any unusual powers, but I did feel like some kind of mutant bionic creature with this stainless steel implant in my heart.

Premonitions

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.DraDrawing, Febuary 14, 2007

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In September 2001, I dream

An airplane with a red, four cylinder engine is leaking oil and smoking.

The plane takes off and crashes.

I woke up and the first thought in my head was, “I am having heart problems.” I immediately set up an appointment with my doctor. We talked about what to do. I had no symptoms. I had no difficulty exercising. My cholesterol level was good. Probably the best diagnostic alternative was to run a thallium treadmill test, but how do you justify doing this test on the basis of a dream? I didn’t particularly want to have what I feared was a radioactive substance in my blood and to have a large medical bill.

Four months later, I was walking up a hill 100 yards from my house and started getting dizzy and sweating. I had to sit down three times before I could make it home. I was told to go to the emergency room. Six hours later I came home, after promising that I would fly to Anchorage, three hundred miles south, and get evaluated the next day.

By the time I reached the cardiologist’s office at the Alaska Heart Institute, I was dizzy and sweating again. The cardiologist spent fifteen minutes with me and gave me, according to the bill, “a thorough heart evaluation.” This cardiologist was going on vacation, and since I had an infected tooth, he did not want to do a angiogram, where a catheter is put up through your groin, dye is inserted, and pictures of your blood flow and any blockages to the coronary arteries are seen. He sent me home, and told me to come back in two weeks.


After getting home that day, I quickly went to the Internet to research my situation. Everything I read said that I had “unstable” angina. I called Dr. C. in San Francisco, a friend I had gone to school with. He said to fly down to San Francisco and they would take care of me at the California Pacific Medical Center.


The next day I was on a flight to California with my family. For the first time at the airports, I took one of those motorized airport carts. Walking was difficult; the world seemed very gray to me. I kept thinking of the Emily Dickinson poem, “The fog is rolling in. I must go inside.”


The cardiologist I was scheduled to see called me at the hotel. When he learned I had taken three nitroglycerin tablets (which oxygenate the blood and prevent heart attacks) and still was feeling strange and nauseous, he sent me to the emergency room. The angiogram showed a long ninety percent blockage of the left descending coronary artery, and a stent was put in. I had just missed a massive heart attack.

Wounded

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The Education of Achilles by Chiron by Pierre Puget, 1690

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.A heart attack is a deeply wounding event.

I have been struggling with this never-ending wound for more than a year, and still it haunts me by the hour.

A heart attack is also a deeply isolating event; others act as if their lives will go on forever. How can I participate in this charade, knowing deeply and irrevocably that any moment could be the last one? I feel much more in common with people with terminal illness than those who are caught up in the illusion of every day life.


To reduce the isolation and find a way (with the help of blog readers) through this purgatory, I thought I would post some my musings on the Web.



I am fascinated and struck by the myth of Chiron, that mythical Centaur who had a permanent wound that would not heal. In Puget's painting, Achilles is being dragged by his rationality (his head), and it doesn't look like there is much he can do about it.
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"Ducunt volentem fata, nolentem trahunt."

("Fate leads the willing, the unwilling it drags.")

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Not particularly wanting to be trahunted, I have to figure out just where this heart attack is leading me.