At Home: 3:40 a.m.

I bolt upright—my heart racing, blood pounding in my ears. A voice inside me whispers, The phone is going to ring. My eyes dart to the clock—3:40 am. That’s ridiculous. I left him last night, and the doctors said he was just fine, my logical self argues back.

There is a ticking time bomb. The phone is going to ring, the voice insists.
But it can’t ring, I plead.

I have an early morning. I need to get back to sleep. That seems impossible as my heart is racing, a pressure against my ribs like a herd of bison thundering in me, trying to escape.
John was admitted to the hospital on Tuesday, after doctors discovered a ninety-five percent blockage in his left anterior descending artery—a type of blockage that can cause what’s known as the widowmaker, an often-catastrophic heart attack. It is now early Thursday morning, with his quadruple bypass surgery scheduled for twenty-four hours from now.

I take my meditation position and close my eyes, fighting against my urge to run to the hospital. It takes me seven minutes to get there if I don’t speed.

But he will think I’m ridiculous, and more importantly, he will worry about my lack of sleep, I remind myself while concentrating on my breath.

Breathe in five, hold five, breathe out five. Breathe in five, hold five, breathe out five.I repeat this pattern until the bison slow to a walk, carrying me forward, pressing my chest from the inside. But I have hope now that I can get back to sleep.

I settle under the covers while little Chihuahua Jesse buries herself under the blanket, in the crook of my leg while Mercury, John’s thirty-two-pound French bulldog, takes his spot at the foot of the bed, his head always on my foot or calf, always touching me, reminding me he is there, just as John does with his hand on the small of my back as we sleep.

The Phone Call: 5:40 a.m.

The ringing phone jolts me awake. I am not surprised. I already knew it would ring. I didn’t trust myself because I didn’t want it to be true, but that doesn’t change the fact that the phone rang, just as I expected.

“I’m calling from the ICU. John got really sick overnight, and you need to come right away.”

The fog of sleep still shrouds my brain, or perhaps I don’t want to believe what I am hearing. I had left John in his room on the cardiac surgery floor with a hug and an “I love you,” just a few hours earlier. The directions that the nurse gives me to find the ICU in the hospital’s labyrinth escape me.

“Let me grab a piece of paper.”

I fight the drawer of the nightstand and see my journal and a pen waiting for me. With a sigh of relief, I find a blank page.

“Okay, I’m ready.”

She repeats herself, the fear she is trying to protect me from reveals itself between her words. The silent morning surrounds me, contrasted with my wild mind as it wonders, What does this mean? What happened?

After seven painful heart events, and an increase in dizziness yesterday, I started treating John like a fragile figurine—afraid that if he moved, he might break. When I left him last night, despite my argument against it, all bed rest and fall restrictions had been removed.

The doctors continued to tell us, “We have it managed,” while we waited the three days for John’s quadruple bypass surgery.

How did I know when everyone else seemed to ignore the signs?

One week ago, the cardiologists at a different hospital sent us home without doing an angiogram which, when it was later done, showed the ninety-five percent blockage in John’s left anterior descending (LAD) artery. I had argued for the test, but against my better judgment, let them convince me it wasn’t needed; instead, we went home with statins in hand and a follow-up appointment three weeks later. Six days after that, I received a call from John.

“I don’t want to scare you, but I was beginning to collapse at my desk. I am driving home and need you to take me to the ER.”

Now that the cardiac arrest that I dreaded has happened, what am I supposed to do?

I can’t think; I’m on autopilot. It’s the only way I can hope to do what I need to: get dressed,
grab my purse, my phone, and find a jacket for the February cold.

I have never gone from asleep to walking out the door so quickly. The cold hits my uncovered head like icicles piercing my forehead, the familiar nausea caused by my own illness creeping in. I push through the pain that usually drops me to my knees.

It doesn’t matter! Forget the stupid hat. I have to get to John.

As I climb into my car, I remember last night, John’s arms around me, my head against his chest. Somehow, even from our first embrace, he knew how to bear-hug me without smothering me, despite being a foot taller. He leaned in and kissed me gently, his deep voice quietly whispering, “I love you. Thanks for the great day!” His recognition that it doesn’t matter where we are, we always enjoy our time together.

“Sleep well, and I will see you tomorrow. I love you!” I said in return. Now, my sleepless brain is struggling to reconcile with my current reality.

The cold air snaps me out of my warm, cozy memory of the last time I saw him.

The Drive: 5:50 a.m.

I am alone. I want to cry. Tears want to flow, but I must drive, so I fight to keep them at bay. Do I take the freeway or the backroads? No one is out this early, so the freeway is fine.
But I choose the back roads in case I lose my composure before I get to the hospital. (Tear-induced blindness at thirty miles per hour seems safer than at sixty-five miles per hour.)

I must call someone my frantic brain screams. No one knows what has happened. But I need more information before I call Julie, John’s daughter. I don’t want to scare her, and I have no helpful information.

Diana, my dear friend. I’ll call her. She will be awake. The darkness outside envelops me; my headlights pierce the inky blackness.

“Hello?” Diana’s voice is the only thing that feels familiar.

Without warning, the dam breaks. The tears I’ve held back come crashing down. I can’t catch my breath. Through a sob, I say, “John’s in the ICU.”

“What did you say? I’m sorry, I can’t understand you.”

I try again – gulping oxygen to try to calm myself.

“He’s in the ICU.”

“Oh no, I’m so sorry. What happened?”

I recount what the nurse told me, and Diana reassuringly reminds me that I don’t know anything yet.

“Wait until you know more. I’m sure it will be okay.”

I pull into the Emergency parking lot and grab the accessible parking spot I had left just hours before.

The Intensive Care Unit: 6:00 a.m.

In my shaking hand, I hold the directions I wrote to find John in the ICU, but they don’t make any sense to me. The young woman at the information desk waits for a lost soul just like me. I manage to ask her where the ICU is, and she gives me the same directions as the nurse who called me, yet they seem just as foreign. The only thing my brain can hold on to is that I must get to John, but it can’t seem to do anything to help me accomplish that.

I’m in a daze as I walk/run to the elevators. It feels like an eternity before they open. I punch the button labeled “ICU” in big letters, and the doors slowly close—a speed in contrast with my body, which is shaking. The doors open, and I see the ICU nursing station directly ahead. I don’t have to say anything before the nurse asks, “Are you with him? With John?” Her head tips to the side, a look of anticipation in her eyes because we both know the answer to her question.

I follow her gaze, which lands on the surgeon John and I met a day earlier, the surgeon in the Red Sox hoodie tasked with doing John’s quadruple bypass surgery tomorrow. The irony of his confidence yesterday is not lost on me. He sees me—his blank stare telling a wordless story. His wet hair and gym clothes suggest that the emergency ICU call interrupted his workout. His eyes bore into me, confused and unsure, nothing like the savant of cardiac surgery who had introduced himself yesterday.

“I don’t know what happened. He was so good yesterday–even off bed rest,” he says.

I feel white-hot anger boiling up and want to scream, but I somehow hold back the biting response I longed to say.

Yes, I am well aware, and I questioned all of you because of it.

Despite the doctor’s guidance that he could get up, I told John not to: Don’t move. Stay put. Don’t bend. Don’t twist. My unspoken message: I don’t want to lose you.

With only ten percent perfusion—meaning minimal blood flow and minimal oxygen to his brain—the surgeon informs me that John needs an Impella pump that reduces the heart’s workload. The surgeon shuffles across the hall, his shoulders slumped in defeat, to a room full of doctors and nurses. The whites, blues, and greens of their coats are like colorful apparitions—quiet, focused, concerned. Even from a distance, I can feel their desperation.

My pace has slowed dramatically since my race out the door, and as I make my way to the tables in the ICU waiting room, I see my phone flash red; it has five percent battery—only slightly worse than John’s heart. In my rush out the door, I forgot to bring a charger, so the nurse gives me one. The charger is now my lifeline connecting me to the wall—the only thing holding me down as my life shatters around me. I have no option but to stand because there are no chairs close enough to the outlet. I begin the terrible task of calling John’s family. I call his daughter Julie first. She is local.

“Your dad is in the ICU. He’s in grave condition.”

“I’ll be there as soon as I can,” she says, unable to hide the panic in her voice.

John’s mom is in Dallas. She doesn’t answer. I’ll need to call back later. His dad, whom I’ve never met—also thousands of miles away in Dallas—is next. John spoke to him yesterday. He said that people couldn’t understand their relationship. They didn’t see each other or talk very much, but they always said “I love you” at the end of their conversations.

John sent a group text to his dad and me to connect us so I could send updates. Afterward, John told me that they had spoken for twenty minutes—much longer than their usual five-minute conversations. So don’t expect a lengthy conversation with him, he warned me.

Now, my mind races, trying to determine how I am going to tell him that the son he loves is in grave condition in the ICU. Just as my feet propelled me out the door into the unknown this morning, my fingers dance over my phone, knowing the steps I need to call John’s father in Dallas. I push the final number, but I get his voicemail; I’m not leaving this news as a message. So, I hang up and move to the next call.

John’s sister, Sandy, is taking her kids to school near their home in Dallas when she answers. Their life goes on while mine has become a photograph, a still—the before and after. As I give her the details of John’s status, I hear her tears. I want to provide reassurance, but I am a wreck myself and don’t know that everything will be okay. Out of the corner of my eye, I see a stretcher leaving the first room past the nursing station. That must be him, right?

“Sandy, I have to go,” as I hang up the phone in the middle of her sentence. My tunnel vision is on the person on the stretcher with the ventilator. Between the figures in different-colored scrubs, a sign of the myriad medical professionals feverishly working to keep their patient alive, I see the patient’s grey hair, brushed back in a familiar way, which gives me the answer I already know. The answer I don’t want. It is John.

The stretcher moves quickly, and I have to run to catch up.

“Is that John?” My unfamiliar voice breaks the silence.

The apparitions in their differing-colored coats and pants don’t hear me. They are too focused on the job at hand.

“Is that John?” I yell, more desperate than before. Without thinking, I race up and push the doctors and nurses aside to reach him. I stretch my arms across John, my feet moving to keep up with the stretcher that hasn’t yet slowed. From behind a mask, someone says, “She’s with him,” and I feel the stretcher slow below me as I lay my head on John’s chest, the cold, hard steel of the hospital bed railing cutting painfully into my hips.

“I love you so much,” I say.

There is no holding back tears.

I lift myself enough to reach John’s forehead and gently kiss him—a familiar gesture I show him while snuggled up, watching a show, or settling into bed for the night.

“I love you. I’m here. We are going to get through this,” I say again.

His eyes remain closed, his hand unmoving below mine. The only thing I hear is the whooshing of the ventilator that is keeping him alive as the nurse pushes it alongside him. With one last squeeze of his hand, I move back so the doctors can continue their race to the cath lab where they will use a catheter, under X-ray, to implant the Impella pump that will reinforce John’s weakened heart. I watch as the robed and masked ghosts—ghosts upon whom my life depends—whisk him away.

A few hours later, we will leave this hospital when they send John to another hospital where they will put him on two forms of extracorporeal membrane oxygenation (ECMO), a life support system that will act as an artificial heart and lung to help pump and oxygenate his blood while John rests.

A nurse who was on early in the morning when John coded walks me to my car. She tells me that his heart stopped for eighteen minutes. When they got it started again, he sat up, fear and awareness in his eyes. Then he arrested again for another five minutes.

“Maybe if he was aware, it means he was getting enough oxygen,” I say.

But in my heart, I feel a deep pain at the thought that perhaps the last thing John would ever feel was agony—a pain and fear I carry while I hold him three days later, when he takes his last breath, a weight that travels with me through the devastation, sadness, love, and transformation born from grief.

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