by Steve Gaines

Ten years ago
walking down town
on a late fall morning
with a gentle ache beneath my left arm
coming and going
with the up and down
of the gentle slopes
and on my bike later that day
riding with the same curious pain
describing the relative effort of my
ride
wondering casually what was going on

it went away when I stopped doing
whatever I was doing
whenever I sat down to catch my breath
something was happening
something not quite benign
yet not quite catastrophic

I was a vigorous man in my mid fifties
fighting the age old
battle with my waist line
still hoping to buy back
the distant memory of youth one last time
before I descended unceremoniously
into the decade sixty something
practiced but unprepared
for the deeper thoughts of mortality

the next Monday I was taking my annual physical
a curious and appropriate
serendipitous piece of scheduling
chatting amiably with my long time GP
his own waistline long ago having lost
the war with middle age
mentioning parenthetically the pain from last week

“oh, how often?…how severe?…
let me get you an appointment with the folks
in coronary concerns…just a precaution.”

the folks in coronary concerns didn’t like my story
sounded serious
maybe they should do a heart cath
(short for a longer and much more ominous word)

take a quick look at the suspicious vessels
see what’s going on!

something was going on!
my LAD was 90 percent occluded…
clogged up that is
LAD!…
now this acronym heard from?
left anterior descending…
a very important tributary it seemed

something had to be done

three days later they went back up
my femoral artery with their “snake”
something like the catheter only with more to be done
like blowing up a balloon inside the vessel

an angioplasty…just one…no big deal
should keep me open and
going forward for many years…unless!

the dreaded unless

by the following January, three months later
along came the “unless!”

climbing steeper slopes in Colorado Springs
walking with my
brother and my brother’s dogs
noticing the old familiar ache under the arm
could it be?

it could!

the following week the coronary folks
becoming familiar old friends as well
run me through a stress test
pump me up with Thallium…
a radioactive isotope
take pictures of my over worked heart
much tongue clucking
and take me straight up stairs and check me in

this time only a bypass will do the job they speculate
things have re-occluded
even worse than before… hmmm?

less than twenty four hours later
I come to dancing with tubes
and oscilloscopes blinking
in a cold room in the ICU

slowly I remember
slowly become aware of the recent hole in my chest
now sprouting tubes

“everything went well!”

“this will do the job!”

“you’re just as good as new!”

great sighs and relief…
back on my feet that same day
and home within the week
my future bright and promising
new diet to understand and practice
fifty pounds to lose…
with a better reason to do it!

a grand reprieve

unless!

this time it takes almost ten years
back in town from the theatrical hinterlands
Buffalo and back
having “gone to seed” on my own cooking
too much cheese and easy to cook
prepared foods probably

and the old ache in the arm back
at least I knew what to do
so back to the stress test…
cardiolite this time
and the pictures tell the tale

“let’s do another procedure…
add a little support…
called a stent.”
so after the balloon goes up they leave
a little mesh thingie to keep
things open

of course!…

there’s a chance for the old scar tissue to develop
seems like I’m rather clever alone those lines
able to make something out of nothing
if you know what I mean

but its only fifty percent
a couple of new drugs should do the job

“and there are a lot of men out there
with fifty percent blockages
…doesn’t that reassure you?”

so I walk out into the dark unknown again
learning not to hold my breath…
for fear I drop off the precipice
just in case I’m susceptible after all!
to the common fifty percent

alas I make it through the best part of another year…
twelve months
walking on thin ice
waiting for the pessimism to work out

and sure enough…!!

that next August in Albuquerque walking in the altitude
the old breathless tuck in the side gives me a notice

okay!

by November I’m back in the cath lab
“yeah, a couple more vessels have given it up…
seventyish
another balloon, another stent
and of course one little proviso…
“one in the back I couldn’t quite get to.”

there’s never a clean bill of health in this game
at least not with my system
perverse in its monotonous ability
to clog up regardless of my good intentions
in spite of my good behavior or bad

I slowly begin to assume that “someone” out
there has a really cruel sense of humor
casting me in this minor Job like role
just to see how I accept it
see how I deal with inevitable endings
held over my head day and night
to see if I give it up or keep at it…
just as perversely

and that’s where I am today…
perversely going forward

not waiting for the last shoe to drop
and not waiting for some grand reprieve

winning and losing have taken on a strange reversal
I can’t seem to conquer this bizarre fate
and I can’t give up trying…

at least it gives me something to do in the interim

until whatever happens
until whenever it will
unless the old “unless!”

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