It begins late one afternoon in her kitchen. There is no collapse, no massive pain. Just a slight fluttering sensation in her chest, then chills, and finally, nausea. Probably nothing to worry about, the doctor assures her on the phone. It doesn’t sound like a heart attack.
But it is. Heart attacks in women can look and feel dramatically different than they do in men, which is why they often go undiagnosed. But heart disease is the number-one killer of American women—greater than all forms of cancer combined.
When the doctor examines Lear the day after her episode, the verdict is shocking. So begins an account, filled with grace, humor, and ferocity, of her hard-won return to good health, beset by mysterious postsurgical complications and haunted by memories of her late husband when she finds herself in the same coronary unit in which she lost him all those years ago.
It begins late one afternoon in her kitchen. There is no collapse, no massive pain. Just a slight fluttering sensation in her chest, then chills, and finally, nausea. Probably nothing to worry about, the doctor assures her on the phone. It doesn’t sound like a heart attack.
But it is. Heart attacks in women can look and feel dramatically different than they do in men, which is why they often go undiagnosed. But heart disease is the number-one killer of American women—greater than all forms of cancer combined.
When the doctor examines Lear the day after her episode, the verdict is shocking. So begins an account, filled with grace, humor, and ferocity, of her hard-won return to good health, beset by mysterious postsurgical complications and haunted by memories of her late husband when she finds herself in the same coronary unit in which she lost him all those years ago.
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Overview
It begins late one afternoon in her kitchen. There is no collapse, no massive pain. Just a slight fluttering sensation in her chest, then chills, and finally, nausea. Probably nothing to worry about, the doctor assures her on the phone. It doesn’t sound like a heart attack.
But it is. Heart attacks in women can look and feel dramatically different than they do in men, which is why they often go undiagnosed. But heart disease is the number-one killer of American women—greater than all forms of cancer combined.
When the doctor examines Lear the day after her episode, the verdict is shocking. So begins an account, filled with grace, humor, and ferocity, of her hard-won return to good health, beset by mysterious postsurgical complications and haunted by memories of her late husband when she finds herself in the same coronary unit in which she lost him all those years ago.
Product Details
| ISBN-13: | 9781497646117 |
|---|---|
| Publisher: | Open Road Media |
| Publication date: | 09/16/2014 |
| Sold by: | Barnes & Noble |
| Format: | eBook |
| Pages: | 206 |
| File size: | 3 MB |
About the Author
Martha Weinman Lear is the author of Where Did I Leave My Glasses? as well as the bestsellers The Child Worshipers and Heartsounds, which became a Peabody Award–winning film. She is a former articles editor and staff writer for the New York Times Magazine and has written extensively for that and many other national publications, including AARP The Magazine, the New Yorker, the New York Times Book Review, GQ, House Beautiful, Redbook, Ladies’ Home Journal, Woman’s Day, McCall’s, Family Circle, and Reader’s Digest, often on medical, cultural, and sociological subjects. She lives in New York City with her husband, screenwriter Albert Ruben.
Read an Excerpt
Echoes of Heartsounds
A Memoir
By Martha Weinman Lear
OPEN ROAD INTEGRATED MEDIA
Copyright © 2014 Martha Weinman LearAll rights reserved.
ISBN: 978-1-4976-4611-7
CHAPTER 1
It crept up on me like a cat burglar. No sound, no warning. A balmy late October afternoon, the trees along Central Park West showing the last pale traces of autumn color, dusk casting shadows in the kitchen where I sat at the butcher-block table, eating a bowl of soup and feeling totally, unremarkably well.
That was one moment. In the next, something was wrong. Something suddenly was there, inside me, something that did not belong there, that had never been there before, not painful but powerfully there, a strange unpleasant fluttering sensation low in my chest, down there at the sternum, like the fluttering of wings, fluttering upward now toward the collarbone. I stood and considered it.
As I ate, I had been making a list of clothes to pack for the birthday trip. This was our custom, one of the countless little customs that define a marriage, to take each other away on birthday trips. Mine were in March. Usually he took me south, to Caribbean islands ringed by waters of improbable beauty. His were in October. I took him north, to country inns awash in chintz, for the foliage, or to American cities we loved—San Francisco, Chicago, New Orleans. The next day, we were scheduled to fly to Charleston.
But now there was this foreign presence within me. The strange fluttering had grown stronger, those wings now insistently beating their way up into my throat. The room was warm, in fact a bit too warm, but suddenly I was ice-cold. I began to shake. A moment later, I felt nausea, everything coming suddenly, and now there was pain too, not great but pain, midline, Adam's apple down to sternum, and with this pain came a dreadful sense of foreboding.
I went into the bedroom, where he was packing. I said, "Al, something's the matter with me."
"What do you mean? What do you feel?"
"Nausea."
It grabbed hold of me just then, it clogged my throat, and I was caught up in a paroxysm of dry heaves. In moments, I was kneeling on the bathroom floor, clutching a pillow to my chest and retching into the toilet bowl, so violently that I felt I would spew out my life.
He stood helpless in the doorway. I said, in a moment's pause, "Do you think I could be having a heart attack?"
"Oh, of course not," he said. "You've got food poisoning." The soup? Surely not the soup, perfectly good soup, mushroom barley, I had made it just the day before, we'd eaten it at dinner, I'd refrigerated it overnight. "Or maybe it's some kind of stomach bug," he said.
He might be right. Still, I knew—I had read about it, and in fact, I had written about it—that heart attacks can present themselves very differently in women from the stereotypical ways they do in men. Women rarely suffer that cliché of the crushing pain, the elephant sitting on the chest, the sudden collapse. There may be no more than this clogging I felt in my throat, this modest pain in the chest, or maybe not even this much, maybe just a heaviness in the arm, the shoulder, the neck, something slight, almost a nonevent, a pale wind blowing through town and leaving no visible trail. Which was why it often goes undiagnosed.
I called my doctor's service. "Yes, it's urgent," I said. "I'm having pain in my chest."
He called back immediately. I reported symptoms: the fluttering, the pain, the chills, the shaking, the vomiting, and now diarrhea, too. He asked a rapid sequence of questions: Do you have pain in your throat? No. Do you have shortness of breath? No. Any sweating? No. Turn on your left side. Does that make it worse? No. Now your right side. Is it worse? No.
"Well," he said, "with the diarrhea, it doesn't sound like your heart. I can't say a thousand percent that it's not, but on the tiny chance that it could be, it doesn't seem necessary to go racing to the emergency room with the way you feel now. Just see it through and come in for an EKG in the morning."
The nausea eased. I said, "Maybe my anxiety is making the pain worse. I should take a tranquilizer."
"Good idea," my husband said. He knows me. He knows my anxieties that come from the weight of the genes: My mother and her mother, breast cancer, both breasts. My father and his father, and brother and uncles too, first coronaries in their fifties, dead in their sixties.
I sat on the edge of the bed, still hugging a pillow to my chest. He stood eying me, pretending more nonchalance than he felt. Within an hour, the pain stopped, the pill kicked in, and I slept.
I awoke feeling predictably washed out, but otherwise well. Perhaps it wasn't necessary to call for the EKG appointment? "You might as well. You told him you would," my husband said.
The doctor's receptionist said, "It's a crazy day, Mrs. Lear, but he told us to squeeze you in."
Every day was a crazy day and he always told them to squeeze me in. He was overworked, overburdened, his waiting room always SRO, but he made time for me. We had a bond that went way back, Stuart and I. Thirty years before, he had been the young doctor on call in the hospital emergency room the night I had brought in my first husband, my late husband, Harold Lear: a doctor who had suddenly become a patient with the onset of his first coronary four years earlier. That night in the ER was his eleventh emergency admission. He was on a downward trajectory and he knew it. Everyone knew it. He had come to that point at which doctors often pull back, close down, stop returning the telephone calls, become less attentive, not necessarily consciously and not because they are uncaring, but because they cannot bear to confront their own impotence in the face of the inevitable.
Six months later, Hal would be dead. For those six months, Stuart became his primary doctor. Medically, there was little more that could be done, but in the sheer caring part of medical care, there was plenty that could be done, and Stuart did it. He gave Hal attention, he gave him respect. At the end, there was great mutual affection, and at the memorial service, Stuart spoke, saluting the spirit of his near-indomitable patient; since then he had been my own primary doctor and the friend to whom, through the intervening years, I had remained deeply grateful.
"Want me to go to the appointment with you?" Al asked.
"No need. I'll be back soon."
"You think we'll be able to go to Charleston?"
"Of course we'll be able to go to Charleston!"
"You really feel okay?"
"Perfectly!" And I was out the door.
"Your cane!" he called.
My cane. A torn meniscus had been causing pain in my knee. "We could operate on it," the orthopedist had said, "but sometimes, when you have underlying arthritis"—as I had—"those surgeries aren't too successful. Try using a cane for six weeks, and then we'll reevaluate."
I hated using the cane. I hated the seventeen metaphors for cane, the nervous jokey preoccupation that we had all begun to show, my friends and I, with health, symptoms, doctors, aches, pains.
"When I was a young girl," Molly had told us, the Richmond lilt soft in her voice, "my mother would have her friends come to tea, and I would hear them, and all they ever talked about was doctors and sickness, and it was so boring. I swore that when I grew up, I would never do that." Pause. "But I didn't realize how much fun it would be."
We had all laughed. That particular laughter, with a tinge of rue.
I took the cane. In the street, waiting for a cab, I started playing with it, twirling it about my legs like a demented baton twirler, until the doorman said, "Watch it, ma'am, you could break a leg on that thing," after which I accepted that a cane is a cane and stood quietly until a cab pulled up to the curb.
When they saw what was going on inside me, one of them told me afterward, they thought it was quite remarkable, really, that I was feeling so unremarkably well.
CHAPTER 2"You're not going to Charleston."
I had known it. I had been hoping that I didn't know it, but I had known it.
I had been waiting and hoping in the waiting room, a space filled, like every doctor's waiting room, with vibrations of hope and fear. It was always crowded, mostly with seniors. Stuart's patients adored him. Especially the very old ones, who had no one else to listen to their complaints. Especially the very sick ones, from whom other doctors may have distanced themselves; Stuart stuck around, as he had done with Hal.
I sat for some ten minutes, willing myself to be wrong. Then I was shown into Stuart's consulting room. ("You sure sound better than you did last night," he said. "Totally fine. We're going to Charleston this evening," I said), and then I went to the examining room for my electrocardiogram.
It was done quickly. "Okay, you can get dressed," the nurse said and took the printout to show the doctor.
She returned almost immediately.
"Stop dressing."
"Why?"
"He wants to do an echocardiogram."
"Why?"
She shrugged. "Maybe he sees some change." Red flags waving in her eyes.
And now here is Stuart, looking stricken. "You're not going to Charleston," he says.
I am on the examining table, half-dressed. "Why not?"
"Something's happened."
"What?"
"Not sure yet."
But clearly he is sure. His face is grim, as I have never seen it before; his mouth is set in a thin grim line and I can sense, rather than see, his teeth clenched hard behind those lips. He is muttering, more to himself than to me, "I can't believe it ... The diarrhea last night ... That just didn't fit the picture ... I should have ... I could kick myself ..."
Stuart has always expressed faith in my long and healthy future. For twenty-odd years he has been monitoring my annual flu, my encroaching arthritis, my bad cholesterol ("not too bad"), my good cholesterol ("excellent"), the very texture of my platelets ("beautiful!"), and, whenever he would listen to my heart, he would punctuate his faith with a tch of pleased disbelief and the invariable assurance, "You've got the heart of a teenage kid! You'll outlive us all."
Oh, Doctor. Where is your faith now? He is doing the echo and I am looking at him and he is looking at the screen and he looks vastly different from the composed man I saw five minutes ago. He is agitated. He is miserable. Come on, Stuart. Me, Martha? A heart attack? Don't be silly. I know it, but I know it merely on the level of objective reality, the level of mere facts. Subjectively, where we live most of our emotional lives, where feelings trump facts every time, I know no such thing. I reject it completely, Stuart. Something happened, sure, something happens all the time, but to other people. You've got the wrong electrocardiogram. You've got the wrong diagnosis. You've got the wrong I don't know what, but it's wrong.
But wait. Now that I think back, I remember—how odd that I didn't remember this earlier, last night, this morning—that I have been feeling unspecifically unwell for weeks, a generalized blah, saying often to Al, "Do I look awfully pale?" and "I just don't feel great," and "Why am I so tired all the time?" So why is it such a shock to hear that something happened?
Into a thick silence, I ask now: "Is it mild?"
"Not mild," he says. Not mild. That is all he says, and instantly I am off on a thirty-year-old trip. I am on a story assignment in France and have just gotten word that Dr. Harold Lear is lying in a bed in the Coronary Care Unit of his hospital, where he is on staff, in New York City, having suffered a heart attack, and now I am screaming into the telephone, for the transatlantic connection is dreadful, "Mild? Did you say "mild?" and an unknown doctor's voice screams back, "Not mild. Myo. A massive myocardial infarction ..."
Oh Jesus. The terror of that moment. It comes back to me like a poisonous taste. And here now, in this absurdly unbelievable moment of my own, here is Stuart saying, "Not mild." A massive myocardial infarction ...
"Is it massive, then?" Coming into the Coronary Care Unit where he lay in a cubicle, kneeling at his bedside, hearing him whisper It will be alright; it will be just like it was, sweet deceitful lies, for as the doctor knows, as even I know, nothing is likely to be just like it was ever again.
And Stuart says now, "Not massive. Moderate."
Moderate. A new word for a new phase: all things in moderation.
"I am stunned," I say.
"So am I."
"I can't believe it."
"Neither can I." He still looks stricken. I learn much later, after I have done the research, that diarrhea almost never accompanies a heart attack. This was an easy one to miss. Any doctor might have missed it, even the best, and Stuart is the best, and knows it. None of which, at this moment, keeps him from looking stricken.
"What happens now?"
"I'm going to admit you. We'll send for an ambulance."
"I don't need an ambulance; I can take a cab." More echoes of Hal: "I don't need a stretcher; I can walk." This the day before he died. Walking dazed, his final walk, in his blue terrycloth robe, through the lobby of our building, refusing the doorman's arm, staggering out to the street and into the waiting ambulance.
Now I wait for my ambulance. They seat me in the corridor, away from other patients. Why? Am I contagious? Well, yes, I suppose I am, in a way: the irrepressible contagiousness of bad news.
A heart attack. Fancy that. If they had told me I had breast cancer, I would have said, "Of course, no surprise there: consider the genes." If they had told me I had terminal lung cancer, I would have been devastated but not in the least surprised. I would have said, "What took it so long to show up?" For I had smoked two to three packs a day for forty years, and after quitting—a triumph, hard won—it had became a waiting game. While other people, stricken in various ways, might say, "Why me?" I kept saying, "Why not me?" thanking the gods for my luck thus far and waiting for the luck to run out. Cigarettes will ruin a heart even faster than they ruin a lung, I knew that. But I had never expected the luck to run out on my heart. I am not certain why. Perhaps because, mere facts to the contrary (fact: heart disease is the number one killer of American women), and my own knowledge to the contrary (for I have written many articles about medical matters, I should know better than to think stereotypically), there still exists that kne–e-jerk assumption that coronaries are what happen to men.
Okay, what must I do now? I know very well what I must do, but I don't want to do it. What I must do now is call my husband and tell him that I am sorry to spoil his birthday, but we can't go to Charleston because I have had ... how to put this ... a heart attack? How do I put this to a man who, some twelve years ago, which in its own way is ten minutes ago, awoke in the middle of the night to find his wife—his first, late wife, his wife of nearly forty years—dead on the bedroom floor?
My cell phone does not seem to be working. Its workings are beyond me. We are both, Al and I, technologically challenged, a harmonious meshing of incompetencies.
Someone hands me a landline phone.
Al answers: "Hello?"
"Hi."
"Well? What did Stuart say?"
"He said ... Al? We can't go to Charleston."
Warily: "Why not?"
"Listen, Al."
"I'm listening."
"I had a heart attack."
"You're kidding."
He knows that I am not kidding. I would be crying, except that I don't believe it yet. You can't cry over what you don't believe. There is silence while we breathe in emanations of each other's disbelief.
"Where are you now?"
"In Stuart's office. I'm waiting for the ambulance."
"Okay. I'll meet you at the hospital." Cool voice. What does this cost him? Is he in a shocked state of mind? Is he in a hyperactive state of mind, looking down a long dark road, imagining a second widowerhood? Or, far worse, imagining life with a cardiac invalid, pushing her in her wheelchair, portable oxygen tank in her desiccated lap, across the many cobblestones of life? Imagining what else?
Stuart's staff, four or five of them, now stand in a semicircle gazing at me, but they maintain a curious distance, as though standing on the far side of the floral arrangements, gazing at the bier.
(Continues...)
Excerpted from Echoes of Heartsounds by Martha Weinman Lear. Copyright © 2014 Martha Weinman Lear. Excerpted by permission of OPEN ROAD INTEGRATED MEDIA.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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Table of Contents
- Cover
- Praise for Heartsounds
- Dedication
- Foreword
- Chapter One
- Chapter Two
- Chapter Three
- Chapter Four
- Chapter Five
- Chapter Six
- Chapter Seven
- Chapter Eight
- Chapter Nine
- Chapter Ten
- Chapter Eleven
- Chapter Twelve
- Chapter Thirteen
- Acknowledgments
- About the Author
- Copyright
Interviews
- Lovers of romance
- Readers who have lost their partners
- Cardiac patients