Monday, October 6, 2008


Two months ago, I had an internal defibrillator procedure at Kaiser. It’s a little like having a small cell phone on my chest. My defibrillator is about four times bigger than a pace-maker. The point is not so much to enhance my day-to-day activities, as to provide insurance against sudden cardiac arrest, for which I guess I’m at serious risk. I had a major heart attack forty-nine months ago.

I suppose if you’re going to have a heart attack, I had mine at an optimal time. I recently read an article about the efficacy of angioplasty and of stents. Its conclusion was that preventative stents are of questionable value—that the gold standard for inserting stents needs to be within an hour of a severe heart attack. That qualification fit my scenario to a ‘T.’

Saturday August 28th, 2004 was the wedding of Dan Hutchings & Rachael Lu, musician friends (Dan of the Schola Cantorum at St. Francis) in the Green Room of the War Memorial Veteran’s building next to the opera house. Dan sang Schubert and Rachael accompanied him on the piano.

Dennis and I went to the ceremony and reception in the same room and sat at the table with Tom Hart from Chanticleer days. He said I looked terrific.

Earlier that day, I had gone to William Stout Architectural Books near work and bought a huge folio of Karl Friedrich Schinkel, the great 19th Century German architect. The book weighs about 80 pounds. I brought it home by taxi, but carried it upstairs and moved it around several times before settling on the floor in front of the Napoleon window in the dining room.

When I later suggested to my cardiologist, Sheryl Garrett, that this might have been the proximate cause of my heart attack the following morning, she agreed. She said it was the first time she had heard of a heart attack caused by a book! More common was somebody lifting a car engine.

On Sunday morning I woke up early, sopping wet. I frequently sweat a lot at night, but this was different. Dennis was still asleep. I decided to take a shower, which was probably not such a hot idea. Then Dennis got up and went down to the garden to read the paper, drink his coffee and have a smoke. I think I had some coffee. I’m sure I had already made a pot for him. Still sweating after my shower, and starting to feel a sharp pain in my back, I called to Dennis in the garden and asked him to make some phone calls for me. To demonstrate my priorities, the first was to John Renke, my organist and choir director at St. Francis, to let him know that I wouldn’t sing at church that morning. Then I asked Dennis to call the advice nurse at Kaiser.

Dennis described my symptoms to the advice nurse. As we were talking to her, my left arm started to go numb. She immediately said to call 911. Dennis offered to drive me to Kaiser, but the nurse insisted he call 911, which of course, he did. Within minutes there were six or seven strapping firemen in the house, hooking me up to all kinds of things and injecting me with whatever is standard procedure. Then they strapped me into a chair and carried me down to their emergency van, which must have been only a few blocks a- way when they received the call. For some reason they went up Fair Oaks to 20th St and then to Dolores on the way to Kaiser on Geary. I think Dennis was with me in the emergency van.

When we got to Kaiser, I was immediately taken to the emergency room. It turns out that Kaiser’s Cardiac headquarters for Northern California is at that very location. Had I been taken to a different Kaiser facility, I would have been transferred to that one. Within half an hour or so, I had an angioplasty with two stents. One of my main cardiac arteries had been 99% blocked. It was a heart attack waiting to happen.

Most heart attacks occur on Monday mornings about 8:00 am. I guess people are apprehensive about going back to work. I suppose my parallel is that Sundays used to be work days for me, when the Schola Cantorum had regular services every Sunday (until we got fired).

Fortunately, Karl Friedrich Schinkel caused my attack to occur early on a Sunday morning, when the emergency vehicle was close by, there was very light traffic, and when I had the actual heart attack the very moment we were consulting the advice nurse!

Dr. Sheryl Garrett was the doctor on call in the emergency room that day. She was not my surgeon, but heard about my arrival. Dr. Garrett later told me she has had two most memorable experiences among the hundreds of cardiac patients she has treated during her seven years at Kaiser. The first was a seventy-eight year old woman who had cardiac arrest the very instant Dr. Garrett shook her hand. The patient survived, then years later had another heart attack, and was still alive when I heard about her story.

The second memorable experience was seeing Dennis in the lobby outside the emergency room. Dr. Garrett had not yet met me, but had heard of my circumstances. She surveyed the waiting room and noticed Dennis among the group of people there. Immediately she knew who he was. She said his great concern, fear and love was absolutely palpable.

Although I was initially surprised by my heart attack, I really shouldn’t have been. There is significant history of heart disease on both sides of my family. Dad had his first heart attack at thirty-nine when he tried to hold his breath while swimming under water the full length of a pool. Then he had another one a few years later. I remember visiting him in the Harrisburg Hospital when I was three or four years old. Of course, his dramatic cardiac arrest was in 1977 when he was sixty-eight. That was when Dad collapsed after giving a tight three minute roast of the mayor at the auditorium of the Hershey Medical Center, and Helen screamed and followed Dad in the ambulance –and Mother was left behind because she was trying to stay out of the way of the care givers. Many people thought Helen was Mrs. Bell. Dad’s performance ended the show! Lastly Dad died of a heart attack the day he was supposed to be released from Temple University Hospital in Philadelphia on October 30, 1982, about seven weeks before his 74th birthday. He had been treated for a major stroke the previous June, and was going home to recuperate before a scheduled operation on his other carotid artery.

Dad’s favorite sister Alice died of heart disease in her late fifties. And Mother’s mother, Julia Trump Rich, died of heart failure about age sixty-five.

Recently, of course, was the unexpected death of my first cousin Roswell Brayton, Jr. As his sister Anne said: “He was the golden boy. Nobody expected him to die so young.” He was almost the same age as I when I had my attack – a few months after his 55th birthday. Rozzie was the genuine athlete in the family. He was the star pitcher on his Harvard baseball team and made the Harvard Sports Hall of Fame. I guess he was also a fanatic golfer, as were many others of my Mother’s family. He had a wooden box full of score cards from every golf game he had ever played (over a thousand). It was buried with him in his casket. And since his father had lived until his early eighties, Rozzie had every expectation that he would do likewise. Nevertheless, he evidently had already planned that detail of his funeral.

The irony was, he died doing cardio in the company gym in Woolrich. I suppose the hard decisions he had taken to make Woolrich competitive to survive in the new global economy took its toll. As President and CEO of the family company, he had had to let go almost 80% of the US workforce. I’m convinced it killed him.

I just received word from Dennis’ step-mom Evelyn that his step-sister Jackie’s husband died of a heart attack last week. The shame was he wasn’t feeling well and went in for a check-up, but the hospital didn’t do any tests for heart condition and thought instead he was coming down with pneumonia. He went back to work and died a few days later at the farm co-op in Clarence, Iowa.

Dennis had been sick for years, and I had been preparing myself to be a caregiver to him. The amazing thing is I never anticipated that he would be such a marvelous caregiver to me. I’ll always be grateful that I survived to be there for him at his end.

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