Metaphors for Existence

Being a computer geek, I tend to conceptualize many aspects of life in terms of computers. (And vice versa — computer people tend to anthropomorphize computers). I like to think of my “mind” as software, the body as hardware, and the “soul” or “self” as the combination of the organization of the two.

That said, at about 6:00 this morning, my hardware underwent a hard reboot.

I am subject to occasional episodes of “paroxysmal atrial fibrillation”. Atrial fibrillation is a cardiac arrhythmia caused by mis-coordination of the neural signals that control the contraction of the atria and the ventricles of the heart. Ventricular fibrillation, or “V-fib”, is generally fatal in a matter of seconds. Luckily, atrial fibrillation, or “A-fib” still allows enough blood flow to survive for several days if necessary. Treatment includes various drugs that can stabilize the heartbeat. Sometimes, however, they don’t work.

My last major episode of atrial fibrillation was in 2001. In my young and innocent state, I had no idea what was going on when one evening I felt persistant heart palpitations. Early the next morning, I “wasn’t feeling so good” — nauseous, light-headed and weak. So I drove to the hospital, no doubt overworking my guardian angel squad. I wobbled in to emergency, to see a sign on the wall saying “Due to the nurses’ strike, emergency room waits may be up to 6 hours.” I almost turned around and went home, but the triage nurse asked what was up. “My heart feels a little wonky,” I said, so she pulled out her stethescope to take a listen. “Come with me,” she said. The next thing I knew I was flat on a bed being hooked up to multifarious monitors, intravenous lines and oxygen cannulae. This was all very exciting, especially as the heart monitor I was hooked up to was programmed to beep loudly and spit out reams of printout if it thought it detected an abnormal rhythm. This was every five minutes, in my case. But I was pumped full of some confusingly-named product of modern pharmaceutical science, and after a few hours the rhythm went back to normal.

Since then my heart goes pitter-pat now and then, but it can be controlled by a “vasovagal maneuver.” Take a deep breath, hold it, and remain calm. The irrhythmia goes away within a few seconds. Until this morning.

This morning at sometime before 3:00 I woke from a somewhat muddled dream in which I was experiencing both atrial fibrillation and an acute need to urinate. I realized that the need to urinate was, in fact, a reflection of waking reality, and proceeded to satisfy it. That’s wierd, I thought. I was having a-fib in that dream. As I stumbled back to bed, I noticed my heart racing. Hmm. Felt my pulse. Definitely racing, but in a stumbly sort of fashion. I held my breath, stood still, and felt again. Definitely tripping the light fantastic in there. The feeling is extremely wierd. There’ll be a strong pulse, some weak ones, a couple strong ones, some miscellaneous flutters, and general disorder.

Remembering the canonical parental advice to always wear good underwear to an accident, I shaved and showered, reasoning that it couldn’t hurt, and I didn’t think I was dizzy enough to collapse in the bath quite yet. I was getting a little short of breath though. So, dressed and ready to face the medical system, I checked my pulse one more time, and headed out onto the blustery Vancouver streets. Since 2001 I’ve moved to downtown Vancouver, and I live only about 5 blocks from a hospital. When I moved I remember wise-cracking about how handy it was.

So I made my slow, out-of-breath way to the hospital. “I’m sorry to bother you,” I said to the triage nurse, “but I’m afraid I’m having a bit of atrial fibrillation.” She determined that I was familiar with it, so things weren’t quite so urgent this time. Some paperwork later, I was gowned and gurneyed and hooked up. This time I knew the drill. After some monitoring, the rhythm seemed pretty darned persistant, so some drugs were administered by automatic pump.

I noticed my nurse, Sandy, hanging around and watching the monitors pretty closely. She abruptly asked me how I was feeling. “What do you mean?” I asked. It’s four in the morning, and my heart isn’t working right. How am I supposed to feel? My chest was feeling a little tight, though, and I wasn’t getting any longer of breath. The doctor was summoned, and nurse and doctor stood looking at the monitors until the next automatic blood pressure reading. “That’s my cue,” said Sandy, and she shut off the drug pump and increased my oxygen flow. “Hmm,” said doctor Mitchell. “Your blood pressure was getting pretty low there, so we’ll stop that drug. We might have to use the machine.”

Yes, in case you were wondering, “the machine” is what you’ve seen on TV. Shout “clear”, charge them paddles and give the patient a jolt. I’d never had to have that done before, so I was getting a little apprehensive. “Don’t worry,” said the doctor. “You won’t remember a thing.” Wont remember? Oy.

Things were not made better when a cute young thing showed up at my bedside saying “Hi, I’m Iris, your respiratory specialist. I’ll be making sure you keep breathing.” Thanks, I guess, although if the heart doesn’t restart, I don’t know how long keeping breathing is going to benefit me.

So eventually I got my chest shaved — ooh, kinky — a small machine with lots of wires and blinky lights was delivered to the bedside, and a small crowd gathered. The nurse pumped some sedatives into my IV. Dr. Mitchell looked at me and said with a grin, “I think he’ll need some more.” Was is the rictus of fear or the rivers of sweat that tipped him off, I wonder?

Luckily, I suppose, the next while is a blur, and already mostly slipping away. I remember a kick like a mule, and suddenly being in a rather different position and entangled in the bedsheets. One of the residents let slip that I yelled a bit. I hope it was a dignified and manly yell. Anyhow, the heart was back to a normal rhythm, and I slept until shift change at seven, whereupon the report was: “This gentleman came in with a-fib, was cardioverted, and is all better now.”

So I’m a little tired, and my chest hurts like a mule kicked it, but all’s better now.