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Life and Death Redux




“Doc we’ve got to stop meeting like this” I told Dr. Pattarapong as he prepared to insert the cardiac catheter into my groin. Dr. P. chuckled appreciatively at my “gallows humor”. One thing you’ve got to love about Dr. P. is that he does have a good sense of humor, and I for one would prefer my heart surgeon to be in a good mood before he goes poking around in my arteries!

Although it’s been almost three years since we last met in this operating theatre, right now it seems like only yesterday that the Grim Reaper and I were trying to stare each other down. Last time he blinked. Today, who knows? He may yet have the last laugh.

So how did I end up back here strapped to the operating theatre? I thought I was doing fairly well for a guy approaching 60. While my diet was perhaps not perfect, my blood chemistry (good and “bad” cholesterol, triglycerides etc.) was right on the money. I was getting plenty of light exercise. My teerak and I had just celebrated our 8th wedding anniversary. Our young son Sam was blossoming before our eyes. And I had just started a new teaching job that seemed to be working out fairly well. Life was good. What could possibly go wrong? Apparently plenty!
I was just getting ready for bed when I first felt it. There are some things in life that you never forget. The beginning twinges of an M.I. are one of them. It felt as though someone had reached into my chest and was squeezing the daylights out of my heart. The pain was so intense that I literally fell to my knees in agony. My cry brought my wife running into the bedroom with an anguished look on her face. “I’m sorry” was all I could whisper. After what threatened to be a bout of hysteria evaporated, she quickly got me into the car and we were on the way to Khelangnakorn Ram Hospital here in Lampang. It’s only a short distance away, so it was only a matter of minutes before I was in the E.R. having an EKG.

Before leaving the house I had the presence of mind to take a nitro tablet. I keep these handy in a small tube on my keychain. I had carried the damned things around for years without ever unscrewing the cover. I was relieved to see one of these tiny pills tumble out. I immediately placed it under my tongue and waited for it to kick in. It immediately began to relieve my torment. The pain ebbed away until it was only a dull throbbing ache.

The EKG showed no irregularities, but I knew what I had just experienced. My wife called my cardiologist Dr. Pattarapong at Chiang Mai Ram Hospital and explained what had just occurred. He ordered me up there in the morning to perform an Angiogram, so we could really see what was going on. Needless to say I spent an uneasy night. How was it all going to play out and how was I going to pay for it all?

Early next morning I found myself strapped down to the operating table while Dr. P. injected radioactive dye into an artery and followed its course through my heart. I could see the whole thing. The picture I saw on the monitor was not a pretty sight! One artery had closed almost completely and another wasn’t much better. Dr. P. informed me that I had indeed suffered a heart attack, and that it was a miracle that I was still alive. He immediately proscribed inserting two stents into those arteries. He wanted to do a few other things while he was “in there”, but our budget just wouldn’t permit it. It seems ridiculous to be talking about money when you’re this close to dying, but this is Thailand, and in the Land of Smiles, “There Ain’t No Such Thing As A Free Lunch”. At a first class private hospital they don’t hand you a bill; they hand you a receipt stamped “Paid in Full”! When Dr. P. found out that I earned my living as an English teacher, he had a hearty laugh or two. “Oh now I understand” he said. “It’s definitely the economy menu for you”!

“But” I protested in mock seriousness, “Isn’t today buy two and get one free”? That had the whole operating room staff in hysterics! No it didn’t quite work that way. Isn’t humor wonderful? Actually it helped me from being scared shitless.
When faced with imminent death some people talk about their lives passing before their eyes. For me, all five senses were focused on the here and now. It was as though I was hyper aware of all of my surroundings: the hum of the air conditioning, the smell of disinfectants, the beeping and whirring of the monitoring equipment. Every small perforation in the ceiling tile above my head seemed to take on a surreal significance. I wondered if these would be the last things I experienced here on Earth. This was of course a standard procedure, and I had the utmost confidence in Dr. P., BUT this is the real world, and things do occasionally go wrong. Oh well, it was all out of my hands now.

One of the amazing things about having an angioplasty, is that you are wide awake watching the whole procedure. Dr. P. had obviously done many hundreds of these before, because I barely felt the catheter sliding into my artery, and nothing whatsoever as it slid into my heart. In spite of my nervousness, I was captivated watching everything on the two monitors suspended above me. I asked Dr. P. if it wasn’t a distraction, if he could please talk me through it all. With a twinkle in his eye he proceeded to do so in great detail. Besides the fact that this was my heart he was talking about, I do have a great love of science, and this helped once gain to distract me from any fear. There goes balloon # 1. Okay here comes the inflation. Now here comes stent # 1. I didn’t feel balloon #1, but I did feel balloon # 2. It was not a pleasant sensation I can assure you! But it was over soon, and then stent # 2 was securely in place. That was it. It looked that I would live to see another day. As one of the nurses was unhooking me from the monitoring equipment, she smiled and whispered in my ear, “Happy Birthday”! With all that had been going on, I had completely forgotten that today was my 58th birthday! The gift of life is not a bad birthday present to receive!

Of course while the Fates might have given me back my life, it was the hospital billing department that would eventually give me a different kind of “present”. That would be enough to cause a coronary in an unsuspecting person! But Dr. P. kept to the budget. It’s hard to put a price on life, but in my case it was pretty clear what maintaining it would cost: 400,000 baht. Now for some ex-pats living here in Thailand, that’s mere “chump change”. For my wife and I however, that pretty much cleaned out our reserves. I guess it’s a good thing that we both have full time jobs…even if that’s teaching English! Oh well, I would cheerfully give every baht away just to see my darling wife and son again.
Before I continue I can’t say enough good things about the nursing staff at Chiang Mai Ram Hospital. They were not only professional and courteous in the highest sense, but were genuinely friendly and comforting in their care. Whether in the operating theatre, in the ICU or in my room, they were a tremendous help in getting through this ordeal. Love and kisses to them all!

So what do you do when you have another chance at life? In some ways I won’t be doing things much differently. I don’t lead any type of exotic lifestyle. For me it’s family, work and the simple joys of everyday life. The flowers in my garden do seem a bit more colorful today I must admit. My wife has threatened me with un-named grief if I don’t follow her dietary regimen to the letter. I hope there’s a place on her list for an occasional beer! I do NOT intend to where a “hair shirt” until the day I finally do die! Meanwhile I promised to get this submission out today, so I guess it’s time to get with the program and start living!

Stickman's thoughts:

I am SO relieved you're still with us. Sawadee2000 actually dropped me an email this past Sunday saying that he was in a bad way and was going to see his cardiologist the next day. His confidence that he would even make it to see the cardiologist, let alone beyond that, was not high. I feared the worst. We had met up once in Bangkok a couple of months back and I have been meaning to visit him at his home since. Would I get the chance? Not that that was important when I considered he had a wife and young kids. Fortunately he emailed me after the procedure and let me know all was well. Thank goodness!

I really do wish you a speedy recovery and am amazed that you'll be back in the classroom next week!

But ouch, 400,000 baht. That has got to hurt!