One year later: Acceptance and Parchat Behar-Bechukotai

Today marks the one year anniversary of my heart attack. Not sure if that should be celebrated as a birthday or a yartzheit but regardless I'm happy to still be here and in good health, and I am very grateful for all the love and support I have received.

I've been feeling like I should mark the day with some great poetry or original song, some art driven by the pain and emotion I've been feeling, but for one reason or another I can't sort it out enough now to develop any.

I'm moving continually closer to acceptance, in the grieving sense. Definitely cycling through depression and anger on a regular basis. Pretty much past denial and bargaining, although I do seem to think that I can ignore my workout routine without any consequence, and most days I can focus on life rather than "life with heart disease."

But still.

There are the days, many days, when I want to cry because there's nothing I can eat, nothing I want to eat, no joy to be found in eating or even relief from whatever sadness I may be feeling. Food has become...not quite an enemy. An obstacle, a reminder, a lost pleasure. I've lost most of my vices. Physical activity follows different rules (I get epic bruises after even a short, gentle fencing practice), drinking is difficult because of interactions with all my pills, and the triple-threat combination of work, kid, and marriage pretty much take care of the rest (hard to stay up all night playing video games, even on the weekend, and still meet my responsibilities). Makes it hard on those days when I need something to take me away from myself, for a little while.

I live in constant fear, when I remember, of my own mortality. Constantly wondering not if, but when I will be forced to abandon my young son, my wife, my friends. It hurts me, not because of the pain I would feel at their loss but because of the pain I will cause them. We're making long-term plans, my wife and I, even more so than usual: buying a house, discussing a second child, saving for vacations...I leave every discussion wondering if I have started something I cannot finish.

And even though I keep getting positive health reports (except on the weight - that's creeping up a bit again; need to be careful about that) from every doctor I see, I get a massive jolt of terror if I experience any combination of the following symptoms:

• Pain in the chest, shoulders, neck, or arms (Hello fencing!)
• Shortness of breath
• Unexpected tiredness or weakness
• Lightheadedness
• Stomach cramps (because that was a symptom of a heart attack in a book I read when I was a kid)

Now if that sounds like a list of symptoms one would commonly experience in every day life due to job, carrying a kid, not working out enough, working out too much, eating the wrong foods, not getting enough sleep...well, yeah. Until I get that pocket-sized EKG so I can get a status update on my heart as needed, or I get a lot more acceptance, there's going to be a portion of every day spent checking each symptom against every other to make sure they are a) unrelated, and b) due to known causes. 

I realize this has been a fairly heavy post so far; that's not really my intent. Life is very good right now and, as I may have mentioned, I'm glad to be a part of it! But as the anniversary has drawn closer I have been increasingly worried whether I could actually make it through a year without a heart attack, so there's a lot of heaviness to exorcise right now.

Anyway.

In the absence of art, I found myself wondering what the Torah portion was for this time last year - maybe I could find some inspiration there! Lucky me, it's Parchat Behar-Bechukotai, ie some of the driest-of-the-dry bits at the end of Leviticus. 

As I read through it, though, it became increasingly appropriate. Consider that the parsha is about:

1. Rules, lots of them. Rules that rabbis from that day to this have debated and studied and considered. I found myself thinking of my friends who converted to Judaism, and how they had to accept all these rules at once. That was my post-CHD experience - doctors handing me lists of rules I had to study and follow. As if my life depended on it. In many ways my experience with studying Jewish law prepared me for this new stage of my life. For example, koshering my kitchen was much harder than learning to buy the low-sodium products.

2. Jubilee. Granted, the biblical Jubilee is a very specific event, but that type of celebration and renewal is very much needed in my life at this point, so I'll take it.

3. Endings and Beginnings. This parsha is the end of Leviticus. After reading this we start on Numbers. Likewise, the heart attack marked the end of a chapter in my life, and, by extension, the start of a new one.

Many of the commentaries on this parsha note that while Moses received the entire Torah at one moment, it took many years to write the whole thing down. I can relate to that too.

Thank you to all my friends, family, coworkers, medical support, and everyone else who helped keep me healthy and sane and preserved me and enabled me to reach this season. Here's to another great year.

I'm Dreaming of a White Pesach

To the tune of I'm Dreaming of a White Christmas

With apologies to...well...everyone

I'm dreaming of a white Pesach,

Just like the one in Exodus.

Where the matzah crunches,

And kinder search bunches

Of chairs for afikomen crust.

I'm dreaming of a white Pesach,

Read the haggadah as you lean.

Greet Elijah with "Shalom ale-cheem,"

And next year in Yerushala-yim!

Less Of a Man

Since my heart attack I've lost about 15 pounds. That's more impressive than it sounds; my weight had been fluctuating a lot in the months prior, so I had to stabilize before I could lose anything. I weigh less now than I have in about seven years. And I resent the hell out of it.

Wait; let me back up a bit.

Last week I had my three-month checkup with the cardiologist. It went well; I'm as close to "perfect health" as I ever will be again. When he told me I was "normal" I got quiet, withdrawn, and very nearly cried.

Not, I think, the reaction he expected.

Still not sure what that was about. I mean, I don't want to be sick or have anything horribly wrong with me. Why can't I be happy about being healthy? My wife's analysis, which seems to fit well, is that this is such a fucked up situation (my phrasing) that I need to feel equally fucked up to make sense of it. I think that's pretty accurate. Another piece of it is the disturbing thought that this is now normal. This situation is pretty messed up to be "normal". Plus it means that all the lifestyle changes I've made the past three months now need to be continued. For the rest of my life.

But back to the weight loss.

Every time I look in the mirror and see how thin I'm getting, I get upset. Don't get me wrong, I'm not completely unhappy with the results. I've had fun buying some new "skinny" suits and not buying others because I legitimately believe they'll be too big for me in a few months. And it's a lot of fun having my pants fall down every time I cough. But for the first time in my life I'm losing weight not on my own terms.

I lost a lot of weight a few years back. Since that time I gained about half of it back, but I was ok with that. I felt good, was able to be as physically active as I wanted to be, and liked the way I looked. I was casually trying to lose five pounds, but knew what I would have to do and did not, at that time, want to make those sacrifices.

And now the choice has been removed from me.

I'm Too Young For This Shit: Me & My Heart Attack

Ok, it's been a while. Things have been a bit busy, what with the moving cross-country, starting a new job, and having a kid. Through it all I'm continuing to deal with an existential quandary about my place in and relationship with organized Judaism, so the blogging about religion has somewhat tapered off.

Oh; also there was a heart attack.

As you may have heard around Facebook, I had a minor "major health incident" almost three months ago. You may not have know the details, though, because at first I was hesitant to post them online. Then I was... embarrassed. Not sure why that's my reaction, but it is. I decided it was time to write this post, though, and be a bit more open about the whole thing for one particular reason:

There are absolutely no resources out there for people who have heart attacks in their 30s. Or at least none I can find online.

Granted, the over-50 crowd make up the bulk of coronary heart disease (CHD) patients so it makes sense to cater to them, but you would expect with the hyper-niche formation that has become emblematic of the internet that something would be out there. I have my own theories about why it's like this. First, I suspect that, like me, many younger CHD survivors are too embarrassed to talk openly about their experience. Add in the rarity and it becomes nigh-impossible to gather a critical mass. Second, I suspect that, like me, 30-somethings refuse to accept the possibility they are having a heart attack.

So there's not enough of us who survive the experience in order to bond over it.

I wouldn't have gone to the hospital myself if it weren't for my loving, wonderful, hyper-protective wife. I had been feeling fine, or at least not noticeably bad, and spent the afternoon gaming with some friends. On the way home I started feeling some pain and assumed it was tension-related. When I got home I told Alex; she said that if I wasn't feeling better in 10 minutes we were going to the hospital - "just in case". Nine and a half minutes later we were in the car.

Many experts recommend that if you even think you might be having a heart attack or other life threatening emergency you should call an ambulance rather than drive yourself because you'll get seen sooner. I now agree. We walked into the ER, I told them I was having chest pains, and they directed me to a lovely blue plastic chair where I sat for nearly an hour. Then to the exam room. The nurse hooked up some wires, checked my EKG, and promptly ran out of the room.

That's usually a good sign, right?

She came back in, strapped me to the gurney, and pushed me into the hallway, alternately yelling at people in her way to either move or help.Then I met the nice doctor who got to tell me I was having a heart attack.

Oh.

There followed some crying and some staring quietly into space while they prepped me, inserting and withdrawing various objects and substances as appropriate. I'll spare you for now the details of the operation and my stay in the ICU, although I may tell those stories sometime, to return to my main point:

It sucks to have a heart attack in your 30s.

Granted, there is no good time to have a heart attack but having one so young adds a special twist. When I go to physical therapy I'm the youngest person in the room by an order of magnitude. Many of the people I meet there tell me they took or are considering early retirement to reduce their stress load - not so much an option for me. They talk about their children coming back home to help or spending as much time as possible with their grandchildren while they can; meanwhile I'm wondering if I'll be around long enough to see my 7-month old son graduate from high school. Or get married. Or learn to walk. Even if I do, will I be able to play with him? Will I be able to teach him sports ("That's great, doctor, because I couldn't play sports before the operation!"), take him camping, or wrestle with him, or  will I be the perpetually weak, tired father on the sidelines his whole life? Having to take more than ten medicines a day or stick to a harsh diet plan for the rest of your life means something very different at 63 than at 33.

I should add that as of now I'm recovering as well as could be hoped. Physically, there was little damage and few lasting side effects. Pharmacologically, it'll take a while longer to get used to the new pills - and the inevitable experimenting until we find the right cocktail. Emotionally...I'm getting there.

I hope in writing this that I can reach other people my age who have CHD to let them know they are not alone. We are here, we are survivors. If you you just went through this and need someone to talk to, contact me. Likewise, if you went through this a while ago and have any advice, I'd be glad to hear it. I'm trying to remember that, long run, this will be a good thing. We found the problem early and with minimal damage, giving me time to learn to manage it. When I reach the age where CHD becomes a more common, more serious problem, I'll already be an expert on the medication and lifestyle.

I know that. It's just hard to internalize.

Yue Yue - Never Again!

It is a central and universal teaching in Judaism that Torah can, should, and must be ignored to save a life. Bystanders have a "religious, ethical and legal" duty to help those in danger (even if they're non-Jews!).  So while I didn't hear about this story when it first broke last week, only learning of it from Geek in Heels today, I am sure it will surprise no one that I join the ranks of those horrified by this event. Originally I was going to say "shocked and horrified", but the more I thought about it, the less shocked I was. From Jenny's blog post:

But when discussing the story over dinner last week, my in-laws told me a couple of things that set things in perspective:

1. Due to the underdeveloped legal infrastructure in China, there have been many cases in the past where a good samaritan would step in to a stranger’s aid, only to be blamed and charged with the crime they had never committed.
2. Additionally, local laws dictate that if a person is found guilty of devastatingly injuring another person(s), they are responsible for all of the medical bills and expenses for the rest of the victim’s life. This, coupled with the fact that the majority of the Chinese population — especially in poorer regions like Foshan where Yue Yue lived — would not be able to afford to financially provide medical care, leads people to leave victims for dead rather than help. That is, they would rather go to jail for manslaughter than be in debt (and become a burden and embarrassment to their families) for the rest of their lives.

This isn’t to say that I — or even my in-laws — believe what the 18 passerbys did was right. Neither am I justifying their actions (or lack thereof, in this case).
But now that I have been informed these cultural factors, I can better understand what had happened.

While some blame China's pursuit of economic growth and educational system, most stories confirm Jenny's; Good Samaritans in China help others at their own risk. It even seems some good may come of this; at least one university has pledged legal defense support to Good Samaritans (and started a new meme in the process), and international attention has ignited a new debate about China's ethical future.

So horrified? Yes. Hopefully this will catalyze positive change? Yes. But surprised? No; not at all. This is, after all, the Capitalist ideal.

My high school government teacher used to refer to "capital-C Communism" versus "small-C communism" to differentiate Marx's political theory from the real-world governments of the same name - say what you will about its validity, Marx's theory never killed anyone; that was the government that co-opted it. It is in that spirit I refer to Capitalism; not the economic theory, but the way we see it practiced in America today, where people are financially incented to let their neighbor's house burn down. Where we take as given that we're willing to let children starve to death and freeze on the street, and only debate how much we're willing to let it occur.

Look, what happened to Yue Yue should never be allowed to happen anywhere ever again. Good Samaritan protections should be universal and powerful; no one should hesitate to help those in danger because they fear financial or legal retribution. But let's stop kidding ourselves that this obligation to help others only applies on the individual level, and only to emergencies that happen right in front of us. Starving a child kills them just as surly as hitting them with a car - it just takes longer.

None of us are obligated to save the world entire; what is expected of us is what we are able to provide and no more. It's the "and no less" part that gets forgotten. Some see this as encouraging individual action, with each of us giving as best we are able (hey; that sounds like small-C communism!). In truth, though, what we as a nation are capable of is so much greater than what we as individuals can do that it is unconscionable to me to settle for anything less.

This is the origin of my political "liberalism". Not a desire to coddle everyone or contribute to a culture of entitlement, but a deeply held conviction that when the power of the world's mightiest nation is applied problems like hunger, poverty, and sickness cannot stand.

Do I honestly believe we can feed, clothe, educate, house, and treat every soul in the world? No; not even every in our own country. But I do believe we can save many. And I, for one, want to be sure the next time a child dies that I was not an inactive bystander.