Atrial Fibrillation: The Visibility of Mortality

Atrial Fibrillation and Mortality
Most of the time we can avoid thinking about it.
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After drinking a glass of orange juice one morning, my heart began racing, then slowing down, then picking up even rapider than before. When the ambulance arrived, my heart rate was at around 150. By the time I arrived at the hospital, it had sped up to in-between 180-200 beats per minute. Just as bothersome as the heart rate were the gaps that occurred when it seemed to stop beating at all. I’d wait, already panicky in mind, and when it seemed like it might not beat again it would pick up, as irregular and rapid as before. I was quickly given a shot of lorazepam to at least calm me down, but regardless, my heart kept going in its inconsistent, irregular fashion.

I was moved to a room and hooked up to an IV, told that I would be given medication for my blood pressure which was far higher than normal and also for my irregular heart beat, which even with the medication hadn’t returned to normal. My Mom was located across the state, a near six hour drive away, but my Dad was located in the same town so he was able to visit, a visit that provided some comfort despite the constant flip-flopping that was occurring in my chest. I was hooked up to various machines and given X-Rays throughout the day. I felt better, but I wouldn’t have a diagnosis until the following day, and I dreaded the night ahead. It was going to be difficult.

In the following night, alone in my hospital bed, I became aware of just how frail our bodies can be, that anything can go wrong at any time, that regardless of life choices and lifestyles, how “healthy” we eat and how much we exercise, death should be visible to all of us. However, before this instance, I had worn a shroud that had blinded me to the one awareness that everyone has, the awareness of the one certainty that life carries, the certainty being that life ends.

That night the worst possibilities ran through my mind. Heart failure? Heart disease? Something more horrible that I hadn’t even heard of? I wondered how hard it was to get a heart transplant; the survival rate of open heart surgery. The shroud had been lifted and all I could see I was my own mortality and the growing threat (at least in my mind) that it had been compromised. I thought of everything that I hadn’t done: travelled to Europe, written a book, fallen in love. What if it was too late now? I believe we all carry these fears unconsciously; things that we want to accomplish in life but may never get the opportunity to do. Suddenly these fears emerged from my unconscious and manifested themselves as distinct possibilities. The next day couldn’t come soon enough.

I managed to at least get a few hours of sleep with the help of some more lorazepam. I was visited in the morning by a heart doctor. I was nervous; fears had been spinning around in my head all night, what catastrophe would be revealed. Atrial fibrillation, she said. A progressive form of irregular heartbeat, but by no means a condemnation. Medication in the immediate future, then a small operation to fix it when it progressed to a certain point. I was elated! Death wasn’t on my doorstep; I could achieve all those things that I wanted to, my expiration date extended outward, far away, once again. However, something had been opened up; that growing awareness of my mortality, finally made visible. But I didn’t recognize this at the time. I was released from the hospital later in the day.

So I returned to my routine. My students expressed some concern but I reassured them that everything was all right. School, teaching, reading the classics which I was suddenly interpreting with new eyes. I was writing my thesis on Othello and his cries at the end of the play over his lost reputation were suddenly cries for his legacy after death. Emily Dickinson’s poetry, full of references to death, suddenly spoke to me like it never had before. Everything: books, movies, art—all were consumed by a singular fear of the finite and the possibility of nothingness in the hereafter.

But that was nothing compared to the moments of panic that followed. I remember going to a school play and feeling trapped within the auditorium. What if the atrial fibrillation were to act up then? How would I be able to leave and go to the hospital without drawing attention to myself? What if I were to develop a blood clot (a danger with atrial fibrillation) and suffer a stroke? As I watched the play, increasingly trying to focus on the actors and their words, my mind continued to go back to the possibility of death. It was everywhere, inescapable, in all of our bodies at all times. All it took was for something to go wrong.

Another time I was taking a shower and I felt my heart speed up slightly, then palpitate. A small thing, it had happened before, but now a deeper, more powerful fear grew from it. Could heat cause an attack? I quickly came to the conclusion that it could. Panicking, my heart sped up and continued racing. I got out of the shower and called 911. I compulsively felt my pulse while I waited. The back of my head turned numb. In my mind, it was obviously the beginnings of a stroke. When the ambulance arrived I told them about my atrial fibrillation, that I thought I was having another attack. I told them about my head turning numb, about a possible stroke. They performed an EKG and the paramedic told me that my pulse was regular, rapid but steady. He informed me that I had had a panic attack and that next time it would be good idea to just lie down and breathe, just breathe deeply and focus on something else. The clonazepam I had been prescribed kicked in and I felt better; however, I was worried. If I could enter panic mode that easily, what would stop it from being a reoccurring pattern?

Unfortunately, before things got better, they continued to get worse. A palpitation was a sign of the progression of atrial fibrillation. An enlarged lymph node with a cold meant I had cancer. A numbness to the side meant my kidneys were failing. Every bodily mystery meant that something was terribly wrong. Constant trips to WebMD, the looking up of symptoms of various bodily illnesses, all of it contributed to a growing fear that a disaster was looming. My body was a catastrophe waiting to happen. My mortality had been made visible to me; my awareness of death was overdeveloped, the finitude of life, the dark unknown of death, stood in stark contrast to my day-to-day life in which I moved. Death: a quiet, unseen influence over all that we do. My friends and family members remained the same. Walked about unaware, caught in ready-made belief systems designed to protect them from the awareness of mortality.

My thoughts turned existential. Every essay I wrote for school focused on the inevitability of death, the possible meaninglessness of life, the nothingness that awaits us. Every great building erected, every good deed made by a public figure, every great piece of art or novel or other ambition—all of it was a way for the individual to leave something behind after death. It was the undercurrent of every life, the ultimate motivator for human action. As a race, we were in a constant battle with the concept of nothingness. People were drawn to faith by a fear of there being no life after death. After all, what thought is better than being reunited with those whom we loved and who loved us back long after their gone? The very belief systems we constructed were a guard against death, formed to give life meaning in a precarious universe. My mind was consumed, my ambitions out-of-view, everything I wanted could be washed away in one quick minute. The world was changed.

And to be honest, although eventually I was able to shake off the constant fear of death, the fear of the body gone wrong, I have never able to shake the awareness that death can come on us at any time. There is no getting around that fact. However, the very awareness of death can help us lead a more meaningful life. Towards the end of my schooling I read Hamlet. Near the end of the play, the title character says, “If it be now; tis’ not to come; if it be not to come, it will be now; if it be not now, yet it will come. The readiness is all.” Normally, I would have passed by this quote, recognized in it the idea that we should always be ready for death, which the passage is about, partially. However, also in it Hamlet expresses the uncertainty of fate. Whether fate exists, is up to the individual to decide, but death will certainly come at some time. It may be in a month, a year, 60 years. There is no way to know. But in this proximity of death, in the visibility of mortality, is one place where we can find meaning. Maybe human action is driven in part by our unconscious knowledge of death, but it doesn’t mean these actions are meaningless. Rather, these actions carry meaning exactly because they are finite. If all things were meant to go on and exist forever, how would anything stand out in contrast to the ultimate fate that lies in store for us, whenever it may be. 

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