I am gripping my chest as my colleague attempts to reassure me. “The paramedics will be here soon,” she says. “Everything is going to be OK.”
I spent the morning mouthing these words — everything is going to be OK — as I prepared for the final week of the semester: It was my first year in a doctoral program, and I was anxious to finish teaching for the day so I could return to writing a thirty-page paper on the potential for new communication technologies to expand conceptualizations of the public sphere. Everything was going to be OK. But I never did make it out of class. In the midst of telling my students that I would have all thirty of their final essays graded by the end of the day, the weight of yet another deadline collapsed onto my shoulders. I paused to take a deep breath — everything is going to be OK — but the air stopped short of my lungs. As it beat against my throat, one student raised his hand, suggesting I didn’t look well. “I’m fine,” I said, trying to convince myself as much as I was him. It’s just a panic attack, I told myself, but my students had already summoned my colleague, who was calling for an ambulance.
At 38 years old, I understand it isn’t entirely impossible for me to be having a heart attack, but I’m a petite guy, toned and scrappy. While the doctoral program hampered my gym routine, I still run 15 miles a week, lift weights most mornings, and follow a Mediterranean diet. Why is my body betraying me? How am I having a heart attack?
The cardiologist tells me it is a combination of high cholesterol and stress. The cholesterol is genetic. My father has long been medicated for his own cholesterol levels. The stress, well, that’s just me.
I thrive in stressful environments. It’s partly how I made it into and through my doctoral program: by perfecting things like the art of the essay due the next day. I’ve always done my best work under the worst pressure. My journey into the doctoral program is marked by award-winning essays on communication and technology that I frantically composed the night before a deadline. While stress is a trait I associate with identity, worry also runs in the family: my mother suffers from a host of anxiety issues ranging from the warranted to the banal: She has spent an equal number of nights lying awake reviewing the consequences of all her life’s decisions as she has worrying about the length and style of her hair.
In the hospital bed, while I try to wrap my head around what just happened, my mother repeats a phrase she’s often said before, but today, I understand it differently: “You and I just aren’t wired right.”
Wiring happens early. Some geneticists suggest that parental trauma may be passed on to children. Researchers at Emory University trained mice to associate an odor with an electrical shock. The effect of this association was that simply smelling the odor startled the mice. The most controversial of their findings, however, was that the odor-induced alarm was found in the next two generations of mice, including those conceived through in vitro fertilization. The research suggests that trauma may be passed onto future generations, that epigenetic changes in a parent may alter not only their own, but their children’s wiring as well.
My mother zipped up the Pepto-Bismol pink suitcase and ushered us into the hallway. I could hear him crying from my bedroom and each step down the brown shag carpet amplified his wailing. I wasn’t certain what was going on but I instinctively knew it wasn’t good. My father was an emotional guy, but I had never heard him cry like this. As we exited the hallway into the kitchen, the sounds of his sorrow were met with his image. Standing only 5-foot-5-inches, my father was never an intimidating man, but his thick black mustache and stocky frame made up for the masculinity not afforded to him by his height. However, in that moment, it felt as though he were the child; weeping over the kitchen sink for reasons I would only come to understand much later in my life. At 4 years old, the packing of a suitcase had always meant we were going on a road trip to see relatives in North Dakota. I turned to ask him if he was coming, my question met with my mother’s hand firmly on my arm. I can still see my sister running up and clutching my father’s leg, my mother angrily calling after her, the Pepto-Bismol pink suitcase clunking down the shag carpet steps, my father weeping without saying goodbye.
Epigenetic transfer is difficult to prove. Traumatic experience generally shapes behavior, and parental behavior has an enormous impact on children. Is it really genetic? Or do traumatic experiences alter behavior in ways that impact the environments we grow up in? In the hours following the heart attack, this question sits with me in my hospital bed, as I try to make sense of what just happened. I have always flourished under pressure, I reassure myself as the nurse gives me more morphine. “A heart attack?” I mouth for the hundredth time since the cardiologist implanted the stent earlier that afternoon. The nurse insists I get some rest. I will be in the hospital for at least two days and she suggests I stop stressing out about why I am there and focus on recovering so I might leave. Drifting in and out of morphine-induced states of wakefulness, I speak to my stress, asking how my closest companion could turn so aggressively on me.
Unlike open-heart surgery, coronary angioplasty isn’t very invasive. A small opening is made in a blood vessel in your groin. A catheter is used to carry the stent to the site of blockage. While you remain awake, the doctors use a minor anesthetic to place you in a “dream-like state.” The time between my initial heart attack and the placement of my stent was long enough that my blood clotted. During the procedure, the clot sent me into cardiac arrest. I died on the operating table. They used a cardiac defibrillator to shock me back to life.
My first night in the hospital is restless, with me tossing and turning over the memory of the procedure. At one point, I am jolted awake by a current of pain circulating through my back. My right arm is numb. Convinced I am having another heart attack, I call out to the nurse.
Running in, she checks my vitals. Another nurse pokes at my arm, trying to find a vein that is not already occupied by an IV or battered from a previous blood test. “The EKG looks good,” says the first nurse. “It’s normal to experience some anxiety after an event like this.”
But anxiety doesn’t explain the numbness in my arm. Anxiety doesn’t explain why I am lying in a hospital bed, track marks up and down my arms, veins stuffed with IVs, needing a nurse’s assistance to take a fucking piss. I recall the cardiologist’s words as the other nurse injects more morphine into my arm.
It’s a combination of high cholesterol and stress…high cholesterol and stress…stress…you have to reduce stress…you have to learn to let things go.
How does one let go of their primary coping mechanism? How do you reduce a core part of your identity? I attempt to let the numbness in my arm go as the morphine carries me into slumber.
How do I let go of me?
I could hear the worry in my mother’s voice, but I was eight years old, and after four hours of following her around the mall, I had given up hope that we would ever leave JCPenney’s. My mother was silent while she shopped, her only words whispers as she stared at a price tag before sighing and adding it to the cart. When I slipped away from her side into a rack of clothes, she was staring at the department store ceiling, mouthing numbers, calculating the cost of a blouse against the balance in her checking account.
Even at such a young age, I was aware we did not have the money to be spending on an entire day of shopping. And I knew that my stepfather would greet our shopping bags with a clenched fist. Unlike my father, my step-dad didn’t have to rely on his thick brown mustache to intimidate. Standing 6-foot-4-inches, he towered over my mother’s petite 5-foot frame. I saw the storm coming, the clouds darkening over my mother’s head with each item she placed in the cart. Nestled inside a fortress of floral patterned dresses, I was safe. For now, at least.
Her yells grew more distant. I pulled one of the dresses off the rack, bunched it up and placed it under my head. I could still hear her calling for me as I drifted off to sleep, mouthing, Please don’t find me.
The first morning, I awaken to the cardiologist standing by my bedside.
“How is your arm?” he asks.
It’s still numb and the pain in my back has only gotten worse throughout the night. He offers the same answer: it was likely anxiety.
“We’ll do the stent procedure again,” he says casually. “Go back in and check things out. Better safe than sorry,” and before leaving the room, he smiles.
While I welcome his willingness to “check things out,” memories of the first procedure still haunt me. The cardiologist seems so cavalier, if not emotionless, about performing the procedure again. Did I not die long enough the first time? The buzzing of the defibrillator paddles returns. I look down at the still-visible burn marks on my chest. While they wheel me back into the operating room, it occurs to me that I am willing to die again, just to ease my anxiety.
Eventually, and with the help of mall security, my mother found me inside the clothing rack.
“I thought someone kidnapped you! Why would you do that to me?”
“I was so worried!” she continued.
So was I, but not about myself. She marched me outside, dragging me by the arm as we made our way across the JCPenney parking lot. She buckled me into our tomato soup-colored Scout and slammed the passenger door. As we drove, her silent whispers continued, but her concerns about me faded, her worry now converging with my own: What was going to happen when we got home? How angry was my stepfather going to be?
This would become a game I learned to play often: attempting to read my mother’s anxious lips, mouthing her worries while she drove. I would mimic the movements of her mouth until her worries rolled off my own lips, as automatic as breathing. I played the game until I no longer had the energy to give her worries any attention. I eventually started mouthing worries of my own.
When we arrived home, she opened my door.
“Don’t you ever do that to me again,” she said as she lifted me from the Scout.
“Now go to your room so I can talk to Tony.”
The rest of the afternoon didn’t require lip reading. The argument between them was loud enough for the neighborhood to hear.
My sister and I learned early on to sit quietly with our arms folded.
“Don’t touch that, you’ll get hurt!”
“Stay out of the water, you’ll drown.”
“Stop climbing on that, you’ll fall and break your neck!”
“No, you can’t go outside, you’ll get kidnapped.”
“How many times do I have to tell you that there are snakes in that field?”
For my mother, the world outside the walls of our house was dangerous.
I often wondered what monsters had made my mother so frightened of the world. What makes a person scared of their own shadow, too frightened to see the actual monster terrorizing her? I knew my mother’s childhood had not been idyllic, but it wasn’t until I was 30 and she had a few glasses of wine that I learned just how horrible it had actually been.
“You know daddy was a mean son-of-a-bitch,” she said one day while making her way to the kitchen table. “He had that temper. I worry that you got it too.” At this point our conversations would generally devolve into her lecturing me, but this time, I was adamant to hear about her.
“We aren’t talking about me,” I said, “And didn’t you once mention that grandpa tried to kill grandma?”
She looked away momentarily, her wine glass pressed against her lips, and I wondered if the scent of alcohol brought back memories of my grandfather’s drinking, of his temper.
“Yes, he chased her around the house with a knife. I was five. I can still remember hearing mom crying outside my closet door. You see, every room in that house was connected. It was before we installed a bathroom. He chased her around with the knife for a while before they ended up in my and Jeannie’s room. I hid in the closet. I heard him drop the knife. It was a while before I heard mom’s voice. I thought she was dead.”
She mouthed something, not knowing the years I had spent mastering the reading of her lips.
I wish he did.
She wished that my grandfather had killed my grandmother. It occurred to me then that my mother was used to living with monsters. I moved from the kitchen to the back porch, hoping the night sky would settle my nerves. Taking a seat beneath the stars, I took a drink of my wine, folded my arms and stayed quiet.
After the second procedure, I am told to remain still and not to lie down for six hours. The hospital room is quiet. My family and friends have left to allow me some time to rest. But resting isn’t something I am good at. Without the anxiety of another heart attack to occupy my mind, it wanders to other worries: my high cholesterol.
I can make sense of the genetic link between my own cholesterol and my father’s. Physically, the two of us are carbon copies. Placing his high school graduation photo next to mine, the images appear to be the same man: thick dark hair, long slender nose, and sharp jaw. The only differences in the two photographs are an inch of height and the fact that his photo is in black and white. But beyond the image, we couldn’t be more different. While both my dad and I are intensely emotional, his disposition is much more easygoing than mine.
Seeing the worry on my face, the nurse asks if I need anything.
“You are free to lie down now,” she says.
I am too worked up to lie down. My work deadlines are still looming. I am trapped in this hospital room while the minutes continue to tick by, the urgency for completing essays and entering grades only increasing. I bounce from deadlines to being dead. What will I be able to eat? How am I going to finish my paper? Will I get student grades in on time? Can I still run like I used to? I settle on the irony of stressing about how much I am stressing out. I am losing control of the only consistent thing in my life. I don’t have time to rest.
Reaching into my pockets, I could feel the tiny orange pills resting in the denim lining. Words began to tumble from my lips in whispers. “One, two, three.” I was calculating whether I had enough to get me through the weekend when she joined me on the back porch with a pack of cigarettes. I assumed our earlier conversation about her parents had upset her. She was hiding something. I knew better than to chastise her for smoking, but my concern was amplified when she nearly fell face first into the patio table while reaching for her glass of wine.
“How much have you had to drink today?” I pried. She told me she had only had the single glass I poured her. She braced herself long enough to light her cigarette.
My mother had been in and out of doctors’ offices for as long as I could remember. While she suffered from fibromyalgia and sciatica, her primary disorder was more akin to hypochondria. At the heart of all of her ailments was anxiety, for which she was prescribed the benzodiazepine, Xanax. Referring to the tiny orange pills as “zan-icks,” my mother could hardly pronounce the surfeit of medications that had turned her nightstand drawer into a variable pharmacy, let alone keep track of their effects.
She took a long drag off her cigarette, pretending she hadn’t heard my question.
“How many pills have you had today, mother?”
It was clear that my prying was starting to upset her, but she finally acquiesced.
“Well, your sister was stressing me out, so I had a zan-icks at noon.”
She felt it was important that I know not just how many pills she had taken, but also why she was taking them. Her need for medication was not her fault; it was the result of the people around her. It was all of us monsters.
“And then you started in on me so I had another zan-icks around one. And then I needed my pain pill, so I had that this afternoon, and another one early this evening. I had another zan-icks and a pain pill at six and I just took another pain pill and my Ambien so I can sleep tonight.”
She put out her cigarette and made her way back into the house. Her prescription drug use was worrisome. Whispered words made their way across my lips, “One… two…” I reached into my own pocket, pulled out a couple of tiny orange pills and took them down with the last of my wine.
“Goodnight monster, I mean mother,” I whispered.
“Everything happens for a reason,” my mother tells me as we drive home from the hospital, trying to help me come to grips with the heart attack. I hate that phrase. It assumes the universe gives a fuck about us. That we are each so unique and special that some sort of divine entity takes the time to provide everyone with tailored life lessons.
“Nothing fucking happens for a reason!” I yell back at her. As the words leave my lips, I realize the irony of my response. If nothing happens for a reason, then why am I so desperately searching for one?
The next morning, I awake in my own bed for the first time since leaving the hospital. I make my way into the kitchen. My mother has decided to stay with me for a while, and I do my best not to wake her as I prepare a pot of tea. I look around my 500 sq. ft. casita, my mother asleep on an air mattress in the middle of the single room. This time I don’t whisper. “And now I am just supposed to go back to life as fucking normal?!” I scream.
“Good Lord, “ my mother shouts as she is jolted awake. “What the hell is it now?”
High cholesterol and stress? I ask myself.
Nothing happens for a reason.
And if there is a reason, it’s because of our own actions. I can reconcile the cholesterol, but the stress?
Attaching the stress to my heart attack means questioning its normalcy, it requires accepting that it can no longer be part of life as usual. It means addressing it. It means making it a reason. But I won’t let reason come between us. Like my mother, I have grown attached to my monster. Worry has become part of my personality. I’ve turned my stress into a loveable character, my monster into Oscar the Grouch.
I circled the lake near the university for the twentieth time as the running application on my phone told me I had just passed my thirteenth mile. It had only been a week since my 35th birthday. My body was moving 8 minutes per mile but my mind was racing at much faster speeds. I turned back toward the university trying to make sense of how I got there. “What have I accomplished in these 35 years,” I whispered through my heavy breath. “I’ve done nothing with my life.”
The weight of my 35th birthday collapsed on my shoulders like a ton of bricks. I had spent the weeks following the day repeatedly rewinding and replaying my life. I watched as it passed the weddings and children, high-paying jobs and successful careers, retirement savings and bright futures of my peers. I was still single, working an adjunct teaching job that barely covered my monthly student loan payments. I had no retirement. I had no future.
I found myself back on the track outside of the university recreation center. The water dripping down my face was no longer just sweat. I wiped the tears from my eyes and fell onto the gravel as my phone application alerted me I had completed my twentieth mile. My average pace: 7:15 per mile, almost as fast as my monster.
“You’re going to have to start eating more protein,” the dietician tells me as she leads me into the exercise room for cardiac rehabilitation. In the weeks following the heart attack, I only ate fruits and vegetables, sometimes going three to four days with nothing more than a handful of baby carrots and small bunch of green grapes. I wasn’t attached to my high cholesterol. I had no problem saying goodbye. I would starve it away if I had to.
The dietician brings me to a large room with exercise equipment: treadmills, stationary bikes, small free weights and a trail of latex footprints pasted to the ground around the perimeter of the space. “A specialist will be with you shortly,” she says. I am greeted by a woman who appears to be in her eighties circling the room, carefully following the neatly laid out footprints. A man in his nineties looks up from the book he is reading while barely moving his legs on a stationary bike. “I think you got the wrong room,” he quips, his voice loud, indicating he is hard of hearing. “No, you’re in the right place,” a woman in bright pink scrubs responds and ushers me to a basket of machines. I am grateful to have finally been cleared to begin cardiac rehabilitation. I am anxious to get back to some semblance of normalcy — my morning rituals of working out and weekly runs — something to occupy both my body and my mind, me and my monster.
The specialist instructs me where to place the “stickies” and the corresponding wires that will monitor my heart during the session. She then provides me with my workout plan: the hour will consist of walking on a treadmill, lifting 10-pound weights, and riding a stationary bike. I look over the plan as I join the old woman for my warm-up following the latex footprints around the space. It indicates that walking will be more like crawling, I should only do sets of five when lifting the weights, and I should not set any resistance on the stationary bike so as to not overdo it. Taking my place on the treadmill, I can’t help feeling defeated. I was used to intense weight training, and to running. I scan the room for support. A sea of blue hair and high-waisted sweatpants stares back at me. The wires hanging from our chests, membership badges for the “I survived heart failure club.”
Driving home from my first session, I call my mother to lament.
“It’s me and a bunch of 80-year-olds,” I bemoan.
Cardiac rehab reminds me of how betrayed I feel by my body. “I just want to be able to do what I used to!”
But my mother changes the subject. She is already mid-way through a story about her terrible boss and how she just can’t take working there anymore.
It matters little, however, as I am no longer listening. I speed down the freeway mouthing all of the things I have to get done, crafting a mental calendar that will fit both my responsibilities and my tri-weekly exercising with geriatrics.
“So can you help me craft a letter to them,” she interrupts.
“Yeah, sure mom. Okay, I’m driving so I should probably pay attention to the road.”
I hang up the phone.
Despite all of the changes in my life after the heart attack, there are some things that will always remain the same.
Three months later, on the drive to my check-up with the cardiologist, I flip on a Radio Lab podcast. The episode is an hour on whether or not we are sealed by our genetic fate. The program presents a number of stories about whether our behaviors are learned or genetic. One of the stories is of a group in Northern Sweden, a tough and isolated place that experienced a series of harsh winters resulting in minimal crops and malnutrition. The data showed a health benefit in generations who had a starving grandfather. There seems to have been a genetic transfer of resilience passed between generations. As I listen, I posit the connections between our parents and ourselves, between my own parents and me. Between high-cholesterol and stress.
Entering the cardiologist’s office, I am preoccupied with thoughts of my mother’s childhood and my own. I sit in the waiting room considering my genetic links, my health and my impending visit with the cardiologist. Stories of my mother’s childhood wrap my own like a thin layer of cellophane. I see kitchen knives and pink suitcases, a tomato soup-colored Scout and the farmhouse my mother grew up in.
“Brandon,” the physician’s assistant calls my name.
The gravel pits outside my grandparent’s farm fade into the fine, red gravel of the university running track. I see the accomplishments of my peers and my father weeping over the kitchen sink. My memories pool like tears atop the brown shag carpet.
“Brandon,” the cardiologist’s voice jolts me back into the room. He tells me that my heart is in perfect working order. My cholesterol and triglycerides are low.
I slip back into my mind, my memories mixing with the moment, reminding me I have been given a second chance.
“You’re doing great!” the cardiologist says. “We’ll see you in six months.”
On my way home, the Radio Lab podcast echoes in the background as I call my mother to tell her the good news. I catch a glimpse of my reflection in the rearview mirror.
“Hello,” my mother says.
The good report from the cardiologist means I have successfully slayed one dragon since the heart attack.
“Hi, mom,” I say.
I think it might finally be time to face the monster.