Appreciating the murmur

I would like to think I’ve evolved to the point where I live to serve, but it’s entirely possible I’m simply desperate for human company. Despite being an avowed apanthropist, I enjoy being around people once in a while. Not too close, and not for too long. I am protective of my solitude, to the point where people call me antisocial (ask me if I care; the answer is no). I can't always tell what I am feeling. Still, I don’t actually hate people, even though I sometimes act like it.

This week, speaking of people, I visited my cardiologist at the cardiology clinic at the hospital to discuss the results of last week’s echocardiogram. I admit, I might have been overly eager to see him, to see anybody really. I smiled at everyone. Nobody was wearing a mask in the hospital, so I took mine off, too. I trudged up the stairs to the second floor with a stupid grin on my face, hoping I wouldn’t pay for it later by getting Covid.

I really like my cardiologist, for so many reasons. First, he’s a short round guy with a thick beard, curly gray hair, and a handshake that resembles a spatula swooping in to flip a pancake. I like that he sits heavy on the padded wheely stool. He doesn’t pretend to be thin. Second, he looks me right in the eye. Even when we were wearing masks in the exam room, he really seemed to see me. Maybe he’s perfected the doctor stare, but it works on me.

I could hear the muffled voice of my doctor through the thin walls between exam rooms. Hey, he's my doctor, I thought, as he greeted somebody, who answered in a quavery old lady voice. I fidgeted and tried not to feel possessive. Finally, a quick knock came on the door. Before I could say "enter," the door opened to admit a slim young man I’d never seen before. Definitely not my cardiologist.

“I’m Xavier, the doctor’s assistant,” he said, blinding me with straight white teeth. He couldn’t have been more than thirty, and he was perfect. I could find no flaws. Perfect white teeth, perfect black hair, perfect figure in a perfectly tailored clean white lab coat. I welcomed him and his laptop, glad to have something other than the heart failure chart pinned to the back of the door to stare at while I was waiting.

Xavier proceeded to ask me a long list of questions about my physical and mental health, my meds, my vitamins, how much I exercise, plus more I’ve forgotten. He didn’t check my cognitive function, by the way. I did my best to answer truthfully, being careful not to indicate the slightest hint of depression or anxiety. I will check his report later and probably find he thought I seemed depressed. I consciously tried to be perky, but I have a hard time pulling off perkiness.

When we got to the topic of exercise, he brightened when I mentioned my intention to jog. Big hopeful smile. His shoulders sagged with disappointment when I complained the summer had been so hot.

“You should get a gym membership,” he advised.

I nodded. “I could, but I’m nervous about Covid, a little.”

“I know what you mean. I go early in the morning when there’s no one there,” he said.

“Yeah, good, early . . .” I trailed off to indicate early, no, not really my thing. “What time do you go?”

“Between four and five,” he said. “You could use the treadmill.”

“Right, I used to do that,” I replied. “I’m afraid with this imbalance thing, I might . . .” I left off the rest of the thought: I might fall on the floor and break a hip. Or my neck. Which would be a relief in some ways.

“They have stationary bikes.”

Feeling kind of like a bug wiggling under a microscope, I was relieved when the doctor entered, trailed by two other people.

“You met Xavier? I hope you don’t mind, I brought Sasha and Roberto too? They are students. Roberto will be our scribe today.”

I practically quivered with excitement. No longer alone with the pushy Xavier, lots of company, plus a teaching opportunity! What could be more fun!

I perched on the edge of the exam bed table thing. The doctor put his stethoscope at various places around my chest and appeared to be listening intently. Then he invited Xavier to listen. Xavier took the stethoscope in his ear, put the round end on my chest somewhere near my sternum, and leaned toward me for a couple seconds. He stood back with an expression I couldn’t read.

“What did you hear?” the doctor asked him.

Xavier shook his head in embarrassment. “I did not appreciate a murmur.”

My mind worked on the word “appreciate” as the doctor took the stethoscope, put the round end in a different place, and beckoned him to listen again. They stood there together, student and teacher, joined by a stethoscope, apparently appreciating my murmur.

“Ah. Two out of six,” Xavier said with some satisfaction.

The doctor motioned to Sasha, who up to this point had been watching silently. She approached and took one end of the stethoscope in her ear.

“Hear it?” the doctor said. “Whoosh, whoosh.”

I don’t know if she heard it or not. She acted like she did. I’ve been a student. Performance pressure in front of one’s peers is a terrible thing. In a few short years, she will be treating patients of her own. We can only hope she can detect a murmur that is a two out of six on the murmur scale.

I was released with an order to have a followup echocardiogram in one year, which was the outcome I’d been hoping for. My sticky leaky calcified bicuspid valve has not deteriorated appreciably over the past six months, so I might dodge a heart attack for a while longer. Not sure about all the other stuff, but at least the ticker is still ticking.

The doctor herded his charges out the door. As I waited for the medical assistant to fetch me and escort me to the appointment desk, I reflected on the weirdness of my life. I still keep trying to make sense, to find meaning in my experiences, which I suppose means I have enough curiosity to see what might come next. 

 

Things that don't heal by themselves

I've heard time heals all wounds. That sounds nice, but time doesn't heal everything. A few things come to mind. Cars. Teeth. Hearts. Money can heal some things, though. Cars, for example. If you have enough money to throw at the problem, you can definitely get that dreaded check engine light to go off. For a while. 

A business person once said something like, "I know half my advertising is wasted; I just don't know which half." I feel that way about car repair. When Charlie the mechanic says things like "Well, first we'll replace the coil, and if that doesn't work, we'll replace the fuel injector," it makes me suspect I just got a new coil for nothing. Not that you can't always use a new coil, but generally, I try to wait until I really need a new thing before tossing out the old one. It's the guess-and-by-golly approach. You guess, and if it works, you say, well, by golly! If it fails, you say, golly, sure screwed that up. The approach works, either way. After $2,300 worth of new everything, my car is running great. 

Another thing that doesn't heal by itself is teeth. Repairing teeth chews up a lot of money (ha, see what I did there). As I lay stiff as a board in the chair, with a drill, a water pick, a suction hose, and four hands in my mouth and the whine of the drill blasting my eardrums as it ground #3 and #26 to smithereens, I had a solid two hours to really savor the feeling of money being siphoned out of my bank account. I kept picturing the moment when I would be sitting at the receptionist's desk, pulling out my debit card. While I suffered in the chair, I couldn't wait for that moment. Once I survived the grinding and was actually pulling out my debit card, I felt somewhat less enthused. However, my deal is, I pay as I go for services rendered, even if they render me impoverished. How could I refuse? I got two new crowns for the bargain (Medicare) price of only $1,500. Such a deal. 

Speaking of dental deals, I hear that my insurance company has denied the $1,550 cost of last month's root canal re-do. I'm going to call them and weep into the phone, but I don't have a lot of hope. You can't petition the insurance company, not with prayer or anything else. The root canal had to be done, though, to save the tooth. So they say. Do we have to save teeth? I'm starting to think I'd look pretty good with dentures. I wonder if the dentist would let me customize them. Could I get them sharpened to points, maybe? That might come in handy in the upcoming zombie apocalypse, when I might be called upon to bite the throats out of water thieves. 

My bank account is starting to resemble Lake Mead—that is to say, a lot going out and not much coming in. I am not good at math, but even I know that is not sustainable. 

I knew this was going to happen. I was mentally prepared. Cars and teeth do not repair themselves. As long as I have the money, I will pay to maintain them. After that, it's baby food and bicycle. 

The other thing I'm thinking of that doesn't heal on its own is my heart. I don't mean that I'm grieving the losses of the past three years, although I am, and I probably always will miss my mother, my cat, and my sense of "home." I am actually referring to the actual meatball beating in my chest. Taking up yoga and jogging won't fix the valve that is gradually calcifying. My father used to lift weights to "muscle" his way through his maladies. It seems likely that I have inherited his genetic heart condition. I doubt if lifting weights is going to save me, any more than it saved him. But I understand his motivation. After a long walk, I feel a sense of sweaty accomplishment, like, yeah, take that, you stupid meatball. I'll outlive you yet, you just wait.

Speaking of dead, I'm pretending there will be a tomorrow, and I'm making plans accordingly. In a couple months, I'm going out in the world to seek my new home. Am I too old to go on a quest? I haven't heard that there is an age limit. This might be the adventure of my mediocre mundane lifetime. Or it might be the stupidest thing I've ever done. It's so hard to know ahead of time. Most of my bright ideas fall into the second category, but I've been lucky a few times before. It could happen again.