On June 17th we learned that the latest right wing assault on the Affordable Care Act had failed before the Supreme Court. The news prompted President Biden to tweet that the “ACA is still a BFD.” Yes Mr. President, it truly is.
The Summer Solstice, which occurs between June 20th and 22nd, is commonly referred to as the “longest day of the year.” It is, of course, no longer than any other day, but in the Northern Hemisphere the Summer Solstice is the day with the greatest span between sunup and sundown. Hence the nickname.
But exactly five years ago today, June 21st did indeed seem like the longest day ever to the people who care about me. My family. My friends.
Because five years ago today I was in a coma, being kept alive by two machines. One did my breathing for me, while the second one used helium to inflate and deflate a small balloon that had been threaded into my aorta via an incision in my groin. This “balloon pump,” as it is commonly called, didn’t take over for my heart, but it assisted it. Its use carries with it multiple risks, primarily that of an ischemic event. But it had to be used.
Because in the early morning hours of June 21st my heart’s mitral valve suffered a catastrophic failure. Its posterior leaflet…one of two...had torn away and was, I was later told, “hanging by a thread.”
The mortality rate for an occurrence such as this is around 98 to 99%. Immediate medical intervention must be taken. Brain damage occurs within minutes. Death shortly afterwards. Fortunately for me, immediate intervention was taken.
And it was taken because I was in a hospital when it happened. And I was in that hospital because I’d been admitted through the ER. And I’d gone to the ER the day before because, thanks to the Affordable Care Act….Obamacare….I was insured for the first time in over a decade.
So I didn’t hesitate to go to the emergency room when I got out of bed and I felt an odd kind of weakness, as though I was walking in a swimming pool up to my neck. And once there…the fluid in my lungs misdiagnosed as pneumonia rather than the pulmonary edema it was...I was admitted for IV antibiotic therapy and further testing. They did not instead write me a script for oral antibiotics and send me on my way with instructions to “follow up with your doctor.” An ultrasound the following day revealed the real problem. The cardiologist assigned to me…a man who looked and sounded as if he could be Mel Brooks’ brother…entered my room and informed me that “Your mitral valve is failing, and blood is GUSHING everywhere!” To this day I have no idea if he was a good cardiologist or not, although I strongly suspect he was, but I just loved him because of his friendly and engaging nature, and…well, like I said, he looked and sounded like Mel Brooks’ brother.
There was luck too, of course. Or, as one friend seemingly believed, the hand of Christ (Jesus being apparently too busy to heal those other more worthy and certainly far more devout occupants of the ICU who didn’t survive.) The valve’s failure began slowly, giving me notice that something was wrong. Usually such failures occur almost instantaneously, the person dying within minutes of collapsing.
And I was lucky that when the valve finally failed completely there was a raft of nurses and other medical personnel in my room. They had responded to my 2 AM complaint that I was having difficulty breathing. A man who I only assume was a respiratory therapist placed a BiPAP on me….the “fighter pilot mask”…..and I resisted it because while it absolutely helped me inhale, the force of air was so great that I found it difficult to exhale. Three times I pulled it off to complain, each time the therapist ordering me to put it back on.
The final time I put the mask back on felt different. I thought “This is great….I’m falling asleep.” In actuality I was losing consciousness. The leaflet having suddenly torn loose my lungs were experiencing something called flash edema…their complete and immediate filling up with fluid. What little oxygenated blood I still had was being poorly circulated, my heart still beating but operating with only three of its four valves working.
I assume that when I stopped resisting the mask and closed my eyes somebody in the room had asked me if I was now okay, only to receive no response. Or perhaps they noticed that my blood pressure had fallen to where the systolic (the higher number) was in the 20’s. Not the 120’s. The 20’s. I don’t know if my diastolic pressure even registered.
Had my valve failed only two minutes later everyone would have by then left the room. At some point someone would have come in only to discover a dead man.
Instead I was rushed to the ICU, my lungs cleared and my throat intubated, and my naturally occurring coma was replaced by an induced one, since the balloon pump precludes much in the way of movement. I was later told by one person that my wrists were tied to the sides of the bed in case I woke up, but I was never able to confirm this.
By dawn I was stable enough to be taken, still on life support of course, for an angiogram. The reasoning being that as long as they were going to crack me open and stop my heart they’d perform any needed bypass surgery at the same time. Remarkably the angiogram showed that, as the cardiologist told my nephew who had dropped everything to fly in from Atlanta, “Your uncle has the heart of a 35 year old.” No bypasses or even stents needed. Pretty great news for a man on the cusp of 60. Surgery was scheduled for the following morning.
I remained stable for the next 24 hours and went into surgery at 6am. It was finished at 12:30. Three out of four times when such surgery is performed in a crisis situation such as mine, the valve must be replaced with either an artificial one or a pig valve. Each has its drawbacks. But the surgeon who had been assigned to me…another stroke of luck…was able to cut, sew, and resection the leaflets, stabilizing the valve with an annuloplasty band…an omega shaped piece of non-ferrous metal wrapped in Teflon string.
I was placed back in the ICU for a few hours and then moved to a room in the cardiac care unit. Where another problem arose.
They couldn’t wake me up. I was eventually taken for a CT scan of my head, since brain damage was a very real possibility. In all I was comatose for close to five days, three of those after surgery, and I like to say, only half jokingly, that if you’re going to experience something like this, being in a coma is the way to go! For my loved ones of course it was horrible. But when I eventually woke up to the sound of my nephew explaining to me where I was, what had happened, and assuring me that his mother...my older sister who I look after…was fine, I was like Dorothy at the end of the Wizard of Oz. It all seemed unreal to me, and only the scars and my extraordinary weakness (holding a phone up to my ear for a minute was all I could handle) confirmed to me that I wasn’t on the receiving end of some elaborate practical joke.
Two days later I was discharged to a rehab facility to regain some of the strength I’d lost lying in bed for eight days. After a week I returned home, still incredibly weak but gaining strength every day thanks to the physical and occupational therapists who came by several times a week. Three months later I was back at both my jobs...neither of which provide health insurance...working fifty to fifty-five hours a week. My mitral valve’s regurgitation is now zero freaking percent.
A couple years after the surgery during one of my six month visits to the cardiologist...who in my first post-surgery visit had dubbed me “the Miracle Man”…I asked him what he had thought my odds were that June 21st morning when he learned of my situation. He said “Well, I don’t do odds. We knew that if we could get you to surgery and fix or replace the valve that you’d survive.” I said to him “But you didn’t know what I’d be like when I woke up,” and he said “No...that we didn’t know.”
Then he absolutely cemented my affection for him by saying (and try to read this with Mel Brooks’ voice in your head,) “Let me put it this way…..you were sick as shit.” Gosh….could you put that in layman’s terms doc? The last time I saw him he told me that he was retiring to Israel to enjoy his many grandchildren. When I recounted to him his “sick as shit” comment he didn’t recall saying it. But he told me “If I said that I was wrong, because you were sicker than shit!” All I can say doctor is todah rabah.
All of this…ALL OF IT...even the rides to and from my doctors’ offices since driving is proscribed for several months afterwards lest a deploying airbag snap the still healing sternum...were covered by my state’s Medicaid program. I was not plunged into debt. I was not dunned by a collection agency. I did not have my credit rating damaged. Nor were these burdens placed on anyone else in my family
The radical right has so successfully poisoned the minds of Americans that when people with private insurance learn of the incredible coverage I have, many of them think “I don’t have that. So I don’t want you to have it!” I look at them with their co-pays and deductibles and I think “I have this. And I want YOU to have it too!” In perhaps the greatest irony of all, my nephew who flew up from Atlanta had undergone mitral valve surgery only three months earlier! His had been elective, performed arthroscopically, and done to correct a different, but not terribly dissimilar problem. His employer-provided insurance left him with thousands of dollars in out of pocket costs.
And now, just four days ago, after many worried months, I learned of the Supreme Court’s decision. Even all but two of the court’s radical activist judges…they should never be called “conservative”...rejected the challenge. But it was thrown out on standing. In other words the litigants had not shown any actual harm had occurred to them. I’ve no doubt that the wing-nuts...now with extra orangey wing-nuttiness!...will continue to try to tear down Obamacare without even attempting to formulate a replacement that would accomplish the same things as that monumental piece of legislation.
When I awoke from my coma one of my first questions was “Did Brexit pass or fail?” The news that it had passed may have been a harbinger of what was going to happen that November in our country. The following January, as tRump’s inaugural approached, with the promise by him and his minions to repeal the ACA, I wrote an op-ed that appeared in the Chicago Tribune. I even got paid for it, allowing me to joke that I could now add “Professional Writer” to my Tinder bio. Which I have not done, BTW. The op-ed prompted a producer for the CBS evening news to call from New York, asking if I’d like to participate in a story they were doing. I passed.
The reTrumplicans tried mightily, time and time again, to repeal the ACA. Their ultimate failure to do so rested on three GOP Senators. Much attention was focused on John McCain, with his flashy thumbs-down signal. But Lisa Murkowski was responsible as well. And had Susan Collins bought into some other empty promise from Moscow Mitch and voted with the GOoPers (while no doubt expressing her usual “serious concern,”) they would have succeeded. I truly detest that woman, but I try to occasionally remind myself of that vote that saved the insurance that had in turn saved my life.
But for tens of millions of Americans healthcare continues to hang by a thread thinner than the one that kept my mitral valve from flushing away. We must elect more Democrats to the Senate, while also bolstering their margin in the House. Real Democrats. Democrats who will abolish the filibuster, strengthen and broaden the ACA, and set the country on a course for true universal healthcare.
It’s a BFD.