BRATTLEBORO — In 2004, the Angel of Death paid me a visit and gave me a close brush. As it turned out, he was not there to reap, but to teach.
My ordeal began when doctors attempted what was supposed to have been a routine catheterization. My blood started to clot uncontrollably, and only the skill and dedication of the surgeon in an emergency bypass operation saved my life.
I had a then-undiagnosed hereditary predisposition to clot easily, further complicated by a hospital error: I was continued on the anticoagulant drug heparin for two days after I tested positive for heparin antibodies - a mistake that, statistically, doubles the likelihood of fatal clotting.
Finally, I had been treated with new drug-eluting stents, which were recalled a couple of weeks later when they were implicated in an unusually high rate of clotting and death.
All this made for a “perfect storm.”
On the fourth day after the operation, I was recovering and almost ready to go home when spontaneous clotting clogged the bypass grafts, and after a touch-and-go four-hour operation, I ended up in a coma, on life support, for three weeks.
My kidneys failed. I was on dialysis, intubation, and a heart-assist pump, barely hanging on.
1. Facing death
Although I appeared to be unconscious and insensate, in my own world my mind was active, and I was very much aware how close I was to dying.
Perhaps because of the continuous sounds of bells and whistles - hospital noises - I thought I was being held captive as a political prisoner in the hull of a ship.
Some staff members had ignored my wife's instructions not to play the television, so that accounts of Abu Ghraib - the breaking news story at the time - probably fed my delusions of captivity and torture.
Intravenous feeding left my mouth and throat parched, so that in my heavily-sedated, delusional world I believed that I was being deprived of food and water in order to try to break my spirit.
No matter what, I knew that I would never give in.
I felt that my will was indestructible, and because of sheer determination, I would not die.
My son at the time was 13, and I very much wanted him to have a live father, at least until he became old enough to live on his own. My responsibility as a father - more than anything else - kept me determined to live.
But when I weakened and breathing became a struggle, I felt that my captors were intentionally depriving me of air. Up until then, my goal had been to stay alive, and I had been certain that I would succeed.
Now that I was struggling for air, I realized that, no matter how strong my resolve, if the burden became great enough, my strength would be overcome and I would die.
Still, I was not willing to allow my captors to control the outcome. So I changed the criteria to put victory entirely in my control.
Until then, staying alive in the face of this attempt to torture me to death had been my goal.
But now, I realized that my captors had the power to kill me, and there was nothing I could do about that. I also knew that their real purpose was to destroy my sense of self-worth and get me to believe that I deserved this treatment.
So, despite the fact that I could not stop them from destroying my body, I knew with certainty that they could never get me to give up my belief that I am a person worthy of life.
I could barely gasp my next breath, and I knew that I would die within minutes.
But I was certain that, somehow, my son would know that his father never gave in, never collaborated with his captors, and that this knowledge would be important to him. Although I would not be alive as he grew up, I felt that his knowing that his father had died with courage would be my last gift to him.
I knew that I had about a minute and a half left to be alive. I lost consciousness.
* * *
Much later, I drifted back to awareness. My mind was thinking. Then I realized that if I was thinking, then I must still be alive. I was amazed!
I figured it was a fluke that I was still holding on, and I expected it not to last too much longer. I fully accepted the inevitability of my imminent death, but I did not consent to it. Nor was I was going to cooperate in any way.
While this was going on in my world, my wife, Donna, my son, Leif, and my wife's sister, Stephanie, who had come up from Virginia Beach to lend her support, were keeping vigil by my bedside.
The phone rang. It was my brother, who had just arrived in Brattleboro with his family.
My brother told Stephanie that they were tired and would stop at a motel and in the morning drive the final hour to the hospital in New Hampshire.
“If you want to see Steve alive, you better come right over,” Stephanie replied. “He may not make it through the night.”
2. Turning Point
My friend and business associate, Terence Sellaro, was shocked when he saw me on life support. Much later, he told me, “You looked bloated, like road kill which had been lying in the hot sun for five hours.”
The doctors tried to prepare Donna for what they saw coming.
One of them (who probably could benefit from sensitivity training) seemed to be annoyed that she was not getting it, and he told her: “You should be making arrangements.” They told her that it was time “to think about making a decision.”
Later, at a second conference, they again broached the subject and asked if Donna would give permission to terminate life support.
She told them: “My mother always said, 'Where there's life, there's hope.'”
* * *
In general, though, the doctors and staff were incredibly supportive, even making sure that my wife and son had lodging in a room in the hospital.
When I read my medical records now, even though they are formal documents, the compassion and concern for my family comes through.
The doctors were clearly pessimistic, but they fought hard to give me every possible edge.
They were diligent to maintain the flow of oxygen to my brain. Several times my heart stopped, and I was immediately defibrillated. Twice, when I had become very weak, I was given transfusions.
Later, I found out that at times my coma was medically induced to keep me sedated because otherwise I would become agitated. I even tried to pull my breathing tube out.
* * *
The line between dreaming and waking consciousness eroded so that there was no longer a distinction.
When my eyes were closed and I seemed unresponsive, I was actually aware of what was happening around me, although my understanding of it was distorted. Even when my eyes were open and I could perceive my surroundings, I was simultaneously somewhere else.
Perhaps the continuous bells, whistles, and other hospital sounds seemed nautical, because most of the time I thought that I was being held prisoner in the hull of a ship.
At times, from the shore, I thought I saw a Jewish cruise ship (blue stripes on the hull with the Star of David on a white background) which periodically arrived and departed. I boarded the ship once but disembarked before it began its journey.
Later, when I was able to talk again, my wife reminded me that we had recently seen an Israeli film about a cruise ship filled with the souls of the dead. She said that if I had stayed on the Jewish cruise ship when it embarked, I would have died.
* * *
As I drifted seamlessly between worlds, various people would appear and fade away. I saw two women with coffee cups who were cleaning the room. I thought we were in a restaurant after hours, and I wished they would give me some coffee, but they did not seem to notice that I was there.
I saw nurses and tried unsuccessfully to get their attention. I hoped they could help me escape or at least get word out that I was captive. Although I could see them, they showed no sign of noticing me.
I began to wonder if I were a ghost, present but invisible. I now realize how important it is to talk to a patient, no matter how unaware the patient might seem.
* * *
I knew that my brother and his family were coming, and I also knew that I was close to death. In my delusional world, my brother's family was a tribe of Native Americans, and if I could only hold out until they got there, their powerful magic would save me.
I knew they were coming closer and closer because I heard a rhythmic tap...tap...tap as they tapped their magic sticks and sang powerful chants, walking slowly with a commanding air. (Later, my wife told me that the tapping must have been the sound of the heart-assist pump.)
Vividly, I saw my brother's tribe arrive. I saw each one of their confident faces as they filed by.
In the real world, my brother is a dedicated Christian, and he prayed hard for me, as did his wife, their sons, and the members of their church.
Over that weekend, my brother prayed fervently at my bedside. My grown nephew, Russell, prayed to God and pleaded with me not to give up.
* * *
On Sunday, for the first time in three weeks, my family saw me open my eyes.
I caught Leif in my gaze, stared at him, and - they tell me - I gave him a big smile. I looked at him like that for about 20 seconds, and then I closed my eyes again.
In my world, I had been held in the hull of the ship for a long time, isolated and deprived of food and water. I was amazed to see my son and could not understand how he got there.
Before that weekend, the doctors had given me very little chance to survive.
But now they told my wife they were “cautiously optimistic.”
3. Brooklyn, 1909
One morning, soon after I had been transferred from intensive care, Donna received a call from the ICU nurse, Wayne Lannon.
“Hurry, come right over!” he said.
When Donna and Leif arrived, she found that my breathing tube had been removed.
The physicians had been sure I needed a tracheotomy and had scheduled the operation for later that day. But Wayne had convinced the doctors to give me a chance to breathe on my own.
With Donna at my bedside, Wayne instructed me to breathe slowly and deeply.
Donna then looked me in the eye, and asked, “Are you going to breathe slowly and deeply?”
I hate to be told what to do, so I shook my head “no.”
This stubborn and stupid gesture was a great relief and comfort to my wife, because it meant that I was returning to my normal self.
When the tube was first removed, they continued to feed me intravenously and would give me no water, fearful that I might choke. I was literally begging for water, but still I could not help making a joke.
With my weak voice, I said to a nurse: “If you give me some water, I'll vote for George Bush!”
The nurse did not look amused. Perhaps she was a Republican.
* * *
My world was a blend of dream and waking perception. For example, I thought that Donna and I had gone to a police station to offer the attorney general of New Hampshire some important information.
I truly believed that this had happened, but later, Donna became concerned about my mental state when I asked her, “Are we going to talk with the Attorney General again?”
It did not help any when a doctor, evaluating me, asked if I knew where I was and what year it was.
“I am in Brooklyn,” I replied. “It is 1909.”
Later, I found an entry in my hospital records stating that I was disoriented; it said that I thought I was in “a police establishment” and noted that I “could not identify [my doctors] as physicians.”
I then realized who the “attorney general” was. He was a neurologist who (according to my records) had asked me if I could identify objects: a box of Kleenex, a pencil, a straw.
That was the “important information” the “attorney general” needed!
At times, a group of muscle men came to lift me from the bed so I could sit on a chair. One time I got impatient and attempted to get off the bed myself, only to be surprised by how weak I had become. My legs buckled, and the impact of my fall struck an intra-arterial needle.
They had to sedate me and place a sandbag on my chest to stop arterial bleeding. I thought that I had gone into a restaurant run by bears and had ordered tea and honey cake before ending up on the floor when the bears attacked me.
No matter how bizarre my delusions, I totally lived in their reality.
There were a lot more delusions. And there were strange, inexplicable experiences, such as my being able to describe accurately to my wife places in the hospital which I could not have seen. Apparently, my astral body was wandering around.
4. Recovery
A week after regaining consciousness, I was transferred to Grace Cottage Hospital in Townshend, noted for its friendly and homey atmosphere.
My health was fragile. I was confused and told a nurse that I had been homeless for the past couple of months and had been wandering the streets in Brooklyn.
Dr. Robert Backus - who only a few months before was named the Vermont Medical Society's Physician of the Year for 2003 - treated me with dignity, as did the rest of the staff.
The kind treatment I received at both Dartmouth and at Grace Cottage when I was vulnerable and defenseless meant a lot. During the few days that I had spent at Brattleboro Memorial Hospital, the nurses had also been incredibly protective and supportive.
Dartmouth-Hitchcock is a very large facility, Grace Cottage is very small, and Brattleboro Memorial Hospital is somewhere in between. This disparity shows that it is not size, but the spirit in which a hospital is run, and the caliber of the rank and file, that determines whether the patients will be treated with love and respect.
Even after I became able to ingest solid food at Dartmouth, my appetite was absent. I drank, but I hardly ate. I had lost nearly 30 pounds, but food tasted dry and uninteresting.
On my first night at Grace Cottage, a nurse, Conn Rose, spoon-fed me like a baby. I figured I would force myself to swallow it anyway to reciprocate Conn's patient care.
The next day, the head of food service came to my room.
He said that getting back enthusiasm for food is an important element of recovery. Because my wife had requested vegan food for me, he made a point of telling me that, regardless of what was on the menu, I should let him know what I wanted. Access to suitable food was important, but the real boost to my morale was knowing that the head chef cared enough to go out of his way for me.
Later, I was told by Mary Gyori, director of development, that as a result of our encounter, the chef had enthusiastically attended courses in vegan food preparation.
The devotion of hospital staff - not just medical people but also even a cleaning woman who gave kind words of encouragement - was remarkable. It was clear that for them, it was not simply a matter of putting in the required hours and punching out: The hospital workers I encountered are on a mission of love.
* * *
After five weeks in bed, I had lost muscle tone and needed help just to stand up. I struggled with edema and congestive heart failure.
My time at Grace was spent relearning to walk, and even doing simple things, such as buttoning a shirt.
Severe illness had infantilized me, and now I was like a child - literally learning to tie my own shoes, which took an hour the first time I tried.
I suppose life support is analogous to being in the womb, and the removal of the breathing tube is like cutting the umbilical cord.
So my experience was like being reborn and revisiting the journey to adulthood.
* * *
After three weeks in Grace Cottage, I was discharged.
My old friend Wally White came to the hospital to drive me home. When he arrived, he prayed for me, asking for cleansing of the blood.
Later, I asked Wally if he had prayed for purification of my physical blood or if he had meant “the blood” spiritually.
“Both,” he said.
* * *
Home was completely familiar but, after so long away, it seemed strange to be there. At first, I would sit on the couch for hours, not reading, not talking, not listening to music: satisfied just to experience being alive.
Gradually, I got back to work.
After a few months, I was admitted to the Cardiac Rehabilitation Program at Brattleboro Memorial Hospital, where the emphasis is on exercise and stress reduction.
Despite the aroma of eggs smothered in melted cheese, butter, and bacon coming from the hospital cafeteria down the hall, the instructors would also recite warnings about the risks of cholesterol.
The program helped me get my strength back and gain confidence.
* * *
Prior to my hospitalization, I had experienced some difficult challenges, including some frightening events for which I felt I had not received much emotional support. I had cynical thoughts about whether love is real or if people just pretend to care about each other because of what they want from each other.
But when I was ill, the outpouring of support was without limit and had nothing to do with self-serving gain.
We found ourselves surrounded by people who were ready to help in any way they could. Friends took care of our house and pets. Business colleagues covered for me. My wife and son had no trouble getting rides.
Later, I found out that even strangers were praying for me in churches, synagogues, at a yoga group, and even at Realtor meetings.
* * *
When I asked my wife why there seemed to be such a contrast between the lack of support I felt previously and the response to my illness, she said that people do not always get it when a person has an emotional need, but a serious illness is an unmistakable crisis that people understand and respond to.
I realized that when people do not seem to care, it might not be indifference, but rather that they do not understand how much their love is needed.
It was a terrible ordeal to put my family through, but from my brush with death I learned something very important.
There is more love in this world than anyone can ever imagine. I hope no one else will need to go through such an extreme experience in order to realize that love is real.