Bad Patient
If you can't get better, at least go away.
“I’m not one of those doctors who can’t stand to lose a patient,” the cardiologist is telling me. “If I can’t solve a problem, if you need to talk to other people, fine. It’s not about me. It’s about the patient.”
Oh, the heartache of being an older babe. I used to get the kiss off after a romance, where at least I’d get to make out in the back of a taxi. Now, it’s medical. The doctor talks, I hear Bob Dylan singing, “It ain’t me, babe.” With a cardiac twist.
You say you’re looking for someone, never dumb but always smart.
Who’ll figure out your shortness of breath and calibrate your heart.
Who’ll find beta blockers that won’t make you faint…
Well, it ain’t me babe – maybe check out Weill Cornell because it ain’t me babe, it ain’t me you’re looking for, babe…
A recap: Since the fall, I’ve been having having shortness of breath and light-headedness when walking up stairs — or sometimes, just walking. There was also a Temporary Ischemic Attack, a very brief stroke which lasted about a minute.
That kicked off a series of tests that led to all kinds of exciting diagnoses, Paroxysmal Atrial Tachycardia; some cardiac arterial blockage; high blood pressure.
Last week, I had the crème of the heart tests – a catheterization in which they thread a tube with a tiny camera up an artery and through your heart. (I like to imagine this at Disneyworld. Cath Ride. Recommended for chest pain or abnormal heart rhythm. Note the way it narrows in here — I hope nobody’s claustrophobic!— and how tough the walls of those plaque encrusted arteries are. No, do not carve your initials on there. The patient could D-I-E.)
I was stoned through the test, but I did hear the doc who performed it talking to Herb after:
“The plumbing’s fine. If there’s a problem, it’s electrical.”
Two days later, I’m sitting with Dr. Dylan, getting the cardiac kiss off.
“You came to me in the fall because you felt light-headed on exertion,” he says, “And there’s nothing in your tests that explains that. Your heart is strong and healthy. You have no major blockages.”
But (SOB!) I thought we had something serious going on there, you and me. You had murmured those three special words, no doctor had ever said to me: Paroxysmal Atrial Tachycardia.
“It’s not all that severe,” the cardiologist says, “You had two episodes. One lasted 11 seconds, one lasted two seconds. There were no extra beats in the top or bottom chambers. Your heart blockage is normal for someone your age. Your cholesterol levels were pristine.”
And then, my darling Specialist, you put me on my first ever low blood pressure meds. Now you’re tellling me I don’t need them. Talk about mixed messages.
“You turn out to be one of those people for whom less is more,” the doc says. “Just keep up the statins and aspirin.”
Oh, the heartbreak of trying to find the right specialist. In this case, it could be literal. My medical adventures in the last few months, in addition to the cardiologist, have led me to neurologists, pulmonologists, with an electro physiologist, an extra special specialist, coming up.
These all important pre-publication weeks, when I should have written the sixth hundredth essay on “The White Lotus” for the New York Times in order to sneak in a “Joyce Wadler is the author of” tagline and promote my book, I have been sidelined trying out meds for high blood pressure, which has been terrifying.
This is another one of those older babe rites of passage nobody told me about: Taking drugs which make you feel you are going to collapse in the street which doctors fine tune until they find one which will make you confident you will be able to get back to your apartment before you collapse.
“Oh, yeah,” a friend tells me, “It took them about four months to find the right mix. I was on Fire Island, where there are no doctors, and I felt I was going to pass out. Be assertive with them.”
I was a reporter. I can fake assertive. But when you’re a tough fix, terrified and you make demands, you’re at risk of being tagged the difficult, neurotic patient. With high blood pressure, tension can make the condition worse.
“Remember, the fear and anxiety of an episode will further complicate this,” a doctor I’ve known for thirty years says. “So try to relax and not let this get into your head.”
You see where we’re going here?
Hysteria territory. Perhaps it’s the showman in me, but I see another Disney ride:
A stagecoach, the Hypertension Express, is traveling in a strange and foreboding land. A white coated specialist is exhorting his steeds on, as he only has fifteen minutes. Inside, three older women, in No Stress Organic Linen Eileen Fisher, are looking out the window anxiously. The bleached bones of a Lorimar exec who suffered a hemorrhagic brain bleed lie in the remorseless sun.
“I had a meeting with her once,” one of the women says.
CUT TO: A high cliff, where a 77 year old woman, who could pass as 62, at least at this distance, mutters, “My head feels kinda weird.”
The woman staggers to the edge of the cliff, then falls dramatically, landing beside the stagecoach.
CLOSE ON the woman’s face: One side sags to her shoulder. The other side is fixed in a deranged Joker grin.
The white coated stage coach driver brings the coach to a screeching halt and leaps down beside the woman.
“How many fingers am I holding up?” the specialist asks. “Thirteen. Very good. Grab my hand — squeeze as hard as you can. That’s my nose. What’s the name of the President? Eleanor Roosevelt? Okay. I don’t suppose you have long term health insurance? No worries. There’s a nice nursing home where we can park you for the rest of your life. Are you aware you can get adult diaper covers with ruffles? Ladies — try not to get upset.”
I remember when I turned forty and everyone said it was the end of the world. What a joke. Forty is nothing. Forty is a blip. At forty, people still look at you. They still see you. They still listen when you talk.
At seventy-three, I've become invisible. Like you, Joyce, I walk into a doctor's office, and before I've even opened my mouth, I can feel it—that subtle dismissal, that mental categorization: elderly female, probably confused, definitely a complainer, possibly demented.
Did you know that if you're over seventy and you say you have pain, it's automatically considered less important than if you're thirty and say the exact same thing? I didn't make this up. There are studies.
The other day I was waiting to check out at Whole Foods, and the cashier kept looking past me to the young woman behind me, as if I might disappear if he ignored me long enough. I wanted to grab him by his organic cotton collar and say, "I've lived through eleven presidents! I marched on Washington! I've had more interesting conversations than you've had hot meals!"
But of course I didn't. I smiled. I was pleasant. Because that's what we do, my generation of women. We've been trained to be nice while being erased.
And this is how it happens—this is exactly how the sweet, hopeful woman of fifty-five transforms into the cranky old lady of seventy-three who seems perpetually annoyed. It's not age. It's accumulated indignities. It's death by a thousand cuts of condescension.
So now I understand my mother's generation and why they turned into such hardasses. They weren't born that way. They were made that way—by doctors who called them "dear," by mechanics who explained simple concepts to them very slowly, by a world that decided their expiration date had come and gone.
I've joined their tribe now. And here's what nobody tells you about this tribe: we remember everything. We're keeping score. And some of us still write.
Grimly funny. Great job.