By the following day, Wednesday, my don’t-care view of a. fib. had been replaced by a cringing wariness. I walked around carefully, as if my heart were made of glass, and I was carrying it on a velvet cushion of my breathing. I felt whipped. The procedure had jangled my entire system, as I knew it would—any operation, no matter how minor, takes anywhere from a week to a month to recover from, and don’t let anyone tell you otherwise—but this particular event had left me shuffling around like an old man in bedroom slippers. Life in the household went on around me. I once knew a bunch of ageing rockers who decided to name their band Old And In The Way, and I knew just what that phrase meant.
Even walking up and down stairs took a certain deliberateness, as if I were carrying a loaded tea-tray in my chest—but once again it wasn’t when I was active that things went wrong. It was when I tried to be inactive.
The event started out around 10 p.m. like a no-account threat, a slight uncertainty. My heart stuttered, but then beat fine for half-a-dozen beats or so, then stuttered again, then picked up its rhythm once more. I walked into the bathroom, which seemed to throw things off balance a little more, and took a bath, which seemed to settle everything down completely. It wasn’t until I tried to lie down in bed that everything got out of control. For the first time I felt the familiar invasion, the abrupt manic whacking in my chest. I sat back in an armchair and laid my right palm over my heart, as if this would somehow offer it sympathy and encouragement, and slowed my breathing to cathedral calm. And for a while that worked.
Over the next twenty minutes, though, the tension and the stakes rose. By 11:30 I felt as though I were in a medieval morality play in which the stage represents Everyman’s soul, which in turn is the battlefield on which the forces of chaos strike at the forces of order, trying to overthrow them and establish violence and despair.
My heart beat normally for four or five beats, sometimes as many as thirty, but then a kind of invasion took place: my arms felt as if they needed to flail or twitch, and this current converged on my heart, which abruptly went into spasm, beating hard and fast, feeling less as if it were beating and more as if it were being beaten. These were heartbeats that had nothing to do with circulation of blood: they were a kind of war drum, or a great gate being battered. My chest and throat constricted, and that sense of squeeze rose into my ears, which grew hot, and my head. I felt dizzy, and head a soundless buzzing. And yet this most extreme symptom was the sign that everything was passing, because the energy, like a tiny, vicious whirlwind, seemed to rise out of the top of my head, leaving silence and calm behind, and when I recovered and looked around—well, inside—the attack was over, and my heart was like a mild sea breaking at the foot of the castle walls.
During the attacks, I felt so besieged I couldn’t speak, and had to give Barbara instructions in sign language. As soon as it had passed, though, I had the absurd sense that I was talking as casually as a Noel Coward character, sitting in a drawing-room armchair, wearing a dressing-gown and mildly waving a cigarette-holder to make his points.
After about an hour and a half, I quit trying to fight this battle on my own. I got Barbara to drive me to the hospital again.
It was like Homecoming Weekend. I was delighted to see the action-figure silhouette of Dr. Peter Weimersheimer, who greeted me like the artistic director of a summer-stock theater company greeting one of his New York actors, back for another season on the rural boards.
Once again I was on the bed, wired to the monitor, IV in my arm. Yet Weimersheimer seemed curiously reluctant to describe what was going on as atrial fibrillation. Like me, he felt that this curious two-phase see-saw that was going on was different from the out-and-out madness of two nights previously. “There’s something called atrial flutter,” he said, but on the discharge sheet he would ultimately write simply “Palpitations.”
As usual, I was trying to deal with the weirdness and anxiety of the situation by studying it, and myself. The most peculiar aspect of the night’s upheaval was that it reminded me more than anything else of Restless Leg Syndrome.
RLS, as it is abbreviated, is a mysterious neuromuscular disorder. Nobody knows what causes it, though in my case there may be a genetic component, as my mother had RLS, too. It’s one of the strangest and most infuriating of sensations: a kind of energy or impulse appears in (usually) one leg, making you feel as if you need to twitch or kick it. (I heard a Tourette’s Syndrome sufferer describe exactly the same build-up that, no matter how hard you try to relax or to fight it, forced him to burst out in a kind of verbal twitch.) It can go on for hours, and most frustratingly—and most like my a. fib. symptoms—it typically starts just when you’re trying to relax. I’ve had it since I was 19, though often it has vanished for years at a time, and at its worst it would keep me up virtually all night until, utterly exhausted, I felt like crying in frustration.
Whatever this particular cardiac event was all about, it seemed to behave much like RLS—only instead of creeping into the nerves and muscles of my thighs or calves, it crept into my left shoulder and pectoral muscle. The first sign that my calm phase was about to end, in fact, was that my pec/shoulder area started to feel that build-up of electrical charge, which then seemed to dive down and sideways, sending my heart into its manic phase. It was as if I had Restless Heart Syndrome.
I twitched around in this fashion until around 1 a.m., and then began noticing something else that seemed odd. The phases seemed to be polarizing. The manic phase was, if anything, more manic—at its peak I felt hot and dizzy and on the verge of passing out—but the calm phase lasted longer and longer. In the end, it was as if the existential battle was won by the forces of order if only because the forces of chaos had retreated, perhaps to regroup and mount another attack another day, perhaps to go and try to win someone else’s soul.
I left sometime before 2 a.m. Weimersheimer gave me one metropopol, a beta-blocker that would slow my heart (though not do anything specifically about the arrhythmia) and another one to carry home and take in the morning. He also left phone messages for my internist and the cardiologist I had seen five years previously, Dr. John Fitzgerald, who would make time to see me later that same day.
They were clearly serious about this chaotic cardiac event, whatever it was. Time to ramp up the gear and find out what the heck was going on.
As you can probably gather, this is by no means the end of the story. I hope you’ll follow as I add new chapters every few days and continue to explore both the narrow subject–atrial fibrillation–and the broader subjects, such as the heart itself, and what Whitman called “the body electric.”
I also hope you’ll forward this to anyone who has arrhythmia. This may possibly turn into a book, in which case I need all the help I can get from others, whether what they have to offer is answers or questions.