The Heart in Denial

I have to be careful about what public broadcasting I tune into.  New Mexico’s offbeat branch of NPR runs weekly campaigns on cardiac disease and the many signs of a heart attack, as told by survivors or the children of non-survivors.  On any day you can enjoy a visceral description of heart failure as told by an elderly Hispanic woman, with panels on what you should do when you have your heart attack.  It’s gotten to the point that I have to turn the station the moment I hear the word, “heart.”  Shortly thereafter, the odds are I’ll drive by a billboard with a handsome, white paramedic that reads, “Heart attack? Call 911.”  Albuquerque is a cardiac minefield.

I feel a violent discomfort with the idea of billboards reminding me about the ever-present heart attack, like little mortality postcards on the roadside just in case you were feeling relaxed, but I begrudge the billboard its funny setup.  It seems like a weird memo, from a business that needs no advertising, with a weirder setup, like the way to talk about a cardiac event is the same way to ask about car troubles. “Heart attack?”  If they put enough up, anyone drifting around having a heart attack in Albuquerque and wondering what they’re supposed to do now will get the snappy reminder, “Hey, you can call 911 for that.”

My anxiety is generalized enough that any podcast or radio feature on illness either repulses or enthralls me.  I especially like stories from the ill, first hand, about their coping strategies.  How did they feel when they were diagnosed?  Do they have any funny quips about disease?  But you’re OK right?  But you’ll die?  Find me any successful person with a serious illness who isn’t full-out dying, interview him or her, and send me every minute you have.  It will either embolden me or ignite a downward spiral of mental anguish.

I recently listened to a podcast in which the hosts were interviewing Michael Kinsley, creator of the magazine Slate, about his Parkinson’s.  It was one of the better illness interviews I’ve heard, full of whit and unconventional observations about death, many of which hadn’t yet occurred to me.  This in particular stood out to me: when it comes to bad mortal news, “there are only two strategies: denial or confrontation.”  Usually people say you can accept or deny your terminal illness, but acceptance, Michael says, is frankly not a choice a person can make.  It either comes to you, or it doesn’t, so you’re left with denial or confrontation.  In the latter, you attack your own illness via support groups and doctor’s consultations and juicing.  You feel like you’re accepting, but the method is more akin to stomping on an ant hill until all the ants inside are dead.  You are in reality fighting, which any white American who’s read a book on Zen Buddhism will tell you is a very different animal from acceptance.

Denial, the former option, is sold as is.  You deny that you have an illness, and you go on about your life as if you’re healthy.  I suspect denial works for some illnesses better than other’s, namely, Parkinson’s over terminal cancer, but it’s more of a gut instinct than strategy in that sense.  It’s your reaction to bad news, the kind everyone gets but maybe you were secretly hoping you’d slip past.  Michael chose denial.  For eight years, he lived as a person without Parkinson’s, and he’s remarkably un-selfconscious about it.  In his mind, he gave himself another eight years without living as a sick person, without requiring constant sympathy.  His friends, naturally, the ones who knew, weren’t thrilled about the denial thing.  We like to see people doing things.  We prefer fighting over delusion.

When I heard this interview, I first thought of all the surgeries or medicines or experimental treatments he could have used those eight years to try.  I mean, I’ve had generalized anxiety for three years, and I’ve exhausted my options already.  Who knows, he might get rid of his Parkinson’s?  Can you get rid of Parkinson’s?  Maybe he would have become the first human to never die.   But denial?  Who the fuck just denies it?  Who is that brave/crazy?

Michael identifies denial as the cowardly choice, an inability to deal with the truth, but I find myself seeing it as the braver one.  As someone who’s obsessed over his own mortality and dove headfirst into the world of the sick without an invitation, I envy the balls it takes to just say, “Nope,” when a real illness is staring you in the face.  Young people make this choice all the time without realizing it, like I did until age 26, at which point, I decided being horribly ill was a better fit.  Because no young person really knows if he or she is healthy.  If she decides to climb Kilimanjaro, she doesn’t really know her heart won’t give out at 18,000 ft.  She says, “Nope,” every day, choosing to live the life of the healthy and do, or ignore doing, the things healthy people do, like running or drinking or eating bacon, without consequence.  They assume the long life ahead of them.

I’ve met a lot of people in my age bracket who’ve had panic attacks and tunnel vision and hammering hearts, and most of them returned fairly easily to the isle of the healthy, drawn back by the soft ukulele and bottomless Mai Thais.  For most, it’s the obvious first choice of a short list concerning illness.  I could have (1) confronted like Michael J Fox or (2) denied like Michael Kinsley or (3) just been healthy again.  Only one of those routes is the sane one to take when you’re not actually sick.

I chose a garbled nest of the first two.  I attempted a sort of half-assed confrontation strategy, willing myself to be sick even after the test results came back empty handed.  I went to therapy, talked to anyone who would listen about my symptoms, stopped exercising, adopted fully my warped interpretation of how a cardiac survivor lives.  And I denied being healthy, even as it announced itself time and time again.  I forced my own amnesiac lapse of what being healthy actually feels like.  So many expressions of love or sympathy or  tenderness lost to moping, thinking of how hard it all was, wondering if I’d ever be able to do it again, believing that I’d barely scraped by.

On one occasion, after using the row machine at a gym (which was, coincidentally, in a center for cardiac rehab), a stooped elderly man approached me.  “Say, how long d’ya do that for?”  I was reading my pulse, which was fast, because of the aforementioned rowing, which I didn’t like.  “What? Oh, uh, 30 minutes.”  Was my breathing constrained? It felt like my breathing was constrained. “30 minutes?! At the clip you were going?  Geez, you’re in fine shape, aren’t ya?”  I shooed him away like a fly, busy as I was thinking about my own death.  A wasted opportunity.  He was saying everything I wanted, validating what I begged for, an old man watching a young one and envying his health.  Little did he know, how thoroughly I was squandering it.

It made me wonder, would I someday be an old man at a cardiac rehab center lifting five pound weights and eyeing a young person slingshotting to and fro on a row machine, so healthy and energetic, and reminiscing on when I used to feel like that.  With a vampire glint in my eye, I’d say, “I was young and vigorous once.  There wasn’t anything I couldn’t do.”  And maybe, behind me, an even older man, lifting two pound weights in a wheel chair, watching me in my youthful vigor, thinking, “I used to lift five pound weights.  God, I was so young and healthy when I was his age.  There wasn’t anything I couldn’t do.”



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