Green Hills Literary Lantern




I had a heart attack thirteen months ago.  I was sitting on the bedroom floor, reading, when it suddenly felt like a two-hundred-pound man had placed the heels of his palms just below my collarbone and was leaning his entire weight on my chest.  “What’s happening!” I whispered, more astonished than concerned.  Then, pain ripped down my right arm, so bad I dropped my magazine and crawled onto the bed.  Marc was making dinner; he came to the doorway—we have a very small apartment—at the sound of my moaning.  Marc was a medic in Viet Nam, although he rarely talks about it and didn’t keep any of the medals he was given.  The man I’ve lived with for nearly twenty years but never got around to marrying (an arrangement that suits both of us) asked me some terse questions: where was the pain? how long? how severe?  When Marc told me I was suffering the classic symptoms of a heart attack and that he was taking me to the emergency room, I laughed.  The pressure on my chest was already lessening, although intense aching had traveled to both arms.

“How can I possibly be having a heart attack?  I don’t even have high blood pressure.  Man, I’m glad one of us doesn’t jump to the worst conclusions!”

“You said you felt enormous pressure on your chest.  Get up.  We’re leaving.”

“Marco, you’re being silly!  I am not having a heart attack.  Just let me rest.”

On numerous occasions, Marc’s kept a level head when I have flown into panic, but my own behavior can make him crazy in seconds.  After arguing more and more loudly with me as I continued to moan on the bed, he threw up his hands and swore that if I changed my mind in the middle of the night, he wasn’t taking me to the hospital.  “Those are my last words, Frannie.  I mean it!  You’re going to have to call an ambulance.”

It wasn’t until the following evening that I admitted, sheepishly, it might be a good thing to get the pain in my arms checked out.  As we drove to Fairview Hospital on the University of Minnesota campus (not the closest hospital to us, but one I knew my insurance was more likely to cover), I studied my tired eyes in a makeup mirror and applied lip gloss to an otherwise bare face.  “People usually don’t put on makeup when they go to the emergency room,” Marc observed irritably.  I couldn’t blame him.  He’d done everything possible to get me to go to the hospital; when I finally decided to, it was just as he was about to fry a trout for dinner. 

            The last time I’d been to an emergency room was twenty years ago, in Chicago.  I had twisted my ankle and thought it was broken.  It turned out to be a sprain.  The doctor who examined me—probably overworked and sleep-starved—was openly dismissive.  One of the reasons I waited so long before going to the emergency room was that I didn’t want to feel that kind of humiliation again.  I needn’t have worried: I had suffered, I was to learn, a “spontaneous dissection.”  That’s the medical term for a heart attack that should never have happened.  I had just turned forty-seven; was not overweight; did not smoke; exercised regularly; did not have high blood pressure; did not have high cholesterol; was not yet menopausal; and was in otherwise excellent health.  There was no buildup of plaque in the artery that split.  Yet, split it had; doctors had to insert five metal stents (each about an inch long; stents resemble those little springs of wire inside of pens) in my left anterior descending coronary artery to repair the damage.

I know it was that artery because I’m looking at a copy of the Cardiac Catheterization Laboratory Preliminary Report.  That’s about all I know.  Some patients, during their two-and-a-half day hospital stay, would have asked a slew of technical questions; some might have requested their complete records, or at least googled “spontaneous dissection heart attack” when they got home.  Not me.  I’ve never concerned myself with my body, except to be happy it’s working.  I have no idea where my pancreas is; I’m not curious about my reproductive system.  When Dr. Wilson told me there was nothing I could have done to prevent my heart attack—that the chance of its occurring was one in one hundred thousand, and that those same odds applied to it ever happening again—that was all I needed to know.

            I didn’t ask, “Why me?”  A pamphlet I was given during my stay at Fairview explained that it’s perfectly normal to feel angry after a heart attack.  But I wasn’t angry, I was grateful: grateful my heart attack hadn’t been worse, and damned grateful my graduate student insurance was paying the $85,000 bill.  A year and some weeks later, I feel exactly the same way.  But with what might be a delayed reaction, I’m starting to question if what happened was indeed a freakish accident, purely physical, as my cardiologist claims, or if my emotional history had anything to do with an artery suddenly rupturing.

It’s odd I never wondered this at the time.  As an adult, I’ve always assumed a mind-body connection.  In my thirties, I dabbled, like a kid given a brand-new set of watercolors, with a palette of then-hot topics: lucid dreaming, trained intuition, alternative medicine.  Instead of the poetry and essay collections I buy today, I devoured best-selling paperbacks by Deepak Chopra and Andrew Weil.  It made perfect sense to me, as these and other authors contended, that anger, or grief denied, can poison cells the way acid corrodes metal.  I stopped short of blaming those who got sick, but I thought it was naïve to believe feelings don’t affect the body.

That debate didn’t concern me one whit as I was wheeled into an operating room, transferred to a bed, and informed by a doctor who looked young enough to be at a fraternity party, that I was about to undergo angioplasty.  I had expected that Marc and I would have to wait at least an hour before seeing a doctor at the Fairview on the West Bank of campus, the hospital we’d gone to originally, but when I mentioned chest pain to the receptionist, I got a flurry of attention.  Nurses put me on a gurney and asked detailed questions as they hooked me up to a machine and took blood.  After results came back, I was told I’d be taken, by ambulance, to the Fairview on the East Bank.  The driver used the siren, just like in a TV show.  In a matter of minutes, I was in a room full of medical staff, all of whom looked under thirty.  I said it was humbling to be the oldest person in the room; they laughed easily.  The young doctor, who in fact was both likable and professional, gave me something to help me relax.  When he asked me to slip off my panties (black cotton, no holes, thank God), I wasn’t embarrassed.  Nor was I upset when he told me, some time later, that they’d found a tear in my artery, but that everything would be fine.  I actually felt a dreamy mixture of pride and relief: something was wrong with me after all!  All this attention was justified. 

One of the operating staff found Marc; I got to talk with him before being taken upstairs.  I don’t remember what we said; I remember his voice was so gentle and full of concern I wanted to cry.  Not sad tears, happy ones.  I love him so much.

The night that followed was anything but restful.  My blood pressure was taken what seemed like every five minutes by a machine that wheezed and gasped and beeped so shrilly, it sounded like I was going to die any second.  Flat on my back, as one has to be for six hours after angioplasty, I imagined nurses laughing and gossiping at the main desk.  Weren’t they worried about me?  What if I turned over and somehow unhooked myself from my many attachments?  Around six in the morning, I finally managed to slide into a shallow pool of sleep just as a doctor and his brood of interns (the first of many such visitors; Fairview is a teaching hospital) marched into my room, all business, and formed a semicircle around my bed.  I was too drained to protest.

It wasn’t until hours later, after more blood samples, more interns, more of the same questions, when a nurse was crisply reviewing the medications I’d be taking from now on, that it hit me: this was serious.  I’d had a heart attack.  I’d have to take pills every day, the way Dad had for his high blood pressure.  I pictured the rows of brown plastic containers sitting on the shelf of his cabinet in the kitchen, next to his taped-up Bible and a shoebox full of odds and ends.  I’d never been close with my dad; even at forty-seven, love and admiration for him competed with anger and hurt I had never dared express.  But now, it seemed, I was finally my father’s daughter.  The nurse was explaining how important it was to always carry tablets of nitroglycerin with me when the phone rang.

“Hello?”  My voice was a little wobbly.

“I’m on my way over.  How are you?  Did you get some sleep?”

If it had been anyone other than Marc, I wouldn’t have started crying.  “I’ve got to take all these pills.  Like an old lady.  I don’t feel any different, but now I’ve got all these medications.”

“That’s just for a while, honey.  It’ll be all right.  The doctors know what they’re doing.”

Marco rarely calls me honey; when he does, it feels like he’s stroking my hair.  I met Marc when I was twenty-seven and he was forty.  I seldom notice our age difference except when some unexpected tenderness on his part makes me realize how protected he makes me feel.  By the end of our conversation, I was laughing through tears as I described my awful night of unrest.

My body, as I had told Marc, really didn’t feel any different.  It was hard to believe I had five metal stents inside me.  When I began physical therapy, which both the hospital and my insurance company recommended, one of the first questions Maureen asked me during my pre-therapy interview, was whether I’d been under any unusual stress.  I hadn’t.  It was the summer before my third and last year of the MFA program at the University of Minnesota.  Marco and I were getting along fine; I had an easy part-time office job I walked to.  One terrible thing, it is true, had happened: my nephew had committed suicide.  Brendan was twenty-two.  The last time I’d seen him was six years ago, and then only briefly.  He was waiting outside of a courtroom where a ridiculous and unnecessary fight over my Aunt Ginny’s will was taking place between his mother, the oldest of my five sisters, and the rest of us.  “Hi, Frannie,” Brendan had murmured, embarrassed, as if he’d been instructed not to talk to me.  He was very different from the blue-eyed little boy I had found so adorable: almost six feet tall, with pink dreadlocks.  It didn’t matter; his sweetness was still obvious. 

Brendan’s suicide was horrific, but I knew the grief I felt was nothing compared to his mother’s, whose loss made any dissension between us irrelevant.  The shock of my nephew’s death could hardly have been the cause of my heart attack, yet it did make me heartsick; and I mean that literally.  When I feel sorrow, my heart actually hurts.  Call me cowardly, but I avoid watching the news; I send money to the Humane Society, but I don’t read their literature.  Once, when I was leafing through People magazine, I learned what some rural boys did to cats after they broke into an animal shelter.  For three days, the grisly details played like a tape in my head and my heart felt like it was bleeding.  This can’t be an unusual phenomenon, given the many metaphors in the English language that link emotional pain with physical pain and assign the heart as home to both: heartache, heartbreak, heartrending, heartsick, heavy heart, sinking heart, pining heart, bursting heart.

“You hold so much in,” my sister Katherine told me during a phone conversation a few days after I came home from the hospital.  It was the closest she ever came to suggesting that what happened to me might not have been purely chance.  But who doesn’t hold things in?  When Marc and I fight, I’m almost always the one who ends up saying something I regret horribly.  Plus, my writing provides a catharsis, even if rejection of it is—ironically enough!—cause for heartsickness.  Skimming through a journal from a few years ago, I came across these sentences: “It has been months and months since a magazine accepted even one poem of mine.  I don’t know how much more rejection I can take; my heart feels like it wants to break when I think of how I have tried and how maybe the magazine editors are right, maybe my writing is not good enough and never will be.”  It’s painful, but that kind of self-doubt goes with being a writer.  I don’t know any artist who doesn’t feel this way sometimes.

I recently re-read entries from the dream journal I kept last summer, concentrating on the ones written within four weeks before July 29, the evening of my heart attack.  I was curious to find any images that might be considered, in hindsight, warnings of what was to happen:

Dreamt of a spider, a kind of light brown tarantula that could fly; it grew into a mammal, too big to kill; it had a face . . . I was going to the prom and I realized at the last minute that I had put off everything: hadn’t bought a dress or shoes . . . I was all bloody and Mom finally came into the room and I thought, good, she’s going to see how beat up I look, but she stitched me up very matter-of-factly, she was merely annoyed .  .  . I was in a strange hotel with Katherine, watching firecrackers being set off very close to us; it worried me because I had gun powder all over my skin . . .  I was on a balcony with no railing, scared of falling off . . .


This sampling is fairly typical of any month’s worth of my dreams.  They are seldom happy, often ominous and angry.  I scream and rage at people I’m not upset with in my waking life, or at least haven’t thought about.  My mother, with whom I was very close, is almost always cool and indifferent.  No image or line from these dreary entries leapt out at me and cried, See? See how your body was trying to tell you something?  Yet a familiar tenet, and one I happen to agree with, is that our bodies do try to tell us things; if we ignore their initial attempts to make us listen, they’ll use increasingly dramatic ones.  The spontaneous dissection of an artery is pretty dramatic.  Even after it happened, I waited a full twenty-four hours before seeking help, sure the pain in my arms would lessen, thinking it was probably from a strain or a slipped disk.  It’s humbling to realize how out of touch I was with my own body.  On my bookshelf are medical guides like Christiane Northrup’s Women’s Bodies, Women’s Wisdom that emphasizes how the creation, or breakdown, of health is dependent upon our physical, psychological, emotional and spiritual welfare; how important it is to pay attention to our bodies and respect the messages they send our conscious selves.  I’ve underlined dozens of passages in Northrup’s book, even written “yes!” next to them.  Yet I couldn’t recognize my own heart attack.

It’s a mysterious muscle, the heart.  Laughter strengthens it.  Stress and rage make it more vulnerable, as does, some claim, anger.  I’ve experienced a fair share of anger in my life; maybe more than fair.  I asked Marc the other day if he was still angry with anyone from the past, say from ten years ago.  The question amazed him.  “Ten years ago?  No.”  I am.  There are people from grade school I haven’t honestly forgiven.  I remember being thirteen and sitting at a pep rally in front of two boys who decided to pick on me, discussing in loud, contemptuous voices my hair, my skin, my body.  I remember their pleasure when I began, finally, to cry: as if they had hit the sweet spot of something.  If I ran into Tim Ryan or Pat Flavin today, I suppose I would be friendly.  But if I really think about that hour back in St. Patrick’s Grammar School, I still hate the little bastards.

I’ve had flashes of intense anger towards my father.  Not so much anymore.  But in past years, I’ve raged at him in my heart, all out of proportion to what caused the initial hurt.  At fifteen, for instance, I came home from a canoe trip, exhausted and happy to be home.  Dad was quiet as Mom and my sisters asked me about my weekend, but later on that evening, he came upon me in the kitchen, eating baked beans right from the pan where Mom had warmed them up for me.  I can still see the disgust on his face when he told me what poor manners I had: his first words to me since I’d come back.  I said nothing—I never spoke back to my father—but the coldness in his voice made my internal organs feel sick.  I didn’t know my silence, my acquiescence, in such moments would keep them alive, able to blaze into flame years later.

But love stays alive, too.  I have moments of love for my father that are just as intense as any anger I felt for him: moments of remembrance that wash me clean and leave me peaceful.  A sister I was once very close to, best friends, in fact, would find the fury I’ve felt towards our father appalling.  She sees things as Dad did: black or white, right or wrong.  I can’t live like that.  In The Crack-Up, Fitzgerald emphasizes the difficulty of holding two opposing ideas in the mind at the same time and still being able to function.  But the truth is, we do this all the time.  Maybe it would be better for our hearts if we weren’t so complex: if we didn’t both love and hate people, didn’t long for reconciliation even as we cherished our hurts.  But oversimplifying relationships can do just as much harm.  The sister I was once dear friends with embraces, as my father did, an “if you are not with me, you are against me” philosophy.  Our relationship is now limited to sending each other Christmas cards once a year (mine signed; hers not).

When I got home from the hospital, I did something I might not have done ten years ago.  I wrote and emailed friends about what happened to me.  Part of me thought, I’m going to be fine, why bother to tell anyone?  But the truth is, I wanted their concern.  And I felt better for it; better for the book about angels sent to me by my mystical friend, Victoria; and the beautiful card depicting rock art in the American Southwest my friend Genie sent (“I bought this on vacation over a year ago and thought it would be perfect for just the right person”) and the vase of summer flowers from Katherine that were waiting for me at the door.  Even the typically dramatic note from my sister, Gale (“I am so grateful that you escaped the Angel of Death!!!”) made me laugh.

Once heart tissue is damaged, there’s no healing it.  I had minimal damage.  That’s pretty amazing when I think of how long I waited before going to the emergency room.  I was very, very lucky.  I’ll never know for sure what caused my spontaneous dissection.  It would be nice to say, “But after it happened, I stopped drinking, began to meditate, lost all my anger, and now live every moment with an open and trusting heart.”  No, I don’t.  I still drink wine, probably more than I should.  My heart still pounds like it wants to break out of my chest when I open a letter from a journal where I’ve sent my work.  I still get angry sometimes at people from the past.  But less and less.  And I don’t worry about having another heart attack: I, who as a child worried about quicksand (“There isn’t any in Joliet,” my mother would tell me) and the Syndicate putting a jukebox in my father’s piano store.

My father.  I had a dream about him a few nights ago.  We were talking together in the kitchen of 206 South Raynor, the house where I grew up.  Whatever he was saying to me was very kind, very encouraging.  I went over to him and hugged him.  “I don’t tell you enough what a good father you are,” I said.  A metal cabinet in our pantry was all rusted inside: That has to be repaired, I thought.  There’s a lot of rust in my heart that has to be cleaned out.  But when I woke up after that dream, my heart felt good.


Francine Marie Tolf's poetry and essays have appeared in many journals. She has work forthcoming in Southern Humanities Review, Comstock Review, and Under the Sun. Read more about her at