I am like Schrodinger’s cat trapped in a box, superimposed between two states, both alive and dead until someone opens the box to observe the result except that in my case the latter extreme is more variable. Will it be one year, or two, or thirty, in which case the entire supposition collapses, because that is about when I would die anyway. I was in the box two nights ago, the night before my heart catheterization when I wrote my last post while Sue slept behind me, softly breathing. I am in the box now, awaiting the preliminary results from my pleural biopsy three hours earlier this morning and, again, Sue is sleeping behind me, softly breathing, because she didn’t sleep much at all last night while I slept like a rock because I was up all the night prior. Strange, and funny. I like that. I like the symmetry, one of my favorite words, probably because of this poem:
The Tyger
BY WILLIAM BLAKE
Tyger Tyger, burning bright,
In the forests of the night;
What immortal hand or eye,
Could frame thy fearful symmetry?
In what distant deeps or skies.
Burnt the fire of thine eyes?
On what wings dare he aspire?
What the hand, dare seize the fire?
And what shoulder, & what art,
Could twist the sinews of thy heart?
And when thy heart began to beat,
What dread hand? & what dread feet?
What the hammer? what the chain,
In what furnace was thy brain?
What the anvil? what dread grasp,
Dare its deadly terrors clasp!
When the stars threw down their spears
And water'd heaven with their tears:
Did he smile his work to see?
Did he who made the Lamb make thee?
Tyger Tyger burning bright,
In the forests of the night:
What immortal hand or eye,
Dare frame thy fearful symmetry?
Two nights ago I thought I had a bad heart. I thought that somewhere along the way, somehow, I wrecked my heart, mainly because of the patient portal, because I was able to log on and read the report of the moderate regurgitation/leaking of the tricuspid and mitral valves and severe right atrial enlargement, which were all new findings. And it fit so well; the exercise intolerance, the pedal edema, the exertion with long sentences and climbing of stairs;–that had to be it, but it was not. I was wrong about the test too. It was an heart cath with exertion and I thought that it would be a chemical exertion with medication and that I’d sleep like a baby, all the morning long, the white milk of Propafol drip, dripping away, but it was not that way. It was not that way at all. Sure, I had some Fentanyl and Versed, but that’s never enough when you’re 250 pounds, and supposed to be awake to pedal a bike. It wasn’t a chemical exertion. It was mechanical.
So I’m on my back pedaling, waiting for it to come, and it didn’t, not as bad as what I’m used to, in fact, Dr. N asks me to slow down a bit, then it started to come, but then that part of the test was over. As I lay there, puzzling, the answer came to me, when I’m laying down, zone two is much larger than when upright, but, by then the shorts were off, I was naked from the waist down in a room of people, some of which I were pretty sure were women, and Dr. N was threading a 6 French introducer into my right femoral artery, and I didn’t think he’d welcome a conversation of pulmonary physiology and debate about the relative merits of the results of exertion supine versus upright.
Pulmonary physiology for the lay person:
Blood is pumped by the heart to the lungs where there is air exchange across the alveolar-capillary membrane (the little air sacs, millions, at the terminal branches of the airways), then the oxygenated blood is pumped on into the left heart for dissemination around the body. Imagine that each lung is like a scuba tank; because of gravity, the flow of air and blood into the lungs is not the same from top to bottom, it is best/more evenly matched some where in the middle. Now, imagine a cross section of a scuba tank in the upright position. Now, imagine the cross section of a scuba tank laying on its side. Big difference, approximately three to one; therefore, in my case, when supine, I breath better because the best zone for ventilation/perfusion match is increased and shifted to the lung not as involved by the basilar pleural fibrosis and inflammation.
It is time for me to go now. It is 3:30pm and Sue is up. I must get dressed for the second time today to walk the two blocks to the Gonda Building for my Last Visit with Dr. E who will make the observation, and my superimposed state, my wave function, will collapse into reality; or, you could say, a new S splinters off into an alternate reality, a parallel universe. We are ready. It’s time for us to realize our universe.