Brief Interlude

BRIEF INTERLUDE E. MYLES GLENN* Editor's Introductory Note.—The following story was submitted in response to Gunnar Biörck's "Thoughts on Life and Death" [i]. It is a true account of tie autior's experiences following development of a massive ventricular aneurysm. Subjective accounts of tie fears and agony of a patient who expects death and would at tie time welcome deati seldom appear in medical literature. Ordinarily we would not publisi a somber story, but tie outcome illustrates tie progress of modern surgery. Dr. Jay Ankeney ofCase Western Reserve University headed an open-teart surgery team which successfully removed a grapefruit-sized ventricular aneurysm from die patient and permitted recovery to an active productive life. At a time when many gifted young researchers seek to avoid teaching tie depti and breadti of biology necessary for tie practice and advancement ofmedicine and disavow interest in health-related research, tiey commonly lack personal experience with serious illness and its successful treatment. I do not imply diat basic research cannot be health related or that tie understanding of minute processes is useless. But tiere is a growing tendency to neglect processes of regulation and integration at tie organismic level and to be reductive. Subjective reports on illness and recovery could add a dimension ofunderstanding and appreciation of modem medicine as deserving die full support of tie preclinical sciences. When he awoke, the sun was shining through his window, his view, the top of a dirty roof on which the rain had fallen the night before. The windows, like his eyes during their sickness and frightful moments, were fogged with moisture and the dirt ofages—the streaks ofyesterday's dirt, a sign oftheir own helplessness and blight. He had known the conversation , only the gist of it, then nothingness, an abyss, a darkness, a spaceblankness , a nondescription. No sinking, singing, music, drums, trumpets, greetings ofwelcome, terror, screams, signs, love, or hate—nothing. He had eaten to please her. He was dying. The forceful entry offood, * Present address: Upjohn Company, Kalamazoo, Michigan 49001. 394 E. Myles Glenn · BriefInterlude Perspectives in Biology and Medicine · Spring 1969 the attempt at conversation, painful though it was, would give some assurance , some confidence that all would be well—there wasa futile attempt at laughter, though it was a cackle from parched, weak, dry, and quivering lips and moisture-filled lungs. Then the moment of truth—the big zero. It was despairingly cold. He awoke. The whiteness oftheir coats, their remarks about defibrillators , about overdigitalization, cardiac failure, kidney damage, congestion, irreversible shock, were a long way off. There were so many of them, males and females, black and white. He was shouting, thrashing about, his arms and legs a windmill of motion—aimless and uncontrolled. "He's going again," he heard from a long distance away; again the big nothing. The contracted throat, the convulsive behavior ofhis legs and arms told him something was wrong. He tore at his hospital gown and removed it, lying helplessly naked, as when he was born, while all the nameless white coats ignored his nudity, shocked him, injected him, resuscitated him, revived him, while he kept saying over and over, "Let me go. Let me go. Let me go." "We're trying to save you." He heard it from a so-soft voice. From a depth reverberated a great canyon ofbooming sound that could be heard rolling like thunder. "You're trying to kill me; you're trying to kill me." It peeled from the walls, into the corridors, and rolled back and forth like echoes of nameless misdirection—grotesque and without pattern . It's only a dream. Then the waves ofsweat, ofcold; the endless vomiting and non-productive retching. It would be nice to go again, to leave. It had been so long. Three months and no improvement. A glimmer ofhope here and there, from time to time, followed by relapse and a worsening of the heart muscle. Its ability to push fluid to the vital parts ofthe system had failed. Heknew the signs and wanted to forget. They werenotpart ofhis belongings . What had he accomplished really? Nothing! He had tried, but nothing came ofit except words, words, words, endlessly...