February 20, 2019.

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It was Wednesday. Hump day of the week I was forced to take off.

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It had been raining and snowing on and off all day.

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The idea of dying wasn’t on my mind.

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# # #

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YK, a senior partner of our New York City consulting firm, had come into my office months earlier and sat herself directly across from me with her typical “all-business” grin. “David, I want to talk to you about your accumulated vacation time.”

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“I didn’t think I had any left?”

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“And the fact that you have broken every promise you made to me in the last six months to take time off.”

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I was managing two financial restructuring projects and had proposals out for another three. I was scheduled to fly to Chicago for a client meeting in the morning. Vacation time was the background noise of my life.

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“We carry vacation time on the books as a liability so, as you know, if something happens to you, we are responsible to pay you your accumulated vacation time, which now is nearly at twice the firm’s policy.”

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Divorced, with two young girls, she was brilliant, charming, and looked like she had stepped out of a fashion magazine. Lebanese born, French educated, YK was the definition of stunning.

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The only piece of jewelry she wore was a small golden amulet hung from a thin gold chain around her neck.

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“A gift from my grandmother when I was born,” she said when I had once asked.

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Something like a talisman, an object, either natural or man-made, an amulet is believed to be endowed with special powers to protect or bring good fortune. It was beautiful and understated. It was YK.

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She leaned in. “Apparently, I care more about you than you care about yourself so, as a personal favor, please take a week, just a week, in February.” She said got up and looked around my spacious corner office. At thirty-two years old I was the youngest junior partner. “As a favor to me, a week in February,” she said again and flashed a smile that melted my resistance.

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# # #

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I wasn’t always indifferent to vacations. During my graduate school years in Boston a friend introduced me to Edward and his wife, Marcia. At three times my age, we quickly connected over our love of sailing. Edward was a renowned hand surgeon whose greatest joy was in training the next generation of surgeons. The first time they invited me to spend a weekend at their Falmouth, Mass., summer home I never wanted to leave. A modest, though stunningly designed and generously landscaped four-bedroom home with a dock for their sailboat on an inlet that led to a broad bay that led out to the Atlantic. I spent two weeks every summer over the next eight years sailing with Edward and Marcia. He was a rail thin 6’3”, Marcia was 5’3”, and there was no doubt who ran the household. Edward passed away three years ago, and Marcia sold the Falmouth home.

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I was devastated. Their whole family was bereft. Edward was the kind of man whose charm and genius were infectious. Everyone who met him wanted to be his friend. When I lost him, I just stopped taking vacations. I didn’t see the point of it.

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# # #

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The holidays shot by as the impending February drop-dead date loomed large and frightful. Then it was upon me.

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I made it to the Wednesday of the week, keeping myself reasonably sane. One of my vacation projects was to clean out a closet filled with junk and irrationally organized necessities. Two hours later, I was tired and, being mostly left-handed, I had already stressed a muscle in my shoulder.

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“Enough,” I said and backed away.

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I washed up, put on fresh clothing, and went out at 6:15 p.m. to meet up with friends. A group of about a dozen, we started out attending foreign policy lectures at the local Y and gathered monthly at 6:30 p.m. at a fancy-assed bagel shop on 86th Street on the Upper East Side of the city.

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The six blocks from my apartment to 86th street was bitter and laced with angry bursts of sleet. Still, it was good to be out the apartment, having survived half of my enforced punishment without taking a single Xanax. Five were already chatting away in the back about the president, military expenditures, and climate legislation foundering in the Senate. I took off my leather jacket and sat down, and just as quickly, realized that my shoulder didn’t hurt when I put my heavy leather jacket on or when I took it off. I sat stone-faced for about five minutes without engaging.

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“Hey, guys, I’m feeling shitty so I’m calling it an evening,” I said during a conversation about how to save the world from the corrupt, misguided, and polarizing idiots who ran it.

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“What’s wrong?” Caroline asked, as did Jennifer and Bobby.

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“I woke up tired and haven’t shaken it off. I am going home, have a cup of tea, take two Advil, and go to sleep.”

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There was more concern than protest. 

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“I’ll text you in the morning,” I said.

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# # #

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I was throbbing with uncertainty during the walk back down First Avenue to my apartment on 80th. On 81st I caught the red light as traffic crossed east in my path. Two Advil’s and a cup of tea and get to bed sounded like my version of heaven. I was cold and wet and couldn’t shake the slight pain in my shoulder.

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The light turned and I crossed to the south side of 81st. On the corner was one of those Urgent Care centers that had been springing up in major cities. Being blessed with some of the best doctors in the country, it was a place I never seriously considered.

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“Hi, can I see a doctor? I think I pulled a muscle in my shoulder,” I heard myself say in an alien environment. A nurse was summoned and escorted me into an examining room where a doctor was waiting. I was impressed.

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They asked me a few questions and hooked me up to an EKG, which I was certain was going to be an unnecessary expense. As the tape sped out of the machine, one of the nurses left the examination room. Minutes later two EMSs entered and told me they were going to take me to the hospital for further evaluation.

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“We just want to be sure,” the Urgent Care doctor said.

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I didn’t say a word. Didn’t ask the doctor anything. Just quieted myself down and was slid into the back of the ambulance. Two nurses were waiting for me at the hospital ER. I was taken to a corner where I was given another EKG and examined and answered a battery of questions. A blood draw was taken at 7 p.m. The results were negative. There was no trace of troponin in my blood, an enzyme given off by the heart as a result of a heart attack.

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The head nurse came over to my curtained-off space. “We’re going to keep you here for another four hours,” she explained, “as quite often the enzyme isn’t immediately present in the bloodstream after a heart attack.”

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A heart attack? I’ve heard of that. I’ve seen it in movies and read about it in books and knew someone who knew someone who had a heart attack. But that couldn’t happen to me.

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“Four hours? Why can’t I just go home? I’m feeling fine,” I insisted.

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“It’s a precaution and important. Your EKG showed some abnormalities.”

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She explained that troponin is a type of protein found in the muscles of your heart. Troponin isn’t normally found in the blood. When heart muscles become damaged, troponin is flushed into the bloodstream. As heart damage increases, greater amounts of troponin are released.

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Four hours? I could finish a shitload of proposals in four hours. Then I realized I was on vacation and settled into my prison term with a heightened resolve. So much for tea and Advil. Time marched on as more patients left than arrived. By 10:30 p.m. there were four patients left in the once overflowing ER.

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At exactly 11 p.m. they did another blood draw. That same head nurse was still on shift and had been keeping an eye on me. “I am going to start the discharge paperwork.”

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“Thank you, “I said, relieved.

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Finally, someone grasped the futility of my sitting around in the ER. I slipped out of the surgical gown and put on my pants as the elevator doors shot open across the ER. Two nurses and a gigantic aid came to my space and yanked aside the curtain. The head ER nurse read the results from the blood work.

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I was quickly lifted onto a gurney and rolled into the elevator, which shot up to the cardiac floor where I was greeted by a team of doctors. Since arriving at the ER, I was calm but annoyed. My vacation was being interrupted. I was just as calm when they heaved me onto the gurney and the cardiac team moved me to a private room and just as calm as they hovered over me, attaching electrodes to every part of my body. Several were anxiously trying to push a metal ultrasound probe between my left rib cage to gauge the extent of what they described as a “possible” blockage.

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It was surreal. As though I wasn’t part of the turmoil that was threatening my life.

 

“Were taking you up in the morning for a catheterization, which will show us the extent of the blockage. You’re number four,” the head cardiac resident said. “You’ll be fine. Try and get some rest.”

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I asked a few questions but wasn’t alarmed. I was number four. I guessed that would put me close to noon, estimating without any basis that each catheterization would take around two hours.

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When the room cleared, I texted friends and family, though not YK, about what was happening, though with no sense of urgency. Nurses and doctors passed my room. The entire floor was filled with cardiac patients. A few residents and nurses came in and asked me the same battery of questions. I was number four. How serious could my condition be?

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# # #

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I dozed off a few times, still not a participant in my own crisis. I was awakened by the head nurse twice. I responded but was getting really tired. The soreness in my shoulder had eased. I knew that was a good sign. 

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I awakened by two aides and a nurse at 5:20 a.m. “Were taking you up,” she explained while I was lifted onto a gurney.

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“What happened to number four?” I asked as the elevator took me up and I was wheeled into an operating room.

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Masked faces surrounded me. The room was cold. I was wrapped in a heavy, warm blanket and reassured by everyone that I would be fine. Fine is number four, not number one.

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The room was noisy. Like I was in the middle of a giant MRI machine. There was an ongoing exchange asking questions, getting readout confirmation, and acknowledging the progress of the catheter that was making its way up my right arm toward my heart. I closed my eyes and tried to relax. I tried meditation. Time passed.

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Then silence. Was it over? I couldn’t let myself get caught up in the reality.

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“Mr. Warren? How are you feeling?” I heard someone at my side say.

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I nodded.

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“There was blockage. We placed three stents in your heart.”

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A surgeon came by my side as the nurses prepared me for the move back to my room.

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“There was a 95 percent blockage of your left anterior descending artery. The widowmaker. The artery is a major pipeline for blood to the heart. If it gets 100 percent blocked at that critical junction, it can be fatal without immediate emergency care. That’s why they call it the widowmaker.”

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I was alive, but just. A swell of tension finally caught up to me and the electronic monitors flashed red stopping everyone around me. Finally, I was terrified.

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# # #

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I woke sometime later. Judging from the dark sky outside my window, it was late afternoon. I wasn’t in pain. Just exhausted. I remember asking someone, I don’t know who, what would have happened if I had gone home instead of to the Urgent Care center?

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She said, “You might not have woken up, and if you did, by then your heart would have been seriously damaged.”

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I was surrounded by electronic monitors. Patients, nurses, and doctors moved past the glass window separating my world from another. The head cardiac nurse stopped to look in. I stuck my tongue out at her. She hesitated, shook her head then stuck her tongue out at me, and moved on.

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I don’t remember much of the afternoon. Lots of nurses, residents, and doctors checking the monitors, asking a lot of the same questions about how I was feeling, and one by one adding more pieces of information that was the incomplete puzzle of my circumstances.

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# # #

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I couldn’t manage much for dinner and spent what energy I had reassuring friends and family on my condition. Laura, my sister, who was at my side an hour after I texted her, remained a great comfort. Friends started showing up staying for only a few minutes that first evening. Most were shocked to see my condition. I had been a gym rat since junior high school, never drank, smoked, or took drugs and, at 5’11”, was the same lean 170 pounds I was when I rowed crew in college.

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“I’ll be back in the morning,” Laura said, brushing the hair from my forehead. “Try not to give the staff a hard time.”

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“I love you,” I said.

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Laura nodded, unable to choke back the tears.

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I was alone in a strange place under uncertain circumstances. With my history and lifestyle you don’t get a heart attack. I could see that question in the eyes of everyone who helped save my life. I could feel myself getting anxious. I fought through it and slipped off to sleep.

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Sometime, maybe only minutes, later I woke. YK was sitting at my side, her hand clasped over mine, her face flushed red with tears. I looked at her like I always wanted to.

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“I’m so, so sorry for this,” she cried.

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During her two-year tenure at the firm we had lunch twice and coffee on the run once. Every conversation contained a quiet connection. I was delighted with the spark, no matter if I was reading more into things than necessary.

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I reached over with my left arm, dragging the IV line with me, and placed my hand over her head. I gave it a gentle stroke. I felt her nod and I quickly fell back to sleep.

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The midnight shift came on. The head nurse woke me to take a reading. “You’re a lucky man,” she said.

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I didn’t understand.

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“Your friend. I had to ask her to leave it was so late. She had a hard time letting go of you.”

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It wasn’t a dream?

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“She asked me to give you this when you woke,” she said and handed me a long golden chain and amulet.

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“My husband looks at me the way you were looking at her. He’s why I get up in the morning and run home at night.”

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“Thank you. Thanks for everything.”

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“You’re a very lucky man,” she said.

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I smiled and nodded. It took a near-death experience, but it was worth it. Suddenly, I felt better, more happy than ever before.

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Thank God I insisted on taking a vacation.