Losing Brightness

This photo shows a cardiogram

First, I felt the flush run to my face, a heat streaming up my arms that gripped my shoulders, raced up my neck, and finally settled in my cheeks. I looked down at Andy, who lovingly washed my feet, the shower’s steady pulse of water raining over both of us. The shower walls tipped, ever so slightly, to the right, and thin beams of light seemed to dance in between the water droplets. My stomach lurched, and I reached to the wall for support. My hand slipped against the wall’s wet surface; I gasped for breath.

My head seemed to loll a bit, a wilted tulip on a weak stalk. “Andy,” I said, blinking against the light. “I feel a bit faint.” I looked down at him, my head heavy and useless.

“What?” Andy yelled over the water, lifting my toes to lather their underside. “You feel fake?”

I inhaled deeply, trying to restore equilibrium, and got a mouthful of water. Spitting it out, I attempted to speak louder. “I feel faint!”

Andy quickly got to his feet. “What’s wrong?” His eyes were wide and scared.

The water pounded against his shoulders and my hands as I held onto him, tightly so I wouldn’t fall, and closed my eyes for a moment. He turned me so I would be under the water, perhaps to revive me, rejuvenate whatever part of my body was choosing to break down. I sputtered, again inhaling thick, watery air. “I don’t feel so good,” I mumbled.

I opened my eyes to see Andy’s frightened face close to mine. I focused on his eyes, the kind, reassuring ones I love so much; his wavy hairline; his Roman nose. “What is it?” I heard him say.

I heard him first, and realized with fright that I could no longer see him. Starting in my peripheral vision, a cluster of black stars had swarmed forth, dark masses with central pinpoints of light, obscuring anything real. “I can’t see you,” I tried to say matter-of-factly, breathing in to quell my panic, hoping this would be a temporary situation.

“Okay,” I could feel Andy’s grip on my shoulder and the small of my back, heard the shower turn off; I shivered in the cold, and then all senses were gone.

I came to holding on to Andy, my head against his shoulder, arms limp at my sides. I heard him calling my name. I still was in darkness.

“Can you see me?” he asked urgently.

“No,” I croaked in response–but as I formed the word I could see his shape, blurry at first, then distinct and true. I could see some light, and made out his face. “Wait … now I can.”

We sat there a moment. “Maybe we should go to the hospital,” Andy offered.

“No,” I said, trying to shake my drooping head. “I’m fine, I just need to go back to bed for a little while.” I reached my hand to my scalp, feeling the lingering oily sheen of the conditioner I had applied just before fainting. “Let’s just rinse this and I’ll lie down for a bit.”

I remember standing to turn the shower faucet back on, tentatively tilting my head back under the shower stream, and being overcome with a wave of sleepiness. I remember sitting down, and resting my head on Andy’s shoulder to “just take a little nap.” But this memory is false.

Andy, alarmed and teary, greeted me when I opened my eyes.

“What’s the matter? What happened?” I asked him.

He was trembling. “Honey, you just fainted again–twice. The second time, you went completely limp, started coughing convulsively and shaking, and your eyes rolled back,” he exhaled raggedly, wrapping his wet arms around me. “I thought you were having a seizure–you went completely white. I was just about to call 911.”

***

Before that Monday back in 2004, I had only fainted once in my life.

It had been in July 1999, one of the hottest summers on record in Washington, D.C. My apartment building was older, a massive brick multi-family built in the 1920s. Not having air conditioning, my roommates and I attempted to cool down our place by using strategically placed box fans to circulate air from room to room, but they did little damage against the heat and humidity, such formidable adversaries. I wondered daily why our nation’s founders choose to build the capital on swampland…and why I chose to live there.

The fainting day was typically muggy, the dense humidity resting in each room, still and thick. We waded through the pea-soup atmosphere, trying to move as little as possible, sticking to furniture and sweating over such simple tasks as answering the phone.

While I had little appetite from the heat, I languidly walked into the kitchen to snack on something (as I hadn’t eaten in a few hours), anything to hold me over for awhile. Perusing the fridge, I discovered a bag of deli bagels and cream cheese, and located the bread knife drying in the dish rack.

Slicing past the bagel, the blade found my index finger. I felt the sharp pain first, then saw the cut, shallow but bleeding fast. I rushed to the bathroom, the humidity blanketing me, my head swirling in the blood and heat. I leaned over the sink, flushing out the wound. My roommate followed me.

And then–My roommate stood over me, looking down, concerned.

“What’s going on?” I asked. “Why am I on the floor?”

“Are you okay?” she asked gently.

“Did I just faint?” I asked, feeling tears prick at my eyes. I was frightened at how my body could shut down like that, how in one moment I could be in a different place and consciousness, the danger of falling without being able to catch myself.

“Let’s get a Band-Aid on your hand,” she soothed me. “We’ll get you to bed in a sec.”

***

To faint, from Webster’s:

  1. archaic: to lose courage or spirit
  2. archaic: to become weak
  3. to lose consciousness because of a temporary decrease in the blood supply to the brain
  4. to lose brightness

To become weak and lose brightness–these certainly applied. I felt the greatest fatigue, even though I had only gotten out of bed not fifteen minutes before stepping in the shower. I fell into a deep sleep again, then rose for tea and toast. The day moved murkily, my head feeling loose and jumbled for a few hours after the fainting spell. Around mid-afternoon, I decided I felt well enough to take a walk.

Andy held my hand, and we moved slowly in the tawny afternoon light. Stopping to rest in Faneuil Hall, we watched the swarms of tourists and shoppers take in the sights of historic downtown Boston. I took them in from my perch on a bench, amazed at how quickly they were moving, how fast they chattered; their conversations rapid fire while they juggled a cell phone, shopping bags, and often a child or two.

I rested my head on Andy’s shoulder. “Do we move that fast?” I asked incredulously.

“Sometimes,” his gaze followed mine as I watched a pack of teenage girls pour out of a clothing store, packages in tow. “Do you want to go home?”

“No, I could walk a bit more, even though I still don’t feel 100 percent normal,” I answered. “I think I should call the doctor and get checked out,” I stated it casually, even though I’ve had a lifelong aversion to going to the doctor. Throughout my young adulthood, I’ve always prided myself on my good health, stamina, and ability to tough out an illness. My fainting, though, had been so sudden, so strange and unexpected, that I wondered what mysterious mechanisms were going on inside my body. I was fearful of waiting and toughing out whatever lay within.

“That could be a good idea,” Andy held out his hand, and helped me up for the second time that day.

***

The waiting room of the doctor’s office was warm. I loosened my coat, flipped through a magazine to distract my thoughts. One week after the fainting spell, I still carried myself gingerly, as if a “fainting time bomb” was ticking inside me, ready to steal my consciousness away at any moment. I walked somewhat slower than my usual pace. I never leapt out of a chair or got out of bed quickly. I took deep breaths, feeling my lungs expand, trying to get as much oxygen to my head as I could.

I was still jolted by the fact that, even though the blackout had only been a few seconds, that I had completely lost my sense of being, alertness, myself. What if I had been alone and had not been caught when I fell? What mystery was my body holding, what mechanism was so powerful it could completely shut me down?

I was surprised to have gotten the doctor’s appointment that week, as I was first informed that a regular check-up had a four-month waiting period. When I told them that I had fainted three times in five minutes the day before, the receptionist’s voice changed from indifference to concern. “Oh, so it’s not just a physical,” she clucked her tongue. “Want to see a resident? He can see you next week.”

“Sure, I’ll see anybody. I just want to make sure this isn’t going to be a recurring thing,” I answered.

And so I sat across from a young doctor just a few years older than myself, a sweet-faced man from India who was in Boston just for his residency. He had thick dark hair and stylish small-rimmed glasses, and a smart blue tie peeked out from the collar of his white lab coat. “What is wrong? You look so young and healthy!” he exclaimed as I settled in. I meekly explained what had happened.

“Hmmm,” he sat at a small computer terminal in the examining room, typing some notes out as I talked. “Have you ever had any problems fainting before?”

“No.”

“Heart disease–you or your family?”

“No for me, yes for family history–extended family.”

“But not immediate?”

I shook my head.

“Good. How about diabetes?”

“Yes, extended family.”

“Ok. How’s your cholesterol?”

“Don’t know, never had it checked,” I replied as he typed furiously.

“We’ll get that checked,” he furrowed his brow. “Now you had said, when you fainted, you had just woken up?”

“Yes, I hadn’t even been up fifteen minutes.”

“Nothing to eat?”

“No.”

“Ok, when was your last period?”

“It had just ended the day before.”

“A-ha!” the young doctor cried out, hitting the keys with jubilant force. “Hormone levels, no food in your stomach, still groggy from sleep… You said you were looking down when you first started feeling ill?”

I nodded.

“You probably were just hypoglycemic for a few minutes and that led to the fainting,” he smiled warmly, and I felt cured. “However.”

I waited.

“I still think we should do some tests on your heart over the next few days.”

“Whatever you think is necessary,” I replied.

“Ok. We’ll order an EKG for today, a blood test tomorrow to check your cholesterol level, also to make sure you’re not diabetic or anemic. We’ll also do an ECHO cardiogram. Have you ever had these tests done before?” He checked several boxes off on a chart, then looked up.

“No, never,” I said meekly. Were these routine procedures I had somehow missed?

“They’re just standard heart tests to make sure everything is normal–circulation, oxygen levels, sugar levels. I think the fainting was a one-time isolated incident, but we just want to make sure, and these tests will verify my hunch. Can you come in over the next few days? We can set up the appointments today.”

I nodded, looking down at my body, wondering if the upcoming tests would make me feel like a pincushion. I smiled. “Sure.”

***

The room was dark, and a bit cold. To lose brightness, I thought as the attending aide prepped her cardiogram machinery. A cardiogram, I had been informed, would be just like an ultrasound–except instead of examining a fetus, the doctors would be scrutinizing my heart. The attending stood in front of a large workstation that held a computer terminal, camera, programming board, and a wide electronic screen that displayed the camera’s recordings in crisp green on a black background. Naked from the neck to the waist, I watched as electrodes were placed across my shoulders and chest, prepping for the camera. I’m ready for my close up, I thought, and felt my heart beat faster in anticipation of its photo shoot.

The doctor held the camera’s lens, a long tube resembling a microphone, and pulled its cord for some extra leeway to reach me on the adjacent hospital bed. After pressing a few buttons on the computer and then positioning me on my side, she lifted the camera and slathered its tip with a thick blue gel. She paused, the camera held in midair, and gestured toward the screen.

“You can watch if you like,” she said. “I might have to ask you to move around a bit, but you’ll get a good view.”

“Okay,” I replied, craning my neck in curiosity against the stiff hospital pillow.

A green blob appeared on the screen when the attending touched the cold, gooey camera to my chest. It jumped in regular intervals, different pieces of tissue mugging for the lens. “There it is,” the doctor explained. She moved the camera around, recording several images, stopping at intervals to plug in data on the programming board. Each movement of the camera left a sheen of goo across my chest, and she reapplied the gel frequently. Soon I’ll be slathered, a blue blob, I thought to myself. A prime candidate for a walk-on part in Ghostbusters, or as a contestant on Double Dare.

“Do you see the different chambers?” She slid her finger over one section of the screen.

“Yes,” I stared at my heart on screen, seeing its beats corresponding visually with the taps I felt in my chest.

“Looks healthy on first glance,” she smiled broadly to reassure me.

I shifted when asked, keeping my eye on my heart when I could. I closed my eyes for a bit, relaxing in the dark room, and was about to drift off to sleep when I heard “Hmmm.”

“Is anything wrong?” I asked, now fully alert.

She reached toward the screen, and pointed to small dark area within the green mass of my heart. “Do you see this dark portion?” she asked, and I nodded. “It looks like you could have a small hole in your heart. It’s nothing to worry about initially,” she consoled, when my eyes widened in alarm. “But it may explain your fainting. It’s more common than people realize, and is developed in the womb–rather than the tissue coming together neatly, sometimes it doesn’t overlap just so,” she gestured with her hands, indicating a small space where her hands once had touched. “And a small gap is left.”

“Why this would lead to your fainting,” she continued, “is that rather than traveling along the path of your veins, some oxygen, nutrients, you name it, could fall through the gap, thus depriving you momentarily of oxygen, and poof–you faint.”

“Is this going to be problematic for the future? And do I definitely have this hole? Can you tell just from the image?” I felt unsettled, as if this hole was metaphorically speaking for my condition, my health.

“No, it’s not really anything to worry about,” she was saying, prepping the camera with yet more gel. My chest felt the odd combination of sticky and cold, and I longed for a hot shower–yet still feared it, as it was the site of my fall. “If you do have it, and we’ll test for it today, you’ll just be informed and aware of what can happen, and how you might be more susceptible to fainting in the future.”

“Another test?” I asked, watching my heart dance faster on the screen.

“We’ll do it right now–it won’t take too long,” she promised gently. “We might as well, since you’re already here.”

Two physicians were called in to administer a saline test; one a strapping man with a patch of strawberry-blond hair and a big booming voice, the other beanpole thin with wire-rimmed glasses, mousy brown hair, and a soft Eastern European accent. The big doctor settled himself down by the monitor, scanning the images already taken that day, while the European examined the veins in my right hand. I was informed a saltwater solution would be injected into a vein there, enabling the fluid to rush to my heart. If the solution, visible on the green screen because of the salt bubbles, rushed the way they were supposed to, there was no hole. If it plummeted to the nether regions of my heart, the existence of the hole would be confirmed.

Andy, who had been waiting patiently in the cardiac unit lounge while I was goo-ed and scanned, was called in. I waved meekly, happy to see him but also worried. I wondered if the doctor’s requesting his presence signaled that my condition might be very serious indeed.

I couldn’t look at my hand as the doctor poked and prodded the syringe into it, and instead turned my gaze to the screen. My heart ticked the seconds away, the green orb patiently doing its job.

“Ready?” the big doctor asked. I nodded.

The European released the saline, and before I could blink, a wave of bubbles, like a stream from a fish tank filter, whizzed across my heart. They sped in from the left of the screen and exited to the right.

“No hole!” Big doctor announced.

“You’re done!” the attending declared.

I looked at my heart, still chugging along on screen, and wondered if the ordeal really was done, just a one-time fluke.

***

The results of the cardiogram and blood tests came back, all status quo. And now, more than a decade later, my heart has been behaving. I’ve stayed vigilant: I’m more cautious when I take super-hot showers, I try to eat healthily (and at regular intervals) so my blood sugar levels stay normal. When I feel taxed or strained, I sit for a moment, outside if I can, to get fresh air. As a result, or perhaps just from luck, I haven’t fainted since.

I don’t know if the “fainting time bomb” is still inside me, waiting to go off when I least expect it. I can only hope that being aware of my body, as well as staying healthy, will stave it off. In the meantime, I keep watch, eternally conscious of my becoming unconscious.

Photo courtesy Kevin Dooley via Flickr Creative Commons

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