When my mother sees my heart in arrhythmia, she says it looks as though a butterfly is stuck in my chest, fluttering my skin. “I can see it moving,” she says. I am in high school. It feels too zippy to be a butterfly, so as I lie in bed at home, waiting for the bad rhythm to break, I picture a hummingbird caged in my ribs, buzzing from valve to valve.
“Scram,” I say. “Vamoose. Bird begone.”
Eventually it does. But it takes its sweet-ass time. And it’s only a matter of time before its return. It’s building a nest in there.
The doctors say: “Have you been smoking? Drinking too much coffee? Were you maybe a little upset—trouble with a boyfriend?”
I say, “No, no, no.”
Their eyes narrow. My ticker complaints seem to them operatic and hysterical. They believe I have a condition called “teenaged girl.”
“Your heart sounds fine to me. Kids your age don’t have heart problems.”
I roll my eyes. This confirms their diagnosis.
“Lay off the caffeine,” they say. “No more smoking. Teenaged love is tough.”
“Whatever,” I say.
Years later I’ll consult the Oxford English Dictionary for help understanding this noise:
c1640 Youths Behaviour (1663) 1 Sing not within thy mouth, humming to thy
self, unless thou be alone.
I finally catch the sucker on a heart monitor. This is fantastic. I want to throw a party for this evidence. A ticker-tape parade.
The doctors say, “Yes, well, okay.”
I’m shooed off to cardiology, where new doctors explain the difference between plumbing and electricity. “Cholesterol in your arteries, that’s a plumbing problem. What you have is messed up electric. SVT—supraventricular tachycardia. The charge gets caught in a cycle, and that kicks up your heart rate.”
The doctors draw oddly-shaped bubbles and label them: right atrium, left atrium, right ventricle, left ventricle. A loop shows the eddy of electricity.
“The thing to do is have an ablation,” they say. “Snake catheters into your heart and burn the rogue cells so the charge can’t circle back.”
Complications could include stroke or needing a pacemaker. I am in college, and eschew stroking out or pacemaking. I put off the procedure for years, but whenever the hummer returns, I circle back to the idea of ablation. And when I’ve finally had enough of these visitations—the hours marooned in bed or on the bathroom floor, waiting for it to break; the trips to the emergency room when it doesn’t; the dud anti-arrhythmia drugs—I make the call. I tell myself it’ll be fun to be able to say, like some soap star on her sixth or twelfth husband: “Baby, I’ve been burned.”
I can’t picture it as any other creature, but at first I’m not wild about this “heart as hummer” comparison. This is because:
- Early Spanish explorers called hummers joyas voladoras: flying jewels. My heart doesn’t feel gemmy.
- My arrhythmic rate—280 beats a minute—is nothing next to a hummingbird; 1,200 is what they clock.
- They’re so precious, sweet as nectar or sugar water, e.g.: They weigh less than two pennies. And I’ve seen a picture of one parked on the tip of a pencil eraser.
Later, though, I become enamored with Rufous hummingbirds. I think they are a bang-on comparison. This is because:
- The birds’ feeder-behavior is described as “relentless” and “pugnacious.”
- Their feathers “glow like coals: bright orange on the back and belly, with a vivid iridescent-red throat.”
- One article reads:
Agonistic Behavior: Aggressive Territoriality.
Play: No information. Does not appear to be playful.
During my ablation, the one for the SVT, the cardiologist finds a second, less common arrhythmia: focal atrial tachycardia. I resist the urge to ask if he’s calling me FAT. He tells me this arrhythmia is easily masked by anesthesia, and difficult to pinpoint if the patient has been sedated. This is why they weren’t able to burn it the first time—I’d already had the juice.
If I want it fixed, I’ll have to have a second ablation, this time without anesthesia.
My mother raises doubts re pain: “The anesthesia they gave you last time—it makes you forget how tough it was. It’ll be much tougher without drugs.” She’s a nurse, so it’s hard to completely write off her concerns. But my doctor thinks it’ll work, and my mother is right—I don’t remember.
A week or so after my first ablation, one more trip to the emergency room convinces me. When my rate finally slows, they page my doctor and hand me the phone.
“How are you feeling?” he says.
“Okay,” I say.
“You don’t sound okay.” He sounds exasperated, and this ticks me off.
“Well I don’t think I’m going to die, but I don’t think I can live like this either.”
There’s an extended pause, after which he says, “Okay.”
I hand the phone back to the ER team. His office schedules the second ablation.
1779 Wedgwood in Smiles Life (1894) xviii. 232 My girl is quite tired out with
her miserable hum-strum.
A senile woman one bed over from me in the cath lab’s pre-op area is discussing the history of feminine hygiene products with her nurse.
“Do you remember the belts, dear?” she says.
Her nurse does not.
“Oh, dear. What you did was…”
This is the thing about ticker-ology: I’m 27, but I’m still the youngest patient they’ve got in pre-op. I’m not sure what inspired this woman to talk pads (recent pre-op groin-shave?), but I’m relieved when one of my doctors, a cardiology fellow, drops by.
He’s wearing scrubs, and this pleases me. “At least you’re properly dressed,” I say, waving my hand up and down. “The surgeon stopped by earlier and he was still in a suit and tie.”
The fellow tips his head back and laughs, then listens to my heart.
My ticker is in the 140s, and this, he believes, is a good sign. This means I might be in the arrhythmia they’ve been looking for, which runs slower than the SVT. I need to be in it for them to zap it.
They roll a young woman out of the cath lab, and she is clearly doped up—eyes heavy and unfocused, arm slung over the side of the bed. There is a kind of bovine placidity about her that makes me realize how drugged I must’ve been last time, and how awake I’ll be this time.
A kind of liquor; strong or double ale
a1625 J. Fletcher Wild-goose Chase (1652) ii. iii. 21 Would I had some Hum.
Lying on the table in the cath lab, I feel a primal connection to alcoholics. The sense that there is no way to proceed through this day without some kind of numbing agent is crushing and palpable.
They prop my feet up on eggcrate foam and a male nurse lifts my blankets to put ECG (electrocardiogram) stickies on my chest. He vows to “preserve my dignity” as he does so. A confusing promise, as it seems to suggests that I should be shamed by this nakedness. Also, it’s not unclear to me that this nurse is gay. I doubt even a young nun would be embarrassed by this blatantly un-sexual activity, so I’m more discouraged than anything by his words. In truth, he makes me pine for the nurse I had at my last ablation, a woman who would wander over to my face now and then to press her hands to my cheeks and coo in this enormously sympathetic way that would be disturbing in any other context but is just right for the place and time when your heart is being torched by angry villagers.
The male nurse further discourages me when he can’t get one of the ECG leads to snap on a sticky correctly. The stickies have gel pads that help transmit my heart’s electrical activity. But if the lead’s not snapped on right, it won’t work. The sticky is positioned on a rib, and he presses hard, snapping and unsnapping for a lengthy period of time (the mammas in maternity are pushing them out faster) before another nurse suggests he try a spare lead. Finally it clicks, and I breathe in relief. Though the smell of hot iodine reminds me we’ve only just begun.
Another nurse fusses with my blankets, tucking me in like a child at bedtime, and the cardiology fellow says to her, “Hurry up. I’m sorry, but hurry up.” He wants to get at the arrhythmia before it breaks.
She hurries. He stands at my groin, where he will “gain access” by threading several catheters into an artery that leads to my heart. He must’ve already forgotten I’m awake, because as he stands by the table with the bowl of iodine, he snaps his tongs as if he is at a barbeque, about to flip some steaks.
Food is a definite issue for hummers. They need to guzzle more than their weight in nectar every day or else they’ll starve. If hummingbirds had an at-flower song, it would definitely be Def Leppard’s “Pour Some Sugar On Me.”
Some flowers pour more sugar on than others, and this is what drives a hummer’s taste in flora. It’s a myth that they prefer red flowers and feeders; color preferences are learned, and have to do with a hummer’s impressive memory for nectar output. Territorial hummers, like the Rufous, will stake out a claim, learn which flowers put out the best juice, and defend the shit out of that flowerage. They can remember which nectaries they’ve already visited and emptied, which they’ve visited but not emptied, which they’ve never visited, and which are brand new.
Some birders suggest talking to your neighbors to make sure they don’t up the sugar concentration in their feeders and Bogart the hummers. They also suggest lowering the concentration if you don’t have to worry about competing with neighbors. This way, like the elderly in Florida, you can manipulate the little ones into calling more often.
Birds that are used to feeding on red flowers will tend to hit up a red feeder first, but you can easily switch the bird’s preference from red to yellow by using more sugar in the yellow feeder. What the bird prefers is to not be hungry.
The catheters’ trek to my heart the first time—during the drugged ablation—felt like nada. This time, sans drugs, the journey feels more like bumper organs. My insides abhor this game. They turn to one another and say, The fuck that is? Throughout the procedure, nurses will continue injecting the catheter site with Lidocaine (a local anesthetic of the sort found in products to sooth sunburns), and it will continue to be as impotent as a noodle. The catheters are tiny, but they feel like serrated garden hoses.
My surgeon arrives, and promptly scoots into a small room with computers that will tell him what my ticker’s up to. One of the catheters has a tip that will heat up and burn the tissue that’s misbehaving, but first they’ll use the other catheters to “pace” my heart, i.e. encourage it to do every wrong thing it might ever want to do so they can watch and learn. This is somewhat like inviting every asshole who’s ever pissed you off to one big dinner party so you can map the intricacies of your rage. It feels not good. At one point my heart races so fast that I’m about to pass out. I see stars, feel pins and needles. I say as much to the cardiology fellow, who doesn’t reply as of yet. The bad rhythm breaks just before the room goes dark.
“That was just because your heart was going really fast for a minute there,” the fellow says now that it’s over. He turns to the surgeon in the computer room (pay no attention to the man behind the curtain!) and says, “What was that, anyway?”
I don’t hear a response, but the fellow spins back around as though he and his questions have been asked to kindly shut the fuck up.
Hummingbirds are flying circus freaks. The Rufus’s wing-beats clock in at 50-60 beats a second. If you slow down video, you can see their wings moving in a circular motion, not just up and down. This helps hummers be the only birds that can fly backwards, and the only ones that can hover. That’s how they swig all that nectar—by hovering next to the flower or feeder, not by perching on it.
They tread air, and put enormous effort into doing so. I think of humans treading water, the circling of arms and legs, and how absurdly slow these movements are, how lax when compared to hummers.
To work that hard just at staying still, suspended in mid-air—that’s what it feels like as I wait for the doctors and nurses to finish pacing and get on with the burns.
Finally I hear my surgeon say, “Warn her that it’s going to hurt.”
1856 J. A. Froude Hist. Eng. (1858) I. iii. 189 The hum of expectation
sounding louder and louder.
Quick, radiating heat. Like an electric burner’s been switched on in my chest so the doctors can make Jiffy Pop. “Fuck, fuck, fuck,” I say as softly as possible while a nurse counts up for the surgeon. “Thirty seconds. Forty-five seconds. Sixty seconds and in a great deal of pain.”
They go up to 140 seconds and 139/140 watts. It’s difficult to translate this length and wattage, but perhaps your hand held to that burner would approximate the vibe.
1644 K. Digby Two Treat. i. xxviii. 256 Trembling bells…humme a great while
longer then others.
My family used to go to a community pool in the summers, and I remember listening to all the kids standing at the deep end with their toes over the edge, yelling, “Dad, watch me dive! Dad! Dad! Dad, watch me dive!” Eventually a bored, middle-aged man would glance up from his newspaper and nod, and the kid would slap his hands together and sort of crash into the water.
This is what the cath lab reminds me of when they are deciding where to burn next. My surgeon’s in the computer room, and the nurses and fellow are by the table, messing with catheters and asking my surgeon for his opinion and approval. “Pete, what do you think of this? Pete. Hey, Pete, what about here? What do you think, Pete?”
There is a pause while he considers their work. Then he says, “Better,” or “Worse,” or “What? Um…No.”
The nurses ask me, during the burns, if I’m okay, and I say, “Well, it hurts. It hurts every time.”
I try to breathe through the pain, but then I hear my surgeon say, “What happened there?” To which the nurses say, “I don’t know; she breathed or something and the catheter moved.” I want to scream, but God knows what the catheter would do then—maybe go for a stroll and burn a hole in my lungs. Try screaming now, sweetheart.
I hear laughter and the muffled sounds of happy conversations coming from the computer room, and though it’s clear they’re just doing what people do at work—fumble for ways to entertain each other—hearing it brings on a terrible loneliness.
My left arm is starting to kill. In their rush to “gain access,” they didn’t manage to tuck it in as well as they did the first time, so it’s half off the table and tangled in some wires. The automatic blood pressure cuff is also on that arm, and doesn’t seem to be self-adjusting, but getting extremely tight every minute or so when it takes a reading. I ask the male nurse about this, and he says, “The only thing we could do is give you something for the pain, but we can’t. We don’t do this very often, you know.”
He leans over me like a praying mantis—the hateful, predatory bug that devours hummingbirds—then adds: “It’s not easy for us either.”
The surgeon calls to the male nurse, “How does it look?” Meaning my heart—how do the burns look on the fluoroscopy (X-ray) screen.
“It looks like you’ve done a lot of work,” the nurse says.
His voice is both proud and impressed, as if the surgeon has encrusted my heart with diamonds instead of burns.
I can’t see the screen from where I am, but I try to picture it myself. What do the dead parts look like? Black spots? White spots? Is my ticker a Rorschach—could I take it to psych and have them hold it up to me? I see a male nurse being de-balled by a laughing little bird.
2002 Rolling Stone 14 Nov. 63/3 I pimped out the Bentley with white-and-
blue-striped interior. On the Hummer, I got the rims and the whole front
grille dipped in chrome.
More burns, and then a period of consulting where several surgeons huddle in with my surgeon in the computer room. The male nurse tells me I have a break while they discuss options, but what I really want to know is how much longer I’ll have to do this. I’m starting to worry that I might inch off the table and fly out of the lab, the catheters trailing behind me, caught in my organs like barbs.
They now say they’re watching to see if the occasional heart blips they’re seeing will turn into anything more sinister. They don’t appear to. The fellow leans around all of the equipment to say they’re going to give me medicine to help me relax, and then they’ll finish up with their usual testing.
“I get drugs now?” I say. “Does that mean you think you got it?”
He hesitates, then looks almost apologetic. “We found several things,” he says, “but we’re not sure how many of them you actually experience when you’re awake.”
I don’t care that his answer is less than solid. I just want the liquid.
It takes a few hits for the drugs to kick in. Earlier, they gave me a medicine that simulates exercise, and I’m still jumpy. They also gave me heparin—a blood thinner. I’ve overheard orthopedic residents joking about the dangers of blood thinners: “Man, we killed like three people that weekend. That was pretty bad.” So I’m a little strung out about this heparin thing, too. Finally I feel my cheeks start to flush, to burn.
1701 G. Farquhar Sir Harry Wildair iv. ii. 36 The Wine was humming strong.
During their final tests, my heart doesn’t feel any different than it did before the ablation, so I’m not sure if the hummer’s flown or not. I’ll have to just wait and see. This realization feels slanderous, like something I should be able to fight in court.
My surgeon descends from his aerie up in the computer-tops and says, “How sleepy is she?”
“Not sleepy enough.”
There’s a silence while the nurses and doctors glance around, searching for the locus of the asshole who said this. When they realize it’s me, they all burst out laughing, like a cloud breaking, and seem to reach for each other, to hold themselves up.
I curse again when they yank the catheters out. My eyes tear up. “Can I move my hand now?” I say, and several nurses chirp, “Yes,” in perfect unison.
I cover my eyes. The fellow presses on the catheter site to stanch the bleeding, and says, “I think the pain you’re feeling will stop when I’m able to move my hand.”
He says something else I can’t quite make out, and a nurse objects, “But I just gave her—”
“Just give it to her,” he says.
She sighs and puts more juice in my IV.
At home, I think of my mother’s advice—that over time the drugs make you forget—and I scribble down notes before the details decamp. I do this on instinct, just as people check the tissue they’ve just blown their nose into: we like to know what our bodies have been up to.
I tuck my notes away, and don’t think about them. Five years later, though, I land in the ER again, where a new doctor says, “It could be your arrhythmia has returned, or this could never happen again. We don’t know.”
This episode gets me thinking about my notes, and I begin revisiting them with some frequency, filling in the holes in my memory. It also gets me thinking about anesthesia.
Doctors dig the juice for lots of reasons; it’s good for more than a patient’s pain. Anesthesia also makes a patient appear less human, more cyborg. You’re out cold. And it’s easier to slice, burn, drill, pin, fuse, aerate, or otherwise operate on a human you can pass off as a complex machine. Anesthesia numbs doctors, too.
I understand this intellectually—that the lack of feeling in the lab relates to this routine numbness, and the doctors’ and nurses’ inability to sensitize themselves to me. But whenever I think of being seen as a box-o-wires, I get all charged up. I want those doctors fixed.
To withstand frigid temperatures and prevent weight loss during migration, Rufous hummers go into a state of torpor overnight. It’s like a mini hibernation—their heart, breathing, and body temperature all drop off. On thermodynamic videos, you can watch their bodies go from red to blue as the birds become nearly as cold as their environment.
In the morning, as the air warms, the hummers’ bodies shift back from blue to red. Their heart and breathing quicken, and they lift off the branch, fully awake.
I keep revisiting my time in the cath lab, and soon this includes writing fiery letters to my surgeon in my head. I think if I can uncover the right word then I’ll break through the anesthesia, rouse the human. Heads will cauterize and roll. I consult the OED, become consumed with shades of certain words: burn, nectar, hum. The entries for hum seem to have the most to say about my experience, though I doubt it’s the kind of word that would combust on contact the way I’d like.
One morning I wake up with the word “necrophage” humming in my ears. I don’t recall its meaning; it’s not a word I was studying. It turns out a necrophage is an organism that feeds on dead tissue, e.g.:
1995 Times 20 Jan. 35/2 Hunger can make necrophages of us all.
This hits me as a not-so-subtle hint from my subconscious about what I’ve been chewing on, and what this will feel like if I don’t spit it out: Warn her that it’s going to hurt.
Once awakened to this fact, I start to feel better. It’s relieving, this consciousness. Like a bad rhythm breaking.