I had a heart attack on June 14th. It was a mild one, but it scared me nearly to death. In fact, it triggered an anxiety attack as soon as I got out of the hospital later that week.
Together, the two attacks knocked me on my butt. They’ve also knocked some sense into me. On things like how many work projects to juggle, how to loosen control over my two teenagers and how to manage a life-long mental health challenge.
Most importantly, this coronary-angst episode offered a lesson around manhood: how we need our full humanity as men to survive and heal from serious health scares.
That is, we need to embrace the entirety of the male symbol:
We need the arrow — the strength, the clarity of direction, the assertiveness. And we need the circle — the connectivity to others, the vulnerability, the compassion.
Cutting off any part of it deadens us as men. Can leave us dead prematurely. But being a whole man — an arrow-and-circle man — frees us to feel fully alive.
At least that’s what my healing heart and head have taught me.
My Heart Attack
My heart attack seemed straight out of central casting. I huffed and puffed up a hill near my home in San Francisco as I spoke on the phone with a friend. When I walked down the hill, I started to feel chest tightness, nausea and light-headedness. I had to sit down on the sidewalk for several minutes before those sensations ebbed.
I called my doctor’s office a little while later, and the Kaiser Permanente nurse on the other end of the line told me to come to the emergency room right away. I did. A blood test showed elevated levels of troponin — a marker of heart trauma. And an electrocardiogram (EKG) differed from a baseline measurement taken a few years ago.
Conclusion: a mild heart attack. A myocardial infarction. Part of my heart had been starved of the blood and oxygen it needed.
The next question was, “Why?” My cardiologist predicted a blockage in one or more of the arteries that nourish the heart. A cardiac catheterization would solve the riddle. Doctors would snake a tube with a tiny camera from my wrist into the arteries of my heart and take a look.
So I was wheeled into a room that reminded me of a spaceship — a brilliant white chamber with powerful overhead lights encased in mirrors. A massive flatscreen monitor sat to the left, and a hulking imaging device descended from the ceiling to just above my chest. The narcotic fentanyl put me in a daze.
The next thing I remember is doctors showing me a movie on the big screen. It was my own heart, with one artery branch crimped in a zig zag shape. Then the miniscule camera-tube squirted out a liquid — nitroglycerin — and the artery sprang back open.
This meant I had a relatively rare kind of heart attack. Not the typical buildup of plaque related to poor diet and minimal exercise. I had a coronary artery spasm. One of the heart’s blood vessels had clenched up of its own accord.
Coronary artery spasms aren’t perfectly understood but chief suspects for them include extreme emotional stress, smoking and illegal stimulants, like methamphetamine and cocaine. Since I’m not a smoker or a coke user, stress was the likely culprit.
This was good news. I could work to reduce stress. What’s more, my doctors put me on a calcium channel blocker — a medicine designed to relax blood vessels and inhibit future spasms. After three nights in the hospital, doctors sent me home with a positive prognosis. I should limit alcohol and caffeine, and stay away from marijuana. But gradually I could return to regular exercise like yoga and swimming.
Overall, the docs said, I was on course to rebound to full health within several weeks.
My Anxiety Attacks
My mind, though, had other ideas.
The very day I returned from the hospital, I felt tightness in my chest again. I took two of the tiny nitroglycerin pills I’d been given in the event of another spasm-induced heart attack. I called Kaiser to report the experience, and they suggested I come back in. My wife and I got in the car and started driving to the hospital again. But we decided to turn back.
My discharge papers, after all, anticipated I might need the nitroglycerin pills. And a return to the hospital would mean an ordeal.
The background is important here: I have a history of exaggerating and even making up physical ailments amid stress. My previous anxiety attacks have included hyperventilating and fear that I was incontinent. The incontinence incident happened just before my first child was born, about 19 years ago. I was convinced I was leaking urine, and started making doctors’ appointments to address the issue. Then my wife challenged me to pull my pants down to check.
“Fine,” I said, sensing wetness. But when I felt my underwear with my hand, it was dry. My peeing problem had been in my brain.
Might it have been the same with the chest tightness I felt in the wake of the heart attack? Could my psyche have manufactured the feeling of a myocardial infarction?
So we drove home. And a follow-up call with my regular doctor was reassuring. He said the medicine should protect my heart, and that I wasn’t “in a life-threatening” situation. But the next two nights were torture. I continued to experience “surges” of sensation in my chest with tingling and pain that radiated throughout my torso, arms and jaw.
On the second night, I kept falling asleep and waking up with a pounding in my chest and more surges that spread through my body. I worried that I’d had another spasm, and my slowing pulse during sleep meant my heart wasn’t getting the blood it needed. It therefore kept jolting me back to consciousness. One way or another, it felt like I might die.
In fact, I even made a kind of peace with that possibility. Just as despair threatened to overwhelm me, I felt the presence of my mom, who died seven years ago. I heard her soothing, deep voice.
The voice that used to calm me as a child: “It’s Ok, Eddie.”
Then I imagined other beloved relatives — my maternal grandmother and paternal grandfather — comforting me along with my mother.
I didn’t die that night. But I knew something was wrong. The next day, a Sunday, I called Kaiser again. Based on how many surges I’d felt over the past 48 hours — at least 20 — they wanted to see me in the E.R.
That visit confirmed the anxiety attack. I diagnosed it even before blood and EKG tests came back. Almost as an afterthought, I asked the E.R. doctor for a drug to help me calm down and sleep. He gave me the sedative lorazepam.
It was a revelation. The lorazepam allowed me to see that what I had been experiencing as heart trauma was actually superficial muscle strain. As the drug took effect, the intensity of the chest sensations melted into nearly nothing — just minor tension I was holding across my torso.
Sure enough, the doc returned with news that my troponin levels were normal and my EKG was fine.
“Your heart is perfect,” he told me.
Relief washed over me.
But the anxiety didn’t drain away completely. Like past anxiety bouts, it lingered. For much of June and early July, I experienced a low-grade dread much of the time. And occasionally I was plagued by intrusive thoughts, including worries that my heart might be spasm-ing again.
Actually, “thoughts” and “worries” don’t do the anxiety justice. I went on to experience moments that felt similar to the original heart attack and to the psycho-somatic surges that landed me back in the E.R.
In other words, many more scary moments of chest sensation.
Scary, yet also silly on some level. Some of these incidents had triggers that are laughable in retrospect. One time, my wife and son and I were watching The Royal Tenenbaums, Wes Anderson’s comedy about a dysfunctional family. At the moment when the con-artist father is revealed to have faked a case of stomach cancer, I felt a surge come on.
It’s as if I were doubly punishing myself. I already was disturbed that I had “fake” symptoms of heart trauma, and here I was lashing myself with another episode of chest “pain.”
A Fresh Perspective
Today, I can look back on that event and smile at its absurdity. Because, over the past two and a half months, I’ve gradually worked through the anxiety and heart attacks.
My healing has much to do with the remarkable support system I have around me — the circle of people and institutions that have cared for me, loved me, encouraged me.
“Encouraged” is a fitting word here, by the way — as its Latin root “cor,” means heart.
The heart and head help I’ve received starts with the skilled, devoted medical staff at Kaiser Permanente. With the doctors who performed routine but nonetheless miraculous procedures to find the cause of my heart attack and prescribe me medicine and guidance for preventing another one. With the nurses and other Kaiser folks who monitored me, kept me safe and lifted my spirits with jokes, extra apple juice boxes and additional warm blankets.
Then comes my inner circle of family and friends. In particular, my wife Rowena has been huge in my healing. She has combined tenderness with just the right amount of tough love — snuggling with me in a hospital bed, reading to me as I nervously awaited my surgery, and weeks later prodding me to see the bigger picture around sensations that I worried were heart attacks.
My two teens have been terrific too, offering me more hugs than usual and holding my hand when I was at my most scared. And close pals dropped what they were doing to connect, express care, pitch in with advice and meals, and lend me their generous ears.
Perhaps the most pivotal group in my recovery, though, is the set of people and organizations just beyond my most intimate tribe. My church pastor, Maggi Henderson, paid a house call and prayed with me. Members of the Teal Team professional group I co-founded treated my family to flowers, groceries and ice cream from foodie icon Bi-Rite. And the seven clients I serve overwhelmed me with their flexibility, affection and empathy. Great Place to Work, my former employer and current client, sent flowers and caring cards, for example.
But beyond the gifts and kind gestures, the Great Place to Work folks and others in my wider network did something else: they made space for me to discuss my anxiety attack. They made it safe for me to talk candidly about a mental health challenge — I could discuss the craziness without feeling like a crazy person.
Nobody shamed me. Even when I walked them through the context of my earlier incontinence scare and my heart attack delusions. Instead of retreating from me in horror, a number of people surprised me by sharing similar periods of difficulty or darkness.
And every time someone else opened up, I felt a little lighter. A little more like myself. In fact, I’m convinced that I am working through this bout of anxiety faster than I did in earlier incidents because I feel less shame. I feel less alone.
On the one hand, this points to societal shifts under way around mental health. The Covid pandemic all but forced us to be more honest about when and how we are “not ok.” Many workplaces and leaders are acknowledging the importance of mental wellbeing and destigmatizing ailments such as anxiety and depression.
The greater openness around mental health had been building for decades. And it reached new heights recently as top athletes Naomi Osaka and Simone Biles bowed out of competitions citing mental wellbeing — and were largely embraced for their choices.
On the other hand, my willingness to discuss anxiety and the support I received speaks to the company I keep. I’m blessed to be surrounded by people unafraid to be vulnerable, especially when they think that vulnerability will benefit someone else. I have spent decades cultivating relationships with folks with big hearts and wise heads — and those bonds bore sweet and nourishing fruit in recent months.