when COVID When the virus hit Rebecca Saltzman’s family, it revealed a life-changing discovery. Her husband and two of their children had a genetic heart disease. The type where people fall and die. As a healthy wife and mother, Ms. Saltzman also took on a new role: guiding her family through what Susan Sontag called “the kingdom of the sick.”in this columnshe explores the anthropological strangeness of this new place, the mysteries of the body, and how facing death distills life into its purest form: funny, frightening, and sublime. I’ll explore.

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Part I, Part II, Read Part ⅢPart IV.

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I once went on a family tour of the Kingdom of the Sick. On the night of December 5, 2022, when I came home from her work, I found her husband sitting on the sofa with a strange expression on his face.

“I don’t feel well,” he said, touching his chest. “Something happened today. As I was walking outside, I suddenly fainted and fell against the wall.”

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In marriage, there are times when you have to respect your spouse’s feelings, and times when you are told to shut up and listen. December 5th was in the second category.

“I have to go to the ER,” I said to Josh. At 7pm we were sitting across from each other in the living room.

“No, it’s no big deal,” he said. “I feel good now.”

“For you, electro-cardiogram” I said. “Just a quick trip to the ER and you can go home right away.”

In the months since the genetic test for QT prolongation and Josh’s hypertrophic cardiomyopathy came back positive, we have each dealt with stress and fear in different ways. I threw myself into learning everything I could. Josh chose the opposite approach. He missed my scheduled cardiology appointment and never rescheduled it.

I can’t say my approach was better. Yes, there is such a thing as too much Google. But after some Googling, I found this important fact. Cardiac syncope, or syncope caused by cardiac arrhythmia, is an important predictor of sudden death.

Josh is one of the most level-headed people I know. But in this case, I was unfazed.

“I’ll come with you,” I said. “But your ass is going to the ER.”

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There are many benefits to having heart disease. Did I say a lot? There really is only one. No need to wait in the emergency room.

Even in New York City, where ERs are overflowing, heart disease is a top priority. VIP Passed. The velvet rope goes up. You instantly bypass the plebs in the waiting room and are transported through the hallway to the hospital. electro-cardiogram Machine (bottle service not included, can Please buy the hospital’s delicious ice). Just because you don’t have to wait in the ER doesn’t mean you’ll feel better. This means that the staff who was watching everything has determined that there is a good chance that you will die.

While the nurses connected Josh to the hospital, I wedged myself into a small corner of NewYork-Presbyterian/Columbia’s Barbara Walters Acute Care Center, balancing between a chair and ugly pastel hospital curtains. I was there. electro-cardiogram.modern electro-cardiogram The machine works on a computer algorithm that allows medical staff to instantly get an interpretation, albeit incomplete, of the results printed at the top.If your mind looked normal, it would say usually electro-cardiogram.

Josh’s strip has the entire catalog of issues listed at the top. Abnormal electro-cardiogram.

“I’ll admit you,” the ER doctor said, furrowing his brow. “your electro-cardiogram strange. It’s just… weird. ”

Also, being an oddball in the medical world is never safe. Boredom is a good thing. Is it strange, interesting, or noteworthy? All are bad signs.

As soon as a bed was available, Josh and his strange heart settled in the cardiac ward (Barbara Walters’ name was also written on the wall here). Since it was December, there was an electric menorah at the nurse’s station and a tinsel Christmas tree taped to the crash cart.

Josh’s room overlooked the hospital complex and he could see miniature people crossing three different levels of glass skybridges.A huge banner outside praised us “BE” wonderful. Pigeons gathered on his windowsill, staring at us with their orange eyes.

We read the entire story aloud to the nurses, residents, and attending physicians.long COVID and long QT and genetic testing. The kids say Josh’s chest X-ray and echocardiogram in the ER also came back positive. The cardiology team scheduled further tests.

Josh is a professor with a PhD in mathematics. At the time of his hospitalization, he was also the president of the university’s faculty union. He has now set out to optimize his hospital stay.

“Are you part of a union?” he asked the nurse. When he heard that she was and that her union was currently negotiating a contract with the hospital, he began encouraging the nursing staff to go on strike. Although a questionable strategy for getting the best medical care, he decided that workers’ rights came first.

He dutifully measured his urine output and competed against himself every day to beat the number of milliliters Josh had urinated yesterday. You learn a lot about the person you married during difficult times. I married the type who likes to quantify his pee.

In cardiology, patients spend all their time on continuous wireless electro-cardiogram monitor. This means that you cannot leave cardiology. Otherwise, you will be out of range. Like a dog trapped behind an invisible fence, Josh roams the hallways, learning exactly how far he can go before someone comes running.

He found a conference room with a whiteboard and began scribbling equations on it. good will hunting– Styles, until a nurse catches him.

“Sir, you shouldn’t be here,” she said.

“No, it’s okay,” Josh explained. “I’m a doctor.”

(About mathematics.)

“You may be a doctor, but here you are a patient.” She shooed him out of the room.

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A few days passed, then a week. A “quick trip” to the ER turned into an extended stay. Love means never saying “I told you so.” But I’m not that nice of a person, so I said it anyway.

Every morning, I wake up, get the kids ready for the day, wave to Iris and Gabriel as they go to school, walk 10 blocks downtown to drop off gas, turn around to visit Josh, and then head back to school. I went 60 blocks uptown, took the subway 60 blocks down to pick up Gus, made sure my other two kids got home, fed them dinner, and went back to see Josh again. Or maybe he just collapsed from exhaustion. Although I didn’t have family nearby, I was lucky to have a network of friends who brought me food, sent me delivered meals, and kept me well stocked with DoorDash gift cards. (my friends were included). McSweeney Writers, you guys are interesting. and Kind? ? ).

Additional medical tests confirmed that Josh’s genetic hypertrophic cardiomyopathy was indeed causing his physical illness. The walls of his heart became thicker.

His continued monitoring revealed that he was having multiple arrhythmia episodes called nonsustained ventricular tachycardia.NSVT). This meant that his heart suddenly started beating fast and irregularly. Although all of his episodes were self-terminating, NSVT It could lead to a life-threatening arrhythmia or cardiac arrest, and meant he could not be discharged from the hospital until doctors understood what was happening and how to treat it.

But life brought us more plot twists.

In addition to, Ho Chi Minh City And with a mysterious long QT, Josh’s echocardiogram showed otherwise: He was born with a congenital defect in his aortic valve. This valve regulates the flow of oxygen-rich blood from the heart to the aorta, a large artery that carries that blood to other parts of the body.

A typical aortic valve has three leaflets that open to allow blood to flow into the aorta and then close tightly to prevent blood from flowing back into the heart. Josh had only two leaflets on his valve. And these two flyers of his, which have served him best throughout his 39 years on earth, are now deteriorating. Blood was flowing back into the heart, and the heart had to work three times as hard to replace it, struggling to keep up its job.

His heart was failing.

Not only that, but the increased pressure on the aortic valve was also causing the formation of an aortic aneurysm. An aneurysm is a condition in which an artery becomes wider than normal, making the walls weaker and more susceptible to tearing. Aortic lacerations are highly fatal.

The cardiology team was surprised. Congenital defects. Another genetic disease. Her unexplained QT prolongation may indicate a third genetic disorder. and an aneurysm. Josh’s mind wasn’t just strange. It was one in a million.

“Don’t Google surgery for this,” my friend Mindy, who works in the medical field, warned me.

“It’s too late,” I said.

To save Josh’s life, a team of surgeons must cut through his sternum and stop his heart. They had to repair or replace his aortic valve and reinforce his aorta with mesh while he was kept alive using a bypass machine. The recovery will be long and difficult. But without surgery, he probably won’t live past 40.

The good news is that no emergency surgery was needed, as the valve or aneurysm was not believed to be imminently fatal. But it was too urgent to wait long.

Josh looked healthy. As we walked down the hospital hallway together, I couldn’t believe he was that sick. Through the windows I could see the city lights flashing, the starry cables of the George Washington Bridge, the ribbons of headlights rolling down the Hudson River.

The biggest challenge of our lives now lies before us. I kissed him goodnight and took the subway home alone, 50 blocks away.