the original version of this first appeared in 2013. I re-worked it for my Substack. EKG via ECG Stampede. Selfie by me.
I had a tsunami of pulmonary emboli in August, 2012. I was asymptomatic until it was nearly too late. Very nearly. Like 12 hours to go. After a week in the hospital, I went home, barely able to walk up the stairs. I was gentle and diligent with my PT over the winter. The clots had done some damage. I saw the CT scans.
In March of 2013, had a stress echocardiogram to look for any unhealed damage before the doctors allowed my return to full activity. Hooked up to EKG leads, I walked for ten minutes at a moderate pace and then had a sonar exam of my heart. Easy-peasy.
A week later, the results came back- no damage to my heart. Left ventricle is of normal size. I am fine. After a fashion. I have a slightly irregular and inverted “T” wave. I’ve had it all my life. At the time of my PE, I was 54. I had ridden and raced a bike for over 200,000 miles. “T” waves represent the repolarization of the heartbeat. My heart repolarizes just fine - about 176 times per minute when I was racing.
I have an ejection fraction (EF) of 65. EF measures how much blood is ejected from the left (main pumping) ventricle of the heart. On the high end of normal, 65 can mean the heart is overworked; it has to compensate for stenosis (narrowing) of the blood’s passageway. In my case, it means that I’ve been busting my fitness ass for the last forty years, and my left ventricle is plenty strong as a result. That, and my resting pulse of 52.
But if I was a 54 year old with the typical array of middle-aged health issues (high cholesterol, diabetes, obesity, hypertension), a high-normal EF plus the T-wave issue is a cause for concern. I have none of those issues.
The cardiologist’s PA was concerned.
“Doctor will probably want to do an angiogram,” the PA said.
“Shoot some dye into my heart?” I thought. “No freaking way.”
I explained to her that I was active all my life, very active.
I could hear her nodding.
“Well, still…,” she said.
“Let me explain,” I said. “Before this, I rode anywhere from 75-150 miles every week. Except when I was younger, when it was 300 miles per week. I lift twice a week, except when I lift 3 times per week. I don’t know that I’ve missed more than a few days in row, except for injury or some such, since about 1975. I’ve had the T-wave thing all my life. We found out about when I had a VO2max test for the Olympic Training Center back in 1983.
“Look at my chart. It’s all there, right? I had a DVT. I had a bunch of embolisms. Look at the rest of my numbers. Look at my history. Treat your patient, not your numbers. (I stole that line from my Dad. He was a physician.) I’m not sick.”
“Ah. Yes,” she said. “I see. You pretty much slay yourself, don’t you?”
She laughed.
I laughed back.
“Yep, pretty much. Started when I was in high school, just never quit.”
“This makes a lot more sense, then. Listen, let me double check with the doctor,” she said. “I think you’re fine. If you don’t hear back from me by the end of the day, don’t worry about it. Good? Good.”
What a great phrase – You pretty much slay yourself, don’t you?
This begs the question.
Why do we slay ourselves?
1) It is real. Hard work; on the bike, the weight room, rowing, running – is visceral. Nothing gets me more in touch with my true nature than sprinting right up, and sometimes over, the edge of my perceived physical limits. The Stoics said, “Punish the Body. Purify the Soul.”
2) It feels good. A momentary victory over gravity and blood and breath and anatomy and physics and psyche satisfies the body, soul, and the mind. As ace climber and Gym Jones founder Mark Twight once said, “It doesn’t need to be fun to be fun.”
3) Vanity. I like how I look. Simple. It may be the armor that I have chosen to put on in life, but I like it. I earned it. I own it. Said Diana Vreeland, style and fashion’s Grande Dame, “I loathe narcissism, but I approve of vanity.”
4) Because I can. Had I waited another day, or perhaps an hour, my embolisms would have killed me. They didn’t. When I set foot in the weight room, when I put a leg over my bike, when I snap into my skis – I do so fully aware that many would love to have that opportunity just one more time. I do so fully aware of how close I came to losing this chance to use this body, fearfully & wonderfully made (Psalm 139), ever again.
Why do we slay ourselves? How can we not?