Heart on a Screen (Part I)
Inside the body—my body, yours—a heart. Contracting, releasing, independent of the mind’s desires and yet linked in language to love and yearning, devastation and joy. Place your fingers beneath your jaw. Feel the movement of your heart. Is it calm and measured, each pulse occurring at precise intervals? Is it eager, clumsy as children’s footsteps down a hall? Is it strange to you, this feeling of your heart on your skin?
Historically, I am not a good listener to my body’s needs, to the vulnerabilities it tries to convey through discomfort. “It’s just allergies” has eventually turned out to be bronchitis. “It’s just a UTI,” a kidney infection. “Bad shin splints,” hairline fractures. Mind over matter, we hear, and we repeat it, this code for “keep going, push harder, fight.” This country, after all, wasn’t founded by slowing down and listening, by quiet, thoughtful assessment, and we are still expected to be those brash frontiersmen—a challenge I’ve long accepted.
My mom likes to tell a story about when I was on the high school swim team. I’d been out sick for a week, maybe two, and when I came back, my warmup exercise was a 600—24 lengths of a 25-meter pool. I groaned, saying something along the lines of, “Coooooach! You know I haven’t been training!”
He of the unnecessary Speedos bent down toward me. “I’m taking it easy on you,” he said. “Everyone else is doing an 800.”
Indignation made my body stiffen. “You didn’t think I could do it?” I said. “Fine! I’ll do a 1,000!”
It’s the easiest way to motivate (or manipulate) me: just tell me I can’t do something. When Adrian and I were in Joshua Tree last spring with my RTC team and I was nearly in tears, struggling to climb a 70-foot rock, he almost shouted at me from the ground below: “You can’t do it!” He knew that would get me to the top.
The problem with this, of course, is that it almost ensures I take things too far. That I overcommit or insist on good health or injure myself; that I place too much emphasis on the mind and too little on the body, cutting off communication between the two like relatives who are prone to argue.
Last year, I made a laughing comment about how fast my heart was beating as it tried to keep up with the vast amount of rice, beans, and fajitas I was consuming. Adrian shook his head, and one of my best friends, Christina, looked at me, baffled.
“She has a really high heartrate,” Adrian explained flatly, “and refuses to get it checked out.”
“It’s fine,” I said, waving my fork. I looked at Christina for support. “It’s not a big deal. It’s just on the high range of normal, and it goes a little faster when I eat. Like right now, how fast is your heart going?”
The three of us set our fingers to our necks, timing our beats for 15 seconds and multiplying by four. Theirs were both in the 60s. Mine was 120.
Christina, whom I can always count on for a good dramatic response, gasped. “Katie, no! No. Oh, my god. It’s like that all the time?”
“All the time,” Adrian confirmed.
“Not all the time,” I said, irritated. “It’s usually around 90 and just goes up a bit when I eat.”
“When she runs it gets up to 200,” Adrian said.
Christina gasped again. “Oh, my god!” she said, and I felt bad for how genuinely upset she sounded. “Katie, you have to go see a doctor. Seriously.”
“That’s what I’ve been saying,” Adrian said.
“Alright, alright. Calm down.” I thought for a moment and then, to placate them, I said, “I’ll ask one of my functional medicine doctor clients, and if he says I should get it checked out, I will.”
This was a Sunday, and I texted David as the three of us drove from Austin to San Antonio, explaining the situation and asking if he had some time to chat in the next few days. He called me immediately, filling me with gratitude for the career that connected me to such brilliant people who were also so generous of time and spirit.
We talked for five or ten minutes, with David asking me questions about how high my heartrate rose, during what activities, for how long: did I know what it was when I woke up, before even sitting up in bed? Did it spike when I went from sitting to standing, and if so, by how much? Where was it usually during the day? What about when I exercised? At the end of the conversation, David told me that my “symptoms” sounded like POTS, or postural orthostatic tachycardia, but that of course I’d need tests for any definitive diagnosis, and yes, he said, I should go see a cardiologist—soon.
When I hung up, the car was silent. The I told you so was heavy, but no one said it.
* * *
We dropped Christina off, and on our way home, Adrian stopped at the CVS. To my quizzical look, he said, “I’m buying you a heart monitor watch and I want you to wear it.”
I sighed. “Okay.”
With that, I started to put some numbers together: heartrate around 75 upon waking, quick jump to 100 upon standing. Eating: 120. Stairs: 150 (embarrassing). Running, level ground: 180. Running, hills: The heart monitor peaked and went red around 209, at the same time I stopped and put my hands on my head to catch my breath.
At this point, I was working with a personal trainer at a gym by our house. For the first time in my life, I’d gained a few pounds that weren’t coming off when I wanted them to, but when the trainer discovered, via my heartrate watch, that burpees instantly jolted me up near 200, she broke up with me. “I’d prefer you get the okay from a doctor before we continue,” she texted. And after my husband, family, friends, and even a doctor I trust pushed me to get checked, it was this—the “You can’t do it”—that finally made me go.
The first thing the cardiologist did was ask me to wear a heart monitor for 24 hours, a clunky apparatus that bulged under my shirt. After that, she wanted to do a stress echocardiogram. I hadn’t yet met my insurance deductible, and after getting pricing over the phone, I said I’d call back to schedule.
“Eighteen hundred dollars!” I told Adrian. “There’s no way. That’s crazy.”
But he was done with my denials, my airy insistences that everything was fine. “Look, you need to go,” he said. “That’s it. What do you have, if you don’t have your health?”
I’m not psychologically deaf to the fact of my own mortality. The happier I am, the more deeply I love, the more excited I become about the future, the more I think about the random and sad and absurd ways I might leave this world. Yet there was a disconnect: I could not conceive of my heart, of all things, being on this list of potential causes. My heart was what kept me alive, and I took for granted that it would continue its vital function until something external stopped it; not that it might simply stop, cause and effect in one silent failure to contract after another. If I were in Adrian’s position, I’d be just as frustrated.
So I called back and scheduled the tests.
Read Part II.