Women and Heart Disease: The Heart of a Woman

Here is more of the manuscript... it's strong, but hopefully useful, particularly for women, whose voices are still not loud enough!


Chapter III. The First "Event": Coping With The Initial Reality
My friend's initial response to my desperate call was "You're kidding!", reflecting both her fear and disbelief, but she knew by my voice that there was no question that I was in trouble. She left her job and reached me so quickly that I thought the phone was still attached to her hand when I somehow managed to open the door for her. We arrived in the triage area of a local hospital at breakneck speed. Initially, I was told by the nurse that I was probably fine ("Just indigestion, dear"), and the pain did finally abate. It was a surprisingly strong pain, so focused on the left side of my chest that I could describe it by simply placing three fingers on the very spot from which it emanated. There was no "elephant" and absolutely no other symptoms to report. Parenthetically, I have a family member who recently complained of pain in her right arm and shoulder, and, based on my experiences, sought help and was diagnosed with blockage in a small branch of her LAD. Lesson learned.
My speedy friend owned a hair salon and was literally in the middle of a haircut, so she left me in the presumably competent hands of the staff. I sat on a hard chair, in the midst of the usual variety of ER patients, crying quietly, feeling terribly alone, weak, scared and absolutely ignored. By the time I was actually seen by a physician, anger had taken the place of pain and fear, based in large part on the frustrating, seemingly interminable wait. If I did need care, and I had not yet admitted to that, I certainly was not getting it! Characteristic of emergency rooms and of the mindset that affects even female caregivers, no one seemed to feel that I was a true emergency. I longed for them to be correct, but it was their responsibility to notice that I existed! Never allow yourself to be overlooked and always have someone with you who can provide advocacy for you. My friend had to leave and I was initially too demoralized to assert myself. We are often taught, especially as women, to smile sweetly, wait our turn, consider others. We are labeled aggressive when we attempt to fend for ourselves and admonished for calling attention to our needs. In a medical setting, it is critical to bypass this prevalent attitude (pun intended) to make certain that we receive the best possible care.
Having some knowledge of cardiac enzyme tests, electrocardiograms (ECG's) and other tools of the trade, I announced that I wanted an ECG as a "rule out" device so that I could meet my husband as planned at the airport. My mother and stepfather were picking me up at home and I saw no need to alarm them. Whatever happened, it was over and I wanted out of there, yet another universal theme. No one wants to sit in an ER, particularly alone. Despite my adamant pleas, even in light of their limited attention, I was not going to escape admission.
I relented and gave permission for my husband and parents to be called, but decided to wait to alert my daughter, a physician only two months into her first job. By the time the first contingent arrived, I was a proverbial basket case, at once alone, frightened, filled with disbelief and frustration. I still was not entirely convinced that I belonged where I was. This is a poignant example of insistent denial, improperly paired with the fear that this might well be a major problem. For me, the worst part was knowing that my pain was being dealt to the people who loved me the most. I was told by them then and since that this notion is "ridiculous", but not to me. I was accustomed to being the caregiver, the strong, able one, certainly not the patient, let alone the one who was disrupting the lives of others. For anyone who has encountered these feelings, I can offer a note of consolation: listen to the significant people around you; they are more than likely telling you the truth. Your suffering is affecting them, but they are not holding you responsible. You are not at fault, not for the situation or for their responses. Allow them to dote on you, sit with you, encourage and nourish you, for it is deserved and essential. There will come a time when you will be available to comfort them, but the tables cannot to be turned just yet.
Every patient has valid complaints, often minor, sometimes quite important. Here is one of the most irritating of the many incidents that unfolded in the ER that afternoon: an EMT (emergency medical technician) trainee search for intravenous (IV) access in the most difficult vein in the arm. He finally managed to insert the line, but his inexperience caused my arm to ache, turn into a veritable rainbow about the circumference of a good-sized peach and definitely rendered me much angrier than before. We all have a true need for competent, sensitive care in a situation like this, and I instead felt like a mauled kitten. I did not, nor could I have expected to know that there is a vessel affectionately called the "intern" vein, a comparative breeze to enter! Stoicism is not a friend: if you want to avoid this unnecessary assault, speak up, insist that the IV team or a more experienced staff person be called in. There is no reason to increase your stress level - I urge you not to take on a "good-guy" role. This is not the time to engage in such niceties. Of course, in the scheme of things, this incident became unimportant, but it set the stage for creating a veritable handbook for coping with a string of similar nonsensical moments to come.