After I met with a writer friend today, I thought (as I often have) there are times that all that needs to be said fits best in a poem. This can seem true to me even when dealing with heart specialists, who truly (reasonably so) love their own esoteric language. But I can get frustrated sitting in examination rooms, searching for the right words. It is challenging to articulate emotional nuances, sensory experiences, and random thoughts that accompany pain or sudden discomfort. Dizziness or breathlessness. A sense of suspension of time. Flashes of intuition that come from deep within–and how they can be an accurate alert system.  How can I tell Dr. P what it really is so he can better help?

Sitting on the table, the stethoscope against my back and chest, I often suspect that what my cardiologist hears is something other than what I hear within. Because I do hear my heart in my inner ear as well as feel its beating. Dr. P early on informed me that most people do not; some of us do. I had complained that it was annoying, sometimes distressing, but he reassured me that I was fortunate, as then I could quickly inform him when something seemed unusual, wrong. Reluctantly, I agreed, but how to translate it all?

Then came an appointment that built a bridge of communication with Dr. P. It was after the second stent implant 18 months following the first. My heart seemed confused and angry since the last invasions, even though relatively small ones–a fouth angiogram and the tiny stent implant. Despite it being successful, I had worse arrhythmias than ever. They distracted and interrupted my life. They hurt and alarmed. They reminded me, even when I felt  pretty well, that I had coronary artery disease. My heart chided me.

“If you were a musician I might be able to explain them better because they have distinctive patterns of rhythm,” I told him in exasperation.

He grinned. “It so happens I was a musician. I played trumpet in high school. So try me.”

“Good. Well, it’s like a run of sixteenth notes followed by a half-measure of rests, then maybe six or eight more sixteenth notes, then a rest that goes on so long I feel like I am going to pass out. Then a full note and it kicks back in hard with plain old four beats to the measure. And I’m back to normal. But sometimes it’s like acid jazz–free-form, you know? And it feels like it could actually kill me. ”

“So,” he said, “that’s great–I mean, this musical thing. I understand better.” He shook his head. “That’s sure a new way to interpret and explain.”

It was a relief that music had come to my rescue again. But that discovery also gave rise to musings about heart disease, music as central to my being and just how my life had been changed. And as I wrote, confoundment, a sort of awe and anger all came to the fore. So here is that poem–never given to Dr. P. One day, maybe. But it helped me.

Memo to a Cardiologist re: palpitations

I have told you what I know, how there are
hidden notes beneath the bursts of pain but
it is not like the songs of my childhood,
gentle and guileless,
nor the songs that I stole into the night to hear
when I thought I was old enough
to know some things, the music all bombastic and tricky.
This is more like jazz, all icicles and firecrackers,
split time and beyond time but
unable to quit, moon-dazzled and
howling but cool as can be.

Or it might be something else
all the notes and sounds that were forgotten
or shown the back door in a lifetime of concerts
now gathered and tossed onto taut drum skins,
sizzling, renegade rhythms,
speaking out of turn but not committed to anything,
damaging each other in their greed for recompense.

And then there are nights of errant dancers,
when they burst out of my ribs
and tap and stomp and slide across my chest,
their steps wild like bats in darkness,
pushing me from bed and into
the thick of it,
now a possessed woman, drinking air.

And all this time I think I need to write it down
for you, the quarter notes, sixteenths and dotted halves,
the peculiar rests amid the trills and fortes, decrescendos,
notes tripping over each other,
one long life/line of syncopated simpatico,
the rhythms daring me to do something, anything
when the beats heave themselves over a distant waterfall 
and are gone. Floating in rivers somewhere exotic.

Someone has called for intermission
and I am left with the wild taste of starlight and
hot blood, salt and the sharp reminder
that this is where I have been left and will have to resume,
my midnight manuscript in hand, pen poised,
the symphonic possibilities of Antarctica or Amazonia
still unheard by anyone but me,
this sudden incremental music
a foreshadowing of what is yet to come.

And it always comes, the second or third or fourth part
of this ordeal/song/ride to unknown destinations.
From here it seems dangerous and entrancing as
a white panther caught in a wildfire — I imagine her now
as I lay back–her feet scorched but poised for
a death-defying leap across the chasms.
This heart is beating like a thousand captive birds with
each tiny wing pushing against the wind,
all the way into heaven’s celestial soundings
and, perhaps, back home again.

copyright 20011 Cynthia Guenther Richardson