Plumbers and Electricians

I don’t pray because it makes sense to pray. I pray because my life
doesn’t make sense without prayer.   
Noah Benshea[i]

Retirement is deceptive. You’re lulled into thinking that things will pretty much go on as they always have. They usually do. But then, life happens.

I’m working in my college office when the phone rings. “Jim, I don’t know what to do. I’m just sitting here on the sofa sewing and three times I’ve felt faint—like I’m about to pass out.”

My mind races. Is this just in Barbara’s head? In the past, I’ve joked with her that I’ve decided on her epitaph: “I told you I was sick!” But what if something’s really going on? She’s never complained about feeling faint before.

“How often is this happening to you?

“About every half hour or so. Oh! I feel like I’m fainting now!”

“Okay—I’m calling 911 and I’ll come home as soon as I can.”

I call 911, run out to my car, and drive home, praying as I go. When people ask me how prayer works, I always have a ready answer: “I don’t know. But the Bible tells us to pray, and Jesus prayed, so I pray.”

When I wheel into our driveway, there’s a white paramedic van sitting in front of the garage, and they’re rolling Barbara out on a stretcher. She gives me a wan smile as they roll her in. I can almost read her mind—Oh, don’t worry about me. I’ll be fine. They’re just going to take me in to check me out. I’m not reassured. I jump into my car to follow the wailing siren.

The emergency room people admit Barbara immediately and hook her up to an EKG monitor. Sure enough, every eighth beat or so, the little squiggly line gets tired, flattens out, and squiggles more slowly.

After a short wait, Dr. Olinger walks in. “Your heart monitor indicates you’re skipping beats once in a while.” He’s in his early forties with alert, spiky brown hair, no glasses and the requisite white coat. He sits relaxed with crossed legs, talking calmly about life and death issues.

“We’re going to keep you overnight for observation and then we’ll probably give you a monitor to keep an eye on those skipped beats when we send you home.”

But the next morning, Dr. Olinger comes in, “I don’t like those skipping beats. We have ‘plumbers’ and ‘electricians’ here in the heart center. We’re going to send you to our ‘plumbers’ for an angiogram to see if any plaque is plugging your arteries.” I smile and nod my head in agreement.

Not Barbara. “I don’t want an angiogram.” This is vintage Barbara—even in the midst of medical emergencies, she’s still in control, questioning, making her own decisions.

“Well, we can just send you home with a monitor and take our chances, but what if you pass out again? I think you need an angiogram to check for blockage.”

“How do you do that?”

“Well, the doctors will insert a tube through your groin with a tiny camera on it and go hunting through your arteries.”

“What are they looking for?”

“They’re looking for blockages. We’re wondering if a partial blockage might be causing your fainting spells.”

“What if they find one blocked?”

“Then we can immediately put in a stent. It’s a little mesh cylinder that we insert collapsed.” He shows us a picture of the stent. It looks like one of those Chinese finger puzzles that you put your fingers into and then can’t pull them out. “After it’s inserted, we inflate a tiny balloon to push it out against the artery walls. In a few months, it gets ‘adopted’ by the artery and feels right at home there, and it’ll hold the artery nice and open.” I’m nodding my head to encourage Barbara.

“I don’t want a stent.”

But eventually she relents and decides to have the angiogram. I sit outside, wait and pray. After what seems a long time, they emerge and I walk alongside with my hand in hers as they roll her back to her room.

Dr. Olinger comes in and reports, “We did an angiogram and found a 70 percent block in your ‘widow maker’ artery.”

Widow maker? I think, That doesn’t sound good. He shows me the X-ray and I can see a narrowing in the artery that runs across the front of the heart.

“It’s called a widow-maker because if it’s completely blocked, you die. But we put the stent in. Hopefully that’ll take care of it, Barbara. We’ll keep you overnight and send you home tomorrow morning. But we’ll give you a monitor so we can keep an eye on your heart.”

Barbara’s having trouble getting used to the idea of an invasive stent in her body.

In the morning of day three, I’m watching the EKG screen. The squiggle’s mostly behaving itself but sometimes it stops and rests a couple of seconds.

Dr. Olinger says, “Hmmm. I don’t like the way the EKG looks. I don’t think the stent took care of the problem. I think you need to see an electrician.”

“Why? What’s that?”

 “The ‘plumbers’ work with the mechanics of the heart; the ‘electricians’ specialize in the electrical circuits that energize the heart. The heart nerves shock the muscles and contract them. One shock contracts the upper part of the heart; the other contracts the lower part. We’ll check them both out. They’ll stick a thin electric wire down into your heart area to see if the current is flowing normally to your heart.” He talks as if they’re checking your car’s ignition harness or something.

“I don’t want a wire in my heart.”

He gets up, walks over to his butcher-paper flipchart and draws a diagram of the upper and lower heart chambers, the little nerves that deliver shocks to each and the “bundle branch” in between that acts like an electrical switch that causes the lower muscle to contract just after the upper one does.

“We need to see if everything’s working.”

Barbara asks, “What happens if it’s not?”

“Well, since we’ve installed the stent and it hasn’t made any difference in your heart rhythm, we think you have a ‘bundle-branch block.’ This little switch here isn’t always working like it should.” (He points to the flipchart.) “If we find that it’s defective, we’ll install a pacemaker here to regulate the electric pulses.” He reminds me of my mechanic when he told me, “All you need is a new alternator.”

Barbara’s not convinced. “I don’t want a pacemaker.”

“Well, you don’t have to get one. You can just go home and see if you start fainting again. Why don’t you two just talk about it for a bit and I’ll come back in a while.”

Barbara’s looking at me. I’m looking at the green squiggles.  “We’d better let them check out your electric circuits.”

“But I don’t want a pacemaker.”

“They said they’d only install one if your electric circuits aren’t doing the job.”

“Yeah, but they’ll probably say I need one. I don’t want a wire in my heart.”

“But Precious, I don’t want you to have another fainting episode. Why don’t we pray for wisdom here? We need to make a decision.”

We pray. Dr. Olinger comes back in, and looks at Barbara. “You’re mad at me, aren’t you?” he says.

She laughed. “I just don’t want a pacemaker.”

“Well, you can always just go home and hope for the best.”

“Well . . . Jim thinks we should get it checked out, at least.”

“We can do that but if we find it isn’t working, we need to install a pacemaker.”

“Well . . . okay,” Barbara says, brow furrowing. “But I don’t like it.” Pen poised hesitantly, she ponders the permission document that has phrases like, “You might be disabled” or “you might die” or whatever. I can see her mind racing. It’s not that she doesn’t trust doctors—it’s just that she doesn’t trust them very much. She seems more comfortable with chiropractors, herbalists, naturopaths, or nutritionists.

Finally, she signs.

Barbara and I have had many conversations about health. She doesn’t seem to appreciate my personal philosophy—”Everybody needs to believe in something. I believe I’ll eat ice cream.”

If I complain of any health problems, she usually says, “Well, if you’d eat better, you’d probably feel better.”

“Maybe, but I’d rather be happy than healthy.”

(Eye roll) “Well, don’t expect me to take care of you if you get disabled.”

I think, Empty threat! I guess that’s the chance I’ve got to take.

She insists, “Why don’t you ask your doctor if you should change your diet?”

“Well, because I’m afraid he would say yes. Anyway, I think that if my body craves something, that must mean it’s good for me. I’d rather just take pills for any problem. Besides, what if I ate healthy for years but then got hit by a truck—all that sacrificial eating would be wasted.”

(Harder eye roll, furrowed brow. Then silence). I fear she’ll get her revenge when she writes my epitaph: “I tried to tell him but he wouldn’t listen.”

But now I’m concentrated on Barbara’s heart. They roll Barbara away to the procedure room and in an hour roll her back in.

“They put in a pacemaker,” she says. “I’m not too happy about it.” She shows me the purple bulge near her collarbone with the red slit and stitches. (Later she’ll show it off to relatives, friends and strangers.)

The nurses hook her up to the EKG, and I watch the little green squiggle. It’s squiggling perfectly, not missing a beat. “Barb; that means you won’t faint again, and if you should have more problems, the pacemaker will jump in and take over—it’s good insurance.”

Dr. Olinger comes in and explains that she must take Plavix for twelve months to prevent her stent from clogging up. “If your artery blocks again, you will probably die.”

“I don’t want to take lots of medicines.”

I say, “But Barb, you don’t want your stent to get clogged up.”

So she tries Plavix for a week; then we return to see Dr. Olinger. “I can’t take this medicine; it gives me headaches and I can’t sleep.”

“Well, headaches are better than dying.”

“Well, I guess I’ll just have to die.”

I feel like I’m in the middle of a food fight between people from two different cultures.

“Well, we can stop the Plavix and try putting you on Effient, but only if you don’t read the side effects!” (He laughs.) “But you have to take it faithfully every day for a year. Take half a pill in the morning and the other half in the evening.”

Barbara has always considered a prescription more a suggestion than a command. She starts the medicine, but at her own pace.

The next time we see Dr. Olinger, Barbara says, “You’re mad at me, aren’t you?”

He laughs. “Have you been taking your Effient?”

“Yes . . .  I take the half pill every morning but I only take the evening pill on alternate days.” Dr. Olinger groans, holds his head in both hands and drops his head onto the table in mock horror. “Barbara, you’ve got to take this regularly, or your stent might clog up.” Barbara smiles and says she’ll try.

*          *          *

Now it’s a year later, and Barbara’s feeling very good. She wasn’t kidding—she was very ill, and I’m grateful she’s feeling better now. She telephones in every three months so they can remotely check pacemaker function. Her Effient pills are finally done, but the final month she’s cut down to one-half pill per day. Did I mention she makes her own decisions about medicines?

Now we’re at Barbara’s last follow-up visit with Dr. Olinger and he’s smiling. Is it because Barbara’s doing so well, or because he won’t have to deal with her any longer?


[i] Noah Benshea, Jacob the Baker: Gentle Wisdom for a Complicated World. Random House, 1989.

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