I guess I’m paying for the things that I have done.
If I could go back, oh, Lord knows I’d run.
But I’m still losin’ this game of life I play,
Losing and dying with the choices I’ve made.

George Jones; Choices
____________________

Three weeks ago, I got real sick and almost died. I can’t remember writing such an abrupt and brutal thing, ever before. So I guess I’ll say it again. Three weeks ago, I got real sick and almost died. Or, as I said on Facebook back then, after the fog had lifted some and my vital signs had balanced back from critical to stable. That was a bit of a near thing. I came very close to wandering off the reservation for good, there.

And there’s a couple of things I want to say, right here up front. There is no promise of tomorrow. Not for anyone, not ever, not anywhere. And the thing that stood out the most to me. I don’t care who you are, or what your work is here on this earth. You are expendable. I mean, you really are. It doesn’t matter what you’ve got going here. It doesn’t matter if you’re leading ten thousand people in a mega-church, or if you’re some wild-eyed prophet proclaiming the gospel to the poorest of the poor in the most remote wilderness. It doesn’t matter, your family, your sons and daughters. None of it matters. The Lord doesn’t need you, to fulfill his work. Sure, he may use you, and probably will, if you want to be used. But he doesn’t need you. You are entirely expendable.

OK. That all being said, I step back a few weeks. I hadn’t been feeling all that well, for the weeks leading up to that time. I wasn’t feeling all that badly, either, in all fairness. I mean, I had my normal aches and pains. When you’re fifty-four, you’ll have a few of those.

I don’t remember exactly when it was that I noticed my feet and legs were swelling up. It was a gradual thing, I think. I remember that Janice noticed my ankles had swollen some, down at the beach, in September. “You should see a doctor, when you get back home,” she told me. Yeah, yeah, I said. I didn’t mean it, that I agreed with her. I don’t like doctors. And I remembered all too well, how it went, back in March of last year.

I remembered it all. The bloody eye. The flutter heart. The ablation. And the aftermath. The Coumadin, that awful blood thinner they put me on, that made me sick. This time, I swore, the doctors wouldn’t get a chance to sink their claws into me. And so I kept an eye on the swelling in my legs. It would all get better soon, all on its own, I figured. Just give it a little time.

Well, it didn’t all get better, real soon or otherwise. My legs kept swelling. And then my stomach, too. Suddenly, there were only two old pairs of jeans that fit, anymore. Two pairs, from way back, when I was real heavy. I never hurt much, anywhere. And gradually, I got it figured out, of a morning when I got up. And late last month, on a Thursday, I made the decision. I would stop in at my family doctor in Leola, just to get checked out. I had no idea that morning when I walked out of the house. No idea that I was about to enter a strange and desolate land, a land where the death angel hovered close a few times. And it was just as well I didn’t know. It’s best not to know such things when they’re standing, lurking at the door.

My local doctor in Leola saw me after about an hour. The nurse checked everything. Height, weight, blood pressure. All was good, except the weight. I was about thirty pounds heavier than I’ve ever been. And it hit me why, and I told her. It’s the fluid in my legs. Everything is swollen. She smiled and wrote lots of stuff down on a chart. Next, the doctor came bustling in. He didn’t like what he was seeing. A short test, and he told me. “Your heart is beating way too fast. Almost double what it should be. I’m getting you into the Heart Group clinic this afternoon.” I thanked him, and waited in the waiting room until a nurse came out and told me the time and place of my afternoon appointment.

That afternoon, I walked into the Heart Group clinic on the edge of Lancaster. One of the main doctors there saw me. He looked at the numbers on the chart. “You really should be admitted to the hospital, at least until we can get the swelling under control,” he said. I don’t want to go to the hospital, I said. Can’t we do this as an outpatient? And he thought about it. “Come in to the hospital tomorrow, first thing,” he said. We’ll figure on shocking your heart back into the proper rhythm.” I thanked him, and left. I was relieved. At least I could get everything done as an outpatient. I knew I hated hospitals, from my last stay.

I was scheduled to check in at 6:45 the next morning. And I wasn’t supposed to drive in myself. So that night, I called Steve, my brother. Was there anyone around who could take me in at that early hour? “Yeah, someone would,” Steve said. “I’m planning on going to work, but I think Wilma can take you.” And that’s what we planned.

That Thursday night, I attended an Amish wedding feast, evening services. The daughter of a good friend of mine got married that day. As usual, I begged off, from attending all day. I’ll come in the evening, I said. And I went. I remember feeling a little tired, and a little short of breath that night. I ate supper at the side table with all the other ex-Amish, then begged a few pounds of fresh Roasht from the goodwife. And by eight or so, I was heading home with my loot.

And the next morning right at six, Wilma pulled in. I was ready. I had packed a few extra clothes, just for anyhow. You never know, when you walk into a hospital, when you’ll get out of there. I remember thinking about all that, clearly. And just before walking out to where Wilma was waiting, I did what I always do when leaving on a trip, or when leaving for the doctor’s office. I crossed myself. And I spoke to the Lord. Lord, I said. Bring me safely back to my home, I pray. Bring me safely back to my house again.

And right on time, Wilma dropped me off outside Lancaster General, at the James Street entrance. I’ll call you when it’s done, I told her. And I’ll be waiting outside, when you get here. I walked in to the check-in desk. After signing in, I was taken back to a corner that was curtained off. There, a cheery nurse checked all my vitals. All seemed in order. They would shock my heart back to regular rhythm around 9 or so. I settled in to wait, blissfully unaware that all I knew and loved as a normal world was just about ready to spiral, spiral down, down, down into a dimension I had never seen before.

A nurse stopped by to prep me for the treatment. She asked routine questions. Had I taken the drugs the doctor had prescribed the night before? Yes, I took them last night. But not this morning, because no one told me to. And right there was the first glitch. She called around, and the operating doctor said he would not do the shock treatment on my heart, because I had not taken that pill. I could feel it, all semblance of order passing away. Look, I told the nurse. Whatever we have to do, to get the treatment today. And eventually the head doctor came in and negotiated with me. They would give me the drugs, but I would have to wait four hours before they did the treatment. OK, I shrugged. I want it done today, and I want to get out of here today. Whatever works. So the nurse brought me a few pills and water. I swallowed those, and settled back to wait.

And the spiral just continued. Right at 1:30, a nurse fetched me and took me downstairs to the operating room. Here is where they would shock my heart into a regular beat. Everyone seemed all cheerful. This wouldn’t take long. I’d be out of the room in half an hour. They knocked me out, right there on the table. And twenty minutes later, I woke back up. My first words: Did the shock work? And the nurse answered, all matter of fact. No. It did not work. My heart was still in an irregular beat. I instantly felt it settling in me, the depressed state of mind. Now what? They trundled me back up to the waiting room, where I had spent all morning.

A young nurse practitioner walked in to see me. He spoke carefully. They were very concerned about all that fluid in my legs and stomach. He wanted me to check in, and get some treatment over the weekend. Then, on Monday morning, first thing, they would try the shock treatment again. I groaned. I don’t want to stay here, I said. Can’t we do this as an outpatient? The guy was really good. “Yes, we could. But we are very concerned. We feel like you should check in.” Of course. Doctors always feel like you should check in.

Give me half an hour to think about it, I told the man. He agreed, and turned and left. I made a few phone calls, and talked it over with family and friends I trusted. The advice was all pretty much the same. Check in for the weekend, then see what it all looks like on Monday. There are worse things than spending a weekend at the hospital, although I couldn’t really think of any right that moment.

The nurse practitioner returned in half an hour. And I told him. OK. Check me in. I’d way rather do this as an outpatient, but I’m going to trust that you guys know what you’re telling me. He nodded, and looked satisfied. He had done his job. He had kept me there. A nurse came in soon, and trundled me off to my room over at the Heart floor, on level six. I settled in, feeling sorry for myself. Hospital and hospital food. Those were just about the last things my mind would accept, right at that moment. Oh, well. It was what it was. Hopefully, I’d be out of here sometime Monday, by mid day.

And right that moment, from a dimension far away, the death angel looked on at the scene before him. He lifted his hand to shade his eyes from the setting sun. Well, well. This was interesting. Very interesting, indeed. They were admitting a new patient at Lancaster General. The guy didn’t seem all that willing. But the death angel could see from where he was. The unwilling new patient was sick. Very sick.

“Ah,” the angel thought. “Why couldn’t they have waited a few more days? Then it would have been too late. Then the call would have come.” He marked the incident in his mind, though. This was worth keeping an eye on. Only the Lord knew. But when and if the call came, the death angel would be ready. He was always ready. He prided himself in always being ready.

And that first night went about like I had figured it would. I dozed off, fitfully. No beeping machines in the room. Just an interruption every few hours, as a nurse or an aide stopped by to check my blood pressure and take my temperature. And Saturday morning dawned.

Steve and Wilma and my friend Gloria had stopped by the night before, to see me. And I had told them all. I feel just like I did when I wasn’t in here. I expect to be out by Monday sometime. Saturday morning passed, slowly. Noon. College football was on. I watched, switching between games listlessly. And by mid afternoon, suddenly I felt ill. In my head. And in my stomach. I hated to bother the nurses, but I pushed the call button. And soon enough, my nurse appeared. I don’t feel good, I told her. I feel cold. And my stomach hurts. She took my blood pressure. It was low. Another nurse brought in a bag of some liquid or other, and I was hooked to the IV line.

And for the next few hours, they checked my blood pressure and took my vital signs again and again. Things did not improve. And by four or so, they called in the nurse practitioner who was in charge. No doctors were around over a weekend, on the regular floors. So a nurse practitioner filled in. She had my blood pressure checked regularly. It kept plunging. And by five or so, she made the call. I would be transferred to intermediate ICU. Intermediate intensive care. I remember feeling mildly alarmed about it all. Would this mean I couldn’t get out of here on Monday? But mostly, I remember being cold. Very cold.

And in the IICU, they poked and prodded and did all kinds of tests. A whole bunch of company showed up, too. That’s one thing that amazed me throughout, the people who showed up. Family. Friends. Church people. And people I was surprised to see. And by ten, everyone had cleared out. I was getting colder and colder. And they kept testing me, taking my blood pressure. Around 11:00, the nurse practitioner abruptly made the call. I would be taken downstairs, to an operating table. A team would be called in. And the team would install a catheter into my neck vein. So they could shoot a bunch of drugs into me at the same time.

I was always conscious, through all of what happened that night. I remember clearly most of the details. As the team was being called in, I called my brother Steve. And I told him. They’re doing a procedure, installing a stint thing in my neck. So they can administer more drugs. “I’ll be there in a few minutes,” Steve said. Let the family know, on the Facebook page, I told him. He promised he would.

Less than twenty minutes later, Steve walked in. He looked a little stunned. But he was upbeat. At that moment, I had a pretty good idea that I was in pretty bad shape. I asked for a moment alone with my brother. And we spoke there intensely, me and him, there in that room that night. I told him where my important papers were, in my house. My will. And when I finished, he held my hand and prayed a short prayer. For healing. For comfort and rest. And then the IICU people pushed me off, down the hall, and around to the elevator. Down a floor, to the operating room. It was after midnight.

An aside, here, a few words. I’ve wondered sometimes why people fight so hard to stay alive, to hang in there one more day, when death comes calling. Especially older people. Why? Why fight for more time on this painful vale of tears? What good will a few more moments do you? Or a few more days? Or a few more weeks, or months, or years? In the end, the end will always be the same. Ashes to ashes, and dust to dust. In the end, all of us will die. All of us, without exception.

For me, that night, well, my vital signs were plunging. The lowest blood pressure I heard was 50 over 35. That’s almost comatose. But I was awake, and totally alert. There were a whole lot of emotions that waved through me. But there was one emotion I never felt. And that was fear. I felt none. None at all. Maybe it was the drugs. Maybe I was just exhausted. But I remember thinking, quite clearly. Lord, you know who I am. If you take me home tonight, then so be it. Sure, I want to live. But I got no immediate family. No wife. No sons or daughters. No one, really, who will long remember. So it doesn’t really matter to me what happens. Some things are worse than death. Like a stroke, where you’re totally helpless. Or Alzheimer’s, like Mom had for all those years. Spare me from such a fate. If that means you take me tonight, then take me tonight.

The operating team had me in and out in about half an hour. The catheter was installed in a vein in my neck. And the next thing I knew, I was being wheeled up and up. The ICU, the real intensive care unit. That’s where they were taking me. They wheeled me in right at 2 AM. A male nurse (I think his name was Noah, but I was a little groggy.) and his assistant greeted me. And right there at that moment, as I was being wheeled in, I was as close to death as I have ever been. I was immediately hooked up to many bags of powerful drugs, to make my heart beat stronger. At that moment, my heart was functioning at 30% strength. I knew none of this until later. And for the next two hours, the nurse and his assistant worked feverishly, to get all the right drugs hooked up and flowing to all the right places. By 4 AM, they were done, and I settled back and actually drifted into slumber.

And late that night, the death angel hovered near, his dark sword drawn to strike. He lurked there like a giant specter, waiting for permission. All was silent. The word did not come. And still, the death angel waited. And still, no word. The angel stirred, then, and turned and spoke to his boss.

The death angel was disappointed. But he shrugged, resigned. His time would come, soon enough. And then he turned, and left the room.

And that night, as I slept, the battle raged for my life in the desolate wilderness. My legs were filled with fluid. As was my stomach. And my lungs had started to fill up, too. Another week without treatment, the doctor told me later, and I would have been gone. That night, the drugs worked in overdrive to shore up a greatly weakened and damaged heart.

As I slumbered on, the valley bottomed out before me. And I started struggling, struggling weakly, up and out the other side. It was as close as I’ve ever come to letting it all go. All of life, and all that life is. And I was exhausted enough that none of it mattered much to me, one way or the other. Only the Lord knows how hard the battle raged. But I remember coming up, awaking from a deep sleep. I glanced at the clock on the far wall. 8:30. And then I heard a familiar voice outside my room. Steve. He had decided to skip church, and come in. I called out to him, and he approached, smiling almost shyly. He reached out and held my hand and asked how I felt. A lot better than I did last night, I told him.

They had brought me food. Breakfast of some sort. It was not appealing at all. Smelled like slop. I could think of only one thing I was hungry for. A fruit cup, with mixed fruit. Can you get me some fruit from the cafeteria? I asked Steve. And he immediately left and went downstairs to bring me the first of dozens of servings of fruit. That’s all I was hungry for, those first few days. And that’s all I ate. Fruit. Fresh, life-giving fruit.

And that was as low as the valley got, on that little journey. That first morning, the drugs had obviously taken hold, and I felt a lot better. For five long days, I stayed in ICU, in critical condition for at least the first two if not the first three. Five days, and I was so tired during most of that time that it never occurred to me to grumble about anything. Well, except for the food, maybe. That stuff was just flat out inedible. But otherwise, I settled back and rested. Each day brought more color to my face and more life to my body.

And the family closed in, in ways I simply could not believe. Janice took over, from her home in Phoenix. And she scheduled things. On Tuesday, my nephews, John and David Wagler (Joseph’s two oldest sons) arrived from their homes in the Midwest. They had left their families, and would stay a few days. Then their younger brother, Mervin, arrived on the train from his home and family in upstate New York. And they all came in to see me, kind of awkwardly. They weren’t used to seeing their uncle, laid out flat and helpless like I was.

Steve provided the base for all the visitors who needed a place to stay. On Wednesday, my younger brother Nathan showed up with our nephew, Ivan Gascho, one of Rosemary’s sons. Ivan had left his family to get there and to travel with Nathan. I was happy to see everyone as they came. And definitely a little awed and humbled, that family took so much time and made so much effort, just to come and see me.

Wrapping it all up, then. After five days in ICU, I was moved to a “regular” room on the sixth floor, where the heart patients go. The next morning, early, they took me downstairs and stuck a camera up through one of my veins to check out my heart cavities. I was told. There will likely be some clogged arteries. And the first bit of all-good news came at me, there. My heart was totally clear. Totally. No obstructions at all. I could see the doctor was surprised. But he tried not to let on.

And the days were winding down, then. Sometime late that week, my heart jumped back to normal sinus rhythm, all on its own. Well, with the help of lots of drugs, of course. A lot of drugs that I’ll be taking daily, for the foreseeable future. The heart-failure doctor gave me strict, strict orders. A low-sodium, no-salt diet. Drugs, every morning and every night. And no alcohol at all, not even a drop. That’s my world right now. And it will be my world for a while.

A quick word here, about all the people, all the friends who flocked in to see me. I mean, I look back at how many people I’ve visited in the hospital, and I think I can count them on one hand. It’s been that sparse for me. But people showed up at my room every day, and every evening. Friends. Church people. The last Saturday I was there, in late afternoon, a tall, familiar figure walked through the door. My friend and fellow author, Jerry Eicher, had driven 4-1/2 hours from his home in Farmville, VA, just to see me. Jerry was instrumental in connecting me to the publishing world through people he knew, years ago. I will always be indebted to him for that generosity. And here he was, in person. I was astounded. We visited about the publishing world in general, and the old days in Aylmer. And he told me it’s time to get serious about a sequel to my book. After less than an hour, he turned and took off for his home, 4-1/2 hours away. I was impressed and deeply touched to see him.

The doctor thought that I might get released the following Monday, if all went well. I was excited and eager to hear the news. Sometime on that last Sunday, I was unhooked from all IV tubes. I felt unbelievably free. I could get up and just walk around, whenever I felt like it. It was all pretty simple and it was all pretty amazing.

My nephew, Andrew Yutzy (Rachel’s oldest son) was scheduled to fly in from his home in Missouri to be with me for a few days early that week. It turned out that he would arrive at almost exactly the time I was being released. He texted me when he landed in Baltimore, and I texted back my location and room number. Just get here when you get here, I told him. And shortly after 2 PM, he strolled through my door, all decked out in Iowa Hawkeye gear. Those Midwesterners sure aren’t shy about which team they’re rooting for. We hugged. And then we picked up my bags and a few bouquets of flowers that had appeared from somewhere in the last few days. And we walked out of that hospital, ten days after I had entered it. I was almost exactly thirty pounds lighter than when I had walked in. That’s how much fluid was extracted from my legs, my stomach, and my lungs.

Half an hour later, Andrew pulled his car into my drive and parked. We carried my stuff into the house. And I told Andrew. When I left for the hospital that morning ten days ago, I stood right here in the kitchen and crossed myself. And I asked the Lord to bring me safely back home again.

“Well,” Andrew said. “He certainly heard your prayer. You are safely home, now.”

Yeah, he sure did that, I answered. And believe me, I’m thankful to be home. It just took a lot longer to get here than I figured it would when I left.
****************************************************
Aftermath: It’s been different, since I got back home. A whole lot of lifestyle changes kicked right in. I can’t eat any food that tastes halfway good. The main doctor, the one that saved my life, has been all grim about a lot of things. This past Monday morning, during a follow-up checkup, he told me I’ll be on drugs for the rest of my life, a statement that spiraled me into real depression. I just couldn’t believe him when he said my heart will always be weak.

And on Wednesday, my hunch was backed up by the A-Fib doctors. I sat down with a real nice lady, and we just talked for a solid hour. She told me many things. My heart has stayed in rhythm, and is at 60% strength, up from 30% when I checked in. The drugs I’m on are toxic and they want to get me off all prescriptions ASAP, probably within a few months. They are hoping the heart will get strong enough to go in and do an ablation. Sear some muscles. And she told me. There is no single definitive factor that caused my heart to go off-beat like it did. I’m an enigma.

And she chided me a bit. “Keep closer track of your heartbeat. If it goes A-Fib again, it’s not an emergency. But let us know within a day or so.” And she told me. “You went right up to the edge of the hole and looked down, into the pit. We don’t ever want you to do that again.” No, no, I said. I won’t ever do that again.

And that’s how our conversation went. Compared to all the gloom and doom the heart-failure doctor had dumped on me, I was just ecstatic at what the A-Fib doctor told me. Yes, I am on some strict restrictions. And yes, I will walk the line I need to walk. But I’m hoping pretty strongly that one day my heart will be normal, or close to normal, again.

As always, the Lord holds the future in his hands. So I can only wait and see what tomorrow will bring.