Who Beats
Your Heart?
You know you have a problem in the Emergency Room when you are lying there on the gurney, hooked up to machines, the dials behind you, on the wall, and the doctor, about fifteen years old, looks at your vital signs and turns away and says I'll be right back and he's not to be seen for a half-an-hour or so.

In my case, the doctor who came back was a cardiologist. She looked at my vitals and said, "You need a pacemaker."

"I can't hear you," I said. "On top of everything else I'm hard of hearing." She said it again, "You need a pacemaker."

"Give me a couple of days to think about it," I said.

"If you want to leave you know you can't drive," she said. "It would be very dangerous."

"It might be temporary," I said. "Can't you give me some pills?"

"There is no medication for it," she said. She unwound the seismic paper from a roll and showed me that there was something missing. Like every other beat of my heart. Sometimes more.

I call my brother. They gave him a pacemaker in 1988. "Piece-of-cake," he says. He tells me that if he hadn't done it, he wouldn't be here now. "I just had my battery replaced," he says. "Piece-of-cake."


The operation, like most, is quick, and they try to get you out of there within twenty-four hours. Before you go under, you can have anything you want. I say to the anesthesiologist, "Give me the best you got." He did. For a while there, I was on the sunny beaches to the south: gentle winds, seas, waves, palms.

The next day, my cardiologist came in with a computer, part of which she klunked on my chest. For fifteen minutes, she tweaked up my new heart-part, offered to give me a bit more oomph for a bit less battery time. The pacemaker manual she gave me had the expected rosy pix of rosy geezers on the cover: Wrinkles --- but not too many. Hearty smiles --- enough. Dentures --- but not too many.

The Medtronic manual she gave me told me I must avoid arc welders, advised me not to be working on automobile engines or around radio or television transmitters. Watch out for iPods, whatever they may be. No lifting of heavy objects and, for a month or so, no golf at all. A 240-yard drive might pull the stakes that had just been driven into my heart.

As I read this, a song kept running through my head, the one sung by Marilyn Monroe,

    While tearing off a game of golf
    I may make a play for the caddie;
    But if I do, I don't follow through,
    Because my heart belongs to Daddy.

§     §     §

On Google, I read at length about several pacemaker recalls. I remember thinking that it's not like recalling a lawnmower or even a car: It goes deeper than that.

I also find that I am one of three million people in this country with a pacemaker --- me and Dick Cheney (he does have heart) --- and that the concept was invented in 1948. The early models weighed in at a pound or so and operated outside the body, with glowing vacuum tubes and cables.

I also find that the rock star Martin Bullock just got his replaced. His band, Mogwai, has been influenced, so his home-page tells me, by My Bloody Valentine, The Dirty Three, and The Jesus and Mary Chain. Their style is a mix of something known as "shoegaze" and "math rock." Their latest hit is "Mr. Beast."

He --- Mr. Bullock, not Mr. Beast --- is planning to auction off his old pacemaker on eBay, proceeds to go to the Heart Association. This tells me that, in five or seven years or whenever time before my current pacemaker dries up, and if I survive so long, and if my fame somehow gets into the stratosphere alongside Mogwai, I will be able to turn this new body-part into a bonanza for the charity of my choice.

At another site there was some discussion of whether, despite this new battery-operated device I carry about with me, my heart would keep on pounding when I abandon this vale of tears. The answer is no, apparently, because the original pacemaker, the one that I was born with --- the sinoatrial node --- will, with my departure, go out of business, shut down, take a walk. This new unit only follows the leader, doesn't take up the rhythm when there is no band, Mogwai or no.

One site went on at length about "Twiddler's Syndrome." I thought that was yet another rock band but that's not it. Some people, when they have this new toy in their chest, just won't leave well enough alone. They keep twisting it, twiddling, twiddling, as if it were a radio dial, a TV remote, a stereo system. I have been warned.

"Who beats your heart," asked Alan Watts in one of his last talks, in 1965, just before he died (of heart-failure). I used to not know, didn't much care. Now I know. Medtronic does. It does so as we speak, will be doing so tomorrow, the day after: for the rest of my born days. At least will be doing so ... until I auction it off.

--- L. W. Milam
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