Saturday, November 23, 2013

8 Minutes

By Mark vonAppen

I wake up to a spunky gal standing at the foot of my hospital gurney in bright blue scrubs and a skull and crossed bones bandana.  

She says my name.

I stir from my fog.  Sleepy from medication and an irregular heart rate of 61 to 190.  I say, "That's me."

In a voice that is entirely too chipper for me, she bubbles, "I'll be your anesthesiologist.  You're scheduled for a cardioversion, right?"

I think, she's awfully plucky.

Plucky it is.

"When's that?" I ask absent-mindedly.

She draws back the curtain, looking at the clock on the wall she says, "Hmm, in eight minutes."

My mental brakes seize. 

Eight minutes?  My mind swirls, my body tangled in wires, I sit bolt upright.  They said they were going to do this, but they didn't say exactly when they were going to do it.  

I'm not ready yet.  I have a lot left to do.  

Eight minutes.

When someone tells you that they're going to put you to sleep and momentarily stop your heart by shocking the shit out of it and then restart it in eight minutes, there is a sense finality associated with it.  My lack of any control of the situation is as palpable as the dysrythmic liquid slamming of my broken heart.

My phone is almost dead, "Can I call my wife before you stop my heart and jump start it again?"

I need a phone charger.

Plucky opens her fishing tackle box of night-night drugs on a table next to me.  "I'm going to be giving you propofol."

Isn't propofol the same stuff Michael Jackson's doctor overdosed him with?  Michael Jackson took the big sleep on that stuff.  I hope I wake up. 

I hope you're good at math Plucky. 

15% battery life...

The blood pressure cuff squeezes my arm.

Seven minutes.

A nurse horses in a defribillator.  I sit in detached wonder as she places a patch on my chest and another on my back.  Is this really happening?  A guy in scrubs walks in, "Is your blood pressure usually this high?"  I reply, "No, but then it isn't every day that somebody says, 'We're gonna stop your heart for a second and then restart it by shocking it.  It usually works.'"

So there's your answer.

Six minutes.

My fingers stumble across the keypad of my phone, dialing my wife's number.  Please answer.  What if this is the last time I talk to her?  What do I say?  The kids are at school, will I see them again?  She answers, I try to explain what the doctors have planned for me.  

She cries.  

The cardiologist walks in holding a cup of coffee, his medical student in tow.  The student is listening too eagerly for my liking.   

My wife doesn't want to understand what I am saying so I try to explain again.

Please don't cry.  

It's not working. 

I hand the phone to the cardiologist so he can explain in cool doctor-speak.

My battery is going to die.

Five minutes.

This should work; right?  What could possibly go wrong?

My car is such a mess, how embarrassing.  Everything that I worked so hard to achieve, nothing matters except what happens right now.

A moment has never seemed so real.   

Plucky cleans the IV port in my arm. 

My son has a football game today.  I wonder if I'll get to see it.   My daughter sleeps with her soccer ball.

I take a deep breath and savor it. Be here now. Everything before and after is just a story.   
Four minutes.

A clipboard and pen are thrust in my face by another doctor who is trying not to spill his coffee as he parts the crowd around me.  "This says that you consent to the procedure.  I need you to sign in a few places."  Turning the page, "This one says that you understand the risk of the procedure, including death."


I sign the pages.  I sign all control of my life away.

More nurses and doctors walk in and surround my bed.  As a rule, eye contact is avoided, but when it is made I get the requisite look of sympathy.

The heart monitor beeps erratically, and the blood pressure cuff squeezes tight again. 

None of these people know me.  I could die in the company of complete strangers as the one person who cares most about me is driving in a panic to get here.  If I do die, I know how it will go, "It was such a bummer.  We had a 42 year-old male who died today when we attempted a cardioversion.  Sucks for him."

I'm just a 42 year-old male.  I'm a problem.  Every doctor that walks in the room sees me as a 42 year-old male with an acute medical problem.  I'm a statistic.  I have no name or personality.  

The doctor hands me the phone.  He hung up with my wife.  

I didn't get to say goodbye.

This wasn't long enough.

I wanted to say goodbye.


Three minutes.

"His blood pressure and heart rate are going up," a disembodied voice says.  "We need to get this thing going."

Plucky asks, "Are you doing okay?"

The cracking of my voice betrays me.  I croak, "Yeah."

Peter Brady.

Keep it together.

A nurse lays me flat.  The light above me is entirely too bright.

Plucky says, "We're going to give you some oxygen."

I hold the mask to my face.

I say, "Why do they give you oxygen when your plane is about to crash?  Because oxygen gets you high," and chuckle at my contrarianism.

Nobody gets the reference.  As usual, my brilliant sense of humor is evident only to me.  

I breathe deeply from the oxygen mask.  What if I wake up and I'm somewhere else.  What if I'm nowhere at all?

Two minutes.

Be here now.  Everything before and after is just a story.  

The kids were asleep when I left this morning.  What was the last thing I said to them?  

What will I be remembered for?  What did I accomplish?

Have I been a good father?

This can't happen to me.  

Everybody that this happens to thinks it can't happen to them.  Then it happens to them.  So much for immortality.

I am always in control.  I fix things.

Everything is fine.


Plucky says, "The propofol is going to make your arm burn a little when I give it to you."

"What time is it?" I ask.

It's time to go to sleep.  I hope it's not the big sleep.

The syringe enters the port.  

One minute.

What if I wake up to nothing?

I don't feel anything except regret.

I take a deep breath and savor it.

I say to no one in particular, "My arm is starting to burn..."


Wednesday, November 6, 2013


By Mark vonAppen

What do you believe in?  Do you believe everything you are told?  Do you always do exactly what you're supposed to?  I believe leadership is a two way street.  Do you believe in that?

What motivates you?  Is it the promise of moving up in the world and the status that supposedly accompanies it?  What if I told you that getting to the top by any means other than hard work won't garner the respect of your peers?  What if I told you I'm not exactly like everybody else? 

I won't follow anybody just because somebody tells me to.  Never have, never will.  I make up my mind about who to follow based on the character they demonstrate.  I believe in character, not characters.   I won't follow somebody just because they wear a badge of higher rank or hold down a position that wasn't earned the hard way.  I might obey, but I won't follow.  I am not so blinded by positions of power that I validate and give respect to all who claim it.  You shouldn't either.

What motivates me?

  "I am amazed at honesty's ability to cause people to deny, become enraged, or be a catalyst for change."
The level of honesty that is required of a leader is what motivates me.  A leader can  identify weaknesses, need, even point out (unpleasant) reality in order to help others overcome them without causing resentment.  Honesty builds trust.  By making those you teach face reality you help them build character.  The type of person who derives power from intimidation, empty promises, and inconsistent policies will never truly lead effectively.  One who is a mentor must encourage the mentee to ask good questions of those in charge, make no excuses for passion, and tell the truth about their performance and experiences so that they will grow.  A leader with heart tells the truth.

How do you build character?
  • Ask good questions 
  • Make no excuses for passion 
  • Tell no lies about performance

What do you believe in?  Authority and dogma, or honesty and respect?  Fame, titles, wealth, or authority have never impressed me and they shouldn't impress you.  A body of honest, quality work commands respect.  I am awed by the power of honesty and integrity.  We all should be.  I am amazed at honesty's ability to cause people to deny, become enraged, or be a catalyst for change.

Whether someone likes you or not is immaterial.  Whether they respect you is not.  Respect is earned through consistently fair actions and built through trust.  Respect is built on character.  When you teach someone something learned through the lessons of your life it isn't you who is doing the teaching, it is your experience.  Some people believe that one person can't make a difference, but that's a big lie.  One person with passion is all it takes to make a difference.

What if I asked you where your heart is?  Could you tell me?  Would you have the courage that it takes to tell the truth?