“The First Heart Attack” by Rachael Wesley

The roots of my first significant mental breakdown were planted unknowingly during my divorce.  Though I initiated it, the split with my husband forced a lifestyle to which I could not adapt. The mental trauma festered, untethered and unknowingly, within my brain before the first noticeable signs appeared.  I was caught off guard when they arrived on a Tuesday evening in May.

 I had just finished a dinner of soba noodles and raw vegetables, wet and flavored from a sauce of soy, lime juice, sesame oil, and a variety of Asian spices.  This dish was easy and standard for me now that I was cooking for one.  Dinner was eaten in the same place every night, perched on the left side of my gray sofa in front of the television.  Even when Jason lived here, this was my spot. There were adjustments to make when my ex-husband moved out, but I thought I liked how my evenings had morphed.  They were no longer spent thinking of things to converse about with him.  There was no need to compromise about what we ate for dinner or what we watched on television.  I could eat soba noodles three times a week and watch HGTV for hours if I wanted.  This was the night I stopped enjoying my quiet evenings alone, and an awareness of how terrifying my new life could be awakened within me.

This tangible loneliness was far different from the abstract lonesomeness I had felt from an unhappy and unfulfilling relationship. Dissatisfied with everything about my marriage, I had struggled to revive our love for months.  I had little in common with my ex; our weekly dates were generic, quiet dinners out, the silence punctuated with banal conversations of the day’s events.  He wouldn’t join me on arranged group hikes in my attempt to make friends.  I lost interest in watching him play soccer.  This dying relationship imbued me with a unique loneliness. While he sat beside me on the couch, I would suffer intense isolation from wanting to connect with someone other than him.  His warm body was present but nothing else was.  Our relationship included no intimacy, no merriment, no sex – all replaced with plenty of arguing, tension, and nights alone in bed.  I felt disappointment and anguish in what we had become.  I longed for a partner to provide me with the laughter, conversations, shared experiences, and orgasms I desired.  It would have been better if he wasn’t there.

And then he wasn’t, and I was truly alone.  I liked the new arrangement for four weeks.  That changed with the chest pain.  The ache arrived while sitting in my spot on the couch, my dinner of soba noodles devoured and cleaned up an hour ago. I sprawled lazily with my legs on the couch extension, fully consumed by the digestion process.  Then, a sharp pain struck the middle of my chest, bullseye exactly between my breasts. I registered the slight change within my body like a gunshot victim feels the bullet.  My right hand shot to my chest. 

I’m having a heart attack.

I was a week away from my thirty-second birthday.  How could I be having chest pains?  My mind and body joining forces to play a joke on me wasn’t a novel trick.  As a five-year-old I was convinced a scratch on my neck would decapitate me and this bold health anxiety followed me through adulthood.  A sudden headache, random pain, or a symmetrical but new birth mark all had potential to throw me on a death spiral, but there was always someone around to talk sense into me.  With my ex gone, I now lived alone for the first time in my life.  There was no one to instill logic and reason.

 I pressed my hand down, away from my chest and back in my lap, and turned to the Paul Rudd movie I was watching.  I willed the pain to go away with a forced a laugh, trying to concentrate on something other than my chest.  If I stopped thinking about it the pain would go away, but it intensified. The sharpness rose to my throat and I could focus on nothing but my discomfort.  My hand went back to my breastbone, rubbing compulsively with the vigor of a shaman using his connection between the physical and spiritual world to evacuate the pain from my body.  I rubbed until I was left with soreness and bruising from the constant massaging.

I walked to the bathroom and sat on the toilet with my right hand glued to my chest.  Was I going to collapse on the toilet and leave this world in the same manner as Elvis Presley, but with none of his fame?  It would take far longer for somebody to find my body than had the King’s.  I feared it would be the smell of my rotting corpse that alerted others.

This grotesque image spurred me to action.  I put a sports bra on beneath my T-shirt, not bothering to change from my sweats.  It was approaching eight o’clock and the twilight sky was more navy than pink.  Though irked I had to leave the house after I was “in” for the night, my fear of dying far exceeded this minor irritation.  I left the house in a fluster as my anxiety grew, hand still pressed firmly to and rubbing my chest.

My hooptie, a muted red Kia Rio, was parked beneath a covered parking spot which shielded the paint job from the harsh Las Vegas sun.  I turned the key in the ignition and chose NPR over music.  The seriousness of the situation warranted the national news over funky jams.  I briefly wondered what would happen should I pass out at the wheel.  A call to 911 would have avoided this potential car crash disaster. 

But somewhere in the back of my head I knew this was not a heart attack.  I was young, ate healthy, and exercised daily.  I had no pre-existing conditions that would put heart disease on my radar and I never avoided annual health appointments or bloodwork.  This trip could have been avoided if my Vegas life was not so solitary. Without the distraction of company, I could not stop the death march playing on repeat in my head.  Chords of logic could be heard, just not enough to keep me at home.  Off to Urgent Care I went, but by my own locomotion instead of in the back of an ambulance.  It was a tug-of-war between logic and absurdity with neither a clear winner.

I arrived at the Urgent Care fully conscious and still alarmed, the pain no worse but no better.  The interior screamed in depressing tones of muted yellow.   Reminiscent of the 1980s, the harsh fluorescent lighting exacerbated the melancholy mood created by the cream walls, beige carpeting, and cheap brown wood chairs. The room was occupied by two other sets of people waiting to be seen and a middle-aged woman handling the check-ins at the desk up front.  I approached her.

“Hello,” I said to her.  “I’m having chest pains.”

The woman looked me up and down, taking in my age and appearance and assessing my declaration.  “Honey, are you sure?”

I nodded my head and pressed my hand again to my chest.  “Yes, right here.”

She nodded.  “OK, because we take chest pain serious around here and the doctor will take you back before these people waiting up here.”  She motioned to the others in the waiting area. 

Her words reassured me.  I was grateful someone was acknowledging me and my predicament.  She made photocopies of my driver’s license and insurance card, handed me an intake form to fill out, and again gestured to the waiting area.  “The doctor will see you very shortly.”

I chose a thinly cushioned seat at the furthest end of the small room.  I filled out the generic intake form, pausing for a moment to ponder the “In Case of Emergency” line.  It was only recently that my “in case of emergency” person had ceased to be Jason and I hadn’t changed this designation to someone else.  My ex and I moved to Vegas nine months prior, a move made from a marriage compromise in attempt to save it.  Now I was stuck here.   I didn’t have any family in Las Vegas and didn’t feel right giving the responsibility to one of my few casual friends.  Though twenty-five hundred miles of distance separated us, my mother made the most sense. I wrote Roberta Wesley and her phone number, one of the four numbers I knew by heart, in the space.

I handed the completed forms in and sat back in the seat.  Though the Urgent Care “took chest pain very seriously,” the doctor was not ready to see me. At least if I did keel over now, I was in a medical facility.  They possessed the skills and equipment for resuscitation should I need it.

What if I did collapse and die here, in this depressing and dated medical facility? It would illustrate a fine example of life’s “fuck you.”  Months ago, I had acquiesced to the disappointment of my life.  My marriage loveless, my Vegas existence boring and friendless, my new job stressful and unsustainable – it was all a result of my own choices.  I felt I had to own up to it; I had made my bed, now I had to sleep in it. It was only through deep reflection and heavy conversations with loved ones I learned I had the power to change my course and forge new paths.  I was not stuck.  Newly emboldened, I initiated painful yet necessary conversations with Jason that led to our divorce.  I started making moves to eventually leave Vegas.  Life gave me a second chance. Now it was robbing me of it.

“The doctor is ready to see you now,” A nurse appeared at the front desk. 

He led me around back, depositing me in the first bare bones examination room on the left. There was a tan pleather examination table with a thin and crunchy layer of disposable paper covering the surface, a stool on wheels, and a desk containing the basics of first aid: sponges and gauze, a syringe disposal, and rubber gloves.  These supplies would be useless if my chest pain proved to be as serious as it presented itself.  The room gave off even more gloom than the waiting area.

The nurse gave me a small smile.  “So, you’re having some chest pain, huh.  We’ll get that figured out.  First, we’ll do an EKG to see if there’s anything going on with your heart.”

The young nurse left for a moment so I could change into a gown. He wheeled the machine over.  It looked like a computer monitor on a cart from which hung a plethora of wires. The wires attached to my chest via circular pads stuck directly to my skin. I was very thankful I put on a sports bra before leaving my apartment.  The chest pain had not abated but I felt calmer already.  I didn’t know what was wrong with me, or if I was indeed having a heart attack, but it was comforting to be in the company of others.

The results were immediate and fed directly into the monitor.  I watched them appear on the screen but couldn’t make any sense of the peak and valley scratches. I didn’t learn whether my heart passed or failed until the doctor entered the room a few minutes later.  He was older with a full head of long frizzy white hair that stuck up around his head as if he had taken a shock from a defibrillator.   

“Hello,” he greeted me as he removed the stethoscope that hung characteristically around his neck like any good doctor.  “How are you feeling?”

“I was good until this chest pain started.”

He listened to my heart.  “When did the chest pain start?”

“Maybe an hour or hour and half ago.”

“Have you eaten dinner yet?”

“Yeah.”

“When?”

“Probably about an hour before the chest pain started.”

“What did you eat?”

“Soba noodles.”

“Were they plain?”

I shook my head no.  “There was a sauce.  It had soy sauce, lime juice, and hot sauce.” 

He was silent while taking my blood pressure.  Satisfied, he stepped away and looked at me.  “Your EKG is normal, and your heart and blood pressure are all fine.  Have you ever had indigestion or heart burn before?”

Confused by his diagnosis, I cocked my head.  As a former heavy smoking and heavy drinking college senior, I had experienced the horrible burn of stomach acid regularly, but that pain afflicted the space directly below the hollow of my throat.  “I used to get heart burn in college, and this is nothing like that,” I told him.

His mouth turned up ever so slightly beneath his bushy grey and white moustache.

“Indigestion can affect us very differently.  I think you have heartburn.  It can be caused by foods high in sodium.  Spicy things too.  You had both for dinner.”

The relief was immediate, life’s second chance resurfaced.  My heart was fine, though the condition I had did involve the word heart.  It’s a shame that a usually harmless affliction includes it.  Not many medical conditions inspire fear more than any that include “heart.”

The doctor grabbed a remedy for my not-heart-attack – a tiny plastic cup, the kind you use at the dentist, filled a quarter of the way with a viscous green liquid.  “Drink this up and we’ll have you hang around for twenty minutes or so to see if your pain goes away.”

I obliged him, drinking down the chalky green liquid in one gulp.  The doctor left to attend to the patients I cut in line due to my chest pain.  He returned in the promised twenty minutes to check my status.  I proclaimed I was free of all pains and was sent home with advice to pick up TUMS from the pharmacy.  My hands swung freely at my side as I exited Urgent Care.   I sang along to the rock song playing loudly in my car, driving away with both hands on the wheel. 

Once home, I assumed my position on the couch with a paperback.  Tomorrow, after stopping at the pharmacy to add antacids to my medicine cabinet, I would divulge tonight’s story to my parents. It would be the first of many conversations of this nature.  In twenty-four hours, I would be able to put a humorous spin on the story.  They were always funny once there was distance in between such incidents. 

This was not my last “heart attack.”  I would have dozens in the months ahead.  That maiden trip to Urgent Care left me with a few tools to help me deal with random chest pains at home instead of hurrying off for medical care.  I would pop a few antacids and give someone a call to talk logically to me.  The caring voice of a loved one on the other end of the line was the cure.  My loneliness eased while engaged in conversation and the irrational thoughts that accompanied novel body sensations dissipated.

This was a solid plan, except it was temporary and only worked if I was successful in reaching someone by phone call.  What happened when they hung up or if I couldn’t get in touch with anyone?  That’s when the despairing anxiety hit me, thoughts of a lonesome death on an endless loop while my fingers firmly rubbed new bruises on my body until I found my way back to another Urgent Care or emergency room.  I learned in Vegas that living alone, a luxury to many, is not for me.  It only took a much-desired divorce for me to figure out my biggest mental health trigger.  I was able to begin healing from this semi nervous breakdown when I moved to Denver a year later.  It is a city where I never have to be alone.  I will always suffer from flare ups of hypochondria, but they are more manageable in the company of others. 

It’s just me rubbing, rubbing, rubbing without the frantic trips to the ER.

About Rachael Wesley
She/Her/Hers

Rachael lives in Denver with her husband and dog. She is a writer and a high school Reading Intervention teacher. Rachael is currently seeking a literary agent to represent her first full length book “Second Set Chances” and her writing has been featured in various printed and internet media. The main goal of her writing is to use her experiences to normalize social stigmas. She finds life to be the most fulfilling when she spends time with her loved ones, traveling, and seeing live music. She also seeks sanity through outdoor activity and escaping with reading and writing. You can follow her writing and life adventures on Instagram at @Rachaelwesleywrites.