matters of the heart

My gym demands, according to Israeli law, that I bring a note from my doctor every year assuring them that I am healthy enough to be let loose on their machines. This is what is known as "ass-covering," of course. It's a word I recently learned from my boss, a champion in that sport, specializing in email, which she refers to as keese-tu-chim -- literally, "covering of the tuches".

This medical form is a minor annoyance, particularly since I rarely have a reason to visit a doctor so it's not something I can piggyback onto some other request; usually it's a special trip, along with the indeterminate amount of waiting, etc. At least it's free -- good ol' socialized medicine: one of the best reasons to live in this country (that, and the weather).

So I dropped in at my doctor's the other evening on my way home from work, and after a blessedly short wait (the weather is warm; we're between flu plagues), I went in and told her what I needed. "Oh, fine," she said, and took my blood pressure. I didn't think to ask what it read and she didn't tell me, just saying its normal.

Then I remembered I needed a referral to see a cardiologist for an echocardiogram. Here's the story: My biological father died at 27, when I was two, of a congenital heart defect (something to do with a defective valve, if memory serves). He had four siblings. Of them, one was definitely a carrier, and one of her sons -- davka the cousin I had a huge crush on, the musician -- died before 30 of the same thing. Another sister was thought to be a carrier and one of her sons was diagnosed in his 20s as well. My brother and I have both been checked periodically over the years but appear not to have inherited it. But until now I'd always believed that this was a problem that would manifest early, if at all. I figured I was out of the woods, and haven't been checked for several years. Now suddenly, I've learned that the mother I'd thought was only a carrier (her son has it, and is managing it with medication so far), has been diagnosed with it too. And she's in her 60s. So much for that theory. So I figured it was time to get checked again.

Talk about TMI: When I explained to my doctor why I needed a referral for the cardiologist, she changed her mind about handing me the medical release for the gym that she'd already printed out. "Uh-uh," she said, shaking her head firmly, "with all these people dying in your family, you're not getting this until I at least get a clean EKG from you."

oops. big mouth always gets me in trouble.

While I was at it, I decided to go whole hog and get some blood work done too, since that's another thing I haven't checked in years. Everybody should know their cholesterol reading, no? I mean, it's such useful information in geriatric company.

So off I went to the Kupat Holim [sick fund/HMO] clinic this morning, handed in my card, received paper with stickers for the blood tests and a blue-lidded plastic cup to pee into. The technician had a lot of trouble finding a vein to stick -- mine are so thin as to be almost invisible -- so I had that rubber tourniquet on so long my arm started to ache. But she told me I was "very brave" so that put a smile on my face. [Biyatch probably says that to all her victims.]

Then two floors up, to the nurses' station, where they do the EKG. I was extremely lucky this time -- I'd come an hour earlier than my appointment just hoping they might squeeze me in, and sure enough, absolutely nobody was waiting. She took my BP again, and this time I paid attention: 106/67 --- nice. And off to the table. Turn off your cell phone. Pull up your shirt. Take off your boots. Gel-clip; gel-clip; gel-clip. Don't talk for a minute. That's it, you're done. Wow. I'm sure this thing used to take a lot longer. Here's a line that shows what your heart's doing, lub-dup lub-dup; take it to the nice doctor in room 407 and he'll interpret it.

This, it turns out, is the same cardiologist who I've seen a couple of previous times over the years, the tall, smiling French, Doctor B. that I found very pleasant, friendly and un-doctor-like. I waited my turn in the corridor, and when he came out he took my EKG as if to look at it quickly and just sign off on it, but came back with the surprising, "It's not normal."

oh shit, was all I could think, now I'm not going to get my release for the gym. I said, "Not normal? Why?" And he showed me the EKG that had looked so innocent a moment before, and with his pen circled a little blip that appeared just after each spike.

"It could be that your normal EKG is irregular, but I can't sign off on this without checking," he said. I told him that I already have an appointment for an echogram on Jan. 3, but now that it's going to prevent me from going to the gym, I'd really like to get an earlier appointment. He told me to call him "in a few days" and he would see what he could do. I'm planning to call him tomorrow.

Actually, this doesn't worry me. About 20 years ago, a hysterical young cardiologist looked at my EKG and told me something like I was a heart attack waiting to happen and needed to be on beta-blockers permanently. I didn't like what he told me about beta-blockers -- it sounded a lot like a lobotomy for some reason -- and I wasn't in any mood to slow down, so I got a second opinion, which was fortunate. The more experienced cardiologist determined that I simply had an unusual pattern, but that an echo revealed nothing abnormal. And since then it's always been fine. I'm pretty confident Dr. B will determine my heart to be ... if not normal, then at least acceptable.