June 22, 2022

"Since my bypass surgery I’ve been haunted by the presence of a terrible knowledge that is just out of reach..."

"... my brain can’t access this pain but my nerves, bone, muscle, tissue keep the fact of it with them, I feel.... I had been... reading three newspapers a day, reading many magazines, and in general, trying to stay informed. But more or less overnight, staying informed ceased to matter to me. Though I subscribed to the New York Times in three cities I put it aside one day and didn’t read another issue for seven months. From being a living person with a distinct personality I began to feel more or less like an outline of that person—and then even the outline began to fade, erased by what had happened inside. I felt as if I was vanishing—or more accurately, had vanished.... The thing, more than any other, that convinced me I had in some sense died was that I couldn’t read. I went to my bookshops but could not connect with the books.... I had read every day of my life... It was the stablest of all pleasures, and now it was gone. The fact was that even then I could read professionally.... But read for pleasure, no. I had floated down the Nile and out to sea.... The problem, I eventually realized, was that reading is a form of looking outward, beyond the self, and that, for a long time, I couldn’t do—the protest from inside was too powerful. My inability to externalize seemed to be organ based, as if the organs to which violence had been done were protesting so much that I couldn’t attend to anything else."

61 comments:

rhhardin said...

Apparently it doesn't prevent writing.

Howard said...

Sounds like feeling of impending doom you get with heart failure. You feel like you are dead and no longer part of this world. It's a lonely melancholy of dispair. Getting the bypass should have fixed that. Maybe he hasn't been working on improvements to general fitness.

Ice Nine said...

>Though I subscribed to the New York Times in three cities I put it aside one day and didn’t read another issue for seven months.<

That will add years to his life.

Michael K said...

Maybe he has "pump head." I had my single vessel bypass ten years ago and it was done without heart-lung bypass.

Ann Althouse said...

The surgery that he believed caused this condition was done in December 1991. The book describing the experience was published 10 years later.

"Sometime in the third year [after the surgery] I slowly regained the power to read."

Writing the book, he says: "Even now, eight years after the operation, reading is an uneven experience—though I began to read again several years ago, I am only now regaining my velocity—the ability to read several books more or less at the same time, at a fast clip. If many looked-forward-to books fail to engage me I suspect it may be because the operation left me with a less generous level of attention to bestow. I think of the heart surgery now mostly in metaphors of editing. I am nervous about letting an editor edit my manuscripts—even editors who have known me for years—and yet I let the surgeon, a man I had met for only ten minutes, edit my body on the basis of information from machines. This is not to blame the surgeon, who did a fine job. I merely call attention to the oddity of letting the body be abruptly edited by one who has no knowledge of the self of which the body is but one expression. All the machines can tell the surgeon or cardiologist, after all, is about the defects and flaws of a given body; the machines can’t read strengths, particularly not psychic strengths."

Ann Althouse said...

@Michael K

I don't know that term, but his description is very focused on the machine:

"In my own efforts to understand the aftereffects of bypass surgery, now that I’ve lived with them for eight years, the heart-lung machine figures powerfully and ominously.... The heart-lung machine may not really be able to keep *you* there, but it does keep your body viable, breathing for it and circulating its blood. But the you that involved thought and personality, where did that go during the five hours or so when the heart-lung machine was taking care of your basic biological functions? Your brain is not dead, but it has been neutralized, keeping only its own secret register of what is going on. The fact that two major involuntary functions, blood circulation and breathing, have been assigned to a machine takes you about as far from common sense as one can go. While the operation is happening you are neither really alive nor truly dead."

McMurtry, Larry. Walter Benjamin at the Dairy Queen: Reflections on Sixty and Beyond (pp. 131-132). Simon & Schuster. Kindle Edition.

Ann Althouse said...

He died last year.

Lem said...
This comment has been removed by the author.
Kay said...

Sounds like me and my naturally slow reading ability. I have a novel I have been trying to finish since last Dec. I’ve got maybe 3 chapters left. The entire experience has been quite a slog. I had been familiar with the first chapter for a long time, but nevertheless felt like the beginning of the novel was pretty slow to start regardless. At some point the story did grab me but somewhere near the end it lost me again. There is enough interesting about the book to make it worth my while to read, but maybe overall it’s not a great book. But still I’m dedicated, and meanwhile all these unread books on my shelf are screaming out at me.

Joe Smith said...

'He died last year.'

So the operation wasn't a success?

TickTock said...

I had several major surgeries in the period 2007-2009, including replacement of my aortic valve by a metal device and sleeve. I was on a heart/lung machine for 8 hours during that surgery.

While my experience was not nearly as bad as this fellow's, there was definitely a psychological impact from the surgery (and the others) that took some time to recovery from.

But I think there is an aspect to "staying informed" that goes beyond this. Significant and profound life threatening events make you sharply aware of your mortality. And you become more focused on your immediate wants, needs and loves. Now, years later, I stay informed sufficiently well to think that the world is going to hell (as my father and grandfather also thought.) but I am no longer as concerned about that as I once was.

It is now up to my son and his very liberal wife to deal with. All I really care about is helping those around me, and doing my best to make certain my grandson learns some very basic values to help him survive a life that is certain to be much more difficult than mine.

Gahrie said...

I broke my shoulder a couple of weeks ago, and had the same thing happen to me.

rhhardin said...

I'll rewatch a movie sometimes but the new ones are awful, which is to say woke. The old ones are still good. Most rewatched: Closed Circuit (2013), but at long enough intervals. A terrorist romcom with all the action legal.

Carol said...

I think Mike nailed it.

Had to look up "pump head." Yikes.

farmgirl said...

When reading this post- I bypassed the heart and was thinking gastric. Idk why?

My dad had a quadruple bypass. It took a year for him to feel like himself again.
He had 1/2 a lung removed due to cancer.
He survived so much- to end as he did.

It’s a weird world.

Mike (MJB Wolf) said...

Larry was a guest lecturer for a section in one of my creative writing classes at UC Riverside and was very conversational and relatable, discussing Leaving Cheyenne and Lonesome Dove, which had yet to be made into a miniseries, so yes this was early 1980s. His recall about writing and rewriting was exceptional at the time and it must have been quite blow mentally to for him to lose access to those internal references that allowed him to connect to outside events. My own father is just now going through an Alzheimer like process that takes him away from us a little bit at a time and I pray I display the same level of grace and calm as he seems to be accepting it with.

Narr said...

"'While the operation is happening, you are neither really alive nor truly dead."

To be dead--to be truly dead--must be glorious, doctor van Helsing!



mikee said...

This man experienced a brush with death and has not gotten over the mental trauma of learning that his life is not under his own control, even internally among his organs.

See Sam Spade's story of Mr. Flitcraft in The Maltese Falcon, Chapter VII, for another example of the same sort of thing.

Temujin said...

He was one of our great modern writers. I was not familiar with this book, but now I'm reminded that I have to add a few more 'McMurtry's' to my reading list, which continues to grow to a size that I'll never catch up with. I guess the point is to enjoy what's in front of me at the moment.

I have a friend who recently was diagnosed with a glioblastoma in his brain. Surgery removed about 90% of the tumor and he's since been on chemo and radiation- trying to buy him a couple more years. He's a fighter and is taking this on aggressively, but one thing that seems to have knocked him for a loop is that he can no longer read. His brain, having been cut up, cannot decipher words any longer. The letters get all jumbled up to him. He's working through therapy for it, but it's immensely frustrating for him and he says it physically hurts his brain when he's going through the lessons- either for his practice at home or with the therapist, who is trying to help his brain reroute those abilities to read toward a different part of his brain than the part that has been 'worked' on.

I don't know what I'd do if I could not read. I guess audiobooks would become my new thing.

Ann Althouse said...

“ So the operation wasn't a success?”

He died 30 years after the operation.

Joe Smith said...

'He died 30 years after the operation.'

It was a joke...

My grandfather had a '57 Chevy farm truck that took a lot of abuse, and had almost 200k on the odometer.

Sometime in the late '80s he was driving it on the highway with my uncle on board.

Of course it broke down.

According to my uncle, my grandfather was calm about it, and said, 'What do you know, I bought a goddamn lemon.'

Molly Pitcher2 said...

Morbid anxiety.

Tina848 said...

My dad had bypass surgery in the same timeframe, 1990. He had lingering effects too. The most pronounced was vivid nightmares. My dad was a WW2 veteran, and started reliving things from 45 years earlier. He said he also dreamed of his parents, who died in the 1960's. He saw them clear as day. According to medical type friends, it wasn't the bypass machine, but the anesthesia that caused some of this. Also, narcotics given to reduce pain.

Bypass back then was a very long operation and the removal of a vein from the leg was more complex. It included a an incision and scar down his entire inseam. That and his breast bone bothered him until he passed, some 10 years later.

My FIL had bypass surgery 5 years ago, no long scar, minimally invasive, was doing PT at home 4 days later. No effect.

Amy said...

Comment not relevant to this thread, but I didn't know where else to post it: I just finished the Ai Weiwei book that you quoted from several times on this blog. I found it very thought provoking and impactful. Thank you for bringing it to my attention. I would not have known about it otherwise.

CJinPA said...

I had quadruple bypass in October. I feel better than ever and am extremely grateful. The giant scar on my chest is a constant reminder that something incredible and incredibly complicated happened. There are a few details I haven't explored and might not ever.

CJinPA said...

"He died 30 years after the operation."

That's quite comforting to read.

LA_Bob said...

According to Wikipedia, "Postperfusion syndrome, also known as "pumphead", is a constellation of neurocognitive impairments attributed to cardiopulmonary bypass (CPB) during cardiac surgery."

A "constellation", huh? So, you see stars for some period of time following the procedure?

Michael K said...

"Pump head" is a real thing which is why I had my single bypass LIMA to LAD as "beating heart surgery." It was not an option when I was doing cardiac surgery but it has become popular for single vessel bypass. Now aortic valve replacement is being done with a catheter and no bypass. Lots of progress in 30 years but the skill level has to keep up. The young guy who did my bypass looked like one of my students. He did a good job. It is still open.

Tom T. said...

It just sounds like a form of anxiety.

Jamie said...

I'm reminded of a pretty obscure Heinlein story, in which a dictator in an unnamed country needs a pituitary gland transplant and the candidate who is his match is a concentration camp prisoner. For some reason I can't remember - to show their prowess maybe? - the medical team doesn't just let the prisoner die; they implant the dictator's failing pituitary gland in him.

And it turns out that the pituitary gland is the seat of personality - the "soul."

BUMBLE BEE said...

Tom T. When somebody has been wrenchin on your ticker, you get a whole new outlook on life.

Tina Trent said...

I had a student years ago, a man older than me, once an aircraft technician but now dying rapidly from a brain tumor. He asked me to explain to the other students that he might twitch, convulse, or say incoherent things. By happy coincidence, several girls in the class were becoming nurses or nurse techs, and even though they were 18 or 19, they were mature and had seen a lot of life. So when he did begin to fall out of his chair and even convulse a few times, they were the ones who handled it. And when he (fairly quickly) couldn't drive anymore, the other students or I would pick him up.

He told me he didn't want to spend his last days watching tv while his wife worked. He had spent his whole life as an engineer, and now he wanted to figure out the meaning of life. We read the Odyssey, and when I saw he couldn't read well, the rest of us took turns reading to each other, and the Metamorphosis, Aeschylus, Euripides. I'd fill in with lectures. I'm too quotidian for philosophy, but I had a few amazing teachers, so I was taught to use literature to make sense of the present through the past. To understand the human unity and also our weird alienation from the past. I worried about the young people, but they were just kind, and it was the best class ever.

One day he didn't show up: he was dead. Several students wrote in their evaluations that learning with him made the classics alive to them. His courage made me see everything we studied in a different light. I would hate to lose that faith in the stories we tell each other. That's all we are.

Lurker21 said...

Reading (fiction) does mean looking beyond oneself, but does it really mean looking outward? I'd say it means submersing oneself in the author's world. That's not really looking out into the world. If I'm reading a novel about Egypt or Indonesia that can in a sense be looking out into the wider world, but more often I'm looking away from the world around me (and the world beyond that) and entering the writer's world.

That gets harder to do as one gets older. I loved the novels I had to read in school and college, but since then I find it harder and harder to enter a writer's world and to make a commitment to staying there. Film, video, theater, and audiobooks pull or push one directly into a different world, without one having to muster the will for a long slog through scores or hundreds of pages.

traditionalguy said...

Getting over surgery and induced coma means waking up in a weak unbalanced body. To someone who took a strong healthy body for granted that is a new world. Best recovery therapy is lifting weights for the body and reading Althouse for the mind.

Virgil Hilts said...

I loved the five Lonesome Dove-connected books, but never forgave McMurtry killing off, like within a couple chapters, this young feral girl/woman character. She was just this absolutely terrific character and he just killed her off. I got the sense reading his books that he would take the names of all of the characters (except for Gus and Call) paste them up on a wheel of death and then spin it to see who should arbitrarily die in the next chapter. I suppose it would help bring a sense of brutal reality to your work. But the killing of this character really upset me as the reader. Kind of like watching Barry!

Virgil Hilts said...

I didn't know about his surgery. After just loving the Lonesome Dove books I tried reading /listening to the Berrybender Narratives. They were relatively boring and uninspired. Sounds like they were written post-surgery.

Valentine Smith said...

It's the overthinking, the obsession but mostly the fear of death.

Had a triple bypass and was working 3 weeks later. Great epiphany to discover I was unafraid to die. In fact, it never occurred to me even in the lead-up to the surgery and only came up after the fact. My only fear was shooting a clot causing a stroke as happened to my father but even that concern was relatively minimal. I attribute it to being a theist, at least in part. Also I have been in a couple of life threatening situations that did not work out well but I did survive.

At this point I'm the luckiest man alive and yeah gratitude helps.

Ann Althouse said...

“Great epiphany to discover I was unafraid to die.”

Is there anything you can share with us, some insight or trick?

gspencer said...

I've heard several stories about changed personalities whenever the heart is stopped in order to do a procedure. And for those receiving a heart transplant the changes are even more pronounced.

Tina Trent said...

I wasn't asked, but have/perhaps may soon be there, and unmitigated boneheaded willpower helps. Monty Python helps. Demanding, while being respectful, in medical crises helps. Food gift cards for nurse's aides are inconceivably effective. Don't home bake. And target practice helps. I mean in a licensed gun range. You hold death in your hands, then you shred a paper target. You hold death in your hands but only kill paper.

Oh hell, I keep a list of my enemies. I would never hurt them physically, but I will do what I can to destroy them publicly when I get the go button. That's called a Sicilian Bucket list. Al Sharpton has been number one for decades. I have ten library inches of files on him alone.

Tina Trent said...

Also, Connie Willis. Doomsday Book. Even if you no longer read fiction. And don't overlook medical history to foster gratitude. The Mystery of the Exploding Teeth is a good one, plus any gynecological or amputation book from the early 20th Century or before.

Perspective is logical gratitude.

Mikey NTH said...

It sounds to me that the author was surprised to discover after his life-saving surgery that many things he thought important really weren't.

Valentine Smith said...

"Is there anything you can share with us, some insight or trick?"

I have to say I blanched a little at the word "trick."
I have no answers. There is no formula. I think it is the sum of my life experiences.

I was a deeply flawed kid but not without a gift or two. Just a working-class Brooklyn story: An accidental severe trauma at the age of 3, chaotic family life, murder of my brother, barroom run-in with a rogue cop, being shot arrested and put on trial for attempted murder and 11 other charges, being acquitted. Trouble constellates around extreme dysfunction.

Took a while to stop the runaway train but what I can only call grace at specific points threw my life into reverse. Those points were much more powerful epiphanies than the one about death.

My turnaround experience is certainly not at all rare. The others simply do not post on Althouse once in a while.

If this is not what you had in mind please don't hesitate to trash it. I feel naked.

Yancey Ward said...

Is there a reason to fear death? Fear it all you want, but it comes regardless. I am big believer in not worrying about things I can't do a whole lot to prevent.

boatbuilder said...

Shit, Tina. I think it must be getting dusty in here.

wildswan said...

" I find it harder and harder to enter a writer's world and to make a commitment to staying there."

I had this problem. My "solution" was to carefully try to see just what I was thinking about. If my books, fiction or history, went along with what I was really thinking about I could maintain my concentration. For instance I have huge general question: what is conservatism? I've been able to read about Curzon, Balfour, Lord Salisbury, Lord Randolph Churchill with this question in mind though they were all horrible to the Irish and normally I would not look beyond that. Similarly I like mysteries from the Forties but I also like Robert Parker's Spenser series. Evidently somehow the question of how (and when) the Forties became the Wokies is met in these books.

wildswan said...

So, to complete my thought, I think the writer has a whole series of new undermind questions following his realization that he might die and so he can't drift along down the river of the old books. Probably he also realized that the left is decadent but he doesn't want to be a Republican so he cowers away from the news.

realestateacct said...

He turned his experience to good account in his continuation of the story of Duane and Sonny from "The Last Picture Show" starting with "Duane is Depressed" published shortly after "Walter Benjamin at the Dairy Queen."

Lawnerd said...

I had my aortic valve replaced in January. This was the most dreaded thing in my life: my dad had the same surgery and it changed his personality for the worst, my mother in-law had the same surgery and had a major stroke the day after the surgery. What the author describes was my worst fear, that like my dad, the surgery would mark a fundamental change in my personality - whether from being on a heart/lung machine for hours or some other reason. Six months later and I feel blessed to have passed through intact. My sympathy for the author's plight.

Fred Drinkwater said...

Like V Smith (Mars?), I had a triple bypass after a heart attack.
While enroute to the ER, I thought, "well, I might die right now. Huh." ( My attack was nearly painless, and was initially misdiagnosed.) Kind of a relaxing idea, to be honest. The ultimate in "no worries". Selfish, I suppose, since that reflects no concern for my survivors. But after all, no one was going to be homeless just because I died. Reward of a prudent life.

But I was recovered enough to walk into the ER under my own steam. Later, I was perfectly comfortable going into surgery, because of the place, and especially because of my totally awesome surgeon. I believed my situation was as good as possible, that there was nothing I needed to do, or could do, to make it better. Roll the dice, the odds are as good as they are going to get.

The only time I was in fear was in recovery. For a brief time, it was so painful I literally could not breath. Incredible pain, and no air. 0 / 10, would definitely not buy again. But, I lived.

I was incredibly lucky all around. Superb medical care, barring the diagnosis bobble in the ER. Incredible family support. (My wife turned her anxiety into action, many actions.) The lowest stress way to have your life threatened.

No epiphany, I'm afraid.

Nancy Reyes said...

the bypass machine does cause subtle neurological damage, something we docs first noticed 40 years ago in our patients after bypass surgery started becoming more common.
https://www.verywellhealth.com/cognitive-impairment-after-heart-bypass-surgery-4122168
but as a believer, and as a doc who has seen many people develop anxiety after being confronted with dying, I suspect part of his problem is confronting the fact that he will die might be part of the problem.

traditionalguy said...

Eternal life will be fun. Don’t leave your body without it.

Tina Trent said...

Boatbuilder: not sure what you mean nor the spirit of saying it, but sawdust does deter slugs.

Vonnegan said...

TIna Trent, that is an amazing story about your student. And Connie Willis is wonderful, although I could only read Doomsday Book once. I've read To Say Nothing of the Dog several times just for fun (last time we were in Oxford, which made it even better) and Blackout and All Clear several times as well, but only because I'm a sucker who likes to cry at the end. If you haven't read her Christmas stories, they are also very good.

I want to be the kind of person who doesn't fear death, but right now I'm a cranky 52 year old who was an absolute witch for a week before my hysterectomy, as far as I can tell only because I was afraid. As someone who claims to be a Christian, it's something to work on. Let's hope I have time to do that, since it's clearly going to take some doing.

farmgirl said...

I think our boatbuilder meant he’s eyes were watering- it must be the damned dust in here.

Keep shredding paper, Tina.

Bruce Hayden said...

One of those delightful comment threads that are Althouse worth following.

I do know someone very well who may have lost her ability to read through flatlining (for the physicians here - through what I would call medical malpractice). Initially, there was some loss of her central vision nerves. That, over a decade improved, but that improvement was hidden by growing cataracts. When they were fixed two years ago, it turns out that she can now easily see the letters, but she struggles to put them together into words.

What was interesting was her near-death experience. She remembers partying with people close to her she had lost through death: a brother, sister, father, grandmother, husband. When I first visited her in the hospital, it felt like she was still living it. She really didn’t want to come back but felt compelled to do so.

farmgirl said...

Hey to the 52yr old cranky pants…
Keep your chin up. It’s going to get better:0)

Keep the Faith.

lonejustice said...

Several years ago I almost had a heart attack. I was able to walk into the ER, but nearly collapsed when I got there. Turned out one of the coronary arteries was 95 percent blocked. The surgeon put 2 stents in me, entering from my wrist and going into my heart. I was awake the whole time, but was given intravenous fentanyl for the pain. The next day I was released.

Modern medicine is a miracle.

Cliqof1 said...

As happens so many times reading the comments, thank you ALL, for reminding me that I’m not losing my mind! It’s not just me—many, most?, people have these same thoughts, experiences, feelings that I’m having. A life long reader of everything—non fiction, fiction, newspapers, magazines, the last few years I have struggled to stay interested in books, stay focused. It comes and goes. I had attributed part of it to the use of short form reading on line.

My brother has had a 28 year history of heart complications, procedures, with a successful heart transplant 11 years ago. I’ve watched how it has changed him in some ways, but ultimately made him much more focused about what he likes, how he spends his time. And changed his close friends and family members—hard to whine to a guy who has his chest cracked open three times!

boatbuilder said...

Tina--what Farmgirl said.
Your story was beautiful and touching. Especially as I had you pegged as more the Sicilian bucket list type!

Tina Trent said...

Thanks Boatbuilder. Thanks farmgirl. You folks are my medicine. You have no idea. My poor husband. To the recent hysterectomee: go stand in the tampon aisle and laugh. You are free! You never need to go there again. I had mine the morning after 9/11 (who could forget that?). For complicated reasons, though paying, I was at The Grady. Thus, I was the only pre-op not chained to my bed with an armed cop sitting by my side. I remember walking down the worn linoleum hall to the restroom, loopy, dragging my IV, nekked rear end hanging out of my gown, and all the convicts cheered. We watched the towers fall over and over, and the cops and convicts cried together and agreed that they would get the bastards. Some of the cops were heading to NYC to work the rubble pit. I never wanted to leave that room.