Foreword by Steerpike
It was 2008 – around this time of year, actually – that I sent an email to Jen, and asked in oh-so-casual a tone what it cost to maintain Four Fat Chicks, the beloved gaming site she had run tirelessly for nine years before announcing her retirement.
She told me. “Are you thinking about taking it over?” (absolutely not, I thought, I wouldn’t have the first idea how. I’m just curious).
And then: “You should talk to Brad. That’s MrLipid. He asked me the same thing.”
Well heavens, I thought. Maybe we could do it in partnership. That would make it a lot easier. He’d do the work, I’d take the credit, everyone would win. So I got Brad’s phone number from Jen and gave him a call.
More Foreword by Steerpike
Brad and I have now been talking pretty regularly over Skype for four years. That reedy, disembodied baritone belongs to someone who’s become one of my dearest friends. We’ve talked games and movies, websites, business startups, fecal transplants, Republican inexplicability, high school reunions, human centipedes; even one lengthy discussion about the giant bronze warrior Talos from the Ray Harryhausen classic Jason and the Argonauts. We’ve endured technical nightmares, hackers, DDOS attacks, name change, host migration, and me breaking the place more times than either of us can count. We’ve been friends for a long time now. Like so many people associated with this site, I have never shaken his hand, but that doesn’t make him any less precious to me.
Not long ago Brad went through something that almost took him from us. This is that story.
When I read the first draft I called and asked if he was sure about this. It is, after all, a personal and terrifying experience. To my shame I admit I’d been the one to suggest he write about it, callously not realizing until the instant after the words left my thoughtless lips that maybe he didn’t want to put his most harrowing moments, his brush with Hell, up on a game site. To be honest I felt more than a little guilty. I’d only suggested it, but I was kind of feeling I might have made him feel obligated.
“Everyone hears these stories, but they’re about people they’re not connected to,” Brad replied. “But the people on Tap are part of our lives. If they hear the story from me, it might become more real.”
There are morals to the story, and messages. But mostly it’s an honest and frank narrative, written in that classically dry, wry, only-him MrLipid style. Be warned that it is also as scary a thing as I, at least, have ever read; because it happened to someone close to me.
One of the most wonderful things about the time in which we live is how it’s brought us all together in unimaginable ways. That opens us up, naturally, to more loss as well as more gain. That I’d never have known any of you existed were it not for Four Fat Chicks and Tap, and that such a thing would have irredeemably diminished me, is what I learned as I read this. “More loss” is a risk I’m willing to take. But it is nonetheless something we have a responsibility to appreciate, and remember.
Game (almost) Over!
Being the tale of my nonfatal myocardial infarction (NFMI aka nonfatal heart attack), subsequent back-to-back GI (gastrointestinal) bleeds, and struggle to sort out all the hospital bills.
Oh, and finally, a fair amount of medical lingo (with plain English definitions) to give the whole experience a veneer of verisimilitude.
My First NFMI
My story begins with a modest chest pain after a speaking engagement in late October 2011. Modest, in this case, means a perceptible but hardly crippling tightness behind my sternum. Went to bed with the pain, noticed it, slept. Woke up, noticed it was still present, thought about what my wife had said about digging me up and killing me again if I left her by dying from something like an untreated heart attack. Decided to do something about it.
Showered, shaved, drove to the emergency room, and stated I thought I was having a heart attack. That got people’s attention. Saw a physician’s assistant and his assistant, got an EKG (electrocardiogram – traces the electrical activity in the heart), got a ride in an ambulance. Seems I really was having a heart attack. Got to the hospital, was told that there was triponin (an enzyme found only in the heart) in my blood, which indicated a heart attack since triponin only leaks out into the blood stream when there is damage to the heart. Given my low level of pain, I preferred to think of what was happening as an “enzyme leak.”
Got wheeled on a gurney to a private room where I was put on a heparin IV (intravenous) drip. A drip involves one of those hanging bags that dispenses a measured amount of liquid through a tube and then through a needle into a vein in one’s arm. (Little did I know how many needles I would be poked with in the coming month). Heparin is a powerful anticoagulant (blood thinner) that heart patients are given to prevent or break up clots that might form in the blood and create problems somewhere else in the body. Unlike warfarin, which is an anticoagulant usually given in pill form, must gradually build up to therapeutic strength, and was first used as rat poison, heparin is an anticoagulant that works almost instantly, making it ideal for emergency situations. Which, apparently, I was now in.
My wife arrived, having been called from work. I put on my chipper face and said my discomfort didn’t even rise to the I-shouldn’t-have-eaten-that-last-burrito level. I was definitely glad to have her presence in this strange new world. I had managed to last sixty years without spending any time in a hospital.
An internist and a cardiologist dropped by to talk about what I might expect in terms of treatment. I might need a stent — a fine metal mesh tube inserted into a narrowed artery to keep it open. Or I might need my coronary arteries reopened through the insertion, inflation and withdrawal of a small balloon. There was an intense discussion of the pros and cons of bare-metal stents or drug-eluting stents. (A drug-eluting stent has been coated with medication which is slowly released, or eluted, as blood flows over it.) Show of hands from anyone who has ever run into the word “eluted” before.
Got another trip, again on a gurney (I never walked anywhere as a patient), to another part of the hospital where they perform an angiogram. A thin tube was inserted in my femoral artery (they cut a small hole in my crotch next to my junk and feed the tube up to my heart), and the doctors took a look at the condition of my coronary arteries. Some blockage, but nothing worth an operation. No stent required, drug-eluting or not, and no balloon.
Back to my room. The cardiologist, having heard I didn’t require his healing skills, had vanished and only the internist remained. I was told what to expect from the drugs he was recommending. He recommended a beta blocker and a statin in addition to the ACE inhibitor and low dose (81mg) enteric coated aspirin I was already taking.
Let’s go to the drug store…
Time to sort through this pile of pills. ACE (angiotensin-converting-enzyme) inhibitors, originally synthesized from compounds found in pit viper venom, lower blood pressure by reducing the ability of blood vessels to contract. Beta blockers lower blood pressure by causing the blood vessels to enlarge. Statins reduce the amount of cholesterol in the blood stream. The theory behind the therapeutic value of statins is that cholesterol can build up on artery walls and cause a disruption of blood flow in someplace vital like, say, the heart. (I say “theory” because there is a fair amount of debate within the medical community about the value of statins.)
And finally, the lowly low dose (81mg) enteric coated aspirin. It’s called low dose because a single standard aspirin weighs in at 325mg. The enteric coating keeps the aspirin from dissolving before it reaches the small intestine. Aspirin is an acid (acetylsalicylic acid) and it can cause mischief if, for example, it dissolves and disperses in the stomach.
I was told that the beta blocker tended to produce fatigue and I should be ready for that. (Brace for fatigue!) It was suggested that I take it at night and use its side effects as a sleep aid. I was not told, and only learned later, that a possible rare side effect of beta blockers is spontaneous bleeding.
I suggested it might be an idea not to start multiple drugs at the same time since it would be difficult to sort out any side effects. We settled on my starting with the beta blocker.
I was taken off the heparin drip and told I would be discharged in the morning.
A nurse showed up in the middle of the night like Banquo’s ghost and asked if I wanted to take my first statin. I explained that I had already had this conversation with the internist and had decided to start with the beta blocker.
Went back to sleep and awoke eager to leave. Midmorning a nurse came in and presented me with a small cup containing the daily drugs I was to take from this point on. There was the ACE inhibitor, the beta blocker, and a single low dose aspirin.
There was also a small brown bottle, about 2/3rds the height – and a bit more in the girth – of an AA battery. It contained 25 nitroglycerin tablets. Like the tablets Clifton Webb is reaching for in Laura when he collapses. I was told I was always to keep them on my person, and always to keep them in my right pocket. In the event of severe chest pain, I was to sit down, place one tablet under my tongue, and let it dissolve. (They fizz if they’re fresh.) If the pain had not gone away after taking three tablets, I was to call 911 (emergency medical services). The sitting down part was important because there was a possibility of falling down after taking the pill. Nitroglycerin, in addition to being a great way to blow things up, is also a rapid-acting vasodilator — it opens up the vascular system and allows blood to flow more freely. If it were to flow rapidly out of my head, I might not be able to remain upright.
I put the tiny bottle in my right pocket and took my other pills with a glass of tepid water. Instructions upon discharge included seeing my primary care physician within ten days. Per hospital regulations, I was taken by wheelchair to the discharge area while my wife fetched our car, picked me up, and drove me home.
I thought my exposure to modern medicine was pretty much over. I was wrong.