By Lynne Nugent
“Syncope and sudden death are the same thing, except in one you wake up.”
—Dr. B. J. Carey, Irish Medical Journal, June 2003
No dainty wilting violet, he. His whole body thunks to the floor. He can’t see. He can’t hear. He can’t speak. He can’t think. And here I am, new to the scene, with my notions gleaned from Victorian novels: fainting couches and smelling salts and fluttery ladies caught by dashing gentleman at the most romantically opportune moment. Not he. He throws everything into it, or rather is thrown, flung. From wherever I am in the house, I’m jerked into the room by the sound of the crash. I kneel down, take his hand. He stares through me, unblinking, as I hover above him, trying to catch his eye like a schoolgirl with a crush. I repeat his name into the void, love unrequited. I pat a stiff, clammy hand that is no longer his hand. For five seconds, ten seconds, twenty seconds, he is motionless. His heart stops. He is dead.
Then, as I am preparing to dial 911 and trying to remember my CPR class from high school, the face suffuses with berry-red. The unmoored eyes dart, saccading across the ceiling until they rest on my face with a look of great alarm. Kembrew has said that when he first comes to, he has no idea where he is or how he got there. So I’ve learned to tell him. He listens with intense attention—“You passed out; you’re on the bedroom floor; you’ll be okay”—and the eyes start to reflect light again; he speaks, remembers, a skipped record needle sinking back into the groove of life.
More than once I’ve I dragged Kembrew to the emergency room after one of these incidents. It’s maybe the worst thing I can do: the anxiety of being in a medical situation tends to cause more episodes of vasovagal syncope, a condition in which the chutes of the blood vessels open in response to some physical or emotional trigger, and not enough blood can reach the brain, which in turn causes loss of consciousness. In other words, fainting. Blacking out. A common condition, often benign.
I simply don’t learn, though. I can’t be alone with him, with it—especially in the middle of the night, when it always seems to happen. The word “syncope” comes from the Latin and Greek “syn” (together) and “kope” (to cut off). Each time, this cutting off of everything that holds him together, that holds us together, unnerves me. To see him in an unresponsive state, even for a few seconds, is intolerable.
All the more so because my husband is not the kind of person who is normally known for being at a loss for words. Kembrew teaches for a living, leading discussion in small classes or lecturing to large ones. In his spare time, he organizes protests. He writes multitudes of letters to the editor of the town newspaper. He delights in the fact that upper officials at the university where we both work consider him a troublemaker and give him dirty looks at receptions.
I remember one of the first times I heard his voice, back when we barely knew each other. I was driving somewhere with the radio on; he was a guest on a local NPR show. A listener called in to vehemently disagree with his position and hold forth upon his own. Rather than being taken aback, as I would have been, my future husband jumped into the fray—“Let me ask you this,” he interrupted when the caller took a breath—and gleefully debated his opponent, matching the man’s intensity, never backing down. And yet, when it’s three a.m. and he’s sick, or he’s struck by sudden medical fears for himself or others that remind him of his childhood when his family couldn’t afford to go to the doctor, he succumbs. And I’m the one who has to step up, fill the silence with my words, and I can’t. “Syncope” also has a grammatical definition: the excision of part of a word. In his proposed absence, words whose significance we built together—marriage, family, love—become distorted and lose their meaning. My vocabulary fails.
So I end up driving Kembrew through our sleeping town toward the permanently-lit red EMERGENCY sign. I tell myself that since the fainting spells are usually brought on by dehydration caused by ailments like the flu, it’s worthwhile to make the trip since they can give him fluids through an IV. Really, I just want company. I want someone else to be there.
During our most recent trip to the ER, a nurse hooks Kembrew up to an EKG machine, and it catches the next syncope on its ticker tape. I watch as the heartbeat, that clichéd beeping line with its regular jerk upwards followed by a slow slope downwards, just keeps sloping down and sloping down and sloping down. “Um, hello!” I call out to a group milling at the nurses’ station. In a flash, our small room is crowded with people. “Get the cart,” someone says. They place defibrillator pads on his chest. They inject his IV with atropine. Then we all stand around and watch.
Again, notions. Notions of heroic rescue. Not the Victorian novels, but TV hospital shows this time. Everyone leaping onto the body, massaging it back to life, deploying machinery. Instead, we hover ineffectually, exactly the way I do when it’s just me and him and the bedroom floor. The nurses and residents and a rumpled cardiologist-on-call who has been paged and still seems halfway in whatever dream he was having—we all stand there in the presence of the body’s lonely struggle to survive. It’s not like the TV shows: at some level, he must do this for himself. The heroics are all internal. My voice sounds from somewhere in the back of the room, repeating my usual mantra: “You’re okay, sweetie.” Someone glances at me as if I’m insane. “He’s breathing,” one of them says, looking on the bright side in lieu of a heartbeat.
I think back to the early morning of June 12, 1999, to the paramedics’ unfamiliar voices in the background as my mother’s familiar one, catching on her fear, tells me over the telephone, “They say he’s still breathing.” By the time I hang up and put my clothes on to go to the airport to get on the next plane to St. Louis, my father’s dead from a heart attack. Breathing often continues for a few moments after the heart has stopped.
But that was then and this is now, and now the usual invisible hands—not mine, not the doctors’, which are all just hanging there useless—throttle him back to life; Kembrew’s face goes scarlet, and he is again among us. Only now do I notice that taped to the side of the crash cart is a laminated sheet of paper that says, “When there is no pupil response for X seconds”—I can’t now remember how many—“page the social worker/grief counselor on call.”
When we were first in love, I would watch him as he slept. One morning, as I was watching him, he opened his eyes and looked right at me, and that simple action seemed like such a miracle that I started to weep. I remembered how I was taken to see my dad in the ER exam room where they put him after he died, in the same hospital where I was born, and how I studied my father’s face then, touched his cheek. For a long time afterward, whenever anything good happened to me, I would think, “I’d trade it all for another five minutes with my dad.” All of the accumulated good in my life since he died, over two years, over five—I’d have traded it all without a second thought. Then I fell in love and wondered if that was indeed true anymore. You have turned my mourning into dancing, I thought, looking into the eyes that were looking back at mine, having performed the miracle of opening on a summer morning. It was a verse from Psalms I had somehow picked up during my atheistic life. You have taken my sackcloth and clothed me in joy.
After the drama is over and our room empties of hospital personnel, I corner one of the doctors in the hall and explain that there’s been a small misunderstanding, ha ha, that this has happened before, that perhaps we could try not to alarm him with more talk of how serious it is. “But it is serious,” she tells me. “Your husband scared the bejeezus out of us just now. His heart stopped.”
“Okay,” I say, thinking, Yes, course. This is how it is. I knew it. It’s not benign; how could it be? The body doesn’t lie. Into the Cardio-Vascular Intensive Care Unit we go, where his new neighbors are gray lumps on their hospital beds. Having fainted three times in quick succession this morning, Kembrew looks almost as gray as they do. They say he must remain for a couple days of observation. There is talk of implanting a pacemaker. There is talk of implanting an emergency pacemaker to cover the time before a permanent pacemaker can be implanted. But after a few hours, during which I watch the green line of his heartbeat and the blue line of his respiration on the monitor like it’s the most fascinating show on TV, it’s broad daylight out, no longer the fluorescent-hued night of the ER. A new mood arrives with the day shift.
He doesn’t look like his neighbors any more; anyone can see that, so they set him free. It’s benign, the day-doctors tell us. It mimics sudden death so naturally it causes alarm. And his heart didn’t stop, they clarify: it just paused briefly. It maybe pauses longer than some others’, but it’s still an acceptable pause. This makes us feel better, but for me, every day still has a tinge of three a.m. around the edges, and it always will. Each time it happens, the floor will fall away from my life, and I can’t help that any more than Kembrew can help fainting. How many seconds is X?
Back when few of our friends had children, and long before we contemplated it ourselves, babies seemed like alien beings to us. In one of our first up-close encounters with one, we marveled at how small and delicate our friend Chris’s newborn son was. The baby plunked into our arms, we each displayed the stiff, awkward don’t-break-it arm-crook of the childless. “Don’t worry,” Chris told us, already a seasoned father with one older child. “They’re not as fragile as they look. They cling to life!” His hearty “they cling to life” has stuck with me over the years. I believe it and I don’t believe it about anyone I love, because it’s true and it’s not true, and I’m sure Chris or any parent, or any wife, or any daughter, must feel the same way. The body’s drive to live is invincible. Until it isn’t.
Dismissed from the cardiac unit and the hospital, which in the daytime is once again our friendly, local, familiar hospital where we get check-ups, we walk to the parking ramp on our own two feet with no follow-up appointment scheduled. It’s what I’ve come to think of as the get-out-of-jail-free card, yet another to add to the several we’ve accumulated as we approach middle age: that breast lump that turned out to be nothing, the stomach pain that required a peek with the stomach-camera. Outside in the bright sun, back in the community we know so well, everyone looks outrageously healthy: so ruddy, so active, so obliviously jogging and pink. It’s easy to believe that there are plenty more of those cards in the deck.
When it happens again, though, it’s always night. Since Kembrew knows I’m not strong or fast enough to catch him, he aims for the floor. Sometimes he makes it all the way there before he passes out. Sometimes he falls the rest of the way. I run in, always too late, in no way the dashing Victorian gentleman, appalled to find that the person who most pleases and irks and understands me in the world has cut himself out of our shared experience. And there isn’t a thing that I can do about it. I can’t catch him. I can’t resurrect him. I can just be there.
LYNNE NUGENT is managing editor of The Iowa Review. Her essays have appeared in the North American Review, Brevity, the Modern Love column of the New York Times, and the anthology Moving On: Essays on the Aftermath of Leaving Academia.