There is something I am compelled to tell you. I think you would like to know. Maybe not.

I’m driving my wife, Mary Ann, from our home on Bainbridge Island to the Kaiser Permanente clinic in Bellevue, Washington, for a routine procedure. A trip off-island by ferry to Seattle, then a 10-mile drive to Bellevue. As we get on the ferry, I’m suddenly finding it hard to breathe and I feel a strange ache in my chest. I think, oh, this will pass, as I’m not the sickly type and I’ve had indigestion before. I keep driving and say nothing to Mary Ann. By the time the ferry reaches Seattle, a thirty-minute trip, the pain has radiated out from the center of my chest to my shoulders and up my neck, and I know I’m in trouble. I also know that on some level I have been waiting for this moment all my life, wondering how ready I would be when it happened. Still, I say nothing to Mary Ann because I don’t want to go through the STOP-THE-CAR!-CALL-911! kind of panicked confusion and traffic disruption that I know would ensue. I have visions of ambulances, fire trucks, hovering helicopters, state police cars blocking the four lanes of I-405, holding up rush hour traffic, and me supine in a gurney being rolled past all those angry commuters shaking their fists as I pass by. That’s not the kind of attention I crave. I think if I could make it to Kaiser I could slip quietly into Urgent Care while my wife is having her procedure and pick her up later and she’d be none the wiser. And why not? I’ve never had anything seriously go wrong with me healthwise, except maybe that bullet wound in the Marines, and that was a different order of medical emergency than, say, the natural failure of a tried-and-true, well-seasoned organ (See, zombie fans, how those little unintentional puns keep spouting out like clots from a severed aorta?). By the time we arrive at the clinic I’m all hunched over, clenching my fists, humming with the effort of suppressing groans and grunts as Mary Ann follows me through the parking garage. “What’s your hurry?” she asks. “We’re not late yet.” And even in this moment of my extremity I start laughing. Late? Hold my beer, I want to say. Why do I feel I have to be such a wiseass all the time? Mary Ann, annoyed now: “You don’t have to walk so fast.” After we take the elevator up to the main floor, I know it is time to tell her. “Go ahead upstairs and get your test done,” I say, “I’m just going to drop into that Urgent Care unit right down the hallway for a little visit. Meet me down here later? Okay?”

“WHAT DO YOU MEAN URGENT CARE!” And so it starts.

Me to Urgent Care receptionist: I think I’m having a heart attack.

Receptionist: Have a seat.

Me: Okay. (Starts for chair).

Mary Ann: Wait a minute! Wait a minute! The man said heart attack! That’s with an H, not an F! (Looks at me.) Why didn’t you say something sooner? Like in the truck?

Me: I didn’t want to spoil your day.

Mary Ann: Argh.

No matter, I’m sitting for less than 30 seconds when a team comes through a door and takes me into a little blond-paneled windowless room, where they make me take off my shirt in front of a nurse who I later find out is from Moldova. “Mm-mmm,” she says as her eyes widen in a continental oo-la-la kind of way. She has a Russian accent. “It’s so nice to see an older gentleman with pecs instead of boobs.” (I think I made that part up; I was distracted.) The techie hooks me up to the EKG machine, pasting the electrode leads on my chest, sides, and ankles and fires it up. In a matter of seconds, not minutes, the tech abruptly shuts down the machine, pushes a button, and rips all the electrodes off in one swipe—taking a little chest hair—ouch. It sounds like the suction cups of a bath mat being pulled up from the tub all at once. Next thing I’m in the emergency room and I know I’m on the brink of something very real. Everything is in motion around me, yet I feel a little reckless, daring myself to show bravado through the pain.

When I was a kid, my friends and I were a tribe of bicycle heathens, all of Brooklyn open to us. The ground in our neighborhood was mostly level, but rising off Fresh Pond Road was an elevation we called Crematory Hill. The crematory itself, bordering Mt. Olivet Cemetery, was at the top of the hill, a beige stucco building with a tall campanile-like tower rising from the center of the roof. We all knew the artful tower was an architectural euphemism, a gently designed chimney through which (we imagined) the immortal souls of the departed rose from their vanishing bodies. We would push our bikes to the top of the hill, always careful to avoid looking directly at the tower, and perch on the brink, trying to gather the courage to plunge down the impossibly steep grade. We were right to be fearful, because once we started down, gravity was so relentless, the momentum so strong, that it was impossible to brake to a stop without tumbling headlong into the sidewalk or across the hood of a parked car. We had a trick: the intersection of Crematory Hill Drive and Fresh Pond Road had neither traffic light nor stop sign, and—me first, my friends next in single file—we would fly right through the intersection at top speed without checking for cross traffic, toying with mortality. It was a dare. A crazy thing to do, but the kind of thing teenage boys come up with. We were committing ourselves to fate. I remember well tipping my bike over the edge of the hill—steep enough to trigger vertigo. You felt you were dropping off a cliff. At that instant I felt released from all human-made laws, subject only to the immutable laws of nature, physics, and fortune. I was trusting the universe and my own reflexes to get me safely down the hill and through the intersection. My troubles vanished the instant I tipped over the edge of the hill until the moment I shot through the intersection. A short trip, but what a rush.

Now on this emergency room table, I’m on a bike careening down Crematory Hill and I’m overwhelmed by a similar sense of release. This is how it’s going to be. I’m not weeping with anguish or befuddled with grief. Instead, I’m outside myself waiting for the huge revelation, the realization at the end, trusting that there would be one. I’m completely present in the moment, curious as hell and hyperaware of everything, the unshaven cheeks of the doctor, how tired he looks, the little obsidian stone on a necklace dangling on a silver chain from the nurse’s neck, the bead of sweat over her lip, the lank curl hanging loose from the clasp in her hair, her fleeting expression of empathic anxiety, the kindly and sympathetic expression on the face of the technician. I feel the crinkling of the paper sheet on the examining table beneath me. IV needles are shoved into both my arms and I watch my wife’s face crumble as she is led out of the room taking what might be the last look at her husband alive. I notice again as I have a thousand times before that her left eye is slightly off. I was always aware of her lazy eye but now I think how beautiful that wayward eye is, her face angled with exactly the right dreamy degree of Picasso and I wonder if that’s why I never get tired of looking at her. If the sight of Mary Ann is the last thing I see in this life, I’m good to go. Before she passes from view, I mouth the words I love you. As the nurses and doctors cluster around me I think about consciousness and how lucky I am to have been on this planet, even for such a short time. Planet Earth. My name is Arthur and I’m embedded in earth (e-art-h). Arth is an old Celtic word for bear—the totem animal for the ancient ones, who believed we all live on the back of a cosmic bear: Planet Bear. I realize the distance I’ve come and although fame and fortune eluded me, even the kind of modest success in art and music I aimed for, my wife is safe, my children are safe, and I’m swamped by a wave of gratitude. Yes. I’m sure of the nature of this sudden overwhelming emotion. I see the arc of my life and it adds up to something that has nothing to do with fame and fortune, but I can’t put that something into words. They roll an X-ray machine into the examining room. I didn’t even know they could do that. The X-ray machine rolls out and another machine rolls in: echocardiograph—mapping the heart with sound. The doctors tap my body here and there, haul me up into a sitting position so they can maneuver their stethoscopes. A nurse puts a small tab of nitroglycerin under my tongue and the pain finally starts to subside. Eventually, I’m admitted to the hospital, ending up in a private room overlooking a construction site. There is a television, but I never once turn the damn thing on, tired at last of witnessing the death throes of a democracy. Instead, unable to sleep, I stare through the window at the construction of the new hospital wing, content to lay eyes on something being built rather than torn down. Every three hours during the night a nurse comes in to take blood and it is almost morning before I can doze off. As I fade halfway into sleep, wondering if I’ll ever wake up, I hear a radio down the hall, probably from the nurse’s station. It takes me a few moments to recognize the Beach Boys. No lyrics. Just a concerto for the wordless human voice, and it’s as if I’m caught in a river of polyphonic harmony. I’m rapt in how utterly, utterly beautiful the human voice is and how it can’t be heard anywhere else in the universe except here on our planet, and for a moment I wonder if language has co-opted the natural beauty of the human voice. There must have been a time before language evolved when humans, perhaps after listening to the birds, communicated by tones, whistles, and barks, learning to sing before they could talk. I’m happy the radio is loud as I fall asleep dreaming that I’m hibernating in a snow cave waiting for the vernal equinox while being held gently in the paws of a huge kindly bear. I didn’t know Brian Wilson could do something like that—mapping the heart with sound.

The next day I’m awake and alert when the doctor comes in the room to explain that atrial fibrillation caused my heart to fail, leading to pulmonary edema, which is when the air sacs in the lungs fill with fluid. The doctor is very patient, and he takes the time to explain to me how the heart works. He shows me diagrams and even a plastic model of the heart that can be disassembled to show how all the parts, atria, ventricles, arteries, and veins work together to pump oxygenated blood through the body. He warms to his subject when he senses my interest and he goes through the entire circulatory system, explaining how oxygenated blood is delivered throughout the body and depleted blood returned to the lungs for reoxygenation. I ask him how the heart regulates itself in the first place.

“An electrical signal that starts in a group of cells at the top of your heart called the sinoatrial node travels through the network of conducting cells, triggering first your two upper chambers, the atria, and then your two lower chambers, the ventricles. Each cell in the heart activates the one next to it, passing along the electrical signal in sequence so that the entire heart contracts in one coordinated motion, creating a heartbeat.” For some reason I think of the audience in a baseball stadium doing the wave.

“In a healthy heart,” he continues, “the signal travels very quickly, allowing the chambers to contract in a smooth, orderly fashion. An irregular heartbeat, which we call atrial fibrillation, weakens the pumping signal to the atria and the half-assed response of the ventricle causes blood to back up and pool, thus creating the conditions for blood clots to form.

“You can live your entire life with atrial fibrillation,” he says, “if you’re careful. Blood clotting is the major risk. There are some measures we can take, but in the meantime, we’re putting you on blood thinners. Your heart is undamaged, so you’ll probably be around long enough to finish several novels.”

I leave the hospital on the third day—the day after Thanksgiving—feeling no pain at all and with a healthy blood pressure. As I’m leaving, I stop at the nurse’s station to ask if the Beach Boy concerto I heard the other night was on Sirius or Pandora. The nurses and orderlies gathered at the nurse’s station don’t know what I’m talking about. “We don’t play a radio on the floor,” the nurse says. “Certainly not at night.” They all agree that the ward had been pretty quiet all week. The choirlike performance I heard that first night must have only been a strangely beautiful hallucinatory experience that had come out of nowhere. And yet, the singing was so real, so original, so intense, and I felt so instantly bereaved at how quickly it all vanished when I awoke.

I’ve lived a relatively long time with not much going wrong physically. I got used to being alive—seemed like it was going to go on forever. But I can’t help wondering about the endless mystery that hangs on the thin spark that keeps the heart beating. I weigh all that happened to me in the last few days, from the music to the doctor’s detailed explanation. That spark seems such a tenuous and vulnerable link to life. Wherever it comes from, it has brought all of us a long way, and yet it’s also a single point of failure—the ultimate vanishing point. I’d better see to its care because gravity is relentless, and momentum doesn’t go on forever. It’s not like I can change the batteries.

Art Hanlon was born in Brooklyn, New York. After serving in the Marine Corps, he attended the University of California at Berkeley, taking a bachelor’s degree in American history and English, and a master’s degree in journalism. He worked as a newspaper reporter, a country blues musician, a theater set carpenter, a technical writer, and a book editor before returning to the University of California Riverside Palm Desert for an MFA in creative writing and writing for the performing arts. He is currently an associate poetry editor for Narrative Magazine. His song “Spokane” won first prize in the 2005 Tumbleweed Music Festival in Richland, Washington. His essays and fiction have appeared in Surfing Illustrated, Art Access, Narrative Magazine, Coachella Review, and Kelp Journal. His essay “The Brilliant Present” was included in the Special Mention section of the 2019 Pushcart Prize Anthology. 

Header image by Marilyn Hallett Granzyk