Are you ready to die, Carl Feather?

A memoir of heart failure, open-heart surgery and complications

I have chased sunsets most of my life, although of late I’ve not had no passion for such pursuits. Nevertheless, on that evening in February 2021 was before me the most stunning example of a fading Helios I’d ever witnessed.

The afterglow across the Amish hamlet in North Central West Virginia has more orange than a pumpkin field and red than a blood bank. It glows brighter than a searchlight. Bare, blacker-than-eternity hardwood forms stand gaunt against this sunset of sunsets.
I stand in the side yard of a brick church and gulp the blazingly cold air into my lungs; my body shudders and begs for more air as my legs tremble.
The day star and I are one in this moment, both fading, both dying.

A preacher comes alongside me. “Are you ready to die, Carl Feather? Before this day is over, you will be dead.“

February 5, 2021

For weeks I have been working 16 hours a day on the house at 6 Seaford Lane, Bruceton Mills, West Virginia, into which my wife Ruth, my father Carl J. and I moved into in mid-November 2020. The joy of buying a retirement home and relocating to our favorite state has quickly turned into a nightmare of undisclosed, serious issues with the house requiring far more energy and money that remained after remodeling and selling our home in Ohio, then making the move of 240 miles.
I am exhausted. For days, I have been unable to work on the house. My nights are sleepless with worry and coughing; day and night I struggle to draw in enough air to gasp for the next breath. I and my wife suspect Covid, but I won’t know for four days if the test that I took the day before is positive. I need air!

Shortly after noon that Friday, I struggle to the front door, throw it open and stick my head into the frigid mountain air. I inhale like a diver who has just broke the surface after having his oxygen tank spring a leak. But I get no relief; dizzy and weak, I struggle back to the sofa and resume staring at the disaster.
“Dad, I have to go to the emergency room.”

The ER physician at the Mon Health System hospital in Kingwood listens to my heart and orders blood work. The extremely elevated level of the enzyme troponin indicates that I am either in the midst of a cardiac event or coming out of one. I have congestive heart failure, as well.
Within two hours of my wife delivering me to emergency room and convincing the intake person that it was indeed an emergency and my Covid test results were not available, I am in the back of a KAMP ambulance, prostate and under the care of a muscular, middle-aged male EMT who makes small talk about his open-heart surgery. As the ambulance traces the winding concrete ribbon of Route 7 from Kingwood to Morgantown, he assures it will all turn out well. He pulls open his shirt to reveal the zipper scar on his chest as proof, but he warns me not to have it done locally.
“Go to the Cleveland Clinic, that’s who did mine,” he says.
“Great,” I think. “I lived 50 miles from Cleveland for 66 years and never once required medical care from the facilities there. I move away and three months later, I have to go back for open heart surgery.”
Life.
That unpleasant prospect aside, as the ambulance snakes its way through the Appalachian night my thoughts are not so much on myself or the likely surgery and painful recovery as they are on my third great-grandfather Jacob Vatter. He and his wife Mary settled in Preston County circa 1810 and lived out their lives on a farm in Crab Orchard, five miles from our new residence. I thought of how frightful the event I was undergoing would have been for him and his family, living without benefit of blood tests, a physician, ambulance service or choice of cardiology departments, let alone a hospital 275 miles to the north.

Among the reasons for wanting to live out my years in West Virginia was to experience firsthand the land of my fathers and eventually be buried among them in that soil.

It appeared the second part of that objective was about to be fulfilled much earlier than I had anticipated.

February 7, 2021

The EKG, echocardiogram and heart catheterization confirm what the ER physician had suspected. My aortic valve is failing, and my heart drowning in fluid. There was no going home to get stronger or anticipate the surgery; the event is scheduled for February 12, a Friday.
The surgeon is optimistic that the valve and single bypass will take care of the issues. I should be fit to go home a week or so after the surgery.
This is one of those events that I expect to happen to others but omitted from my map. My journey thus halted, the washed-out bridge before me, I have but one option: jump into the raging river and trust the surgeon to have a good lifesaver and rescue team waiting for me downstream.
I put it all into God’s hands as they wheel me into the operating room that morning. I expect the worst, hope for the best. My mind races with all the unfinished projects at the house, unfinished manuscripts and unaccomplished dreams. They will have to await the outcome of the surgery. My heart has run out of time, this is my only shot at life.
As the drugs are injected and the bright lights over my eyes grow dim, I determine that if I meet God along this journey, there is one question I want to ask him.

What is truth?

I am an electron. In the alternate reality of anesthesia and whatever drugs are pumped into the body of a man whose chest has been opened and heart repaired, and while he recovers in intensive care, I am reduced to an electron trying to escape the maze of logic gates in a computing device.
For the next several days, I travel this circuit in a Fed Ex box destined for a boutique in Pittsburgh. In this reality, Fed Ex has developed smart shipping boxes with circuitry between the layers of cardboard. At my departure point in Japan, I am injected into this maze of diodes and logic gates, resistors and a trillion possible paths.
It is maddening, and I just want to escape the circuit, take on the body of a human and go home. And it continues for days: it is the only reality my mind knows during and after the surgery.

The early morning of February 21, my wife receives a text message from the hospital. During the night, I suffer another cardiac event. My heart fails while undergoing another catherization. I am placed on an external pump; my only hope for survival is an advanced heart failure unit. The nearest such facility is at Allegheny in Pittsburgh.
I recall nothing of this, not even the $32,000 helicopter ride. In my alternate reality, I gyrate between imprisonment in an electronic maze and hospice care at home.

Visitors over my body as I lie on a table in my office. I speak faintly to the former neighbors, coworkers, pastors and friends who travel from Ohio to say their goodbyes and extract mementos.
The pastor who told me I was going to die talks to me about Jesus and the afterlife. He did not hear my mother’s voice and is certain of my fate.
At some point, I get to pose my question, although I cannot say to who. The answer is simple and complex.

“Truth is in the moment.”

I repeat it over and over. I don’t want to forget it, in the event I emerge from this alternate reality and have the opportunity to finish the unfinished life.

I wander into that brick Brethren church on a Sunday night and assist a young woman and her band with the engineering of a recording of her lovely Christian song. It is the most beautiful song I’ve ever heard. She snaps a picture of me with my dog for the CD jacket and delivers copies of the recording to our home. Indeed, I discover she is our neighbor and lives across the deep gully where the old Kingwood Railroad tunnel was built. Carved into the rock of the tunnel’s entrance is an elephant; the carving is being extricated by the young woman for $100, and she is incorporating it into the mantle of the massive fireplace being built in our living room.

Specialists in Pittsburgh offer Ruth little hope for my survival without a transplant. In the interim, an extra-corporeal life support (ECMO), takes over my heart function and a ventilator performs my lungs’ work. Counselors prepare her for the inevitability of being married to an invalid whose very existence will depend upon this machinery.
Daily she drives from our home in the mountains to Pittsburgh’s nest of interstates and side streets to be by my side and make crucial decisions about my care and our future. She takes off time from her job, which she started just two months earlier, to attend to these tasks. My father holds down the homestead and takes care of the pets in her absence. My son drives from Ohio to visit and help out in myriad practical ways; my step-daughter-in-law, Kristine Evans, comes from Wilkes-Barre, Pa., to encourage and support Ruth.
My father, Ruth and our friends from Ohio turn to God and call upon believers in their circles to do the same. Entire church congregations pray for me.
Each day brings a new complication and, oftentimes, a new procedure that involves going under anesthesia again, blood transfusions, more tubes and more equipment. I am told that at one point during my stay in Pittsburgh, four stands were required to hold the 16 bags of drugs, blood and fluids trickling into my body.
I kick off whatever coverings they place over my body and grab at the mass of tubes and needles penetrating and protruding from skin. I am restrained; my hands are placed inside boxing-glove-like mittens that leave my fingers numb. My upper lip is pressed between my teeth and the ventilator tube, resulting in a deep, painful cut.

Concurrently, my mind is dealing with its own reality.

I am back in Ohio with my father. The nation is in turmoil as youth have risen up against our generation, demanding relief from the onerous burden of student debt and increased taxes required to keep the older generation alive. Hunting down and killing the elderly has become a sanctioned pastime in my alternate reality, the only one my mind knows.
I witness the shooting of my father and desecration of his body. The undertaker publishes a full-page ad in the newspaper announcing that I will give the eulogy for my father. I am wheeled before hundreds of people at an outdoor gathering, but I cannot speak. For six hours, I sit before this restless crowd, speechless, motionless.
Punishment ensues. I and my wife are arrested for allegedly stealing the metal frame for an underground structure we are building onto our house to accommodate the nursing home and restaurant businesses that Ruth had to start in order to pay for my care. She develops a fashion line and makes commercials on the beach in California, propping me up in the background as a pathetic onlooker. She goes to work each day in a helicopter.
As we are booked on the theft charges, our accusers take turns abusing me. A malfunctioning CT scanner is used for my mug shot, and the sheriff repeatedly passes me back and forth through the radiation field, assuring me that the dose will be sufficient to induce brain tumors. A government official comes to my side and tells me his hobby is playing with needles. Dressed in a 19th-century undertaker’s outfit, he pulls out his collection and samples each artifact’s effectiveness and range of penetration on my body.
It is during this procedure that I notice my accusers are caring white notebooks. Someone whispers to me that if they have white notebooks, it is just a nightmare. I am given the mental tool by which to escape the nightmare, only to return to the alternate reality of an electron seeking an outlet.

Nightmares are nested within hallucinations.

I remain in the heart failure unit throughout the remainder of February and most of March, using up the 30-day Medicare limit. Each day brings a new challenge. As I gradually defy the odds, there is one fewer tube, one fewer IV bag. I recall nothing of it. My body is there, but my mind is trapped in these alternate realities. If I display any awareness of my surroundings and the gravity of the situation, I beg to go home.
It is out of the question.

Continued February 12, 2022