I finally figured out what my back pain was. It was a heart attack. I first mentioned it back on August 12^th, so that’s been about a month. A month-long heart attack. I didn’t even know that was possible.

In retrospect the giveaway was the wrist pain which accompanied my back pain. That was novel, and apparently the classic “chest pain radiating down your arms” symptom you’re supposed to recognize. Only I never had any chest pain, and it certainly didn’t “radiate” — my wrists hurt, and the center of my back hurt. And my back has hurt a lot over the years. That’s hardly out of the ordinary.¹

So I kept going, and sometimes the pain would vanish for a few days and sometimes it’d be back for a few hours, but it generally didn’t bother me all that much. The wrist pain was annoying but I figured that was just carpal tunnel, and was being triggered by the back pain. So I arrived in Warsaw, checked into my hotel, and tried to get a good night’s sleep.

But it was still there in the morning, and after a few hours it ended up getting worse. I eventually decided to go to the ER, but wasted a lot of time trying to get help from the organizers of the larp I was about to play.² And then going to a clinic that ended up being mostly shut down.³ And eventually arriving at a medical building where I must have wasted 30 minutes wandering around trying to find a doctor.⁴

But I did eventually find the desk to sign in at, and after communicating I might have the symptoms of a heart attack⁵ they had someone take me to a doctor who had them take me right back to reception to fill out some forms. And then I went to intake, who gave me some pills and administered an EKG and asked some questions. And then I was put in a wheelchair and wheeled down the hall to a bed in a waiting area where they took some blood. And ten minutes later two burly Poles threw me back into the wheelchair, wheeled me into an ambulance, and drove me out of the hospital with the sirens blaring.

We arrived at a different hospital, and I was wheeled directly to an OR, where a doctor explained for the first time I was having a myocardial infarction and they were going to have to operate immediately. Within five minutes I had a wire jammed up through my wrist and into my heart, and ten minutes after that I had two arterial blockages cleared and was being wheeled into the cardiac care unit to recover.⁶

There’s a happy, funny story I might have been able to tell at this point where all these events were weird and terrifying and strange but ultimately no big deal beyond being a call to arms about improving my health. The doctors would put in a couple stents a few days later to improve blood flow in some other arteries.⁷ I’d have spent most of the weekend in the hospital and been discharged on Monday — most first-line treatments for heart attacks are basically outpatient procedures at this point — and even been well enough to catch a planned flight to Paris on Tuesday.

I’d spend the rest of this post telling you about the horrors of a Polish cardiac care unit, which are manifold. For recovery and observation you’re placed in a bed — this one had about a dozen, although at most four were full at any given time — hooked up to a heart monitor⁸ and an IV, and left to yourself. Although you’re never really left to yourself. What privacy there was is provided by a curtain on either side of your bed and another wheeled curtain they sometimes bring over to cover about 75% of the foot of the bed. The lights came on at 5am when the nurses arrive and go out at 8pm, although they’ll turn on all the lights at 1:30am for an hour if a patient’s being admitted. They frown at you if you stand up and you certainly aren’t permitted to walk so there’s no baths or showers. They have to wheel a chair over for you to crap in which is at least better than a bed pan but not by much.⁹

The beds were incredibly uncomfortable. They were modern hospital beds where you could adjust the height of the foot and the head but the mattress was less than a handspan thick and by the end of my stay I was starting to develop bedsores. If you’re lying on your back in bed all your weight rests on your tailbone and if you’re trying to sleep on your side your weight all grinds down on your shoulder or elbow or hips. There’s no “call” button so if you want to get the attention of the nurses you have to kind of shamble up and get their attention by yelling at them. I kept trying to get water but for some reason they would only bring tiny plastic cups.¹⁰ I eventually just started drinking juice my friends had brought me — not very healthy, but I was over it — because I was sick of asking.

But the real horror was the food. Polish food has its moments¹¹ but they’re mostly deep-fried. Hospital food is supposed to be cheap, healthy, and utilitarian. You get three meals a day in the hospital. Breakfast and dinner were always the same — three slices of bread, a pat of butter, a raw vegetable,¹² and a slice of ham. Every day, twice a day. I wouldn’t eat the ham and eventually even the bread was nauseating; getting through even half of it was a challenge. Lunch was the larger, hot meal of the day and was usually a slab of meat (chicken, pork, or fish), fried potatoes, and a kind of flavorless noodle or rice soup. Sometimes it was a kind of mixed stew over rice which would have been okay, except I couldn’t eat around the meat. I ate what I could.¹³

The whole thing highlights a puzzling disconnect for me. You’ve had a heart attack. You’re in recovery. Your sole focus is supposed to be staying calm, keeping your blood pressure down, letting your body recover. But the situation in which you’re expected to do that is so unpleasant and inadequate to that task it’s hard not to feel it’s counterproductive. It’s certainly dismal. And the longer you stay, the worse it gets.¹⁴

The doctors did put in the stents a couple days after I arrived, but I did not get to go home a couple days later. A cardiac ultrasound revealed bad news. When you have a heart attack, whether it’s painful or not, whether you’re even aware of it, there’s a clock ticking down. Your heart is dying. There’s a race on to restore the blood flow to your heart. My doctor’s quote after the ultrasound: “We were too late.”

I can’t know if most of the damage came from the weeks before or the four hours when it got particularly bad in Warsaw but at some point, my heart muscle started to suffocate. A lot of it’s now just … gone. Dead. Scarred. It’s never coming back. A healthy heart contracts about 60-70%. After the stents were put in, mine was doing about 30%. This is, to put it mildly, bad. It doesn’t just mean I’m not getting enough oxygen to my muscles so I get exhausted ridiculously quickly. It means I’m not pushing enough blood through my heart and lungs. Sluggish blood is stagnant blood and stagnant blood clots.

So this sounds dreadful, and it is dreadful. But it’s not the end of the world. Getting back to 65% isn’t going to happen, but apparently with recovery and treatment and work and lifelong drugs, you can get back to 50%. And 50% is the very tail end of “normal.” Below 50%, lots of bad things happen. Above 50%, a lot of that just isn’t a big concern.

I spent nearly two weeks recovering in a Polish hospital. The goal was mostly to make sure I was stable on medication, so they focused on changing the injectable medications into pills which did the same thing.¹⁵ In another fun discovery, I’ve got a clot in my heart which is going to need to dissolve before I can take an airplane.¹⁶ That could take three months. I’ve spent a lot of time canceling my plans up until the New Year. And I had a lot of plans.

The “recovery” was the worst part. There’s really nothing much to do after a heart attack. You need to rest, and to a hospital that means you need to lie in bed and do nothing. I was hooked up to a heart monitor and had my blood pressure and pulse taken on a regular basis. And that was it. No television, no WiFi, no visitors.¹⁷ I had my computer, at least, and a robust enough mobile phone plan that I could fiddle around on the internet, but not enough that I could stream Netflix or download movies. You’re there until the doctor decides you’re well enough to be released, and that has a lot to do with EKGs and blood work and cardiac ultrasounds and not all that much to do with you.¹⁸ So I waited, and waited, and waited, and finally the doctors decided I was healthy enough to leave. And so I left.

I’m right now in the Warsaw train station, where I’m going to carve a perilous path back across Europe to the UK.¹⁹ Warsaw hospitals apparently don’t bother to give you any medications when you’re discharged, so I had to spend a nasty hour wandering in the heat from pharmacy to pharmacy in downtown Warsaw collecting a complete set, but I got there.²⁰

The good news is it appears I can still stand up, and can even drag my sorry ass around a way-to-hot autumn day longer than I ought to be. The bad news is I get dizzy way too easily. I took it very slowly, waiting for a good 15 minutes at each pharmacy to cool off and let my heart recover, and I still feel like I’ve been going at it for eight hours. Some of that’s just the crap sleep I’ve been getting, some of it’s just having spent two weeks in bed, and some of that’s just a long recovery ahead. And some of it’s just gone. We’ll have to sort out what’s what.

So that’s where I’m at. I don’t feel well, but I don’t feel sick, exactly, either. I certainly don’t feel like I need another day of “recovery” in that hospital. I just want to see some friends, relax a bit, and sleep some place where they don’t turn on all the lights in the middle of the night. And see how it goes from there.

Next: Berlin to London
Prev: Berlin to Warsaw

Footnotes

¹ I mean, the appearance of the wrist pain was weird enough for me to look up symptoms of a heart attack online, and I ended up on the NHS website, which pretty much convinced me I wasn’t having one. The first symptom was chest pain (no), and the second was “… it can feel as if the pain is spreading from your chest to your arms (usually the left arm, but it can affect both arms) …” (no chest pain, so no) and then dizziness (no), sweating (no), shortness of breath (no), nausea or vomiting (no), anxiety (no), and coughing (no).

It does, eventually, go on to say that they were lying about the chest pain — it’s common but far from universal. So, you know, jaw pain and anxiety? Maybe a heart attack. Sweating and shortness of breath? Exercise can trigger a heart attack. Lightheadedness, nausea, and coughing? Probably a heart attack.

² Nobody was available to help me navigate the Polish medical system, so I ended up going on my own after about 90 minutes. I don’t know if it’s reasonable to expect medical help from larp organizers in a foreign country but based on my experience, if you have an emergency, you should assume you’re on your own.

³ I should have called the emergency services number but I wasn’t sure that would work on my foreign phone and didn’t speak Polish. I decided to ask for help from the hotel but there was a huge line waiting to check in and I still didn’t think I was having an emergency. There was also a argument on the larp chat over whether I’d get charged if the ambulance showed up and wasn’t actually having an emergency, which is why I called a cab. And of course, I got bad information on the chat over what clinic to go to.

That clinic eventually directed me to the correct place, although not before assuring me I was clearly not having a heart attack, because heart attack pain doesn’t make it difficult to breathe.

⁴ I’d have thought — like most medical buildings I’ve been to — there’d be some kind of information desk or reception where they’d direct you to the right department. There wasn’t. There were a bunch of signs around entirely in Polish and long corridors leading off into the buildings.

This is where the lack of a local escort hurt. I had no frame of reference for navigating these spaces, and while I did figure it out it turns out this was one of the few instances where time was absolutely critical.

⁵ Google Translate

⁶ I have to say, at just about every other point in this story you are free to imagine Soviet-era facilities or maybe underfunded community hospitals built in the 90s in the US, but the one time that will lead you astray is here, where they actually operated on my heart. The machine for the angioplasty was clearly new and sleek, with a giant screen for the visualization which floated and pivoted in and out on its own. Poland ranks pretty low on health care for the EU, but this was one of the few things I had zero concerns about.

⁷ Same deal as the angioplasty, minimally invasive through the wrist. Took 30 minutes.

⁸ For some reason, for the whole damn time I was on the cardiac care ward, they’d slap these sticky conductive patches on my chest directly over my chest hair to hook up the heart monitor, then wonder why they came loose within a few hours. Coming loose means tearing them off and replacing them, and by the end of my stay we had gone through dozens and dozens of them. The nurses took to leaving a pile of spares near my bed.

Not once did they actually bother to shave the area to get a decent connection.

⁹ If you’re thinking it’s better in the private rooms, that’s true, but “private” isn’t accurate. I was moved to one for the last few days and it had four beds and no dividers whatsoever. And they still moved people in and out of the rooms during the night, for whatever reason.

¹⁰ Even when they dropped off pills they wouldn’t bring water with it.

¹¹ Pierogis, obviously

¹² A leaf of lettuce is popular. So is ¼ of a tomato. Occasionally there’ll be a slice of green pepper, or even some bland cottage cheese. Once they had a two-bite chunk of dill pickle and it was the best thing I had tasted in a week.

¹³ Truthfully, I would have been in terrible shape except I had some friends bring in fresh fruit for me, so I was supplementing the hospital food with fresh apples and plums and apricots and grapes. I still lost a lot of weight.

¹⁴ I get that a lot of this is money. Better food costs money, and the Polish health care system doesn’t have much of it. But that doesn’t explain why the nurses so frequently slam the doors open when they come in and out of the rooms. Or why so many of them wear heavy perfume. Or why they don’t bring soap and water when you use the toilet in the cardiac care unit. Or why there’s no shampoo or towels in the showers. Or why the nurses talk so loudly at their station for hours when it’s slow on the ward, even after the lights are off.

¹⁵ Direct quote, when they switched up one of the anti-clotting medications: “There may be bleeding from your … waterways. Everywhere. Maybe.”

¹⁶ For most routine heart attack treatments — angioplasty and stents — the delay between them and when you’re cleared to fly is ridiculously small: about three days. Even after open heart surgery you’re generally good to fly after four to six weeks.

¹⁷ Granted, this was a me problem. I just don’t know anybody in Warsaw.

Wards in Poland seem ridiculously lenient on visitors. There doesn’t seem to be any restrictions about who can visit or what hours they can be there or what they can bring in for you. I had huge boxes of fruit and juices and diet sodas and chocolates and nobody said word one about it.

¹⁸ I hope I can pass on at least one thing from this post to you. The medical establishment does not have your best interests at heart. The minute you become a patient you cease to be a human being and the more severe the treatments you require the worse this will get. You are a lump of flesh to be kept alive at any cost, no matter how you feel about the matter, no matter if you are made miserable by the process. Modern Western medicine is a nihilistic process only made possible through the denial of your soul; it is capable of miracles, but you are largely irrelevant to its functioning.

It is absolutely critical you understand this. The medical establishment largely prefers you to be in agony with a 96.2% chance of survival than happy with a 96.1% chance of survival. If you or a loved one gets seriously ill, you are the ones who are going to have to assert your humanity. The system can’t and won’t.

¹⁹ Why the UK? Well, I can’t fly, and I can’t stay in Schengen. But I can find a private cardiologist in the UK and have a little continuity of care while I figure things out.

²⁰ Here’s a useful, if obvious in retrospect, tip: the pharmacies in Poland with people over 50 working there are probably useless to you if you don’t speak Polish. They were to a one unfriendly and unhelpful.

If there’s someone working there under 30, though, their English is better and they’re actually helpful — suggesting generics, offering to call around to see who’s stocking the last medication you need.