The Little One

Reminders of our mortality

In little existential bites

In the last twelve months, we have had our share of medical drama in the family. It began with my breast cancer scare during the summer of 2021 and the lumpectomy that followed it. It is strange to me that after that we had a string of health news and events in such a short span of time – it feels to me like someone, somewhere is poking us repeatedly… or in my case, pounding through my thick stubborn skull the fact that life is very fleeting and that we actually have little control of how it unfolds. “Hey, it’s about time you get it: you’re actually not in control over anything… except your hygiene.”

The cancer scare from last year has a happy ending – it was benign, and the lumpectomy in the fall was out of precaution. But for about six days in August, I sat around waiting for the biopsy results, and that was an interesting time. Being me, of course, I thought about how to leave my affairs in order, making sure that Jeff was taken care of (as if he needs it… he’s 19 years older than me and has more life experience!). First of all, a tad dramatic, I know. A biopsy on a 6-mm tumor led to “oh no, I’m going to die!” One does not automatically lead to the other. But my thought process was important at the time because I was forced to think about death. I thought, “so, is this how the cookie crumbles? Why so early, God?” During the wait, I was visiting my brother and his wife who welcomed their first child just two weeks before. I wondered if I would be able to see this precious boy grow up… Needless to say, it was an existential six days.

The episode of Jeff’s medical emergency was the next existential experience, and frankly, we are still processing it. It was traumatic, so I don’t like thinking about it too much, too often, and I know that Jeff is going through some surviver’s guilt – aortic dissections normally kill people… “why was I spared?” is the question he is dealing with. For me, it was another lesson that really nothing about this life is within our control. The few hours after Jeff and I parted ways in the ER were a real low point in my life – I thought Jeff might die, and I may become a widow, and how am I supposed to live the rest of my life without him?

As if that wasn’t enough dose of existential lessons, I recently had another such moment. During a fairly routine visit to the doctor, I had an EKG/ECG done. The doctor saw me afterwards and didn’t even talk about it – presumably because it looked normal. A week later, the test result appeared on my “mychart,” and boy was I shocked. It said that I had had an infarction of unknown age. A heart attack? I quickly ran through my memory bank to check if I had felt anything bad. Nope… I don’t remember having a heart attack… huh?? I was skeptical of what I was reading because I felt fine – more than fine! Of course, I consulted Dr. Google to see if you could even have a silent heart attack and be completely fine (that’s a bad idea BTW). I’m not obese, I do not have hypertension, I am not pre-diabetic, and my triglyceride levels are super low, etc… so what gives? But for the next 20 hours or so, I was so confused, and frankly, a little scared in case it meant something. Your heart is a vital organ and it is so deep within your body… and during those 20 hours, I got a small taste of what it meant to put one’s life into God’s hands. I did not even tell Jeff about it until I knew for sure. And just in case, I ordered a vegetarian meal for dinner that evening (hahaha, so unlike me). And the next day when I spoke with the doctor’s office, I found out… that this happens all the time to healthy people because those machines are so sensitive!! This is why you need humans to read the actual report.

After I knew everything was okay, I told Jeff and we had a really good laugh about it. We even laughed about that rogue vegetarian meal (which was really delicious, by the way). It was a comic episode, but I cannot help noticing the messages that are piling up before me, and they point to a singular lesson… one of human mortality and of humility that is required to accept it, to be at peace with it. When we are young, it is so difficult to imagine that our lives could end… so it is easy to focus on our own goals. Of course, our accomplishments on earth are important because we are supposed to express the potential God allowed for us… but at what point does it become purposeless? Achievement as the end in and of itself? Money for its own sake, safety out of fear, ego because we are all to some degree narcissists (while we accuse others of being full-blown narcissists)…

The awareness that we do not control or “own” the days, hours, minutes, and seconds in our lives helps us to truly embrace them and be responsible stewards of them. In recent years, I have seen stoicism make a comeback, and with it the Latin phrase “momento mori,” or “remember that you must die.” This sentiment helps us to put everything that is happening around us into a larger holistic perspective. But let’s take it one step further: We all die, but the real kicker is that none of us know when. The potential immediacy of that fateful moment is what should drive the notion that we do not actually own the next 24 hours. They are not guaranteed. Not under our control. Why? Because just maybe history, even our story, doesn’t revolve around us.

I am a fan of Bishop Robert Barron, and one of the things he says is that we in reality are all a part of “Theo-drama,” but our perspective is set on the “ego-drama.” I love this spiritual way of looking at life. I know that I have made decisions in my life based on this “ego-drama” I was writing for myself. But it is all in vain. Because no matter how spectacular and special I think this little “ego-drama” is, it is really an illusion of control and importance. The existential moments, when they come, teach us of this illusion and helps us to see the reality of the bigger drama unfolding through history. One where we have roles but the story does not revolve around us. This humbles us (there is that word, “humility”) and helps us to ask the right questions and to act with the right motives. “How can I help you?” “What can I do to make things better?”

I am so grateful that my existential lessons came in bite sizes. My cancer scare had a happy ending. My funky EKG reading was a technical glitch, and the internal Sturm und Drang only lasted less than a day. And while Jeff’s experience was traumatic for the both of us, my slice of true existential fear was a few hours… and I got him back. Not in the least, our dog Maris’s journey into “home hospice care” is the latest lesson in mortality. Okay, God. I get it. I get the picture. Nothing is under my control, and I need to put my trust in you.

The other patient in the house

ever sweet, ever loving, ever ours

Through the saga of Jeff’s surprise surgery and the recovery process, something else has also been bringing us together. And that is our dog, Maris. On March 24th, just one day before Jeff’s aorta ruptured, we found out that our little furry family member has an aggressive form of cutaneous lymphoma. All of our attention was on the dog for about 24 hours until Jeff’s surprise visit to the ER on the 25th.

Maris was born on May 14, 2011 at Double Gap Farm in North Carolina. Jeff and I had been newly married and was interested in getting a dog. We really liked the Swiss German canines, especially the Greater Swiss Mountain Dog. But these dogs get to be as much as 150 pounds. I am not little, but I am 5’4″ and at a healthy weight. I told Jeff, “I will not be last in pecking order!”

One day, we were just browsing through the American Kennel Club website, and we saw a smaller version of the Greater Swiss Mountain Dog. After some research, we found out that there were four Swiss Mountain breeds: Greater Swiss, Bernese, Appenzeller, and… ah, the Entlebucher Mountain Dog. We found a breeder in North Carolina, visited the farm to “meet the parents,” and then on July 19, 2011, we traveled to the farm to pick up the 9 week old puppy named “Pink Camo” that would become Maris.

I am sure that I will reminisce about our amazing 11 years together when the time arrives for us to let her go. For now, we are focused on cherishing our time together and on trying to make her as comfortable as possible. Maris still has some energy – still likes to go on walks with us, even though the distance is much shorter than it used to be. She tires easily. She has sores on her body that make every day activities uncomfortable, I am sure. But she doesn’t complain – she just works around it. We place a cone on her at night so she doesn’t scratch her wounds while she is sleeping, and she wears a blue inflated donut around her neck during the day for the same reason. But she just accepts that she will now be wearing these things for the rest of her life and is just happy to be next to us wherever we go.

She is such a good dog.

Jeff’s medical ordeal put Maris’s health challenges into perspective, so I am at a relatively calm place. Everyone who knows me well knows how much I love my dog. And she has had a great life because of it! People used to say to me, “when I die, I want to come back as Anna’s dog!” Maris was a great friend to me when I felt the most lonely, and the combination of Jeff and Maris was the perfect healing salve because Maris was the prism that expanded Jeff’s ray of sunshine into a beautiful spectrum. Living with them, my world grew a much richer palette of colors.

But some time this year, I will have to let her go. And I think my experience volunteering with hospice patients may help me here. During these last weeks/months of her life, it will really be about her, not my grief. We will have the most fun possible, share the most love possible, and eat as well as possible. She does not know that she is dying yet. We will cherish the time we have left together, and when the time comes, Jeff and I will be grateful that we were given the opportunity to be stewards of such a magnificent animal. It was another gift that God gave us to teach us lessons in love, giving, and healing. All creatures belong to God – and how wonderful that we got to take care of one of them!

Maris is about to teach me the proper downward facing dog

What is a miracle?

is it something improbable or impossible?

My line of work is in investments. I lean into history, try to learn from it, and use it to understand probable outcomes in the future. There is no way to know for sure if there is going to be a recession or if the current state of high inflation will be persistent. We can take the variables from the past with the understanding that the current situation also has new considerations, and apply them to understand the probability of different outcomes to set reasonable expectations.

Whew, okay, done with the shop talk. Why did I just write all that? Because anticipating a range of possible outcomes and understanding their probabilities is at the core of what I do all day, every day. So when I think about what happened to Jeff, I marvel at the extremely slim probability of the final outcome. Truly a far out “tail event” in statistical speak. And I’m not just talking about that giant clot that ultimately saved his life (and yes, that in itself was a tail event!). I am talking about the probability of a string of decisions and developments that had to occur precisely in such a way that we could get Jeff the help he needed just in time for him to live. And I want to string them together to paint a picture of this unlikely outcome and why we feel that it was God’s hand guiding us, both in decisions we didn’t know we were making towards this favorable outcome, and in things that were completely out of our control, but in God’s brilliant design.

After Christmas of 2020, Jeff said to me in passing that he sometimes drives around the town of Bath (Ohio) and looks at different houses. We lived in Richfield at the time in a wonderful home that we built in 2013, and frankly, we thought we would live there for a very long time. What Jeff didn’t know was that Maris and I had also been exploring Bath while driving to and from various nature trails in Northeast Ohio. Both Jeff and I (and Maris, haha) love nature and quaint living environment. Richfield already has that (we had 2 acres of woods), but after being cooped up at home during the first year of the COVID-19 pandemic, we were ready for a change.

The problem was that there was no home that would work for us for sale in Bath. So we expanded our search to different parts of NE Ohio, actively trying to avoid the busy-ness of Cuyahoga County and the urban feel of the “East Side.” After many weeks of doing this, Jeff found something on Zillow… it was a home in the county we were actually trying to avoid, but the house was right. The design was right. the size was right. It was a model home, so after meeting with the builder, we decided to buy and finish a partially built house that was not even in the location of our original intent. What we came to realize was that our desire to live in a quaint environment spoke to our internal poets but did not jive with the busy schedules we kept. We came to love the idea. We sold our home in Richfield, finished the new house, and moved in on June 28th of 2021.

What we didn’t think significant at the time was just how close the neighborhood was to Hillcrest Hospital (the Cleveland Clinic). Eight minutes by car, if you’re just leisurely driving and hitting lights. I could shave off two minutes if I’m speeding a bit and with green lights. During the fall of 2021, I really learned the ins and outs of getting to the hospital because I had to get a lumpectomy (don’t worry, the tumor was benign and it was out of precaution), and then I had multiple appointments afterwards due to not serious but strange complications. Back and forth, back and forth. The thing is that I am really bad with roads and have no sense of direction. Now I look back and realize that God was perhaps making me practice driving the fastest route confidently for when it really came to matter.

When I think about it, that move was a crucial component to Jeff’s survival. If we had still lived in Richfield, I know that I would have probably taken him to a more remote ER. They would have had to transport him to either the Main Campus of the Cleveland Clinic or to Hillcrest anyway, and it would have just delayed everything. This was a decision made for unrelated reasons that proved to be so crucial.

There were other choices that were made for unrelated reasons that proved to be vital in the succession of events. Me working from home, randomly deciding to work in the living room instead of my home office that allowed me to notice that something was off; canceling the morning meetings because everyone was on top of things but it freed me to take Jeff to the ER; Or even taking Jeff to the ER because I thought it might be a kidney stone, but of course, it turned out to be something much more serious. These were decisions made without deep insight, and I cannot tell you that I had some sort of hunch or a feeling that I had to do these things.

And then there were things out of our control. The aneurysm had been there for many years that it grew to be the size of a baseball – it really could have burst at any time. When the aneurysm started to dissect, it didn’t happen all at once – it happened in small tears, which meant that blood started to leak out slowly, giving it time to actually clot and plug the hole. Again and again for nearly a week. And the fateful moment when the dissection became untenable, it happened during the day when I was home. If that dissection took place a few hours later in the evening, Jeff would have been driving a 3 hour road trip to Bowling Green, probably on I-90 West, alone in the car, far from the world class healthcare available at the Cleveland Clinic. That the aorta decided to rupture during that small window of time… we do not view that timing as a lucky coincidence.

When we think about how easily that clot/plug could have come undone, it sends chills down my spine. We had used a vibrating massager on Jeff’s back when we thought he twisted a muscle (yikes!)… that was a really bad thing to do to the aneurysm! What about the violent vomiting? Every time he lurched forward to throw up, the clot could have dislodged. And of course, further delay would have also meant that the outcome could be different.

All these things had to work together and with right timing. The clot itself was of course, statistically unlikely. A tail event. A black swan event (but with a positive connotation). But also at each decision point, when we thought we were making decisions that were independent of each other, it turned out that there was this beautiful design to how they were actually related… and each played a small but important role in contributing to Jeff’s survival. And in some of those decision nodes, we actually made the unlikely, less probabilistic choice based on our original intent. For those of you who have calculated the probabilities of multiple events and outcomes, you know that when you have multiple unlikely events stringed together, you end up with a really really low probability.

So, okay. Something with a low probability, even if the odds are only 0.000001% in your favor, is technically possible. So is it really a miracle? Isn’t miracle something impossible becoming possible? like turning water into wine? This is where I have to stop thinking with my head and listen with my heart. This is where I don’t want to lose perspective, the meaning of the big picture, the opportunity to experience God’s grace… all because of some technical point. When something happens, which in turn changes your perspective on life, brings more love between two people, and brings us closer to God, I consider that in itself a miracle. No matter how high the probability. And maybe it had to take such a tail event to pound through my data-driven, rational skull that only God can string events together, move hearts and minds, and put us in right places in order to bring us outcomes that are inconceivable to our human imagination. Furthermore, that we, as rational beings, would choose to accept this outcome not as low probabilistic “luck” but as God making His presence firmly known in those moments, that we should choose to see it as God’s grace, as His love, and as His gift to us… that in itself is the greatest miracle for me.

Sunrise: a daily “miracle” that lifts my spirits!

Marriage: a miracle of two very different people spending a lifetime together

A battle scar

And a reminder of grace

In order for Dr. Rizzo and his team to perform the vascular surgery, they had to create a very long incision down Jeff’s abdomen. During those first days in the Cardiac Surgery ICU, the incision was bandaged up, so we didn’t know what it actually looked like… yet. After a few days, they removed the bandage, and there it was, a 20-inch scar. I was surprised to see that they used metal staples to hold the skin together at the surface level. I don’t really know what else I was expecting.

For a long time, we had to tiptoe around it and couldn’t do normal things. At first, he couldn’t use his ab muscles at all so he couldn’t even move an inch without wincing. But he kept sliding down the hospital bed! So they had to move him around with the sheet that was underneath him. He couldn’t sleep on his side. He also couldn’t cough or sneeze – the staff gave us a firm, pillow-sized and -shaped block, which I would push against his abdomen to support and stabilize his incision. I was so scared to put any pressure on his tummy, but I quickly learned that I needed to put nearly all my weight down to counter the force as he cleared his lungs. After a while, we had a routine down: Jeff would suddenly sit up “I’m gonna cough!” and I would shoot up from the chair, run to the bed with the “pillow” and put all my weight down. But the worst of all was that Jeff couldn’t laugh very hard… at his own jokes. He was really disappointed.

The incision was healing beautifully, but the staples had to be in for about a month. It was uncomfortable for Jeff even after he came home and was able to do regular activities because the incision site was very tender (still is two months later), and the metal pieces bothered him. Wearing a seatbelt was very unpleasant because the belt would dig into the staples. Sometimes, a sheet or a blanket would get caught on the staples and cause discomfort. I examined it from time to time to make sure that there was no infection or anything suspicious, but I could tell they were really bothering him. One night, I decided, well, maybe we just need to embrace the staples – I said “they aren’t going to be in forever, so let’s get to know them before they come out. We’re counting the staples!” I counted them one by one, all the way to forty. Wow, 40 staples. “This is your battle scar.” Then Jeff opened up about it and told me that he dreaded seeing his incision for the first time. He thought “oh God, it’s going to be so ugly.” But then he said, “but I would rather have this ugly scar than the alternative.” Yes, a thousand times YES! This is his battle scar and a reminder of the grace of God that was showered on us through that most valuable clot, the temporary plug that held everything together for just the right amount of time. It represents the time when we felt God’s hand firmly in our lives.

Near the end of April, it was time to get those staples removed! While we were waiting for Dr. Rizzo, a really kind nurse came in. I remember her Russian accent and her beautiful hair… not everyone can pull off side-swept bangs! She was so seasoned – she saw that there were quite a few staples so she made small talk with Jeff. Oh, it was so easy, small movements with the staple remover. Jeff later said that it was mostly painless except for a few that felt like bug bites. And before he knew it, she looked up and said, “I am done!”

Everything looked great to Dr. Rizzo, and we were cleared to go home again. I brought a list of questions to ask, like a taskmaster. He probably found me annoying! Among a string of questions, the one that made me most happy was “Will he be able to go on TCO’s European tour late summer?” to which he replied, “oh yeah.” This made me really happy for Jeff – back to normal life if he can manage all the stresses of a European tour! The one that made Jeff most happy was “When can he play golf?” to which Dr. Rizzo said, “I’m okay with mid to late May.” We both left the doctor’s office really happy, even if for different reasons.

Removing the metal staples was a really big deal. Jeff was able to move around comfortably and not be in fear of the healing incision. That evening, I saw a familiar expression come over his face, one that I have seen thousands of times since we met in 2007. It was one of mischief – I knew that he had a joke coming, and it was going to be epic. “I had 40 staples… now I have 80 holes!” Then he went on to laugh and cackle at his own joke, just like old times.

Jeff and Maris pretending to be giants descending upon the Christmas Village people

Jeff pretending to be a freshly hatched baby dinosaur (Tucson Zoo)

An epic nosebleed

a story about ‘inflation…‘

I was excited to bring Jeff home because it was a vote of confidence from the hospital that he was doing well. But I was also scared to bring him home because I am not a medical professional. How do you take care of someone who has just gone through a very invasive vascular surgery?

Googling doesn’t help you here. In fact, I don’t recommend it because you might find some scary stories. I asked the hospital social worker to help us arrange home healthcare, and these people were wonderful. It was so valuable to have someone come and check Jeff’s vitals. But I was really good at preparing Jeff’s meds. I became an expert at using the pill splitter. As Jeff’s mind was still foggy from the anesthesia, I had to keep everything straight for him. I was also good at walking with him to make sure he got his exercise. For the first week or two, he had to wear a stretchy binder around his middle to keep his stitches from moving around and bothering him. So I also became an expert in putting the binder around Jeff and the use of the gigantic velcro that came with it.

Funny, the dog (Maris) quickly realized that Jeff wasn’t really the alpha dog when he came back. As much as she missed her daddy, she looked at me as the alpha dog. And when we walked together, she knew something was up. She walked gingerly beside me instead of being her normal adventurous self.

Jeff was discharged on a Tuesday, and things were improving every day. On Friday night, Jeff woke me up just after midnight. He was so gentle, his usual MO, that I didn’t realize it was an emergency. I am normally a really deep sleeper – you can carry a conversation with me, and I might even talk in my sleep, but I won’t remember it the next day! So when he woke me up, I remember seeing a flashlight and thought I was dreaming. But Jeff was holding his phone in the dark, reading up on how to stop a nosebleed. I was really groggy but sat up straight… the rate at which his nose was bleeding, and knowing that he was on a high dose of aspirin, I knew this meant another trip to the ER. I will spare you the gross details! So while we tried to stop the bleed, I told him to hold on to the tissue and stopping up his nose, I went and got dressed. After about an hour of trying, we went back to Hillcrest Hospital.

We ended up spending the whole night in the ER. Who knew a severe nosebleed was a thing that ER professionals saw all the time! I have never had a nosebleed in my life (and neither has Jeff, really), so we were discovering a whole new world. We think that the darn NG tube and the multiple efforts to get the thing down his nose caused a lot of trauma high up in his nasal cavity… the first attempt to control the bleeding did not work. It was time to use the balloon.

I am thankful that Jeff nor I suffer from nosebleeds because if you can help it, you don’t want this balloon up your nose. They inflated a balloon inside his nasal cavity at the source of the bleeding in order to create enough pressure. Jeff had a tube hanging out of his nose, which we then taped to the side of his face. It was not a pretty sight. And the pressure inside his head was causing a headache! Jeff was a good sport for putting up with it, but honestly, he was really miserable. He worried with a chuckle that one nostril might be permanently bigger than the other! When it was all said and done, the balloon was in there for five full days, and he had to see an ENT to get it removed from his nose. When the ENT pulled it out, the first thing I did was to look at Jeff’s face and said, “you’re still symmetrical!” We all had a good laugh.

The nosebleed was a setback, but honestly given all that we had just been through, it was a minor one. We were so grateful for life that we were really okay waiting those five days, no matter how uncomfortable. Jeff even went to get a haircut with the balloon up his nose and the long tail of the tube taped to the side of his face! With the balloon out, Jeff’s spirit continued to inflate (haha, sorry), and he continued on his road to recovery without any other roadblock. Soon, Jeff no longer needed the binder to walk comfortably around the neighborhood. His pace quickened daily. The dog gradually stopped walking gingerly around him and returned to her adventurous self. And full two months after that crazy day on March 25th, Jeff is getting ready to play in a golf tournament at the end of June with his best friend. Frankly, I’ve never been so happy to see him play so much golf. (Wives whose husbands are golf fanatics… you know what I’m talking about!) God is so so good.

After those small steps in recovery, taking a short hike in Punderson State Park on 5/30.

Happy Graduation

from the hospital!

The day that Jeff graduated to a regular hospital room was a very happy day. It was like a pat on the back from the hospital, “good job!” We packed everything up, Jeff no longer needed oxygen nor an NG tube. His face was clear of plastic for the first time since the surgery. His multiple “central lines” were reduced to just two, and the scary one that was plugged into this carotid artery was patched up. He sat in his wheel chair ready to be transferred and gave me a huge smile.

The staff took us to the third floor of Seidman building at Hillcrest. Room number 22. It was a single room (thank goodness) and the whole wing seemed to be newly built. There was a desk, where I set up my computer to do some work while Jeff slept. There was a couch, which was a really nice for me because I was really tired. I took naps there from time to time, and the super considerate nurses worked silently on Jeff to keep from waking me up. We were so grateful for such state of the art facilities… except for the weird bed that had an alarm. Jeff’s hospital bed had an alarm that would go off like a fire alarm whenever he got out of bed. The first time it happened, we were both panicking – what did we do wrong?!! Ahhh, how do you turn this thing off? Later, I learned how to shut it off when it went off, but boy was it funny. They really want you to stay in bed, apparently!

Jeff had a few things on the checklist to accomplish. He needed to be able to tolerate oral medication, his digestive system needed to wake up (so he needed to move things along), and he needed to be able to eat a full meal before he could be discharged from the hospital. Slowly, they weaned him off of the IV meds, and eventually, he was taking his pain meds orally. But it was the second on the list that took a long time, and also prevented him from being able to eat. In fact, they had taken the NG tube out too early – they realized that they needed to put it back in. NG tube prevents the gastric juices from flooding your stomach by sucking it out – any buildup would make Jeff nauseated and would make him throw up – that would be a threat to his freshly stapled incision site. Let me tell you, putting a plastic tube up your nose and down your esophagus is not a pleasant thing. And he had to redo it twice because the second one that was put in fell out (it wasn’t taped well enough). The third and last time they tried it, I was there, and it was painful for me to watch. They were not successful and had to try later. I went home early that night because I couldn’t bare to watch it again. I figured that I would let the medical professionals get done whatever they needed to get done. When I arrived the next morning, it was in. I used a lot of medical tape to stabilize that sucker so it would never fall out by itself again! When I was done, Jeff looked like an ant-eater.

Progress on the digestive tract was slow… until it wasn’t. Suddenly, things started to move, and Jeff was able to eat a full meal. It felt like the hospital was happy to kick him out! Suddenly, on the morning of April 5th, Jeff was cleared for discharge. At this point, I was comfortable visiting him in the afternoon and being able to get some work done at home in the morning. After my early afternoon meeting, I packed a bag full of clothes, shoes, and other things, and rushed to the hospital. He looked so good for a man who had been disemboweled not two weeks earlier to get his aorta replaced!

What is really remarkable is just how quickly he was expected to get back to normal life. As the nurse read the discharge instructions, I asked if he needed to be on a special diet. Nope, can resume normal diet. Later, we had home care nurses and physical therapists come to check on Jeff at home. The nurses thought he was doing great, and the physical therapists didn’t think he needed physical therapy! And later I asked Dr. Rizzo if Jeff needed to see a cardiologist – nope! His heart is very healthy, and the ultimate stress test was the pain that he endured as his aorta was breaking apart, and the massive surgery itself. So it was this structural defect that once fixed would allow Jeff to resume normal life like before.

I am typing this in early June 2022. It has been a little over 2 months since the surgery. Jeff has been resting at home, gaining strength. It took a little over a month for him to feel like anesthesia had fully worn off so he could drive again. And since the weather has become nice in the spring months, he has been slowly playing golf, his favorite sport, starting with putting and now swinging fully. He is getting his strength back. He still gets tired, and it will probably be another month until he gets his full stamina back. And I still watch him with sheer wonder at the walking miracle that he is to me.

Jeff, so happy to be discharged, wearing the outfit that I scrambled together for him.

Fight for your life

because you still want to give so much

The next five days were spent in the cardiac surgery ICU (CSICU). I would arrive at 9am, go home for lunch and to let the dog out, come back and spend the afternoon with him, at about 5:30pm go home to eat dinner and to let the dog out, and then spend the evening with Jeff until I got kicked out at 9pm. Rinse and repeat. Jeff slept most of the time because he was still under the heavy influence of the anesthesia, but when he woke up, I wanted him to know that I was with him. We also had work to do. He had to blow slowly into a spirometer to open up his lungs and to strengthen them. He was supposed to do 10 iterations every hour – I was happy to be the spirometer police! Otherwise, I wanted to keep him company, keep his lips moist, and just watch him sleep in wonderment at how he was still here with me.

On the second night, his oxygen level fell, and he had to be put on a breathing machine (not a ventilator). They kept his oxygen level at 14 for a while. Jeff complained about falling into a deep sleep, only to wake up feeling like he had stopped breathing and had to catch up. That’s a scary feeling – almost like you might drown. He asked me to keep an eye on it, and to make sure that the staff took this seriously. So I watched him closely while he slept, making sure that he didn’t stop breathing, and when the pause between breaths seemed a bit too long, I was ready to leap out of my chair.

Slowly, he got better, slowly, he was in less pain. The staff in the CSICU at Hillcrest Hospital were amazing, and we are so grateful to them for the care they provided. Sometimes I would arrive in the morning, and I would see a huge improvement. One morning, he was sitting in a chair! After lunch one day, he had the NG tube removed! (that is another saga because it had to be put back in… ugh). Another time, he no longer needed oxygen! These were not little victories – they were big ones. We were able to graduate from CSICU without post-surgery complications. He was still being infused with a lot of medication, but boy was it great to be put into a regular hospital room. I would still keep the 9am to 9pm schedule, but now there was desk where I could set up my work. And there was a couch where I could take a cat nap. And there was a door so Jeff could sleep with less interruption.

As I sat there and watched his body expand and contract with each breath, I was moved by his will to survive, to advocate for himself. As is usual with me, I extended this observation as a metaphor in my own life. Jeff’s joy, his zest for life, the way he greets each day and conquers it, all these things I watched for nearly 12 years of our marriage made sense to me. He fought for himself. I wondered, why don’t I fight for myself? The outside world sees an accomplished woman, perhaps a person with numerous talents, successful on life’s stage. I have the right schooling, many letters after my name, etc. etc. But despite my confidence in the things I know, my will to succeed, and to achieve tasks at the highest level possible… sometimes, I just let things happen to me. And I’m not talking about the right way, as in the Biblical sense of “Thy will be done.” Or the wisdom of “this is out of my control.” I mean the psychological resignation to everything being so hard. Instead of seeking control where I can, saying no when I need to, and actively finding joy in the tasks ahead, I was living a life where everything felt difficult. And in general, even when things were so good, I couldn’t enjoy it to the fullest because wondered when the next shoe was going to fall.

Deep underneath this weird coexistence of high achievement on the outside and internal resignation was a lot of turbulence during my childhood and adolescence. Knowing this, I got frustrated often because I am now in my forties, and I felt that I should be over it. But it was really in watching Jeff fight for his life and stand up for himself that I understood how I was to live the rest of my life. I needed to fight for my life, for the gift of joy and peace. It’s one thing to fight and to lose. It’s another not to fight at all.

During the first day of Jeff waking up from anesthesia, we caught up on what happened after we parted ways in the ER. What astounded me and still moves me every time I think about it is what Jeff prayed just before going under for surgery. He prayed that if it is God’s will that he would survive this surgery so that he could see my face again and to spend many years more with me. I was speechless when he told me – I don’t know if I would have had my wits about me to utter such a beautiful prayer. I also realized that underneath this goofy and joyful layer of this person who never lost touch with the child inside, was also this person who loved me so much, in ways that I could not even comprehend before this incident. He wanted to live not only for himself, but also for us. He fought not only for his own life, but for our life together. As I learned about his last prayer, I grew up even more – we must fight, not only for a meaningful life, but also because we still have so much to give back.

Things quickly turn silly. Hard to take a normal photo…

The world’s most valuable clot

to plug a giant hole

Dr. Rizzo is a man of few words. After the surgery, he just said, “the surgery was successful.” I’m like… how? what happened? I need details! I asked him, “what held the rupture together?” He said that the hole was the size of a baseball, but the torn fringes were inflamed and swollen, which helped to reduce the size of the hole. But it was really the giant blood clot that formed and stuck between the front side of his spine and the aneurysm that kept the plumbing intact. Jeff had been on borrowed time because it would not have held for much longer. “Actually, here, I’ll show you the photos.”

Later I would tell Jeff that seeing his empty abdominal cavity and the front side of his spine brings new meaning to our marital intimacy. The photos were incredible. His aorta was completely shredded, tattered. Then Dr. Rizzo showed us the new synthetic aorta that would be a part of Jeff’s vascular system for the rest of his life. It was a gigantic, Y-shaped single piece that graced the back of Jeff’s abdominal cavity from top to bottom, and into his hips. Incredible. “Oh,” Dr. Rizzo casually added, “he didn’t need any blood.” Jeff went through one of the most invasive vascular surgeries around and didn’t need a single drop of blood. Miracles continued to pile up.

As we caught up, I saw a bed rolling by. It was Jeff. After they set him up in his room, Dr. Rizzo got up and said that I could follow him into the CS ICU. There was staff transferring all his bags of fluids and tubes to the ICU equipment. Jeff was still under anesthesia, intubated, hooked up to so many things. I was afraid to touch him because I didn’t want to mess anything up. I sheepishly touched his left hand and found it to be so swollen. I looked at his face and realized that his entire body was swollen. Dr. Rizzo read my expression and told me that they had to pump him full of fluids for the surgery and that the swelling would go down in time. The night attending at the ICU was a very nice female doctor who said that he would sleep all night, and they would watch him. She encouraged me to go home… the ICU closes to visitors at 9pm anyway. I knew he was in good hands, so my friend drove me home.

I slept soundly but woke up early, around 5 am. I thought immediately, “what if he doesn’t wake up?” The nurse had given me the ICU’s phone number, and I called. They told me that he did well during the night and that I should come around 9am when they hope to have completed the extubation. It felt like forever from 5am to 8:30am – I just couldn’t wait anymore and drove to the hospital. When I arrived, they were still extubating him. I kept a little distance because I didn’t want to get in the way of the staff. There was a lot going on!

The same attending from the night before walked over by my side and told me that he was already breathing on his own, and that he looks really good. As I conversed with the doctor, Jeff must have heard my voice. Jeff’s nurse turned around and said, “he wants you to come over.” He can hear me! As I walked closer to the ICU bed, I saw his right arm, gesturing me to come to him. He is awake and alert!! When I got to his bed, I saw that the tube was still down his throat, and he was in a lot of discomfort. He held my hand and tried to spell something. I was so nervous that I would not quickly understand him and that might frustrate him more. “G”… “A”… “G,” he wrote the letters in the palm of my hand. “Gag?” He nodded affirmatively. “You have a tube down your throat. it’s supposed to be uncomfortable. But they are taking it out.” It didn’t matter what I said. He still looked so miserable.

It is so hard to watch your loved one suffer. I had never watched an extubation process – it looked completely miserable. It seemed like forever, but the tube was finally out, and he was trying to talk to me. He can talk! he can form sentences! All the things that we take for granted in our daily lives, I was so relieved and grateful for them.

Those first few hours of him being awake, me being by his side watching him breathe with wonder are some of the most precious memories I will carry with me for the rest of my life. We had passed the most harrowing part of the journey, but we were not clear of all dangers. I knew that we needed to continue to pray to avoid post-surgery complications. The hard part may be just beginning. I was so grateful that I was ready for anything.

On the other side of the OR

The waiting game…

Once Jeff was taken to the OR, our stories diverged. Here is my side of the story.

I have never lost anyone very close. I have been very fortunate that way. Sure, all four of my grandparents have passed away, but I was not very close to them, with me being here in the United States since 9 years of age, and them being half way around the world. We did not make the trip to Korea very often, so we lived isolated in the U.S. as Korean immigrants, and also isolated from family that was already so small to begin with. So no, I have never been really close to anyone who have passed.

So when Jeff went into emergency surgery, it was the first time I had come so close to such danger. I did not know what to do with myself. “Just wait from home. You live so close. They will let you know when the surgery is done,” the ER nurse told me. And it’s true – there wasn’t much of a waiting area at the hospital. And remember, I was bawling loudly, which was not a pretty sight. So I managed to get myself home, wailing into the phone intermittently while talking to my best friend and to Jeff’s sister. Sitting on the couch at home, I continued to cry, and I felt strange. Is this really me? Is this really happening right now? If I keep crying, does that mean that Jeff isn’t going to survive? Get it together!

What scared me was that the aneurysm had already ruptured and we didn’t know what was containing it. Whatever was holding the plumbing together could give out at any moment and then he would bleed out in a matter of seconds. Could everything be held together until the Cleveland Clinic surgeons could get to the aorta? My mind was reeling, but I knew that there was nothing I could do. I had never felt so helpless while desperately wanting a specific outcome. The situation felt like a coin toss, but that was not what how I viewed life. I knew that God was in our midst, and that He wanted me to turn to Him.

I started to pray but could not find the words. I repeated, “dear God, help us, help us” about a thousand times. I knew that I needed the help of people who could pray for us. I needed warriors. So I started to go down the list of contacts on my phone and texting everyone whom I knew would kneel and pray for Jeff. Copy and paste. Copy and paste. over and over again. Positive responses started to flood my phone. I kept myself busy expanding the prayer circle, and I knew that my fellow Christians would lift a prayer so loud that all the angels would hear them. This is an emergency! Please pray for us now!

Jeff and I parted ways in the ER just before 3pm. At around 5pm, I saw Hillcrest Hospital calling me. I panicked. “This surgery is supposed to take 4-6 hours. Why are they calling me 2 hours in?” I stared at the phone and plopped down on the floor because my legs were shaking. Jeff had not survived it, I thought. He bled out… whatever was holding it failed in the end. Shaking all over, I answered the phone. “hello?”

“Is this Anna?” yes… “This is nurse___ from Hillcrest Hospital, and I am calling to give you an update on the surgery. They started the surgery about an hour ago, and it is going really well. Jeff is doing beautifully. You should plan on coming to the cardiac surgery ICU waiting room at around 8pm.”

What a relief. Thank you, God!! I was so happy and… there are no words! In a span of 20 seconds, I went from complete despair at the thought of losing Jeff to an exhilarating high. I knew that we were only 1 hour into the surgery and not completely out of the woods, but I was overflowing with optimism. And then I was super annoyed. Why would you scare me like that by calling me and leaving me in suspense? Haven’t you heard of texting?

After the call, I was bursting with energy I didn’t know what to do with. What am I going to do for three hours? I started to clean the house to keep myself busy. Wiping everything down, scrubbing the bathrooms, vacuuming, putting things away… It was probably my way of regaining some control in my life. Just after 7pm, the nurse texted me this time to let me know that the surgery was progressing very well!

I had asked my friend to take me back to the hospital because I needed company. She arrived around 7:40pm and we left the house to see Jeff. I was still so giddy and high from the rollercoaster ride that I think I scared my friend. It was so good to have her by my side, just talking about random things while waiting for the surgery to end. At about 8:30pm, Dr. Rizzo came to the CSICU (Cardiac Surgery ICU) waiting room to give us the update.

How big is a baseball?

It depends on the situation

I will never forget the moment when the ER doctor rushed back into our room. He just started talking. There was no easing into the topic. He said “there is a baseball sized aneurysm in your aorta.” He reached over Jeff’s abdomen and made a baseball sized air-ball with his hands. He then pressed Jeff’s abdomen with his fingers and said that he could not feel a pulse where he normally should. “I’ve already called the vascular surgeon, and he is on his way.”

Wait, what? I know an aneurysm is bad, but he’s sitting up and talking to us. Couldn’t you repair the aorta? I guess there is going to be… a surgery? Okay, calm down – Jeff is still sitting up and talking to us, and there is no better place to have an emergency than in a hospital. Okay, the surgeon is on his way, and we will get this fixed. My job until then? Keep his blood pressure down.

At this point, we knew that all the weekend obligations had to be canceled. “Jeff, you just relax and stay calm and think of happy things. I’ll make the calls.” I stepped out of the room to call the orchestra to tell the personnel manager that Jeff would not be able to play the rest of the weekend. I made calls to his students to let them know that weekend lessons would be canceled. Jeff was supposed to teach a masterclass about 3 hours away on Saturday, and I had to cancel that for him, too. Taking care of business… that’s my job.

When I came back into the room, the lead surgeon had arrived, along with two other surgeons. Dr. Rizzo said that he wanted another CT scan with contrast. This time, there was no waiting – he was wheeled out right away for the scan. In the ER room, Dr. Rizzo, another surgeon (I will call him “Will” because I cannot remember his real name), and I stared at the first CT scan. As he scrolled through the scans, I could see Jeff’s aorta expanding from one film to another. How big is a baseball? At that point, too big. It seemed the size of an ocean. Just too vast, too large, too vulnerable. Dr. Rizzo said that the aneurysm had been there for a while. I asked, “what is ‘a while?'” He said, “years.” I stared at it and said, “Jeff is a wind player,” thinking that they would know what I meant. Both of them turned to me and asked, “what’s that?” “Jeff plays oboe for The Cleveland Orchestra. He’s played the oboe since he was nine years old… he blows into a very small reed to make sound and there is a lot of pressure.” I’m not sure if that was significant to them – Dr. Rizzo proceeded to tell me that he saw something that looked like inflammation or an infection in the artery. He would find out once he was inside.

Jeff came back from the second CT and he was in great pain. They gave him more painkillers to calm him down. A few minutes later, the original ER doctor rushed into the room and said that the aneurysm has already ruptured! But is somehow contained… what?? This was when I really started to panic and reality hit me over the head. I knew what that meant – how is he still alive? How did Jeff not bleed out already? Suddenly there was a whirlwind of activity, people coming in and out, voices being raised at the nurse to get Jeff’s blood pressure down. The surgeons were in the room looking at Jeff who was clearly sitting up and talking with us. How could this be if a baseball sized aneurysm has ruptured? What is holding this man together? “Will” explained the procedure to me and Jeff, and while I listened attentively, I had tears streaming down my face. In the middle of his explanation, he stopped, looked at me, and said, “don’t worry, it’s okay. We are going to fix it.” I will never forget those words of assurance and the comfort they provided during those moments of chaos.

As the staff was preparing to take Jeff away, we waited together in that room. I was listening to everything that was going on, and I tried to comfort Jeff who was very serene (was it the painkillers or just his nature?). I had my mask on, so he could only see the top half of my face, and I tried to put a brave face on – I didn’t want Jeff to know that I was crying. I am not sure why… I didn’t want him to worry about me? I should be comforting him, not he me? Or maybe I wanted him to believe that everything was going to be alright, and my crying would not support that cause. I still haven’t figured it out.

Whatever the case, I waited until he was taken out of the room and on his way to the OR before I burst into tears and wept out loud. It was surreal. Because I never cry. I heard myself wail, and it was like an out-of-body experience, like watching someone else cry. The ER nurse who was left behind came over and gave me a hug and I wept into her shoulder. Then I cried as I walked out of the ER and to my car. I backed out of my parking spot and started driving, only to park again a few yards out because of the tears. Somehow I drove home, sat on the couch and cried. Who knew that I had an abundance of tears? I had assumed that they had dried up during all those years of being on “survival mode.” To survive my childhood/adolescence, even my adulthood. From somewhere unknown, tears just poured out as the reality of the situation burst open the dam I had built brick by brick, layer by layer for decades.