One minute you are moving through your day, clearing tasks off of your to-do list and anticipating all the things you will still tackle during the rest of the afternoon. The next moment you’re wondering if you will make it through the afternoon, and can you ever get what is choking you, out of your throat? In an instant, life changes.
I talked the other day about “awareness and staying in the present moment” in relation to my racquetball game. Shift to the future and you blow the present shot. The same thing happens in life.
My meditation class talks every week about paying attention to what you are doing, and that anything can be a meditation if you do it mindfully, full of awareness. I never thought about this extending to swallowing pills. I also never thought about how I swallow pills as a possible life-altering moment.
It’s something we do automatically. Grab the pills, toss them back, throw in a mouthful of water, all while in motion through the day’s to-do list. As you tip your head back to swallow, your mind is already on the afternoon’s plans and everything you want to get done. Suddenly there is this sense of something horribly wrong.
It is said that when we are in pain, our world narrows. While that’s usually said about emotional pain and our tendency to pull away and close down our connections to the world, the same is true of physical pain.
In just a second or two, the brain, reacting to that sense of something horribly wrong, starts reeling in the attention and cranking down the focus. It shifts gears from 4 p.m. back to 2 p.m. Within another second or two, it registers panic and pain. It tries to rally its resources to deal with the emergency. Whatever was on your mind before evaporates. It is suddenly incredibly irrelevant. You may never get to it.
Now focused very much in the present the brain is frantically trying to get a clear picture of what the hell is happening. It’s processing emergency signals from several places in your body simultaneously – heart rate, throat, blood pressure, lungs, mouth, cervical nerves. The eyes bulge, hands go up to the throat, and the left brain finally grasps that the pills you swallowed without thinking, tumbled down the wrong way. In a one-in-a-million shot they’ve lodged side by side in your esophagus and are blocking the whole passage.
At the same time you’re looking for a waste basket to throw up in and get those things out of you, additional panic shoots through you. The brain has further grasped that not only can’t you swallow, but that the water you took with the pills has backed up into all of your air passages and is now choking you. Inside your head you hear the liquid close off passages. For an odd moment, like time standing still, you notice that the sounds in your head right now are the same as when you’ve dived underwater and everything is flooding with fluid. Except you’re not in someone’s pool. You’re standing in an office wondering if you’ll ever take another breath.
The breath. All those meditation classes. Come back to the breath. Breathe in your pain and fear, breathe out caring and calm. But even the breath has been taken from you. Panic. Focus. Panic. Focus. The battle in the brain begins because it knows if panic wins, you may lose the battle completely.
Suddenly the water drains out and you can breathe. The breath. Come back to the breath. You’ve been given another shot. Don’t blow it. The brain is in command. Stay in the moment. Just this moment. Breathe – just one breath. Assess. What’s your next move? Think. Take stock. Breathe again. Just one breath.
You determine you can’t swallow except for tiny amounts. Okay. Focus. One swallow at a time. Look around. What are your options? Get help. Someone to be here in case they have to call 911. You remember the pills are large. Hard. Coated. They’re not going to dissolve. You need assistance. Get to the ER.
Someone stays with you. They’re trying to help. It’s a comfort and calms you, even though you can’t really respond. You’re using all your focus and energy on “Breathe – just one breath. Swallow – slowly. You cringe. Intense pain shoots up your throat as the liquid shoves the pills against the esophagus wall and ever so slowly drips around them and down your throat. Breathe. It takes a few seconds to swallow saliva that you normally don’t even notice is there. A few seconds more and the swallow is finished. Take another breath.
The brain starts to race – how long will it take my husband to get here? How long to get down the street? How long to the ER? How long before they can do something to make this better? Panic. The brain takes charge again. Stop. Stay in the present. Breathe. Swallow.
Every shift of the car gears hurts. You want to be sick. Take a breath. Swallow. Another bump. Breathe. Rounding the corner. Still a mile to go. Breathe. Swallow. Traffic backing up. Panic rising. Breathe. Swallow. Close your eyes. The ER doesn’t exist. Just this moment. Breathe, swallow. Breathe, swallow. Lean forward because it doesn’t hurt so much. Breathe. Swallow. You turn into the hospital. The ride to the door might as well be an eternity. Close your eyes. Breathe, swallow.
You struggle through admissions. Whisper name, date of birth, insurance, address. Breathe. Swallow. The nurse typing in your vitals seems to be taking forever. Will you ever get relief? Come back to the moment. Breathe. Just one breath. You spot your blood pressure and heart rate. It scares you. Close your eyes. Breathe. Swallowing is harder. Lean forward. Get ready. Breathe, swallow, tighten your fist to take your mind off the pain in your throat. Breathe. Stay calm.
I know my husband is there. His presence is calming. I can’t respond to him. Can’t even focus on him because I am focused on breathe, swallow. For a second I feel his hand on my back. Its warmth relaxes me, radiates through my muscles. Calms them. But I can’t tell him yet. Just breathe. Swallow.
The doctor is approaching the room. Breathe. Swallow. You stare past the doctor and see a room across the department that looks just like the one your husband almost died in a little over a year ago . . . when he almost choked to death. Breathe. Swallow. The nurse pushes in the needle for the IV line. Breathe. Swallow. Meds are moving through your veins. Breathe. Swallow. Breathe. Swallow. Calm. The meds are calming. The muscles in your throat unlock. Breathe. Swallow. Suddenly, a tiny burp. Air is moving up. Breathe. Swallow. They give you water. Tiny sips. It slides down your throat. Pills shift and hurt. Breathe. Swallow. Ever so slowly, the burps get bigger. The sips of water larger. The medicine slows your heart rate. Your blood pressure has dropped. You can swallow and breathe without total concentration. Will you ever take another pill unawares?
Joan Didion wrote a book, The Year of Magical Thinking, about what it was like the year after her husband died of a massive heart attack. She was with him when it happened. It happened in an instant. In that moment as he fell, dead, everything changed.
Even as Kate Braestrup stared at her husband’s cereal bowl in the sink that morning, he already lay dead in his state police car, killed when another vehicle lost control and crashed into him. Her life changed in that instant as she described in her book, Here If You Need Me. Lee and Bob Woodruff wrote a book, In An Instant. He was covering a story for ABC News in Iraq when an IED exploded near his vehicle. In an instant he nearly died. In an instant everything in her day changed dramatically.
It happens so often. It happens to everyone. Yet we all try to ignore that an end will come. We pretend that reality doesn’t exist even though it does. In an instant we are reminded that though we think we are masters of our fate, we never are. It’s out of our hands.
Friday night, terrified after what had happened to my day, my body, and with the calming effects of the valium wearing off, I scrambled to put myself in a place that brought me back to a time where I felt I had power. I retreated to the movie, Patton, about the controversial, powerful, and legendary World War II general, George S. Patton, Jr. His nickname, given by his men, was “Old Blood and Guts.” He never retreated.
It’s a standing joke in my house, that especially when I was younger, I was Patton. I was the general. I ran the situations. Whatever needed doing, I gave the order or executed the action. Failure or retreat was not in my vocabulary. Back then, my thought was, work hard enough, push hard enough, refuse to be defeated or back off, and you can do, achieve, overcome anything.
In the movie, there is one scene where Patton, played by George C. Scott, speaks and my family looks at me and laughs. Patton, has been reprimanded and his command taken from him. Patton, like him or hate him, was a brilliant field commander. He also put his foot in his mouth constantly, and some of his actions were controversial. Yet he was a power to be reckoned with. He bludgeoned his way through things, though aware of the pecking order, did manage to yield some deference to God. In this scene he is speaking to his aide after being told he might be sent home from the war in disgrace:
“I feel I am destined to achieve some great thing, what I don’t know. But, this last incident is so trivial in it’s nature and so terrible in its effect, it can’t be the result of an accident. It has to be the work of God. The last great opportunity of a lifetime . . . an entire world at war, and I’m left out of it?! God will not permit this to happen!! I am going to be allowed to fulfill my destiny!!!” [LONG PAUSE] “His will be done.”
The last four words are said almost as an afterthought, Patton remembering that God just “might” have some say in things. For some reason, at that time in my life, maybe even now a little bit, my family saw a lot of me in that scene. 🙂
So Friday night, I took comfort from retreating to a place and time in life where I felt powerful and in control of everything. Yet, in truth, even as I watched that movie I knew it was just an illusion, a temporary salve for a traumatic day. None of us are really in command of our destinies, only our responses to life’s questions. Even the powerful General Patton learned that. He preferred to die in battle. Instead, in Dec of 1945 he was paralyzed from the neck down as a result of injuries in a car accident. He died a couple of weeks later from an embolism.
I took temporary sustenance from the movie, even as I am aware that we can only take charge of some things, our choices, but for the rest, there is just the one and only powerful tool we can use: stay aware in the present moment, and breathe.