Part of the benefit of writing this for me is discovering in review and digging a little deeper into the experience to understand it better. I had some pretty wild dreams and visions as I emerged from 4 days under anesthetics. This is common. As I looked into this aspect of surgery I was relieved to find out it was not only me. I say this now because when it was happening it was very real. During this period I was not sure in this heavily medicated state if I had made it through the operation.
Maybe this will help someone to know this ahead of time. For me it was very similar to times in my past when I was sick with a very high fever and trying to sleep. When in that condition I would frequently have extraordinary dreams. I would wake up. Have a drink of water. Go back to sleep and the crazy dreams with the same theme would resume. This was like that, only more so. Dreams sometimes can be hard to recall. I remember all of this like it was yesterday.
It is very hard to piece together chronologically when things occurred either in my imagination or in reality. It is a long period of time from when I was led into the O.R. through to 4 days or so later when I really had half a grip on reality. I can tell you what I experienced, but I cannot pin down when it was. I believe it was part of the process of waking up.
FLYING
I kept having repeated visions, dreams or hallucinations of flying over ever-changing landscapes. I was flying between large mountainous ranges and cliffs that resembled the kind of topography that I have seen in films of the Nordic regions. Huge mountains and deep fiords. I saw a wild array of different features beneath me. This seemingly went on for a long time.
There were enormous, long stem flowers or trees of some kind in a variety of beautiful and amazing colors. They were waving rhythmically back and forth in unison, as if driven by wind. These objects waving to and fro were much larger that trees.
Then, without warning the whole view suddenly changed. It was the same topography of peaks and valleys, but now it was grinding and churning dirt. I could see bones, skeletons, and skulls popping up and disappearing in the undulating earthen morass. It moved in the same rhythmic motion that the giant flowers did.
I began reciting the 23rd Psalm.
I repeated this, in my thoughts and out-loud many times over. I have no idea how many times. 25? 50?
A colleague I worked with many years ago told me one night over dinner when we were traveling together that as a Vietnam combat veteran, he would recite this Bible chapter. He would whisper it over and over every night out on patrol, creeping through the jungle.
I was also mixing in The Lord’s Prayer.
I was raised Lutheran and my dad worked much of his later career for Lutheran publishing companies. Most of the people where I live in the Boston metro area are Roman Catholic. We Lutheran’s call it the Lord’s prayer, and in the Boston area it is known as “The Ah Fah-thuh”.
SEQUENTIAL COMPRESSION DEVICES
I later figured out that my tripping visions of rhythmically moving giant flowers and churning earth were moving in unison with devices that were wrapped around my calves while I was in the ICU. When a patient is immobilized for long periods of time these leg massagers, called Sequential Compression Devices, are fitted on both calves and inflate and deflate in a gentle rhythmic squeezing sequence. This improves circulation and reduces the risk of blood clots. For me they were a source of these recurring rhythmic dreams that I would wake up from and jump right back into upon falling asleep. Later, once I started to move my legs in bed around a bit, I asked the nurse if she can shut those off and remove them. That helped.
SIRENS
Beth Israel Deaconess Medical Center is centrally located in Boston and surrounded by several other major medical centers. The Brigham Hospital now part of Mass General, Dana Farber Cancer Center, and Boston Children’s Hospital are all right there. These are all large medical centers. As I was lying there in my semi-conscious state, my status unknown, I kept hearing sirens. Every few minutes I would hear different types of sirens whoop and start-up and take off, wiz by outside or fade into the distance. I also heard choppers coming and going.
This went on for what seemed like every 3 or 4 minutes. Of course, I have no idea what reality was, but I know there were a lot of emergency vehicles coming and going. With every siren I heard, I thought it was coming for me. I was convinced that I had not made it through the operation and that the ambulance was headed my way.
A couple of days later, after I came to my senses, I was sitting in my room drinking coffee one morning with the sunlight streaming through my floor to ceiling windows a question occurred to me. If I had died on the operating table, would an emergency vehicle come for me? Hmm. Probably not. EMTs are probably not going to able to help at a table surrounded by a crew of cardiologists, surgeons, anesthesiologists and O.R. nurses.
If I did died on the table, the most likely call they would make would be for someone to move me down to a stainless-steel sliding bed that rolls into a refrigerated compartment located in the basement, as seen in the movies.
MIND GAMES
Also, while in this semi dazed and psychedelic state, I kept seeing small, hunched over beings scurrying around the sides of my bed. They seemed like little trolls moving very quickly and low enough that all I could see was the hump of their backs. It was very creepy. I didn’t know if it was real or not. Just when I would finish the 23rd Psalm they would be gone. But then what seemed like a few minutes later they would be back.
This mystery also had an answer. My urine catheter and my chest tubes were draining down into containers on either side of my bed. Periodically those are checked, recorded and emptied on some kind of regular basis by the nurses and people watching over me in the ICU. I think what I was seeing was the routine checking and emptying of these containers. At that point I had no idea those containers were there.
One of the nurses was an older man. He looked and sounded like the actor Sam Elliot. Very deep voice. He wore an American flag doo rag on his head. He had leaned on my bed rails and and said, “Don’t worry man, you are doing just fine”. I was convinced he was God. Then he said “I am stepping out, but I will be back later.” Wait, what? God is coming back? For what? Do I need to have something prepared? I need to pull it together.
I started to review my life one snapshot at a time. Like an old KODAK round plastic carousel clicking slide after slide after side. I did that for a long time. But was it 3 minutes, or 3 hours?
That Sunday night was Super Bowl Sunday. The TV was on my room and I tried to focus on watching it but it was impossible. For some reason in my condition that game was running continuously at 2x – 3x normal speed.
RESTLESS LEG SYNDROME
In recovery my legs were going crazy. Extreme restlessness. I have taken a medication for decades for restless leg syndrome. I have taken it every night without exception. For some reason I believe it was left off my list of meds so I had not had it for days. My legs were going crazy. In the ICU recovery I was banging my legs against the guard rails of my bed in the middle of the night. For some unknown reason I was shouting “Hut” at the medical staff that I could see through the distant window. I guess I thought it would be rude to yell “Hey!”. I must have had a button I could push that was way past my cognitive ability.
I could see through a window people were conversing, looking at computer screens, and going about their business. Then I started yelling “HUT HUT” and banging the aluminum bed rails with my legs harder. In my head I am screaming “CMON! WE NEED SOME CUSTOMER SERVICE OVER HERE!”
This went on for a while. Finally, a nurse came in and I asked her if she had given me my Ropinirole for restless leg syndrome. She checked and said it was not on the list. I tried to explain that it should be and that I was going crazy with restlessness. She said she would check with the pharmacist and disappeared.
Now I’m lying there thinking they have not been giving it to me for days now. I didn’t know. A long time went by and she finally arrived with the tiny paper pleated cup with my Ropinirole in it. Relief!
THE CHAPLIN
During this very early time in the ICU I was approached by the Chaplin who worked in the medical center. She was young, in her thirties. Short hair, a kind face and big round glasses. She bent over me in my dimly lit room and asked me gently if I wanted her to pray for me. “Yes! Absolutley!” I pleaded.
She proceeded to read from her prayer book. She did not pray with me. She prayed at me. Her demeanor was intense. I felt like a child being admonished by my mother when she spoke. It startled me. I thanked her and asked her if I could have a copy of the prayer. She said she would bring a hardcopy of the prayer by to my room later.
Then she left. Later I found a piece of letter size white paper on the rolling adjustable table that usually held my meals and meds with this prayer typed on it:
______________________________
God of all mercy we confess we have sinned against you.
Opposing your will on our lives we have denied your goodness in each other, in ourselves, and in the world you created.
We repent of the evil that enslaves us, the evil we done and evil done on our behalf.
Forgive, restore and strengthen us through your son Jesus Christ that we may abide in your love and serve only your will.
Almighty God have mercy on us and forgive us our sins through the grace of your son Jesus Christ. Strengthen us in all goodness to keep us in eternal life through your Holy Spirit.
May the God of love visit us in our times of trial and raise us to newness of life in Jesus Christ and by the power of the Holy Spirit. Amen
__________________________________
Later, I figured in my altered and confused state it was likely that I had imagined or misinterpreted the way she delivered the prayer. It rattled me though. It stuck me as very powerful.
I came away with the distinct feeling and palpable impression that if given the chance, I can do better. It’s a both motivating and unsettling feeling. I felt energized to get started on this new life of being a better person, but also felt crushed by the feeling that for the bulk of my life I had fallen short of what I could have been doing.
My delirium spilled over as my family visitors began to trickle in. I put that piece of paper in each of their hands as they arrived and I said “Here, stand next to my bed and read this. Out-loud. Right now”. I was on a mission. I even made my 12 year old grandson read it. Later he asked his Mom (my daughter) “is this the way Gramps is going to be now?”. Everyone was so patient and understanding with me.
I’ve done my best to describe this very unusual, scary and spiritual time during this part of the journey. I tried to dig around on the web to see what I was given for medications. There is no way to know. I could ask my doctors, but I won’t waste their time. This is where my head went. I was never in pain. It was strange. My faith in God was all I had and it was my rod and my staff.
I will proceed next with the early recovery, which thankfully takes place right here back on planet Earth.
My Heart Transplant Journey 
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