Dr. Borreros glanced over the top of his horn-rimmed glasses and looked me in the eyes.
“You have a SCAD, and you are dying.”
I sprawl naked, surgically taped by arms and legs to an overlarge operating table. There was only a thin blue sheet covering my unmentionables, and I felt vulnerable. The surface was frigid, smooth, and sanitized for my protection. I am a man of size, and it took no less than eight nurses to scoot me over from the gurney. Filipinos are not massive people known for feats of strength and a body my weight is not a simple thing to maneuver. The fluorescents were dimmed, but not romantically so. This room was for serious, life-altering business, and its utility spoke of calmness and assurance. This was the Cath lab of The Medical City Hospital, and I was the patient in the middle of an Angiogram.
I wasn’t sure I heard the cardiologist clearly with the low, busy din of the nurses in the room. They had given me some kind of narcotic to help me relax before they jabbed a thick needle in my left wrist – through which a tube and a wire went in through the artery, all the way to my heart. “Relax” said another voice when I grimaced in pain and grunted, because it turns out being stuck to an icy, unyielding table for hours was painful and uncomfortable. The muscles in my butt and legs were a painfully numb and prickly mess, so all I was thinking about when the doctor spoke was easing the discomfort in my extremities. I knew the next few minutes would decide my fate, but all I could think about was trying to move my leg a few inches to ease some anguish.
“Please, sir jason, do not move,” came the rebuke from the masculine, yet syrupy-soft voice of my nurse, sitting a few inches behind my head. A few minutes later, I was trying to move again without being noticed by my eagle-eyed captors.
Don’t Worry, I’m Only Dying
I found myself in the middle of an emergency procedure because I had stumbled in the ER a day before, complaining of excruciating chest pain. Two misguided and overworked doctors in another ER had overlooked my elevated Troponin I levels and had sent me home, saying they couldn’t find what was wrong with me. My EKG was normal. But, after being released, my wife, Flora, forwarded the test results to my primary, Dr. Fuentes, and he phoned us back almost immediately, saying a Troponin I level of .60 was undoubtedly a heart attack and I must go back to the ER as fast as I could manage.
We were dropped by taxi uneventfully and triggered the noisy automatic doors of Metro Hospital, after dropping the kids off at the in-laws and racing to the only hospital that wasn’t swamped by Covid cases. Test results in hand, we informed the baby-faced intern on duty of the situation and complained about the terrible chest pains again. He ordered yet more tests and strolled back momentarily, nurse in tow with a steady flow of enough medication to put a horse to pasture. The goal was to stop the heart attack and prevent any more damage if that were possible. I could easily have already died by now.
After I took all the pills they asked, and an IV was inserted in my left hand, they didn’t just page any run-of-the-mill cardiologist, but a legend in Iloilo City. He was an overachiever who mostly handled celebrities and politicians in the area, so I was honored, because he was taking a real step down in status taking my case. Sure, he cost a pretty penny more, but when you are dying, price in no object. He and his stone-faced resident pored over my EKG and blood tests with a composure that reflected the seriousness of my situation and told us I needed an angiogram to find out how many of my arteries were blocked, causing this massive heart attack.
I shared a look of genuine concern with Flora, one that said we had no insurance in the Philippines, and this would cost more money than we could hope to wrangle at short notice. Her smoky eyes misted, partially obscured by her coffee-colored hair, but didn’t look away. A fact about hospitals in the Philippines is you must pay for all services rendered before you leave the hospital – there was no such thing as credit or paying later. The issue was, if the angiogram proved I had a blockage or two, I would also need angioplasty, which would be another million pesos, and we couldn’t hope to pay. Our bank balance was zero. She hesitated, asking Dr. Borreros, a diminutive and modest man, if the angiogram was necessary. Not skipping a beat, he let out a sigh and said, “Absolutely, your husband could die without it! It should be done sooner than later.”
As a pair, we decided to get the angiogram done immediately and began to gather the 100K Pesos ($2000) down payment by borrowing from my true friend Mike, who laughed and told Flora that “he knows five fat people, and I was four of them” I could always count on Mike for insults and money, like all my good friends. We also borrowed against the credit cards of Josh, my brother-in-law who is more than blood to me, and would play it by ear when we found what was wrong with my arteries after the initial procedure. After a stormy and melancholy ambulance ride to the only hospital in the city with a Cath lab, and a night in the tiny yet modern ICU, here I was, horizontal on an unyielding slab trying to figure out what a SCAD was.
Let’s Have a Round of Applause
SCAD is short for spontaneous coronary artery dissection, and it is exactly as bad as it sounds. The Dr. pulled the bleached sheet that had been blocking my view and I realized for the first time that the entire wall next to me was covered in monitors. Currently playing on the CRTs was a loop taken by the C-arm, a white fluoroscope machine, with the business end hanging precariously over my chest. Through the tube in my artery, they’d released dye, which clearly showed some of the large arteries that fed my heart had been blocked and one inexplicably burst and was leaking blood. The two ends of the artery were inches from each other - not at all where they should be – and one end was in danger of disappearing into my chest, unable to be retrieved. The team needed to try to fix them but weren’t sure they would be successful – it would be a blind procedure. Dr. Borreros stated matter-of-factly that if they didn’t try, I would surely die – maybe in hours, maybe in days.
I didn’t know drama was unfolding twenty feet away: they were spilling the news to my frightened and skittish wife, who was trying not to have a panic attack. She retreated to the corner after crying for a few minutes, worried and inconsolable, and got on the phone with my parents in Arizona, whom I had a strained relationship with. She explained that I needed emergency angioplasty, but because this would be blind procedure, the doctor couldn’t guarantee it would work. It was a 50/50 thing, and Flora could not make this decision on her own. She, my solid and level-headed dad, and emotional but resolved mom decided it was best to try save me right away, as soon as possible. Dr. Borreros floated the idea that I could go to the States and have the procedure done there - there was a slim chance I would survive the trip, because he couldn’t make any guarantees of success. But we all knew he was a consummate professional and could be trusted just as much as any doctor in America.
As I lay trapped and in extreme pain, stuck to the torture surface they called an operating table, Flora whispered so close that her breath tickled my ear, “They are going to do the procedure,” barely holding on to her composure so as not to stress me out. “I’ll see you when it is done.” She held back tears, knowing that she might never see me alive again.
Ten minutes later, the whole cadre of doctors, nurses, and technicians in medicinal blue scrubs cheered and clapped - and the nurse by my head softly chuckled and said that the procedure was a success. Dr. Borreros had rejoined the two ends of the artery with a stent, all blind, a feat that even I understood to be almost impossible. Being the professional he was, he did it without breaking a sweat, without hesitation - and saved my life. An iceman in his own right. Because of him, I had a new lease on life.
Ten Years Before - September 2011
Swampy air and staggering heat slapped me in the face as I plodded down the damp and treacherous steps of the gangway. I’d arrived in Manila, Philippines by dead of night, just missing a passing rainstorm that made landing an experience I wanted to forget. I was in this country to change the way I lived, and hoped changing my address and hemisphere would do the trick. I’d left Tucson behind a few days before, having only known suffering in the States, saying goodbye to my three boys. They were men who still had too much growing up to do. I also left my parents who knew that leaving was the best choice for me considering all I had been through. I had just lost my only brother, and because I was due to step on an international flight, couldn’t attend the funeral. Waiting for me outside the terminal was a beautiful soul with a welcoming smile, a beautiful Filipina bride almost two decades my junior. We had only met online, never in person. She held promises of white sandy beaches and cocktails of sweet coconut milk. I hoped against all hope that I was finally home. A home only a broken man could appreciate.
2022 Heart Attack – The Aftermath
After the angioplasty – the unblocking of a few arteries and adding a stent where the SCAD had been - I languished a week in a nondescript taupe room, streaked windows with fingerprints from past residents covering one wall. An adjustable single hospital bed filled the middle of the room with a turquoise Naugahyde-covered bench along the window-wall. The air smelled of the alcohol I used on my hands religiously, because the last thing I wanted was Covid in the hospital and having to stay longer. Masks were mandatory and mine smelled of the chicken and rice I’d eaten for lunch. I lay, attached to an IV, unable to wander because I had been relegated to dreaded bedrest. But everything was different in a moment. Dr. Borreros and his ever-present resident said I was ready to go home because I had finally pooped in a diaper, which I wore like a badge of honor, despite my best efforts to avoid having to go number 2 in bed. Having someone cleaning up after my rectal gymnastics was the last thing I wanted, but days of eating plenty of roughage and taking copious laxatives left me with no choice but to let go. I’d held it in for too long, and the diaper was nowhere near capable of holding the feces that came flooding out. Before I could react, it was everywhere, peanut butter-colored paste that smelled of Cthulhu’s ball sack, running down the sides of the bed to pool on the floor. I responded by screaming into the intercom that I needed help immediately. They thought I was having a medical emergency. Four nurses, two men and two women, arrived in time to see me losing my mind in this maelstrom of my own stool. Dr. Borreros and resident must have heard of my embarrassing plight because he let me go home that weekend. In my shit-induced psychosis, I could tell they were holding back a fit of the giggles, but in truth, they were as professional as ever. The damages came to 690,000 Pesos, or $13,000, and if it were not for my brother-in-law and his magical plastic money, I would never have left the hospital, probably still working off the debt in the kitchens a few years later.
This was the second time since I arrived in the Philippines that I came close to death. The first being after I took too much medication and fell asleep in a beanbag in the living room thinking I wouldn’t wake the next morning. Both experiences left me feeling I had cheated the reaper, and it was up to me to ensure I didn’t waste these second chances on life I had been handed. My first brush with death pushed me to completely change everything about my life at the time. I went back to college, quit smoking, and broke an addiction I had to my anxiety medication by suffering through months of horrendous withdrawals. I started communicating more with my wife, instead of suffering through my illness alone, and we both started the process of building a worthwhile marriage, instead of the daily screaming matches we engaged in the first few years I was in Iloilo City. Flora started to change too because she had been cursed with anger issues and terrible anxiety. Me almost losing my life twice only caused more trauma for her, but she persevered through her undiagnosed PTSD.
Instead of continuing to do the same things I did in America unsuccessfully to survive, I set out to improve everything a little bit each day. I promised myself I would stop regretting the past, and even though I am still struggling with that very thing to this day, have been improving my outlook a tiny fraction daily since then.
2011 – A New Life?
A month after arriving in the archipelago, Flora and I married, even though she was reeling and confused that I had never told her about the severity of my various mental baggage. She was a beautiful and vibrant island girl, and I was a sick, broken, and obese shell of a man. The first few months, because of medication issues, I slept constantly. She and her family didn’t know how to deal with me because they had no frame of reference or experience with anyone who suffered as I did. Despite not really knowing each other and my medication-driven asexuality, she announced she was pregnant. But another issue would ruin the experience of impending parenthood for both of us. I had been on Social Security Disability for years, and right before I left the States, they told me my benefits would be ending. My experience with the administration was that they used the possibility of losing benefits like a carrot on a stick, making sure I would jump through whatever hoops they asked. Right before I left, I’d filled out reams of paperwork about my condition and attended to my day in court, all to keep my benefits by proving I still needed them. But they cut me off anyway. I mistakenly thought I could maintain my moods and get a job in the Philippines when I arrived but could not handle the medication issues and the sadness that sent me in a spiral down the rabbit hole. I also had no chance of getting a job because there were none, and even if there were, I had no college degree.
After months of almost starving and being unable to support Flora and our unborn baby, I borrowed enough for a plane ticket and flew back to America to get my benefits back. Unfortunately, it took more than a year - I missed the birth of my first and only daughter, and I couldn’t make it back until she was officially one year old. I worked at a convenience store in Tucson the whole time and sent money back for diapers and formula.
2022 and Beyond
Two months after the heart attack, something happened that would forever change our lives again. My son, only three years old, was diagnosed with autism spectrum disorder (ASD). We had known for a while that something was different about Joey, a hefty and rambunctious boy, but it wasn’t until we got him tested, we found out he was on the spectrum. Flora regretted missing the first few years of his life because of work and quit her job to focus on the boy who needed us more than ever now. Add to that the fact we had a year to pay back $13,000 in loans on various credit cards. We were broke and there was no way I could get either medical or life insurance. If something else happened to me, I would most likely die because we had no more resources to pay for medical care. Add to this we had to pay for therapy for Joey, because his speech was delayed, and he needed help learning how to do things that other kids took for granted. Somehow, we made it with only my Social Security and the little money I made from writing.
If it had not been for my closest friends Mike and Annie, to people in separate parts of the world, we would never have made it this far. I was thankful for the two people who had stuck with me through everything. It had been a long time since I had people I could call friends, and thankfully, I chose well, because both of them are the best people I could have asked for. In addition to providing financial support, they were willing to listen to both Flora and I rant about difficult our lives were. Yes, it is a give and take relationship, but I feel lucky to have struck gold in the friends I have today.
2015 – An Academic Journey Begins Again
After starting the journey to changing my life, I went back to college online. The first six months at Ashford University were a dream. I was accepted into the Honors College and was a member of Alpha Sigma Lambda. I kept a 4.0 GPA just as I had done throughout my associate degree back in the late 1990s. But the stress of college, and all the improvements I was trying to make made me feel as if I was burning the candle on both ends. The worst was trying to break the addiction to clonazepam and cigarettes which was about as enjoyable as chewing nails and sawdust. The hellish withdrawals and crippling anxiety were making me feel as if I couldn’t cope. I just couldn’t maintain and dropped out. I felt like a failure and like nothing would ever work out for me. But several years later, in 2021, I started again at a new college, Southern New Hampshire University, and continued back where I left off with a 4.0 GPA. But disaster struck when I had to quit because of the heart attack. After my health improved, and I was able to pay back what I had borrowed to stay alive; I went back to SNHU to finally complete what I started all those years before.
A year later, present day, I will be graduating Summa Cum Laude with a degree in General Studies and a member of Alpha Sigma Lambda. I have plans to start my MFA next year if I can get grants and scholarships, because I don‘t want to add to my already huge student loan debt. Even though many are telling me to slow down at my age, I can’t say goodbye to academia. I love it too much. I also have too much to prove to myself and cannot bring myself to exit the college experience that I couldn’t get younger in life. Flora is also going back for that elusive undergrad degree next year as well. Even better, my friend Mike suggested I teach English in China next year as he does, and it looks as though I will be a teacher starting in 2024. Through it all, every hardship, every illness, every setback, Flora and I kept the faith and tried to stop regretting the past. We looked with hope at the future. If I had continued on the path I was walking when I arrived in the Philippines, I would never have made it this far. We kept improving and kept our hopes for the future alive – and most of all, we started planning for a future that was as bright as the sun over the azure waters of the Philippine archipelago.
I have my family, friends, and a wife who wants only me in her future. At 55, as I plan for the next ten years – learning, growing, teaching, traveling, making money, and building our future one step at a time, I feel something that had been missing all those years ago, when I got fed up and boarded a plane for the beaches of Iloilo. I feel hope, and it all started when I stepped off that damp gangway, in the mid of night at the airport in Manila, and said, “I’ve arrived.” I felt a glimmer of hope for the first time in my life.