Electrophysiologist

 Remember my recent post regarding the Cardiology department? Well, I’ve just returned from the sequel. This time, I sat down with an Electrophysiologist.

For those of you not fluent in Medical-Speak, the difference between a Cardiologist and an Electrophysiologist is roughly the difference between a plumber and an electrician.

The Cardiologist is the plumber. He’s worried about the pipes, the water pressure, and whether the main pump is rusted through.

The Electrophysiologist is the guy who shows up when the lights are flickering and the microwave starts screaming for no reason. He doesn’t care about the pipes; he’s there to find out why the wiring in the walls is sending "disco mode" signals to your atrium.

To become an Electrophysiologist, you have to survive two additional years of training after finishing a four-year cardiology residency. In other words, these people have spent so much time in school that they’ve forgotten what sunlight looks like, all to ensure your heart doesn't decide to improvise a drum solo at 3:00 AM.

We sat down to discuss my history of ablations—which is a term for "intentionally scarring the inside of one’s heart with a tiny soldering iron."

My heart occasionally likes to engage in "atrial flutter," a condition where the electrical impulses get bored and decide to do donuts in the parking lot of my upper chambers. I learned that my next step up the ladder isn’t just a "tweak." It’s the nuclear option: a radical ablation that would permanently sever the connection between my heart’s upper and lower chambers.

My heart would essentially be "unplugged." To keep the motor running, they’d have to install a permanent pacemaker.

Since I currently have zero chest pain and no symptoms of heart failure, I decided that turning my chest into a high-tech battery housing unit felt a bit like installing a commercial security system on a garden shed. If it’s not broken, why try to rewire the whole neighborhood?

I asked the good doctor about my QTc interval—an electrical measurement that sounds like a premium cable channel—and he gave me the classic "no worries."

Then, we got to the scheduling:

Me: “So, should I keep coming in for an EKG every six months?”

Doctor: “Goodness, no. Once every three years is plenty.”

Me: (Calculating the math of mortality) “Every three years? Exactly how many ‘three-year periods’ do you think I have left on the lease?”

Doctor: (With the breezy optimism of a man in his thirties) “Oh, you’re not that old!”

I had to level with him.

“Doctor, we are operating on two very different timelines. When you go digging through your desk for documents, you’re looking for your birth certificate to renew a passport. When I go digging through my desk, I’m looking for our marriage certificate to make sure my wife and I have a confirmed reservation at the National Cemetery.”

He chuckled. I think he realized that while he sees a "stable patient," I see a guy who doesn't want to buy green bananas if the EKG is only happening once every presidential term.

In the end, we shook hands and agreed on the golden rule of both plumbing and electrical work: If the lights are on and the toilets are flushing, leave the toolbox in the truck. I’m officially staying "un-rewired" for the time being. I’ll see him in three years—provided I can remember where I put my keys by then.

Pulsed Field Ablation

 For twenty-one days, I lived in a self-imposed medical bootcamp. My mission? To master three words that sounded more like a weapon from a sci-fi flick than a heart procedure: Pulsed Field Ablation.

I ran drills. I interrogated Google. I repeated the syllables while brushing my teeth until the phrase transitioned from a clunky "guess" to a polished linguistic weapon. By February 25th, I wasn't just a patient; I was a man with a vocabulary mission. I was ready to walk into my cardiology appointment and let that term flow from my lips with the casual grace of a seasoned surgeon.

The room was sterile, the paper on the exam table crinkled under me, and the stage was set.

The Doctor: “So, what brings you in today?”

Me (internal): This is it. My moment.

Me (external): “Well, I’m here for the results of my week-long Holter monitor from January. And,” I added, pausing for effect, “I want to find out if I’m a candidate for a Pulsed Field Ablation.”

I waited for the nod of professional recognition. I expected a nuanced discussion on cardiac tissue and electrical currents. Instead, I got a blank stare.

The Doctor: “What’s a pulsed field ablation?”

In that moment, the air left the room. My internal monologue, usually a polite observer, screamed: What the hell am I doing here? If my cardiologist—the man currently tasked with managing the rhythm of my most vital organ—was asking me for a definition of a breakthrough cardiac procedure, we were in trouble. It was like asking your pilot about the landing gear and having him ask, "Wait, this thing has wheels?"

But the comedy of errors wasn't over.

Seeking an exit strategy, I pivoted. “Can I get a referral to Electrophysiology?”

The doctor shook his head with the confidence of a man who hadn't checked his own company directory in a decade. “I don’t think there’s an Electrophysiology department here at Fontana.”

At this point, I felt less like a patient and more like a whistleblower. “Actually,” I countered, “according to the portal, there is. It’s right here.”

The punchline? I got the referral. I’m headed to Fontana Electrophysiology this Wednesday to speak with the people who (hopefully) know what their department name means.

The Moral of the Story: Your health is a DIY project. If you don't do the homework, you might find yourself being treated by someone who forgot to open the textbook. As for my current cardiologist? I think it’s time for a "Pulsed Field Separation."

Walking

Roughly a "barbed wire’s length" into my trek—that specific, jagged distance where the house is out of sight but the destination is still a rumor—my subconscious erupted. It wasn't a gentle nudge; it was a tectonic shift. It spewed a complaint so sharp I could practically hear it vibrating in the crisp morning air.

"Why," my shadow-self demanded, "are you doing this to yourself?"

It didn’t stop at philosophical inquiry. It moved straight to biological blackmail. It offered a menu of misery designed to force a U-turn:

• The Leg Weighted-Lapse: A sudden, phantom doubling of the gravity affecting my quadriceps.

• The Oxygen Embargo: A calculated tightening of the chest to ensure every breath felt like sipping through a cocktail straw.

The hill ahead was particularly severe—a vertical insult to my morning ambitions. My subconscious saw the incline and decided it was time for a hostile takeover.

I skipped the walk for two days, and I could practically feel my inner saboteur reclined in a lounge chair, sipping a metaphorical lemonade, smug in the knowledge that it had successfully negotiated a surrender to the "Easy Way Out." It had convinced me that comfort was the prize and effort was the enemy.

But here is the thing about the easy way: it’s a cul-de-sac. Today, I returned. I stepped onto that severe rise and stared down the hidden version of myself that begs for the couch. I felt the burn, I heard the whining of my ego, and I kept walking anyway.

Perseverance isn't about the absence of that complaining voice; it’s about treating that voice like background noise—a radio playing in a room you’re just passing through. I didn't quit. I didn't bargain. I just climbed.

Ants

 A word has been added to my vocabulary although I shall likely never speak it again.  Into one of my unused vocabulary slots I added the term thigmotaxis. Holey shit Batman, what happens when thigmotaxis sets in?  While walking and just taking in all that nature and mankind has to offer on my simple circuitous trek about our community, I see ants, lots of ants.  Among the population of local ants there are trails of those beasts that cross from one side of the sidewalk to the other.  Always, not just sometimes, but, always those sidewalk crossings occur within sidewalk grooves. One might just speculate that sticking to the grooves avoids squashing by a person’s foot.  While that’s certainly true, there’s much more than that to the groove choice.  The real predation protection afforded by sidewalk grooves is in consideration of birds that might consider an ant to be a food source.  Now, back to thigmotaxis.  Ants are evolutionarily programmed to seek the tactile benefit of guidance that enables them to be free of relying on navigating by way of the Sun or visual landmarks.  It’s simpler to follow an edge or groove.  Ants communicate through pheromones and the pheromones emitted by those six legged bugs become concentrated when spewed in sidewalk grooves.  Breezes are less likely to cause pheromones to dry out in a sidewalk groove than if on the flat surface of a sidewalk.  The microclimate that exists in a sidewalk groove is much more beneficial to an ant than the flat surface of a sidewalk.  Groove humidity is likely greater than on a sidewalk’s flat surface so that the risk of an ant drying out is lessened  there.  So, there’s much more to crossing a sidewalk, if you're an ant, if you're an ant you should be groovy. 

A farewell to Doris

 

The Gospel According to No One: A Farewell to Doris

The room was packed—a testament to Doris’s standing in the community, or perhaps just a collective desire to see if she’d finally folded her hand. The afternoon began with a grace that Doris herself would have approved: a volunteer soloist and pianist who performed with such professional polish you’d almost forgotten they weren’t on the payroll.

Friends offered brief, salt-of-the-earth tributes that hit all the right notes of genuine affection. It was a lovely, dignified affair.

And then came the Pastor.

Evidently, this man serves as the self-appointed governor of the bi-weekly marathon events Doris frequented. I say "governor" because he spoke with the administrative stamina of a man filibustering his own conscience. For forty-five grueling minutes, we were treated to a "spew" of oration so relentlessly Jesus-adjacent that Doris—the supposed guest of honor—became a mere footnote in her own obituary.

Is it impious of me to suggest that a "celebration of life" should, at some point, actually celebrate the life in question? To the pews of "normal" people, his ranting felt less like a eulogy and more like a hostage situation. In my younger, more volatile years, I’d have checked my watch at ten minutes and checked out of the building at eleven.

Still, we were there for Doris. She was a fine woman, even if the tributes to her card-playing prowess leaned heavily toward the hagiographic. One speaker suggested she was a master of the table; personally, I’d say her grasp of contract bridge procedures was "experimental" at best.

She may have lacked a killer instinct for a Grand Slam, but she deserved better than being upstaged by a man who couldn't find the "Amen" if his life depended on it.

Veterans Day 2025

 Veterans Day holds a meaning for me that is deeper than the olive drab I once wore —a meaning rooted not in foxholes and flags, but in the sterile, terrifying drama of a hospital room, exactly fifty years ago.

You see, fifty years ago, as the calendar turned to November 11th, Sue, was carrying a passenger who was under siege. Her body, with the cold efficiency of a biological weapon, was rejecting the life growing inside her. The blood types were at war. This precious, seven-weeks-premature fetus was already facing the risk of grave maladies, a medical certainty if she arrived too soon.

The afternoon of November 10, 1975, saw Sue and me in the hushed, leather-scented office of our psychiatrist. We were charting the treacherous waters of the dilemma: to terminate the pregnancy, or risk a catastrophic birth. For fifty agonizing minutes, we turned the terrifying question over and over, its edges sharp and unforgiving. We left, not with an answer, but with a paralyzing confusion that followed us home. We talked until the words dissolved into silence, and finally, we fell into a troubled, undecided sleep.

Then, at 2:00 a.m., the silence was shattered. A sharp, undeniable cramping pain. Sue was in spontaneous labor. Her body had made its final, brutal decision, forcing the battle to an immediate climax.

We moved in a blur. Clothes on, a frantic call to my dear mother to rush over and care for our two older girls, Lisa and Melissa, and then the urgent, heart-pounding dash to Valley Memorial Hospital. Sue’s obstetrician met us at the Emergency Room. One quick, grave examination, and the verdict was delivered: “Valley Memorial cannot handle this. You must head to Stanford Medical Center. Now.”

The hour-plus drive to Palo Alto was a torture chamber of worry. Every dip and turn was an appeal to fate, praying that the unthinkable—a premature baby spilling into the back seat—would not happen before we reached the sanctuary of Stanford.

The doctor who greeted us there was a man who understood crisis. He was a Vietnam Veteran, a former surgeon in a Mobile Army Surgical Hospital—a MASH unit—in Southeast Asia. He claimed the sheer, unadorned trauma of war had convinced him to trade combat injuries for the miracle of birth, switching his specialty to obstetrics upon discharge. It was a fitting presence, a veteran standing guard over a fragile life. His approach was tactical: inject medications to stall the labor. We were united in one desperate hope: to continue the pregnancy, to buy more time.

Then, at 3:00 p.m. on November 11, 1975, with the clock ticking toward the close of Veterans Day, the overhead television displayed the soothing distraction of a daytime drama, All of My Children. And there she was. Gliding across the screen: the incredible, undeniable beauty, Susan Lucci, in the role of Erica Kane.

A sudden flash of inspiration, a spark of hope amidst the fear. I turned to Sue and said, “That’s it. Let’s name her Erica.” And we did.

But the battle wasn't over. As soon as Erica arrived, she was Baptized in emergency, a silent plea for protection, and swiftly carried away. The Vietnam Vet MD roared, “Wait up! You can’t take that baby away!” But the specialized pediatrician squad, focused on saving a life, ignored the command.

Erica was rushed to an incubator, a glass-and-steel surrogate womb, where she fought for fifteen days until her tiny, imperfect lungs could finally draw a breath without aid. For weeks, her irritated vocal cords allowed her only a silent scream—she cried, but no sound escaped. Slowly, miraculously, she began to generate noise.

Now, on this very Veterans Day, 2025, that remarkable beauty—our Erica—is fifty years old. Her life, born from a medical war and a day set aside for honoring those who survived conflict, is the most wonderful, personal victory we have ever known.

Nail Clipper

 Just now, as my fingers wrapped around the green, rubbery handle of our nail clipper, a vivid flash of memory burst across my mind like a film spliced into the present moment. In that sliver of time, I was suddenly back in Shanghai, China — a city of perpetual motion and mist. I remembered handing over a few folded bills of Chinese Yuan — the Renminbi -  to purchase that very clipper.

Outside, rain was falling in fine diagonal lines, the kind that blurs the world into watercolor. Four of us ducked into a nearby Starbucks, seeking refuge under the halo of its glowing sign. We legitimized our stay with two cappuccinos crowned in foam and two steaming cups of jasmine tea that perfumed the small table between us. Just an hour before, we had descended into a basement silkworm exhibit — a quiet, oddly mesmerizing space of soft lights and whispering guides — watching the patient artistry of the creatures that spin luxury from nothing but leaves.

By noon, the city had begun to hum with hunger. In a narrow, bustling food court, a young woman with bright eyes and a damp umbrella offered us a taste of a steaming dumpling she had just claimed after a heroic wait in a winding queue. She demonstrated unsuspected kindness.

Now, as the click of the clipper echoes in the quiet of my room, I can almost hear the distant chatter of Shanghai again — a reminder that our most ordinary objects sometimes hold entire worlds within their surfaces. Yes, my nails are trimmed for another week, and my heart, unexpectedly, is back on that rainy afternoon half a world away.