Medication and the hidden structure of experience

I woke up this morning in the hospital, feeling a lot better. It was a reminder about how our given world -- the world of experience -- is not the world. The fundamental fact about the world, it seems, is that we actually dream it.

I had been admitted yesterday to change my anti-arrhythmia medication. Over the last year I've steadily lost ground in my ability to control my heart rhythm, to the point where I have been in atrial fibrilation about 20% of the time, despite a pacemaker and diltiazem. Fibrilation is a sustained high (e.g., 180 beats / minute) and erratic heart rate. I don't suffer, exactly, but it is debilitating. There wasn't a crisis that led to the admission. It just took some time to acknowledge that the old therapy was no longer working. 

So now, following the advice of Dr. Charles Love, my awesome electrophysiologist, we are pulling out a higher caliber weapon and switching to propafenone. Bigger drugs have bigger risks and you have to start propafenone in the hospital to make sure you can tolerate it.

And so far, so good. My heart is STABLE. This is revelatory:

Then felt I like some watcher of the skies
 When a new planet swims into his ken;
 Or like stout Cortez when with eagle eyes
 He star'd at the Pacific — and all his men
 Look'd at each other with a wild surmise —
 Silent, upon a peak in Darien.

What I hadn't understood was how much of my attention had been focused on my cardiophysiology. Even when I was thinking about other things, part of me worried about whether a mild flutter was about to become a hammering effort regain a steady beat. Or whether just standing up from a chair would lead to a sudden loss of blood pressure and syncope. Those concerns are gone. I'm able to be here in a way that I wasn't yesterday. All the metaphors about character and the heart are true: When you can't count on your heart, it's difficult to be steadfastly present.

The person I was yesterday had forgotten what it was like to have a steady heart. I am now back in the world; and I hadn't recognized the degree to which I was gone. The former state seems like a dream state although at the time it seemed wholly real. Our experience is constructed, and we only see the moving parts when something like a change in heart points it out to us. When you encounter another person, be gentle. He is in a dream and so are you.

UPDATE: Thanks to Dan, Austin, Paul, & Brad for their kind wishes. As it happens, I had a stress test right after the post and went right back into atrial fibrilation. So much for the hopes that profanenone (aka rythmol) would be sufficient. Looking at a ablation procedure on Monday.

Comments

[Daniel S. Goldberg]

Glad to hear it, Bill!

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