Published on March 3rd, 2020 | by Marylou Fusco


Spontaneous Dissection

When you’re healthy and active and still feeling pretty invincible although not necessarily young, there’s all sorts of games you play in the middle of a heart attack. You convince yourself you’re just tired and/or stressed. Lie on the floor to crack your back hoping it will relieve some of the pressure. You pop antacids and Tylenol. In the middle of the night, after Googling Heart Attack Symptoms in Women, you think me, not me, me. Then you try to go back to sleep.

My heart attack happened while walking up a hill that I had walked up a million times before. The pain lasted for a moment and then disappeared. The rest of the day the pain came and went as I was busy with my four-year-old, library visits, dinner prep. It wasn’t until early the next morning when I opened my eyes and felt as though my heart was being crushed that I knew.

In the hospital I received the official diagnosis of Spontaneous Coronary Artery Dissection (SCAD). “You can practice medicine for thirty years without ever seeing this type of heart attack,” is what one doctor said. The rarity of my condition made him sound a little giddy, and I learned that the line between freak show and superstar depended on where you were standing.

The Mayo Clinic defines SCAD as an uncommon medical emergency that occurs when a blood vessel in the heart tears, causing a heart attack or sudden death. It mostly affects women in their forties and fifties, though it can occur at any age. Sometimes it happens right after a woman has given birth. SCAD patients usually don’t have traditional risk factors for heart disease like high blood pressure, high cholesterol, or diabetes. Often they are fit and otherwise healthy. 

In the hospital, I was surrounded by wires and machines, and my daughter wouldn’t touch me, wouldn’t even come close. I didn’t blame her. Death had been banished, but it still hunched in the corner waiting for a second chance. My daughter could sense its presence. I felt it too, late at night, as I sweated through morphine dreams. 

Photo by Daan Stevens on Unsplash

When I returned home I smelled like milk gone bad, rancid fear. My body bore bruises and reddish streaks as evidence of LIFE SAVED. The catheter they had inserted through my wrist left a wound that seemed to go all the way down to the bone. I could not look. I looked all the time. 

During a lifetime of sports, my body had always reveled in motion—gymnastics, soccer, yoga, kickboxing. Now I moved slowly and napped a lot. My body became something to be managed. There were doctors to see, cardiac rehab sessions, a lifetime of medications, and while I recognized these things were saving my life, none of them could return me to me. Also, none of them could guarantee that I wouldn’t have another heart attack.

At first my chance of having another heart attack seemed to be around thirty percent. Then my cardiologist explained that the recurrence rate was more like nineteen percent. A kindhearted man who was also a research scientist, he presented the eleven percent difference as good news.

“But what were the chances of someone like me having a heart attack in the first place?” I snapped. “One percent? Two percent?” 

I watched his face fall and later examined this kernel of meanness inside of me. I wondered if this meanness was brand new or if it had always inside of me waiting for the right set of circumstances to bring it to life.

In the lobby of the building where I still attend cardiac rehab sessions, security gives me a neon yellow wrist band with the hospital’s logo on it. The first time my daughter saw that wrist band, she screamed. She remembered the logo from when she came to visit me. 

Since my return home, my daughter had taken to following me from room to room. She slept poorly. As the weeks passed she started to talk more and more about what happened to me. Sometimes she was only able to articulate her own feelings. Remember when you were at the hospital? I was so sad. Other times she got straight to the point: Are you going to die? 

“My heart got hurt,” I told her. “But it’s getting better now. Every day it’s getting stronger and stronger.”

Photo by jesse orrico on Unsplash

Her preschool teacher tells me this has become the mantra. Her mom’s heart got hurt, but she is getting better. This is her delicious secret that she tells to anyone who will listen. There is magic in the repetition of certain phrases, my daughter recognizes this. Say the words enough times and they become true.

In the spring doctors discover another tear in my body. This time it is my carotid artery that has torn at the base of my skull. I make the rounds from vascular surgeon to stroke neurologist. None of them can pinpoint when or why the tear occurred, although they assure me that it has mostly healed on its own. Continue with your meds and we’ll check again in six months, they say. You know the signs of stroke? 

I do.

At night, while my husband bathes our daughter, I go downstairs to watch random Game of Thrones episodes. I fast forward through the torture scenes. These episodes are like sneaked spoonfuls of ice cream after your parents have gone to bed. Like the sneaked ice cream, a single episode leaves me both vaguely sick and wanting more. I listen as my husband and daughter sing “Wheels on the Bus.” 

Seeking God after a crisis is a cliche, yet that’s exactly what I do. I harken back to my Catholic childhood and come to view this terrible winter as a test, a trial. Okay, I surrender. I admit my brokenness, pride, and vulnerability. Now I am waiting for a healthy body to be bestowed back to me. I will accept nothing less. Every morning I take my medications with a reverence once reserved for prayer. One by one I swallow the pills and imagine they are filing my body with a holy, healing light. I buy a pill case. Refilling the empty slots with pills on Sunday night becomes a soothing ritual. Before I leave the house, I touch the pill case as if it were a good luck charm. When I go to church I sit in the pew waiting to be struck. 

Photo by on Unsplash

Solvitur ambulando one doctor wrote on my after visit summary. It is solved by walking. As the weather starts to warm and cardiac rehab comes to an end, I start walking through the medical campus on my way home. There is a path that runs along a man-made pond. Everything is peaceful and tinged with green. While walking I often have imaginary conversations with people I haven’t seen or thought of for years. Their faces and mannerisms are suddenly clear and precious to me. I tell them things that I hadn’t told my friends or family or even God. Sometimes I even answer their questions out loud.

Once, taking a different route, I stumble upon a stark hospital wing with rows of windows that stop me in my tracks. Beyond the windows, inside those rooms, I don’t picture people in beds surrounded by wires and machines. Instead I imagine those who walked out on their own two feet amid reminders of how lucky they were. 

You are so lucky, you are so lucky, they told themselves and mostly believed it. Still, they startled easily. The smallest things, the dumbest commercials brought them to tears. They tried to cultivate tenderness alongside the meanness within their hearts. They stared too long at hospital windows waiting for someone to appear. And when that person appeared, they would wave their arms shouting here, here, their voices ringing with something like joy.

Tags: ,

About the Author

Marylou Fusco grew up in the wilds of New Jersey and knew she was a writer for forever. She has worked as a newspaper reporter, GED instructor, and ghost tour guide. Her fiction has appeared in Carve, Swink, So to Speak, and Philadelphia Stories magazines. She lives with her family in Baltimore, where she is finishing a novel about reluctant saints and resurrections. She is eternally grateful to the doctors at Johns Hopkins hospital for their skill and care.

2 Responses to Spontaneous Dissection

Leave a Reply

Your email address will not be published.

Back to Top ↑
  • Subscribe to Mutha

    Enter your email address to subscribe to MUTHA and receive notifications of new articles by email.

    Email Frequency