If only

A couple of years ago, I had a medical scare. I lay in bed waiting for my wife to finish her nighttime routine and settle into bed so we could get to sleep when a stabbing pain hit me in my chest. It was so fast and hit so hard that I yelled out loud.

My wife came running, and as I began to assess what I was feeling, I noted the pain going down my left arm. I told her what I was feeling, and as you might imagine, she exclaimed that I was having a heart attack.

Another spike of pain hit, and I yelled again—louder this time.

The pain kept hitting me, leaving an ache behind but otherwise subsiding after each strike. She made me chew and swallow aspirin, called 911, and we had a squad at our house in minutes.

I remember facing my mortality head-on in that event. I thought about how young and healthy I was. I imagined leaving it all behind: my family, the world, and my life. All the regrets you feel at the end of life hit in that moment. If only I told them how much I loved them. If only I started writing sooner.

At the hospital, they took my blood, wired me up, and the cardiologist who worked on me rushed me to a heart catheterization procedure to check my veins for blockages. I particularly remember being on that bed thinking over my life, asking myself if I’d lived enough. What were my regrets? Was I about to meet God? Despite the worry on everyone’s faces, it didn’t feel like it.

During the heart cath, the doctor scrambled to look around my insides to find any immediate cause. I remember because I was awake throughout the procedure, numbed but awake. After minutes of poking around, I remember him retracting the tool with a glib resignation.

He gave me a disapproving look and said, “You’re clean. Clean as a whistle.”

After follow-ups and tests, my cardiologist decisively ruled out a heart attack. Okay, so what was it then? I was told I needed to cool it with my exercise routine. It was a bit too vigorous, and I had a severe chest cramp. Essentially, I had a charlie horse in my man boob. If only I’d known that could even happen.

As much as you’d think this story was about that event, it isn’t, but it sets up the story I’m about to tell.

Have you ever left for a trip that feels rote? This story is about a routine trip flying across the country to see my parents, brother, and in-laws. Due to COVID, we hadn’t been back in a few years, but other than that, it was completely routine.

Over a month before we left, I had been sick with a lingering cold that seemed to take weeks to shake. As it cleared, my son and I went on a mountain retreat with significant elevation changes. Both of us came away with plugged ears. Since that trip in mid-September, we both struggled with clogged ears.

The morning of our flight was chaotic and stressful. Our flight was bumped earlier to an 8:30 AM take-off instead of the initially scheduled 10:30 AM. That meant a much earlier wake-up to load the vehicle and get everyone in for the 1+ hour trip to San Francisco International. Lucky me, I woke at 4:04 AM. Time not found, I remember musing to myself. At 5:30, I all but jumped out of bed to get dressed. The rest was the usual stress of pushing everyone to get ready and do all the things so we could leave.

We arrived at the airport to find the checked baggage line far too long for the hour we had before boarding. My wife scouted the scene, and her resourcefulness kicked in. She noticed the curbside line was far shorter. We jumped the line and were able to get the bags checked. Then, the security line. My word, it was enormous. What was going on? The airport was packed beyond what we were used to being normal. It looked far too long for the time we had. We hadn’t even reached the zig-zag ropes before our plane started boarding. If only we’d left earlier, we wouldn’t have had so much stress. Little did we know that this was just the beginning of the chaos we’d go through that day.

Thankfully, we were at just the right security checkpoint. Gate F1 was just on the other side of it. No running, just rushing to make it through security smoothly. We managed to make it. I ended up being the last passenger to board.

Everything seemed like a normal flight. I started working on my writing project and popped my air pods in. We took off with a smooth ascent.

I was starting to find my rhythm in my current writing project when the pressure in both my ears began to build to the point that it was distracting. I tried to work through it, but it just kept getting worse. I’m no stranger to it. I’ve always had ear pressure issues when flying, but it usually happened on the descent, not the ascent.

I tried to keep working, but the pressure distraction was too much. I switched to watching a movie, hoping to distract from the building pressure. My right ear released, and I thought it was a simple matter of time for my left ear.

Instead, I started to feel strange. There’s no good way to explain it except to say I felt off. As I watched the movie, I kept moving my jaw and massaging the skin to pull things around, hoping my Eustachian tube would open and release the pressure. No dice. The pressure got worse. It was excruciating.

My head ached at the back and spread down my neck. I closed my eyes to help the headache go away. That’s when I noticed I couldn’t entirely close my left eye. Then, a strange feeling spread to my cheeks and my mouth. I say ”spread”, but I think it was already there; I had just begun to notice those areas feeling not right.

I knew I was in trouble.

I turned to my wife sitting beside me and told her in a severe tone, “Something’s wrong. Something’s wrong with me.”

I made a facial expression of concern to let her know I was serious, but she saw that the left side of my face didn’t move; it was drooping. Her eyes went wide.

“You’re having a stroke! You’re having a stroke!”

I took the AirPods out of my ears, both ears, with both my hands. A stroke? How could I be having a stroke? What do I do? What are the steps? That’s all I could ask. What do I need to do for the best outcome?

My wife, ever courageous and resourceful, smashed the call light button and shouted at the plane, “We’re having a medical emergency! Are there any doctors on board?”

An older woman, we learned her name was Lisa, in the row ahead got up and began to help.

Unlike my wife’s calm procedural mastery, I was my typical deer-in-the-headlights stunned, trying to internally assess my state and figure out what I needed to do for the best outcome.

Lisa began to ask me questions, touch my face, and assess me. After some back and forth, she suggested I lay down. So I slowly got down into the middle of the aisle as the plane crew began to help, running over me to get a first aid kit, oxygen, and more. They also discussed landing the plane and diverting it to the nearest airport. Every minute of a stroke does severe damage to brain tissue that can become permanent at around 3 hours.

Lisa continued to assess, and another doctor from the back of the plane joined. Lisa mentioned she was an OBGYN, and the new doctor, Jason, was a surgeon. They did their best to assess me.

I was asked to smile and raise my eyebrows. They touched my face on my cheeks and forehead. An O2 monitor snapped on my finger; then they put on a blood pressure cuff. A tank of oxygen was primed, and Jason used a stethoscope to listen to my breathing and heart.

Being relatively young and healthy, the surrealness of the situation sunk in. Was this really happening to me?

All the while, the feeling in my face and down my neck was worse. It wasn’t a tingling, but it was pretty uncomfortable—a strange imbalance of muscle control. I couldn’t move any of the muscles on the left side of my face. At moments, it would get better, then worsen a bit.

In physical assessments, I had complete control over my arms and legs with dexterity in my fingers. I could hold them in place, push, pull, and feel touch everywhere. The only exception was being able to control my face.

Jason asked me knowledge questions. Do you know who you are? Do you know where you are? What year is it? Who is that sitting beside you? How do you know her? Can you tell me the names of your kids? What are you doing right now?

Then, he moved on to the complex questions. “I’m going to give you information in the form of three words and then ask you to do a task.”

He gave me three words to remember: dog, rainbow, Janet. Then he asked me to spell “world” backward, which I struggled with at the time, trying to hold onto the words I was given. It came to me after I focused and pictured the word. I spelled it backward and then recited all of the words he’d given me. I seemed to pass all the tests.

He touched both sides of my face simultaneously. It felt the same to me. I could feel touches on my legs and arms. I had complete control and strength everywhere but in my face. They continued to puzzle about my strange manifestation of symptoms. While some of my symptoms looked like a stroke, not all of them did. They called for some aspirin from anyone on the plane. Again, my wife, ever the fierce advocate, boldly and loudly asked if anyone had some to share. A pill appeared, and I was asked to swallow it. I didn’t find it difficult, but the headache’s pain began at the front left side of my head. The left side of my face remained numb. My throat was parched and very tight.

I took heart rate readings on my watch. I even managed to get an EKG while the O2 sensor occupied my forefinger.

Jason’s assessment switched from stroke to some manifestation of Bell’s Palsy. He asked about exposure to ticks–nope. Family history–nope. Sudden deaths in the family from aneurysm-nope.

So I had a heart attack that wasn’t a heart attack and a stroke that wasn’t a stroke. What is up with me?

They tried to get me something with sugar.

Someone offered a bag of apple chips. It wasn’t the best decision. Chewing was challenging. Only one side of my face muscles were cooperating. If I held my head the wrong way, bits of apple would fall into the left side of my mouth and get trapped there. My tongue wasn’t cooperating, either.

I asked for some apple juice and continued to lay there for quite a while. Then, I felt something in my left ear. My look went distant as I tried to assess what was happening internally.

“What’s up? Are you ok? What’s going on!?” My wife freaked; she feared something worse was beginning.

It was the opposite. In a high-pitched whistle and rush of air. Pressure slowly released from my ear. It was like literal wind in my ear. Even midway through the release, I felt my facial muscles change, like they just came back online. Welcome back, face!

It was an enormous relief. The pain, headache, tight throat, and facial muscle malfunction were all gone. The doctors both expressed interest that the symptoms cleared so quickly. That wasn’t like Bell’s Palsy. Jason noted, “Hey, you’re wrinkles are back!”

Whoever thought about being grateful for wrinkles.

The crew brought the apple juice. I sat up and downed two glasses quickly. I was urged to remain lying down, but I felt completely normal again and wanted to sit up to drink the juice.

I’m not clear on the plans for diverting the plane, but at some point, it sounds like the plane crew could not communicate with the ground for some time while we were flying over restricted airspace. In the end, we were able to continue to our destination.

Much ado about nothing? I hoped so. My next worry was the landing. Will descent cause another pressure-induced event?

I chomped on gum and used all the techniques I knew to open my Eustachian tubes. Nothing. I didn’t even feel a pressure change, really.

I was the last person to board the plane when we left, but when we arrived at the gate, I was the first one off (LIFO). The medical team on the ground pulled me off the plane onto a gurney, asked me perfunctory questions about what happened, and then strapped me in to take me up the gangway.

There was a lot of repeating the story, more of the same physical and mental assessments, and a diabetes blood sugar test. I have a strong vagal response to punctures that I felt compelled to warn them about. I call my ”fainting goat” syndrome. If you want a laugh, search up fainting goat videos.

All my vitals were good, but they warned that while it could be a kind of Bell’s Palsey, it might also be a TIA. They recommended I go to an ER. A TIA? That was a new term for me. My wife filled me in: a mini-stroke, a potential precursor to a major stroke.

I felt so normal; it just didn’t make sense. I declined an ambulance ride to the hospital. We instead started our 1.5-hour journey to in-laws. During the ride, we discussed whether a trip to the ER was necessary. Given the information I had, in contrast to how I felt, I decided we would go to the ER once we got the kids settled at my in-laws.

It was a long night.

The intake process at the ER took very little time. Possible stroke victim? Straight to the front of the line. A quick assessment, quick room set up… ahh, but the night was young. The first order of business was getting wired up with EEG probes, an IV, and a blood draw—more fainting goat syndrome. I warned of my strong vagal response for punctures, and she improvised, angling the table so I was inverted to keep the blood in my head.

Then, there was the private parade of doctors. I must have repeated the story half a dozen times to different medical staff. Stroke victim? Who could imagine for someone my age… I’m solidly middle-aged at the moment.

So how did the story end?

Between the floor doctor, the neurologist, and the CT scan, all of them agreed. There was no indication of a stroke. The tell was in our description of my forehead. As we learned, the nerves that control the forehead crisscross with redundant connections to both sides of the brain. That’s why stroke victims most often can raise their eyebrows and wrinkle both sides of their forehead even when the rest of their body movements are impaired on one side or the other. My forehead, along with the rest of the left side of my face, was entirely paralyzed. Smooth as a baby on the left, wrinkled-old-man-forehead on the right. The things you learn in this life.

The doctors shied away from giving a definitive diagnosis. I was shuffled off to consult with my ENT as soon as possible. But, my tenacity for research led me to a documented phenomenon that’s being called “Plane Palsy” that was written up in the National Library of Medicine. A 31-year-old had nearly the same experience I had on the other side of their face.

Plane palsy is an ischaemic neuropraxia of the facial nerve caused by increased middle ear pressure compressing the facial nerve in an exposed facial canal.

So that is my crazy story.

My takeaway from all of this is that my wife really is the most incredible, courageous advocate for her family. Nothing gets in her way, secret military bases notwithstanding. I love her, I love my family, and I’m grateful to everyone who helped me endure the situation. The cabin crew and pilots did the best they could to assist. I’m especially grateful to Lisa and Jason for their willingness to assist.

As I stare at the cliff at the end of life, again, I’m reminded of a phrase I heard recently from an article interviewing the elderly about their thoughts on life. They all marvel at how fast it all goes, and the older I get, the more that proves true. But the thing that struck me most was that they repeated a sentiment I had never heard before.

Not a single one of those interviewed ever had a regret of getting revenge against someone who had wronged them. At the end of their life, with all of that perspective, they all found the wisdom of not holding onto grudges. Revenge is such a petty thing. As one of my favorite adages goes, “Don’t sweat the petty things, and don’t pet the sweaty things.”

May I never go down that road of pettiness ever again. If only everyone could learn that simple truth early, how different this world could be.