After my HMO refused to work up the pain that I had return after my coronary arterial bypass graft (CABG) surgery following a heart attack, I wasn’t daunted. Since I was in a city rich in teaching and research hospitals, I called around until I talked to the principal investigator in a cardiac research unit. His major project was gaining better understanding of atypical chest pain. While my particular issue didn’t quite meet the program recruiting goals, he told me that he needed volunteers, on a continuing basis, both to help evaluate new diagnostic techniques, and to train new medical scientists. I agreed, and never regretted it for the more than ten years in the program, getting literally state-of-the-art care.

This meant coming in, about once a year, for a week of inpatient testing. I didn’t always fit the system. For example, when they did a magnetic resonance imaging (MRI) study of my heart, with some special computer processing, their computers crashed. They had left the intercom open, and, after listening to them curse at the machine, I called out some possible fixes. Once they figured out that the patient was kibitzing, they questioned me, agreed I knew what I was talking about, and we worked together to correct the problem.

A couple of nights later, I awakened, at first frightened. All I could see was reds and oranges. Was I on fire?

Awakening a bit more, and feeling gentle brushes on my face, I realized what I was seeing was the flaming red hair of the night nurse.

She was saying something. My ears picked up, “I want you”. Was a fantasy about to be realized?

Alas, no. Waking up a bit more, I learned that what she was saying was “I want you to wake up and stay awake until I can get a cardiologist here. Your heart has been stopping for up to 15 seconds at a time.”

The cardiologist arrived and diagnosed Sick Sinus Syndrome, where the sinoatrial (SA) node of the heart, its primary biological pacemaker that signals the heart to beat, stops working. There are backup mechanisms that will pace if this node fails, so I wasn’t in serious danger. Nevertheless, SA-related pauses of 3 seconds or more are considered absolute indications for pacemaker insertion.

They transferred me to a community hospital to have the pacemaker inserted, which, at the time, involved an overnight stay. It was not quite the superbly staffed research hospital. Lying in bed, I shifted, and felt some of my cardiac monitoring leads fall off. This should have shown as asystole -- heart not beating -- on the display in the nursing station. I also had a hose disconnect from my continuous positive airway pressure (CPAP) breathing machine, so I really needed a nurse.

Two hours later, no one had responded to my call button. Posted everywhere is the extension to call to invoke the “code blue” team for cardiac arrest. I called the number, telling them I was the patient in room 1234, and, if they’d check their monitor, would have been showing as dead for the last couple of hours. I didn’t really need the code team, but could they send someone?

There continued to be nursing battles through the night. I tried to leave at around midnight, but my cardiologist called and asked me, as a personal favor, to stay until the morning.

In the morning, the head nurse stormed in. “What’s this I hear about your giving my nurses a hard time?”

“No, it was more the reverse -- either they gave me a hard time, or no time.”

“You can’t leave until you see the pacemaker educator!”

“Oh? On what am I to be educated?” I’m a biomedical engineer and medical informaticist. Getting up, towing my IV pole, I went to the whiteboard in the room and drew the components and linkages of the pacemaker, lecturing where it was programmable. Nurse Ratched Jr. did not appreciate that.

“Nurse, I’m leaving. You have three choices. The number of your choices are three, not two, not four.

1. You remove my IV, bandage my arm, and leave.

2. Give me the pads and bandages, I’ll take out the IV, and leave.

3. I’ll take out the IV, use the sheet to stop any bleeding, and leave.

“You wouldn’t dare!”

That is not a good thing to say to me. I had to remove the IV and clot on the sheet. When a nurse came for me with the obligatory wheelchair, I discovered I had a Medusa gaze that got her to stop suggesting it. I went home.