Saturday, April 10, 2010

Is it Good to be Cooperative?

I'm a cooperative person. I'll almost always put a lot of effort into complying to the wishes of other people. It turns out, though, that this doesn't ensure I'm making the world better for anybody.

Mitral valve prolapse is a heart condition which usually has a low risk of serious complications. The primary recognizable symptom is that the beating heart makes an extra sound that can be heard by a stethoscope. The stethoscope does not have to be cold, but you know it will be.

When I was in about 5th grade, my pediatrician heard some extra sounds in my heart. "Heart murmur." My memories of this are (1) I got to get out of school for part of a day, (2) I had to swallow some kind of barium gunk that filled up my throat until I thought I would choke, and (3) no one ever told me the outcome of the tests.

Fast forward nearly 15 years. Now I'm living in Southern California (though not taking the time to learn to surf, which I'll later regret) and a doctor says he hears an extra sound in my heart. I mention heart tests in my youth, but can only remember "heart murmur" and "barium." He says "mitral valve prolapse" and prescribes antibiotics to take when I got to get my teeth cleaned. I carefully file the prescription paper in the pocket of my demin jacket. I think it's still there.

Another few years and I'm back in Missouri. My new doctor asks about existing medical conditions. "Valve prolapse" is all I can remember. She adds the "mitral" that I forget, but can't hear the sound herself, no matter how cold she makes the stethoscope. Still, it's worth clearing this up, so I get to have an ultrasound.

Watching a technician's face appear more and more worried while she's rubbing an ultrasound device on your chest doesn't make for fun times. Especially when she starts checking the equipment for failures. I know a little about mistakenly blaming medical equipment: I remember when I was about five, I was lying on the sofa and I heard my Mom say "This thermometer is broken, too! 105 degrees F can't be right." "Mom?" I asked right before we headed to the emergency room, "Why do you keep getting really really big and then really really small?" Sometimes the equipment is fine and the problem is with the patient.

"I couldn't find your heart," the technician finally said, smiling, "But it's just way down here." Much lower in my chest that it belongs. Please do not include this in the ever-growing pile of evidence that I am not of terrestrian descent. I'm reasonably certain that you'll never be able to prove I come from elsewhere. I mention the mislocation of my heart only in case I do ever become a vampire and need to be staked for the good of all humanity: you need to aim a lot lower than you might think. Also, please note that if I'm a sparkly vegetarian vampire and you still feel the need to stake me, you have prejudices that you'll need to work through if you ever want to become a truly happy person.

The ultrasound shows I have a fine heart, once you are able to locate it. No evidence of mitral valve prolapse or any other difficult to name medical conditions. Finally I think to ask my Mom what the diagnosis had been in my youth. "Oh, " she said, "They didn't find anything wrong with your heart." The team of doctors finally decided that I was able to sit so still that they could hear heart sounds normally drowned out by other body movements.

All that testing -- including swallowing that barium -- because I was a child that could follow the command "sit still" with great concentration and compliance.

At least I found out that while I may think I'm a good and cooperative person and believe that I mean well, my heart isn't in the right place

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