In the meantime, in case of pain, Mailhot insisted that I carry a small, brown-tinted bottle of nitroglycerin, a drug that causes the heart vessels to open within seconds.
With the nitro in my pocket, I sought out several cardiology professors at the University of California at San Francisco Medical School. Many of them didn't practice angioplasty but had trained pioneers in the field. I wasn't comfortable with the hospital where Mailhot would be performing the procedure. It was old, its facilities were outdated and the cardiac catheterization lab there didn't have a long track record. Instead of blindly following our internist's recommendation, I wanted to select the person to whom I'd be entrusting my life.
On my 37th birthday, Iris and I met with Dr. Kanu Chatterjee, the Lucie Stern Professor of Cardiology at UC San Francisco. He was a cordial, soft-spoken man who agreed to see us on a Saturday at his university office, even though he didn't know us and we hadn't been referred to him by another physician. Chatterjee viewed tapes taken during my angiogram and suggested an angioplasty to be performed by a group of cardiologists in Palo Alto headed by Dr. John Simpson. Two days later, I met with Dr. Bruce McAuley, one of Simpson's associates. McAuley was only 38. Should I be entrusting my life to a man just a year older than I? Perhaps because of our closeness in age, he seemed genuinely sympathetic, and I felt on an equal footing with him. When I asked him point blank how many angioplasties he had performed, he didn't hesitate, saying 550.
In early September, Iris and I drove to Sequoia Hospital in Redwood City, 25 miles south of San Francisco. After I checked in, I waved off an orderly who had instructions to shave me from neck to toe. We reached a compromise, a shave from navel to thigh. Half an hour before the operation, a nurse gave me a sedative that made me drowsy almost immediately.
"Don't let them hurt you," Iris whispered as I lay waiting, my lids drooping like window shades. She kissed me. While being wheeled to the operating room, I caught a glimpse of her over my right shoulder. Her eyes were damp with tears. What had I gotten this woman into?
Another sedative, administered intravenously, kept me groggy. The only part of my body not covered with the green surgical cloth was a fist-sized area on the left side of my chest. Should the angioplasty fail, surgeons would need quick access to my heart for a bypass operation.
As the procedure began, an anesthetic was injected into my groin. "This will burn," McAuley warned. Thirty seconds later, he punctured the skin covering my femoral artery with a scalpel.
Tubes, tubes, lots of tubes were being handed from nurse to nurse to the three attending cardiologists. There were so many tubes that I thought I must have been in the middle of an enormous home aquarium. There was no pain, but I had an eerie sensation. I could see my own insides on a monitor about six feet above my left elbow. McAuley encouraged me to watch. The monitor was his only guide as he inched the catheter toward my heart. As the tube moved forward on the screen, I could feel it snaking through my body. I was able to follow the tube all the way to the injured heart vessel.
I'm not sure if it was the anesthetic or a fit of whimsy that seized me in the operating room. The scene reminded me of an episode of "Dr. Kildare," except that everyone in this operating room seemed calmer than on television. Some of the nurses were fat; some were thin. None looked like Yvette Mimieux. The anesthesiologist was bald and wore a pinky ring. With their faces behind gauze masks, the cardiologists looked like benevolent bandits. I half expected the whole lot to break out in song and synchronized dance.
Suddenly, I was jolted from my reverie. Watching the monitor, I saw the obstruction in my own heart vessel. And I was amazed at what my own body had been harboring. The vessel changed in size from a small tube to an even smaller tube. It looked as though someone had taken a straw and kinked it shut in the middle.
"See it there?" McAuley excitedly asked as though he had found the prize in a Cracker Jack box. "That's the artery we're after."
A thinner tube with a deflated balloon on its tip was pushed through the first tube. The balloon was positioned midway in the clogged vessel. Then I heard the whir of an air pump. I turned my head to get a better look at the monitor. The balloon inside me expanded--110, 120, then 150 pounds per square inch. The diseased artery doubled in size, like a plump little sausage.
My chest suddenly ached. Flushes of nausea seemed to spread from my heart to my head. As the vessel inside me expanded, the waxy plaque deposits clamping it shut were being split apart. I felt like a soccer ball that had been kicked and stretched and was about to burst.