Deep in My Heart in Texas

Since my literary career was going south, I decided to join it. I loaded up my van and drove down from my adopted home state of Montana to help rebuild Louisiana and write about the experience. I spent up to 10 hours a day, sometimes seven days a week, digging ditches, demolishing and constructing buildings and, using skills gained in our Navy during the Vietnam era, repairing a marina and refinishing yachts. I did double duty, keeping up the sometimes-strenuous physical labor while researching and writing a proposal for a book about the experience. Then personal disaster struck: I suffered a series of heart attacks. The major one came as I was rushed to a private hospital in Covington, Louisiana, feeling like the title character from the film Alien was growing out of my chest.

I woke up in the ICU with a morphine-induced smile on my face and about six tubes stuck into me. The surgeon explained that one of the three main arteries from my heart was 90-percent blocked and another was 60-percent clogged. He made a small cut in my femoral artery, inserted a tiny balloon, and opened the big block. That’s what they call angioplasty. He then inserted a $2,000 hunk of metal-a stent-to keep it open. Then he ordered me to rest. I sought aftercare.

That’s when I began my empirical study of the seriously broken Veterans Affairs Gulf Coast Health Care System, which seemed to be actively working against my recovery until I huffed and puffed and they flew me to the famed Michael DeBakey VA hospital in Houston’s Texas Medical Center, where I received excellent care. Alas, my many superlatives describing the inpatient DeBakey treatment were replaced with expletives when I fell into a bureaucratic black hole while transitioning out. I was literally dumped onto the street with the clothes on my back in near-freezing weather. I recovered and lived to tell the tale. Here’s the condensed version.

After leaving the hospital, I drove the 40 miles from Covington to the nearest VA outpatient clinic, in Slidell. I had to fight to see a doctor inside of the 30-day wait they’d initially scheduled. Insisting on the care I knew I needed when my recovery demanded rest proved frustrating. My blood pressure once went from 132 over 74 to 179 over 82 during the course of one visit to the clinic. Then they sent my nine desperately needed prescriptions 2,000 miles away, to Montana. I took their suggestion that I go to the hospital in Biloxi, Mississippi, and work with the cardiology department there. The month before, the United Health Foundation had ranked Louisiana the 49th-healthiest state in America. Mississippi is 50th.

Driving past the stone wall enclosing the Biloxi hospital grounds, on a straight two-lane road under a magnificent canopy of century-old oak trees, I was taken aback to see that some idiot architect had sited a national cemetery on the right. I had to pass it to reach the main hospital building. I suppose the proximity saves on transportation costs.

The care was terrible. I pushed and pushed and was able to see both a primary care physician and a cardiologist within three weeks. I still can’t figure out if the cardiologist was ignorant, incompetent, or simply inept, but as it later turned out, he just wasn’t very good. Many professional and personal friends told me, firmly, that I shouldn’t attempt to go back to work until the doctor gave me the OK. He kept ordering more tests. I became antsy. And broke.

So I snuck back to work, doing double time to finish a sample chapter the agent needed to seek advance money from a publisher. Then the agent inexplicably pulled out. His lack of faith punctured me like a nail punctures a tire, and the strength and confidence I’d slowly built up rushed back out of me. Chest pains returned. I took six nitroglycerin pills one afternoon; if two don’t do the job, I’m supposed to call 911. I told this to the cardiologist a few days later. He ordered more tests, including a sonogram. Though he never explained the results to me, he must have seen that something wasn’t right, because he ordered a heart catheter probe-in Jackson, Mississippi. I couldn’t wait for the state to enter the 21st century-the hospital had proved unable to so much as send me an e-mail-and began doing research online.

Experience has taught me that federal funding flows in direct proportion to political might. Given that Texans have occupied top offices in the executive branch for 27 of the last 48 years, Texas should have made out well. Then I found out that the Michael E. DeBakey VA Medical Center’s namesake was the pioneering surgeon who’d basically invented the coronary bypass and had been key in developing the artificial heart. Not only that, he’s still alive at 99, having himself undergone the surgery he invented, administered by someone he’d trained. When I discovered that the outspoken DeBakey had been placed on one of Richard Nixon’s infamous enemies lists, I was hooked. In my book, there’s no better recommendation than that.

Though it took seven visits to cardiology, along with at least six follow-up calls, arrangements were finally made to get me seen in Houston. I’d been told the problem was that my heart wasn’t getting enough blood. I figured I’d have to get another stent, or a bypass.

The flight was direct and smooth, my baggage arrived the same time I did, and the DeBakey Center provided a cab that drove me to a Howard Johnson’s a few miles away. I had the rest of the day off to relax. It felt fantastic to be back in civilization.

The next morning, the motel’s shuttle took me to the hospital, where I went up to the third-floor cardiology department. The receptionist, Janice, smiled and addressed me by name before I even announced myself. My Filipina nurse, Perfecta (really!) was friendly, helpful, and pretty. The cardiovascular surgeon, Jose Baez, carefully answered all my questions with authority. He explained that of the three main heart arteries, one of mine was so naturally small as to be insignificant. The other two-the ones I’d been told were mostly blocked-had to carry the whole load. When I had my heart attacks, my heart was getting only about 20 percent of the blood it needed. He explained that the next morning they were going to give me a mild sedative and local anesthetic, cut the femoral artery, insert a thin probe, shoot some dye into my heart, take some pictures, and see was what happening in there.

“Oh, so you’re going to talk to me gently, give me some drugs, manipulate my heart, then I’ll be flat on my back for a while,” I said. “Sounds like dating to me.”

Fortified by a good night’s sleep, I laid down on the gurney the next morning, heard them shave my pubic hair, cringed when the local anesthetic went into my groin, smiled when they gave me even more, then felt a warm trickle down my crotch telling me they’d made the cut. Then came the best possible news, far better than I’d imagined. The pictures showed that both arteries were perfectly clear. The blood thinner and cholesterol reducer and statin drugs I’d been taking, along with half a dozen others, plus the regimen of simply relaxing, had worked.

To close the wound, they inserted a state-of-the art suturing device. I had to lie on my back for two hours, and was given instructions not to lift more than 10 pounds for the next week or return to normal activities for at least 72 hours. A social worker I’d requested came by. I told her of my plans: that no way was I going back to Biloxi, that I had hardly any money, and that I’d need a place to stay after my remaining two days in the motel expired. Eventually my fate was placed in the hands of a 21-year-old intern from the University of Texas. After some effort, she wrangled me a week in some place called the Healing Room of something called the Open Door Mission.

Checking out of the motel, I arrived at the hospital promptly at noon with my 130 pounds of luggage, which had been loaded then unloaded by the courtesy van driver onto a food cart. Then I was told to rush to the mission. By public bus. I somehow made it to one, got someone there to load my luggage up, and rode for an hour throughout the city before being dropped off in front of the Open Door Mission. It proved anything but.

I had my heavy boxes and garment bag unloaded onto the street. The Open Door has a heavily locked entrance surrounded by a steel-tipped gate. I filled out a short form and waited as the folks ahead of me had a metal detecting wand passed over their bodies, removing everything in their backpacks for the guard to view. Finally, an hour and a half later, I was seen by the guy at intake. When I gave him my résumé, he left without excusing himself. I was outside having a smoke when the head honcho came down. She said she didn’t like my attitude, that I’d never been accepted into the program, and that they were giving me a bus token so I could go to a shelter. I think they were taken aback at my claim of agnosticism-a real issue when social services are farmed out to faith-based organizations, especially those that talk and talk and talk the talk, but balk at the walk.

Not being able to carry more than 10 pounds, and with the VA employees having gone home for the day, I was stranded. A few minutes later a huge Open Door resident-easily 6 feet 4 and 300 pounds-came out, introduced himself as Daryl, and said he was a vet and wouldn’t let another vet be treated this way. He was going to take one of the mission’s vans and get me out of there. He was joined by another resident, Tony, a truck driver from Philly via Florida, who loaded my stuff and sat quietly in the back as Daryl drove, expounding on how good Jesus had been to him and letting slip the fact that he’d served felony time. When we got to the Salvation Army, they wouldn’t accept my baggage, so Daryl and Anthony took me back to the VA, where I stashed my stuff and then caught a cab back to the Salvation Army.

Yes, they had a bed for the night. Oh, and we would be awakened at 4 in the morning, and had to be out of the barracks by 4:30. I’d have to take my toiletries and laptop with me. Dazed, I went up to the third floor and was given a thin blanket, two sheets, and a top bunk-No. 116. I climbed up on top, made the bed, and tried to sleep. Luckily I carry ear plugs. Unluckily, I could find only one. Every time I turned over, I’d have to dig it out of one ear and place it in the other.

Somehow, amid the unsyncopated burps, coughs, snores, and farts of the other 115 men in the barracks, I got two hours of sleep. Then we had to leave the shelter. It was 36 degrees that morning in Houston. I had only a thin shirt and a light coat. Though ordered to rest, I had to walk around to stay warm. At least I wasn’t alone. A chubby man walked in a circle, talking to himself and holding up his pants; another man had a psychotic episode on the sidewalk. I found a coffee shop and began planning my escape.

It took a week, but the VA finally found me a place to stay. All I had to do was prove that my Social Security number was just that, that I was a military vet, and four negatives: that I didn’t have TB, that I didn’t have any money, that I wasn’t drinking, and that I was officially homeless. I documented three. Then the shelter wrote me a letter affirming that I was abode-free, signing it “in Jesus’s name.” What a great recommendation. I was accepted.

But as a friend pointed out, what must it be like for other vets who don’t have my stubborn, informed wherewithal to advocate for better care? And on the other hand, why should I, who had just about the cushiest duty in the Navy-navigating an admiral’s barge up and down the Potomac-get free health care when Peace Corps alums, many of whom face far more harrowing duty, have none? One of my roommates in the Midtown Terrace, where I finally came to rest and where I remain for now, points out that our caretakers at the VA have better health insurance than we vets do-and he took a few bullets in Vietnam.

The current issue of Esquire has a two-page spread on Dr. Michael DeBakey six months before his 100th birthday, on September 8. The good doctor opines that, “In any good society, every member should be interested in the health care of every other member. Because if any member is unhealthy, it’s a burden on society.”

Sorry to be a burden, but my take is that we need universal, single-payer coverage, with mental and physical health care in parity. I’m sure there are many other stories of good and not-so-hot veteran health care in Texas. This one is mine.

Fredric Alan Maxwell is the author of Bad Boy Ballmer: The Man Who Rules Microsoft. He may be reached at [email protected].