[CONTENT WARNING: Frank discussion of trauma and abuse, including of children.]
I first learned I have high blood pressure at the ripe old age of 14.
My father was sitting at the kitchen table, with a man he described bluntly as his drug dealer. The man was apparently a doctor, although he also described quaaludes as “an instant panty dropper” and other things that confirmed the characterization. My father had high blood pressure, and he called me over to the table for mine to be checked, proclaiming that I was always serene and calm and had my cardiovascular system under control.
I don't remember what the numbers were, being a freshman in high school. But they were really high, and surprised both my father and his drug dealer. I waited in silence while they took my blood pressure again, and again, on both arms, baffled at the numbers.
“I don't understand,” my father said. “Kaz is always so in control of his emotions. He takes Tai Chi and meditates, for God's sake.”
The drug dealer shrugged and said it wasn't a big deal for now, and I was dismissed.
I was indeed outwardly placid at home. I did study dharmic religions and attempted to practice Zen Buddhist meditation. I also took Tai Chi classes and worked frantically at it, anything to get the screaming out of my head. My father is a violent alcoholic, and routinely hit my siblings while bellowing at the top of his lungs. He brought drug dealers under his roof and sat me down at the table with them. In a few months, he would molest me while taking me overseas. My mother was almost as bad, in her own way. Instead of hitting me, she took every opportunity to swing a hatchet at my self worth, declaring that I “don't know how to love” and insisting that anything I wanted didn't matter “because we are a community.” Or she would just tell my father to yell at me.1
Of course I didn't talk, and practiced relaxing my facial muscles so I wouldn't betray my thoughts or feelings, and spent long periods away from both my parents, either dissociating and telling myself it was meditation or just walking around the swampy woods behind our rural house. I was terrified.
My blood kept hammering my body as I grew into adulthood. My first ex wife was so abusive that I would often lock myself in a bathroom or spare bedroom to get away from her. During those times an unbearable burning sensation gripped my body, as if my blood was on fire in my veins. I don't think I went a single week in my first marriage without feeling it.
In 2012 I went in for a physical, and the doctor heard a heart murmur. It wasn't a small one either: I would later hear it gushing and knocking in between beats during ultrasounds. Tests showed that I have mitral valve regurgitation, where the valve in question starts to fail and backwash blood into the heart. Sometimes it just shows up and doesn't change. Sometimes it gets worse, as it did for my mother who herself got surgery for the condition while a bit older than I am now.
I knew it was going to get worse, listening to my cardiologist patiently explain it would probably all be fine. I knew how it had happened, too. In all of those nightmarish arguments that ended with me beaten and my blood on fire, my heart was burning out.
But I didn't know what to do about it. Piper only screamed at me that I hadn't taken care of myself and was ruining her life when I told her. And the cost of the diagnosis was already near-ruinous. The ACA was only starting to take effect, and at the time I was on a state-run high risk plan with a $15,000 deductible and nothing else.2 Learning about my bad mitral valve cost me $1,100 out of pocket. An annual echocardiogram was $750, even after I managed to shift into a real health plan. And Piper flew into dangerous rages anytime I left her with our children by herself, even to go to the doctor or AA.
As my finances grew ever more desperate, I just stopped seeing doctors for it after 2015. I couldn't afford it, and privation forced me to drop health coverage several times in the decade that followed.
I took the best care of myself I could, given the circumstances. I jogged for 30 to 60 minutes at a time most days in the week. I went on blood pressure medication when I could. I cooked, and tried to watch what I ate. I sobered up and stopped my sporadic smoking.
But I also couldn't restart my health care. Though my second wife Karen had a great health plan, she also had a shopping addiction. Tens of thousands of dollars vanished down a black hole as she claimed my income fluctuations were to blame. My attempts to rein in household budgeting were ignored, and I would eventually discover she took on $60,000 in mystery debt on top of what I had discharged.3 There was just no money for the testing I needed, barely enough to see doctors regularly.
In a final showing of do it yourself care, after Karen stormed out never to return in early 2023, I rode daily and frantically on the Peloton she bought on credit (without telling me) until I left the marital apartment. I was in no position to replace Karen's health coverage, and due to how she handled the divorce4, I missed the window to buy an ACA plan. It would only be in 2024, gainfully employed at last and after jumping through several paperwork hoops, that I finally got meaningful health coverage again.
I suspected I would need heart surgery this year, and got a plan to reflect that. My blood pressure had surged past the ability of medication to control. More crucially, 2024 was one of the most physically difficult years of my life. I pant and gasp at the top of my apartment building’s stairs. Alarmingly for a proud slut, my libido turned sporadic, and sometimes I gasped for minutes after sex. I passed out from heat exhaustion at a train station. I finally visited a cardiologist last month5, and my first heart ultrasound since 2015 showed that the valve is torn, and my heart is struggling immensely to push blood out to my body. Thus, in the words of my surgeon, “everything that sucks, probably sucks a lot more for you right now,” and while my heart itself hasn't worsened yet, it will do so very soon unless the valve is repaired or replaced.
Just like that terrified day in 1994, my first reaction was to go blank. But this time, I knew what that meant. My chest is getting cracked open like a walnut in a few weeks; no one meets that news with serenity. I was dissociating, I knew it, and I knew I had to let that go somehow.
My second move was to obsess over my children. For years after I left Piper, I was literally incapable of talking about anything I wanted or needed, even in therapy. I had been beaten and raped too many times to even think about it. Instead, I talked about Thing 1 and 2 and what they needed, which incidentally meant I had to stay alive and (sometimes) well. I fretted about them to my therapists, to my partners. In my recent return to Catholicism, I prayed desperately that the surgery would go well, so that I could protect my children from Piper.
But I knew what I was really doing, and that I had to stop. I am my children’s parent, not the other way around. It is not love to wholly lose oneself to parenting, but a lack of boundaries. I'm a walking, sloshy-hearted example of what that does to children.
And so it happened that recently at Mass, I was praying for my children as I always do. But this time, in a silent coda that thundered in my head, I added:
…And for me. I don't want to die, and I want to live.
I've spent a lot of time crying since then. I picked up my kids, hugged both of them and told them I loved them, then rushed to my room and sobbed into a pillow. I thanked Thing 1’s therapist for her home session, and cried. I talked to my partner Marie during a brief interlude, and then I cried myself to sleep.
Because I am afraid, and I'm devastated. It's not exactly because of the surgery; the chances of any complication are nonzero but tiny. Nor do I regret my own choices. I did my best with what I had. I'm devastated over all of those long years, minutes, even seconds I spent in the darkness, the only existence I could claw out devoted to my children. I'm devastated that I still don't know how a lot of healthy interactions work, because I never saw them when I was young. I'm devastated that I poured so much into helping others because I had lost all hope for myself. I worked on the original ACA, and I still fell through the cracks, all because I was the first parent in my life to tell myself I'm a good person and deserve to live. I'm devastated that I worked for years in a sea of people shouting they are here to help, while confusion and anger burned me on the inside that I was one of the people who needed help.
On the merits, my health care is finally going well. I bought a higher end health plan for the anticipated surgery, and the costs will be quite manageable. No complications that could affect the surgery have come up, though I still have many tests to go. I have been overwhelmed to the point of tears how much support and warmth I've received from Marie and my friends. I don't know what to do with it a lot of the time; before this year I didn't understand such kindness could ever be shown to me.
But I do know what my body remembers, in wheezing, sloshing, painful detail. A vagus nerve shredded from decades of torment is every bit as deadly as a weak heart valve. The cruel chaos of my childhood inflicted just as much damage as the alcohol I quit a decade ago. And the kindness of people close to me really can heal and renew what was lost, or never known.
And as many tears as it has pulled out of me, I am glad I have come to understand this.
He didn’t usually hit me, apparently because he and my mother tried when I was too young to remember and I just went blank and stared at them until they stopped.
Back in the day if you admitted you had any sort of pre-existing condition and tried to buy your own health coverage, insurers would just laugh at you. I had been treated for depression since childhood, and that was just that.
She also informed me of this after filing for divorce, and yes it was satisfying to tell her attorney to get fucked and win while representing myself.
Immediately, at great cost to herself and almost none to me.
His bemused lecture on leaving my health hanging for so long was epic.
So much pain in this essay…physical and emotional and mental. All I wish for you is healing in every sense. I hope Marie and your friends and Catholicism and (whatever else) helps you cope.
Of course, you deserve love and support!
May your heart heal magnificently along with your soul.