Here’s a curious statistic: when over-40 adults were asked about their caregiving experience with a spouse or partner, 70% say it was a positive experience while 62% report that it caused stress in their relationship. (The study was done by AP-NORC Center for Public Affairs.) Roughly the same amount who said it was positive, two-thirds, also called it stressful. Positive stress sounds a bit like an open secret or based on a true story (long in the tooth) but there’s some rattle here worth shaking.
With editorial input from my partner, Suzanna, with whom I’ve lived 25 years, I want to describe in this post and in a follow-up next month how my heart disease, beginning in 2006, exploded in our lives with the first of three attacks over a five-year period. I also want to show that I learned a great deal, during my subsequent surgeries, treatments, and recovery, about our sensitivities and expectations, and we avoided a relational landmine.
Though women can develop heart disease in middle age, men are more likely to in their 40s and 50s. Later, the incidence of cardiovascular illness is roughly equal in the genders, though types and symptoms differ. Men are often more symptomatic, women less; men are hit by the freight train while women feel heart trouble like the breeze of a locomotive, in short, as indigestion.
Because of this earlier onset, men enlist their female partners to be caretakers of their diseases with relationship-altering consequences. Most women know that if their husbands or partners suffer heart disease, they do, too.
My story, told in The Sanctuary of Illness: A Memoir of Heart Disease, is not atypical. After the first angioplasty, I had faith in the cardiologists, the stents, and the full-blooded feeling I felt that I would heal quickly. I wanted any trace of uncertainty to pass. I wanted to return to the job I loved, journalism. Suzanna’s comments about my ratcheting up diet and exercise fell on deaf ears. I saw her as over-anxious and nagging. For her part, the more she felt unheard, the more she worried. Our relational balance crumbled. (It was not as strong as we thought.) My three heart attacks slowly, doggedly, forced us to change.
As collaborators, Suzanna and I have gathered four things we believe women should know about how men react when heart disease manifests itself in the couple’s lives.
First, with heart disease, a man’s sexual vitality drops dramatically. A man’s plumbing is clogged because his blood flow is constricted. (He’s probably noticed his erections are not as hard and less frequent.) Impotence may result. Sexually weakened, men feel physically and psychologically numb: it’s not so much a loss of libido as it is a systemic shock.
What’s a spouse to do? Remind him that his body has been damaged, not his maleness. Remind him that he can regain his vitality but only via a new diet and increased exercise. That’s a conversion he must make but one that needs support.
One road there is for the couple to realize that even though our culture tells men with heart disease they can’t change, the stereotype is just that. Too often a man rationalizes his inability to act by relying on this exaggeration (at least, trying to make his wife or partner commiserate with him) instead of recognizing that his biology has been revised.
Second, heart disease affects a man’s self-perception. He feels threatened by impotence, fatigue, the mortal jolt of near-death. He usually retrieves his old cockpit character and avoids an awakened vulnerability, an emotion he’s seldom felt. His fears of another heart attack are not expressed but projected onto his partner. Blame gets triggered, tossed back and forth.
“You’re not sharing with me,” she says.
“Well, you’re judging me,” he replies.
“Quit asking me that.”
“You don’t understand how I feel.”
“Are you nuts? I’m the one who had the heart attack.”
Yes, men know they have been irrevocably altered by a heart attack. But for many waking up to this fact is not in the cards. A woman’s loving advice doesn’t let them (the American male) fix the problem, which is all the more reason women and partners should offer it.
The medical model plays right into this arrogance. If a cardiologist solves a heart problem via angioplasty or a bypass, the male patient thinks it’s over. In the wake, why not have the pizza: the blood is flowing fine. Statistics show, however, that it takes a lot more than surgery to extend a man’s life. Heart operations merely turn over the rock to expose the Gila Monster (the image is from The Treasure of Sierra Madre, a classic man’s film), which is lying in wait. The man, any man, has to wake up or his condition will worsen and he may lose his partner.
Next time, how the medical model also keeps the pair from communicating and the woman in a caretaking role. How do couples and partners get through heart disease together?