If you’ve had a heart attack, you have heart disease. No question, no argument. It’s clear; it’s permanent; it’s not something you leave behind like a prom jacket. But what if you haven’t had a heart attack or its bullying forbear, angina, but you have a history of the ailment in your family? (This was my case—debilitating myocardial infarctions in my father and older brother that sprung on them with no warning. I lived unaware for 56 years until my boom came along.) How much of your time do you (should you) spend expecting to be stricken?

In a sense this is the easiest of all questions to answer because if you’re unaware, you can’t know what’s coming: you’re too busy occupying the nothing that’s not there and the nothing that is, as Wallace Stevens put it. Even if you are a likely candidate—mid-50s male, stress-laden job, out of shape, no exercise, fat-, salt-, and sugar-rich glutton, smoker. Add in your genetic predisposition to suffer heart trouble and you’ve got solid “F”s in every subject.

Leaving those symptoms aside, the long habit of health disposes us not to think we will be sick. Health is the absence of illness; health does not mean we are in balance or fortified against pain and misery. It just means the disease hasn’t manifested. One noble consequence is civilization, a homeostasis between self and community. This, for many of us, is where our deeper natures lie: maintaining a healthy world that gave us its enhancements. Here, the healthy get things done. The unhealthy don’t. And they, the ill, must be taken care of, making the unsullied even busier. In the process, few healthy people seldom realize they’re deteriorating (no doubt, too strong a term), though they may feel the ache. Instead, entropy catches up with us one day, and we say, how odd to have once been so well-oiled.

In the West, most of us, pre-55, are well most of the time—and if we get sick, we heal far more often than not. Of course, I’m discounting accidents and viruses, injuries and cancers. I’m saying that the middle-aged American avoids illness: To a point. Once laid low, especially with a life-threatening malady, everything changes. That which you obviously didn’t have before, you do now. (How hard it’s been for me to feel fine of late, symptomless, and remember, memento mori, I still have heart disease.) Ill, our expectation about life’s insouciance shifts: we reconstitute ourselves as sickly or, worse, limp gladly into the wheelchair.

My post-55 friends increasingly confirm it: one is riddled with bone marrow cancer and begins chemo; another has stage four lung cancer, and friends within a month of learning the cold fact compile a book of reminiscences for her; still another who thought her breast cancer had left finds it suddenly reappearing in her brain, which takes its time devouring her, unmercifully. As all that happens to them, it also begins happening to me—initiating a kind of stupefaction.

The odds-makers tell me I’m next or should be. But that’s not what I believe, so powerful has the long habit of living in health or near-health been. (TV befouls reason: its ads for drugs, which percolate the senior’s sex life or happiness quotient, show us fit AARP models, ecstatic to be Viagra-primed or nursing-home-bound.) The longer I prolong this “I’m not the one,” the more my life is streaked with a lugubrious fog until one morning, dunderheaded with denial, I realize there’s no escaping disease—which means I’ve contracted the latest ailment sweeping through the hood, which means my own inattention probably brought it on, which means I had no idea I had the power to infect myself sui generis. And if I care to listen to colleagues and friends, I find an adhesive commonality to this condition that’s been bounding everywhere. How did it miss me?

While senescence is not a disease, it’s still an enigma how sudden illness (seldom that sudden) shocks the older population. I don’t think I appreciated this transition enough until I swerved into heart disease. It’s much more than a transition. It’s a leap. From healthy me. To wounded me. From unlikely afflicted. To highly liable. From nothing’s wrong because nothing’s been wrong to something’s scathingly wrong. In my case, three heart attacks from 2006 to 2011 announced their unanimous verdict that I’d been changed and I’d now (each time, that is) struggle to understand how exactly I had a part in that change.

It’s an unwelcomed exit from worry-free to worried me. This card trick that we think we will be ever free from illness is dealt once again.

Next time, I want to take apart this notion of what happens to us heart patients when we are sick and deny it or when we aren’t sick (or, at least, have none of the prime symptoms) but believe we are. Ah, the endless mystery of the heart-mind meld.

About the Author

Thomas Larson

Thomas Larson is a journalist, critic, and memoirist. He is a staff writer for the San Diego Reader and teaches in the MFA Program at Ashland University.

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