The Heart Suture

In January of this year, I had open heart surgery to repair or replace my aortic valve. Once on the table, it was decided to replace the valve, and conduct other repairs as well. The surgery went very well, and my recovery, now more than a month in, has been relatively easeful. I will have a beautiful scar down my chest and titanium bands inside me that hold the sternum together as it heals. Even when the sternum is fully healed, the bands will remain. 

Would my practice make a difference to my recovery process? I had good reason to assume so, but the truth is, I had no idea how things would play out.

Before going any further, I must express how incredibly fortunate I am. This surgery was planned. I had known about the issue since last June. It wasn’t life-threatening, but I was told It needed to be taken care of within the year. I also live about 50 blocks from one of the finest cardiac clinics in the world at Mt. Sinai, so I had the best possible care available to me. My health insurance makes this expense workable: I knew I wouldn’t be hit with an unexpected outrageous hospital bill. This is not the case for many, many people. I am also acutely aware that I am not living in a war zone or in a region plagued by earthquakes or other disasters where even basic medical services are not readily available.

I want to point all this out so that we don’t fall into the trap of romanticizing mindfulness practice as “the thing” that got me through heart surgery. Yes, it made a difference, but there are numerous causes and conditions aiding in my recovery journey as well, including a supportive partner, family, friends and a wider sangha (community).

With that wider context in mind, I was nevertheless curious about this adventure, as I choose to call it. What difference my mindfulness practice would make, if any? One only truly knows the fruition of years of practice when confronted with a significant challenge. It was helpful to educate myself about the surgery, speak to the doctors, and watch YouTube videos on what one can expect before, during, and after this kind of procedure. I also talked to an old friend and former nurse a week before the surgery. She held back about the recovery process. Everyone is so different, she explained, so it would not be helpful to give me “warnings” about the discomfort and pain I might experience. I went into this relatively knowledgeable, but can one truly ever prepare for such a thing?

During the surgery, I am told my actual physical heart was stopped as it was tuned-up, and then revived. Yikes. So they kill you and bring you back to life. That is quite something to integrate.

While my heart may have been momentarily stopped, my sense of citta—the heart-mind that knows and cares—never did stop. Throughout this experience, I witnessed in myself and in others countless moments of mindfulness (sati), compassion (karuna) and patience (ksanti). These are known as essential heart qualities (parami) in the Buddhist tradition, and they have been my close companions in this adventure. I understand this as a fruition of practice.

Fear would have been a normal and reasonable response in the hours and days before surgery. But it never arose. I am not sure why. I simply surrendered. I was also held in so much care. Before, during, and after, family, friends, sangha and my loving partner all held me in compassion. My work was to receive that and allow people into the adventure.

During my hospital stay, I think I might have met a Bodhisattva (a Buddha-to-be) in disguise. Her name is Monica. This amazing nurse met me a day after surgery when I was transferred from intensive care to the “step-down” unit.  She had blue hair, played the bass guitar, and had pet turtles. We learned all this within the first hour. She had been in the unit for over 20 years. With Monica, I could drop any pretense or shame, as there was nothing to hide from her. She had a loving fierceness about her; she was direct, confident, compassionate, and hilarious. She also moved speedily through the ward. She appeared to have many arms, as she went about her endless tasks caring for several patients. At one point, fiddling with some equipment, she said: “Don’t worry, I am only mildly scatterbrained.” In those hours of vulnerability, I felt incredibly safe with Monica.

There were many other Bodhisattvas passing through in the days following surgery. Hospitals are something of a thoroughfare of people coming and going, and doing all kinds of things to your body. Each in charge of some particular function or organ to monitor. Allowing myself to be on the receiving end of this type of attention was new for me. I had to let go of the idea that I could care for myself. It sounds cliché, of course, but surrendering to assistance for basic bodily functions, or to take a short walk, is quite an experience.

Throughout, I relied on mindfulness as a good friend. I took refuge in being present to experience, whatever that was. From the start, the knowing heart was just curious about every aspect of what was unfolding, right up to the point of fading into the anesthetized state. Slowing coming out of this, and as the ventilator tube was removed, I was met with the loving face of my partner and the skilled intensive care nurse. Both eased my return to consciousness. I became aware of the strange sensations of several tubes and wires coming out of me. I recollected the Buddha’s teachings on mindfulness: know that there is a body!

Without the heart quality of patience (ksanti), I would have been a wreck. This quality brings mindfulness and compassion together. Mindfulness is what helped me to know fully that nothing was in my control, while self-compassion allowed me to release my compulsion for control. 

Patience is also needed with time. In fact, while in the hospital, there is no “time.” Yes, time is marked by certain routines like everywhere else, but since I couldn’t go anywhere or really do anything, time was irrelevant. I also did not have a window much of the time and lost track of the times of day. In some ways, this was momentarily liberating. There was just the work of being here, now.

I have had a good deal of experience offering pastoral care to my students who have been hospitalized and to those I met while volunteering in hospice. Being on the receiving end of this compassion from my partner, nurses, physical therapists, friends, students, mentors, and several different sanghas was something I was not fully prepared for.

Skilled surgeons may have fixed damaged valves with the most up-to-date procedures and technologies. But it is the hearts of so many caring beings that have truly healed this heart of mine, a heart now saturated with love.