When a vacation goes awry.

How a heart attack cancelled our trip to Berlin & placed us on another journey.

Two weeks ago I was up early writing this Wanderland newsletter declaring what our trip to Berlin was about, my finger ready to push the button on sending this image below out when . . .

. . . at 7:15 a.m., my partner Richard came into the living room pressing on his sternum and told me he had a strange pain in his chest.

“How long have you had this pain?” I asked.

“About thirty minutes,” he said.

My mind flashed to how awfully quiet he’d been as he stood at the counter a few minutes earlier, when he’d usually stroll in and joyfully kiss me good morning.

“It’s radiating into my bicep,” he said.

“Do you need me to call 9-1-1?” I asked.

He shook his head.

“We’re going to the hospital,” I said, and then began throwing clothes at him while I pulled on pants and a baseball cap to cover my unwashed hair.

A few minutes later I drove up to the emergency entrance.

“Chest pain,” I said to the nurse at the table offering masks.

They escorted us to the emergency room, attached an ECG monitor, pulse oximeter, and a blood pressure cuff. I looked up to see the machine register his vitals—an athlete’s heart rate and a BP reading of 212/111. Richard was so fit that I thought the numbers must belong to the person who was using the machine before him.

Vintage anatomical heart.

After two baby aspirins, three nitroglycerin sprays, and four visits from the doctor on duty, we were still in denial about what was ahead of us.

“When do you think they’ll let us go home?” he asked, in the hours between blood tests, as I texted friends and family, and tried to find someone to take me to an eye appointment that afternoon.

Then the doctor on duty walked in and said, “It’s not clear yet, but it’s looking like you’ve had a heart attack. I’m sending you by ambulance to the cardiac care unit at a hospital in Calgary.” This ended our refutation of the seriousness of Richard’s condition.

I called our adult children from the hallway, staying focused on the data that we’d been given by the medical staff. Our youngest had just arrived in Berlin where we were to meet a week later. This would be the trip where we hoped they'd show us the city they’d lived in for several years while they were making a film, studying and performing opera. Our son was launching his new video game¹ that day, but until we made it home, we wouldn’t learn about all he grappled with that moment.

When the paramedics arrived, we were all on the phone talking with each other, making jokes, asking questions we would pass to the medical teams in the days ahead.

The paramedics strapped Richard onto a gurney, turned to me and said, “If we have to put the lights on and speed to the hospital, don’t try to keep up with us.”

I stared at them, haunted that I’d never considered such a possibility, then kissed Richard, and told him I’d be there by the time he got settled in. I wasn't worried about the costs ahead; I was only worried about making the drive alone.²

A few hours later we met the cardiologist assigned to him at Rockyview Hospital Cardiac Care Unit (CCU) in Calgary. After learning about the procedures ahead, we asked what we were really thinking about—can we get on a flight in a week?

The doctor looked down, then back at us. “If you’re lucky, you will have had the procedure in a week, but you’d have to travel without health insurance.” He told us that no travel insurance companies covered people this soon after a confirmed heart attack, though the evidence was that modern medications effectively controlled most heart symptoms.³

Beloved, ready to travel home + Hospitals, where they serve you a side of bread with your sandwich.

Unlike in pay-to-play American health care, he cautioned us that we would wait in a triaged system where the most critical patients received access first. And that this was a burdened system where a trip for an angiogram that should take a couple of hours instead took six hours. That there weren’t enough staff to adequately care for the sixteen patients they were equipped to test in a day. That the city’s EMS had higher call volumes, overworked staff and fewer ambulances than needed. That the one cardiac catheterization lab⁴ served seven towns and cities, and they’d long needed another one to tend to the heart attacks in the region. That this week was a bad one for heart attacks. That Richard was too sick to leave the CCU and too healthy to go to the front of the list.

Richard had worked as a physical therapist for corporatized health care in America, and was aware of its immoral systems. We had long advocated for socialized medicine. Having grown up in Canada, we were also aware of the shortfalls of a bureaucratic system that often can’t change fast enough to serve the people who need care. As frustrating as delays might be, we knew we were in a waiting game. What we didn’t have in this moment was a sense of whether we would take the risk to go on our planned wandering despite not having health care for him.

Days later, still without an MRI, ECHO or angiogram, we were both frustrated. I texted my friend the Senator: The Canadian hospital system is failing.

Richard had been in the CCU for a week when I called a strategic-minded friend to help us decide what to do about our trip.

“The thing is we are risk-takers and adventurers. We can’t give this up seemingly without giving up that identity,” I heard myself say.

The holding on was not just because of the promised trip, one where we would meet our adult child’s friends and learn about their time in that great city. We would also meet two of our friends whom we hadn’t seen in years. We would explore the Berlin that Susan Neiman had written about in Learning from the Germans, just the kind of reckoning I was interested in exploring as I researched how America refused to memorialize its horrific violence. Then Richard and I would go on a nonduality retreat⁵ to northern Germany, an experience we’d cherished all the more after we’d been to one by the same teacher in southern Spain in 2019. We'd spent two years saving for this trip, and had many conversations exploring and anticipating what we'd do on the journey. How could we give this up?

That day we held hands on the hospital bed and cried, realizing that it was unlikely that he’d be well enough for the trip. We slowly awoke to his fragility. We remembered that medications took time for the body to balance. We heard our children when they said, “You might question whether this will be the only possibility for this trip.” More than most, we knew that being physically vulnerable was agonizing. I’d been in my own frailty for years with a rare disease, and had written about the perils of his life-altering cancer in books and essays. You’d think we would know how to change course.

There is wandering, and there is wandering because we want something from that wandering. The needed change arrived when we realized that being an adventurer was another identity.

The essence of who we are (who I am) isn’t wrapped up in notions I have to carry with me. We were free to enact the aftermath of a heart attack as a nonduality retreat.

After the tests came back, there hadn’t been anything other than a blood clot rampaging its way through an artery, a random event, or possibly linked to the virus he’d had six weeks earlier. No arterial blockage, no muscle wall dysfunction, no electrical conduction abnormalities. One tech said that at nearly 65, Richard had the heart muscle function of a sixteen-year old. One week after that two-hour emergency ride, he came home. On the way out the door, we paid $86 Canadian ($60 US) for seven medications. There were no other hospital bills.

This challenge happened in just the right time for our dream trip to be cancelled, possibly rescheduled for another season. We’re both home resting, listening for the signs that it’s time to go again.

Last wandering: Torrey Pines State Park, January, 2023.

1. MLB The Show 2023, SONY, San Diego.

2. No one asked us for a payment arrangement any time in the week we were at two hospitals and three ambulance rides. Once, I was asked to confirm his address and birth date. We spent no time thinking of how we were going to pay for any of this. This is a larger story for another time, still thank you, Canada.

3. Things we didn’t know about insurance: Some travel insurance plans eliminate coverage following a heart attack, under pre-existing conditions. For others, as long as your doctor has declared you fit to travel, you can purchase your travel insurance without any issues, though it may be expensive. Usually, coverage can be found between 60 and 180 days after an incident, however some consider pre-exisiting conditions for the three years prior to the start of the plan.

4. Serving those needing diagnostic cardiac angiography, percutaneous coronary intervention, structural heart diagnostics, structural heart intervention.

5. Welcome to my weirdness. Nonduality means “not two,” or there is no separation. It’s a philosophy I’ve been studying/experiencing since Richard had his brain injury nineteen years ago. Here’s some information on nonduality from my dear friend Lisa Cairns. Feel free to write me questions in the comments about any of this, and I hope to write about my philosophical wandering one day too.