Incidental
Preparing for an out of body experience
Next Tuesday, they’ll cut open my chest, saw through my breastbone, and stop my heart. For three hours, a machine will keep me alive while surgeons remove a bulging section of my aorta and replace it with a synthetic sleeve.
I still can’t quite believe I have a date with open-heart surgery. Everyone I tell reacts with shock, which is how I feel when I really think about it. I’m young-ish — fifty-six. A longtime runner. No family history of heart disease. I quit smoking and drinking more than twenty-five years ago. I eat my vegetables. My blood pressure has always been good and my resting heart rate is borderline smug.
And yet: an aortic aneurysm.
The aorta is the body’s main pipeline. When its wall weakens, it can balloon outward. This is not a feature. The bigger it gets, the more likely it is to tear, or worse, rupture. If that happens, you have minutes — if you’re lucky.
I wouldn’t know any of this if not for a routine lung scan. At a physical last fall, my doctor ordered one because I’d once been a smoker. The scan came back clean — no lung cancer — but tucked into the report was a single line: “Apparent dilation of the aortic root measuring 5 cm. Cardiology consultation recommended.” Delivered in the flat, calm tone of a dispatcher reporting a car accident. I looked up the normal size of an aortic root: around 3.5cm. Suddenly a centimeter felt like a yard. If I’d never smoked, this never would have been caught. Of course, if I’d never smoked, things might not have gotten this far.
Living with a bomb
Cardiologists were booking months out, so my primary ordered more tests. A calcium CT showed some arterial calcification. An echocardiogram showed my heart beating in real time — valve opening, closing, and in my case, leaking. The bulge had pulled the valve leaflets apart, preventing them from closing cleanly and forcing my heart to work overtime. Was this why I’d been tired these past few years? I’d been blaming age. Work. Life.
“Results will be in your patient portal,” the tech said. Early the next morning, my phone rang. It was the cardiologist on duty. He mistakenly thought I was training for a marathon and wanted to catch me before I headed out on a long run. He said the aneurysm measured 5.3 centimeters. Was that growth or just a better measurement? Unclear. Oh god, was it growing right now?
When he called, I was lifting a pair of fifteen-pound dumbbells. He asked how heavy. Then told me not to lift more than fifty pounds. Definitely not overhead. And don’t hold your breath.
“Can I bike to work?” I asked. Five miles. Flat.
Pause. “That’s okay,” he said. “If you feel lightheaded, stop.”
So, basically really cut back on the existing?
After we hung up, it felt like a bomb had been planted in my chest. I stopped exercising. I practiced unlocking my phone to call 911. I kept a running mental note of my exact location at all times. Quick — where am I right now?
Could I drink coffee? Fly? Sneeze? Google answered some questions and made others worse. My wife quietly intercepted any strenuous activity. When I lifted my bike onto a wall hook at work, I panicked, googled its weight — thirty-five pounds — and exhaled. Hold on, had I held my breath? One night, I woke with chest pain and reached for my phone. Was this it? Heartburn. Vindaloo: 1. Aneurysm: 0.
In the cardiologist’s waiting room, I was the youngest by decades. People dozed with magazines open on their laps. Apparently, this was my cohort now.
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The doctor said causes ranged from congenital defects to connective-tissue disorders, chest trauma, even syphilis. I’d taken some hard falls running in the woods. Maybe that counted. I tested negative for syphilis. A small but meaningful win.
He explained the risks: a dissection, where the aorta’s inner lining tears and blood forces its way between layers of the vessel. It’s dangerous and urgent, but survivable if you get to a hospital quickly. And then the worst case: rupture. The artery gives way completely. Massive internal bleeding. Usually fatal.
OK then.
I’d never thought much about my heart — or how long this thing had been growing. All those winters shoveling snow. You hear the stories every storm: people collapsing mid-driveway. Or a runner suffering cardiac arrest in the final miles of a marathon, often from an undiagnosed heart condition. When would my luck have run out?
Smoking isn’t usually the cause, but it doesn’t help. In my teens and twenties, I treated my body like a Superfund site — cigarettes, booze, drugs, all of it. Fifteen years of chase and consumption. I never thought about the bill.
Looking back, the clues line up. The fatigue. Never getting faster despite training. Every marathon ending in a mysterious fade. I blamed the wall. Maybe it wasn’t my legs. Maybe it was my heart. I hit pause on my running last summer — injuries, PT burnout — but if I’m honest, something else had gone flat. A malaise had set in. Maybe that chapter was closing. My dad switched from running to rowing around my age. Maybe my body just wanted a reset, and I told myself everything had a season. A bulging aorta wasn’t on my bingo card.
Surgery enters the conversation when the aortic root dilates to 5.0 cm and the scalpel talk gets louder at 5.5. At 5.3, you could monitor it — but really dial back your life and live with low-grade terror.
“Given your age and activity level,” the cardiologist said, “I’d suggest a consult with a cardiac surgeon.”
Choosing your woo-woo
At Mass General, a contrast CT measured the root at 5.5cm. Ambiguity gone. I was officially impressive — and destined for the heart-lung machine. The surgeon explained everything calmly. I noticed her small fingers and felt reassured. This is millimeter-level work. Feel matters. I wondered if she could remove a few other things while she was in there — fear, envy, regret.
The mortality rate is one percent. Good odds, until you realize that’s one in a hundred. A few years ago, another addict-turned-ultra-runner I knew went in for spinal surgery and never came out. You just never know. A clot or air bubble might form and travel to the brain and cause a stroke or heart attack. Or uncontrolled bleeding might get you. Or infection. I nervously scheduled the operation. Open-heart surgery has been routine for decades, but when it’s you — machines taking over, your heart stilled and opened — it feels wildly experimental. Science fiction. Literally an out of body experience.
Then the big questions arrived. Am I ready if the worst happens? Have I lived well — been kind, been of value? Can I forgive my trespasses? I tried drafting my own obituary and stalled after the first paragraph. It felt premature. And like tempting fate. I considered just-in-case letters to the people I love. When I spotted cardinals, I wondered if they were getting ready.
It didn’t take long to see I was spending too much time in the narrow, dark slice of that one percent. Those gloomy vibes wouldn’t serve me going into the OR. A more optimal mindset was needed.
I leaned into deep relaxation exercises— releasing tension, filling my body with light, aligning my cells. I rehearsed healing mantras. I tried reiki and essential oils. Some of it felt a little woo-woo. But research showed that patients who practiced mind-body techniques used less pain medication and recovered faster. There’s dark energy and positive energy. You can choose your woo-woo.
I’m lucky — where I live, good insurance, a loving family, friends who care. I started a daily gratitude list to stay grounded in the good. Watching my dog dream. Fresh snow. A slant of sunlight across my bedroom wall.
I’ve been preparing for surgery the way I would for a marathon: movement, strength work, yoga. Adjusting my diet. Reading up and collecting nuggets from other survivors. Seeking out any edge I could find. Then show up and let go.
On the other side is 8–12 weeks of recovery. I’m told the pain and fatigue is no joke. Even a short walk knocks you out. No lifting anything heavier than a jug of milk. No walking the dog, no driving. At least for the first month. Maybe I’ll work through the stack of books by my bed. Restart stalled writing projects. And look forward to walking in the woods with my dog. Hiking the Whites with my wife. Celebrating my daughter’s birthday. Maybe another marathon someday.
From the positive woo-woo column: studies say patients who received prayers before surgery fared better than those who didn’t. So I’m panhandling for whatever you can spare. If you could drop a little something in my cup on February 17, around 7 a.m. EST, I’d be grateful.
Thank you all. And see you on the other side.
