Greetings from Big Bear Lake,

I know some of you have been awaiting the next episode in my worldwide odyssey. Planning for an exploration to the Persian Gulf region with its both ancient and modern history has been under way quietly for the past month with a debarkation date expected sometime in early April.

However, last Wednesday, 25 March 2009 while sitting at my terminal around 2AM I suddenly experienced a persistent chest pain that failed to respond to antacids. Concerned the symptoms could be related to a heart attack I drove over to the Big Bear Hospital Emergency Room and planned to wait out the pain, but decided instead to run in and have someone do a quick EKG just to set my mind at ease. The mere mention of chest pains produced express vital data capture and a quick shuffle into the inner sanctums where electrode contacts quickly populated my bare chest. Still with no one to assess the results, the machine spit out a chart and the nurse showed me the results. It looked pretty much like all the others I've seen, so I assumed it to be normal. Fifteen minutes later the on call physician popped in to talk with the cardiac specialist on the phone to whom our staff had earlier Faxed my results.

Then all hell broke loose. "We want to get you to a Cardiac Unit; do you have a preference?"

Do I have a preference? "Just the best and quickest" I replied. Then began a series of phone calls to the three closest facilities. First Loma Linda Medical Facility which assured our emergency room staff they would call back after a search for available resources. Our doctor didn't miss a beat, "Call St Mary's" he barked "and alert the Mercy Flight we have a transport." With his commands in execution he calmly walked over to the gurney to show me the EKG again. "See these little squiggles, they indicate an abnormality... and over here on this node another abnormality... you have definitely had a heart attack. These others are normal wave forms from other electrodes for comparison."

By now my symptoms had totally abated and the alerting pain completely disappeared. "They do that he said, but under these conditions there is no time to waste." I had long ago heard about a then new drug which if administered during the first few hours of an Acute Myocardial Infarction would prevent permanent damage to the heart muscle. He offered it to me and to my question about the adverse effects he replied: "... about six percent of patients have a bad reaction to the drug... including death. I have to offer it to you; it is a part of the protocol." despite the early morning hour our doctor remained completely focused, compassionate and professional.

Within ten minutes the Emergency Room bustled with activity connected with the arrival of the helicopter. My car hurriedly parked on arrival had to be moved to allow greater clearance for the aircraft rotors. A few minutes later several men in military jumpsuits swaggered in to take charge of the compliant patient. The pilot and co-pilot quickly arranged the paperwork while the flight nurse and nurse assistant got me moved out to the waiting plane. Transfer from the rolling gurney to the plane's interior by the two medicine men could not have been smoother. These guy's know their stuff.

The flight from 7000ft Big Bear down to the 2800ft Apple Valley desert location of the Saint Mary's Medical Center and one of only three coronary care units in our area took no more than 15 minutes. Transfer from the plane to the angiogram X-ray equipped operating room took another 5 to 10 minutes and the diagnostic procedure commenced immediately! The angiogram display is amazing. Each time a squirt of dye is released the coronary arteries feeding the heart become visible. The cardiologist, Dr. Patellie tapped on the screen; "This vein is 99% blocked. You need immediate open heart surgery."

Now that is a BIG deal needing time for evaluation... "What are my options?" I asked with focused concentration.

"Well, death. You have already had one attack. A clot probably formed in this narrowed region. The chance of another attack is very high. Your best chance for long term survival is bypass surgery... as soon as possible." He waited expectantly as I processed this profound reality.

St. Mary's Hospital in the small desert community of Apple Valley is not known internationally for its advanced medical research facilities. A friend of mine had been treated here a year ago and came down with a case of MRSA/Methicillin Resistant Staphylococcus, becoming critically ill for a time from it! Transfer to somewhere like UCLA Medical Center, if even possible would eat up precious time... and I must decide NOW. The fact thoracic surgeon, Dr. Devin R Mudgn performs a dozen open heart surgeries every week and is on the staff of several area hospitals bolstered my confidence in him. When he arrived to discuss my options the first time he noted the anti-clotting drugs administered up to this point were a concern. He would check my platelet clotting factors before making a timing decision. At our next meeting he still had minor concerns over the 8-hour half life drug still working it's magic, but they were minor and could be countered by administering donor platelets, if necessary. "I've been thinking about your situation all morning while on rounds and believe we should go ahead as soon as we can schedule an operating room." He waited for my response. Dr. Mudgn is probably in his 50's, soft spoken and quick of wit.

"O.K. Let's do it. But make sure you do a good job."

"I will, but only because you asked me." he replied with a twinkle in his eye. This guy radiates competence and compassion... and what a "good job" he did. Using harvested veins from my left leg and artery segments from my breast, he replaced four partially clogged blood vessels and then glued me back together. To reach the heart the sternum is split down the middle and wired closed after the operation, but the chest skin covering the incision is glued back in place using medical SuperGlue! A little over four days after the procedures the glue still holds.

On a more poignant note, during our pre-operation conversations the surgeon warned there is a one percent chance of mortality and a three percent chance of other complications (I later learned the recent average in California is more than twice that!). As the Wednesday noon time to begin the anesthetic process approached I had a few minutes to consider the distinct possibility this could be my last moment on Earth. A calm never before experienced swept over me and I reminded myself of the Buddhist knowledge that all life is an illusion. My consciousness might cease, but that is a reality of no particular consequence to "me," if "I" no longer exist! I imagine religious people might have a similar calming reaction to the prospect of eminent death based on their particular beliefs.

All of the staff at the hospital seemed to be competent. Two nurses in particular added genuine compassion and humor. Nurse Linsey in the ICU especially impressed me, partially because her mannerisms so strongly reminded me of a young nurse I had dated a half lifetime ago. The ICU staff obviously enjoyed their work... at all hours of the day and night because I asked twice if the loud hilarious laughter coming from staff gatherings, repeatedly awakening me from my brief snatches of sleep could be softened. Healing discomforts, and necessary visits by my nurses to obtain vital sign measurements made any real sleep problematic that first 24 hours in any case.

Concerns over possible Staph infection proved totally unfounded in the pre-operation area and Intensive Care Unit where scrupulous attention to hygiene became instantly obvious. After the operation with my condition quickly improving, they warned me I would soon need to be moved out of the ICU when a bed could be found in the recovery wing. That happened about 11PM Thursday, a little over a day after the operation. Jostled about and sleep deprived I discovered a more casual attitude regarding hygiene prevailed during the early morning hours in this section of the hospital. The matronly nurse, all business and none too happy with her lot focused on expediency. No uncomfortable gloves for her and alcohol wipes just slowed down the process of drawing a blood sample. When dawn finally arrived and a shift change took effect I saw better compliance with the standard precautions promoted by the CDC. During my last two days Nurse Jenny from Romania made me feel like her only responsibility, though she had many duties like all the nursing staff. Her diminutive stature and charming Romanian accent led to some engaging conversations about her homeland which I had visited in 1999.

Well, this little note started as a prelude to my next, now postponed World adventure. I am growing stronger and more vital by the day, so the planning will resume. It is too early to predict a new disembarkation date, but will keep anyone interested posted.

Peace

Fred L Bellomy