Lines in, lines out. The Impella running its quiet rhythm. The monitor glowing green behind my head. That’s what a support system looks like from the inside—not dramatic, not cinematic. It looks like logistics. It looks like someone already moving before you’ve asked them to.
The nightmare woke me at 1:44 in the morning. I felt the kick first, electrical charge running through my chest and arm and head, and came up out of sleep certain the ICD had fired. The nurses pulled the EKG records to prove it hadn’t.
The Impella went in on October 3rd—a catheter-mounted pump threaded into the left ventricle to do the work the heart no longer could. Five percent ejection fraction going in. What happened in the hours afterward was not, primarily, a clinical experience.
Death came to my room more than once. The first time I was at home, alone in the dark, and woke to a figure crouched near the ceiling with the patience of something that had nowhere else to be. I had known for years I would die at fifty-five.
