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The Way To My Heart

"El Corazon Secreto" (The Secret Heart) art installation by Spanish artist Jaume Plensa is pictured at the Hospital Clinic in Barcelona on September 28, 2023, marking the World Heart Day.
Josep Lago/AFP via Getty Images|

For World Heart Day, the Hospital Clinic in Barcelona displayed Jaume Plensa’s “El Corazon Secreto” (The Secret Heart).

Drew Magary’s Thursday Afternoon NFL Dick Joke Jamboroo runs every Thursday at Defector during the NFL season. Got something you wanna contribute? Email the Roo. And buy Drew’s book, The Night The Lights Went Outthrough here.

I have heart disease. This came as a surprise to me, even though it shouldn’t have. Heart disease remains the leading cause of death in the United States. You and I have been warned about its dangers ever since childhood: in school, in the news, on signs posted in doctor’s offices, on direct mail flyers, and everywhere else. I’m also 47 years old, which makes me a prime target for that particular affliction. And, up until Monday, I had been suffering from horrific chest pain for the better part of this year. Chest pain when I rode my bike. Chest pain when I walked long distances. Chest pain when I ate too much pizza. Chest pain when I was trying to sleep.

The pain would build to a crescendo, often growing so powerful—radiating up through my jaw and down through my elbows—that I would double over and groan in agony for minutes on end, praying that it would leave me alone. One night this summer, I sat up in bed and began to cry from the pain, telling my wife, “I hate this. I hate it so much. It's taking over my life.” The pain didn’t care. It refused to listen.

As did I.

“I know my own body” can only ever be a partially true statement. The inner workings of your body operate in silence, only giving you information as needed, if ever. Often, the symptoms that your body sends out as warning signs aren’t easy to interpret. But in my case, the pain (excruciating) and the location (my chest) should have made it clear enough that I had the bad thing.

And yet I remained unconvinced. After all, I lived a healthy lifestyle. I exercised. I ate right. I took a fiber supplement. And I had already explored every possible avenue to get rid of the pain. I had gone to my nurse practitioner, to the ER, to my cardiologist, to my spine surgeon (herniated discs in the neck can cause chest pain), and to my gastroenterologist. All of them had their theories, but none had a definitive answer. My EKGs stayed clean on every visit, so doctors were at a loss. The only good lead I had came from my GI, who had given me anti-reflux meds to dull the pain. Those meds worked well enough that I’d become convinced that gastritis was the culprit. The GI wasn't as certain.

This is because, at the same, my cardiologist had ordered a CT angiogram, which sounds like the name of a catcher, on my heart. I considered this a CYA procedure, given the partial success I’d had with Nexium. To a certain extent, the cardiologist also believed the scan would come back clean. So I didn’t think I had a heart problem, almost certainly because I didn’t want one. I was already a deaf, brain-damaged amnesiac with a bad back and history of alcoholism. I didn’t want more on my plate. So when the lab told me that their only available slot for the CTA was a month out, I hardly cared. I could wait. I kept on living. Kept on eating fatty foods. Kept on biking. If it hurt, it hurt. Fuck it.

I waited the month, drove an hour to get my CTA, and the entire facility’s computer system shut down just as I was about to go into the tube. They rescheduled me for a month later. I went back, got my scan, and then left. They told me I could access the results through their portal, which I didn’t bother to check for over a week. The only reason I looked up those results one weekday morning was out of cursory obligation. I expected the scan to tell me what I already knew. Here is what I was greeted with instead:

“IMPRESSION: 1. Severe single vessel coronary artery disease. Short segment of noncalcified plaque with greater than 90% stenosis in the proximal first obtuse marginal.”

Normally, the hospital is supposed to call you when the results are this dire, but my own paperwork got lost in the shuffle somehow. So I was alone with this diagnosis. Far too alone. Lab results are often written in opaque doctor-ese that’s nigh impossible for the layman to parse (indeed, a close friend of mine who had cancer wished that they could NOT access their many lab results online without a doctor present to explain them in full). I could parse these results anyway. One of my arteries was 90 percent blocked. Not only did I have heart disease, but I had skipped right past the mild stage of it and was now in deep shit. I had lived with this blocked artery for months, if not longer. I had biked hundreds of miles with it, risking God knows what sort of consequences in doing so. I felt quite stupid about that extended run of treacherous denial, and still do.

I called my cardiologist, who assured me that I was not a ticking bomb, and that I needed a stent put in. I scheduled the procedure. The insurance company, United Healthcare, declined to cover it—a rejection so inexplicable and cruel that even the company’s operator was angry on my behalf. Everyone was angry on my behalf.

I showed up for the procedure anyway. If I had to pay in full, I would. I wanted my heart fixed. Anyone would.

Thanks to some heavy backdoor maneuvering, insurance granted my bank account mercy right before kickoff. The nurses led me back to the cath lab. I stripped down to nothing, put on a backless gown, and then slipped on the complimentary airplane socks that hospitals give their patients as a little treat. The doctor came in and explained that I did not have to go all the way under for this procedure. I could stay awake for the entirety of it.

“By all means,” I told him, “knock my ass out.” He laughed and told me I might fall asleep anyway, as many of his patients tend to do.

I did not. I was awake for the whole thing.

The good news was that they would not need to perform open-heart surgery while I was watching. All I needed was a stent. For those of you who don’t know, stents are a relatively new advance in treating coronary artery disease. Invented in the 1980s, a stent is a small steel cage wrapped in an antibiotic sheath that’s passed along a guide wire inserted through the arm—in the beginning, they passed it through the groin—and into the blocked artery, where doctors then wedge it into the blockage to keep the vessel open. After that, the stent stays in your body forever. You get a special medical card to commemorate it.

If surgeons can’t successfully insert the stent, you have to live with the chest pain, which goes by the clinical name of angina. Your heart can survive this strategic neglect because it has many causeways, and so the flow of your blood will naturally bypass the blocked artery and take the scenic route instead. If you have several blocked arteries, then surgeons have to crack open your sternum and create new bypasses for all of that blood, using vessels they’ve cut away from other parts of your body. Hence the name coronary bypass graft surgery.

Stents help prevent bypass surgery, and with relatively little fuss. They are a net good, so much so that it’s not uncommon for patients to have many of them. The nurse told me of one patient that had 13. I hope I never reach that lucky number myself. But I also know that, given my relative youth, more stents are in my future. If that means I’m spared the bonesaw, so be it.

They wheeled me to the OR and had me scoot onto the operating table. The nurses placed hard plastic wings onto either side of the table to keep me from squirming. They strapped my arms down to the wings with medical tape, making me feel like I’d been institutionalized. While the doctor opened up my pulse point to put in the stent, a giant x-ray scanner hovered right over my body, like an arriving starship. To my right, a panoramic screen displayed a live scan of my insides. I could see the guide wire make its way through the crossflex artery on the outside wall of my heart. I couldn’t tell where the blockage was. All I could see was a looped replay of my filling vessels spreading across the screen like an invasive species, and then suddenly vanishing, and then growing full again.

I was high on fentanyl, but still lucid enough to ask for a play-by-play. The doctor told me that he was having trouble getting the wire through my blockage. CTA results will often overstate the percent of plaque buildup inside a blood vessel (anything over 70 percent requires intervention). Mine understated it. My artery was 100 percent blocked. I continued to watch the monitor as the doctor poked and poked and poked. He needed to try three different wires before breaking through. I felt none of it.

“Did it work?” I asked him.

“You’re all good,” he said. The stent was in. He showed me the difference:

LEFT: My heart pre-stent. RIGHT: My heart post-stent.

This particular artery supplies roughly 25 percent of the heart’s blood supply. That’s what I had lived without for the bulk of 2023. Had that charmed third wire not made it through, I would have had to live with it, and with the resulting angina, for much longer: either forever, or until bypass surgery forced the issue.

But the doctor found his way in with the stent, and suddenly I was a new man. The chest pain was gone an instant. I only had to stay in the hospital for another few hours for them to monitor my puncture wound—the nurse told me that if it didn’t heal properly, it could pop open like a champagne bottle—before being sent home. I watched a replay of Dolphins-Eagles (I didn’t know the final result) on my phone while I waited.

When I got out, I felt free. Free of the pain. Free of the ignorance. Free of the insurance company’s passive evildoing. It’s not fun to know that I have heart disease, and that I’ll have to deal with it from here on out. I’ll have to stay on blood thinners for up to a year to prevent scar tissue from building up around the stent. I still can’t hop on my bike until my doctor gives me the OK. I’ll have to actually pay attention to the little heart icons on restaurant menus. And a lot of white meat is in my future diet. But when I tell you that I’m overjoyed to have a tiny steel cage sitting on the front porch of my heart, I am not lying to you. This is the best I’ve felt in a very long time. I’m pain-free and have more energy than a 6-year-old. And while the specter of death still taunts me from afar, I’ve beaten the reaper enough times to have “Is that all you got?” be my gut response to him.

I celebrated my stent that same night by watching my team play football. My team is not kind to the fragile-hearted, and I was told to avoid heavy lifting—be it physical or emotional—for a week. No matter. I sat in my chair and behaved myself as I watched the Vikings pull a lot of their usual Vikings shit while managing to beat the 49ers anyway. I never got up from my recliner (except during that one play). I never clapped. I never screamed too loud. I was a gentler fan on this evening. And a happier one. Next time my heart cries out for help, I’ll be sure to listen more closely.

The Games

All games in the Jamboroo are evaluated for sheer watchability on a scale of 1 to 5 Throwgasms.

Five Throwgasms

Bengals at 49ers: Well shit man, I just tore my heart out up above, and now I have to write up these games? I should probably be resting. Someone contact Defector’s HR department. I’m being worked to death. Anyway, the NFL’s new “No getting chippy before games!” rules are hilarious bullshit.

Four Throwgasms

Jaguars at Steelers: If you think I like putting the Steelers in the four-gasm section, you are wrong. Somehow they’re even less appealing to watch without Big Ben around. This fucking team is gonna end the season with 10 of the most unsightly wins ever recorded. But that counts as “good,” so I have to pretend like that’s actually true.

Three Throwgasms

Rams at Cowboys: I won’t be convinced the Rams are actually good until they win the Super Bowl this year, and even then I’ll have my doubts.

Bucs at Bills

Two Throwgasms

Eagles at Commanders: If there’s any argument to be made for outlawing the tush push, it’s not that it violates the spirit of football, or that it’s somehow more dangerous than the rest of football. Both of those arguments are wrong and annoying. The better case to make is that it kills the suspense. The Eagles had two fourth-and-shorts on their game-clinching drive against Miami on Sunday night, and it was a foregone conclusion that they’d convert both of them before they’d even snapped the ball. This is mildly annoying. I’m here for good television, not to see Nick Sirianni get all chesty on the sideline. He’s a smug little mosquito, and I don’t like it when he’s happy.

Vikings at Packers
Saints at Colts
Patriots at Dolphins
Ravens at Cardinals
Raiders at Lions
Browns at Seahawks

One Throwgasm

Texans at Panthers: We currently have two pumpkins sitting on our front stoop and neither is large enough. I’m the designated pumpkin carver in this family, and I know that carving medium to small pumpkins is BRUTAL. The flesh on these pumpkins is way too thick. You gotta have a big pumpkin so that you have room to operate. And a big jack-o'-lantern looks cooler anyway. This won’t be the first time I’ve had to go rogue and buy my own pumpkin at a mark-up, but I have to live by some standards.

Bears at Chargers
Chiefs at Broncos
Falcons at Titans
Jets at Giants

Pregame Song That Makes Me Wanna Run Through A Goddamn Brick Wall

"Hey Hey," by Meute. This one isn’t like the other brick wall songs. This one IST EXTRA GUT. From Eric:

A German band that redoes techno music for brass marching band instruments. Try to tell me you don't feel fucking invincible by the end of the song. Also, they look like an ordinary group of dads who've just managed to get away for a few hours to rock out. "Marching uniform? I've got the jacket, good enough."

All this time, I’ve never realized that what every marching band needs is a lead singer and a fucking sick clubhouse beat. I want this band to play at my kid’s wedding.

Eric Adams’s Lock Of The Week: Rams (+6) over Cowboys

“Now I’ve lived in Los Angeles my whole life, and lemme tell you: We have a serious problem with homelessness in this city. You find homeless people everywhere around here: on the street, in your attic, on top of the Hollywood sign, sleeping in the McDonald’s drive-thru, you name it. And when I see these people just lying around and doing nothing, I point to the sky—it’s lovely every day here—and I tell them to be like the sun. You shine and you don’t whine.”

2023 Record: 5-2

Fire This Asshole!

Is there anything more exciting than a coach losing his job? All year long, we’ll keep track of which coaches will almost certainly get fired at year’s end or sooner. And now, your potential 2023 chopping block:

Matt Eberflus
Mike Vrabel
Brandon Staley
Ron Rivera
Frank Reich
Matt LaFleur
Bill Belichick
Josh McDaniels
Dennis Allen
Sean McDermott

(*potential midseason firing)

It’s now become a question of whether or not the Bills will realize that Sean McDermott is the problem before it’s too late. Knowing the Bills and their history, I think you know which way the house odds are tilting. I feel awful about it. Someone needs to slap some sense into ownership (raises hand).

Great Moments In Poop History

Reader Nick sends in this story I call CHARIOTS OF BILE:

During the summer in high school, some of our soccer team would train during the mornings. On one such morning, my brother and I were running on the track. I come around the inside lane of turn four and there is a pile of shit right on the track. It took a minute to figure out what it even was. But when I did, it was pretty clear. I looked around and my brother was nowhere to be seen. Since there were only about five us on the track this morning, and everyone else was accounted for, it wasn't hard to figure out who left this gift.

Another runner came up behind me and asked, "What the hell is that?" Being the great brother I am, I told him that I puked. He proceeded to ask me what I ate. "Sausage,” I told him.

Then I went looking for my brother. I found him in the port-o-potty. He asked me to go home and grab him some new clothes and some wipes. Since I was still young and couldn't drive the car that my brother drove us there in, I ran home. It was about one mile back to our house. I grabbed some baby wipes and new clothes, and then I biked back as fast as I could. When I got back, he was still cooped up in the port-o-potty. It was now about 90 degrees out and he is sitting in his soiled pants in there. What a way to spend a day of summer vacation. 

I have not told this story to a single person besides our parents that night. Every now and then we will call him Trackstar, just for fun.

Tough but fair.

Gametime Cheap Beer Of The Week

Tatra! Fom reader Justin:

Tatra has it all: low rent Indiana Jones, a silly hat, and the crisp, fresh taste of Poland for only $2.30 Canadian. 

Oh wow, the fake Indy can looks like Ron DeSantis dressing up in one of his campaign ads. “Priceless artifacts belong in a museum, but you know what doesn’t? SLAVERY.”

Gameday Movie Of The Week For Panthers Fans

Alice Doesn’t Live Here Anymore. Apart from Killers Of The Flower Moon (my review of which can be found here), this is the only Martin Scorsese movie set in the American west. It’s not a Western in the classic sense, because no one shoots anyone in it. It’s about Ellen Burstyn, who won Best Actress for it, trying to survive as a newly single mom while also trying to make it to (not in) Hollywood as an aspiring singer. If you’d like a painstakingly realistic depiction of what parenting is like, and how shitty most of New Mexico and Arizona are, this movie is definitive. Scorsese made better movies, but he never made another one quite like this. Three-and-a-half stars.

Gratuitous Simpsons Quote

“The watchdog of public safety. Is there any lower form of life?”

“Don't worry sir, I rounded up our less gifted employees and led them into the basement.”

Enjoy the games, everyone.

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