A Normal Heart

The shift of symptoms in a sensitive nervous system.

My New Year’s Eve candle lighting in NYC, taken on film.

Three days after I returned home from my most recent trip to New York City, I had an echocardiogram – a heart ultrasound. I left my office at 2:30 to walk down the road and halfway up the hill. The appointment was in the same hospital I took M to the ER in 2016. This memory crossed my mind as I entered the main entrance doors, which came right before the emergency department.

Inside the hospital, I followed a hallway behind the reception desk to the elevators, traveled to the 3rd floor, and signed myself in on a kiosk. It was only a minute or two before I was called back by a nurse, who gendered me correctly, and then handed off to the technician who would complete the echocardiogram. Inside the dim room, I was passed a gown and given privacy.

I took off my bag, coat, scarf, necklaces, glasses, mask, sweater, and shirt before slipping on the hospital gown like a jacket, opening in front. I put my glasses and mask back on, washed my hands, and sat down on the paper-covered bed next to the echocardiogram machine, which was a stout computer with a large screen, keyboard, wires, and a handheld camera. I slipped my shoes off as the technician knocked and re-entered.

After collecting my vitals and placing three stickers with wires that connected the machine to my abdomen, the technician instructed me to lie down on my left side. She told me the whole test would take about half an hour. She draped a towel over my shoulder and got herself settled into the seat next to me. We made small talk as she squirted lube onto the camera and pressed it into my left pec.

I watched the screen fill with a black-and-white image of the inside of my heart. I could see the valves pumping and little flappy bits opening and closing with the rush of blood. It looked nothing like any heart or anatomical drawing I had previously seen. The technician clicked on the keyboard, sometimes pausing the video to capture a photo, sometimes pulling up a soundbar that played a watery woosh. She drew lines with a mouse and changed the angle and position of the camera every so often.

As I watched her work, I wondered if she saw anything out of the ordinary. I knew it wouldn’t be her job to tell me anything or analyze the photos to me, so I never asked any questions. I allowed myself to be in process. I was grateful that the doctor took me seriously enough to refer the echocardiogram in the first place.

I found the whole experience quite relaxing. I took my glasses off and dozed for a bit. Eventually, the technician asked me to lay on my back so she can get a look at my heart from one last angle, pointed up from under my ribcage. After about a minute here, the echocardiogram was complete. I pulled the stickers off of myself, wiped the lube away with the towel, and dressed before making the snowy walk back down to my office building.

A day or two later, a message came in saying I had new tests results available in my medical app. I looked over the verdict and message from the doctor: Normal heart function, let me know if you have questions. I was simultaneously relieved and unsurprised.

-

“Sounds like angina,” M sent to me over text, “bodies do a lot of weird stuff. I get that, too.”

I told them I was going to talk to the doctor about having bouts of pain and tightness centered around my heart. It was never severe enough to go to the emergency room, but was uncomfortable enough to make me have intrusive thoughts about myocarditis or some post-COVID heart complications. I realized I had never mentioned these pains to anyone, and perhaps I should start bringing it up.

“Yeah, you’re probably right,” I texted back, “but I’d rather be safe than sorry.”

I’ve always been a bit of a hypochondriac. When my breasts started developing in puberty, I freaked out because I thought their tenderness meant I had breast cancer. Sometimes I’ll get a random small pain or spasm in my leg and fear it’s a blood clot that will turn into an embolism. Any chest discomfort is now immediately some severe long-COVID symptom, or COVID itself - which doesn’t bode well for someone with multiple anxiety disorders such as myself.

When I went online to schedule a doctor’s appointment with my PCP, the closest one was months out. I put in the request and described my symptoms. Within an hour, a nurse called me to assess whether or not I should go to the emergency room. We determined it didn’t seem to be necessary, but she was able to get me in to see a different doctor the next day.

I was glad that my symptoms were being taken seriously, all too aware of the hurdles most people face with healthcare, especially when it comes to random body pains. If my heart pain was caused by my anxiety, I at least wanted to rule out the severe stuff. The doctor who assessed me was in agreement, performed an EKG, and sent me home with a referral to schedule an echocardiogram.

I considered myself lucky to have a provider who wanted to collaborate on my healthcare with me, rather than write me off.

-

I was writhing in pain, panting, unable to sleep. My stomach was in knots and a bright pain burrowed around my heart. I took note of that feeling, understanding it as a more severe version of my occasional chest tightness. But this time, I knew what was happening.

I was in a triggered state, flashes of memory breaking the surface before crashing back under the tides of anxiety. I was shaking in the fetal position, almost laughing at myself for how absurd it all seemed. I looked around the room for shapes in the shadows, something to grasp onto and help me. No messages revealed themselves. I was alone.

It was 4am and no one was going to text me back. I got up and made tea, played soothing music, paced around, waiting for the energy to move itself through me so I could go to sleep. I was exhausted and frustrated at being too activated to escape. I flicked on a light and tried to read, resigning myself to sleeplessness. I managed to calm myself enough to sleep for an hour before the sun rose.

At one point during the anxiety attack, while hugging my arms around my stomach, I thought to myself, “This is who I am. I wouldn’t be who I am without this pain.”

Although less frequent and less severe than they used to be, I know these states are a part of my life. Something like this will happen, I’ll take it to my therapist, we’ll do EMDR, I’ll have realizations, and then a little piece of me is more healed than before. But, my body grasps its memories well, even if my mind can be a fog about them. Another attack will come eventually.

In the midst of an anxiety attack, and throughout the recovery of one, there is a feeling of intense isolation. It is a solo, intimate experience with oneself. Regardless of how coherently I can describe my feelings, or how quickly I can recover, I know that this anxiety is mine and mine alone. I have built enough networks of support that I can feel a safety net beneath me when I am overtaken by an attack. Even still, there are times where all I can feel is a yawning darkness below me, waiting to engulf me in helplessness.

-

“What’s one thing you wish you could change about yourself?” F suddenly asked while we sat on their emerald green couch listening to music.

I took a moment to think before stating, “I wish I wasn’t such a hypochondriac.”

Their hazel eyes widened in surprise. “But, doesn’t that make you more aware of your body?”

“I feel like it makes me less connected with my body, because I’m too worried about being severely sick to listen to what is actually happening.”

“Oh, that makes sense,” they replied thoughtfully, before I turned the question back on them.

I am of the mind that mental illness and anxiety disorders are a normal reaction to the systems we live in. There’s plenty of philosophy, critical theory, and social commentary that make similar arguments. Given what I’ve witnessed and survived throughout my life, it is understandable that my nervous system is a little fried. Although, my political understanding of my mental disorders doesn’t change how I experience my symptoms.

Being a hypochondriac is a facet of my anxiety. It’s funny that the very thing that causes my random chest pains that send me into a WebMD spiral, is also the thing I have a solid understanding of in its most severe states. After four years of dedicated treatment and recovery, I am no longer in a daily state of chest-clenched dissociation. I no longer have frequent nightmares, get woken up by the sound of low planes, nor go days on end with a knotted stomach I can barely feed. Without these daily symptoms, I find myself wondering if I’m even still disabled at all.

And then I realize: the chest pains I’ve been experiencing aren’t new, as I previously thought. They are less-severe versions of my old ones.

My mom once told me she thinks I’m an empath. I have seen others use the phrase “highly sensitive person” to describe themselves. I am inclined to reject these labels for myself. If I happen to be high on the spectrum of human sensitivity, then so be it. I don’t need to adopt a particular label to communicate my needs, or explain that something that wouldn’t hurt someone else did hurt me. I’m feeling rather tired of labels, finding most of them to be lacking in the depth and nuance I’m trying to experience and convey in my life.

At the end of the day, it is normal to be particularly sensitive, or numb, after surviving abuse. It is normal to fear the unknown. It is normal to love intensely and passionately. It is normal to be unwell and still cared for. Regardless of what my anxiety has to say, there is nothing wrong with my heart. I have the echocardiogram to prove it.