After a huge meal on Sunday night, I got heartburn. By around midnight, the heartburn was so acute, I began to suspect that it could be a heart-attack. (The symptoms are very similar indeed.) So I woke up my wife, and with great embarrassment said I wanted to be taken in to the Emergency Room.
We drove up the mile or two to the hospital, and while my wife parked the car, I staggered towards the E-R admissions desk. When I was upright, the pain often went away briefly, but it always seemed to come back. I filled out a very short piece of paper, not a complete registration form. I said "chest pains", as a safe compromise, and took a seat, hunched up with the pain, which came back as soon as I sat down.
Pretty soon I was taken inside and made to lie down. They listened patiently to my claims of having acute heartburn, and how big that meal was, but in retrospect I seem to remember that they had a sort of long-suffering look on their faces, which seemed to say, you're not the only idiot who has thought that. Let's pretend it's a heart-attack, they said, because if we're wrong, well, heartburn treatment isn't time-critical.
So they hooked me up to an Electrocardiograph (or Electrokardiograph, in German, hence EKG), which involved putting all sorts of stickers on me with little nipples on them, which make me look like a nursing alien mother-dog, and found essentially nothing. I was given a full array of blood tests, which meant I got poked in the inside of my elbow. Then, about half an hour later, another blood test--just one tube.
As time went by ... about two hours in, I complained about the pain, and they first gave me a little Nitroglycerin pill, to keep under my tongue. There was no relief. Then another, and then yet another, but no relief. Then they gave me Morphine! That gave me relief for about 10 minutes.
More Nitroglycerin. By about this time, the pain had lessened to about half strength, but it was still painful enough to keep me from falling asleep.
My poor wife was seated in the room, helping me to the toilet and back, texting the relatives, answering questions, listening to my raving! She isn't an incredibly patient person, but in the early hours of Monday morning, she was the very soul of patience. She guessed, faster than I did, that it was some sort of heart problem. II think the Nitroglycerin had actually worked every time, but not enough to register on my agonized senses.)
It was now about 6 in the morning, and I was admitted to the hospital. They took me up to a room on the floor where they keep people who have trouble with locomotion, and other motor problems. They had no room in the cardiac area; in fact we were diametrically opposite to the cardiac area. The physician for the hospital (in contrast to the Emergency Room doctor) came in, talked to me about all the issues, and I was ordered a special "gastric cocktail." If it was heartburn, this cocktail would fix it right up.
The pain was only slightly reduced.
Then there was another blood test. At this point, a doctor came in and said that, though the EKG had not revealed anything significant, the blood tests had. A certain enzyme is released by the heart when there is a blockage in a heart artery, and this enzyme had been steadily rising in level from the time of the first blood test.
This was the first I had known about this fabulous blood test. So I finally said, ok, let's call it a heart attack if it makes you happy. They put me on some aggressive blood thinner; I think it was a combination of Heparin and Nitroglycerin. No one was allowed to smoke in my room, for fear of detonating the Nitroglycerin. Gradually, as the heart found it easier to pass the blood through its arteries (the problem vessels are those that siphon off some of the blood into the walls of the heart muscle itself. The main outgoing arteries (and the pulmonary vein) are not easy to block, being the size of the New Jersey Turnpike. But if you really try, you can block those, too.
[In case you're interested, here is at least one web page on the enzyme, called Troponin. In the past they used an enzyme called Myoglobin, but apparently Troponin is a superior flag; it kicks in sooner.]
It was the next afternoon before I was taken into this lab, where they do the angioplasty. It is a clever procedure where they send in a wire through an opening in the artery of the right arm, which can disgorge an x-ray -opaque dye. They watch the thing on a highly magnified x-ray screen, on which the wire looks the size of a coffee-mug. We see the dye shooting out, intermittently. Then, they inflate a balloon that has been threaded onto the wire, and a sort of collapsed wire exo-skeleton around the balloon. The inflated balloon (very tiny, of course, being inside a blood vessel) presses the basket against the walls of the artery, compacting the blockage against the artery walls and opening up the blood flow. The basket gadget is what they call a stent, and now they're coated with something that responds to medication, and sort of repels blood platelets, so that a clot does not form (too readily).
Once the procedure was completed, the surgeon went out and talked to my wife, and told her she had a delightful husband. I can't possibly imagine how delightful I could have been; I never said a word, except to ask for a blanket, because it was cold. (They keep it cold, because the surgical team wears all these fancy clothes. That enormous X-ray machine probably requires that the people wear lead clothing. I mean, it looks super heavy, like what a Ninja Jedi would wear.)
Once the wire is reeled back out of the artery and that hole in the wrist, they put a pressure dressing on it. This is a plastic cap which is strapped to the wrist, into which they pump compressed air. The air keeps the clotted blood at the artery opening from popping out. All through the night, the nurses kept leaking the air out of the dressing, until by lunchtime the next day, it was at room pressure. (I related all this to the nurse at my primary care doctor's office, and she was seriously underwhelmed. "Oh, yes, a pressure dressing. Uh huh," she said. As far as I was concerned, the pressure dressing was the most interesting part of the whole thing.
Meanwhile, my wife and I are in touch with the people at work, measuring out the least amount of information they need, to make sure that my workload could be covered. (Fortunately it's Holy Week, and our highly religious* kids will refuse to attend classes from Wednesday on, even though only Friday is a holiday.) In spite of all that, concern and good wishes pour in.
At one time, I had [5 ] intravenous ports going at the same time: (1) Saline solution, which keeps the patient hydrated. A dried-out patient is a dead patient. (2) Heparin. This is a blood-thinner which interferes with clot formation. At this point they did not want clots. (3) Nitroglycerin. This dilates all the blood vessels. At one time, they couldn't find a single vein to use; after the IV Nitroglycerin, no problem. (4) A port from which to take blood, for tests. This was kept unused by the people who were putting stuff in. (5) Potassium. They shot me full of Potassium Chloride; I don't know why. If you have friends who know about medical things, you could ask them. Maybe potassium is good for the heart, in which case I could swallow a bit of Potash. And then, of course, they say: don't soak yourself in a bath when you get home, because the scabs might wash out, and you'll bleed. If you bleed, call your doctor. If the bleeding doesn't stop soon, call 911. Don't try to drive yourself to the Emergency Room! Oh man, you've gotta go pretty far to hear funny stuff like this.
To my horror and delight, I was discharged in the afternoon, just 24 hours after the 'surgery'. At first I resented their conveyor-belt approach to these surgeries: I was prepped and on the table while the doctor was still in an adjoining room with another patient, and while they were working on me, yet another patient was being prepped in the other room. On one hand, they can work on more patients per week, and these are patients in pain. On the other hand, it would be nice to give more work to other surgeons instead of overworking a few. But being a private business, the Hospital is at pains to reduce their costs, which means keeping the payroll small. The payroll is their largest expense, immediately followed by insurance.
But all is well, and Arch's intermittent assaults on your brain will continue.
The first day of Spring, or the Vernal Equinox
Contrary to popular belief, the calendar (for developing which Julius Caesar and Pope Gregory were so heavily criticized) is intended to keep the Four Seasons roughly in the same location on the calendar. In contrast, the Islamic traditional calendar has Midwinter and Midsummer's days marching around the calendar year in gay abandon. This never bothered the majority of the Islamic world, which lay originally essentially within the tropics, and never observed the seasonal variations. But for folks in the higher latitudes, farming, planning for cold weather, all depended on an accurate estimate of when winter was coming.
The seasons cycled round roughly once every 365 days, since the geographic pole of the Earth settled into the direction it points in at present (towards the pole star). But not exactly 365 days, it was closer to 365¼. By the time of Pope Gregory, it was realized that that ¼ was a slight overcompensation, because March 21 began to fall about 4 days later, and by Bach's time, well into the Spring, almost April.
It was easy to observe the Spring Equinox; you measured how long the daylight hours were, and it would be the date halfway between the longest night, and succeeding longest day. Equivalently, you watch for the point on the horizon at which the sun rises; the northernmost point at which the sun rises corresponds to the longest day. Even the Druids could do it, as witnessed by Stonehenge. So all they had to do was to divide the number of days between March 21st and the observed equinox (which should have been on March 21st) and divide by the number of years from the last date when the Equinox was on the correct date of March 21. (This happened at the time of Pope Gregory, when I was too young to remember anything.)
Suppose it was 400 years. So they figured, we've got 4 too many leap years, though leap years are a good idea generally. The thing to do was not to have leap years every 100 years. In other words, you let
But of course, that would stop the calendric misalignment from getting any worse, but it wouldn't bring it back into alignment. So they shortened one particular year by 10 days, and fixed the problem.
(Soon after any year in which the Leap Year is skipped, the Equinox pops back to about March 20th, and gradually creeps towards March 21 for 25 Leap Years, until we pop it back again during one of those Leap Year diets.)
[Added Later:
Here is a chart I made in Excel, and here's what it means.
It starts out with a line going up. This is the Seasons falling behind the date, for four years. By the end of the four years, on February 28th, the First Day of Spring would almost be on March 22nd. Then the Leap Year comes in just in time, and forces the First Day of Spring to be early on March 2oth, and that's the sharp downward line in the chart.
Then the whole process repeats.
But, as you can see, the Leap Day overcompensates, so that every Leap Year, the First D.O.S. falls earlier on March 20th than the previous time. (In Bach's time, this had continued for hundreds of year, until the F.D.O.S. was around March 10th.) So, after 24 zig-zags, we skip a leap year. You can see the graph going up for eight years.
Clearly, though, even the once-every-century-Leap-Year-Diet is too much. So every four centuries, we do have a Leap year. That stops that rising trend you see. To show this adjustment in action, I would have to show you more than 800 years, which is impossible with the resolution we have!! This is what is being described below.]
[Added still later: well, here's a chart showing the skipped Leap Year Diet in year 400! This happened in the year 2000, by the way. The Leap year would have normally been skipped, which would have caused a great deal of amazement. But it was time to not skip a Leap Year, so only people in the know knew that anything out of the ordinary was happening. So that long stretch of unbroken zig-zags is 50 years without skipping a Leap Year. At the end of it, we're almost at the level we started out.]
There is actually a correction in the third decimal place, and even further down the length of a year. But every one of them can be fixed by (1) A leap year, (2) skipping a leap year, (3) skipping the skip of a year that would normally have been skipped, (4) skipping the skip of a skipped leap year, and so on. For errors much smaller than a minute, they simply adjust the National Institute of Standards clock a few seconds forward or backward. This happens on many years. So, to the extent that it is possible, it is my belief that the point on the Earth's orbit that corresponds to the Spring (Vernal) Equinox is passed every year since about 1600 within 12 hours of Midnight of March 20.
J. S. Bach Day!
This is just a very rough description of the problem and the solution, and I would not have known about it if not for the fact that I am such an insane admirer of the music of J. S. Bach, whose birthday was March 21, 1685. Unfortunately, this was according to the calendar of Saxony, a fiercely protestant province of Germany, which regarded Pope Gregory and his popish scientists and astronomers as limbs of the Devil. It was some years later that the Church and Secular leaders of those parts accepted that it was insane to cling to a calendar according to which Christmas would land in the middle of Spring if it went on long enough. So it appears that Bach's actual birthday was closer to March 31, or even April 1.
But here's my thinking. If, instead of dying, Bach was dispatched by alien spacecraft to some advanced planet, where he was frozen and put in hibernation, if he were to be revived today and asked for his birthday, he would say at once: March 21st. So I figure, if he thinks his birthday is on the 21st of March, that's good enough for me.
*NOT
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