Communion Of Dreams

And then one day you find ten years have got behind you*

Another progress report/follow up to my previous two posts.

As of Thursday, I had passed the week-long “don’t exert yourself” mandate following the cardiac stents installation. There wasn’t any worry about how my heart would do, just that I needed to let the puncture in my femoral artery heal completely.

And as I resumed my normal activities, I realized that things had, indeed, changed. Significantly. For the better.

Which was a little confusing, initially. Because as I had noted, I wasn’t feeling particularly poorly or limited prior to the procedure. In fact, as I said in my previous posts, there were no real indications that I had much of a problem. That was because overall my heart was very strong, and was perfectly capable of dealing with the blood demands of my body in almost everything I had wanted to do. It wasn’t until the very upper end of the stress echocardiogram that there was objective evidence of a possible blockage. The ultrasound imagery showed that the lower part of my heart wasn’t doing much work — the upper 2/3 of the heart did almost everything. That was because of the 95%+ blockage of the lower part of the RCA.

But what has become clear to me in the last few days, as I upped my exercise activity significantly, is that having 2/3 of my heart handle all the work of the whole heart meant that it was working harder all the time, if only just to push enough blood into the lower heart muscle to keep it alive and healthy. And now it no longer needs to do that.

The result is I feel a lot more energetic, and less tired at the end of the day. I feel, already, like I am ten years younger. I suspect that as the virtuous cycle continues to build on itself, that even that situation will improve. Exercising (walking every morning, doing yardwork for 60-90 minutes several times a week) takes less effort, and is more productive — which will help me lose weight and strengthen the muscles in the rest of my body. I recover from those exercise sessions faster, and can get more accomplished overall.

While I didn’t realize it while it was happening, I had been increasingly constrained and drained of energy. That constraint is now largely gone. Amazing what a couple of inches of steel mesh tubing can do in the right place.


Jim Downey

*Again, of course.

Everyday miracles.

This is a follow-up to my previous post.

I just sent the following message to my primary care doctor:

Dr M,

I wanted to take a moment and thank you. Your recommendation that I take an echo stress test likely saved my life.

You’ll probably get the cardiac cath results from Dr W, but it may not include an observation he made when he first examined me: that had I come to his practice for a routine exam, presenting the same symptoms I told you, he probably would not have suspected such a serious condition. But the echo stress test clearly demonstrated that there was a major problem. And that the cath procedure showed just how bad it was: 95-99% blockage in the lower part of my RCA.

The seriousness of that condition was masked by my overall/otherwise heart strength. But it could have *very* easily resulted in a serious M.I. or even death. Had you not picked up on the subtle indications we discussed, and taken the prudent step of recommending the echo stress test, my true heart condition may not have been discovered until it was far too late.

So, thank you. Your intelligence, education, and experience probably have added decades to my life.

Why am I sharing this?

Because I got extremely lucky. And I want others to benefit from that luck, and my experience, if possible.

As it turns out, the overall condition of my heart is remarkably good. The strength and efficiency of that muscle is at the very top range for normal healthy people, or at the lower end you’d find in a serious athlete. Furthermore, there are no other indications of atherosclerosis or plaque build-up.

However, due to either a genetic or developmental defect, the lower part of my RCA is badly kinked/convoluted, creating a situation where eddies in the blood circulation form, and allowing what plaque I do have in my system to accumulate, like a sandbar will develop as a result of a bend in a river. In my case, that accumulation had progressed to the point where just the slightest additional clump of plaque could have closed off the artery completely, allowing a part of my heart to die. That’s a classic heart attack, folks.

But the strength of my heart overall was such that it almost completely masked the condition of my RCA. It wasn’t until I was up to about 90% of my heart rate maximum while taking the stress test that indications of the problem surfaced. And even then, just how bad the situation was wasn’t fully known until the cath procedure was done. But when the cardiologist went in and directly observed the condition of my coronary arteries, he saw the problem. And with about 90 minutes of hard work, corrected it with a couple of long cardiac stents.

That was just three days ago. I actually left the hospital the next morning, and have been playing catch-up on things since then.

Think about that: for 90 minutes, a team of medical professionals were playing roto-rooter with the inside of a major artery of my heart. I was completely awake and unsedated through the whole thing. The next day I left the hospital, walking on my own without difficulty. This morning I got in my usual morning walk of a mile. For about another week I have to take it a little easy, to let the puncture site in my femoral artery completely heal, and for the next year I need to take blood thinners, but otherwise I don’t need extraordinary care.

That’s pretty miraculous, in my opinion. One of the everyday miracles which surround us, and which we seldom give due consideration. Stuff that not too long ago would have been considered science fiction.

Anyway, here’s my advice, though you’ve heard it before: pay attention to your body. Don’t succumb to toxic masculinity. Or, if you’re a woman, to the illusion that you’re immune. If you think that something is going on, get it checked out. A little embarrassment at being wrong beats dying.


Jim Downey

Shorter of breath, and one day closer to death.*

“Well, I’d hate for you to have a heart attack,” said my doctor. She was standing against the wall in the small exam room, arms folded in a classic body language message of being skeptical about what I had just said.

* * * * * * *

I wrote this in September 2007:

And as I stood there at the sink, washing the dishes, thinking favorably on the option of having a heart attack, it sunk in that I was done. I mean, I’d been considering that a heart attack might be the best solution to my problems. Yeah, a heart attack. Hell, at 49, I’d probably survive it. It’d come as no surprise to anyone, given the kind of physiological and psychological stress I’m under. No one could blame me for no longer being a care-provider for someone with Alzheimer’s. Hey, it might even get someone to think about noticing my writing, since a tragic character (whether alive or dead) always gets more notice as an artist than does someone who has their life, and their shit, together.

That was a few months before our care-giving journey ended, and Martha Sr passed away. For those who don’t know the story, I was able to re-center, and continue with my role as a care-provider the next day. The following year was spent recovering from the stresses of that role, and getting my shit back together. Because in spite of the perspective indicated in the final sentence of the passage above, my hold on things wasn’t nearly as solid as I thought at the time.

Such is often the case. I think it’s a defense mechanism, with more than a little toxic-masculinity.

* * * * * * *

Did I say toxic-masculinity? Why yes, I did. Such as in this timely article:

Men, in short, are less likely to seek preventive care than women and more likely to put off seeing a doctor when in need of medical care. They also prefer to seek out male doctors, but they tend to underreport pain and injuries to male doctors, thereby compromising the chances of receiving optimal care. And all of this, it should be said, is particularly true among those men who prescribe to masculine ideologies.

“Masculine men tend to not go to the doctor, and when they do, they tend to pick male doctors whom they then underreport their ailments to,” Sanchez said.

* * * * * * *

We recently had a change in our financial situation, thanks to the sale of some property we owned. That, combined with the protections of the ACA which mean you can’t be as easily penalized for a pre-existing condition, made it a lot easier for me to make the decision to having something checked by my doctor.

Howso? Well, our income has never been huge. In fact, it’s always been pretty modest, though in recent years it has gotten better and become more stable. But still, if I had something turn up which required me to miss a significant period of work, or which came with a large insurance co-pay for treatment, we would have lost what progress we had made. And not having to worry about having a documented ‘serious health issue’ mess up my insurance coverage in the future is a huge relief.

In other words, I’m financially stable enough to get sick. Hell of a system, isn’t it?

* * * * * * *

“Well, I’d hate for you to have a heart attack,” said my doctor. She was standing against the wall in the small exam room, arms folded in a classic body language message of being skeptical about what I had just said.

Which was that I was reluctant to go see any medical specialist, since the way the system works it’s almost guaranteed that they would find something which needed ‘treatment’. After all, none of us are walking perfect models of health. And, as the old adage goes, never ask a barber if you need a haircut.

But I nodded my head, sitting there on the exam table.  I had my shirt back on after they had done the in-office EKG, which showed that everything at present was OK, but that there were possible indications of problems in the recent past. And the very mild symptoms I had recently were possibly indicative of a coronary arterial blockage, and it runs in my family on my father’s side. “Yeah, me too. OK, go ahead and book me for a stress test.”

She nodded, we chatted some more, and she left.

I had the stress test last Friday. Got the call with the results yesterday.

No complete blockages. But some constrictions which need to be addressed. So yeah, sometime soon I’ll be seeing a cardiologist, and we’ll discuss options from there.

It’s not good news. But it’s not horrid news. After all, this is one of the most common medical problems around the world. So we’ll see what happens.

But I’m glad that I’m lucky enough to be in a position to have it found, treated (to whatever extent possible), and not worry about it completely ruining our financial situation. And I’m also glad that I’m not quite macho enough to think that I should ignore the classic symptoms, as mild as they were.


Jim Downey

*Of course.

PS: if you feel the need to post a political comment related to the ACA … don’t. I’ll just delete it.

Pop-up phantasmagoria*.

This is completely delightful:


Lots of news from the world of my life. Most of it good. I’ll share in a few days.


Jim Downey


Here there be robots.

Oh, this is just delightful:

Here there be robots: A medieval map of Mars

Recently I’ve been really into old maps made by medieval explorers. I thought it would be fun to use their historical design style to illustrate our current adventures into unexplored territory. So here’s my hand-drawn topographic map of Mars, complete with official landmark names and rover landing sites.

Go check out the whole thing, but here’s a glimpse of the map itself (which is much larger on the original post):


You can even support the artist and buy a copy! Quick, before they’re all gone!


Jim Downey

HT to Margo Lynn.

Progress report and excerpt.

As I noted I probably would a little over a week ago, I’ve just wrapped up work on Chapter Fourteen: Llangelynnin of St Cybi’s Well. It’s a long chapter — twice as long as most of the chapters are — and a pivotal one, since it includes the first instance of the faith healing/psychic abilities as referenced in Communion of Dreams. Here’s a critical passage, which will resonate for those who have read CoD already, where Darnell Sidwell’s sister Megan first encounters the healing energy just as the fire-flu is becoming a pandemic:

She stepped into the small room of the well, her arms opening wide, her face lifting to the heavens. It was indeed as though she were drinking in the light he still saw there, or perhaps like she was drinking in rain as it fell. She stood thus for a long minute, perhaps two. Then slowly she knelt before the opening of the well, her hands coming together and plunging into the cold, still water. The light filling the small space seemed to swirl around, coalescing into her cupped hands as she raised them out of Celynin’s Well.

Darnell stepped inside the small roofless room, bending to help Megan stand. As she did, he looked down and saw that she had water in her hands, but not filling them. Rather, it was water as he knew it from his time in space: a slowly pulsing, shimmering sphere. It seemed to float just above the cradle made by her hands.


That brings me to a total of approximately 95,000 words. I still have one short transitional ‘interlude’, then three named chapters, then a brief ‘coda’, and the book will be finished. Probably another 25,000 – 30,000 words. Which will put it right at about the total length of Communion of Dreams.

What’s interesting for me is that this chapter has proven to be a pivotal one in another way: it feels now like I really am on the home stretch of this project. Just finishing this chapter has changed the whole creative energy for me. There’s still a lot of work to do, but it no longer feels … daunting.

We’ll see.


Jim Downey

Bad medieval book manners.

Oh, this is just completely delightful! Here’s the intro, but you definitely want to go read the whole thing:

Bad medieval book manners. Part 1

Handle with care. Those who have worked with manuscripts in libraries and archives know that the casual relationship between the reader and the printed book stops at the door and a special covenant enters into force once we approach bound parchment (ok, some paper, too, mais j’en passe). ‘Be careful with that’, ‘no flash, please’, ‘don’t open it like that’, ‘use a book-rest, don’t you see you’re hurting it’ are ululations typical of a manuscript room. Needless to say, things were not quite like that in the long Middle Ages. Those manuscripts that have made it through fire and water, deliberate destruction or noxious negligence usually tell us stories of a book culture where the reader and the book were only slowly coming into a friendly bond. Historians have been telling us about book damage arising from negligence, weakness or deliberate fault, but wouldn’t it be great to hear the story from a contemporary who’s lobbied à pleins poumons for the dignity and sacrality of books? This man was Richard de Bury (1287-1345), bishop of Durham, Lord Chancellor, Treasurer and Privy Seal and author of the ‘Philobiblon’, a work that is as fascinating as it has been neglected by modern historians. It is Richard’s manifesto for bibliophilia or the love of books. In it, books take central stage, speaking to us, often through personification, about their ordeals, rewards and achievements. It is, for me, the greatest confession of faith of a bibliophile.

And part 2 is here: Bad medieval book manners. Part 2

Go read and enjoy!

(And yes, I have seen every such type of damage in my conservation practice.)


Jim Downey