Break It Up

Mark Golub
3 min readApr 13, 2022

A couple days ago, my hemoglobin was down. Generally, hemoglobin (red blood cells) drops as the iron level in blood decreases. But my iron level was fine. None of the other expected causes were pregnant, so the heart failure team was worried I was bleeding internally. Sure enough, the site where they inserted the catheter for my balloon pump was bleeding a bit internally. I had a small hematoma. That’s what they call it when the bruise grows on the inside.

My little hematoma

They needed to break it up and stop the leak. Apparently, the method of choice was fingertips. Poking, prodding, squeezing fingertips. It hurt. It hurt a lot. Almost like the doctor was tearing my flesh apart.

It went on for twenty minutes, 30 minutes, almost 45 minutes. The doctors had to change off three times because they didn’t have the strength to keep pressing and grinding. I made them stop twice because I was going to be sick if the pain continued. They stopped a third time because I was going to vomit.

But I made it. Eventually, the hematoma broke up enough that they stopped kneading my shoulder like they were making sausage. The next step was lying there, still, while they squeezed and pressed on the wound to stop the bleeding. It was at this point I thought of something I was too afraid to ask about out loud-what if one of those hunks of clot decided to make a home in one of my overcrowded coronary arteries?

Why am I telling you this, you might by now be asking? Because it taught me something. Someting I think is worth sharing. I can do whatever I need to get this heart. My life, quite literally, depends on it. I felt like I was being stabbed repeatedly by the doctors’ fingers driving relentlessly, deep, using so much force they actually had to tag team me. Their hands, squeezing, gripping so fiercely felt like I was being assaulted. I searched my mind while they worked me over, trying to find a comparable experience to draw from. My first heart attack, the one that left over 40% of my left ventricle ischemic, dead. This was worse than my memory of that. My chest being cracked for the bypass. Ribs split and held open by a metal spreader for 6 hours. I was unconscious for that of course, but the recovery was still fresh in my mind. Nope, this was worse. I was actually stabbed once. That didn’t even register.

Oddly enough, around this time, one of my transplant buddies developed a hematoma. She got 12 hours of being poked, jabbed, squeezed, literally beaten the fuck up. We both agreed-there was a point where we considered if death was preferable. But we didn’t. It took a long time, but eventually it passed. We lived. We won.

Getting this transplant is going to take a lot out of me physically. At some point, I will technically die. My heart will be cut out of my body, my arteries and veins will be severed. It will be momentary; I will then be quickly attached to the ECMO and the art of man will fill in temporarily for the magic of God, Science, whatever you wish to call it.

I am ready to die. I know it is my only way back to life. Living through this experience, the hematoma, taught me that to live I can endure any pain, that I can die, if I need to, to live again. If this srikes you as me being melodramatic, you’re probably right. But then, this whole fucking process is pretty dramatic. I defy anybody to go through it and remain blase.

Thanks for playing. Let’s head on down to the rec hall. I hear they have pie.

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Mark Golub

In 1998 I had a heart attack. I remember the ED doc telling me “You probably won’t die tonight.” I didn’t.