I should preface this account by mentioning that when it comes to health issues I\ufffdm your basic old-school ignore-the symptom-and-it-will-go-away kinda guy, and that this approach has largely worked for me these many decades past. It also dovetails nicely with kindly young Dr. E-W, my "personal physician" at the Oakland Kaiser Permanente Hospital, whose approach seems to be "ignore the patient and he will go away." Dr. E-W appears to feel that she\ufffds letting down the side if I remain on the premises for more than three minutes, and over the years I\ufffdve taken the message, and try not to linger where I\ufffdm not wanted.

So here I am at about this time yesterday, massaging a dreary Powerpoint that I don\ufffdt particularly want to work on so that next week a manager who doesn\ufffdt want to deliver it can bore to tears an audience that doesn\ufffdt want to see it, when a small invisible man, or perhaps a large invisible child, stood on my chest. This was not particularly alarming, because the same thing has happened at odd intervals—every few months or so—for the past three or four years. I was a bit nonplussed the first time it happened, but when the symptoms went away after five minutes I concluded that it was pretty small beans for a cardiac episode, shrugged, and went about my business. This time the sensation (not unlike inadvertently swallowing a large bolus of air, producing the impression of an intractable mass lodged just beneath the sternum) persisted for much longer than usual. Googling "heart attack" and "symptoms" alarmed me a bit, particularly since past episodes (though not this one) had been accompanied by an ache in the left arm, and at the 25-minute mark I caved and called the legendary Kaiser Advice Nurse for reassurance. The KAN heard me out and urged me to find the nearest emergency room (I had suggested that I might take the subway back to Oakland). Then she changed her mind and insisted that I call 911. I promised to do this and rang off.

I had no intention of calling 911, which seemed an absolutely lurid course of action [insert low-bandwidth QuickTime movie of RC on gurney as San Francisco paramedic pounds on his, RC\ufffds, bare chest screaming "No! No, goddammit! Stay with me, you son of a bitch!"], but I was starting to get a little spooked at this point even though, about 35 minutes after the onset, the pressure was beginning to abate. "What harm could it do to have this checked?" thought I. "A couple of hours at the clinic, the rest of the day off, a nice tall frosty to unwind once I get home..."

I explained the situation to the Big Dog\ufffds gopher, who owes me beaucoup favors, and she kindly provided me with a car and driver and instructions to take me to Kaiser\ufffds San Francisco facility. I thought it a bit odd when he got on the freeway, but assumed he was taking a roundabout route to avoid downtown traffic, and established only belatedly that he was absentmindedly taking me to the South San Francisco Kaiser (South SF is a separate municipality), his own accustomed hospital.

I\ufffdve got to say that over the years I\ufffdve gone to the Oakland Kaiser and to a couple of suburban Kaisers, and that the clientele in these latter sylvan settings seem to suffer from less dramatic complaints, whereas in gritty Oakland one tends to share the waiting room with members whose medical conditions appear to involve Second Amendment issues. When I said the magic words \ufffdchest pains\ufffd I was whisked away into the ward with only a brief pause for paperwork (HMO Type: "You say this occurred at work?" RC: "Well yes, but not in the sense of 'workplace injury,' of course." HMOT [grinning wolfishly]: "How little you know."), tipped onto a bed, stripped to the waist and wired up like a telephone switchboard to a battery of recondite chirping and warbling instruments. This was about noon, and there I remained, oh my brothers and only friends, for full six hundred and forty minutes, far from home but, it must be said, well attended by two shifts of brisk, friendly and reasonably attentive medical personnel. Many of them, it is true, addressed me with the bright condescension one might use in speaking to a simpleton or a child, but this appears to be part of the package in much of the developed world ("Why is it when you lose your health the entire medical profession takes it as axiomatic you've also lost your mind?" laments Michael Gambon in Dennis Potter\ufffds masterpiece The Singing Detective), and I found it preferable to Dr. E-W\ufffds chilly get-lost professionalism. For much of the day I was left alone behind my arras, with periodic interruptions for tests and suchlike. Fortunately I had my little satellite radio with me (no reception, but with five hours of stored "Bob Edwards Show" programming on it) and 200-odd unread pages of Hadrian VII to spare me the horror of my own company.

Four EKGs. Four drawings of blood to look for the enzymatic debris of a cardiac calamity. A chest x-ray (did you know that x-rays have gone digital? Oh). The polite refusal, at about six o\ufffdclock, to allow me to disconnect the assorted clip-one wires that attached me to the monitoring apparatus (I gather that interruption of the signals would have been misinterpreted as a cessation of vital signs, causing klaxons to sound, emergency generators to kick on and the ceiling sprinklers to engage) so that I could go in search of a urinal, providing instead a vessel about the size and shape of a plastic bottle of Penn State thirtyweight, except that this one was somewhat disconcertingly formed of what appeared to be heavy-gauge cardboard. A microwaved meal, no worse than airline food ("But a lot costlier, I\ufffdll bet," cracked the SO later). A full half hour\ufffds consultation, halfway through the ordeal, with a physician who opined that the symptoms as described were also consistent with some known side effects of my old friend the gastric reflux yadayada. A certain amount of begging and grovelling before the swing shift at last reluctantly consented to release me at the close of the last round of tests. A bandage malfunction as I got dressed, spraying improbable volumes of blood around my clothing (dark trousers, white shirt) so that I looked rather worse coming out than I had going in. Total cost to me: zip. Total cost to employer if, as I suspect, they attempt to ding the organization under worker\ufffds comp: I shudder to think. Bottom line: heart does not look unsound; they nevertheless want to subject me to the treadmill test in the near future.

I feel rather guilty about taking up a bed for half a day, and if I had it to do over again I\ufffdd as soon have skipped calling the advice nurse in the first place, but it\ufffds reassuring in retrospect to know that the past few years of twinges apparently haven\ufffdt presaged my early death from a massive coronary, as in nervous moments I had permitted myself now and again to wonder, and the level of TLC Kaiser members receive out in the hinterlands is a revelation. Fortunately urban life has its other compensations.

cordially,