The Invisible Black Woman

It was 2 AM and I’d just been discharged from the emergency room. After hours of not being able to get my heart rate under control or catch my breath, hubby finally persuaded me that we needed to go to the ER. We got there at about 8 that evening. It all happened so fast. One minute we were driving to the ER; I did my best to keep calm, almost willing myself to hold my symptoms at bay. Then, when we arrived at the hospital, it was as if my body finally knew I could relent, that I didn’t have to hold it together any longer.

I tried to fill out the paperwork; my hands were shaking, I felt unsteady. I needed to sit. I had to ask hubby to fill out the rest. When I told them what was wrong—that I couldn’t catch my breath, I was having chest pains, and my heart was racing—I earned and almost-instantaneous trip to the back for triage.

Hubby was still in the middle of filling out my paperwork when I heard my name called to the back. The nurse who treated me, Derek, was pleasant. He had a southern accent and an equally warm demeanor to match. He could tell I was scared. He looked at me with nothing but kindness in his eyes.

I said to him, in between breaths, with a voice a mixture of hoarseness and barely above a whisper—so much so he had to lean in to hear me—“my husband. He’s in the waiting room. He’ll be worried. He’s got a heart condition. I need to make sure he’s okay.” Those were my first words to him, not what was wrong with me.

Tears began rolling down my face.

He took my hands in his and said, “Ok. Ok. He’ll be back here soon enough.”

I insisted. “No, you don’t understand. He’ll worry. I need to be sure he’s okay. Please tell him I’m ok.”

With kindness still in his voice, but a bit more forceful, he asked me, “who are we here to treat?”

He didn’t say it sarcastically. He genuinely wanted an answer. I said, “me,” while trying to catch my breath.

“That’s right,” he said. “We’re here to treat you. What do you think will happen to your husband if he comes back here and sees you like this?” he asked gently. “Do you think that will help his heart condition?”

I mustered a chuckle. “No, it definitely won’t,” I whispered. 

“Ok, good. Remember that saying about putting on your mask first before you can help someone else? That’s kinda what we’re doing here. We’re gonna take care of you first, ok?”

The stern compassion in his voice was comforting. It was the voice of someone who genuinely wanted to make sure I was ok.

Midway through another nurse joined him, Lisa. As Derek pulled up a stool close to the reclining chair I sat in, he began examining my right hand. 

“I’m gonna take my time, make sure I find a good one.” By “good one,” he meant vein. They needed to get some bloodwork. 

“Hey, I’m Lisa, and I’m the charge nurse on duty. I’m gonna check your blood pressure and we’re gonna do an EKG, ok?” I nodded. EKG was short for echocardiogram. They needed to take a reading to see how my heart rate was.

While Derek continued looking for a vein on my right arm, Lisa began placing stickers with metal clasps all over my chest and stomach. That’s where they would attach the leads, or cables, that would give them a reading of my heart.

“So, tell me what brought you in to the ER?” Derek asked.

“My heart’s been racing since 12:30 this afternoon,” I replied.

“You remember the exact time your heart started racing?” he asked, but not in an accusatory way, more as a probe.

“Yes. It was 30 minutes before I was supposed to meet with my boss. It hasn’t calmed down since. I’ve had this happen before, but never for this long. Plus now I can’t breathe and my chest feels tight.” I managed to get all that out in one long string.

“Hmmm. Do you feel anxious?” he asked.

“Yes, I would say so. But this is weird. I’ve never had any heart problems. That’s why I came in. My heart just won’t slow down and it feels like something’s sitting on my chest.” 

“All right. Well, we’re a one-stop shop you know. If you need to talk to someone, we can do that here, too,” Derek said reassuringly.

By then, my inability to breathe was only compounded by my mask. With Derek commandeering my right arm and Lisa my left, I had no way to get to the mask on my face. I pleaded, “please, my mask. I can’t breathe.”

“Do you want me to pull it down?” Lisa asked.

I nodded. She pulled my mask under my chin and I took a big gulp while silently praying to God to not compound my symptoms by gifting me with COVID.

And while I was getting hooked up to an EKG, a pulse oxymetry machine to check my oxygen levels, and a blood pressure machine, my phone was pinging incessantly. I couldn’t hear it above the whirs and beeps.

It was hubby. He texted multiple times. He called. He was worried. 

As they were calling me to the back and kept me there, hubby was in the waiting room. He had heard them call me, but then he didn’t see me again. Usually he would accompany me to triage and then to the back. This time, he was left behind. 

“Hi, I think my wife was taken to the back,” he said to the nurse at the triage area.”

“Just a minute, sir,” she replied.

He waited 1 exact minute. Then he came back.

“Can you please check to see if my wife is in the back? I want to make sure she’s okay.”

“Give me a moment. You can’t go back right now, but I’ll let you know.”

He waited 15 excruciating minutes. He came back, more insistent. “Please, just tell me my wife’s okay.”

I knew him well enough to know that every minute would feel like an eternity. This wasn’t his first rodeo and sadly, likely wouldn’t be his last. He’d spent many a time waiting for news. While I was shuttled off to tests or while I was undergoing surgery. 

I’d only been on the receiving end once—when he was admitted and we learned about his heart condition—and I pray to never be there again. So I knew just how agonizing this would be for him.

Derek finally found a good vein and proceeded to run a line to draw blood. 

“You’re gonna feel a small pinch. You ready? On three: one, two—”

Then came the pinch. It was nothing compared to my galloping heart. 

By now Lisa had taken my EKG reading and she said, “it looks good.”

She lied. 

Maybe she lied because she knew it would do me no good to know my EKG was not normal. Maybe because the tests weren’t yet conclusive, so she was hedging her bets. I can’t quite say what drove her to lie, but I didn’t need a machine to tell me what my heart already was, as it did its best efforts to beat out of my chest.

Then came my blood pressure reading. I felt the cuff relax and heard the rhythmic beep. Then I looked up at the monitor: 141/117. For someone who has never had a history of high blood pressure, whose numbers were consistently low hundreds over seventies, I was worried. 

“Do you have a history of high blood pressure? Take any medications?” Lisa asked.

“No, I don’t. This is too high.”

She nodded quietly. 

“Ok. The doctor will be in to see you soon,” Lisa said.

“What about my husband? Did you tell him I’m okay?”

“What’s his name, hun?” said Derek.

I told him his first name, but then I told him he goes by his middle name, so to be sure to call him by his middle name, not his first.

“How do you say it again?” he asked.

I repeated it. 

Derek then smiled and said, “I’ll just call him by your last name so I don’t mess it up.”

I smiled weakly.

A few short moments later, my husband stood in the makeshift room in the hallway. He had his mask on, but I could see the look of three parts worry and two parts relief in his eyes when he looked at me.

Derek introduced himself as did Lisa, then they exited and pulled the curtain behind them.

Hubby made his way towards me and squeezed my hand. 

“How are you feeling?” 

“I still can’t catch my breath and my heart hasn’t stopped racing.”

“I didn’t know what happened. One minute I was filling out paperwork, the next minute you were gone.”

“I know, I know. I told them to get you, that you’d be worried.”

“Did you see my messages? I tried calling.”

I shook my head no.

“I knew it was a long shot, but I didn’t know where you were and they wouldn’t tell me anything at first.”

“I’m sorry.”

“Don’t be sorry. I’m just glad you’re ok—well, you get what I mean.”

I nodded.

A few moments later the doctor came in and introduced herself. I found myself repeating the same spiel from before.

“Ok. I want to do some additional tests. I want to check your troponin and your thyroid levels. I just want to make sure we cover all our bases. I’m also going to do a chest x-ray.” Troponin was a heart enzyme. An elevated level would point to a possible heart attack.

Hubby and I nodded in unison. 

“Do you have a history of high blood pressure?”

“No.”

“Ok. We’ll do some tests and then we’ll go from there. How does that sound?”

I nodded.

A few minutes later, Lisa came back. 

“We’re going to move you into an actual room in a bit. The room’s a bit weird, so just keep that in mind.”

In my head, I wondered what the hell she meant by “a bit weird.”

Then the transporter came in and wheeled me to the “weird room,” hubby in tow.

As we approached the room, I read the sign at the door, “Code Room.” Unbeknown to Lisa, I’d worked in a hospital for 10 years. I knew what “Code” stood for: Code Blue, as in someone is crashing and may require resuscitation. I felt my hairs stand on end. I quickly glanced at hubby to see if he’d put it together. He hadn’t and I breathed a sigh of relief.

We were wheeled into a room bathed in blindingly bright fluorescent lights. Machines and instrument seemingly protruded out of every available inch on the walls. I silently prayed to God that this wasn’t how and where I’d meet my end. The irony was not at all lost on me.

Another patient was directly across from me in another room, and seemed particularly fascinated by my arrival. I felt like an exhibit. Hubby sensed my discomfort and motioned toward the curtains with his head. 

I nodded.

He then pulled the curtain away from the prying eyes and I felt myself relax, probably for the first time since arriving. 

“I’m not going to pull the curtain on the left too much. I don’t want them to forget you’re here.”

He was always thinking 10 steps ahead.

A few minutes later, two personnel arrived wheeling a big machine in tow. 

“Hi. We’re here to do a chest x-ray. Do you have on a wire bra?” said one of the technicians.

I was still wearing the clothes I’d walked in with: a flowy black pleated dress with a colorful, long-sleeved, sheer overcoat that fell to the floor. 

Just because I wasn’t feeling well didn’t mean I had to look like it.

“No, I don’t have on a wire bra, but I do have on an undershirt.”

And by undershirt, I meant a black ShaperMint top that doubled as a bra and shapewear. Pure magic.

The female technician approached me and said, “let me see.” 

Before reaching under my dress, she glanced at her male partner who nodded his head and stepped outside.

She then reached for the strap under my dress.

“Do I need to take that off?” I asked her.

“No, I don’t think so, but can you pull the straps down?”

“Yeah, I think so.”

I proceeded to try and pull off my overcoat, which they’d managed to keep on over the blood pressure cuff and the pulse ox on my left. As I studied my arms to try and figure out how I’d manage, hubby came to the rescue.

He gently pulled off my right sleeve, while making sure not to disrupt the central line that remained firmly in place at the crease of my elbow.

Meanwhile, the technician and I worked on my left hand.

“Can you pull that down for me, please?”

“Sure, how’s this?” she said, while carefully pulling my sleeve down.

“That’s great, thank you.”

Then in two fell swoops, I managed to pull down the straps of my undershirt so they wouldn’t be in the way.

“You did that quick!” she said with a chuckle.

I managed to chuckle back. 

“Will this work,” I said, “or do I need to take it off completely?”

“No, I think this will work just fine,” she said.

“Can I come in now?” asked her partner, as if on cue.

“Yeah, you can come in,” she said.

He brought the large portable x-ray machine closer to me. While he worked to set it up, his partner placed a heavy vest over my chest. 

“Ok, I had her pull the straps down and I don’t think they’ll show up on the x-ray, but let’s make sure.” 

She glanced at me then said, “if it doesn’t’ work, then we’ll have you take the undershirt off. Deal?”

I nodded in agreement.

Once the technician was ready to take the x-ray, he motioned for his partner and hubby to stand back. They both stood at the far corner while the machine took a picture of my chest.

They took a look at the film, nodded with satisfaction, then proceeded to exit.

“I hope you feel better,” she said, as she walked out.

“Thank you,” I said, with a smile.

A few minutes later, a woman walked in wheeling a computer on a tray.

“Hi, I’m from registration. I need to verify some details.”

I was already in the system, so she recited my particulars in between my nods of affirmation. 

“Do I have an advanced directive on file?” I felt compelled to ask.

Hubby looked puzzled at my question. I hoped it wouldn’t ring a bell by wording it how I did. An advanced directive is a living will, that determines who will be your medical proxy if you are no longer able to make decisions for yourself.

“I’m not sure, but I will check. But your husband is with you, so you should be good,” she said.

I thanked her and averted my gaze while closing my eyes, in hopes hubby wouldn’t ask me what that was about. 

He didn’t.

As she was wrapping up, another woman appeared in the doorway. She sported two long pigtails and a beaming smile.

“Hi, how are you?”

She didn’t wait for me to answer.

“My name is Adrielle. I’m here to do another EKG. The doctor wants to run it again since your first one showed you were tachycardic. We want to run it again to see where you are.”

And by tachycardic, she meant my heart rate was elevated and not normal, as Lisa had stated earlier. Busted.

I decided to file away Lisa’s indiscretion and just focus on what was in front of me. Another EKG, and prayers that my heart was ok. 

At the same time, I hoped they’d found something. Not because I am a glutton for punishment, but because the symptoms I was feeling were intense. Surely, they could get to the heart of the issue (pun very much intended).

“Babe, tell her what you told me,” prodded hubby.

 Adrielle cocked her head to one side as she waited for my response.

“I feel a pain on my lower left side. And I still feel dizzy, like there’s a heavy weight on my chest.”

She nodded her head and pressed the button that started the blood pressure cuff again.

131/121, it spat back. My body was trolling me. Now my resting heart rate seemed to want to give my systolic rate, when my heart should be pumping the hardest, a run for its money. 

I silently sighed in exasperation. 

“I’m going to let the doctor know, ok? She might want to prescribe some other tests.”

A few minutes later, the doctor came back in. 

“The technician told me you’re feeling a heaviness on your chest?”

I nodded my head.

“I am going to listen to your heart. Take a deep breath in for me, then hold it.”

I did the best I could to do both of those things.

“Do you have a history of blood clots?” she asked.

“No…” I said trailing off, while I looked at hubby.

“But my aunt did. My aunt on my mother’s side. That’s how she died.”

“Ok. I want to run a d-dimer test on you. I want to make sure there’s no blood clots. Depending on what we see, I might do a scan of your legs. Have you had any pains in your legs?”

“Yes, but I have arthritis in both my knees, so I didn’t think much of it.”

“Ok, let’s just do a few more tests to be sure. I’ll come back and see you when your results are back. Also, I’m going to have them give you some IV fluids. These symptoms could be just a matter of dehydration.”

I nodded. I didn’t have it in me to tell her that I drank water like a fish daily and that day was no exception. So I smiled and nodded.

Hours passed before I saw her again. The tech and the nurse would periodically pop in on me. The last time the nurse came in, I told her I needed to use the restroom. 

She offered me a commode or a bedside catheter. I declined both, choosing to preserve some of my dignity. By now, I was in a one-way gown with hospital booties and the black tights I managed to keep on.

I made the ill-advised decision to walk to the restroom. Hubby grabbed the sheet off the bed, draped it over my exposed back, gave me a once-over, then off we went. Hubby’s arm wrapped securely around my waist on my left. I needed to prove I could walk without feeling unsteady. I wobbled to the restroom.

Hubby followed me inside and stood in front of the restroom door. The lock was faulty, so we could close the door but couldn’t lock it. I knew I didn’t have the oomph to walk the additional steps to the other restroom. So there he stood, keeping watch while glancing over to make sure I didn’t take a stumble. 

An inordinate amount of time later, we headed back to the room. I dreaded it. It was a slow, painful dance. Every few steps, I stopped to catch my breath, hubby would lean in and ask if I was ok, I would nod yes, then on we went.

It took at least 7 minutes to get back. As uncomfortable as the thin mattress on the hospital bed was, I fell back into it with relief. 

I’d finally decided to text back my mom. Hubby had sent her a few updates, but omitted the parts about testing for heart issues and blood clots. I texted her to let her know we were waiting on more tests and she said to keep her posted. I said I would.

A few more hours, and the day became the next. It was after midnight now. The doctor came back in.

“So I looked at your tests and your x-ray. The results came back clean. You don’t show any sign of heart attack or blood clots, and your thyroid levels are within range.”

I was relieved, but puzzled. I guess my look gave my confusion away.

“One thing I did notice is your white count and related levels are elevated. This happens in one of two instances when all other results come back clean. One, when you have an infection. Two, when you’re experiencing high stress.”

She paused, as if for dramatic effect, “ You don’t have an infection.”

Her words hung in the air, waiting for me to process them. I didn’t have an infection. I didn’t have an infection…

When it finally sunk in, I realized all signs pointed to stress. Stress!? How could that be possible? I was as perplexed as I was relieved. 

She sat in the stool next to me and said, “do you think you want to go home?”

“Yes. I do.”

“Ok. I’m going to write up your discharge papers. I still want you to follow up with a cardiologist, but I also want you to follow up with behavioral health.”

“Ok.”

“Please take care of yourself.”

I smiled while thinking, easier said than done.

As I got dressed, I kept turning around what I was just told in my head. Stress made me feel I couldn’t catch my breath. Stress made my heart gallop 100 miles per minute. Stress made me feel like a 500-pound weight was sitting on my chest. 

I was stunned. 

I read over my discharge papers that the nurse handed to me. Diagnosis? “Chest pain of unknown etiology; palpitations of unknown etiology.” Unknown etiology was code for, “we don’t have a clear explanation for why this is happening.” And last but not least, anxiety. 

In addition to a cardiology follow-up, “as soon as possible,” I was to call the local behavioral health center for a psychiatric assessment. 

I rewound back in my head to the day prior, 30 minutes before I was supposed to meet with my supervisor. The heart flutters, the shortness of breath, the chest tightness. All boiled down to one little word: anxiety.

I felt like the person who gets a miniature splinter in their foot and writhes in pain overly dramatic. I felt ridiculous for how I felt and confused at how real my symptoms felt. But it was real. It was happening. I hadn’t manufactured the high blood pressure, the racing heart and the abnormal EKG. 

“Can you believe this? Stress?” I said.

“No, I can’t,” hubby replied.

“But it felt so real,” I said to him, part of me feeling guilt at having put him through such an ordeal for seemingly nothing.

“It was real, babe. Your symptoms aren’t any less real because stress caused them.”

I sat with that for a bit. It still felt so incredulous to me.

“You’ve had this happen before, babe, remember?”

I did. In fact, on more than one occasion, my Apple Watch alerted me that it detected an elevated heart rate even though I was at rest. Each time, I was meeting with my supervisor. 

It seemed amusing at the time. Right now, not so much. 

As we drove home, equal parts befuddled and relieved at my diagnosis, I wondered what it would mean for me. What would this assessment entail and better yet, what would it uncover? 

I wasn’t entirely sure I wanted to know the answer to the latter, but deep down I knew I needed answers. 

Next time around, I may not get off so lucky.