My plans changed! Totally!

I knew exactly what I was going to do. March 19th I would take the midnight flight to Miami and fly on to Santo Domingo for an invitation only conference on Christian teaching. I would lecture about Biblical principles that inform the teaching of Medicine. Integrating scriptural truths into teaching has been my professional passion for over 30 years. After returning home on the 26th I would re-pack and leave April 2nd for Africa.

As staff for a four-day value based AIDS prevention program I would help train educators and health care personnel in Nigeria and the following week in Ghana. During the past 17 years God has blessed me with many opportunities to care for HIV infected people. Because the pandemic continues to spread at an increasing rate, I teach HIV prevention wherever I can present a values based program. CrossRoads developed such a program and tested it in Catholic, Muslim, Hindu and Buddhist countries. Because we share common values and world-view I enjoy working with CrossRoads integrating Christian principles into HIV prevention. Although busy I was happy, I enjoyed what I was doing and I was obeying God's call. My spirit rejoiced! I was like a child going to three birthday parties! I looked forward to each one. I knew schedule, how little did I know!

My health is an important priority. During the last 25 years I jog 4-5 miles 4-5 times a week. I do a little weight training. About three years ago I dropped 50 pounds over a one-year period becoming the appropriate weight for my height and 68 years. Other than being male I had no "risk factors" for myocardial disease. All relatives, not killed by trauma, lived more than four-score years. I was proud of my health. As I jogged past younger people I reflected upon my good health and disciplined life. It was hard to be humble when I was so healthy!

During the mild cold spell this southern California winter I noted a little chest pain that cleared with additional exercise. This could not be angina pectoris! I could not have coronary artery heart disease! No me! Each time I forgot about the pain before I arrived home. When I started to jog on Monday March 13th I began to "feel bad" as well as have chest pain similar to previous episodes and not typical of angina. I turned around and walked home by a different route so those who usually saw me wouldn't think I was shirking my jogging!

My internist, Dr. Ray Wong, scheduled a "stress test" for 10:00 a.m. March 15. I had mixed feelings. On one hand lecture preparation was behind schedule and on the other hand I was concerned and happy that the test would soon be done. Dr. Gary Paul, the cardiologist who monitored the test, said that my "stress test" went well. I had none of the symptoms I experienced on Monday. My atypical symptoms and excellent stress test performance suggested that the test was "normal," despite a minor abnormality in the tracing. However, to be certain, he suggested an ECHO stress test. I agreed and he scheduled it for 2:00 p.m. I was a bit bummed! I would waste more time chasing a "trivial" abnormality. Though unhappy, I agreed.

The ECHO stress seemed to go well under Dr. Ramesh Bansal's direction. I performed the same amount of exercise as in the morning and again no symptoms. However, this time the ECG was seriously abnormal as was the ECHO! I was stunned. Now what? "You don't mean an angiogram, do you?" Lecture preparation occupied my first priority! Obediently I offered to come back in the morning for the "angio." The cardiologists would not hear of it! They intended to hospitalize me! Ignoring my agenda, they hospitalized me over night. I assumed that after the angio the next morning they would prescribe some medication and send me on my way without further interfering with my lecture prep plans. I would be a mature adult patient; without complaining I would "roll" with their plans!

Pouting, I obeyed, but determined to use the time for lecture preparation. I asked the admitting nurse, "Can I bring my laptop computer?" She snorted, "Just a typical Type A!" This hurt my feelings! Me, a Type A, no way! I overcame my Type A behaviors years ago! A little self-talk calmed me down. Later that evening, my angiographer, Dr. Marsa came by, examined me and discussed the procedure. I told him that I was scheduled to fly to Santo Domingo on Saturday night. "Will that be a problem?" He thought that that was too soon. Disappointed I called Dr. Rasi, the convener of the conference. I simply said that I was going to have angiography and could not fly to Santo Domingo. We discussed the possibility that I would fax the paper for another physician to read. A reasonable compromise, I thought.

At 10:00 a.m. Dr. Marsa called me to the Angio Lab. Without general anesthesia I watched the graphics. I am "right dominant," ie, my right coronary artery supplies most of the blood to my heart and my circumflex artery is so small it provides only a minor fraction. Where my right coronary divides it is 90% obstructed! My left coronary artery had several serious plaques. Ignorant of the true facts, I was concerned about preparing a lecture. Reality demanded I attend to the coronary circulation of my heart. I had very serious disease. I was a major heart attack waiting to happen. If it were not fatal I would be a "cardiac cripple." I was in very serious trouble.

Gently, Dr. Marsa began reviewing the angio results with me. "Dr. Elder, I don't remember much infectious disease (my subspecialty) and I don't know how much coronary artery anatomy you remember." I hadn't remembered any. He explained the findings and added, "every cardiac center in the country would recommend bypass surgery." I was speechless-dumbfounded. He consulted with Dr. Razzouk. Within a few minuets they reappeared with Eleanor, my wife, Mary Elssmann, my sister and Glenn Elssmann, her son.

Without drastic revision, this would only get worse. Time, whether measured in days or months, was my enemy. If a couple of blood cells "held hands" (so to speak) the obstruction could become complete. Oblivious to my anatomic reality, I had planned two trips. I believed God had called me to go. Without confidence that God had called me for those trips, I wouldn't have agreed to go. When to undergo surgery? Everything within me said, "do it as soon as possible." Dr. Razzouk was able to operate in one hour (at noon). A very efficient staff quickly arranged the many details.

During this time, Eleanor, Mary and Glenn called family members and informed as many as they could reach. In itself, that was a formidable task. As contacted, family units planned what they could do to help. Mary and Glenn provided crucial support for Eleanor as plans developed. Caroline (Eleanor's sister) and her husband, Don, packed quickly and drove from Ventura to Loma Linda. They stayed with Eleanor and supported her. Cheri (our daughter) was able to phone me before I went "out." Even though I was entering a cloud her voice comforted me. John (our son) and his family moved in with Cheri. Early each day they drove the 25 miles from Fontana to Loma Linda. Children played in the Medical Center's "day room," or at Larry's home (Mary's youngest son) when he or his wife, Tammy were home. Facing this unknown was not my idea! I don't like it when plans change, I want to do what I want to do. (How's that for mature 68-year-old thinking?) By the time they were going to take me to surgery, several things began to clarify in my thinking: 1) I was near death. 2) If God had not interfered, Satan would have accomplished his plans for my death. 3) I was at one of the world's best cardiac centers, to be operated on by one of their best surgeons. I had not had to wait for an opening. "Simply admit it," I told my self, "God has rescued you from certain death. Praise Him and worship Him." Praise I did! My praise to God for His goodness was slowed by medication as I slipped into unconsciousness.

At 11:45 a.m. they wheeled me into surgery. Some of the surgical details that you may want to know:

1) Technically the surgery was very difficult. My subclavian vein clotted off in 1980. I have a small thoracic outlet. We were vacationing in Acalpuco; I got "turista" and dehydrated. The genetic setting met the initiating event and my subclavian clotted. My body made many collateral venous channels to return blood from my left arm and chest to the heart. Many venous channels surrounded the Internal Mammary Artery that the surgeon used as a by-pass artery. Surgical activity in my left chest frequently initiated bleeding. A lesser surgeon would have needed to transfuse me with many units of blood.

2) The arterial blockages were calcified, indicating that they were old. There was no evidence of active vascular disease.

3) The decreased blood flow to my heart caused ischemia-"little blood flow" to the heart muscle. The stress ECHO showed that much of my left ventricle worked poorly when I stress exercised. Ischemia involved not only the pumping muscles but also the papillary muscles (which are supposed to keep my mitral valve working effectively). Even at rest my mitral valve leaked blood (regurgitated). With exercise, the regurgitation became extensive. Following surgery I had no regurgitation-the ischemia was corrected! Praise God!

4) The surgeon said that my heart "was the heart of a 40 year old man." The tissue was strong and very healthy. Despite the ischemia, I had not lost heart muscle! Praise God!

5) They had hoped to achieve at least 80 ml./minuet blood flow in the left bypass. They achieved 200 ml./minuet. They achieved 170 ml./minuet flow in the right bypass. The blood supply to my heart has been more than doubled! Praise God!

6) The anesthesiologist reported that my pulse and blood pressure were far more stable during surgery than is their usual experience! Praise God!

I was taken to the post cardiac surgery ICU at 5:30 p.m. and my family was able to visit though I was still out. About 1:30 a.m., Friday I remember they took out my endotracheal tube (the tube they used to keep my lungs expanded). I felt I needed to urinate. I knew I had a catheter in place, but still, it felt as it feels when I need to urinate. After telling the nurses what I felt I needed, they replied, "It's OK you have a catheter in place, just go." I replied, "I'm not used to urinating with a couple of ladies in the room!"

I awoke 5:30 a.m. Friday morning, had my vitals taken and sat in my cardiac chair. It was more comfortable than the bed. There I could watch the sunrise, praise and worship God. God had done wondrously for me. I love Him so. I want the whole world to know how great He is. About 7:30 I called Eleanor. I knew she was concerned! I wanted to initiate the call, but not so early as to awaken her. She was thrilled to hear me. This was my gift to her. I have had very little pain and required pain pills less than every eight hours. Praise God!

Saturday they removed the bladder catheter and said that if I urinated, they would not have to put it back. Exercise would increase the likelihood I could urinate and narcotics would decrease this possibility so I walked without pain meds. They didn't have to put the catheter back! Praise God! Saturday afternoon I wanted to walk to the day room. My great nephews were there and I wanted to hug them and kiss them. (These are powerful healing modalities-something you aren't taught in medical school!) I couldn't! My rhythm was atrial fibrillation and my rate was over 160. When I got up I felt weak! I was not pleased. I looked at the monitor displaying this information and began to worry. For the first time I was afraid. Then this thought crossed my thinking, "Given who God is and that He has rescued you from Satan's hate-inspired attack, please describe the nature of your problem!" I checked. God was still on duty! I gave my problem to Him and refused to look at the monitor (except once and I was caught!). Nurses and doctors checked my blood, gave me drugs and within a couple of hours my nurse said that my rhythm was back to sinus and my rate was normal! God did this without any help from me! He has His people who know what to do and they did it so simply. I just praise His name.

Sunday they removed my two chest tubes and Monday they removed the leg drainage (source of veins for the right coronary artery). The fact of their removal made the unpleasant process of removing them tolerable!

Many of you received and sent e-mail, courtesy of John, our son. These were very supportive and encouraging. I appreciated them. Many of you told me of your prayers. Thank you so much. Prayer does more than we can possibly imagine. I was constantly bathed in the love of Jesus carried to me on the wings of your prayers. I was graced by the awareness that I am loved, deeply loved by so many people. My flesh could not imagine such love. Confronted with this reality my flesh had to acknowledge the Holy Spirit's power and grace. I was loved, deeply loved by so many people-Only God can create such bonds of love. God gave me the grace to hold and take in your love. By His grace I am healing. My spiritual heart has been infused with grace and love, its sings God's praise and pours out love and blessing to all who will pause and listen.

Some reflections:

What happened? What was going on? I don't know. I have many questions. However, looking at the documented evidence I was very close to becoming a cardiac statistic.

If I had sustained a heart attack, probably it would have occurred at some foreign location or in the air. Only the most expert of emergency medical care would preserve my life until I could be transported to a health care center!

If the heart attack had occurred and excellent medical care was immediately available, I would have had a long convalescence after losing a major fraction of my heart muscle. Probably I would have become a cardiac cripple.

Since it was technically difficult surgery, I may have required many units of blood. This may well have happened in Dominican Republic or in Nigeria or Ghana. In these countries the possibility of HIV contaminated blood ranges from 5-25% per unit transfused! I didn't need a transfusion! That is to say, if the requisite surgery were performed, I might have received HIV infected blood!

Why me? Somebody doesn't like me and wishes I were dead! I believe that the enemy of all people hates me-Praise God! He thought he could get rid of me, but God said "No! I am in charge of Harvey's life. He is in my hands and no one can take him out."

Suppose, just suppose that the symptoms of Monday had occurred earlier in time, or that the stress test had been done earlier, or the ECHO stress were performed Wednesday morning, what then? Probably both stress tests would have been nearly normal. The critical situation may not have been recognized!

From the onset of heart attack until initiation of proper therapy (to save heart muscle) needs to be initiated within less than 3-4 hours. Whether in the air on the way, in Dominican Republic, Nigeria or Ghana, the magnitude of the catastrophe would be devastating.

Don't relax, the enemy also hates you!

The enemy who hates me also hates you! You need the same Person to protect you. Trust Him, listen and obey. He wants to guide and protect you.

Not only was the timing crucial, medical personnel with great skill were available. I was spared the anxiety of waiting.

I knew that Someone was in charge and that He was in control of every detail.

I had been praying for "faith." I had been warned, "Never pray for faith, you can't tell what God will do." I know that I can trust God to be with me all the time. I know God will take me on the path I would choose if I knew all of the outcomes and were wise enough to recognize the best. I want a faith that trusts God even when I don't get my way, because God is good and absolutely trustworthy, He deserves trust. He can be trusted in every situation. My prayer continues to be; now with greater confidence, "Lord increase my faith."

My experience with atrial fibrillation on Saturday afternoon confirmed the fact of God's moment by moment care and help. I want to trust Him more and more. "He is faithful to all of His promises, . . . righteous in all of His ways and loving toward all He has made." Psalms 145:13,17

Family and friends mobilized, supported and prayed. I was bathed in love and support. It was the most wonderful experience I have ever had! Their love flowed all over and through me, their prayers held me. Satan had no access to me because of the love and prayers of family and loved ones.

I am convinced that love heals. Love is critical to each of us. Love, which is God's character flowing through us, heals. When we love we are part of God's healing ministry on planet Earth. Without love, there will be no healing on this planet.

Prayer is powerful, beyond my wildest imagination. Prayer will accomplish far more than we request. Prayer releases God to do what He believes is best. Prayer does not limit God to our request; rather, prayer opens us to God's desires! Prayer is awesome.

I had significant amounts of time to reflect on God's goodness. My heart bowed before Him and sang His praises. This is more than I can understand. Why would God care for me so graciously? Why? I can only conclude that God is loving and gracious, filled with mercy and forgiving towards all His children.

Some nights I would lie awake, looking out the windows. God's intimate presence filled my room. I rested in His arms. He sang to me and gave me sleep. Without any sleeping pills, I slept more than seven hours every night and over eight a couple of times.

I was entirely comfortable allowing others to be the care team and letting them pour over me. I did not check my IV's, bladder catheter, arterial line. (Remember I developed the discipline of infection control! Yet, I was totally at peace). This is a new Harvey!

My mind frequently reviewed the facts in this situation. Why was I doing so well after quadruple bypass surgery? Why had the intended tragedy not emerged? Why was I healing so rapidly requiring so little pain medication? I can only praise God for His goodness. I want the whole world to know "God is good. He does what is best! In every situation He can be trusted absolutely."

This has been a "wake-up call" for me. I was very proud of my physical health. I looked on others as lesser mortals. I coated my self-centered arrogance with a facade of humility. My spirituality was even sicker than my heart!

I felt as if I could do anything, unimpeded by physical limitations. I mowed the lawn Wednesday morning because I thought that after the stress test they would tell me not to mow it! When I got home on Monday, the lawn didn't look any better because I had arrogantly mowed it!

I looked down on "lesser mortals," younger people who couldn't keep up with me. If they had been as diligent as I had in caring for their body, they would be able to. (Notice my humble lack of judge-mentality!)

I appreciated what God was doing for me, but then, why wouldn't He? My implied answer was "I deserved it!" My arrogance was insufferable.

Despite all of this, God did not abandon this child. He watched over me tenderly. He did not let me complete my own arrogance. I praise Him, not only for His goodness but also for His mercy and graciousness to me.

This has brought our family much closer. We were a close family. Having experienced how fragile each person may be, we have pulled even closer. We have been given a new opportunity. We intend to use it "to the max." We want our caring and loving thoughts to be known and become actions. We want every person to live in the assurance that they are deeply loved.

Scrooge has been alive and well in us. We have seen the visions. By God's grace our lives will be different.

any others have been blessed by this sequence of events: my family, friends and people unknown to me!

This was also a "wake-up" call for our family. We have all been busy doing "good works." We would check in on each other, if they were busy, it justified our business. We are not getting together because "they" don't have enough time! (Notice our deep interest in other family members!) John said it eloquently, "I could have been sending notices on my dad's computer to his friends!" So live as if this is your last day. Not everyone gets the warnings we got.

On Tuesday, March 21st John (Marriage and family therapist) said that he shared his experiences of the past few days with a client. She (who does not know me and whom I do not know) responded by dealing with some deep issues, that she was hiding from.

My nephew Steve shared his pain as he thought of a friend who was dying of metastatic cancer. He contrasted the differences in faith. Steve wants his friend to know and trust Jesus so he could trust Him as he walked life's final journey. Steve will share his observations and experiences with his friend. I pray he will listen.

When I arrived home on Monday, the following letter was waiting for me.

Malamulo SDA Hospital,
School of Clinical Medicine,
Postal Bag 2
Makwasa, Malawi
Central Africa
1 March, 2000

"Dear Professor Elder,"
"I believe that God is still taking care of you personally and the entire family."
"I am your interpreter, medical student here at Malamulo. I translated your presentation of AIDS during your visit with the GC team last year (July 1999). I will now be sitting for my Council Examination after my three-year training, this November 2000. I still remember your word of advice to me as a young Adventist. God has been so good to me. I will get a diploma in clinical medicine after passing the examinations."
"My aim is to continue with education should God open doors of assistance as you said. Really I believe that he has a wonderful plan for my life in the future."
"I am wishing your entire family God's blessings and personal good health Professor."

Yours faithfully Edson Monjeza

I was stunned and sat silently with tears coming down my cheeks.

Lest I miss what was going on, God used Edson. There is no way Edson could have had the slightest idea about what I was to go through. This was 12 days before Monday when I felt badly and had some chest discomfort. I have inquired of Edson about what motivated him to write this letter. Edson must know that he wrote in obedience to God.

For the bouquet of blessings God had given me, this was His "gift card" addressed, "Dear Harvey, regarding your experiences during the past ten days . . . ". He wanted me to know the gift came from Him so He signed the card, "Love, God."