OH DOCTOR, PLEASE HELP ME

Oh help me, please doctor, I’m damaged . . .

—Mick Jagger, from “Dear Doctor”

My second son Ian was born on June 19, 1995, and my oldest son Eric turned five on July 24 of that year. That year the heat and humidity between Washington, DC, and Baltimore was out of control. One day during that oppressive summer I was taking Eric to an Orioles game with my father-in-law who lived walking distance from Camden Yards. Eric was a big Cal Ripken fan and going to see a ballgame with him was always a great time for me. Baseball was important in our household: I always made time to play catch with my kids each morning, and coached and attended my sons’ Little League games.

So I was getting ready to make the drive to Baltimore with Eric and had complained to my wife that my teeth were really hurting, and she advised me to see a dentist the first chance I got. Eric and I drove to Baltimore and my teeth continued to hurt, and when I explained to my father-in-law that I did not feel well and that maybe just he and Eric should go to the game, he expressed concern. He had been a pulmonologist most of his life in Binghamton, New York, and was now the medical director of Maryland General Hospital in Baltimore. He said we should go to the emergency room there just to be safe, and I was feeling so unwell that I agreed.

It appeared from my EKG that there might be a slight problem with my heart, but I was assured that it was probably nothing serious. They wanted to keep me overnight and have a cardiologist take a closer look at the test. I was put into their cardiac care unit and then the next morning taken by ambulance to another hospital nearby. I still felt lousy but I was not sure why all this fuss was being made over what I was repeatedly told was probably nothing.

When I got to MedStar Union Memorial Hospital the doctor there wanted to conduct an angiogram. This is where they put a catheter into a vein in your thigh and push it up into your heart so they can examine the condition of your arteries and look for blockages. I was awake for the whole procedure. The cardiologist informed me that I had three severe blockages in my heart, and the tooth pain I had been feeling was actually jaw pain, which was a classic symptom of someone getting ready to have a heart attack. There was no damage to the heart muscle, but it seemed as though a heart attack was imminent. He advised that I should have heart bypass surgery immediately or I could be dead within a matter of hours. Tears began to run down the side of my face. “I am only forty years old. How is this possible?” It was a kind of protest, but I also knew it was futile. He explained the seriousness of the situation and I agreed to the surgery and told them to wake me up when it was over. I could not believe this was happening to me.

I now realized why they had brought me over to Union Memorial Hospital: they did open-heart surgery there, and since Doctor Manzari was my father-in-law I was getting some very special treatment. Within an hour of my angiogram I was rushed into the operating room. Doctor Mispareta had earned the reputation of being an excellent open-heart surgeon in DC and Baltimore. He had also performed surgery on my dad, so history was unfortunately repeating itself in a way.

It is my understanding that they remove your heart from your body and keep it beating and still connected while they replace the clogged arteries. For my surgery they took arteries from my chest instead of my legs as these are usually stronger and last longer. These days they use stents much more often than bypass surgery since they don’t have to crack you open to get to your heart. They just slip in the stents to open up your arteries while they are doing the angiogram. It seems almost routine now to get a few stents and then be on your way and back to work.

Open-heart surgery is a different beast. I remember waking in a fog with tubes down my throat and three tubes in the area above my stomach. The doctors came in and pulled the ribbed tube from my throat, which was a strange sensation I will never forget. I remember my father-in-law coming in and me thanking him for saving my life and telling him I loved him. This was my first memory after the surgery.

I also remember seeing my dad in the same situation. It had scared the shit out of me—he had looked like death. And even though I was a healthy eater (no pork or meat for over thirty-five years) and kept to a natural diet, I had inherited my father’s genes and heart disease was included in the package. If you think that the one having the surgery is going through the worst, you are wrong; the worry and concern of the family is greater. So I can only imagine the fear my family must have felt, especially my wife Deb, with a newborn child to take care of and a five-year-old who had just come down with chicken pox. All at the same time. God bless her and her fortitude to endure all this emotional turmoil that had been heaped upon her.

Slowly I recovered. From intensive care I was put into a private room. I was still very weak. I began to eat and eventually was allowed to leave my bed to go to the bathroom. I recall waking one morning in the hospital with an erection and starting to believe that I might eventually be okay again. It gave me hope and I laughed. But another day I went to the bathroom and all the emergency alarms on my monitor started to go off. My heartbeat had raced up to over 180 beats per minute and I was in severe danger. I was rushed back into intensive care and they managed to get my heart rate under control. In Jamaica a well-known saying is, One step forward, two steps backward, and that was how I was feeling. My heart began behaving erratically with my BPM all over the place: sometimes slow, sometimes fast. And my heart was also going into arrhythmia off and on.

After about ten days, still very weak from my ordeal, I was finally released from the hospital and went home in the care of Debbie. With a lengthy recovery process ahead of me, that night I had a dream I was swimming in the ocean, just beyond the waves. Beams of sunlight from between the clouds were drawing me up into heaven. I woke with a start after being shaken by Debbie, who had grown concerned by the noises I was making. Perhaps if Debbie hadn’t woken me up that night I might have made the transition to the other side . . . Thankfully that didn’t happen, and a few nights later I had a dream I was having sex with Uma Thurman (don’t even ask). But she started crying, then told me she had AIDS. Another example of the fear of death manifesting itself in my subconscious.

* * *

All of this happened when I was working with Rounder Records, who had pretty much given me complete freedom to run the label and distribution company as I saw fit. As long as RAS was making money, Rounder just allowed things to roll along and pretty much left me alone. The three owners were extremely understanding and sympathetic to my medical condition and encouraged me to take the time I needed to recover. I had some people at work who were capable of running the distribution company and the label took a brief hiatus as I healed. My house was less than a mile from our warehouse and offices so it was not too hard for me to make the occasional visit to rally the troops and let everyone know I was on the road to recovery. And thanks to visits from good friends like Fatis and Luciano, who would check up on me and spread positive vibes, I was able to keep my spirits up.

Before long, I was back at work going full-time and continuing to build up RAS. I was amazed at how well I had recovered. I was playing rigorous tennis on a regular basis and working out and felt very fit. I had to thank Jah for making all of this possible.

Then, without warning, seventeen years later during a tour with Bunny and the Marley brothers, my heart acted up again. I had taken two days off from the tour to be with my family back in Washington while the bus carried the rest of the band north to Boston. Even though much time had passed, I immediately knew what it was: atrial fib. It really had me freaked out. After seven or eight hours my irregular heartbeat subsided and I told Deb about it and I think we both just felt it was brought on by the strenuous tour, facing the grueling demands of being on the road—we had seventeen shows scheduled in twenty-one days.

I felt better the next day, but one month later the arrhythmia came back with a vengeance. It rocked my world. Another eight-hour episode and it wiped me out so bad I had to spend the entire next day in bed just to recover. I needed a cardiologist and I needed one quick.

My good friend Marc Appelbaum and his wife Liz always raved about their general practitioner/cardiologist, so I called Doctor Dwyer the next day. At his first open appointment a couple of months later, he confirmed that I was once again suffering from arrhythmia, an irregular heartbeat. He said it had nothing to do with the tour I had been on. It had just decided to rear its ugly head so many years after my surgery, and was caused by a nerve sending out an electrical impulse that fired at an irregular interval and made the heart jump. The only real danger (besides the discomfort it caused) was that it could lead to clotting and I could have a stroke (and die). Nothing major.

He immediately put me on a blood thinner and started me on a regimen of medicine to try to keep the irregular heartbeat in check. Unfortunately, the medicine really fucked with me. I was tired all the time. I had no energy. No sex drive. No nothing. It seemed that I needed to lick the fib problem before I could think about returning to my routine.

* * *

So I was out of work, physically compromised with arrhythmia, and trying to figure out where to go from there. Every time the fib hit me, it hit me hard. The meds were not working. Doctor Dwyer told me about a procedure called an ablation. He explained that the doctors would use a catheter to reach into my heart and fry the parts that were sending out the signals that threw my heart into arrhythmia. He said I should go and see Doctor Andrea Natale at the world-famous Cleveland Clinic, as he was the top surgeon on the planet performing this procedure.

I flew out to Cleveland for my initial appointment, and when I landed there I saw huge posters all over the walls extolling the virtues of the clinic. Eight-foot pictures of their great doctors and the miracles they performed. And there was one of Doctor Andrea Natale, heralded as the greatest of all ablationists in the world. I felt lucky to be able to meet with him.

The doctor explained he could do the procedure but that he was completely booked up and the earliest he could schedule me was about a year from then. For me this was unacceptable. I told him I was leaving in two days on a three-week European tour (again with Bunny Wailer), but that getting this taken care of was paramount—I could not afford to wait another year. I have always had a hard time taking no for an answer, so I continued to push for him to find time for me. He had his nurse recheck his schedule and saw he had an opening in late September and could fit me in then. So I went and did a great tour all across Europe with Bunny headlining a show that also featured Capleton and Third World.

September arrived and Deb and I flew out to Cleveland. Getting ready to go into the OR, I saw another gentleman sitting there in his wheelchair wearing a hospital gown. I asked what he was in for and he said he had a six thirty a.m. appointment with Doctor Natale to receive an ablation. I found this to be unusual and did not understand how the two of us could be scheduled for ablations with Doctor Natale at the same time, but I didn’t dwell on it.

I was put on an operating table and a doctor came in and explained that the procedure would take about three hours and I would be under for the whole time—but still no sign of Doctor Natale. There was nothing I could say. I was laid out on the table with a bunch of tubes hooked up to me and had signed a consent form, so there was no backing out now.

When I finally came out of it I was wheeled to the recovery room and reunited with Deb. Doctor Natale eventually showed up and said he thought things went pretty well but was not 100 percent sure. By the time we got back home to Washington, DC, I was very weak and still had trouble breathing. I called Doctor Dwyer to explain the symptoms I was experiencing, and he sent me to Sibley Hospital the very next day for some additional tests.

After extensive X-rays, the doctor at Sibley explained that in some rare cases the phrenic nerve is hit during an ablation and this can freeze up the diaphragm, causing only one side of a lung to function. He said this could typically take up to one year to heal on its own. This was not good news. I called the Cleveland Clinic a few days later and was told that Doctor Natale “no longer works here,” that his contract had not been renewed. What the fuck? My whole state of being began spinning. When I asked what had happened to Doctor Natale, the woman explained that she was not at liberty to discuss this. Feeling very confused, I searched the Internet for any information I could find regarding his sudden departure from the Cleveland Clinic.

Turns out this was major news in the Cleveland Plain Dealer. Evidently he had been let go due to conflicts related to his outside work with other medical facilities. I had told Deb that the whole day of the surgery did not feel right, and to this day, though I have no proof, I do not believe it was him who actually performed it.

Meanwhile, my cardiologist in DC grew increasingly concerned. He was pissed about my frozen diaphragm and the fact that Doctor Natale, who he had recommended, was no longer at the Cleveland Clinic. I was still having trouble breathing. We all take breathing for granted, but imagine if you cannot breathe: Walking up the stairs would completely take my breath away. Anytime I went to lay down or eat I would start coughing uncontrollably. I struggled to breathe. Do you even fucking know what I am talking about?

I was told I would need to return to the Cleveland Clinic for additional tests. Afterward, a doctor there explained that these tests showed how two of my pulmonary arteries had also been collapsed during the ablation, and I was only getting 30 percent of the oxygen my lungs required. No wonder I couldn’t breathe. Things were going from bad to worse.

I was told I would need to go back to the Cleveland Clinic (again) for a rare procedure from a pediatric cardiologist. Nearly all the cases of collapsed pulmonary arteries occurred in babies born with a defect—along with less than 1 percent of patients who receive ablations (lucky me!). The thought of returning to the Cleveland Clinic was throwing me into another place. It was like I had entered The Twilight Zone. Deb and I sat there holding hands, not knowing what to think.

Then Minerva, a nurse I had gotten close to during this process, shared another bombshell: the ablation procedure had also lodged a large blood clot into my heart, and this could kill me at any moment. Deb and I just sat there and cried; I needed to get this dealt with right away. What the fuck was going on? What had really happened that fateful day in September? While these questions swirled around in my head I went into orbit, and thank God Deb was there to provide the gravitational pull to keep me tethered to the Earth.

For the next month, I had to inject a heavy-duty blood thinner into my stomach twice a day to try to break up the clot. At any moment it could dislodge itself and result in a stroke or worse—death. Imagine walking around with a large blood clot in your heart and not knowing where the sucker might end up.

By this time I was so sick of hospitals. So sick of the smell. So sick of being hooked up to drips to infuse me with dyes and nuclear isotopes. So sick of being told everything is going to be okay and then it not turning out that way. And like Frankenstein’s monster, I had been electroshocked back into a normal heartbeat countless times.

After another month I was now cleared to have my surgery back at the Cleveland Clinic. I will admit that I was extremely apprehensive (i.e., scared as shit) about returning and having this rare surgical procedure, but I felt confident about the new doctor and she had some excellent credentials. I told Bunny Wailer about the procedure and explained everything that had happened to me, and he assured me that the hands of Jah would be guiding the hands of the doctors as they performed the surgery. I’ll never forget Bunny’s words, which he meant from the heart; they gave me more comfort and assurance than I had received from anyone else.

After the operation I awoke in an intensive care unit in the pediatric ward, surrounded by toys and Disney wallpaper. They kept me around a few days to make sure I would be able to breathe on my own without oxygen, and then discharged me. It is a similar feeling to getting released from jail.

The results were good. I had gone from 30 percent breathing capacity to 70 percent. The doctor said we could try and go for more or just hold steady at 70 percent and see how I felt. I elected to just hold steady. I had been through hell and wanted a break from hospitals and surgical procedures. No more trips down the rabbit hole for me. I needed to get on with the life which I had come so dangerously close to losing.