I'm Not Dead... Yet! (57 page)

Then it hit me: I’m getting old(er). I still
think
young, and although my birth year may be the oldest in the room, it doesn’t mean I have to ‘act’ old. I may still foolishly pick my head up when someone says, ‘Hey, kid—come here,’ and then realize it gave me a crick in my neck, but acknowledging and embracing my age does not mean buying a walker; it means that I should never stop walking. Or
trying.

I didn’t need carbon 14 testing to know my age; I didn’t need a birth certificate. I felt young, but there seemed to be a direct correlation (in my life) that everything—
everything
affects my heart in one way or another; more benignly to more intensely—but it all affects the heart. From feeling acute compassion for a tragedy-stricken stranger in a news program, to seeing Karla cry in private when she lost her aunt. The physiognomy-rings around my personal tree trunk, my age-features have nothing to do with my maturation signature, which comes from my ‘heart.’

I still did stupid, dumb, young things.

One day in March 2010, while running on a treadmill, I decided I would run a sub 6-minute mile. This was an act of foolhardiness from a ‘now-jogger’ who runs a 7-minute mile for exercise; I should have known better. In my teens I used to work intervals so that my fast-twitch muscles could eventually handle (after weeks, maybe months) taking 10 seconds off my base-line mileage time.

But now, thirty-five to forty years later,
what
in my brain tells me I can run a full minute faster than I’ve been training at for over a year? Maturity? No. Hope? Maybe. Magic? Hopefully. A memory of what running without effort
used
to feel like? Yes—a frantic search for that fleeting memory.

Every step I took had an effect on my heart. I came to understand that frustration; love; food; a blow to the head; every chemical I must swallow in pill form; every sentence and how I design my words; every feeling my wife feels; every pain my son has; every hope my daughter dreams; every day that my mom and dad get older; every single day that I don’t see my sister… everything has a consequence on the heart. Many times it’s a very abusive punishment—pummeling, drubbing, chastising—everything has an effect on the heart. But sometimes it can be a soothing love—or passion, sympathy, productivity, relaxation, effectiveness, moderation—Moderation? What’s that? Then I realized:

I take everything ‘to heart.’

It’s fascinating how many words we use everyday that are associated with the destruction of the heart. From heartache, heartbreak, and of course, heart attack to heartworm. Sometimes we ‘wear our heart on our sleeve’ and sometimes we do something ‘after one’s heart.’ Sometimes we let things ‘go to one’s heart’ and sometimes we have a ‘heavy heart.’ I tend to do everything with ‘all of my heart’ and with ‘heart and soul.’ But no matter what anyone says, we are never: ‘heartless’!

Inside my King of the Gypsy-like body,
my ascending aorta was swollen to the point of needing repair, my aortic valve needed replacing, and there was significant stenosis on the pulmonic valve.This according to the results of tests that came back on April 17, 2010. My symptoms were more obvious now than ever before. I knew I was once again in serious trouble.

Thoracic Aneurysm

I wanted more time, more life with my wife, best friend, and my partner in this world that we know. I wanted to fight for more time with my children; even if they were off in their own worlds, I wanted to be alive to know that they were now independent and striving for happiness.

At NYU, I was learning how to teach without a single student or faculty member catching me gasp for air. Here were my plans: get to school before anyone else; pick strategic moments to turn my back and write something on the white-board or look for a non-existent piece of paper so no student or faculty member could see my fight: ‘tonight’s card’: Me vs. Heart Failure.

I had finally come to terms with mortality. Even if they fixed my heart, I believed I was going to die soon. In the time I have left could I tell the people I love, in plain words, without frightening them, that I loved nothing more than being their husband, their father, their brother, their son? Why is this so difficult for me? Why am I such a non-evolved human being? Why? I must change that! Now. In the
present
.

The quest for the great doctors
and surgeon and hospital continued. Karla and I did our homework (again) and found great doctors and surgeons in New York. I was given a recommendation to go see Bill Clinton’s cardiologist.

But over the last 16 years I had been told many, many times, that ‘for the best cardiac care, The Cleveland Clinic is the place to go.’ Cleveland? Cleveland over New York? New York with surgeons who operate on Presidents? Cleveland over Los Angeles and the ‘cardiologist to the stars?’ Cleveland? Isn’t that the best joke in
Tootsie,
when the director asks the cameraman how far back can he zoom
out
because the shot is on (the comparatively unattractive Dustin Hoffman in drag) Tootsie, and the cameraman responds, “How’s Cleveland?” Isn’t Cleveland where the lake started on fire? Didn’t LeBron James run away from Cleveland?

Our dear friend Steve Popovich was one of the greatest music executives of all time. He created Cleveland International Records and signed the iconic songwriter Jim Steinman and his partner Meat Loaf when no one else would touch
Bat Out Of Hell.
(Sales to date: 44 million... and counting.)

Steve had heart issues, and because of the kind of man he is, Steve did thorough homework and came to the conclusion that the best place for cardiac care was in his own back yard:
The Cleveland Clinic
.

I met with a famous New York cardiologist who was very nice… incredibly competent (an understatement), yet there was another issue with me: New York City was not the place I wanted to awaken after my
fourth
open-heart surgery. I love New York, but if I were to wake up from surgery hearing curse words, people yelling and cabbies honking their horns endlessly in complete futility—well it was not my idea of a healing environment.

Steve Popovich gave us his cardiologist Mike Koch’s phone number and said he was awaiting our call. I had a meeting with the President’s cardiologist in less than 10 days. Who in their right mind would cancel that meeting and go to Cleveland? Dr. Koch walked us through his recommendations and told us Dr. Brian Griffin at The Cleveland Clinic was an outstanding cardiologist. I wanted to speak to him on the phone. Would he agree to do that? Would he have the time?

Part of the mindset at The Cleveland Clinic is, ‘We’ll find the time. And if we can’t find the time, we’ll make the time.’ Not just for me—
for everybody
. Now, finally—my kind of place! The words: ‘for everybody’ really meant something very special to me. This was a place where your name or your celebrity didn’t matter. Your illness mattered. Bravo!

The name of one surgeon kept popping up in every conversation about the Cleveland Clinic: Gosta Pettersson, M.D., Ph.D.

People spoke about this man in terms of the miracles he had performed. Some surgeons take cases that make their ‘batting average’ 1.000 percent. No fatalities. Dr. Pettersson takes cases to
save people’s lives
.
He takes the cases
other surgeons wouldn’t touch
.

I also kept hearing about how The Cleveland Clinic handles their patients and the patient’s
family
—‘the patient and the family come first at The Cleveland Clinic.’

Where is this place? Disneyland? Oz? Wait—did you say… ‘Cleveland?’

I learned that this attitude came straight from the top. Delos M. ‘Toby’ Cosgrove, M.D.,
is the chief executive officer and chairman of the Board of Governors of The Cleveland Clinic, and I read an article by Ceci Connolly in
The Washington Post
about him. In big headlines:

Head of Cleveland Clinic Is Attacking Big Mac

And in Hospital Lobby, McDonald's Fights Back

Read the Washington Post article

“A heart surgeon who has cleaned out a career's worth of clogged arteries, Cosgrove didn't think Big Macs, supersize fries and inch-thick, six-cheese pizzas belonged in the lobby of a hospital renowned for its cardiac care. So he decreed the fast-food joints had to go.”

I also heard that the head of The Cleveland Clinic was openly against smoking. This is an area that hits close to home.

As an actor, I made a decision to never use a cigarette as a prop. It’s a great prop, too. It gives the actor ‘history’ from the second he or she walks into the room. A cigarette tells us something about the character before the first line is spoken. But, not for me. I’m not ‘squeaky clean’—I just don’t want to inhale hot, fiery smoke into my lungs that’s addictive. And I certainly wouldn’t want an audience member doing it because I did it in a film. Nope—just not for me.

I’ll get off my soapbox with these overwhelming statistics from the American Heart Association: In the United States, an estimated 24.8 million men (23.1 percent) and 21.1 million women (18.3 percent) are smokers.
These people are at higher risk of heart attack and stroke:

Among whites, 23.5 percent of men and 20.6 percent of women smoke (2008).

Among blacks, 25.6 percent of men and 17.8 percent of women smoke.

Among Native Americans, 24.3 percent of Native American adults smoke.

Among Hispanics, 20.7 percent of men and 10.7 percent of women smoke.

9.9 percent of Asian adults smoke.

WHY SMOKE? WHY?

No employee of any kind may smoke on the grounds of the Cleveland Clinic. (And the Cleveland Clinic takes up an entire zip code.)

I had never missed a day of work in my life
and now I would be missing two classes in both courses I was teaching. There was a strange sense of shame in that; I felt I was letting my students down. I still oversaw everything that happened in those two classes—and I desperately wanted to be there—but I physically had finally had all my body could take.

Chair Sanders, Dean Campbell and my students were amazing and helped me get through this very difficult time. And so did the internet. Every chance I had, I was online trying to help my students in any way I could, until typing became problematic. (Once a marathoner and now, no endurance and too tired to type… Humility: the great equalizer; always magnifying my shortcomings. Death isn’t as demanding—I guess it needn’t be. Life is demanding.)

After discussing Dr. Cosgrove and his views on healthcare, Dr. Pettersson’s abilities and his goal to take on extremely difficult cases, and Dr. Griffin’s expertise and willingness to always talk to us and help us understand the gray areas, The Cleveland Clinic—and everything we were learning about it—seemed like an extraordinary hospital. We also learned that they were ranked #1 in cardiac care in the United States by
U.S. News and World Report
for sixteen years. There became little doubt in my New York/L.A. mind that The Cleveland Clinic was the place for me. But still—the cardiologist who worked on Bill Clinton? Come on, that’s got to be a no-brainer. And I knew my mother would be… happy. (I mean, whose mom wouldn’t want their son to have Bill Clinton’s cardiologist?)

Finally, I decided I’d listen to my own heart. Forget all this baloney. I’m going to
Cleveland!

We immediately got on a plane
,
flew to Cleveland and the most remarkable thing happened. Our adventure with the Cleveland Clinic
began at the airport
. There was a very extraordinary man, Mustapha Bounit, who had emigrated to America from Morocco—waiting at the airport to pick us up and take us to the hotel. A hotel that is literally ‘connected’ to the hospital. Mustapha would not allow me to lift my luggage. I asked him why. “Because,” he said, “you need heart surgery. You cannot put more strain on the heart by lifting this luggage. I cannot allow you to hurt yourself.” (Huh?) I looked at Karla and wondered if the slogan (a dictum that would cause the most cynical patient to provide an instinctive smirk) ‘The patient and the family come first’—were
not
empty words. Could this motto actually begin with this compassionate man, Mustapha, at the Cleveland Airport?

I expected and hoped for… ‘wonderful things’… but was this some kind of joke? Was someone going overboard because they liked me in a film? My mind was so small and slightly pessimistic that I kept thinking, it must be because he liked one of my movies or wanted an autograph. But then again, I am a bit of a has-been. Does he know this—or have my films taken this long to make it to Morocco? Then when we were in the car and I asked him what the photo album on the floor of the backseat was, he said I could look at it. The photo album was filled with six years of pictures; pictures of Mustapha posing with different patients, as they came to the hospital and as they were leaving to go home, always with a very proud Mustapha in the photo, smiling as if this may be the most important photo ever taken.

“So, who are these people?” I asked.

Mustapha became passionately animated as we drove toward Cleveland. He genuinely explained, ‘They are patients who come here and are very sick. It is important that I remember this from the second they get off the airplane. The journey was probably very tiring for them in their condition.”

He drove so safely yet at the same time was filled with excitement and energy. ‘These people in the pictures, these patients are very vulnerable people who come to the Cleveland Clinic and they are extremely sick. The wives or husbands—sometimes they must come along—everyone is afraid. They are frightened because they don’t know how the surgery or treatment will affect them. So, I
must
take very good care of them. They need help immediately. They don’t come from Cleveland. They may come from anywhere in the world. I must make them feel safe and feel at home right away in this new city. It is like with you and your wife. You are sick and that is scary for your wife. I don’t want you to be scared. I want you to feel like everything will turn out right and it does here! I see miracles. Every day!”

Let me emphasize—this stranger was our
driver
. After 5 minutes, he was no longer ‘our driver’—Mustapha was our
friend
. A friend who was reassuring us that everything will be okay. He had no idea that I had ever been in a film, and he certainly didn’t want my autograph. He was going to make sure that we got from the airport to the hotel without incident and he believed it was his job that we feel better when we arrived at the hotel.

Mustapha told us he came to this country in 2000. He scrubbed floors, cleaned toilets. He saved up enough money so that he could fulfill a need that he perceived to be valuable to the patients and the families who came to the Cleveland Clinic: someone to reassure them and help them from the moment they got off the plane.

Mustapha did not speak English in the year 2000. But, by taping
Judge Judy
and watching it instead of sleeping after moonlighting on sometimes four different jobs at once, he learned English, little by little. (His English is flawless.) I was so fascinated with a trait that I admire so much in people, ‘hope’ and the willingness to
try
with every ounce of energy, that I asked him what his goal in life was. His answer was so pure.

“I want an office in The Cleveland Clinic. It can be a broom closet. I don’t care. I want to help people from the moment they get off the plane. If their families need to see a movie or get a carton of milk, I want to get it for them or drive them to a place where they may need to think or be away from the hospital—and then when everyone is healed and feeling better, I want to help them get back to their home.”

I wished I was making a film—I wanted to hire this man. He would be invaluable to any film—in any department! But then I thought, this is unique. Mustapha is that rare man everyone hopes they will meet and become friends with; this cannot be ‘the way of the Cleveland Clinic’. That would be… silly.

Silly. I was in for the shock of my life.
Everyone I met that day,
from the bellhop to the person who checked us in at the front desk of the hotel, to the waiter in the restaurant in the hotel that was connected to The Cleveland Clinic’s mantra; (how could this be?) they were all compassionate! This was an exceptional environment—a place, a feeling I had never felt before. I kept waiting for the ‘pie in the face.’ Aha! The TV in the hotel room wasn’t working.

“Hi, I’m here to fix the TV. We’re changing some of the cables. It will only take a second. Is now a good time?”

“Um…” I reached into my pocket for a tip as the gentleman was leaving.

“Oh, no sir. That’s unnecessary. I just want your TV to work. Have a wonderful evening.”

He left me with a few dollars in my hand that I could’ve stuffed into my open mouth.

The next morning I was to begin with meetings and tests with doctors and X-ray machines, etc. Same ol’, same ol’. Our problem was, The Cleveland Clinic is a very large place. How early should we leave? How do we get a map so we’ll know where to go? (I was so exhausted, I could barely think, but the director in me wanted to be prepared.) The phone rang. Karla answered the phone.

On the other end of the phone was a woman named Francine Pate. When I knew we would be coming to The Cleveland Clinic, I was very nervous about the travel, the bigness of it all and to be honest, getting lost in the shuffle—and I didn’t want Karla to have to do endless amounts of work to find offices, blood labs, etc. I asked if there was someone I should speak to from the Cleveland Clinic and I was put in touch with Francine. Francine held the title of: Manager, Executive Patient Services.

The hospital had so many people flying into Cleveland from around the world, they needed people with diverse skills to help the patients in many ways; some as difficult as getting a schedule together of when the MRI would be, and when the meeting with the Cardiologist would be, and how to get from one to the other, and if there was enough time to get from one to another, and would the patient who had to fast for the blood test be hungry after giving blood, and is there enough time to get from the lab to the restaurant to the doctor’s office. This kind of planning on a film is critical—it is not easy or simple—not when you’re dealing with sick people. At this hospital, we filmmakers should take lessons from Francine and her staff.

Francine told Karla to meet us down on the 3rd floor, right at the elevator and she would help us from there. And “don’t forget to tell Robby not to eat anything after 10:00 o’clock.”

Francine helped us all day (leaving us to help other patients—then all of a sudden, she was back. Who knows how many people she helped that day?) But Francine refused to be just ‘a guide’ or a person to make sure we weren’t late for appointments. Francine…
cared
. It happened effortlessly, but Karla and I immediately trusted Francine. She just became… a
friend
.

We listened to all of the doctors we met with, asked all of the questions that were on our minds, and the doctors took the time to answer the questions. If we didn’t understand, they were not annoyed or constantly checking their watches, they would keep explaining any and all things until we felt secure and understood everything they were explaining to us.

I asked Francine one day if she could sum up what she thought her job description was at The Cleveland Clinic.

“How do I describe what I do? Actually, it is quite simple. I treat the patient as I would want myself or a family member to be treated. In other words, respectfully and with genuine care. I respond promptly to questions, concerns or areas of concern. I am a small part of a wonderful Clinic team where
details
are so important; my goal is to assist in
any
manner—to reduce the stress of coming to a large facility for serious medical conditions and who knows, maybe for complicated surgeries. The payback for me is in seeing the miracles that are performed every day by our outstanding surgeons, giving hope where there was no hope and curing so many. The other benefit for me is meeting new and wonderful people and (in many cases) forming wonderful friendships. Does this help? Did I answer your question?”

I looked at Karla in awe. My response was to get a giant bullhorn. I wanted to stand on a cartoon mountain so that
everyone in the entire universe could hear me.
As a patient who has been pummeled by the system and by endless medical procedures, all I was encountering were experts who wanted to make those very specific incidents in my life a thing of the past; and they wanted me to start with a clean slate and show me how it really should be done.

Of course—I was sick, a bit scared (though I was now a true veteran) and very vulnerable; as I’ve been many times in the past. I could have a life-ending experience in front of me and we all knew that. Just like in the past. But no one was being secretive, patronizing or aloof—I was meeting people who were at the top of their game. Even the people who take blood have a nickname (the best were called the SWAT Team) because no matter what condition your veins are in, they not only find ways to take your blood—an ‘event’ I’m an expert at—without the patient
feeling
any pain. That was their goal!

When I would be waiting to see someone, I would be asked if I was willing to fill out a form that had to do with ‘How long was your wait?’ or ‘Were you treated respectfully?’ As I was trying to fill out the first questionnaire, my number was called. This place cannot be as good as I’m experiencing; there must be horror stories—it’s a hospital. I haven’t even had my surgery yet. I’m not some dimwitted convert ready to drink the Kool-Aid.

We met with my cardiologist, Dr. Brian Griffin, and his staff (the nurses and the administrative people who all had the same attitude: ‘How can we help?’). I am still amazed to such an extent that even writing about our experiences, I keep trying to find times where things went wrong so it’s more dynamic to read—to write. (Nothing so far.)