The Night I Almost Died

By LAURA SKANDERA TROMBLEY

Chronicle of Higher Education POV, from the issue dated August 15, 2008

As soon as I sat down, I felt a peculiar tightness in my chest. I instantly rationalized the sensation: My shirt was tight; it was a Friday; I was tired.

I had been looking forward to this special evening. A faculty couple at Pitzer College, where I am president, was holding a small dinner to celebrate a substantial gift that had been given in honor of an emerita professor. As I made small talk and snacked on cheese, I felt the tightness gather into a sharp point on the right side of my chest, just below my rib cage. “Gas,” my internal voice calmly explained. My host, noting that that night marked the beginning of spring break, joked that after 20 years of teaching, his immune system knew just when to fail so he would not miss any classes. Laughing in agreement, I realized I could not take a deep breath.

The other guests arrived, and we sat down at the dinner table. While I was eating, I felt the pain spread to my back. Sneaking looks at my husband, I tried to tell him in the wordless language couples use that we needed to depart. Since we had never practiced the secret “I think I am having a major health issue and we have to leave immediately” glance, he brightly smiled at me in return and asked our hostess for a second serving of the entree.

Just before dessert, my right arm went numb. I excused myself and found the bathroom. Staring into the mirror, I tried to determine if I, in my mid-40s, was having a heart attack. I’m not sure what I expected to see: crazy hair and a pale face? Outwardly I looked the same. My rational voice assured me that I couldn’t possibly be in danger. Why? Because five years before, when I was interviewing as a candidate, one of the dinners was held at this same residence. “You cannot die here,” the voice patiently explained. “It would simply be too ironic.” (I should disclose that I am also an English professor.)

Irony aside, I was starting to panic. We waved our goodbyes, and as soon as the front door closed, I turned to my spouse and hissed: “We have to go to the hospital. I think I’m having a heart attack.”

On our way there, my incredulous husband kept asking why I had sat through the dinner without telling him. Gasping, I tried to explain: because I did not want people to know I didn’t feel well, because I did not want to interrupt the party, because I did not want to appear foolish if nothing was wrong, because I did not want to appear weak, because I did not want to admit there was a problem. While such explanations appeared thin to him, and even to me, in retrospect, I was trying to identify what I then saw as a real concern.

Five minutes later, tires screeching, we parked. Hunched over, feeling as though my chest was caught within iron pliers, I was ushered into emergency treatment. The good news was that my heart was fine. Three hours, a painkilling hypodermic, and a CAT scan later, the physician on duty emotionlessly informed me that I had pulmonary emboli in both lungs, with the larger clot on the right side, and that I could die.

I tried to explain that I was not supposed to be at the hospital, because I had made plans to take my 11-year-old son and his friend on an outing the next day. She was unimpressed. I kept saying my husband’s name, Nelson, as though that would somehow make things better. It then struck me that the doctor was taking a long time to get to the problem-solving part of her talk. I finally asked what would be done and was told I would receive immediate treatment and be admitted. She left, and the next person who stopped by my gurney was a hospital staff member who politely inquired whether I was an organ donor. Words failed me. After a few seconds, my shocked husband responded that I was not that night.

Faced with the prospect of my impending mortality, I switched to automatic pilot and began to administrate. Around 4 a.m., I called the dean of the faculty and, in accordance with our emergency-succession plan, appointed him acting president. Also in keeping with that plan, the dean called an administrative cabinet meeting on Sunday, at which the vice presidents came together and discussed what needed to occur so that college operations would continue without interruption.

Left behind in the hospital, I drafted an announcement for the board chair to send to the Pitzer community designating the dean as acting president. The dean arrived, and we had a brief conversation. I gave him the draft and assured him I was fine.

I was following a process that had been put in place years earlier by the board: Every fall the trustees designate an interim president in case of an emergency. As a result, once I was informed about my dire condition, there was no lag time, no questioning, no filling in the blanks. I knew, as did the trustees and members of my cabinet, what to do. Frankly, had I dwelt on the thought that I might never see my child again, all my carefully piled little blocks denoting rational thought would have tumbled down, and I would have plunged into a terrible abyss. In retrospect, I acted the way I did because it was the only way I could remain functional. Better to think about managing the college.

Fortunately, the treatment was successful. After five days in the hospital, at the end of the spring break, I returned home. My recovery was uneventful, and I soon returned to work. As the weeks and months went by, I found that when I was taking my dog on our early-morning walk, I would often unexpectedly be overcome by emotion. I was just so glad, so deeply grateful to still be here. More than a year later, people have largely stopped asking me about my health, and I no longer feel as though I have to reassure everyone that I am über-fit.

But from the beginning, I saw the need to communicate. Two days after the board chair e-mailed faculty and staff members, students, alumni, and parents, telling them that I was in the hospital, I sent my own message. There were a few good reasons for doing so. First, we live in a tightly knit community and, despite the initial e-mail message, there were already rumors about my illness. (I had breast cancer, a heart attack; one student thought I was pregnant.) Second, I wanted women to know that my emergency had been caused by a bad reaction to estrogen, and that the medication was not without risk. Most important, my family and I had been deeply moved by the kind support we’d received, and I wanted people to know how much it was appreciated. To lighten the message, for myself as well as the community, as a Mark Twain scholar, I could not resist ending with his famous quotation: “The reports of my death are greatly exaggerated.”

My decision to publicly disclose my situation was a personal one. Word would get out anyway, and I wanted my message disclosing the details about my illness to be educational for other women who might be considering taking estrogen. The fact that I had been president of Pitzer for five years also had a lot to do with my comfort level in my disclosure.

My openness is atypical in higher education, however. In off-the-record conversations with other presidents over the years, they have told me about their heart attacks, cancers, and any number of other human afflictions. All those situations were kept secret, or so they hoped, because of worries that, if found out, they would result in a perceived lessening of their status as presidents. Those of us who hold the office realize that in significant and meaningful ways, ours is a symbolic position, and what we want to convey to our constituencies is strength.

The basic question is, When is it all right for presidents to feel comfortable with sharing that we are human?

As a person trained in risk management, I always try to assess situations. I encourage presidents to proactively think about what their comfort level is and to share those thoughts with their administrative group, so they do not have to make difficult decisions while a crisis is unfolding. When I was in the hospital and first given the diagnosis, I was unable to grasp its implications. I kept trying to figure out how to manage it, to contain it, to outmaneuver it. I asked my husband to print information off the Web so I could figure things out. Other than learning the decidedly grim statistics, I found it unhelpful.

It was not until my last night in the hospital, when a newly assigned nurse read my chart, that I fully grasped what had happened. Her comment was simple: “I’ve heard of people like you, but I haven’t met many. Most of them don’t make it upstairs. You’ve been given a gift.”

I still think about what she said. After turning it over and over in my mind, I have come to believe that perhaps the “gift” is a better understanding of the human condition. Asking for help at the appropriate time is not an admission of weakness but, rather, an indication of one’s own strength, and a recognition of the healing power of the collective.

Laura Skandera Trombley is president of Pitzer College.

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Section: Commentary
Volume 54, Issue 49, Page A64
http://chronicle.com/weekly/v54/i49/49a06401.htm