Awake At Last
I came awake briefly in the Cardiovascular Intensive Care Unit at Kaiser Permanente's surgical center in Moanalua Valley on Oahu, swimming up through the depths of anesthesia, to the vision of my brother Gene hovering over me, tears of relief and joy streaming down his face. I awakened again ten hours later to the sight of my brother Jerome, again a face filled with tears.
Thus began my recovery from open-heart surgery to replace a failing aortic valve and counter the lifelong effects of what my cardiologist diagnosed as a severe aortic stenosis. A very narrow and grossly deformed aortic valve made my heart sound like a slush pump on overdrive; it was killing me slowly with its song.
What in the '50s was simply referred to as a heart murmurwith no treatment protocolis now diagnosed as a stenosis (narrowing) of the aortic valve. The "murmur" is the sound of blood gurgling through the narrow valve as the heart works overtime to feed blood to the body, with a portion being regurgitated back into the left ventricle with each beat. My condition was a congenital defect, something I've been living with since birth. The only remedy is open heart surgery to replace the valve.
Fortunately, I've lived a life filled with yoga and music for the past 26 years, and was able to put off surgery until the 21st Century. Science and allopathic medicine have made monumental advances in the past 20 years, saving countless livesincluding, thankfully, mine.
I came to Maui for a two-week vacation in August of 1974. I was immediately under Maui's magical thrall. So far, the vacation has continued for more than 1,500 weeks. Maui has always had a deep attraction for those of us who march to a different drummer.
Having been a gymnast in my childhood, I took an immediate liking to Satchidananda-style Hatha Yoga in 1977. Initiated into the wonders of Ashtanga Yoga by David Williams and Nancy Gilgoff in late 1978, I have practiced faithfully ever since, 4-6 days weekly, living the type of vegetarian yoga lifestyle that could only have happened on Maui. In the 1970s, Ashtanga Yoga practitioners were considered to be radical, even insane, to be committed to such a rigorous daily practice. Now, in a global society which embraces "extreme" sports, thousands worldwide are attracted to Ashtanga Yoga; it demands much of one's mind, body and spirit yet returns great joy and satisfaction.
Fitness buffs who come to Ashtanga looking for a new workout are often surprised when it turns out to be something more than the next great "burn." Asana is the third of Ashtanga Yoga's eight limbs. On a subconscious level, through Asana and unrelenting attention to Ujjayi Pranayama, Mulabandha and Uddiyanabandha, students begin deeper work in the search for union with the higher Self (Paratma).
To my everlasting good fortune, Maui is a popular destination for many people, including the very best Ashtanga Yoga teachers in the worldincredibly gifted and dedicated yogis who return time and again to the island to teach and to experience the wonders of what is consistently rated as the best vacation island in the world.
I've been privileged to study with the founder and master of Ashtanga Yoga, Shri K. Pattabhi Jois (whom we lovingly call Guruji), on five separate occasions right here on Maui: the first in 1980, six days weekly for two months; and most recentlywith my new mechanical valve ticking away like the alligator who swallowed the clock in Peter PanGuruji's September visit to Maui on his 2002 Ashtanga Yoga World Tour. In eternal gratitude and humility, I bow to his lotus feet.
I've also been blessed to study with Tim Miller (who calls me Laghuvajralittle thunderbolt), David Swenson, Richard Freeman, Danny Paradise, Eddie Modestini and Nicki Doane, Tias Little, David Life (co-founder of Jivamukti Yoga Center in NYC), Sarah Powers, Johnny Smith, Kathy Cooper, Helena Berg, Dennis Dean, Lino Miele and Edward Clarke of London's Tripsichore Yoga Dance Theatre. And, of course, my dearest sister and brother in yoga for two-and-a-half decades, Nancy Gilgoff and David Williams. Om Shanti, Shanti.
All the best intentions, the dedication to practice, the lifestyle changes, however, mean very little in the face of imminent death due to failure of a small part of the body. All the yoga in the world cannot cure a congenitally defective heart valve. Yoga practice did, however, keep me strong, centered and focused for long enough.
Two years ago, at age 57, I finally accepted that it was time for surgery. I focused on dealing with my fears, including the distinct possibility of not surviving; making my will; submitting to a battery of laboratory tests and diagnostic imaging; and ultimately, arriving at an understanding of concepts that had eluded me my entire life: bravery, courage, faith.
The cardiothoracic surgical team at Kaiser's Moanalua Hospital in Honolulu is headed by Dr. Francis Duhaylongsod. He and his inspired surgical team took responsibility for my well-being, as they do each and every day for countless others. With kindness, caring and consummate professionalism, they gave me new life.
We jointly embarked on an adventure that had unforeseen twists and turns. It was ultimately necessary, after successful valve replacement, to reenter my body twice more that same day to replace failing coronary arteries and to repair leaks. I suffered a stroke and a seizure while unconscious on the operating table. Surgery lasted more than eleven hours. I was comatose for four days. My dear brothers and my extended yoga family on Maui were on an emotional roller coaster. But I survived.
While I lay on the operating table, the left side of my body totally flaccid from the stroke, the right side thrashing about endlessly in the grip of an intense seizure, the surgeon called my brother Gene in to see me. The situation was grave, the outcome unknown. They wanted Gene to see me one last time in the event I did not survive. The surgeon told him that if I did survive, I could very well not walk for at least a year, and that I would probably spend several months in the stroke rehabilitation facility at the Kaiser hospital.
Now, twenty-four months after surgery, my heart is stronger than ever. A mechanical valvea tiny wonder of modern sciencekeeps me alive one heartbeat at a time. What once was a gurgling rumble is now a strong and well-defined "on-off" action. My skin is no longer greenish-gray, the darkness around my eyes has disappeared, my energy is that of a much younger, healthier person. Each day I awaken to the blessings of precious gifts all too easily taken for granted: a deep breath, a new life. And I am awestruck. And so, so grateful.
From the moment of my first awakening in the Intensive Care Unit, even with no use of my entire left side, I told my doctors, nurses, therapistsanyone who would listenabout Ashtanga Yoga and how my decades of practice had prepared me for this moment: survival and recuperation to a full and vibrant life. As soon as my cardiologist assured me my sternum was healed (about two months after surgery), I returned to my yoga mat at House of Yoga & Zen and Nancy Gligoff's gentle touch to re-create my practice.
Yoga is, indeed, a metaphor for one's life. So I began life anew, unfettered by the desire and ambition that had earlier plagued my practice. Like a baby yearning to walk, I crawled my way through Suryanamaskara (Salutation to the Sun). Lingering effects of the stroke and seizure presented additional challenges: I lost my balance in Tadasana (Mountain Pose), I tottered in Trikonasana (Triangle Pose), and I fell down in Virabhadrasana (Warrior Pose). I got up again and again, focusing each time on the journey and not the destination.
The medical staff at Kaiser's Moanalua Surgical Center on Oahu and at the Kaiser Clinic on Maui have witnessed for themselves over the past two years my rate and level of recovery. They are, to say the least, quite impressedso much so that in June 2001 they invited me to return to the hospital, this time to conduct an Ashtanga Yoga demonstration clinic for the Cardio-Thoracic Rehabilitation group. And in the light of undeniable evidence, my personal care physician wrote a continuing prescription for yoga as my mode of physical therapy. This, to me, represents a major shift toward the new paradigm that, more and more, recognizes other health treatment modalities, especially those arising in the East.
The Ashtanga Yoga Primary Series is called Yoga Chikitsa (Yoga Therapy). Now I practice 5 to 6 days weekly, reveling in each newly learned deep breath, healing a violated body and seeking/accepting an elusive equanimity of mind-body-spirit. I recently began adding Second Series (Nadi Shodana) once a week or so, and even a few Third Series poses. Each day of Ashtanga practice adds more pieces to the puzzle that is Primary Series. My breath deepens, my mind calms, my body heals, my spirit soars.
With each new accomplishment, however minor, great joy wells up within me. And I am happy. Contentment comes easily to me. I am a far more gentle and understanding being. And I hear in my deepest heart Guruji's implacable admonishment: "Do your practice and all is coming!"
© 2003 Jack Fisher
See also this collection of clips from the House of Yoga & Zen in Haiku, Maui. Video features David Williams, Nancy Gilgoff and more! Jack Fisher: Ashtanga Yoga Study and Practice, House of Yoga & Zen (2008).