Hektoen International

A Journal of Medical Humanities

Coronary heart disease

Matko Marusic
Translated by Dalibora Behmen


Heart attack

One night, Ivo felt a strong pressure in his chest. It was followed by fear and panic. He knew at once what had caused this catastrophe, and spoke of it dispassionately and with the technical precision of an engineer who is sick. The cause was the choke in his wife’s new car.

A momentary wave of tenderness combined at the time with an unexpected success in business (a settlement of an old debt he had already dismissed from his mind) had caused him to buy a car for his wife. It was a nice, economical Italian car, of a lovely color, just right for the city. He was told to be extra careful not to pull the choke too hard, because Italian cars were known to have badly constructed chokes that could easily be ripped out.

“Careful with the choke!” he warned his wife while she was still admiring the gift “It gets ripped out easily. If you rip it out, don’t come running to me!

The wife was surprised. How on earth would such a gentle and fragile woman as she rip out the choke? Women don’t rip out chokes!

“Promise to be careful and not to rip out the choke!”

She promised, sincerely and solemnly. The following morning she sat in the car, pulled on the choke, and immediately ripped it out. She felt a surge of panic: “I am a dead woman when Ivo finds out. What sort of second-rate choke is this? I cannot believe it actually got ripped out! What am I supposed to do now? I can’t face Ivo.” She decided to put the choke in her purse, lock the car, and take a taxi to work.

There were only women working in her office. Calling Ivo at work was not an option; and the car could not be started so she could not take it to a repair shop. At last, she decided to do the inevitable—face Ivo and confess. Why in the world would he have bought her that stupid car in the first place?

Ivo was already home, looking nervous, suspicious and upset.

“Why didn’t you take your car to work?”

“You don’t want to know! You’re going to kill me!”‘

“You ripped out the choke.”

“I ripped out the choke.”

“On the first day, the first hour, the first drive!” Ivo moaned, slightly green in the face already. Then he took a deep breath and gasped, “Where is the choke? Give it to me, I will go to fix it.”

She opened her purse for Ivo to take out the choke. That’s when he really freaked out. There it was, in her purse—the car cigarette lighter.

During the whole afternoon Ivo was gloomy. In the evening he was silent. In the middle of the night his wife could hear him pace around the house. He admitted he felt poorly. Being an avid reader, listener, and above all knowing all things medical, she promptly diagnosed an imminent myocardial infarction and took him to the emergency room. From there he was transferred to cardiology.


The hospital

On the following day she came to visit him. She was deeply worried, entirely focused on her husband’s condition.

“I brought you a pair of pyjamas and slippers,” she said, smiling like a good wife who never forgets the little things that matter.

Ivo’s response was unexpected, “Put the slippers under the bed, but I don’t want the pyjamas.”

“What do you mean you don’t want the pyjamas?” His wife was shocked, “They are brand new, just look how beautiful they are . . . I didn’t even care how much they cost. Now that you are ill, I care about such things even less . . .”

“I like the ones I have on,” Ivo said coldly.

“They’re dreadful! They are cheap, flannel, patched, and look like they are from socialist times. You are not just anybody, you are a respected member of the community, and you cannot walk around the hospital in hospital pyjamas!”

“These are by far the best pyjamas I have ever worn! Soft, warm, not at all slippery . . .”

“What do you mean slippery?”

“You buy me those silky ones . . .”

“Well of course, what others would I buy? Silk pyjamas are the best, the most expensive. All decent people wear silk pyjamas . . .”

“I hate silk pyjamas. They are slippery and if you are not careful you will find yourself on the floor in no time! When you brought me those yellow pyjamas from Italy, I had to put a carpet under myself so I wouldn’t slide out of bed!”

“Please, put on the pyjamas!”

“No! I will slide out of bed all the way to X-ray room, and if I hit the X-ray machine I will surely break it!”

“I beg you! The hospital director will be coming any time, and you can’t meet him in these pyjamas. He’s a member of your party . . .”

“I can’t wait for him to come!” Ivo was unyielding, “I will ask to buy these pyjamas from him so I can take them home. Whatever the cost. Or I will ask him to trade these hospital pyjamas for your silk ones. But it all has to be official, with a contract. Our party only operates with written documents.”

After hearing this horrible threat, Ivo’s wife put the silk pyjamas away and prepared for a dramatic exit, but was intercepted by the hospital director. She immediately began to complain about Ivo’s attitude towards pyjamas, but found herself interrupted by the director, who said that washed out hospital pyjamas were indeed the best. In fact, he had taken, one could almost say he had stolen, two pairs for his own use at home. He had tried to pay for them, but the accounting department said they had been depreciated six years ago and there was nothing they could charge him for.

“They are almost gone,” the director said in a business-like manner. “Washing machines tear them up and they became a rarity. We save them for special patients. Ordinary people bring their own pyjamas.”

On the third day of Ivo’s hospital stay, his wife called me to complain that Ivo had been refusing the home-cooked food she had brought for him.

“Hospital food is tasteless, unsalted, unseasoned, and unhealthy. I brought him home-cooked food and he gave it all away to other patients, got upset, and forbade me to bring any more home-cooked food to the hospital. And I had brought him a light, creamy, delicious Dalmatian chicken stew.”

“What is a Dalmatian chicken stew?” I asked inanely. She didn’t get frustrated with me and patiently explained. It’s basically a regular chicken stew, only prepared in a much more complicated way.

“He could have at least tasted it . . .” I acknowledged.

“He didn’t want to. I found him eating that dreadful hospital chicken, with skin, neither cooked nor roasted . . . He said that chicken stew gives him heartburn and that the hospital chicken is excellent, doesn’t give him heartburn, and makes him sleep like a baby.”

“It could be just that the chicken stew doesn’t agree with him. It doesn’t matter, what is important is that he is recovering.”

“We’ve been married for thirty years and now he tells me that my stew doesn’t agree with him! And before we know he’ll start ordering food from the hospital when he comes home.”

“Did you try giving him your cakes?”

“Even worse! He says that my wonderful chocolate cake also gives him heartburn. Okay, I admit, it’s really rich, sometimes it doesn’t agree with me either, but he says it gives him heartburn every time he eats it. And he won’t even hear of my biscuits!”

“Your biscuits? At least that’s not heavy food!”

“It’s not that. He says that all the crumbs that end up in his bed irritate him. He doesn’t want to eat them unless he is wearing his new silk pyjamas.”

“I don’t get it . . .”

“He said he would eat biscuits if he had his silk pyjamas on.”

“What difference does that make?”

“He says that crumbs prevent him from sliding out of bed.”


Risk factors

After completing all the medical examinations, Ivo called me and said in a serious voice that showed he needed help, “My dear friend, there’s nothing wrong with me.”

“Nothing? That’s great! What exactly did they tell you?”

“That my heart vessels are fine and not at all narrowed. I saw it myself. You can see it clearly on the screen; it was like watching it on TV.”

“What did they say, what caused the problem?”

“Stress. I was under a lot of stress and that I should change my way of life.”

“They tell that to everybody . . .”

“They said that stress caused a coronary syndrome. They gave me a new medicine for blood pressure and sent me home.”

“I think we need to find and eliminate all your risk factors.”

“I have only one risk factor, but it’s very strong. The strongest . . .”

“What’s that?” I said without thinking and with great interest.

“My wife.”

“Your wife? Your wife couldn’t be nicer!”

“I know you can’t understand. It’s too complicated for a doctor to understand. My wife is wonderful—she works, cooks, does the cleaning, calls the kids, and takes care of everything . . . Okay, she always has headaches on weekends, keeps losing her cell phones, and she scratched my car, but these are all normal, especially at our age . . . ”

“So what’s the problem?”

“I think she doesn’t even realize that she annoys me. She is good and honest. But that’s the most dangerous kind. The honest ones. And if she is good on top of that, you’re in trouble!”

“You don’t say!”

“She loves me, loves our children, loves cooking . . . I’m fed up with her chicken stew, but she makes a killer fish stew, you can’t argue that, and after some Alka-Seltzer you’re as good as new! But she has a problem with five things that I hold sacred.”

“Which five things? You don’t smoke, you don’t drink, you don’t go out . . . She couldn’t have found five things.”

“Five things! My homeland Croatia, my hometown Split, my job, my party, and our children.”

“Elaborate point by point.”

“First of all – Croatia. You know what Croatia means to me. And she says that it is a horrendous banana republic filled with crooks, corruption, external debt, internal debt, domestic violence, violence against children, and all sorts of other horrors!”

“Well she’s not far from the truth, but that’s hardly your fault.”

“It turns out that everything is my fault. I am guilty of loving such a country, of ever having loved it, and having gone to war in which I could have been killed . . .”

“That’s nonsense. People don’t understand that you have to love your country in order to be able to fix its problems. Nobody else is going to do that for us.”

“Don’t even try saying that in front of her! That annoys her the most. She is adamant that you can only love something that is good and honest and perfect.”

“And Split?”

“She says it’s never been worse! She claims that all kinds of barbarians came to Split after the war, that our original barbarians were at least domesticated and unassertive, and that the newcomers are beasts and not people. Drugs, disorder, dirt, illegal construction . . . ”

“I thought that illegal construction would go under ‘sins from work.’ ”

“No, it’s always the usual when it comes to my job—working too much, earning too little, being too honest, and getting duped by the not so honest others. She says it doesn’t make sense anymore, life is passing us by, and we never get to spend any time together.”

“And the party?”

“She has always been against my political involvement and maintains that I never should have joined any political parties. But since I have, I should have used my position like everyone else has. Instead, everyone ended up hating me! We don’t have any friends left, she has no one to go to theatre with, and the priest looks frowningly at her during mass.”

“She’s not completely wrong on some points. But I can’t see what she could possibly say about the children? They are good at school, well behaved . . .”

“That’s exactly it! She says the children are good and polite, and that they should emigrate. But what is she going to do then? She will be alone and old, since I could have a heart attack or a stroke, or both, from all the work and stress.”

“My dear, your wife is not a risk factor. She is in fact a sensor for your risk factors. You’ll have to work less and avoid so much stress.”

“I know. And earn more. That’s what she also tells me.”



MATKO MARUSIC, MD, PhD, served for many years as a professor of physiology and immunology in Zagreb University School of Medicine and in 2008 transferred to University of Split School of Medicine. He has published four fiction books. The author’s hometown is Split, on the Adriatic coast, some 200 miles south of Zagreb. The long-time residence of his parents, Split remains Dr. Marusic’s home.


Highlighted in Frontispiece Spring 2013 – Volume 5, Issue 2
Spring 2013  |  Sections  |  Cardiology

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