It is the question that I and everyone else have been asking out loud and in our minds over and over again. As I said in my first post, the metaphysical answer to the question will never be known. Now, however, we know what was the medical cause of Karen's death. She had an undiagnosed condition called idiopathic dilated cardiomyopathy, which is an enlarging of her heart, that likely caused an arrhythmia and sudden heart failure. Her condition is termed as idiopathic because the medical examiner could not determine the origin of the dilated cardiomyopathy. What is certain is that it was not a result or associated with the pregnancy. In very rare instances pregnancy can bring on peripartum cardiomyopathy, but this was conclusively ruled out.
I'm not a doctor, but in my journey to understand what happened I've spoken to friends of mine that are and did quite a bit of independent reading online about what the condition is, its symptoms, treatments, prognosis, etc. Based on this, in my layman's understanding of cardiomyopathy, I know that it is very difficult to detect unless the doctors are looking specifically for it. It doesn't show up on an EKG and can usually only be spotted by undergoing an echocardiogram, but sometimes requires a cardiac catheterization. Symptoms for cardiomyopathy are vague - fatigue, shortness of breath, flu-like symptoms - and aren't something that would necessarily raise a concern if they presented in someone 6 1/2 months pregnant and was an elementary school teacher. Simply put, there was nothing to suggest she should be checked for the condition and no doctor she saw ever even voiced a concern. She was in all outward aspects, in great health. Karen ate healthfully, exercised regularly, and generally took care of her self. (Of course this is one of the things that makes the suddenness of her death so difficult to comprehend.)
Even if something did suggest to doctors that they check and detected it, there was little that could have been done, especially while she was pregnant. There are two ways to treat cardiomyopathy and neither are curative. The first treatment is to prescribe a combination of drugs, including angiotensin-converting enzyme (ACE) inhibitors and beta blockers, to reduce the symptoms and prevent additional damage to the heart. These drugs, however, are not prescribed to people when they are pregnant and women who may already be on ACEs and beta blockers are taken off the drugs when they become pregnant. The other treatment is a heart transplant, which naturally presents a whole host of new potential health concerns, not to mention isn't a procedure that would be considered for a patient when they're pregnant.
Moreover, had the cardiomyopathy been detected and a treatment available to her while she was pregnant, the prognosis tends not to be favorable. Despite undergoing the available treatments, she could have experienced the same sudden and untimely death. The difference would have been that Karen would have had to live her life considerably different; eschewing foods and experiences that provided her such great pleasure, and existing with an ever present fear of death by the knowledge of the condition. Without knowing, Karen lived on her terms and extracted everything possible from each day, experience, and adventure.
The medical examiner's report also confirmed what I saw, Karen died instantly and painlessly. Based on conversations I've had with people who know about the condition, it is likely that she felt only a flutter or odd heart beat, which would explain why she looked up at me, and then it was over. There was also nothing that could have been done to save her, even had she been sitting in a hospital when the arrhythmia hit. Her heart was, as one doctor explained it, a ticking time bomb that was going to fail, it was simply a matter of when and where. It could have happened a week earlier when we were at my dad's cabin, where it would have take EMTs up to 45 minutes to arrive, or 24 hours later, when she would have been in front of her 3rd grade class and I at my office. It was, therefore, the best possible way for the most horrible thing to happen.
While knowing the medical reason does precious little to alleviate the pain and grief I continue to suffer, it is of some comfort to know her death was in the fates and not caused by something done or not done. By her not knowing of the condition that she in all likelihood could not have been able to correct, Karen lived her short life to the fullest and didn't suffer at the end. It was, as she said that morning, the way to go.
* * *
In addition to speaking with friends of mine who are doctors, the following websites have provided me with some useful information on cardiomyopathy:
http://www.merck.com/mmhe/sec03/ch026/ch026b.html
http://www.mayoclinic.com/health/dilated-cardiomyopathy/DS01029
Tuesday, December 30, 2008
Tuesday, December 23, 2008
Happy birthday my love
Today is Karen's birthday. She would have been 37. It was one of the many dates I dreaded when looking forward on the calendar - there are still many to come. We only had the chance to celebrate one birthday each, my 37th this year and her 36th last year (I shared by 36th birthday with the KLM in-flight crew on my way to The Hague) . Far far too few, as with everything else about our lives together.
Rather than try and put into words the sadness of this day without her, I thought I would recount her birthday last year....
When December 23, 2007, rolled around Karen and I had been dating only for a couple of months. Everything was still so new and I wanted to do something special for her. There is a restaurant in Park Slope called Al Di La that gets written up consistently as being exceptional Italian food. Karen was a maven for Italian and had been wanting to try it. Indeed she had mentioned it several times as being on the list of places for us to go. I knew that Al Di La doesn't take reservations (nor does it take credit cards, fyi) so did not bother calling. My thought was that we'd wander down there and get on line with everyone else.
Well, imagine my surprise, and unhappiness, when we got to the corner of Carroll and 5th avenue only to discover that Al Di La goes dark for the week around Christmas. Sure, great thing for the staff to be able to spend the holiday season with their families, but at the time all I could think of was "Shit! Now what do I do?"
Here I was, still in the early stages of wooing Karen, the "it" girl from high school who I've somehow managed to get a second (or first) chance with, and we're standing on the corner in front of a closed restaurant on the night of her birthday. What a way to impress Mr. Fried.
Luckily just down the street is Blue Ribbon, another entry on Karen's list of places to go, although not as high up as Al Di La. Blue Ribbon is certainly a good place to eat, but I would not consider it a place for a "special" dinner such as this. However, beggars can't be choosers, and Karen was getting hungry. Off to Blue Ribbon it was, where we had an enjoyable meal.
That was what our relationship was about in a nutshell; living by improvisation and embracing the notion of carpe deim. So when the planned (albeit, not appropriately so) restaurant fell through we just smiled, laughed, and went elsewhere. It wasn't the place that mattered, it was that we were there together. We had the same amount of joy whether we were driving to Tadoussac on our honeymoon or driving to Home Depot on a Saturday. It was that we were sitting next to each other, sharing the moment as one.
Such was how we celebrated her 36th birthday, together and that was all that mattered.
(It is worth noting that we later did go to Al Di La and Karen was underwhelmed by the food. She said it was good, but not worthy of the accolades in her opinion. I have to agree, it has been off the mark on the last times I've been and, while a solid meal, Brooklyn's restaurant scene has many more great places now.)
Rather than try and put into words the sadness of this day without her, I thought I would recount her birthday last year....
When December 23, 2007, rolled around Karen and I had been dating only for a couple of months. Everything was still so new and I wanted to do something special for her. There is a restaurant in Park Slope called Al Di La that gets written up consistently as being exceptional Italian food. Karen was a maven for Italian and had been wanting to try it. Indeed she had mentioned it several times as being on the list of places for us to go. I knew that Al Di La doesn't take reservations (nor does it take credit cards, fyi) so did not bother calling. My thought was that we'd wander down there and get on line with everyone else.
Well, imagine my surprise, and unhappiness, when we got to the corner of Carroll and 5th avenue only to discover that Al Di La goes dark for the week around Christmas. Sure, great thing for the staff to be able to spend the holiday season with their families, but at the time all I could think of was "Shit! Now what do I do?"
Here I was, still in the early stages of wooing Karen, the "it" girl from high school who I've somehow managed to get a second (or first) chance with, and we're standing on the corner in front of a closed restaurant on the night of her birthday. What a way to impress Mr. Fried.
Luckily just down the street is Blue Ribbon, another entry on Karen's list of places to go, although not as high up as Al Di La. Blue Ribbon is certainly a good place to eat, but I would not consider it a place for a "special" dinner such as this. However, beggars can't be choosers, and Karen was getting hungry. Off to Blue Ribbon it was, where we had an enjoyable meal.
That was what our relationship was about in a nutshell; living by improvisation and embracing the notion of carpe deim. So when the planned (albeit, not appropriately so) restaurant fell through we just smiled, laughed, and went elsewhere. It wasn't the place that mattered, it was that we were there together. We had the same amount of joy whether we were driving to Tadoussac on our honeymoon or driving to Home Depot on a Saturday. It was that we were sitting next to each other, sharing the moment as one.
Such was how we celebrated her 36th birthday, together and that was all that mattered.
(It is worth noting that we later did go to Al Di La and Karen was underwhelmed by the food. She said it was good, but not worthy of the accolades in her opinion. I have to agree, it has been off the mark on the last times I've been and, while a solid meal, Brooklyn's restaurant scene has many more great places now.)
Tuesday, December 9, 2008
Angels in the Architecture
Karen is still with me, around me, accompanying me, watching me. I know it sounds strange, maybe a little too mystical, but I’m convinced of it. I’m not necessarily talking in the Whoppie Goldberg and Patrick Swayze type of presence, but she’s with me. Let me try to explain by just telling you of the things I’ve experienced since she died…
Karen’s funeral was on November 19. The outpouring of love for Karen and support for me, my family, and Karen’s family was evident by the number of people who can to remember her. The best estimate was around 700 people in attendance, a truly amazing image.
After the funeral we went to the cemetery. The burial was a blur of cold, Kaddish, tears, shovels, grass, and more tears. Toward the end, as Jeffery, Karen’s brother, and others completed filling in the grave, I wandered away from the crowd, the first moment in three days that I was awake and without a friend or family member in immediate contact with me. Where Karen is buried there are no headstones, only plaques in the ground, giving the area a feeling of a park rather than a cemetery. If such a place where a loved one is buried far, far too early could ever have a positive feeling, it comes as close as I can imagine.
About 50 yards from her grave (she is buried with her maternal grandparents), I was moved to sit on the ground. In a half lotus I closed my eyes, slowed my breathing and began thinking. My thoughts turned to words and I found myself speaking to her out loud. It was cold, indeed I was only moments earlier shivering, but as I sat there thinking and talking to her I felt a warmness wash over me. I removed my winter cap and nearly took off my jacket – I was actually that warm – until something, someone reminded me that it was still borderline-hypothermic temperatures.
After some time I stood with my palms at heart center, and felt more and more calm. The only sounds around me was the hum of the traffic in the distance and the faint scraping of shovels filling the last of the earth into her grave, there wasn’t a single animal or other sound of nature the entire time we were there or during the whole day up until then. I said that this place was beautiful, that is was serene, that she would be at peace her and asked if she was. At that very moment, from out of no where, an enormous flock of geese flew directly over me, honking as they flew south. As quickly as they appeared, they disappeared over the trees and the area once more returned to silence broken only by the sounds of man in the distance, not another single bird or other sign of nature. I had the answer to my question.
That was one event, but there would be more.
Two days later, Friday, I went for a walk in Prospect Park with my brother and sister-in-law. We wandered for some time talking about all aspects of what had happened. The conversation turned to what my plans might be for the future. I was explaining how I thought it was now time for me to reevaluate and reconsider what I was doing, and how part of that process might need me to be away from my current job for a little while. I was saying how I needed to do this not just for me but for Karen’s memory because it was something we had spoken about on occasion, and was about to say that this decision couldn’t be dependant on money since I was convinced that would find a way to take care of itself. At that moment, I looked down on the ground and directly at my feel was a twenty dollar bill. The only person we had seen anywhere near the area was a bicyclist who was riding on the opposite side of the road. Literally there was no one around.
I bent down and picked up the bill and looked to both my brother and sister-in-law. Before either of us could say anything, I noticed another twenty several feet past the first. As I picked that one up I saw another bill, then another, then another, then another. In all there were six twenties in a line laid out before me on the Prospect Park drive. We all had chills, and not because of the weather. When I got back to my mother’s house I mentioned the money to my mother’s friend who immediately said “120 is a good number in Judaism.” I had not idea why so she explained to me that Moses lived for 120 years and it is widely said as a wish for one’s good luck that someone should “live to the age of 120.” The chills returned.
Finally, that night we all went to Shabbat services. As we walked in the ushers were handing out prayer books from the several stacks at the front door. I took the one handed to me and headed for the pew. I sat and opened the book, many of which have a dedication sticker affixed to the inside cover. On this book I read the sticker, re-read it, and read it once more. The sticker said…
“This book is dedicated in honor of Jonathan Fried and Andrew Fried by their mother Janice Cimberg.’
I froze. There must be 700 or 800 prayer books at Congregation Beth Elohim and, on the first Shabbat after burying my wife, my true love, and my soul mate, I’m handed the one dedicated by my mother to me? In stunned silence I showed it to all my family and friends with me. We all looked at each other with the same look. Karen was with me.
Three examples, there have been more, but these three were the ones I keep coming back to again and again. Sure there are some who will say people going through what I am look for and often find the proverbial Angels in the architecture. If it was just a single event I would likely agree. But these were just too poignant for me to ignore as that. No, these events portend something else to me. They say that Karen is indeed with me, she is following me, and she is watching out for me. And her presence gives me some comfort.
Karen’s funeral was on November 19. The outpouring of love for Karen and support for me, my family, and Karen’s family was evident by the number of people who can to remember her. The best estimate was around 700 people in attendance, a truly amazing image.
After the funeral we went to the cemetery. The burial was a blur of cold, Kaddish, tears, shovels, grass, and more tears. Toward the end, as Jeffery, Karen’s brother, and others completed filling in the grave, I wandered away from the crowd, the first moment in three days that I was awake and without a friend or family member in immediate contact with me. Where Karen is buried there are no headstones, only plaques in the ground, giving the area a feeling of a park rather than a cemetery. If such a place where a loved one is buried far, far too early could ever have a positive feeling, it comes as close as I can imagine.
About 50 yards from her grave (she is buried with her maternal grandparents), I was moved to sit on the ground. In a half lotus I closed my eyes, slowed my breathing and began thinking. My thoughts turned to words and I found myself speaking to her out loud. It was cold, indeed I was only moments earlier shivering, but as I sat there thinking and talking to her I felt a warmness wash over me. I removed my winter cap and nearly took off my jacket – I was actually that warm – until something, someone reminded me that it was still borderline-hypothermic temperatures.
After some time I stood with my palms at heart center, and felt more and more calm. The only sounds around me was the hum of the traffic in the distance and the faint scraping of shovels filling the last of the earth into her grave, there wasn’t a single animal or other sound of nature the entire time we were there or during the whole day up until then. I said that this place was beautiful, that is was serene, that she would be at peace her and asked if she was. At that very moment, from out of no where, an enormous flock of geese flew directly over me, honking as they flew south. As quickly as they appeared, they disappeared over the trees and the area once more returned to silence broken only by the sounds of man in the distance, not another single bird or other sign of nature. I had the answer to my question.
That was one event, but there would be more.
Two days later, Friday, I went for a walk in Prospect Park with my brother and sister-in-law. We wandered for some time talking about all aspects of what had happened. The conversation turned to what my plans might be for the future. I was explaining how I thought it was now time for me to reevaluate and reconsider what I was doing, and how part of that process might need me to be away from my current job for a little while. I was saying how I needed to do this not just for me but for Karen’s memory because it was something we had spoken about on occasion, and was about to say that this decision couldn’t be dependant on money since I was convinced that would find a way to take care of itself. At that moment, I looked down on the ground and directly at my feel was a twenty dollar bill. The only person we had seen anywhere near the area was a bicyclist who was riding on the opposite side of the road. Literally there was no one around.
I bent down and picked up the bill and looked to both my brother and sister-in-law. Before either of us could say anything, I noticed another twenty several feet past the first. As I picked that one up I saw another bill, then another, then another, then another. In all there were six twenties in a line laid out before me on the Prospect Park drive. We all had chills, and not because of the weather. When I got back to my mother’s house I mentioned the money to my mother’s friend who immediately said “120 is a good number in Judaism.” I had not idea why so she explained to me that Moses lived for 120 years and it is widely said as a wish for one’s good luck that someone should “live to the age of 120.” The chills returned.
Finally, that night we all went to Shabbat services. As we walked in the ushers were handing out prayer books from the several stacks at the front door. I took the one handed to me and headed for the pew. I sat and opened the book, many of which have a dedication sticker affixed to the inside cover. On this book I read the sticker, re-read it, and read it once more. The sticker said…
“This book is dedicated in honor of Jonathan Fried and Andrew Fried by their mother Janice Cimberg.’
I froze. There must be 700 or 800 prayer books at Congregation Beth Elohim and, on the first Shabbat after burying my wife, my true love, and my soul mate, I’m handed the one dedicated by my mother to me? In stunned silence I showed it to all my family and friends with me. We all looked at each other with the same look. Karen was with me.
Three examples, there have been more, but these three were the ones I keep coming back to again and again. Sure there are some who will say people going through what I am look for and often find the proverbial Angels in the architecture. If it was just a single event I would likely agree. But these were just too poignant for me to ignore as that. No, these events portend something else to me. They say that Karen is indeed with me, she is following me, and she is watching out for me. And her presence gives me some comfort.
Monday, December 1, 2008
The life I knew and its shattering
Many of you know most of this story already, but for those of you who may not or may not know everything about my relationship with Karen - how we met, got engaged, lived, etc. - I wanted to put it all out there, as well as what happened that tragic day two and a half weeks ago, so that those who might not have met her or only met her briefly can know. (Sorry in advance for the length....)
Karen and I met in 8th grade back in 1984. It was a private school in Brooklyn that went from pre-K through high school and we were friendly through high school, as most of us were given the size of the school and our class, but we never dated. Although I did have a crush on her and even volunteered to help with the girls varsity basketball team because she was on it, we never dated.
We graduated in 1989 and went off to college; her to Tulane and me to the University of Arizona. We all but lost touch with each other, although our paths crossed momentarily after three years of college when I dropped out and moved to New Orleans for a few months. Neither of us remember seeing each other while I was there (she was in her senior year), but I somehow had her phone number in my address book from that time. That was around 1993 and we had no other contact after until last year.
One day last Spring I decided to search MySpace for people from my high school class. I found five old friends, Karen was one of them, and emailed them all. She and I exchanged a few brief emails, as you might expect from two people who knew each other a bit but had fallen completely out of touch for nearly two decades, but nothing more for several months. Then, in late September, we made plans to meet for a drink after work. The drink turned into an evening of talking, reminiscing, laughing (something I hadn't done much of recently due to my previous marriage ending in divorce), wandering around the neighborhood, enjoying each other's company, and starting to fall in love with each other. The night ended with us kissing goodbye. There was no "wait a few days before calling" and we started seeing each other all the time. She too had a first marriage end in divorce, but there were so many other things that caused our instant connection. My friends and family soon started remarking how the Andrew they "used to know" was back, laughing, smiling, and enjoying life.
In May of this year we went back to our high school for the annual alumni luncheon. It was our 19th reunion, nothing so special, but we both had friends in the class year above and wanted to see them. We had an amazing time and people were wowed by us as a couple. That night, early morning of May 4, we were at a club in the city with some friends when, without a ring or otherwise preparing, I knelt on the floor in front of her and asked her to marry me. She agreed immediately.
That week, we discussed wanting children and decided - because we were both 36 and have friends who are have had/are having difficulties getting pregnant - to start trying. To our surprise and joy, she was pregnant almost immediately. We held the news as long as we could, but almost everyone we knew that she was about three months pregnant when she walked down the aisle at our wedding on August 17.
Our life was going amazingly, like a dream come true. We spent days together and never argued. We kissed constantly and couldn't spend enough time with each other. We laughed, loved, and talked about our future, including our expectant child. With each visit to the doctor we saw out son grow, even watching him yawn at one sonogram appointment, and Karen was absolutely LOVING being pregnant.
On November 15, my 37th birthday, Karen took me to a matinée of Speed the Plow and then dinner at Aquvit in Manhattan. It was a perfect evening. The next morning began as a normal Sunday. We relaxed for a little while, read the newspaper, and then went to my mother's apartment to meet up with the family and say hi. We had a little brunch and then went for a walk in our neighborhood. We had dinner reservations for later that evening with my mother, brother, and sister-in-law, but at around 2 we decided to grab a bite because Karen needed to eat regularly through the day due to the pregnancy. There is a little Columbian restaurant we'd passed many times and always wanted to try. We decided this was the day for it. We shared a few small dishes and it was wonderful. Karen enjoyed eating, whether it was haute cuisine, like the night before, or just really great down home cooking, like Cafe Bogota. At the end of the meal, when the waiter brought the check, he also brought a comment/mailing list card. Karen remarked how much she liked the meal - rating it a 10 - and asked the waiter for a pen to filling out the card. This is when my life went from a dream to an unimaginable nightmare.
Karen had just begun writing when she suddenly stopped, sat bolt-upright, and looked at me with wide open eyes. I thought she was goofing around and asked what was wrong. She said nothing, but kept her eyes fixed straight ahead and slumped forward onto the table. I immediately knew something was wrong and got up and went to her side. I took her head from the table and pulled her to me. Her eyes were still wide open and unresponsive as she slide lower into the chair. I began to scream for help as she fell against me, out of her chair, and onto the floor with me. I continued to yell for help as people came to assist and began dialing 9-1-1. She was not breathing, nor was she struggling or moving at all as she lay on the floor. The first police officers arrived within a matter of minutes, with fire fighters and EMTs immediately following. I was ushered out of the restaurant by the police officers as I heard someone call for a defibrillator. My world was tumbling out of control.
Time stood still and accelerated all at once. I sat on the sidewalk with two of the police officers as the EMTs continued working inside and was asked questions intermittently - was she on any medication, any medical history, etc. - but could not get any information in return. This was obviously frustrating at the time, but in hindsight I understand that the attention was on rendering aide to Karen and not to answering my questions. I was then led to a police car and driven to the hospital. The ensuing minutes/hours are a blur. I was ushered into a quiet room with my entire family, who had been called by a bystander who took my cellphone and asked if there was anyone she could contact for me. Doctors initially came in to say Karen was being worked on still and that James, our son, had been delivered by emergency cesarean section and taken to the NICU. They had no word on either one's condition.
A short time later the doctors returned, accompanied by the hospital chaplain, and told me that Karen could not be revived, never regained consciousness, and was dead. My life shattered as those words were spoke. I fell to the floor in agony. Every muscle and fiber of my body crying out in pain. Even now I can feel my chest constrict from the memory as I type.
My nadir was yet to be reached. After a little more time passed the doctors came once more to tell me that although they were able to get a pulse from James (with the aide of medication), he could not be saved and died as well. The world's collapse around me was complete.
My family, each one feeling their own devastating grief, surrounded and supported me. They had all found such happiness and joy in Karen, as an individual and not just the woman who meant everything to me, and she had become an immediate and adored member of my family.
I was then taken to see Karen one last time and then upstairs to see and hold my son for the first and only time - I never held him while he was alive. As many of you I am sure know, to try and put into words what I was feeling is an impossibility. It is a devastation that literally transcends comprehension.
It is still impossible for me to believe what has happened; the horror of the day plays over again and again in my head. An autopsy revealed no evident cause of death, i.e., it was not a brain aneurysm, blood clot, etc. The medical examiner is continuing its evaluation, but it could be weeks until more is known, if ever. Indeed I am accepting the very real possibility that a medical explanation for what happened might never be known, just as there is no knowing what the metaphysical explanation is. This reality is bearable only because I was with her when it happened and can assuage my pain with what I saw for myself in that horrible moment. I am 100% certain that she died instantly at the moment she looked at me and before slumping to the table. She didn't struggle for breath or show other signs that she was in pain. It was, as she said as recently as that morning when we saw the end of the Godfather where Marlon Brando has a heart attack while playing with his grandson, the way to go -- quickly and doing something you loved. In this case, Karen was with me, across the table from me, having just finished a meal that she rated a 10 and described as "sublime."
It took 19 years for Karen and I to find each other again, we had 14 months together, three months of marriage, and an entire lifetime of plans. Two weeks ago today was the worst day of my life.
My joy - http://query.nytimes.com/gst/fullpage.html?res=9C00E6DB133DF934A2575BC0A96E9C8B63
My pain - http://www.legacy.com/NYTimes/DeathNotices.asp?Page=LifeStory&PersonID=120369709
Karen and I met in 8th grade back in 1984. It was a private school in Brooklyn that went from pre-K through high school and we were friendly through high school, as most of us were given the size of the school and our class, but we never dated. Although I did have a crush on her and even volunteered to help with the girls varsity basketball team because she was on it, we never dated.
We graduated in 1989 and went off to college; her to Tulane and me to the University of Arizona. We all but lost touch with each other, although our paths crossed momentarily after three years of college when I dropped out and moved to New Orleans for a few months. Neither of us remember seeing each other while I was there (she was in her senior year), but I somehow had her phone number in my address book from that time. That was around 1993 and we had no other contact after until last year.
One day last Spring I decided to search MySpace for people from my high school class. I found five old friends, Karen was one of them, and emailed them all. She and I exchanged a few brief emails, as you might expect from two people who knew each other a bit but had fallen completely out of touch for nearly two decades, but nothing more for several months. Then, in late September, we made plans to meet for a drink after work. The drink turned into an evening of talking, reminiscing, laughing (something I hadn't done much of recently due to my previous marriage ending in divorce), wandering around the neighborhood, enjoying each other's company, and starting to fall in love with each other. The night ended with us kissing goodbye. There was no "wait a few days before calling" and we started seeing each other all the time. She too had a first marriage end in divorce, but there were so many other things that caused our instant connection. My friends and family soon started remarking how the Andrew they "used to know" was back, laughing, smiling, and enjoying life.
In May of this year we went back to our high school for the annual alumni luncheon. It was our 19th reunion, nothing so special, but we both had friends in the class year above and wanted to see them. We had an amazing time and people were wowed by us as a couple. That night, early morning of May 4, we were at a club in the city with some friends when, without a ring or otherwise preparing, I knelt on the floor in front of her and asked her to marry me. She agreed immediately.
That week, we discussed wanting children and decided - because we were both 36 and have friends who are have had/are having difficulties getting pregnant - to start trying. To our surprise and joy, she was pregnant almost immediately. We held the news as long as we could, but almost everyone we knew that she was about three months pregnant when she walked down the aisle at our wedding on August 17.
Our life was going amazingly, like a dream come true. We spent days together and never argued. We kissed constantly and couldn't spend enough time with each other. We laughed, loved, and talked about our future, including our expectant child. With each visit to the doctor we saw out son grow, even watching him yawn at one sonogram appointment, and Karen was absolutely LOVING being pregnant.
On November 15, my 37th birthday, Karen took me to a matinée of Speed the Plow and then dinner at Aquvit in Manhattan. It was a perfect evening. The next morning began as a normal Sunday. We relaxed for a little while, read the newspaper, and then went to my mother's apartment to meet up with the family and say hi. We had a little brunch and then went for a walk in our neighborhood. We had dinner reservations for later that evening with my mother, brother, and sister-in-law, but at around 2 we decided to grab a bite because Karen needed to eat regularly through the day due to the pregnancy. There is a little Columbian restaurant we'd passed many times and always wanted to try. We decided this was the day for it. We shared a few small dishes and it was wonderful. Karen enjoyed eating, whether it was haute cuisine, like the night before, or just really great down home cooking, like Cafe Bogota. At the end of the meal, when the waiter brought the check, he also brought a comment/mailing list card. Karen remarked how much she liked the meal - rating it a 10 - and asked the waiter for a pen to filling out the card. This is when my life went from a dream to an unimaginable nightmare.
Karen had just begun writing when she suddenly stopped, sat bolt-upright, and looked at me with wide open eyes. I thought she was goofing around and asked what was wrong. She said nothing, but kept her eyes fixed straight ahead and slumped forward onto the table. I immediately knew something was wrong and got up and went to her side. I took her head from the table and pulled her to me. Her eyes were still wide open and unresponsive as she slide lower into the chair. I began to scream for help as she fell against me, out of her chair, and onto the floor with me. I continued to yell for help as people came to assist and began dialing 9-1-1. She was not breathing, nor was she struggling or moving at all as she lay on the floor. The first police officers arrived within a matter of minutes, with fire fighters and EMTs immediately following. I was ushered out of the restaurant by the police officers as I heard someone call for a defibrillator. My world was tumbling out of control.
Time stood still and accelerated all at once. I sat on the sidewalk with two of the police officers as the EMTs continued working inside and was asked questions intermittently - was she on any medication, any medical history, etc. - but could not get any information in return. This was obviously frustrating at the time, but in hindsight I understand that the attention was on rendering aide to Karen and not to answering my questions. I was then led to a police car and driven to the hospital. The ensuing minutes/hours are a blur. I was ushered into a quiet room with my entire family, who had been called by a bystander who took my cellphone and asked if there was anyone she could contact for me. Doctors initially came in to say Karen was being worked on still and that James, our son, had been delivered by emergency cesarean section and taken to the NICU. They had no word on either one's condition.
A short time later the doctors returned, accompanied by the hospital chaplain, and told me that Karen could not be revived, never regained consciousness, and was dead. My life shattered as those words were spoke. I fell to the floor in agony. Every muscle and fiber of my body crying out in pain. Even now I can feel my chest constrict from the memory as I type.
My nadir was yet to be reached. After a little more time passed the doctors came once more to tell me that although they were able to get a pulse from James (with the aide of medication), he could not be saved and died as well. The world's collapse around me was complete.
My family, each one feeling their own devastating grief, surrounded and supported me. They had all found such happiness and joy in Karen, as an individual and not just the woman who meant everything to me, and she had become an immediate and adored member of my family.
I was then taken to see Karen one last time and then upstairs to see and hold my son for the first and only time - I never held him while he was alive. As many of you I am sure know, to try and put into words what I was feeling is an impossibility. It is a devastation that literally transcends comprehension.
It is still impossible for me to believe what has happened; the horror of the day plays over again and again in my head. An autopsy revealed no evident cause of death, i.e., it was not a brain aneurysm, blood clot, etc. The medical examiner is continuing its evaluation, but it could be weeks until more is known, if ever. Indeed I am accepting the very real possibility that a medical explanation for what happened might never be known, just as there is no knowing what the metaphysical explanation is. This reality is bearable only because I was with her when it happened and can assuage my pain with what I saw for myself in that horrible moment. I am 100% certain that she died instantly at the moment she looked at me and before slumping to the table. She didn't struggle for breath or show other signs that she was in pain. It was, as she said as recently as that morning when we saw the end of the Godfather where Marlon Brando has a heart attack while playing with his grandson, the way to go -- quickly and doing something you loved. In this case, Karen was with me, across the table from me, having just finished a meal that she rated a 10 and described as "sublime."
It took 19 years for Karen and I to find each other again, we had 14 months together, three months of marriage, and an entire lifetime of plans. Two weeks ago today was the worst day of my life.
My joy - http://query.nytimes.com/gst/fullpage.html?res=9C00E6DB133DF934A2575BC0A96E9C8B63
My pain - http://www.legacy.com/NYTimes/DeathNotices.asp?Page=LifeStory&PersonID=120369709
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