Ian Jackson

Early Monday morning I went to the emergency department with mild but inexplicable and persistent chest pain and shortness of breath to find out if I was having a heart attack.

Apparently not. I made a point of not going to the closest hospital, but to one I knew from my own patients' experiences takes women's risk of heart attack seriously. I showed up at about 6:30 am and there wasn't a single other person in the waiting room. I had an experience kind of like when a race car has a pit stop, only with a team of people hooking me up to the EKG almost instantly instead of changing tires. They had it completed before Mr. Bostoniensis was done parking the car.

They kept me for a few hours for repeated blood draws and did a chest x-ray. The conclusion the EM doc came to was that he felt it's very unlikely that it was a heart attack, but can't rule out something more chronic and cardiac. X-ray showed my heart is the size it's supposed to be; my lungs seem perfectly fine and there's no evidence of pulmonary anything.

Nevertheless, something is very Not Right in my chest, and I have a follow up appointment with my PCP tomorrow. The discomfort is not severe, but it is persistent and NSAIDs do nothing to it, and that and the attendent anxiety is screwing up my sleep. I keep wanting to press my hand against the sore spot to put pressure on it, but it's right behind my sternum so I can't reach it.

There's a non-zero chance that in 20 hours I'll be in the market for any or all of: cardiologists, vascular surgeons, pulmonologists. If you happen to be a woman or otherwise AFAB in the Boston area who has one or more of those that she likes, feel free to recommend. I have a preference for the BILH system as opposed to MGB, but whatever. Alas, I can only take recommendations from women or people likely to be treated as one, because, fucking hell, it matters.

Irritatingly, my health had been seeing a slight improvement. I'm moving a bit better and tolerating sitting better.

Meanwhile, my personal life has been a huge rollercoaster over the last four months. Mostly good stuff, but... emotionally intense. I had hoped to post about it, but it has proved very difficult to write about. It starts with flabbergastry and then moves through some delicate territory where I've been asked to keep some details private by family and also is a very fast moving target and also involves talking about some intrinsically very difficult to talk about things.

This in turn is in a larger context where I feel less and less comfortable self-disclosing personal details here. As you might or might not have noticed, when I moved two years ago, I took advantage of the occasion to stop talking about where I lived. That's now available only on a need-to-know basis. I'm still in the Greater Boston area. But I think I would rather not be more specific than that.

That's one example. There are others, but I don't feel the need to itemize them.

Unfortunately, this kind of opsec comes with a perhaps surprising downside for me: it absolutely cripples my ability to write. I was, like everybody, struggling with the emotional weight of current events and the downward force it put on concentration and motivation, and there was the ergonomics problem I had last Nov/Dec that stole a lot of my mojo. But on top of those and some other difficulties: my capacity for doing the kind of writing I do here is profoundly tied to a specific kind of social dynamic this kind of reserve frustrates if not completely prevents.

Writing has always felt like lifting heavy things with my mind; doing it without that social context makes everything I try to life about two orders of magnitude more heavy. It's not strictly speaking impossible. But it makes it vastly more difficult and unsustainably stressful – you can smell the motor in the winch start smoking – and is what has been burning me out. Writing this way does not feel like any sort of accomplishment, just something to be grimly endured.

P.S. I feel the need for completeness sake to relate that what I was doing at the moment I noticed, hey, my chest feels funny, was trying to debug an old SPF record. If this takes me out, blame Sender Policy Framework.