Ann Patchett Tells Everything She Knows About Love

After learning that her boyfriend of 11 years has a potentially fatal heart condition, the author wonders—is it possible that anxiety ends at the moment when we no longer have time for it?

Anna Bond

Karl decided to go to the Mayo Clinic to have a physical. He’d never done anything like that before. In fact, like many doctors, he never got physicals. If he made an appointment to see one of his medical partners, he’d wind up never going, and if he did go, they would just sit around and talk.

“Is everything all right?” I asked.

He told me he was fine. He’d only be gone one night, and no, he didn’t want me to go with him.

It was the beginning of March. I drove him to the airport early in the morning. He didn’t call until that night.

“Well,” he said. “I failed a test.”

I was standing in front of my living room window, staring out at the pitch-black dark. “What test?”

There had been an abnormal treadmill test, and then an echocardiogram that showed his heart beating at half its normal function. The left ventricular ejection fraction was at 25 percent. Normal was 55 percent. They had scheduled an arteriogram for the morning.

“I’m coming up,” I said.

“Don’t come up,” he said. “We’ll know more after the test. Anyway, there’s supposed to be a blizzard.”

I was pacing a circle through my house: living room, kitchen, dining room, living room, kitchen, dining room, while my dog followed behind. Neither Karl nor I was alarmist by nature, but I was feeling decidedly alarmed. I was at the airport first thing the next morning.

“The plane might get to Minneapolis,” the ticket agent told me. “Might. Or they could close the airport, and you’ll get rerouted. But even if you make it that far, there’s no way you’ll get a connecting flight to Rochester. It’s a whiteout.”

I said I’d give it a try.

All these years I had thought to be afraid of only one potential ending: By not marrying Karl, we could never get divorced. By not marrying him, he would never be lost to me. Now I could see the failure of my imagination. I had accounted only for the loss I knew enough to fear.

The flight to Minneapolis was delayed indefinitely. “The way things are looking up there, we don’t know when we’ll be able to go,” the agent announced, but then two minutes later she said, “Let’s go right now.”

Clearly, this was a plane full of Minnesotans going home, not Nashvillians heading north. Everyone trudged on board without blinking, and we flew away. “Lotta snow up there,” the pilot said.

In Minneapolis, the situation had grown worse. There were maybe 20 of us waiting for a small commuter plane to Rochester while we watched the snow beat into the windows. Rochester was having its worst blizzard in ten years. I looked at my watch. Arteriogram time.

The pilot came and stood behind the ticket counter. “It’s bad up there,” he said. We stared back at him, buried in our coats and hats and scarves. “What do you say? Give it a try?” We stood up together, all of us one unit. We wanted to try.

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Of course you know the plane did not go down in the blizzard—this is a true story, and I am here to tell it. But it occurred to me for the entire 50 minutes of the flight that my being killed while trying to get to Karl, who was sick, would place a burden of irony on the rest of his life. I was in a single seat, and in the single seat behind me was a father who was loudly threatening his two sons across the aisle. The two sons, who were maybe 10 and 12, were beating each other, smacking and pinching and screaming like a couple of wolverines. Between the father and the sons, it was the worst behavior I have ever seen on a plane.Then, suddenly, all three of them stopped. That’s how bad the flight was. We were pitching sideways through the snow, plummeting, climbing, and in the same instant they each put their hands in their laps and did not make another sound.

How the pilot saw the runway, I will never know. We were in the air and then we were skidding to a stop and the passengers clapped and cried. “We’re here,” the pilot said. “Last one in. The airport’s closed.”

I made it to Karl’s hospital room about 30 seconds before they wheeled him in. “See?” he said to the nurse. His voice was bleary from anesthetic. “Didn’t I tell you she’d be here?” He took my hand. “They said, No, she can’t make it. They said everything’s closed. And I said, You don’t know Ann.” And then he drifted off to sleep.

Explain doubt to me, because at that moment I ceased to understand it. In return I will tell you everything I know about love.

They found no blockage in the heart, no arteriosclerosis. It was a parvovirus. He had a cardiomyopathy. The cardiologist explained to me that nearly half of the muscle tissue in Karl’s heart was dead. They would put him on a beta blocker called Coreg for the rest of his life. If his ejection fraction, the volume of the blood the heart was able to pump, fell much lower—say, to 20 percent—he would be eligible for a place on the heart transplant list.

I asked the doctor if there was any chance that the situation could improve with time.

“Heart muscle tissue doesn’t regenerate,” he said.

Two days and many tests later, we were in the airport in Rochester for a flight back to Nashville. The snow had stopped and was now plowed into towering banks. Karl and I stood together at the window, his arm around my shoulder, looking out across the field of white. “I guess when we get home, we should get married,” I said.

Karl nodded. “I think so.”

“I’ll put my house on the market.”

“Good,” he said.

And that was it. After 11 years of discussion, there was nothing more to say. “Every relationship you will ever have is going to end,” my mother had told me. If Karl needed my help, if there were decisions that needed to be made in a hospital, I could do nothing as his girlfriend. He needed a wife.

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