Author Ken L Gould
Author Ken Gould
There is nothing to writing. All you do is sit down at a typewriter and bleed. ~Ernest hemingway

The Book That Almost Killed Me. Literally.

Posted on February 9, 2017

Ken L Gould's Blog Blog BlogOkay, the book didn’t really try to kill me, so maybe not literally. I mean, it didn’t reach out and try to smother me in my sleep. It didn’t hit me over the head time and time again with a tire rod until I was unconscious and bleeding to death, then pour gasoline over my body and light me on fire. Nothing like that. So maybe not literally. But in the process of writing my debut novel, I did almost die. The act of writing almost killed me. Literally. So here’s that story, if you are interested.

On some morning in October of 2012, I awoke with a strange feeling. I took my dog for a brief potty outing. As I held her leash and wandered out onto the grass, as she pulled me toward the bushes, I passed out. I mean, black and out. The world faded into darkness, my vision receded from me, and I writhed around on the grass until the world came back to me just as suddenly as it had disappeared.

My dog, in the meantime, wandered around the bushes, happy as a lark, glad to be free of restraint. What did she care that I was dying? She was free.

Did I mention I was dying? Or did you miss that part?

Every time I stood up, I started to pass it. If there is a doctor in the house, they might have figured out what was going on. I had a pulmonary embolus partially blocking the vessels to both my lungs. The clots most often come from the legs, from what is called deep vein thrombosis. You see, the body throws out small clots all the time as the blood pools and doesn’t circulate, so the clotting factors go to work and get the blood cells to clump together. Normally, this is a good thing, but not when it happens a lot and the clots are really big in size. In that case, they can get lodged in places, or worse, break apart and go to either the brain or, more likely, the lungs.  This can happen with atrial fibrillation, as my grandmother had for the last ten years of her life, since the blood pools in the heart. Clots can also be associated with hip replacements and other hardware in the body. In these cases, where clots are anticipated, they put you on blood thinners like Coumadin (warfarin) or Xeralto or Eliquis.

In my case, it happened spontaneously thanks to prolonged periods of sitting in one place. You know, sitting, often the main activity (or lack of activity) of writers. Because the action is really in the brain, only it’s hard to use the brain when it’s not getting oxygen because of some huge damn blood clot clogging up the works! It turns out, as I was informed later, that sitting for as little as 2 to 3 hours can greatly increase the risk of blood clots. Usually, we associate DVT (deep vein thrombosis) with long plane trips across oceans lasting six or more hours. Obviously not.

Also, as it turns out, what I had was huge. I mean, HUGE. It was what they called a saddle embolus because that’s what it looks like on the CT scan, a saddle. It looks that way because it’s blocking both veins to the lungs. I mentioned that sometimes it can go to the brain and cause a stroke, but most of the time the fragments of clot go to the lungs because that’s the huge flow of blood through the body. From the legs (actually, up through the vena cava, if you want to get technical) through the heart and to the lungs, where the clot is forced into smaller and smaller spaces as the veins become capillaries. Somewhere along that journey, the clot or fragments of clot get stuck. And there, they remain. Until you die or you go to the hospital and they do something about it.

So back to the story. I, being an idiot, remained in bed all night watching TV, instead of calling an ambulance. I awoke the next morning with the same problem. Every time I stood, my blood pressure bottomed out. The echocardiogram later showed my right ventricle was beating like crazy as it tried to force the blood through the clot.

As I said, I awoke the next morning (that’s the important part, waking up) and drove the dog to the boarders, since I knew I would be going into the hospital for days. I drove myself to the ED at Holy Cross Hospital, where they confirmed the clot with a CT scan. They whisked me away to preop, where they did an echocardiogram and administered tissue plasminogen activator (tPA) that is the big gun for breaking up the clots. It worked. They also took me to surgery, where an interventional radiologist inserted an IVC (inferior vena cava) filter into my inferior vena cava (go figure) to catch all those nasty clots from my legs, since, at that time, they had no idea if this was a one time thing or a regular occurrence.

Later, a hematologist told me that I had a slightly greater risk than the normal individual of forming blood clots, thanks to an allele in my genes. If you have both alleles, you are at a significantly greater than normal risk, but I only had one allele.

To sum the whole thing up, they put me on Coumadin and later Xeralto, since Coumadin requires a blood test (prothrombin time, to test how quickly your blood clots) every four to six weeks to check to see if it’s working and Xeralto does not. Of course, Xeralto comes with risks like bleeding to death. As always, consult your doctor.

Eventually, I got off the blood thinners and haven’t thrown out any clots since. So all’s well that end’s well. I’ll let you know if I die of a blood clot. Or someone else will. Or you’ll read about it on social media.

As I sat in ICU for several days and on the main floor for one more, I came up with the final structure for Death’s Grip. All writers have stories about their works and how they came to be. This is mine. The story of how I developed the final version of a book about dealing with death as I convalesced from a near-death experience. Certainly one of the oddest chapters in my life.


Ken L

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