Open Heart Surgery
The bypassing of the self and burnt-out broken hearts
Part 1: Angry Acceptance
My 47-year-old husband needs open-heart surgery. I’m writing this with an open heart since I’ve recently had many emotional breakdowns fueled by rage. I am angry. It is not advisable to stay afraid until we get angry. Even if one tries to be a control freak to honour their need for certainty — as is the case with autistic me — they still can’t control everything. I am afraid. I stayed afraid for so long, fearing this would happen. Now I am enraged at everything, myself, my husband, his attachment to his professional identity, the systems we live and work in daily that speed up disease and illness, and also the lack of ownership we can choose to autonomously enforce to modify some of their effects as we age, let alone the whole shitshow post-pandemic world we now live in with its decreased tolerance and increased impatience. Chaos conditioning causes chronic illness. I realise this is my way of processing things. I have been acquiring this fury and rage for the last five years since his previous heart attack at 42, policing my husband’s health like a hypervigilant health freak, bracing myself for this potential outcome. I now require this rage. I will be fueled by it. I am someone who would, rather than continuing to ask of medicine and science, “How should we treat disease?” prefers to consider “How can we promote and maintain health?” These are not the same thing. The traditional definition of health, “the absence of disease or injury,” gives the impression that eradicating the cause of the disease or injury automatically restores health. But rationally, despite the context of ownership of some of our lifestyles that can accelerate our decline and sometimes more rapidly as we age, it’s nobody’s fault. However, it will take me longer to reach this point of acceptance. Finally, accepting this life event as a biological and physiological defect, being human, that needs to be remedied before one can begin focusing on future realigned health, healing and more harmonic work and life balances. Trying instinctively to understand that maintaining or having health resilience is influenced by physiological processes unrelated to disease pathogenesis and that our health is a dynamic process that can deteriorate with age. Rationale.
Physiological process
This is a defect detected. A detected defect. However, I will not surrender to it is what it is, idiom with its obnoxious ubiquity and depressing connotations. My husband regularly uses this idiom when I challenge his health and boundary-setting. It is not what it is. I am not defeated yet, nor is he. I’m just brokenhearted for his broken heart, though. A human condition. A condition of being human. But arguably, health is difficult to define. No two persons will have the same definition, biological or physiological, aside. Now might be a good time to consider how you define health; however, being healthy can depend on the developed processes that allow us to survive in more hostile and non-homeostatic environments. Think about the world now and consider what sustains you and what drains you. What keeps you alive bar the four things your human body must have to survive: water, food, oxygen, and a functioning nervous system because it appears to me post-pandemic that this is just what so many are just barely doing. Merely surviving.
We all need this:
(HOH-mee-oh-STAY-sis) A state of balance among all the body systems needed for the body to survive and function correctly.
Self-regulation. Balance. Boundaries. Limits (not benchmarks, actual conscious rational limits) We all need them.
Part 2: You’re Going To Get Fucked
My husband is the most tenacious, persistent, and career-focused person I know, frequently putting others’ needs ahead of his own. He is an impeccable leader. That isn’t a weakness unless it starts to become one. Or we choose to let it be one. What he has an abundance of in immense strength; he lacks my ruthlessness in some situations, like setting boundaries, because he cares too much. I have ruthless boundaries because I cared too much. He is the type of man who, in the past, would stay up all night maintaining the power supply that kept ventilators and other life-support systems operating to keep people alive. Commedable servitude. Dependable attitude. I hope someone is doing the same for him until he is stable enough to breathe independently. I can still clearly recall calling him many years ago when he didn’t come home from work as expected. When I eventually got him on the phone, I was agitated and stressed out from my emotional and past health struggles and shouted at him. He was monitoring the backup power supplies on support machines in a neonatal unit that had gone down. Hypervigilanting the health of another tiny human. I felt guilty. The poignancy is that we had just recently lost one of our tiny babies due to one of our several miscarriages. He’s that kind of man — honourable and trustworthy, but yet breakable because he’s human.
Sadly, he did not develop the more balanced homeostatic environments that allow us to survive in more adverse and hostile environments over the last few years as he scaled his career into leadership and management. But it was that commendable servitude that made him an exceptional leader. Environments that were already hostile and adverse became even more so. He stepped up. In a time when an increased holistic approach may have been more beneficial in fostering homeostasis to challenge hostility, this was not accessible. He was always on. By choice, in commendable servitude and then he got fucked. That is not a criticism. It is realism. Same as I did in my thirties, and I got fucked. A servitude gift that keeps on giving while never giving in. I tried to step up my hypervigilance but was unable to reach him while watching helplessly. I stepped down. When you prioritise everyone but yourself, it can be difficult to know what to prioritise. Or, to put it more beautifully bluntly, as Mark Manson says, which my autistic self adores…
If you go around giving a fuck about everything and everyone without conscious thought or choice-well, then you’re going to get fucked.
Part 3: Determined Duality or Determined Detriment in The Waiting Line
He is as strong as I am. I am as strong as he is. Determined Duality. I say strong, not egocentrically, but with ageing insight and melancholy in the spirit of humanity and humility because for me to get stronger, I first had to become incredibly weak, shatter into pieces, and fall apart and then, as I said, enforce ruthless boundaries to sustain favourable homeostasis. The stability that brought me home to myself. I feel like I am home. I basically had to get my fucks in a row because I was fucked. When I discovered that I was Autistic, my boundaries grew even more ruthless because I now know I have a much lower tolerance for burnout as a result of my lived experience. My husband and I have gone through a lot of upheaval and challenges since we were 17 years old. Real life almost never follows a storybook. Communication can deteriorate, relationships weaken, and people drift apart from the security of familiarity. My husband is neurotypical, and I am a neurodivergent. It is a relationship with neurodiversity. Something I’ll go into greater detail about in another article. You will never be able to see the entire road ahead of you when you are married, though, since you wouldn’t want to. If you could see into the future, you could decide to give up. If everything was obvious and you knew what would happen next, there wouldn’t be a cause for the intensity. But there is always a cause for intuition. And yet my Autistic self yearns deeply to know what will happen next. All those aspects are a part of my friendship and my relationship dynamics, which I frequently struggle with. I need to know what happens next until I don’t. And so here we are now; pre-op, op and post-op stages await. I don’t know what happens next. The anticipatory and emotional wait in the waiting game of life. In sickness and in health. A mental state when you are aware of the outcome but are not fully aware of it. Autistic mindfuckery. A place where I can make up my own beginning, middle, and end. A space where you can lose your mind or find your mind.
To buy more time for most of my thirties, I wasted a lot of time in the waiting line at the ER as well as at my consultant’s offices. My premature pre-mid-life burnout. Internal flames burning in a non-homeostasis festering furnace were a precursor to my getting fucked. Perhaps a large number of us in that line are now in our midlife. After 11 years, I stepped out of this line when I was 40 so as not to get fucked up. Determined duality from insight reality from my lived burnout lack of joy ride and professional experience as a financial advisor and life assurance broker. According to insurance payout statistics, the 40–55 age bracket is a challenging time in life since there is an increase in critical illness payments and cardiac events on plans that cover serious illnesses during this time. While inevitably in the queue for my mortality, I’ll have to line up again for whatever comes next in time to get fucked again. Hopefully, a little less fucked that I have done the work on myself mentally, emotionally and physically to date. I hope she will stand alongside me and bring me home again to wherever that is next.
And so my husband, sadly, at 47, has arrived at the top of the queue after being in the waiting line for so long.
His burnout.
Our burnout.
The Self Advocating Autistic is a reader-supported publication. I have paywalled this because it is so private and personal to me, my relationship, my burnout and how my autism has led us to be independent nomads on some levels but deeply connected on another, let alone the emotional labour. I have practically written a book on it. It’s eight chapters long. If you subscribe to read it, thank you. If not, thank you for reading the preview also.
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