The ejection fraction gives the medical world an index by which they can measure, in some sense, just how well a person’s heart is working. An average, healthy adult has an ejection fraction between 55–60. That means with each beat of the heart, about 60% of the blood that was in it gets pushed out. Anyone with an EF in the twenties is in critical condition, though people have been known to live, for a time, with fractions as low as ten. My mother, before her collapse, was walking, talking, and living a normal life with a documented ejection fraction of twenty-six.

The doctors and nurse staff in the ICU here are flabbergasted by it. Even before she moved to Canada, over three years ago, her medical records correctly reported that her heart was in critical condition. Yet, during check-ups doctors thought that since it seems to work, there’s no use tinkering with it. They were most likely right. The condition and quality of life she enjoyed is stunning to me, and to the doctors. No one can seem to wrap his head around the reality of my mother, her strength, and good dumb luck.

Now her ejection fraction hovers at around ten, sometimes a little higher, others a little lower. Again, it’s hard to believe that my mother has stuck it out these past five days. The doctors have installed a balloon pump to alleviate some of the stress on her heart, but it is only a temporizing measure and can’t stay in longer than five or six days. The same goes for most of the medication she’s on. They’ll keep her on the ventilator longer if need be. She only takes about ten breaths per minutes on her own. They oxygen levels on the lowest possible setting, though, 30%. And they’ve been weening her off the drips and balloon. Right now it pumps once for every two of her heart’s. That’s medium. We’re aiming for low (1:3).

I should note that many of her neural and cognitive functions have not suffered. She is very aware of her surroundings. She knows that she’s incredibly uncomfortable and that she doesn’t want to be in the hospital anymore. She has recovered only enough strength to move her hands, one at a time, from her side onto her stomach. When asked questions she can nod in response albeit slightly, open her eyes for several seconds at a time, focus on others, and once Janice and I believe she blew me a kiss. Her doctor uses a crude scale to quantify the relative condition his patients. When my mother arrived at the hospital, she was a one, perhaps even less. Now she’s a three. They won’t consider moving her until she reaches at least a five, ideally, seven.

Studies on those obnoxious family newsletters demonstrate that families can’t help but put a positive spin on everything. Some items don’t need much spin. “Jordan and Angie have decided to get married. They’ve already got a cute apartment priced within their budget and will move in right after the wedding in April,” for example. Here the spin comes from the adjective, particularly from “cute.” Others require a little work. For massive, reconstructive spin, it is often necessary to tack on an unrealistic and unnecessarily optimistic phrase at the end as in : “David has been charged with a count of DUI and involuntary manslaughter after a messy break-up with his high school sweetheart last Friday, but it looks like he might get off!”. It’s within our nature to hold onto those tenuous threads of hope wherever we can find them. Of course, pessimists are never disappointed. Aware of both approaches, I elect to leave you with this bittersweet, moderate summary in proper positive-then-tempered-with-negaitve order.

My mom is doing outstanding well within the confines of a tremendously bleak prognosis.