Reyes is indignant with the fast-food companies. She stopped eating at McDonald's last year and blames the country's obesity problem, in part, on economics. "Ever since they put up that Dollar Menu," she says, "it just gets everybody fatter. You can go up there and get a double cheeseburger for a dollar. Subway is, like, $6 for a sandwich. Do you know how much food you can buy at McDonald's for $6? That's why all of us are getting fat -- because fast food is so much cheaper."
Taylor's final prop of the day is a jar filled with gooey brown liquid with cigarette butts floating on top. "This is how much tar and nicotine you'd get in your lungs if you smoked half a pack of cigarettes a day for a year," she says as she sloshes the contents around. "Smoking affects the blood vessels and makes them paralyzed. If you have blockages in your arteries, it will take less plaque to create an obstruction. If you don't smoke, don't start. If you do smoke, find a way to stop. It causes all kinds of terrible problems."
Students from a summer school program watch surgery at Inova Fairfax Hospital's "Dome."
(Photograph by Chris Hartlove)
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DOWN IN THE OPERATING ROOM, the surgeon finishes sewing the third bypass graft and is ready to revive the patient's heart. As he removes the heart-lung machine tubes, the muscle twitches momentarily, and after a quick shock from the defibrillator, it begins to beat in a regular rhythm.
Alex Brazell, who thinks he will major in biology or premed in college, has been watching the procedure closely. Heart problems have been on his mind lately. His uncle had angioplasty not long ago and received a stent to open a coronary artery, and his mother was put on medication to regulate her heartbeat. Brazell notices right away that the Dome patient's heartbeat has changed.
"The beat looks more crisp now," he says. Taylor explains why: "That's because the blood flow is increasing. It's becoming more efficient."
For all of the relief bypass surgery offers to patients, it doesn't cure heart disease. Blood flow is restored to the heart, staving off a potential heart attack, but the underlying disease processes will continue unabated unless a patient changes his or her diet and lifestyle.
Bypass surgery presents the patient "an opportunity to regroup," LeFrak says. "The surgery is actually easy for the patient. They go to sleep, we do all of the work, and they wake up. It seems hard because they have some discomfort for a few weeks. In reality, that's easier than stopping smoking or starting an exercise program or losing weight or eating low-fat food. Those really take some work. You can't do that under anesthesia."
After more than three hours on the operating table, the surgeon is ready to close the patient's sternum. He threads a length of stainless steel wire through the edges of the ribs to lace them back together.
Scott Tsuchitani watches and wonders about his own risk for heart disease. His father and sister have high blood pressure, and he recently learned that he, too, has the condition. Even though he's in top physical shape, his coach recently told him that he had to sit out soccer practice until his blood pressure came down.
"It's a big realization that you're responsible for what you eat, that this can happen," Tsuchitani says as the surgeon and his assistant pull with pliers on the ends of the wire and draw the ribs back together. Although he has a weakness for pizza, he says he has quit drinking soda and eats almost no fast food.
In the hallway outside the Dome, Sheila Napala gathers her class together. Some look beleaguered after more than three hours of sometimes gut-wrenching observation. One student was so disgusted by what he saw that he ran to the bathroom to throw up.
"Subway today, okay?" Napala says. "Not pizza." More than half the group nods in agreement.
Paul Gustafson teaches English at Quinnipiac University. His e-mail address is Paul.Gustafson@quinnipiac.edu.
