from The Choral Journal,1987

     It was definitely irregular. There was no denying it; it was a cardiac arrhythmia. Face up on the mattress, which lay on the floor of the sweltering dormitory room, the fingers of my left hand pressed to my perspiring right wrist, I felt the throbbing pulse beat randomly, like a dog barking aimlessly in the night. It has been the best week of my life. I had seen the flyer for the Berkshire Choral Institute on a table, during a rehearsal of the Rhode Island Civic Chorale, and had been a week in the Berkshires, preparing and performing great opera choruses under the direction of David Stivender, chorusmaster of the Metropolitan Opera. I had sung with the Met many times before, always at Saturday matinees, and always from the comfort and safety of my living room—not just with the chorus, but solo parts as well, sometimes several parts in one opera. Only recently had I ventured onto the stage, coming out of the shower into full-throated exhibitionism.

     The days began early, at 5:30 a.m. as I traveled down the dirt roads of Sheffield on my bicycle to meet my deer. I encountered them on the first morning as I rounded a bend in the road, singing at the top of my lungs, "On the road to Mandalay/Where the flying fishes play." I was Lawrence Tibbett; but not to the herd of five white-tailed deer who, in critical disdain, bounded silently, like anorectic ballerinas, across a misted meadow into the wings of the woods. A twenty-mile ride would end with a big breakfast in the Berkshire School dining hall, where my wife, just arisen, would patiently hear my tales of mystical encounters with the creatures of the forest. Then came a two-hour rehearsal with Stivender. He was a genius who could communicate and teach. In a week he wove two hundred people who had never met each other into a unity of sound, purpose, and understanding. Out of a chaotic nothingness, Mozart, Bizet, and Verdi came to life. There followed two hours of voice lessons, the first I had ever had. What was there to singing? You just tried to sound like Ezio Pinza or Sherill Milnes or whoever it was your fantasies allowed you to be that day. Now I discovered that the guild of singers had its own jargon: "Sing through the mask," I was told. I heard about breathing from the diaphragm, opening up the mechanism, head tones, chest tones. I quickly attached myself to Steven Bryant, the bass section leader, whose voice had, I thought, the same timbre as mine. To my thoughtful questions, such as, "How can I sing better?" Steven would offer patient and helpful suggestions. Nothing exceeds the narcissism and self-absorption of the singer preoccupied with his voice, except for that of the sick man, preoccupied with his health. After lunch, the afternoon was free. I would bike fifteen miles over a small mountain, arriving at my own private waterfall, where, Walkman in place and score in hand, I would roar the Toreador song into the thunder of the falls. Then it was back to the school for a shower, dinner, and three more hours of rehearsal.

     By Friday night, we had it down pretty well. The evening was free, so that we could save our voices for the concert the next evening. Carol and I decided to go out for an elegant dinner. We shared a bottle of wine, which had become a nightly custom throughout the week, and went to bed early. But not to sleep, for the tiny dormitory room had no air circulating, and the temperature in the upper bunk where I lay in a puddle of sweat, approached ninety degrees. After a couple hours of fruitless attempts to sleep, I threw on some clothes, and fled outside to breathe some cool air and drink some water. Returning, I dragged the mattress down onto the floor in the hopes of finding cooler air.

     "You know, Carol," I mused, "I wonder what would happen if some one put a little poison in Steven's food. Not enough to kill him, you understand, just enough to put him out of commission for the concert. He has a one-line solo in Forza, and if he can't sing it, who will? Who has the best voice in the bass section next to Steven? Whose voice has the same timbre?"
     "Go to sleep, Caruso," she mumbled. And I did.

     At four, I awoke suddenly, feeling uneasy and different. A captive bird fluttered wildly, caged in my chest. Both of us desperately sought its escape. Strange, how a sudden difference in the rhythm of your heart makes such a change in your very identity. How ironic that a musician should develop a disturbance of rhythm, albeit in the rhythm of the heart. After a few vain attempts at willing my heart to be regular, I reluctantly woke my wife. She was used to this sort of thing. A few months after my heart attack, six years before, she had driven me, in the middle of the night to a hospital in Baltimore, from a motel room where I had awakened under similar circumstances with a ventricular arrhythmia. Arrhythmias were a bit worrisome to me. I had experienced the first one a week after my heart attack, asleep in the ICU, where a ventricular arrhythmia had led to a significant complication, cardiac arrest. Successfully resuscitated and restored to health, I had led an active life, but with a constant awareness of the regularity of my heartbeat.

     Trying to look calm and unworried, my wife ran for the car, parked half a mile away. I walked to the pay phone downstairs, called the number written on the wall marked "Hospital," and asked for the emergency room.

     "This is Dr. Ingall," I announced, "I'm having a ventricular arrhythmia. Are you folks set up to handle that sort of thing over there?"

     "Oh sure, hon, you come right on over. Where are you?"
     "I'm at the Berkshire School, with the Choral Institute."

     "Oh, that's great! I'm the school nurse there during the winter. You come right on over and we'll take good care of you."

     I lifted mine eyes to the mountains, hoping for help, and we drove off into the night. There was no pain, just an awareness of an irregularity in the beating of my heart with a slight increase in rate, un poco accelerando, as we say in my new-found singer's jargon. As we neared the hospital, I became increasingly sad. Visions of tearful goodbyes to my fellow choristers, with whom I would be unable to sing, began to pass through my mind. As though I had been hit by lightning, a sudden feeling of warmth passed through my entire body. I thought I would lose consciousness, but was at the same time quite alert; in fact all my senses were heightened. I felt as though I were detached from my body, floating. If the experience didn't terrify me so much, I would have enjoyed reveling in it. Perhaps this was the "rush" that heroin and cocaine addicts compulsively seek. Perhaps it was a release of all those endorphins that had been filling the pages of Newsweek and Time.   I had had this feeling before, during the first year after my heart attack. Was it a sudden attack of anxiety? Once, it occurred after I had resuscitated a jogger who had dropped in the street; that must have been anxiety. When it occurred in airplanes, I began to believe that it was separation anxiety; but then I noticed that it would occur at the instant that the cabin pressure would change and my ears would pop, so that physiologic changes in my body would lead to anxiety, rather than the other way around. Heading toward the emergency room, I was not in a mood to explore the possibilities using the scientific method. I was scared. "Gia regna la morte," sings the chorus in Idomeneo—already death reigns.

     "Move it, Carol," I barked. She heard the urgency in my voice, and still trying to appear calm and cheerful, put the pedal to the floor. My anxiety was not allayed as we approached the hospital, which looked in the dark like a large motel. Indeed, given its low occupancy rate, it was probably the only place within a twenty-mile radius of Tanglewood where you could get a room at the height of the season. A guard was waiting at the door. The hands and faces that greeted me were calm, friendly, efficient, and professional. They knew what they were doing. It was a good motel. The nurse hooked me up to the monitor, and said, to my surprise, "It's atrial fibrillation." On the one hand, I was relieved; it was an arrhythmia more benign in quality than the one that I had anticipated. On the other hand, it was something new, and, in a way, more worrisome. Dr. Patel put me more at ease. He knew his stuff, and his dry sense of humor relaxed and reassured. "We'll admit you," he said, "see what happens with a little time, maybe a little digitalis, and if that doesn't work, maybe the paddles." The last time I had been defibrillated, I had been in cardiac arrest, unconscious, dead. I had defibrillated people myself, as an intern, called, "Clear!" to my co workers, lest anyone touch the patient while the electricity surged through his body, and watched the body jerk into the air, like Boris Karloff when the lightning strikes. I couldn't wait.

     "Just like St. Elsewhere," I announced, as my gurney entered the ICU, whose five beds constituted one-fifth of the hospital's entire bed capacity.

     "Just what we need—anothel comedian!" The nurse's smile was warm and self-assured. Donna seemed to know what she was doing. As I slid from my gurney into the hospital bed, the awareness of my heartbeat suddenly disappeared. Now here was a nurse with curative powers.
     "I'm healed!" I cried, mimicing the devotees of Oral Roberts and Jimmie Lee Swaggart. "Hook me up to the monitor, and you'll see!" Sure enough, as the leads were glued to my chest, the beep of the monitor and the regularity of the waves on the oscilloscope signaled my return into a regular cardiac rhythm.
     "Call the doctor!" I commanded. "Make sure he doesn't leave the hospital. I have to talk with him."

     Dr. Patel smiled as he entered the room. "Looks good," he reassured. "Why don't you get some sleep. You can count on being here for the rest of the weekend."
     In vain, I tried to convince Dr. Patel that I was now all right and that he could safely discharge me. I could not convince him of the importance of the concert that would be given that very night.

     "No way!" he responded. "Chances are this is nothing, brought on by too much exertion, too little rest, and too much alcohol. When you had your strange feeling in the car, it was probably anxiety, but what if it occurred because your heart stopped for a few seconds? We have to keep you on the monitor for a day or two. We have to check your cardiograms and enzymes to make sure you haven't had a coronary."
     I intensified my insistence that I was and would be in good health. To my continuing pleas to be allowed to return to the Berkshire School to sing the concert that evening, he said, "Look, I'm going off duty. My partner will be covering today. He'll be in this afternoon. He's much looser than I am. Maybe you'll be able to convince him."

     Carol went off to spend the day with good friends who were staying in a nearby guest house, having come up to attend the concerts at Tanglewood. I fell asleep, enjoying the cool dry comfort of the room. Each time I stirred, I checked the monitor, and was reassured to know that Donna was doing the same at the nurse's station. The rhythm continued to be regular.

     At mid-afternoon Dr. Mazur walked in. Tall, sad-eyed, and bearded, I could not tell if he followed Jesus or the Lubavitcher Rebbe or the Rajneesh Yogi. Patiently, he listened without expression to my pitch.

     "This is so important for me. I don't expect to live forever. I've only been singing for a year, and I don't have that much time. And tonight I have a chance to sing with the chorus master of the Metropolitan Opera, with Metropolitan Opera stars, and with people who have become my friends. I've been working so hard at this all week. I think my heart's all right; if I didn't, I'd stay."

     His sad eyes glistened. "I understand," he intoned. "I have a disc in my neck. My left arm is useless; I can barely feel it. I can't use it. I have to avoid any movements that would put my neck at risk. But if I had a chance to shoot hoops with Larry Bird..."

     "Then you'll give me a pass to go to the concert? I could come back here afterward, get on the monitor again, and sleep in a comfortable bed with air conditioning, instead of in that awful dorm, where I'll be hot and anxious."

     "A pass? I can't give you a pass!" he exclaimed. "Who ever heard of a pass from an intensive care unit to go sing in a concert? No, you either stay or you're discharged completely. I think you'll be O.K."

     I thanked him, and the nurse, who spilled a few drops of blood on my johnnie as she pulled out the intravenous. When Carol returned, she couldn't decide whether to rejoice at my good fortune or despair at my foolishness.

     There was one problem. I had no clothes. Carol had taken them back to the school earlier in the day. Rather than ask her to make another trip back and forth, I asked if I could keep the blood-stained johnnie as a memento. As we drove back toward the Berkshire School, we passed the guest house where our friends were staying. On an impulse, I asked Carol to stop, and, dashing up the stairs, burst into their room, looking like Jack Nicholson in Cuckoo's Nest, shouting, "I escaped! I escaped!" After some rejoicing together, we pressed on to the school . "Viva la pazzia!" sings the chorus in Forza—Hurrah for madness!   My colleagues in the chorus welcomed me back, curious and apprehensive about me. The Institute director, Mary Smith, despite my bill of relative health from the doctor, was reluctant to let me sing. She feared for my health, and, I thought, for a catastrophe on stage that would embarrass Stivender. I tried to reassure her, reminding her that while everyone knew that the great baritone, Leonard Warren, had collapsed and died onstage at the Met, hardly anyone recalled who was conducting at the time. Instantly, she responded sadly, "It was poor Tommy Schippers." I hoped that she would not remember, and tried myself to forget that Warren had died in the middle of La Forza del Destino, from which we were to sing choruses that night. With some courage, Mary overcame her fears, and allowed me to reclaim my position in the fourth row.
Berkshire Choral Institute
     The Mozart began at about the same tempo as my heartbeat. I held back, singing quietly, checking my pulse after each selection. My beat was as regular as Stivender's. And so with the Forza, I let go. There is no thrill like lifting your voice with two hundred others in the glorious music of Verdi. As we began the Rataplan, Steven roared out his solo: "Alla salute nostra!"—To our health!   And the chorus responded: "Viva!"—Long life!