I woke up covered in cold sweat, and I knew my life was in danger.

I was in the guest bedroom of a woman I didn’t know. She was paying me to drive her moving truck from New Mexico to Minnesota, and I’d hitchhiked 200 miles to arrive at her house the day before.

My body felt like garbage as I waited for my last ride. I had flu-like symptoms without the mucus or the coughing; fever, chills, weakness, and a morbid internal inkling that something was not right.

I thought: maybe it’s the exhaustion from a long day of hitchhiking. Maybe it’s a cold. Maybe I’m imagining things.

I hoped it was anything but another heart infection.

The puddle in which I awoke confirmed my fears. I only get night sweats when I have endocarditis.

Why my heart gets infected

I was born with a congenital heart defect called aortic stenosis. When I was 15, I had an open heart surgery to swap my deformed aortic valve with my healthy pulmonic valve; this left me with pulmonary stenosis instead, a less serious condition.

The stenosis worsened and at age 24 I received a new pulmonary valve. Now I’m part cow.

This prosthetic valve has rough, unnatural surfaces, so any bacteria in my blood can more easily gain a foothold there and begin to multiply. Microbes often reach the bloodstream through our gums when we brush our teeth.

The valve became infected a year after it was implanted, requiring six weeks of IV antibiotics to eradicate.

5 years later, it was happening again.

A wiser version of myself would have sought medical attention right away.

It’s dangerous to wait because sometimes those bacterial growths become so big that they break off into the bloodstream, which can cause strokes and blindness.

I was at a point in my life where I felt like the $400 paycheck made it worth waiting three days to get medical attention. I was also afraid of how my client would react if I bailed on the gig.

We drove over a high Colorado pass in a blizzard, through flat and rolling Nebraska and Iowa, and into Minnesota. I cranked the heat and still shook with the chills while driving. I soaked hotel bedsheets through to the mattress at night. I passed hospitals and thought “I should be pulling in there right now.”

We finished the trip, unloaded her truck, and I spent the night with my friend who lived in the area. It was my first time in Minneapolis. In the morning I walked about a mile to the emergency room and checked myself in.

I had blood drawn for a culture test. The lab processing takes some time, and they weren’t seeing other significant symptoms, so they were about to discharge me and call me back if the test was positive. But they took my temperature one last time, found a high fever, and immediately hospitalized me. The positive result for streptococcus mitis came back later.

Thus began my 5-day hospital stay — the longest in my life so far.

Life as an inpatient

Being admitted to the hospital actually raised my standard of living significantly.

I had spent most of the year nearly broke, living in my car. After a cold and lonely winter with limited access to hot food or warm buildings, it felt luxurious to have my own hospital bed, in a climate-controlled room, with a food service menu. I felt protected more than trapped.

The nurses cared about my needs, and even the pre-dawn phlebotomist stabs gave me the sense that someone was watching out for my progress.

Despite the ways in which I appreciated the relative luxury, hospital visits are always difficult; you’re confined to a single room with a roommate you might not like, tethered to a rolling IV stand, constantly being measured and evaluated like a science experiment. You’re feeling sick and uncertain of your future the whole time.

No matter how good your support system is, everybody goes through medical crises alone. Nobody can fully understand what it’s like to live your experience.

Health scares can also boil away needless drama and recenter your relationships on what really matters.

Two other friends who were in the area came to visit. They brought me a laptop, some books, and other entertainment items to use during my stay. My mom came out from Oregon to keep me company and fly back with me.

Toward the end of my stay, I was starting to feel better physically and I experienced a certain kind of urge due to the fact that I hadn’t had a sexual release in over a week. I went into the bathroom, leaned back on the toilet, and got busy. I figured I’d be stealthy enough that my roommate and his wife wouldn’t even notice I was in the bathroom for longer than usual.

A minute later I heard a banging on the door and my nurse calling, “Joe! Are you OK in there?” I couldn’t believe my misfortune at the bad timing of this attention being drawn to my activities in the bathroom. What were the odds?

It turns out the odds were pretty good. I’d forgotten I was wearing a battery-powered EKG which transmitted data wirelessly to a control room, where someone was monitoring my heartbeat. I’d set off an alarm.

I sheepishly told my nurse what happened. She laughed, said it was actually a good sign that I was feeling better, and even helped cover my tracks in front of my roommate by implying that I’d triggered the alarm with an intense bowel movement. I wonder if he figured it out.

My condition stabilized, and my mom and I booked a flight home, timed such that I wouldn’t miss my regular dose of antibiotics.

A surprising thing happened: I was reluctant to go. I left the hospital in tears. I felt I was losing my newfound oasis of comfort, attention, and support, like a young bird pushed out of its nest.

I had a PICC line entering near my bicep and running straight to my vena cava. I would administer the life-saving poison every day for six weeks.

After those weeks, I’d end the antibiotics and hope I was cured. If the infection was still lingering, I’d need to schedule a second open-heart surgery to replace the valve.

Six weeks is a long time to wait and wonder about such things.

Back in the real world

The minute I walked back onto the streets, society perceived me as a normal, healthy citizen, and held me to the same standards as anyone else.

Nobody could see the PICC line under my sleeve. Nobody understood what I’d been through in the last week or what I would endure in the following months. How could they have known that I felt so emotionally fragile, or why my eyes were red and glazed over?

My mind in a daze, I could have stumbled out into a crosswalk without looking, and the motorist slamming their brakes might have assumed I was stupid, careless, or on drugs.

Medical emergencies have a long history of stimulating personal and philosophical realizations. They disrupt your normal thought patterns, redirecting your attention to new ideas.

The realization I came to this time was: there are constantly people around me going through similar turmoil. How many of us have serious physical or mental illnesses, hidden under our clothes and our public demeanor, at any given time? How many are deeply affected by the death of a loved one?

That angry-looking person on the bus might be on their way to have a tumor biopsied. The person who cuts me off in the grocery store might be shopping for their dying spouse. People are physically present, yet their minds and hearts could be in an alternate dimension of pain and grief.

Hurting people need to receive compassion, not anger.

We are all fragile. We’re all temporary and vincible. Some of us are farther along the dying process than others, but everyone’s presence on earth is a fleeting moment. Being alive right now is an incredible thing to have in common, at least on a geological timescale.

My recovery from my second round of endocarditis was not as clean-cut as the first. I experienced further symptoms of infection during and after my treatment. At one point a cardiologist told me that I’d failed medicinal intervention and would need surgery immediately, which was fortunately not the case.

It’s been 2.5 years and the infection hasn’t returned, but any time I brush my teeth or draw blood I wonder if my immune cells will kill all the microbes in time. The more times a valve is infected, the more likely it is to happen again.

There’s nothing I can do to prevent it; it’s a constant reminder that my days are numbered.

Some days, this reality is heavy, and I’m sure I appear less than friendly to passers-by.

This is why I make an effort to remain calm when strangers act in frustrating ways. I can’t know how their actions might be influenced by their mortal fears, pain, disability, or trauma. It isn’t worth taking personally in the grand scheme of things.

Patience and kindness don’t cost anything, but they can make a big difference to those who are suffering.