I think his name was Jumbo - the elephant that sat on my chest last Friday afternoon as I was talking to our court reporter, There was no warning, We were in the middle of a conversation when he just took a notion to use me for a chair. Flattened me right out, it did. Jaime, the court reporter, asked me if I was ok. I did not want to interrupt the court's calendar and I told her, "I'm OK, just give me a minute." She did not believe me. She called 911.

I don't know how long it took but it seemed like seconds later I was surrounded by Sheriff's deputies opening my collar and loosening my belt. I remember asking Jaime to fetch my file from the courtroom because I did not want my opponent, a particularly sleazy individual just re-admitted to practice, to have access to it.

The paramedics came in a troop and slapped an oxygen mask on me. Someone of them asked me to rate the pain from one to ten. I quibbled with the word pain. It did not hurt in the sense that a toothache hurts or that a cut finger or a sprained ankle hurts. I told them there wasn't any pain - just pressure. OK, then, on a scale of one to 10 rate the pressure. 10 being the largest elephant in captivity taking a break with your chest for a lounge chair I rated it at a 9.5 elephant. The pain came later and was just above the level of discomfort.

They loaded me on the gurney and wheeled me to the elevator. There, in the corner of my vision, was the newly re-admitted lawyer with a George Bush smirk on his face. I remember thinking, "Great, now that bastard will think that HE gave me this heart attack." Actually I had been looking forward to the afternoon hearing. I had the trap set for his leg, jaws wide open and ready to snap.

In the ambulance they pasted the heart monitor leads on my chest and attached the machine. "How's the sinus rhythm?," I asked. I didn't get an answer. BP 180/100, "Jeez, that's high for me. Its usually 135-145/85." I started giving them my history - diabetic on 10mg Glucotrol and 2000mg Glucophage. "How old are you, Keith?". "64 if I last to Monday morning." They started an IV and sprayed nitroglycerine under my tongue.

I went through the history again at our local ER. More IVs and blood draws. Go through the history again. The joke about Monday morning is growing stale. Pressure is subsiding and the chest is beginning to hurt. God, I want a cigarette! The EKG is beeping and the BP is back down where it should be. Blood enzymes are normal. They tell me that they are going to transfer me to the larger hospital clinic in a neighboring city where I will be seen by a cardiologist.

They take me straight to the cardiac catheterization lab. I did not have a heart attack they said. They compliment me on not ignoring the symptoms. How the hell do you ignore an elephant sitting on your chest? They explain the procedure. The catheter will be inserted in the femoral artery. I sign the consents. Another IV drip and I wake up a little later. There is a screen that I can see and it is weird seeing your heart beat. I can see clearly the vessel narrowing to the size of a thread. I close my eyes.

A little later and I am making small talk with the gal who runs the cath lab. She asks if I know her husband. He is a lawyer and the Republican Candidate in our State Senate district. She is making jokes about me being a lawyer and being ordered around by four women. Its worse than that, I've fallen into a den of Republicans. The artery was 75% blocked and they have done an angioplasty, opened it up and set a stent to keep it open.

Now, I tell you all this because I made that 64th birthday on Monday morning, thanks to a lot of expensive expertise that there is no way I could have afforded on my own. I'm on the county payroll as public defender and one of the benefits is an HMO. Drugs are covered and monthly prescriptions have gone from 3 to 5. Cost - roughly $500 per month without insurance. What is the cost of the procedures and my all expense paid vacation over the weekend. Close to $150,000 I'm guessing. This time next year I will be on Medicare, So long as I can keep working I'll have the HMO but with diabetes and now coronary artery disease there is no private insurer that will touch me with a 10 foot pole - even for a Medicare Supplement.

There are millions of people just like me out there in America. We look at the future with a certain desperation. What happens to us? What do we do when time deprives us of the ability to earn a paycheck and the medical benefits that go with it? Do we just ignore that elephant sitting on our chests and shrug it off and wait for the day the elephant doesn't get up? "I'm OK - just give me a minute" - until there are no minutes left. God, I want a cigarette.