What we fear the most is…the unknown

What is it that we fear the most? If you ever thought of this, you would probably come up with hundreds of different things you might fear.  In an article, from the Journal of the American Association of Critical Care Nurses, published in December 2009; there was a feature article titled Edgar Allen Poe, ” The Pit and the Pendulum,” and Ventricular Assist Devices.  It is a comparison of Poe’s timeless  short story” The Pit and the Pendulum” and the various experiences, of several LVAD  patients.  Edgar Allen Poe always used the unknown to capture the attention of his readers.  In this story, he uses the pit to illustrate the unknown. Poe never exactly explains what is in the pit, but through his writing style creates a sense of fear.


As a former LVAD patient, I can definitely attest to the fact of the uncertainty of the device.  One of the issues that I battled with the most, was the stability of this electro-mechanical device that was keeping me alive. The uncertainty of the reliability on this device, was a tough pill to swallow. In the beginning, all I could do was think about adapting to this new device and attempting to live a normal life. It certainly was not easy getting around with this device, which had a direct line into my lower right abdomen that connected directly to the pump. Special care and consideration had to be taken to not pull or move in an abrupt motion that might stretch or yank on the line. Then there was the whole bathing issue. I was unable to shower,  until the wound around the drive line fully healed. In my case, that was a year after having the device implanted. I was restricted from driving or sitting in the front seat , to prevent further injury or possibly death, in the event of a vehicle accident and the deployment of the airbags. Then there was the issue, of the battery packs that powered the pump. The batteries had an approximate duration time of 10 to 12 hours per set, and then had to be changed. If the batteries started to diminish, a very loud audible bell and the alarm would sound to remind you. At nighttime, I was actually tethered to a base device and monitor. I was forced to sleep on my back, even though I have always been a side sleeper. Having to rely on others, to perform ordinary everyday tasks only added to my grievances. My wife had to undergo a thorough training and testing, as my primary caregiver. All these worries, compiled with certain medical complications, were certainly causes to fear, what will become of me.


According to the American Heart Association, more than 5 million adults live with some form of heart failure. Approximately 20% of all patients with heart failure, die within the year of diagnose. The mortality rate increases with time. It is estimated that only about 40% to 60%, lived beyond five years of being diagnosed. Even though there have been incredible advances in the medical field, these numbers have decreased very slightly. The thought of uncertainty is something that truly frightens, even the bravest of us. Obtaining the proper and necessary medical care, is probably the greatest asset in improving these odds. Many people, including myself,  are  frightened to receive unpleasant news; but the reality is that the sooner it is detected, the better your chances for a favorable outcome.


This does not only apply to heart conditions or medical conditions. It applies to every aspect of our lives. We become very complacent, with the normality of our lives, and cannot start to imagine living a different lifestyle. Change is a common occurrence in life. The sooner we learn to embrace it, the easier it becomes to get to the next level. In my situation, I had to learn to deal with the LVAD, even though it was a burden, the reality is that it saved my life. What I needed to do, was to stop thinking about what could’ve been or why this was happening to me. The need to get past this obstacle, and get to the next level ( heart transplant), was where I channeled all my energy and focus. The desire to be independent and not reliant on others, was certainly a huge motivation to excel. I came to the realization, that the unknown will always be there. My obligation was to live every day to the fullest. The only certainty we have is that we wake up every day and it is up to us how we will live that day, until the day, we are no longer alive. As long as we have breath in our bodies and a beating heart, we have the strength to persevere.


Today, I am indebted to the LVAD, for two particular reasons. The first one is obvious, it kept me alive. The second one is not always discernible. The thought of having to live a prolonged period of time with that machine, made me reach deep inside and find the courage and strength, that I never knew I had. Constantly, I had to keep discovering new ways of pushing myself to my goal of getting the heart transplant. Even though the heart transplant brought new uncertainties, risks and obligations, I never stop envisioning how my life would be improved for the better. We need to remove the fear of the unknown and replace with  faith and positive thoughts.


A special thanks to Diane, for her contribution to this post.

2 Responses to What we fear the most is…the unknown

  • Paul W says:

    Sal, you express yourself so well. Your emotions are transmitted to the reader in such a manner that the reader feels your fears and joys as if it were his. Continue to improve. Perhaps you can change careers and become a writer. Paul

    • Gsal says:

      Paul, thank you for your encouragement and support. It is truly welcomed to get positive feedback. A book is in the works, I’ll post updates regularly as to the progress. Anything is possible.

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German (Sal) & Milja Saldarriaga
Fort Mill, SC

I am available for lectures, consulting, life coaching, motivational speaking, interviews and appearances.

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My Life Experience

  • Retired New York City police officer
  • coping with heart disease since 1996
  • had defibrillator/pacemaker implanted in Oct 2003
  • had Left Ventricular Assist Device (LVAD) implanted in September 2009
  • Received heart transplant September 2010.
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