The last thing I remembered was the cold room with a stainless-steel ceiling. I was about to undergo open-heart surgery, an experience shared by about 500,000 people in the U.S. every year. After the anesthesia took effect, surgeons made an incision in my groin to reach my femoral vein and artery. Through the vein they threaded a tube called a cannula into the right atrium, an upper chamber inside my heart. This tube, and another attached to the artery, was connected to a cardiopulmonary-bypass pump, also known as a pump oxygenator or a heart-lung machine. A dose of heparin kept my blood from clotting as it traversed the machine's innards. As the venous blood passed through the oxygenator, it was cooled to prevent tissue damage. My body temperature lowered to 25 degrees Celsius (77 degrees Fahrenheit)--deep hypothermia. Surgeons inserted an inflatable clamp into my aorta to seal it off. Two liters of cold potassium solution stopped my heart, and for the next two hours the machine took over. An eight-inch incision below my right breast allowed the doctors to pass cameras and instruments between my ribs and then to repair my congenitally defective heart valve.

I left the hospital a week later. The incision healed quickly and painlessly. In a couple weeks I was out and about on slow but successively longer walks. Within a month I was back in the gym. Mentally, however, I felt a bit hazy, a little disconnected and sometimes even lost. I soon learned that the physician's warning, "You may be a little depressed for a time afterward," would not do justice to the long, dumbfounding struggle against what seemed to be the sudden onset, at 51 years of age, of attention-deficit disorder or incipient senility. Adrift in a clueless no-man's-land, I felt my moods range from querulous to despondent. I couldn't muster the concentration to deal with the problem. I just wanted to be able to think. Think anything.

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