Born with a congenital heart defect, Christine learned from a young age the limitations her condition would impose
Like any normal teenager, Christine Morrison went through a rebellious phase in high school.
Without telling her parents what she was doing, she showed up one day at tryouts for the track team. The whistle blew. She started running, then promptly fainted and was rushed to the hospital.
In retrospect, anyone could have seen it coming.
"They told me I couldn't do it," said Christine of her short-lived attempt to make the track team. "I was determined, I said 'I'm gonna do it.' I wanted to try."
Christine was not a normal teenager. She was born with a congenital heart defect called Tetralogy of Fallot. Known as "Tetralogy" for short, it is an anatomical anomaly in which blood flow does not follow the normal path on its way through the heart and lungs, with potentially life-threatening consequences.
In normal cardiopulmonary circulation, the right side of the heart pumps blood to the lungs, where it picks up oxygen and returns to the left side of the heart. From there, oxygen-rich blood is pumped to the rest of the body. Diagrams of the heart in medical textbooks tend to denote deoxygenated blood as blue, and oxygenated blood as red. In a healthy heart, the two types of blood keep to their respective sides: blue on the right, red on the left.
When baby Christine's heart developed, there was a hole in the septum that normally separates the right and left ventricles, the major chambers of the heart, allowing blood to flow freely between them. That created a direct communication between the right ventricle and the aorta, which caused blood that had already been depleted of oxygen to bypass the lungs and re-circulate. In other words, the normal barriers separating blue and red blood were broken down. A diagram of her heart would have shown a purple slurry.
Patients like Christine usually require cardiac surgery soon after birth. So far, Christine has had five.
The severity of Tetralogy can vary. Due to the lack of oxygen in their blood and tissues, some babies are born cyanotic, or blue; others are diagnosed later in infancy because they turn blue with crying or feeding.
Patients like Christine usually require cardiac surgery soon after birth. Repeat surgeries as they progress to adulthood are common. So far, Christine has had five. She has a large vertical scar that runs the length of her sternum, an incision that has been opened and reopened many times.
People with Tetralogy may lead normal, productive lives, but their condition will influence all aspects of their medical care, and they will generally need to follow with a cardiologist for life. Although the goal of surgery is to restore normal anatomy and physiology, it does not guarantee a symptom-free existence.
Christine, now 46, is no stranger to medical care. In her case, she was diagnosed with Tetralogy at birth because she came out a pale shade of blue, and doctors recommended surgery immediately. She says her parents, who were young and a mixed race couple (her father is African-American, her mother Italian), were encouraged to give her up for adoption, since staff at the hospital were not confident in their ability to care for a sick child.
"I think it had a lot to do with race, being a mixed couple," she said. "Some people were against that, I guess."
Her father was outraged.
"That really hurt them," Christine said. "My dad said, 'No, we're going to go through all this. We're her parents, and we want to raise her.'"
According to family lore, he marched into the newborn nursery, swaddled up infant Christine and took her to the nearest academic medical center, where she underwent her first surgery. She spent a month in the hospital. Her second surgery followed a year later.
Christine comes across as someone who has endured a lot. In talking with her, the timeline can get scattered: dates and events get mixed up, this or that surgery is assigned to a decade rather than a specific year. This is mostly because so much has transpired; Christine's memory isn't bad, there's just too much to fit into a neatly constructed narrative. Early in our conversation, when I offered Christine an opening to start telling her story, she began to speak, then halted. Maybe it would be better if you just ask me questions, she suggested.
Christine spent much of her childhood in clinics and hospitals. In fact, she was hospitalized with pneumonia when her younger sister, Prudence, was born—also with Tetralogy of Fallot. It was a tough lesson to learn that from then on, she would have to share her parents with her sister.
"I remember them asking do I want to go see her, and I said no," Christine said of her sister's birth.
She and Prudence are now best friends, united by their shared medical struggles. Their father was determined that they grow up feeling like normal kids, with all the opportunities and potential their peers enjoyed.
"He didn't want either one of us to feel like we weren't good enough," she said.
Christine couldn't do the things other children could do, couldn't be as active, couldn't walk too far or too fast without having to stop and catch her breath.
Their father was strict. He had been in the Navy, and at one point he invited a Navy recruiter to their home to talk to his daughters about enlisting once they were old enough. The recruiter quickly realized the girls would be ineligible due to their heart condition.
"He didn't believe that we were any different," she said. But Christine was different. She couldn't do the things other children could do, couldn't be as active, couldn't walk too far or too fast without having to stop and catch her breath. She certainly couldn't sprint or run long distances. But her father had instilled in her a pride that verged on denial, and she felt she had something to prove that day she went out for track.
"I didn't want to disappoint my dad. I wanted to do whatever pleased him," she said. "Maybe if I could run track, then I could go into the Navy. Maybe the Navy was wrong."
Christine has multiple artificial heart valves, some of which have needed replacement over the years. Her last surgery was in 2010. She has a pacemaker. She also has diabetes and atrial fibrillation—an abnormal heart rhythm common in people with underlying heart disease—and takes blood thinners for this.
Along with the mild fatigue and breathlessness that have followed her throughout her life, anxiety and depression have been constant companions—she refers to them as "the mental," as in, "'The mental' was really bad that month, I spent most days in bed." She laments that she didn't have counseling during her adolescence and young adulthood to help her process the complex emotions that come with having a chronic illness.
When things get bad, she is overcome by feelings of worthlessness and hopelessness.
Her medication regimen, when she is adherent to it, includes the antidepressant Zoloft. She's not sure if it helps. She has a history of going off all her meds when she feels depressed.
At the best of times, she is able to pull herself out of bed in the morning, get through a day of work, make it to her appointments and take her medications.
When things get bad, she is overcome by feelings of worthlessness and hopelessness. Twice, she has tried to end her life: once by taking a handful of pills, and once by hanging herself. She's been in and out of psychiatric institutions.
At one point in 2017, she received a threatening call from a former boyfriend who had sexually assaulted her in the past; dark, painful memories surged through her. She was at her father's house at the time. Instead of going home, she checked herself into a hospital.
"I knew that if I went home, I would've killed myself," she said. "I know I would've. I would probably have succeeded. This time I would've made sure."
From the hospital, she was transferred to a psychiatric residential treatment program, where she spent three months. She loved it there. She bonded with her co-residents, participated in therapy, got back on her meds, and re-established a sense of self.
Christine returned to work in 2020 after being out on disability for about seven years. She works in the optical department of a large department store. She also enjoys a loving relationship with her husband, Daryl, who has been a stabilizing and uplifting force in her life.
"I always thought, who would want me?" she said. "It took me a long time to be able to even show my scar. All my scars, really. It took a lot to come out of that shell."
"It takes a lot" to go to her appointments, she said. "Who wants to hear bad news all the time?"
I asked Christine if she ever felt bitter, like she had been unfairly dealt a bad hand. Of course, she replied. Her biggest regret, she said, is not being able to have children. Every doctor she encountered told her that hers would be a very high-risk pregnancy, and complicated by the fact that she was on blood thinners. She was pregnant just once, in her twenties, and suffered a miscarriage.
"God just didn't put it in the cards for me," she said. "We [she and Daryl] laugh about it, what they would look like, because I know they would be beautiful."
Christine still struggles; things aren't perfect. "I can't do no marathon," she says with a laugh, tacitly acknowledging what an understatement that is. Some days it's harder to get out of bed than others. She takes her meds, for the most part. "It takes a lot" to go to her appointments ("Who wants to hear bad news all the time?" she points out), but she goes—every six months to a cardiologist and an electrophysiologist, who manages her pacemaker.
There are times when her mind hones in on her heartbeat, and she wonders if it might stop suddenly. She doesn't dwell on it or let it consume her. She says she's comforted by the fact that she wouldn't be aware if it happened. For now, she moves through life with a cautious optimism, hoping for more good days than bad, taking nothing for granted and seeking gratitude for the time she's been given.
"The scars, you know, I'm thankful for them, because I wouldn't be here without them," she said. "But it did hurt a lot."