Before I went to a Catholic high school I knew very little about nuns except for the stereotypical things: they wear habits, they pray all day, and they like to beat up little kids who don’t do their homework. I had many Catholic friends growing up and I never heard any of them dispute these accepted norms. My dad was a former Catholic who had left his religion for various ideological reasons but still felt they would provide an excellent education which is how I ended up at an all-girls high school taught by many nuns, most of whom didn’t wear habits and didn’t beat us up for not doing homework (the stern look worked much better anyway). But yet it wasn’t until I had a nun as a patient that I learned there were also nuns into weight-lifting and some of them even cursed like sailors.

Sister Theresa Agnes had been visiting NYC with another sister from a parish upstate where they were both stationed, if that’s the correct term. The two women looked as if they could be actual sisters, with similar features and mannerisms. They had been running around all morning going to the more obscure city landmarks that most tourists don’t see. They were particularly interested in the borough of Brooklyn.

We found her in an old church in, what was then, a ‘bad’ neighborhood in Brooklyn. We had driven past this beautiful structure many times and it had often seemed almost abandoned. It was not illuminated at night like many of the other churches and we had never seen much activity, but, of course, we worked at night. Some of the windows had been broken, the openings protected with makeshift coverings that remained in place for years. But it was still a magnificent building that looked as if it were transported from another, much older, country. When we went inside it confirmed my long-held belief that beautiful architecture cannot be fully appreciated from only the outside.

Our patient was found in a large room with a high ceiling and several huge paintings which seemed very old. It had carved wood walls and furniture. The room smelled pleasantly of wood cleaner and old incense. Sister Theresa and the other nun were holding hands with two priests and they were all praying. When we walked in Sister Theresa perked up noticeably. “Look,” she told them. “They sent us two women! Girl power!”

We were told that Sister Theresa Agnes had passed out not once, but twice. The first time she briefly passed out it was blamed on the heat of the day and a change in schedule and scenery. She remained slightly dizzy and became easily short of breath. The second time she was out slightly longer and it had occurred after walking up a short flight of stairs.

The 58-year-old seemed tired and she looked pale from across the room. She asked one of the priests if she could have some more water and he took a glass that had been near her and went to fill it. Like my high school teachers, neither of the nuns was wearing habits and they both had on running shoes. We talked about how the women had spent their day and asked how long Sister Theresa had been experiencing dizziness and fatigue. Upon much consideration and reflection, she admitted it had probably been going on for a few weeks.

“That would explain how you were able to beat me at tennis,” said the other nun. “She’s very competitive when it comes to sport,” she told us.

“Well I’m glad I’ll have a legitimate excuse now,” said our smiling patient.

When we seemed to have a difficult time counting her pulse, Sister Theresa noted that her heart rate was usually slow because she was a runner.

“Runner, yeah, sure,” said the other sister, rolling her eyes. “She’s a triathlete. She does marathons. She’s a cyclist, swimmer, rock climber, and she lifts weights.”

“It brings me closer to God and I feel better when I’m active,” she told us.

But her heart rate was really slow. It was remarkable that she was sitting up and having this conversation with us. We put her on our monitor and found her to be experiencing a third-degree heart block. It’s an electrical arrhythmia usually cured with a pacemaker. It was probably only because of her excellent physical conditioning that she had been able to tolerate so little oxygen circulating in her system for so long. A third-degree heart block is considered to be extremely rare in healthy, physically active individuals making our patient an interesting anomaly. (We found out later that she had once contracted Lyme disease from her many sojourns outdoors and it had put her at risk).

We gave her an IV and tried our first line of treatment which we knew would probably not work. The drug we gave her, Atropine, works at a higher area of the heart than the area causing her electrical disruption. What she ended up needing was trans-cutaneous pacing (TCP).

TCP works much like an internal pacemaker by sending electrical currents that override the heart’s faulty pathways. It’s done through pads on the patient’s chest. To tolerate the constant influx of small electrical jolts we called our telemetry physician in order to give her narcotics. We would be giving her Valium, which works as an amnesiac. It wouldn’t exactly stop the pain but would make her forget it was happening.

We had everything set up and warned our patient of what was going to be happening. She assured us it would be OK. We started up our pacing and she suddenly started cursing like some sort of sailor. A polite sort of sailor.

“FANGDAMMER!” she yelled. This unique word hadn’t yet been added to the lexicon of expletives uttered to me by the public. It was quickly followed by “Poo On A Stick!”, “Crappity!”, “Schinittycrapes”, and “Dookerzonks” (I apologize if I’ve utilized incorrect spelling here. I’m going phonetically because my internet dictionary has been of limited use.) She denied being in pain but she continued to spew words like “Craditoollies” and “Snogerites”. It was an interesting phenomenon brought on by the sedation drug.

Rather than be outraged by all this foul language coming from a bonafide representative of a religious order, I wrote many of them down for future use. I figured that these were secret code curse words, backed up by the wrath of God. My enemies had no idea what they had coming to them.

The unorthodox street talk continued as we moved her to the ambulance. One of the priests helped us with our bags and seemed embarrassed by the constant flow of profanity coming from his colleague. We assured him that we had heard it all before, even though we hadn’t, actually. We have to maintain a professional demeanor so we told him that we understood it was just the Valium talking.

When we got to the hospital she thanked us and apologized for her “rancid potty-mouth”. She also said she had been blessed by our care, which was one of the nicest things anyone has ever said to us. She was quickly evaluated and it appeared she would be getting her own pacemaker that day. She looked forward to getting back on her feet again soon so she could continue to explore our big city. We said goodbye and thanked her for the new words we would be spewing back at terrible drivers with lesser vocabularies. We had all been blessed that day.

Here is a link if you’d like to learn more about third-degree heart block: https://my.clevelandclinic.org/health/diseases/17056-heart-block