I’ve been released by the cardiologist to return to work today, for all I know it will be my last. I missed several weeks in May and June due to a suite of confusing and worrisome symptoms after surgery to correct a serious ailment. At first I seemed to be recovering well. But beginning in late April I started having periods of dizziness, intense weakness, for several days I could barely crawl out of bed. Sometimes it would feel like my heart would jump or gurgle. Blood pressure was all over the place, soaring as high as 160/100 to as low as 100/60 over a period of an hour or two. The only time I would feel halfway normal was when I would walk a mile or two on a treadmill per doctors orders. Finally one morning in May, right after I got out of bed feeling extremely weak to go to the bathroom, I found myself suddenly staring at the ceiling; I had passed out so fast I didn’t notice the blood gushing out after my skull had apparently cracked against the ceramic toilet seat on the way down.

The last time I had symptoms like this, back in December, I downplayed them and kept working. Mostly because my employer ruthlessly penalizes absences regardless of the cause and I was terrified of missing work. But the symptoms persisted, eventually got evaluated by a specialist. That’s when I found out the effort to try and keep working over Christmas was probably the worst decision I ever made: I was suffering a massive heart attack, the kind where the first and most common sign of a problem is often instant death.

It’s hard enough to live on 11 bucks an hour when young and healthy, as a middle aged man used to a modest living wage before the recession, it turned my life upside down. Trying to make it on 60% of that lousy wage for the six weeks allotted me in Jan and Feb to undergo surgery and recover was impossible. And in this latest round I haven’t received even one penny of that stingy disability; in part because insurance companies are evil, the money was tied up in processing delays and requests for more info the entire time. With no income and copays soaring, what little I had miraculously managed to sock away for just such emergencies was quickly exhausted.

I now live a rather drab life, stretching out cheap meals for days, going without lunch or dinner sometimes, something as modest as a new pair of shoes or a used iPad are unthinkable luxuries. But I’ve made the best of it, adjusting to the new harsh reality faced by millions of fellow Americans who fell with me out of a modest middle-class life style into the relentless grip of grinding poverty. Thanks to Wall Street’s incompetence and greed and their sociopathic conservative enablers who bailed them out with a trillion dollars borrowed against our credit, all the while scolding us like children on the evils of debt and government spending.

I even did my best to turn it into an advantage of sorts, using the ordeal as a springboard to lose weight and get into shape. It sure gave me a great start: at one point in May I dropped ten pounds in less than two weeks. Probably the most insane shit forced on me by these dire circumstances was having to cut my pills in half or skip a dose from time to time. That’s insanely dangerous in my condition. These are not optional meds, they are not feel good pills, these are expensive, patent protected specialized drugs heart patient must take twice a day for a minimum of a year to reduce the risk of fatal complications.

It took lots of tests, but the underlying issue turned out to be a new and growing PFO, a centimeter sized hole between the two main chambers of the heart causing brief stabbing chest pains, skipped gurgling beats, and gyrating blood pressure. The PFO was probably a complication from the type of cath used to place the stent and it was likely exacerbated by a low grade infection — I have an autoimmune disease which means I have to take drugs that knock back my immune responses and leave me open to such infection. A round of antibiotics cleared it up, the sore throats and fever backed off, my heart seem to tighten up, a few weeks later a subsequent test showed the hole had closed. Over the last two weeks I began to feel much better and started putting weight back on.

My real fear isn’t the PFO or even my heart in general, that all appears to be controlled and doing fine. What has me up at 5 AM pacing my squalid apartment is anxiety over my fate: despite keeping my supervisors and HR director informed of my progress daily, I’m fearful I’ll be fired on some technicality this afternoon just as Ive witnessed happened to other, low level poorly paid employees. Not only will that leave me facing homelessness, it will immediately cut me off from the group health insurance critical to ongoing treatment key to my very survival. In Texas that culd be a death sentence: a pink slip today will deliver me into the tender mercies of the Texas social safety net, or at least those remnants not yet raided by Governor Rick Perry and his teaparty pals who are intent on punishing the poor to enrich the wealthy. To add insult to injury, Texas Republicans are obsessed with fighting the implementation of Obamacare, my last ditch salvation if worse comes to worse, tooth and nail.

Even if I do last the day and there are no reprisals for having the gall to suffer a heart attack and complications, my future at this company is dismal now. We have an attendance policy straight out of third-world sweat shop, missing three days for any reason in a six month period is grounds for dismissal. A few years ago when I cracked a rib/vertebrae and punctured a lung, my then manager called me while I was still doped up and wired in the ICU ward to tell me I was in big trouble for missing four days of work and having the gall not to call in the official sick line while I was half conscious in the ER.

Given that kind of unethical practice, I anticipate being institutionally shamed for this episode, forced to hear a statement informing me my conduct is not becoming an employee of my firm and then being forced to agree to it in writing. This will mean, despite being the numero uno top performer out of hundreds of my fellow workers in 2012, while unknowingly suffering progressive heart failure the whole time, I will be barred from consideration for any raises or promotions. This probationary period will be last a minimum of six months virtually guaranteeing my Christmas and profit sharing bonus will be reduced or eliminated. Funny how no one at Fox ever mentions that in the annual War on Christmas.

Then again maybe my fears are misplaced, maybe I’m over estimating the ruthless nature of corporate America. I’ll find out in a few hours.