Unexpected illness in 2010

Up until May 2010 I though I was in reasonably  good health for someone of my age. Suddenly the world changed.

Apart from finding that I grew tired rather easily, my first real indication that something was amiss came about in Edinburgh. I had gone there for a weekend to attend a school gathering and was staying with friends in Colinton, some 6 miles away from the station and mainly uphill. I took my bicycle in order to be independent and on the way to their house I noticed a pain spreading down my arms. I went more slowly and the pain retreated.. Back in London I felt worse on the Monday and had to drag myself into Lowther Primary school where I teach poetry once a week on a Monday morning. When I had struggled back home I phoned the surgery and was given an appointment later in the day so I ‘phoned Paul  our friend and neighbour asking him to look after our dog in the event that I was kept in for tests ( Jan had gone to his retreat in the Isle of  Wight for the week). When he asked why I was going to see the doctor and I had explained he said, “you should be calling the ambulance, not waiting until your appointment in the afternoon.” A few minutes later he rang back: he had spoken to Ed, one of my Godsons and said Ed had gone ballistic. I let him call the ambulance and it arrived in less than ten minutes.

We spend our lives visiting friends in hospital
Car park, couple of quid, corridors and lifts,
Blythe Ward, fifth floor; is it East wing?
Hello! Take a chair, over there. Chap in that bed
Died last night. Would you like tea?
See you next week. Keep up the good work.
And then one day it’s 999 for you.
The ambulance, the wires, the trolleys, the tests
The peeps, the patients opposite, their relatives,
The friends, the fruit. Take a chair. Would you like tea?
I’m off to sleep
Ask Nurse not to wake me
I might not be here
But in Tintagel
To travel so far and so fast
Could prove fatal

“Hello! Hello!” The repeated cry comes from some distant ward on our floor. “Hello! Hello!” on a curved, descending, mournful note. In the night, making my way to the bathroom, I come across the man, stooped, white-faced,  eyes focussed on infinity, he shuffles past me, “Hello! Hello!” At close quarters, the voice is more urgent and has an air of desperation, like someone calling on a bad telephone line whose life depends upon being understood.

A nurse trots along behind, ” This way, this way, Mr Brown” as she tries to steer him around and back to his ward, but without success. “Hello! Hello! – Hello! Hello!” and the odd couple disappears around the corner.

Opposite me – it is a ward for four patients- two are men look to be of Asian origin and both overweight. The one on the right, in a turban, receives a visit from a daughter (there are two more daughters, he tells me later) and a son. The young man has thighs as thick as his sister’s torso. They bring fruit and Indian delicacies. After embracing their father they stand respectfully beside the bed while he holds forth and the son eats the delicacies. Papa has the distinction of a pater familias of some importance, a Managing Director perhaps. Later I ask him what business he has been in and he says proudly that he has been a mechanic all his life: “I have repaired every type of wehicle, and WITHOUT A PIT.”

The other man opposite me, but to the left, is more difficult to engage in conversation and for a long time would not meet my eye. At one point the Consultant swept in with his retinue to question him. The paper curtains were pulled around them but of course I could hear every word.
“Where do you get pain?”
No reply.
“Do you ever go up stairs?”
” Never!”
“Do you take exercise?”
“No!”
“Who does your shopping?”
“My wife.”
“You have a spray?”
“Yes!”
“You use it?”
“Yes!”
“It relieves the pain?”
“Yes!”
“What made you come here?”
“The pain spread to my back and numbness.”
“Any history of heart disease in your family?”
“Oh yes!”
“Is your father alive?”
“Oh no!”
“What did he die of?”
“Heart attack.”
Do you have brothers and sisters?”
“Yes!”
“Do any of them ever have angina?”
“Yes! All of them”
“What age is the youngest?”
“Forty six”

Next day I capture his attention. Where is he from, I ask. Sudan, he says.
I’ve only known one Sudanese in my life, I say, and he was a friend at school. He had his bed next to mine in our dormitory and I got to know him quite well, a charming boy called Ahmed el Mahdi. He was the grandson of the man who killed….
“General Gordon,” he completes my sentence, and continues, “His sister is married to my uncle. He is now a very important person in the Sudan: the leader of the Alauma party and the Imam of Alansar. I have his phone number if you would like to speak to him.”

Opposite was what seemed to me, from the deep voice, to be a young, rather small black lad with amazing curly hair. But it turned out not to be a boy; it was a woman and what is more, a grandmother and also a poet. She has written five hundred poems and been published. Her family comes to visit, but she is in pain and hardly speaks to them. The grandson about nine years old sits by the bed, as if he were elsewhere and plays on his game machine or whatever. I’m inspired to write a little poem which I hand to the boy and ask him to give it to Grandma, which he does and this elicits a sweet smile and a compliment:

Poetry is Grandma’s skill
More powerful than any pill
But now she’s had a stroke,
(We always told her not to smoke)
She’s in bed in Charing Cross
And for once she’s not the boss
But soon we’ll have her home again
Her poems will reflect her pain

An old man is wheeled in next to me. He begins talking away mostly to himself, occasionally apostrophising those opposite him, who pay no attention. A visitor arrives: it is his brother.
“Hey ladies!” he shouts at the two old men opposite, “This is my brother.”
Brother, gloomily: “They’re not ladies. They’re men.”

The night before my operation I was taken to a single ward: blissfully quiet until a nurse in the adjacent staff room started a telephone call at midnight. From the accent I would think she was Jamaican and from the loudness of her voice, talking to a friend  on the island. She never drew breath but occasionally the pitch rose to fortissimo, presumably to overcome the attempts of her correspondent to say something. At one o’clock I took my wires off, toddled next door and called through the door, “ Do you think you could talk a little less loudly, please.” There was not even a pause but the decibels reduced a little. After ten minutes, I shouted through the wall, ”Quiet please!” The voice stopped but then I couldn’t get to sleep anyway.

After four days of being tested in every possible way excluding an angiogram, I was taken to another hospital for that procedure which would enable them to see if I had a blockage. ‘No water or food from midnight’ I was told. ‘You will be woken at 6.00am. The ambulance will be here to collect you at 7.00.’ By 8.00 I am lying on a flat firm bed at the new hospital, dressed only in a reversed gown. It is the cardiac surgery unit and the doctors begin to arrive and change into their operating gear: blue pyjamas topped with what looks like a mediaeval jousting jacket and apron covered in  material that would look more at  home in a children’s playroom. One surgeon is a little hunched, one brisk, one hirsute and one laidback. Which will be mine I wonder? Beds with patients trundle past me into the theatre and some time later come out again. The bed is unyielding and my back begins to hurt. 9.00am, 10.00 am, 11am come and go. I begin to worry that they will be exhausted by the time they get to me. Suddenly the brisk one is at my side . He introduces himself and the questions begin. He disappears with the same briskness and new patients continue to trundle past me. 12.00 comes and goes. A stir. Someone of greater importance has appeared in the waiting area. He has an air of authority: the deference of the staff acknowledges this. He is being shown a list but I hear him say, “First I have to do this man”, and his finger points towards me. Moments later he has changed and is standing next to me. The questions begin again: he is reassuring and concentrated.

I am wheeled into theatre. Six people, two in a glass cage; a friendly word and then my gown is removed and I am at their mercy. The nurses and operatives gaze at me and the eye of the camera through me, The surgeon, a charming Palestinian Senior Registrar says he is going to inject me in the groin. “ You will feel a stinging sensation and a few minutes later you will feel the same again.” Hands massage my leg. The surgeon is talking to his assistants calling for what he needs like a dentist. My back is hurting worse and soon the pain has a companion in my chest. “You will feel a pain in your chest,” says the surgeon. I already do. Suddenly I hear him say, “Well, I can see the culprit: you have a 95% blockage of your RCA (Right coronary artery). Don’t worry, we’ll have you right in a jiffy!” Half an hour later he says,”you will feel a warm rush in the groin. I do and it is so comforting I think it must remind me of something that happened long ago, perhaps peeing in my nappies as a baby. “You will feel another hot rush now.” I do and don’t mind how many are still to come. ”The operation has gone swimmingly” says my surgeon. “We have given you a stent. Would you like to see the pictures?” Of course I would and there on a screen are two X-ray photographs, the first showing a meander that has dried up in a parched plain and the second a wide dark river that flows confidently towards the heart. ”You see, all clear now”, he adds  and I think of fishes and frogs and the new life force flowing down this torrent from the tributaries.  I was as right as I could be, though a bruise spread from my knee to my belly button. During the first night back in my ward, I bled almost a pint from the groin so I had to stay in another day before being allowed home.

They’re all so good, it’s hard to chose
But if I had to, Nurse Joyce
Would have to be my choice.
She saw me through the noisome night.
She stopped the flood, she staunched the blood
Her hands were silky soft but strong
And cool as water in a pool

MY 2ND OPERATION SEVEN WEEKS AFTER THE FIRST

Less than two months later I began to feel that I was back where I began, feeling out of breath and ropey. I made an appointment at my local surgery and this time they wanted to see me straight away, so I got on my bicycle and pushed myself a bit to see if the pain came down my arms as before: it did. When I arrived and told the doctor, she said,” In no way are you cycling home. An ambulance will be here in five minutes.” Fortunately a friend was in the waiting room and offered to take my bike home.

As I arrive at the ward a young Pole is leaving. He came in the night before in Handcuffs, with a policeman in attendance. He had escaped custody. Someone bailed him and he left in seven minutes.
The next person in the bed was a senior Inspector at Scotland Yard, a very polite and cultured Asian.
He was followed by a young postman who had gone down from his apartment on a council estate in Fulham to ask some rowdy youths to make less noise. One of them threw ammonia in his face and had blinded him permanently in one eye. The infection spread to his heart and he was in great pain. The offending youth of nineteen was known to the police and caught on camera five minutes after the incident, running from the scene, but they could do nothing as they had no forensic evidence.
The next occupant of the bed was a seemingly mad Irishman. He messed his bed three times in the first hour and swore without a pause at the kindly nurses who cleaned him up, without a word of complaint. When he could he grabbed their wrists until they cried out. He continued cursing most of the night and was violent when anyone tried to take his blood pressure. At one point I went around to the end of his bed and said, “hello Paul!”. He looked at me with his unusually large dark eyes and pinpoint pupils. After a long pause he said, “Fuck off!”
Opposite me was a twenty eight stone man who, when taken short, sat on the edge of his bed and pissed on the floor. A pool of urine would slowly spread towards me. He was so heavy that the nurses put him on the john in the ward, protected only by paper curtains. His favourite food was curry and the resulting smell so powerful that I tore off the wires that were attached all over my torso and fled down the passage. This set off the alarms by my bed and I watched from a safe distance as nurse after nurse approached the ward and then staggered backwards when the cloud hit them. The next day he was stronger and able to propel himself to the bathroom. He was a jolly man and endeared himself to all the nurses with his banter. He even spoke kindly of the Irishman and said that the man’s behaviour was entirely due to the pain he was suffering.
On one occasion I heard him saying to a nurse, “I’m worried about my wife.” The nurse asked if she were ill, to which I thought I heard him reply, “No, she’s dead.” I must have misheard this because the next day she turned up in a wheelchair, bulges of fat pushing out of all the gaps. Peter, her husband, had been a Trade Union representative and was now her full time paid carer and cook. She weighed only eighteen stone but could do nothing for herself. She looked exactly like Giles’s grandma from my viewpoint behind her. From home she phoned him frequently and asked again and again why he was not there caring for her. Peter had explained to us that there was an enormous industrial-size freezer in their apartment and he would cook up to twenty curries and apple pies at a go, so she was not in any danger of starving. On one occasion the lady doctor doing the morning rounds had just arrived at his bedside when his mobile rang. He answered it: it was his wife and they talked for some time before he said, “I must go darlin’.” Darlin’ however had other ideas and the talk dragged on. The doctor’s body language made it clear that she was growing impatient. He smiled at her with complicity while he closed the conversation, “Back soon, my love! Shags tomorrow! Got my dingle-dangle ready for yer: I know you like it, at least the dingle, not the dangle. Luv yer!”

As on the first occasion I was taken to another hospital by ambulance for the operation, after four days of tests. This time there were two surgeons, a Senior Registrar assisted by his boss, the Consultant. It was fascinating listening to their conversation: the to and fro of ideas, observations and the consultant’s advice – “We should use a No 3; the other one is too small.” When they had injected the fluid, the Registrar said to me, “the good news is that your first stent in the RCA is perfect and there is no new build-up of cholesterol. The bad news is that your other main artery, the LCA, is 95% blocked with plaque. But don’t worry, we’ll have you right in no time. In fact it was an hour and a half and increasingly painful both in my back and in my heart. “Out of ten what would you say your pain level was,” asked my surgeon. ”Well, I think it has been around 10/10 for some minutes now,” I replied and immediately I was given morphine that made it bearable. During the operation there was a period when I could not hear what was being said and I knew instinctively that all was not well. Later I was told that a stent had gone walk-about and they had to extract it and use another kind. In the end they had to use four of them, some inserted through the others, “the biggest procedure of this type that we do,” said the Registrar. An hour later I was taken back to my base hospital;  I was taken back to the same floor at the Charing Cross hospital, but put into a new post-operative ward where I spent the night after my operation.

An old woman called Pat from the World’s End in Chelsea is in the bed next to me; she is hidden behind the half-pulled curtain. Suddenly she says in a loud, tremulous voice, “I don’t know the name of the lady next to me.” I lean forward so that she can see me and say, “I’m David and I’m no lady!” She looks amazed: she did not know it was a mixed sex ward.

A young to middle-aged woman opposite me has her mouth wide open all the time so her expression never varies. There is a wide bandage round her throat. She types answers to any question on a device and hears everything that is said to her. From time to time I say something cheerful to her to which she gives an enthusiastic thumb-up sign, but makes no sound. This morning she suddenly held up a little furry white teddy bear. It has a pink ribbon round its neck. Later on I saw her combing it lovingly. Otherwise she just stares at me with the same fixed anxious look, which I try to avoid in order not to have to bob my head up and down all the time.

Next to her is a voluble Polish lady; her husband, who is English and two children come to visit and sit round her bed while she holds forth in a loud voice, with a strong Polish accent. No one can get a word in. On her bed are two large hand bags, which she grabs every now and then as if to make sure no one has run off with them. When the family leave and the lights are dimmed for the night, I see her heaving herself up and checking the bags are still where she left them. An hour later she is take off to another ward, clutching the bags.

This time, I had no bleeding from my wrist during the night, so I was allowed home the next morning. My Consultant knew that it was my birthday on this day so he had arranged for me to have my operation a day earlier than it would normally have been carried out: each hospital has its ‘operation days’ at the Hammersmith Hospital and he managed very thoughtfully to fit me in the day before.

When I popped back to my old ward to say good-bye to the 28 stone man I found that he was no longer going to receive a pacemaker. All operations were carried out in another hospital and someone had forgotten to book a special ambulance required for a person of his weight; it needed forty hours’ notice but he was giving up the battle with his wife and returning home to care for her.

Waiting in a corridor to collect my medications, I watched a middle-aged woman in a flower print dress and a sloppy cardigan, overweight and wobbling from one hideously swollen leg to the other. She was heading for the exit supported by a seriously tall and nattily dressed black orderly walking slowly by her side. As they reached the door she swung round and almost shouted, “God bless all the staff!”  and then added, sotto voce, as an afterthought, “and everyone else.” The orderly tried to persuade her to put on her threadbare coat but this was no easy matter: the sleeve lining had come out of one arm and she was trying to push it back with a fist. The orderly said, “You ought to get this repaired you know.” ”Get this repaired!” she bellowed, “ How could I afford to do that?”

The friend and neighbour who had originally called the ambulance kindly drove me around the village so that I could shop for my party that evening: I had never cancelled it. All I did during the day was to bake three loaves of bread. Most of the guests were the generation of my Godchildren so when they began to arrive they had no objection to being set to work preparing the food. One dug potatoes, another washed them, another picked the salad and arranged the smoked salmon. Jan had tidied the garden room, made it attractive and prepared the drink and glasses but he was very cross with me for insisting on going ahead with the party and no doubt he was right.  However I’m here to tell the tale.

I record the next incidents, not in a spirit of criticism, for I am only too aware of the debt I owe to the NHS, which gave me two life-saving operations and treated me with kindness and consideration. However when I left hospital I read about the number of mistakes and accidents that happened to people when being treated, some leading to death or injury. I ‘suffered’ two mistakes that, I understand, could have had serious results. The first one was on the night before my first operation. I had been given a blood-thinning pill every evening of the four days in hospital awaiting the operation. On this evening a nurse dressed in purple, in contrast to the usual blue, arrived in the ward and handed me a large pill. What was this, I asked. “It’s for your operation, David, to thin your blood”.
Ten minutes later my usual nurse dressed in blue arrived with my evening pill. What is this for, I asked. “Oh, it’s your blood-thinning pill,” she said. “Does the right hand know what the left hand is doing?”, I asked. “What do you mean?”, she said, so I explained that I had just been given a pill to thin the blood before the operation, by one of her colleagues who was dressed in purple. She left with a worried air and returned shortly to tell me that I ‘didn’t need to take the pill’. “And if I had taken it and something had gone wrong with the operation, as I’ve been told it might, could that have been serious?” “I’m afraid it could have,” she said .

The second incident was a week after my second and more serious operation. I received a letter to say that I was to come to the hospital for a treadmill test. Somewhat surprised, I turned up at 9.00 in the morning and was put on to the treadmill with two nurses or assistants controlling the procedure. The belt gradually got faster and steeper over a period of eight minutes. I felt at the end of my tether and said so. One of the operatives said, ”Oh can you just do thirty seconds more at the highest and fastest rate as we can really see then how your heart is behaving.” OK, I replied and began to count backwards from thirty down to one and then stopped. “Fine”, one of them said. `”Please wait a minute or two while we show this to your Consultant”. I sat down and a couple of minutes later I saw my Consultant running towards me down the corridor. He placed both his hands on my arms and said, ”You should never have had that test NOW. It was arranged relative to your FIRST operation. It’s something we do eight weeks after the op.”  Fine, except that I had had a further operation seven weeks later, and only a week before the treadmill test which ‘the system’ had forgotten to cancel.

He asked if I was doing anything at the weekend and when I said nothing in particular he told me to go home and take it easy!