Published 01.01.2021
"If you stumble, make it part of the dance."
Unknown
Where the drama began
It must have begun sometime in the night, but in the morning darkness of Sunday, 7th October, 2001, I awoke to see the numerals ‘6.00’ glowing green on the dial of the clock radio at my beside and sensed what I took to be acid indigestion discomfort in my left chest. I got up, went downstairs, drank a glass of milk in the kitchen and went back to bed.
But the ailment remained, so I left my bed again, drank another glass of milk downstairs and took an antacid tablet. Throughout the morning, for all that, I was unceasingly afflicted with ill-feeling in my chest. At about eleven I had a banana sandwich, drank a third glass of milk before returning to my chair in our front room.
I’d hardly got myself settled when suddenly a seizing pain ran from my lower left chest up my gullet and across my left breast. It was now less like a burning sensation and more like something pressing on my heart. My breath was coming in short gasps too now but I put that down to anxiety. I still had no idea what was happening to me. I ascribed my plight to a severe attack of indigestion. If I could just calm myself, I thought, all would be well. With this end in view, I slipped off my chair onto the floor and lay down on my back. But that gave me no relief at all. In fact I sensed now that my left arm was quacking with pain all along its length from shoulder to fingertips.
Was I having a heart attack? I was loath to admit this opinion because the discomfort in my chest, while bad enough to worry me, was not of an order that I would associate with a heart attack. After all, where do we acquire our ideas of such troubles? Not from real life, you can be sure. They come from drama. The dramatic artist, squirming on the floor in feigned agony dramatizes such anguish for us to make it entertaining. However, I was by now alarmed enough to be thinking of shouting for help.
“Judith!” I shouted.
No answer. All was silent in the house.
“Judith!”
Still hushed.
It was not easy to shout while gasping for breath, but I felt I needed some moral support. I shouted several times more, each time louder, until at last the door opened and a head peeped into the room.
“I’ve been shouting you!” I gasped.
“I was upstairs,” she replied, eyeing me coolly stretched out on my back. “What’s wrong?”
What’s this pantomime? her tone implied. Evidently she thought I was over-dramatizing. I don’t think women believe in men’s pains. They only believe in their own, which they are trained to keep silent about from an early age.
“I don’t know,” I replied. “I’ve got pains in my chest, over my heart and down my arm.”
She came into the room then.
“Try to be still,” she said, “and keep calm. You’re getting too anxious.”
What was an appropriate amount of anxiety to display in such a case, she failed to say.
I tried to summon calm by drawing a deep breath, but no loss of angst ensued.
“Do you want me to ring for an ambulance?” she asked after a time. Not: “I’m going to ring for an ambulance,” note. She was still not convinced anything really was wrong with me.
But then neither was I.
“I don’t know!” I said in desperation.
I did not want to call 999 without good reason. On the other hand, there was no let-up of pain.
“Can’t you get some advice?” I asked.
She called NHS Direct then and described my symptoms. When she hung up I said, “Well, what did they say?”
“They told me to ring for an ambulance.”
She rang.
Looking out of the window several minutes later, she said, “There’s someone here in a car.”
Seconds later what looked like a giant of a man – from my worm’s eye view – dressed in green short-sleeved shirt and trousers replete with pockets and pouches and badges and black belt loomed in the room. He descended onto my chair and, leaning over me, asked what the trouble was. I delineated my symptoms and the pain I was in. He did some checks – I forget what now, pulse at least probably, and then asked:
“How bad is the pain? Where would you put it on a scale of one to ten, ten being the maximum you can imagine?”
I thought that a rather silly question since the answer would depend on two factors:
i. the ability one has to endure pain
ii. the fertility of one’s imagination
“I don’t know,” I said, but not wanting to appear pusillanimous: “maybe between two and three.”
Several moments later two more of these jolly green giants crowded into the room. It was as though I was in a forest of them. They chatted away cheerily to each other, largely about some new curry sauce they’d been trying at work, which was very hot apparently. I imagined all this chatter was intended to foster an atmosphere of calm.
Now an elastic strap was slipped over my head and a transparent plastic mask was placed over my nose and mouth. The oxygen calmed me and I began to breathe easier and relax. Then a grey metal chair was brought in and a blanket draped over it. I was asked if I could get onto the chair. I did so without much trouble and then I was wrapped round with the blanket, arms tucked inside.
“I feel like an old woman,” I said.
“You look like an old woman,” one of these green comedians reprised.
Then the chair was tilted backwards by one of the paramedics while another picked up the black rucksack that my oxygen mask was attached to, and I was wheeled backwards out of the room into the hall to the open outside door and lifted down onto the driveway. The house and garage began receding then as in a kind of dream, for I could not quite believe all this was really happening. As I was wheeled past my car, next door’s door opened, but no-one appeared before I was swerved backwards onto the pavement and swung into position at the back of an ambulance. At that point I was lifted, chair and all, into the vehicle and one of the paramedics – normal size now – got in with the rucksack. He asked me to transfer myself onto the bed inside. That done, he must have attached some wires to me – though I don’t really remember this detail – and then he fiddled with an instrument above and behind my head.
“Do you like bananas?” he asked.
“Well, yes, I do. As a matter of fact I’ve just had a banana sandwich.”
“Because it’s showing up here,” he said.
Then he strapped me down and climbed into the seat beside the driver. The engine whirred into life and I felt the vehicle move foreword.
I don’t know what route we took to the hospital as the lower halves of the windows were frosted, but it must have been a rough one as I was bumped up and down mercilessly while I watched waving treetops receding in the clear upper window spaces. About twenty minutes later, the vehicle stopped, the back door opened and I was unstrapped and evacuated by means of some cunning mechanical contrivance in which my bed became a trolley, and my twin escorts wheeled me and my attached rucksack into the Accident and Emergency entrance of Chorley Hospital.
Chorley Hospital: Accident & Emergency
Inquisitive glances were thrown at us by men standing in dressing gowns and pyjamas and people seated in outdoor clothing from rooms either side of the corridor we sailed down, and then I was wheeled into a curtained-off section of a quiet ward, where my amicable companions waved good-bye and left me in the hands of an odd old bird called ‘Registered Nurse Maggie’, identified by the white plastic nameplate pinned to her breast.
Judith had arrived by now and then Maggie rolled in an ECG machine on a trolley and got me to undo my shirt and roll up my tee-shirt. Then she produced a blunt razor and rasped away at my chest with it until she’d cleared two medallion-sized areas bare of hair.
“Making me a male dancer?” I asked.
Registered Nurse Maggie did not really know how to handle this brand of badinage. She said nothing on her own account and answered my chatter less with words than with a sort of swallowing or hiccoughing sound like some strange species of bird might make. She had thin features and a pallid complexion faintly flushed with pink as though she’d been well-scrubbed. Her movements were delicate rather than competent as she affixed stickers to my chest and legs and then clipped on wires, all in the manner of a stork fussing over its fledglings.
When the ECG had been completed, two men in light blue shirts and navy blue ties and trousers appeared and wheeled me out of the ward with Judith in tow and along a corridor and around a corner and then along another corridor to the doors of a lift. Going up nobody spoke. These two were just doing a job. The lift stopped, the doors opened and then the doors along another corridor were drifting by. The fellow gripping the foot rail was bald and bulky and solemn-looking. His eyes gazed straight ahead or now and then to left or right as if he were pushing a supermarket trolley and in a rush to get his shopping done.
I was parked in another curtained-off section of another ward, lit like the former with dim daylight, and then the mutes in blue vanished. Soon a doctor and nurse were in attendance on me, almost literally on me in the case of the doctor, for he sat down on my bed. He was a young Asian with a black moustache and a flashing smile and he repeatedly patted my arm and assured me that they would soon have my condition ‘stabilised’. The nurse produced a syringe and said: “You’ll only get one of these so make the most of it.” After turning over my right arm and mopping a bulging blue vein with a cotton swab, she then slid the needle into it. In seconds a delicious wooziness suffused my entire body and the pain subsided to nothing.
“What was it?” I asked.
“Morphine,” she retorted.
The young Asian told me that his name was Pia (pronounced ‘pie’) and that he was a junior doctor. He took a blood sample from my left arm and told me that it would be sent to the lab for analysis. This would tell them, he said, whether I’d had a heart attack or not. Then a bed was wheeled in and parked alongside my trolley and I was asked if I could get on to it. I said I could and did. I was wheeled into the brightly-lit ward proper now and my bed was nosed into a space between two two-metre partitions opposite a kind of counter behind which could be seen the slit-vents of several computer monitors.
The friendly Asian doctor now said good-bye and left the ward. Then the nurse affixed three more tabs to me, one to each shoulder and another to my chest. Each bore a little metal nipple like the male half of a snap-on button, and to these she clipped three wires connected to an electronic device clamped to a vertical pole. Now she swabbed my right arm again and inserted a needle with a plastic union on the end of it into the skin up to its full length and then fixed it there by means of a transparent plastic film sticker. A narrow plastic pipe was now joined to the union and the syringe at the other end of the pipe was wedged into a space on top of a second device, also clamped to the pole. That instrument, I discovered later, was set to a particular flow rate and slowly pumped a thinning agent into my blood. It would dissolve the ‘clot’. Finally she wrapped round my upper arm a black band and set a device going that automatically pumped air in and then released it in stages: a blood pressure monitor.
It was perhaps half past five when Judith left for home to find a pair of pyjamas and a housecoat for me, while I, reclining on my bed, still in my jeans and shirt, was now free to focus more finely on my surroundings. In the corner to my left stood a wood-veneered cabinet with a drawer and a cupboard in it and a grey laminated plastic top, and, if I twisted my neck a bit, I could see, peering over my shoulder, the bulb and grey metal shade of an anglepoise lamp fixed to the wall behind. In front of the cabinet stood a grey laminated tabletop attached by a support to a base made mobile by castors. On my right was the pole supporting the electronic devices, while high up in a corner a monitor screen traced two jagged graphs. The improper fraction of my blood pressure was also displayed as well as my pulse rate. This, I recall, was 71 when I first spotted it and I whiled away a few moments seeing how low I could get it by deliberate relaxation. I got it down to 55.
On the partition-wall a white board was neatly printed in black with the following information:
Name: Colin Wingfield
Consultant: Dr Verma
Named Nurse:
Nurse This Shift: Jackie
Forward of each partition a bunch of flowery curtains hung from a curved track suspended from the ceiling, and before my bed was an open space where a nurse passed from time to time. This and the area bounded by the computer counter where there were more white boards marked with patient information and a notice board pinned with printed sheets and an enormous grey metal cabinet that a nurse opened now and then and got out various bottles and boxes and packets – this was now my only window on the world, for my fellow patients were out of sight. Talk amongst the inmates of the place had to be restrained I suppose.
In late afternoon a nurse appeared and asked me to tick selections on a menu she deposited on my tabletop, and at about five o’clock the heavy ward door – which I could just see in the left corner of my window on the world – opened and a tall metal cabinet on castors came trundling in followed by a little fellow in whites leaning forward against it with outstretched hands and trudging the floor with effort. He stopped, straightened up, waved a hand and was thrown a “Thanks!” from somewhere to my right, and then he was gone, leaving his offering dominating the ward like a metallic monument. Several moments later a nurse materialised and began sliding trays out and disappearing with them.
In the evening, I was troubled by some pain again and when I told Jackie she gave me another shot of morphine which wafted me away again on a wave of wooziness. Perhaps my first dose of tablets came then too but I don’t remember. Judith reappeared at about seven with my housecoat and a pair of pyjamas that I now changed into. She’d also brought me a towel and toiletries, a book and some fruit. As she’d had rather a long day looking after me and really needed to look after herself now, she said goodnight some while before eight and went home, while I was left to wonder again about the strange twist of fate that had conveyed me to this place. This was the Coronary Care Unit of Chorley Hospital – it really was – and I was here – could you believe it? – being treated for a heart attack. A heart attack! I just could not get my head round that.
The lights were dimmed sometime after nine and a couple of new nurses arrived. Now there were heads nodding close together and voices talking low behind the counter. The new shift was having a good natter with the old one. However, I was getting a bit desperate by now to relieve myself. I’d ignored nature’s call till now as I was not eager to embrace this particular bit of hospital culture, but at last I was forced to call for a bottle. Presenting this to me with a cheery: “Tell me when you’re done,” the night nurse then dragged the curtains round and vanished.
I opened my pyjama fly, drew my bed cover up to my waist for concealment, thrust the dry grey gourd between my thighs and got poised for a piddle… Damn! I couldn’t go! Better to stand up, I thought, so I slipped off the bed with my wires and pipe attached and stood holding the bottle before the bleeping instruments like Frankenstein having his first piss. Still nothing. I thought: “The nurse is going to come back now and catch me like this!” But at last the pressure eased and with a low gurgling sound the bottle began to grow warm.
A little before ten a couple of nurses left, leaving two on duty for the night. The ward then fell silent and I knew nothing more till sometime in the middle of the night when I had to call for a bottle again. But this time I managed the task in bed. No doubt I was becoming institutionalised.
Next morning, I was feeling fine when Doctor Verma, another Asian, came round the ward with a retinue consisting of a couple more Asians and an African and a white fellow. I thought the white was English until he opened his mouth a day or two later and spoke with a foreign accent. When it was my turn to be seen, the flock gathered round my bed and listened most reverently while the great man unsmilingly elucidated his subject. The analysis of my blood sample, he told me, showed that I had had a ‘substantial’ heart attack. Damaged cardiac muscle, he explained, releases a certain enzyme and the test consisted in counting the number of enzymes released. The normal count is about 200, he said, and this apparently rises to about 500 after a heart attack, from which level it returns to normal over time. My count was about 3000, he informed me in a faintly incredulous tone.
Was ‘substantial’ the right word to describe this heart attack? I wondered. Wouldn’t ‘massive’ be more accurate? Should I even still be alive? But I really didn’t feel all that bad. Who had done this test anyway? I conjectured. Does he know how to do it punctiliously, or is he just a novice? But I didn’t tax Dr Verma with any of these suspicions, and he trudged off anon with his flock following him. I remained in the C.C.U. for a further five days, but I never saw him again.
Five days! Surely they were the longest of my life! Each moment passed like a bondsman burdened with a great weight. Often I cast a mournful glance at the big round clock above the doorway in the right hand field of my vision, noting the time as 10.25, say, and then some half hour later - as I imagined - glancing back again to see it read just 10.35. Sometimes I reached for my book on my cabinet as a way of annihilating several minutes together, but the movements of the nurses, busy behind their counter, as well as those passing my bed from time to time, were a distraction I could not seem to ignore.
Mealtimes were the high points of interest. Just before eight in the morning the metal cabinet laden with breakfast trays trundled into the ward and you would hoist yourself up and reach over and swivel your table top over your bed and then wait, sniffing in expectation, until a nurse brought over your tray. At this time too a tiny plastic tumbler containing several tablets was placed on my table: my morning dose. My selected breakfast always consisted of orange juice, cornflakes, a roll and marmalade and a cup of tea. Now here was something to fill up some time with! When you’d finished your meal you’d glance up at the clock to find that half an hour had elapsed in reality as well as in imagination.
When the tray was taken away, time would drag again till the cleaner came. This no longer young lady would mutely mop the floor by my bedside and dust my cabinet top and tabletop and replace the paper rubbish bag taped to its rim. Next in the hospital routine came the changing of the sheets. On that first morning I was asked to slip down onto the floor with wires and pipe attached and stand by my bed while two nurses swapped the old sheets for new. Next, one of the nurses, Angela by name, brought over a basin of water and placed it on my table. Then she dragged the curtains round. Well, I knew what was coming next. She had blonde hair, this girl, and a clear complexion, but she was rather – what shall I say? - robust in body. Then – would you believe it? – she said to me:
“Are you still at Standish High?”
What? I was to be bathed by a former pupil of mine? How embarrassing!
“You didn’t actually teach me, I don’t think,“ she said in response to my question, “but you were there when I was.”
Well, that was a relief. But still...
“I’ll do your back now,” she said, and while I was stripping off my pyjama top she wetted my facecloth and squeezed a blob of shower gel onto it. When she’d washed my back and my arms too she said she’d leave me to do my front and ‘lower down’ - unless I needed any help.
“No, no, that’s all right!” I hastened to say. When she’d slipped through the curtains I eased my pyjama bottoms down and then ineptly spread a towel under my buttocks and got on with the awkward job of washing ‘lower down’.
When the curtains had been drawn apart again and the basin taken away, boredom settled on my life again like dust in an empty house till mid-morning when someone came round with a choice of a cup of tea or coffee. At about this time too the ward door would open and either a fellow or sometimes two ladies would enter and tour the beds with a trolley freighted with newspapers and crisps and drinks.
Ten-minute chunks broke loose and fell off the remainder of the morning one by one till twelve when the metallic cabinet manifested itself again and beckoned with delectable smells. Lunch consisted of a soup starter, potatoes and meat or chicken, or lasagne perhaps, followed by dessert. Dinner was similar. The menu here was not as light and healthy as what I was used to at home, and to this I attributed the sensation of indigestion that troubled me a day or two later, so that I began to select whatever light options were offered. This was a problem that took on a greater significance afterwards.
Half past twelve was ‘siesta time’. The ward lights were doused and the curtains were closed and the inmates were entreated to sleep in the dim daylight filtering through the small high windows - or at least rest soundlessly on their beds - while the staff toiled away at quiet tasks behind their barrier. In the first couple of days I think I slept for at least part of ‘siesta time’, but in later days I switched on my light and read my book. At half past two the ward returned to life when the lights were lit again, the curtains were thrust back and nurses cruised to and fro as before.
Now the next temporal block presented a smooth and impassive face before it, too, fissured and then cracked and broke up and crumbled into nothing. At five o’clock dinner was served and when the tray had been taken away I awaited the time when Judith’s unmistakable shape would be framed in the frosted glass of the ward door. When she arrived, I was surprised and pleased to see that she was followed by our younger son, Sean, who declared how amazed he’d been when he’d first heard the news of my heart attack.
“The mountain goat?” he said incredulously, a reference to my pride in my zodiacal sign and my much-vaunted (by me) lightness on my feet.
“A sign of things to come, “ I said grimly.
All visitors vanished at eight and then a cup of tea or coffee was brought round. The night shift drifted in in the interval between nine and half past, and then the lights over the beds were put out and you were enclosed in curtains again to listen to the low murmur of nurses’ voices. At length the day shift departed and a night nurse slipped in with a tumbler of tablets and a glass of water. Then you were left alone with just the blip of instruments and your own unquiet thoughts.
On Tuesday morning the plastic pipe passing the thinning liquid was removed from the needle still stuck in my arm, and I was given leave to free myself from my monitoring devices - by removing a plug from a socket - and walk across to the toilet in the ward, my wires and plug dangling out of my pyjamas like a length of my insides that had somehow got loose. First I rendered needed relief to my real insides, for since Sunday afternoon I had shunned ‘bedpan culture’ with a resolve worthy of great deeds.
Now that I was free to escape my bed and move round the ward, I engaged several of my fellow patients in conversation. The denizen of the bed on my left, older than me, displayed a face invested with spectacles and an unfailing grin. His name was George.
“Is this your first attack?” I asked when he once stopped on a walk past my bed.
“No, second,” he corrected, almost with a touch of pride, as thought he was an old stager associating with mere novices.
“I know what it was,” he said with a grin, “doin’ too much in t’garden.”
He seemed to be savouring his sojourn here. One mealtime when a nurse was serving soup out of the monumental metal cabinet, she asked if I’d like it in a cup or a bowl. A voice behind the partition said:
“Ged a bookget, Golin. It’s good!” between slurps of soup.
On his first stroll out of the ward he returned with a wide smile and said simply, “A’ve sin t’leaves on t’trees. Ahm appy.”
Another patient, Tony, was just fifty-three years old. He’d been a runner in his time, so he said, who used to run ten miles a day. He’d had surgery for some complaint some weeks previous to being here, he told me, and on October 7th – the fatal day for me too – he was engaged in doing some exercises when he had what later proved to be a massive heart attack. His doctor told him that it had been caused by a blood clot from his operation that had moved up to the heart.
One wonders about that ten miles a day. What was he trying to prove? One wonders as well why he was doing exercises following surgery. He was an inveterate talker, this Tony, and it was hard to insert a word into his ceaseless speech. He stated categorically that after a heart attack one could build up the heart to its prior strength by exercise, and persisted in this opinion against my claim that a damaged heart could never again be as strong as formerly. He persisted, that is, until forced to desist when I told him my claim came from the cardiac rehabilitation nurse.
Listening to him, I felt that this would not be his last experience of a heart attack. He was a living example – only just – that people are their own fatalities. But he was a friendly sort and proffered his hand on parting, saying he’d see me at the rehabilitation sessions in a few weeks’ time.
A third patient, Bob, was only fifty-one. He’d had his attack on holiday in Whitby, so he said. Like myself, he hadn’t recognised the pain as that of a heart attack, but whatever it was, he said, he did not crave to be laid up in a hospital in Whitby, so he drove some 120 miles home to Chorley, before he was brought into hospital. To make matters worse, his back was a problem, though twice given surgery in the past, and he was due for a third operation, he said, when the attack happened. That had left both his arms feeling like dead weights (the only way he could describe the phenomenon), so he’d pushed his driver’s seat forward in the car (his wife who was with him at the time was unable to drive, he said) and had sat with the wheel gripped between his hands and his arms wedged between his knees all the way home. They just don’t make ‘em like that any more!
Life in the ward came to be pervaded by a grey uniformity. Nothing varied the endless succession of breakfast time, tablet time, lunchtime, siesta time, dinner time, visiting time, tablet time again and lights out time – nothing, that is, till one night after lights out when I lay awake and watchful as well, since my bed curtains had only been drawn out at the sides. A young man in a white coat and spectacles, new to our ward, was in low earnest converse with Angela in the light of the area behind the barrier. Their words were out of hearing but the man’s manner was plaintive. Angela seemed anxious. Something was afoot. After a time, she gave a reluctant nod and the fellow said, “Thanks,” before vanishing out the door.
Some fifteen minutes later, my front left curtain stirred and started shifting along the foot of my bed. On its back-lit folds was disclosed, like an old-time lantern show, the silhouette of a moving bed supporting an oblong mound, manoeuvred by two figures, one at the head and one at the foot. This swift diminishment of my field of vision could have been a casual consequence of the motion of the bed, but I had the suspicion that it was a deliberate attempt at concealment. However that may be, the curtain came to rest roughly four feet short of the curtain on my right, and the man grasping the foot rail appeared in the remaining gap. He looked in at me watching this late-night dumb-show wide-eyed, and made a sort of embarrassed sound. I thought he contemplated saying, “Hello,” but then changed his mind. A pair of pale feet now sailed into view, succeeded by a pair of legs in black and white striped pyjamas, a sprawled torso in matching pyjama top, and then a pallid head straggled with silver strands propped on a pillow against the bed’s head rail and sunk onto its chest. A second attendant trampled past pushing at the back rails and when the curtain had swung to a standstill, all was quiet and still once more.
All this left me meditating. Had the man in that bed been alive? But the show was not over yet. A little later, a bed with an elderly lady tucked up in it was wheeled past my curtain-cleft in the opposite direction, and then another ancient lady patient sailed past horizontally with her two attendants. These ladies were undeniably alive.
Naturally, my curiosity was kindled by all this traffic in the ward at this time of night, as I was settling for sleep, but early next morning my wonder was aroused again when two more figures appeared on my curtain-screen with a bed-shadow in the space between them. But instead of anything stretched upon it in the shape of a patient, they conveyed a rectilinear object almost the length of the bed itself. As it glided by my curtain-crevice, I saw that it was cuboidal in form, about eighteen inches high, with slanted sides, finished in a maroon-coloured vinyl. Now, not only my curiosity, but also my suspicion was awakened. And it grew wilder when that strange shape came sailing back in the opposite direction to span my curtain gap once more before rippling off to the left, silhouetted with its pair of mute stewards.
At breakfast time when Angela arrived with my tablets, I asked:
“What was all the excitement in the ward last night?”
“Oh, just a couple of ladies being brought in,” she answered apathetically.
Significantly, there was no mention of any fellow. One of the two ladies was later moved into the bed on my left that George had vacated when he was shifted to Astley Ward prior to discharge, and I divined that the second lady had been settled in an annexe adjoining the end of our ward. A second annex was occupied by a male patient in his fifties who waved to me once when I peeked in, but I never again saw a sign of the phantom in striped pyjamas.
Despite my choice of the lightest options on the menu each day, I continued to be afflicted at times with a pain in my left side. The sensation felt something like trapped wind, but it worried me, for when I had disclosed the issue to Doctor Verma at the time of his single visit to me, he said that cardiac pain could sometimes feel like digestive difficulties. That jolted my memory, for I recalled then how twice just last week I’d had to abandon a half-mile run because of discomfort in my lower chest that felt just like acid indigestion pains. I’d also felt the same sensation, I recalled, some two miles into the school sponsored walk which took place just three days before I found myself in this ward. These little hitches, I now realised, were harbingers of a heart attack.
It was also significant in retrospect that my running distance had dwindled to just half a mile. I did not seem to have any energy for more. That recollection had induced me to recall how fatigue had compelled me to retire for the night at about eight o’clock on several evenings of the previous week. To be sure, retiring so early was not entirely foreign to me, for I sometimes adopted that tactic precisely as a measure to combat stress and fatigue. But that had always been near the end of a long and stressful school term. In the present case, I’d been forced to have recourse to it after just four weeks of a new school term that had followed upon a long summer holiday.
These ‘indigestion’ pains were more than somewhat worrying, therefore, as they could mean that I was not yet properly on the road to recovery. My anxiety had not at all been allayed by Doctor Verma’s visit, for he had assured me that if the pains did not go away he could send me to Blackpool for an angiogram, an invasive procedure whereby a slit is made in your leg and an optical instrument inserted and threaded up a vessel to your heart to search for any narrowing of the heart arteries. And if any were found? I preferred not to think about it. I didn’t want any angiogram. Why couldn’t I just be like the other cardiac patients here just peaceably getting on with the business of recovery?
I think it was about this time that my future began to look different to me. The sole silver lining to the dark cloud that had flashed this stroke of fate was that I would have a long rest from school at least. Later, I learned that my absence would be even longer than I anticipated, probably as long as three months. But the unthought-of thing here was that I would return to school after it. Now I faced this unvoiced thought. A heart attack after only five weeks of a new school term? Looked at coldly, the fact was that I was no longer young enough nor tough enough to endure the tension and stress of teaching in a secondary school, especially the moribund sort of place that Hesketh Fletcher, where I taught, was turning into.
Then I remembered Norman Mason. Ten years before, following my retraining from English teaching to Technology teaching, I found myself without a permanent position. It so happened that Wigan Education Authority, much to my surprise, complied with my desire to be posted as a ‘supernumerary’ teacher of Technology to Abraham Guest, the secondary school at Orrel, where I had carried out with a certain satisfaction my first teaching practice in my new subject. It was during my service there that I was asked by that same Wigan Education Authority to stand in for Norman Mason, who taught Technology at St. Thomas Moore High School in Wigan, for he had just had a heart attack.
I deemed it wise to comply, though I knew from a former teaching practice I’d done at ‘Tommy Moore’, as it was locally known, that the school was badly managed and that I could expect to endure real trouble from pupils there. But I survived the three months of Norman’s absence all right and was looking forward to leaving and returning to Abraham Guest, when I was told in my final week there that my services would be required for a further week. An arrangement had been made, it seems, whereby Norman would just observe my lessons during the first week of his return, assisting wherever possible prior to taking the helm himself in the next week.
I could not see why he wanted to return at all to a school crowded with rowdies like this one was, for he struck me as a highly-strung person, disorganised professionally, who ventured to rule his pupils through pure force of personality because he simply lacked the imagination to furnish engrossing and worthwhile work. I knew for a fact that he was unable to turn a blind eye to minor mischief as I had several times seen him explode red-faced at pupils when I was doing my teaching practice there.
“Are you sure you’re doing the right thing?” I asked him when he appeared.
“Yes,” he said, “I know what I was doing wrong now. I was taking it too seriously.”
I was not at all convinced he was doing the right thing. On the very first day of his return to school he could not forbear from bellowing at several pupils entering a lesson of mine, though they were not behaving badly at all. Back at Abraham Guest some months later, news reached me that Norman had had another heart attack.
My memory of Norman’s conduct put me in mind of a sample of my own acted out only the previous week. In a Year 9 lesson I had fumed at a pupil simply for being stupid rather than unruly. Such an outburst is a typical sign of stress, of course, but, I repeat, it happened in just the fifth week of a new school year. Diminishing stamina was not, however, the sole factor in my disfavour. When the school failed an OFSTED inspection two years before (largely for financial mismanagement), the current head was forced to resign and was replaced by a new head who devoted himself wholly to winning the praises of the next OFSTED inspection team – to the profound neglect of the school’s disciplinary system.
Pupil behaviour had regressed to a level that reminded me of my time at Tommy Moore. It was becoming common, for instance, to witness scraps between pupils in lessons or to be pelted with miscellaneous missiles as you crossed the yard, or to have to step across a mess at the bottom of a stairwell made up of half-eaten sandwiches or fruit and empty cans or plastic bottles lying in a pool of pop. Verbal abuse was much more common now too. “Hey, you bald wanker!” one kid once shouted at me from an upper storey window as I was crossing the yard.
And there was not much you could do about any of this crass conduct. Punishment had almost ceased to exist at that school. Its use was restricted in effect to the few high enough in the hierarchy with the power to exclude pupils. There was not even much you could do to hamper malefactors in their mischief. Merely laying a hand on a shoulder was enough to earn you a mouthful of abuse. Punishment, I say, was well nigh non-existent, and the pupils knew it. The school was headed for the abyss. It was becoming what was popularly called a ‘sink school’. How long would it be now, I wondered, before you might be marvelling at the spectacle of a shower of urine falling like rain in a stairwell, as I once witnessed at Tommy Moore, or perhaps a pile of turds neatly curled behind a door?
I decided then that I could no longer go on doing this job – unless I wanted to be the victim of Norman’s fate.
“I’m never going back to that place again, “ I told myself. “I just want to get out of this ward and get fit again and then just live.”
The African chap who had appeared in Doctor Verma’s train came to see me mid-week. He was called Doctor Amora and he was a tall, thin fellow lost in a double-breasted suit with a sloping forehead, a prominent jaw and a smooth hide of black silky skin. His movements, usually slow to the point of sleepiness, became animated, I noted, in the vicinity of nurses. He would lope into the ward in the casual manner some men of his race have, as though their legs were loose or something, and softly swivel up to the nearest nurse. None of the nurses in our ward were blessed with rare looks, I imagined, but he’d be sure to curl an arm around the full shoulders of one of them, or perhaps encircle the ample waist of another, and waffle God knows what into her ear. After a moment or two he would take a pace backwards, tilting back a black tufted head, and break into a laugh, mouth wide open, disclosing a double row of ghostly white teeth.
“How you feeling?” he asked, shambling up to my bed.
“I’m all right, “I answered, “but I keep getting what feel like indigestion pains in my left side.”
At that he asked to have me dosed with Gaviscon following every meal. After pressing the palp of his stethoscope to my chest and back, he asked, “What you going to do when you get home?”
I wasn’t sure I understood the question.
“Do you have to do washing and ironing and dese things?” he added.
“Oh no,” I replied, “my wife does all that.”
“Because I have to do this,” he went on, tongue in cheek. “I have nobody to do it,” he grinned, gazing meaningly at the buxom and fresh-complexioned figure of Angela leaning over the foot of my bed.
“You should get a wife,” I suggested.
“He’s frightened of that word,” Angela admonished, gravely averting his gaze.
The Gaviscon didn’t solve the problem. Rumblings and grumblings troubled my stomach often after mealtimes, and sometimes a faint burning sensation radiated in my breast. But this was mere discomfort. I was more vexed by the pains in my side that refused to go away. True, their source seemed located in the intestines rather than in the heart, but intestinal and cardiac symptoms can be confused, as I said.
It happened that I had a somewhat sharp sensation of this complaint after lunch on the Thursday, and remembering that the nurses had stressed that I must tell them if I had pain, I summoned Angela.
“I’ve got this pain in my side again.”
She looked worried. “I’ll page Doctor Amora,” she said, and went off to a telephone.
Five minutes later the white doctor of Doctor Verma’s coterie showed up. After a quick conference with Angela he rushed up to my bed and then tried to reassure me. “Don’t worry,” he said, practising his bedside manner, I suppose, while he fiddled with the wires of an ECG machine. The test complete, he went round the bed and swabbed at the hollow of my left arm, the skin of which was now brown from bruising, a condition, I was forewarned from the outset, that would result from the thinning of my blood. He stuck a needle in and took a sample and then he was gone. I never heard from him again.
On Thursday evening I was given the green light to go for a walk out of the ward in Judith’s company. Great! I would find a window and look out upon the outside world for the first time in four whole days! We turned right out of the C.C.U. and trudged up to the old hospital entrance on Preston Road where a pair of glass doors slid open and we stepped into the vestibule and peered out onto a carpark bathed in darkness. Beyond a handful of shadowy cars, the leaves of several trees glowed orangely in the light of a street lamp. Not much of a scene to survey for sure, but it lent me a cheering sense of reconnection with the world, a world I’d been isolated from for four whole days and nights. A rebirth of the feeling of well-being, you might say it was, but blotted by just one small blemish: a return of the pain in my left side.
On Friday morning I was divested of all wires, and after lunch a tall woman with glasses and a long black skirt came round and sat herself in a chair by my bed. She introduced herself as Sharon Clarke, the Cardiac Rehabilitation Nurse, and told me it was her responsibility to run a program of rehabilitation for cardiac patients. At this point she produced a list of medicines I would have to take.
“For the rest of your life,” she stressed.
“What? All of them? For the entire rest of my life?” I asked incredulously.
“For a good long time anyway,” she said.
Now she pointed to each one in turn and explained what it was for. I had to take an aspirin a day to maintain thinner blood, she told me, a second tablet to suppress my blood pressure, a third to dilate the coronary arteries, a fourth to improve heart pumping action and lastly vitamin B and thiamine tablets to temper the effects of any alcohol I might imbibe.
She put the list on my table and then produced a booklet headed ‘Take Care of Your Heart’, furbished on the front with a not very deft sketch of a podgy-looking hand holding a red heart like the ones pictured on Valentine cards. This publication would tell me, she said, what tasks I might perform without risk in my first four weeks at home. I glanced through the thing and noted jokingly to Judith later that I had to refrain from vacuming until the third week. I was told too that in several weeks’ time I would begin a rehabilitation scheme here at the hospital.
When she was gone, Angela suggested I take a walk alone as a final check that everything was all right, for I might be sent home that day.
“Right!” I said. “How far can I go? Can I go as far as the main entrance?”
“That might be a bit too far,” was the reply. “Don’t overdo it.”
This time I would see the outside world in daylight. I turned left down the corridor and poked along it, playing with no little conviction the part of patient in housecoat and pyjamas against a stream of snappy-paced people in day clothes coming on until I came to a window. Spread out below was a carpark and the Euxton Road entrance to the complex, the most pedestrian prospect imaginable, but there were banks of verdant turf out there and beds of flowers sprouting out of moist, dark earth and trees fairly frolicking in autumn-tinted frocks, all hallowed in a golden light under an azure sky brush-stroked with wisps of white. As my eyes had alighted on no tree – at least in daylight – nor flower nor single blade of grass for five entire days, I fairly devoured these simple sights as though they’d comprised the wildest and grandest mountain scenery.
Ah, to be out there in a sunny world again and well enough to wander where I pleased in it – this was the very pinnacle of my desire now. I longed for nothing more. And so it was, I returned to the ward a little sad, as the pain of yesterday was chafing at my entrails again. What the devil could it be? When I’d complained of it before, the nurses feared angina and gave me dissolving tablets to put under my lip and a little red bottle of liquid to spray under my tongue. Neither seemed to have any effect. I had a hunch I was suffering side-effects from all the medication I was taking, but after all, I thought, it could be angina.
All I wished to do now was to vacate this place of sickness and go home and get fit and healthy again. I would build up my strength bit by bit through walking, and then I would start the rehabilitation scheme in a few weeks’ time, and - who knows? – a time might come when I could start running once more. Sharon had said this could be so. It was while I was lying on my bed reflecting on these things that Doctor Amora came in to tell me I could go home.
I was elated. I felt like a kid going on holiday. I rang Judith to ask her to come and collect me, and then I got dressed in clothes – real clothes! - and packed my bag with my pyjamas and housecoat and books and the CDs and player Judith had brought me and the Get Well cards that had stood on top my bedside cabinet. Then I sat down in my chair and waited. After an age Judith arrived and a nurse handed me a packet of medicines. I called out good-bye to everyone, including Tony, who was seated on his chair by his bed, and then we were out the door. A few yards down the corridor that accursed pain was with me again but I managed to make it okay to the main entrance where Judith went out to pick up the car and bring it round to the door. Then we were off out of the hospital grownds and driving down Euxton Lane in the sunshine.
Wasn’t it just wonderful to be home again! But wasn’t it so strange too to resume my accustomed seat in the front room and muse about the drama that had taken place there five days ago with the big green men. Nothing seemed changed – and yet everything had changed. In fact, the only thing that was new in there was the packet of various medicines sitting on the desk, medicines that I was going to have to take for the rest of my life. That fact was much harder to swallow than the medicines themselves. Strange to say, it pained me as well to dwell on the inevitable cut I needed to make in the amount of beer I consumed in future. For I loved beer. Had I entered already at the tender age of fifty-eight upon that stage of life where all the things one loves in life must be jettisoned one by one?
On the other hand, I needn’t stop drinking beer: I merely needed to give up binge-drinking it. And wasn’t that just plain good sense, even for a fit and healthy fellow? Hadn’t I even been toying with this idea for years? And wouldn’t it be easier to put into practice now that I was no longer tied to a stressful job? The only thing that had changed in this respect since last Friday was that I would now have to have the courage of my convictions. In this and God knows what else as well, it was clear that from now on I would have to subject the control of my life to my will. A certain recklessness and disregard of the consequences might now have to be relegated to the dustbin of the past. Maybe this little drama of mine was my rite of passage into the afternoon of life, into the age of mellowness and maturation.
To look after me, Judith had arranged to take all of the coming week off work in place of the week beginning October 28th, when we were due to go on holiday to Nerja, a holiday that had had to be cancelled, for cardiac patients are barred from flight. Thus we had a whole week together, initiated on Saturday morning with a little – ah – session of re-acquaintance following our five-day separation. But to my horror I saw my semen dark with blood! What in God’s name could have been the cause of that? That damned medication again? I had a new worry now. I would have to see my GP about that pronto.
But later that day Judith was glancing through ‘Take Care of Your heart’.
“It says here,” she said, “that you’re not supposed to have sex until the third or fourth week!”
Oh - . Maybe I wouldn’t be seeing my GP so pronto after all. What would he think? I wondered: ...I don’t know. ...Some people will just not take advice. ...Hardly out of the hospital half a day and already hopping on like a dog!
My booklet said I could walk about the house and garden in the first week. I thought I would walk to the end of the road, a distance not so far as I’d done the day before to leave the hospital. I donned just my fleece jacket and cap, as this was the warmest October on record, I’d read, and went out into the sunshine, but Barbara next door intercepted me for news of my condition. As I chatted to her for five minutes or so about the attack and what I thought its cause – school – that same old pain assailed me again. When I passed the front gate, I sat down on the garden wall for five minutes and then walked to the end of the road and back. But the pain remained for the duration.
The next day, Judith and I set off up Conway Road aiming for the ‘rec.’ when Edna, washing her car on the drive, called over and asked how I was doing. Judith jogged accross the road for a word and I followed, dodging an ice-cream van that came careening round the corner just then jangling ‘Oranges and Lemons’ at seventy decibels. It was enough to give you a heart attack, I said, but then the inevitable chat about the attack and its cause ensued, and after that a repeat of the complaint I’d had to tolerate every time I tried to go for a walk forced me to forsake it and return home to rest.
My efforts at walking that week failed flatly. Judith said maybe I was trying to do too much and suggested I stick literally to what the booklet said: to walk only about the house and garden. However, I soon found that whenever I walked around the house several times for exercise that damned pain came back again. Sometimes it would even recur when I was not walking at all, but just washing a few dishes. Several times I tried the spray, but to no avail. These perpetual reverses started to consume the confidence I possessed when I left the hospital, so that, apart from a few light chores, I would spend the entire day sitting disconsolately in my chair reading or writing. I felt I should be on the road to recovery now. Instead I remained an invalid.
On Thursday morning Judith drove me to Croston to see our family doctor, Doctor Ahmad.
“If I try to walk more than about twenty yards,” I told him, “I get a pain in my side that feels a bit like trapped wind. “Could the medicine I’m on cause that?”
He shook his head and then asked me to lie on the bed and pull up my shirt while he pressed here and there on my stomach.
At the end of the examination he said, “I don’t know what this pain is.”
“I don’t think it’s angina pain,” I said, because the spray that I’ve got doesn’t work against it.
“I don’t think it’s angina pain.” he said.
But I’d just said that.
“Shall I ignore it and try to walk further?” I asked.
“Oh, I wouldn’t do that,” he replied, “just in case.”
On the Friday afternoon exactly one week after my arrival home, Sharon Clarke came for a visit to see how I was getting on. I told her I couldn’t walk more than about twenty yards before I got a pain in my side.
“Have you been using the spray?” she asked. “Doesn’t that help?”
“No,” I said. “It seems to have no effect at all.”
She looked me full in the face for several seconds.
“You really could do with a re-assessment,” she said. “...I think they have a spare bed in the C.C.U.... I wonder if I could swing the system... Could I use your phone?”
Hanging up minutes later, she was pleased to tell me she’d ‘swung it’, and that I could return to the hospital for a re-assessment of my condition.
I was far from happy at that. “How long will they keep me in for?” I wanted to know.
“They might keep you in over the weekend,” she said, “but then again they might not.”
About an hour later I was a bit galled to find myself lolling on a bed once more in the Coronary Care Unit of Chorley Hospital. Someone conducted an ECG test on me and took a sample of blood, and then Doctor Amora came to see me. After I’d tried to explain the nature of the pain I was getting, he shook his head slowly and earnestly.
“I don’t think this is angina pain,” he said.
Well, I was relieved to hear that.
“You take it easy,” he went on. ”Do what your wife says,” and here he turned and smiled pointedly at Judith.
“You mean I can go home,” I asked excitedly.
“Yes,” he said, “but you better be good or I bring you back in here and keep you for six months,” and with a wide sweep of his arm he got hold of my hand and shook it warmly.
Half an hour later I was at home again, no further on for my trouble, but at least now I could be fairly sure my walking problem had nothing to do with my heart. Or could I? At the hospital, Doctor Amora had doubled my Nicorandil dosage and prescribed Glyceryl Trinitrate patches to wear on my chest every day – both drugs used to dilate the coronary arteries – just in case, I guess.
During the next week, the third after the attack, my efforts to walk met with no better success. Always the same pain would overtake me before I made it to the end of the street. The extra drugs were plainly ineffectual. By Wednesday I’d dumped the extra Nicorandil doses and scrapped the Glyceryl Trinitrate patches. It was getting to me now. I began to suffer bouts of gloom. I was just an invalid confined to a chair. For all the use I was to myself or others, I might as well have been in a wheelchair. Even wheelchair victims were mobile! And nobody knew what my trouble was. Would this problem ever end? I wondered.
Sharon came for a visit on the Friday again, and I let her know how I felt.
“Three weeks it’s been now,” I said. “I should be well on the road to recovery but I’m not. I sit here all day every day in this chair because I can’t do much else and nobody even knows what’s wrong with me. I’m just an invalid.”
I realised later it was silly to dump all this on her. She didn’t really know what to say and went about trying to reassure me in the wrong way.
“Don’t worry,” she said. You’ll be all right. They could do an angiogram and find out what the trouble is,” she went on, and then began happily to outline how the angiogram was done, together with several other things I didn’t want to know about.
That increased my gloom. I didn’t want to think about any angiogram or any ‘stent’ either. This ‘stent’ was a tiny device she took great delight in telling me that could be shoved up a vessel into a coronary artery to keep it open to the flow of blood. She still thought the problem stemmed from my heart. I told her I thought its source was gastric, not cardiac, and, God, did I ever want to believe that! I described the symptoms again and she agreed that it sounded like a gastric problem, but she maybe just said that to lift my spirits. In the end she advised going to see my GP and describing the symptoms to him.
“I have seen my GP,” I said. “He told me he didn’t know what the problem was.”
I now decided to take matters into my own hands. Nobody else could help me, I reasoned, so I had to help myself. I would press on with my walks regardless of pain. Maybe it would just go away in the end. In the following week I got myself as far as the stable on Parr Lane, then as far as Digleach Farm and then as far as the bend in the lane past Digleach, and finally I tramped all the way to the bottom of Bradley Lane. Not only did I tramp all the way there – I tramped all the way back too, and though I was seized at every step with that unaccountable swelling sensation in my side, I suffered no second heart attack. And the assiduous use of my spray proved futile too. I was still ignorant of the nature of what ailed me, but I was as sure as I could be that it was not angina. The problem was in all probability gastric. It was clear, though, that the pain was not going to go away of its own accord, so I resolved to confront Doctor Ahmad once more and ask him point blank to prescribe me some antacid tablets.
In his office on the Friday, three full weeks after leaving hospital, I detailed my symptoms with care: rumbling and gurgling in the stomach after meals and a mild burning sensation when empty, constipation, lack of appetite, and most pressing of all, the pains in my side that would not let me walk.
“Is there anything I’m taking that could cause that?” I asked.
He glanced at my medicine list on his computer screen. “Well, maybe aspirin,” he said.
Aspirin? I asked him if there were no other tablets I could take instead of aspirin. Without further ado he wrote out a prescription for a drug called Lansoprazole and I took the first of the tablets that night.
On Saturday, I trailed that stale old pain down Parr Lane once more and returned dejected, but next day, Sunday, while Judith and I were plodding along Parr Lane again and chatting about something or other, I was suddenly struck by the fact that here I was out walking and felt no pain! I was ecstatic! But would this painless state remain with me? Oh, how I hoped it would! If it would just stay away now I might get back to some kind of normal life, and be an invalid no more. At every step I feared a new flare-up, but I made it pain-free to the stable
The Stable on Parr Lain
– where I had stood several times in the days before staring into the horses’ field with my side throbbing and wondering whether I would ever again be able to walk without pain wherever I pleased – I made it pain-free to the stable, and beyond the stable to Digleach Farm,
Digleach Farm
to the bend in the lane, and all the way to the bench at the bottom of Bradley Lane.
And I made it all the way back home too, a distance of about a quarter of a mile all told, with no pain – no pain!
Perhaps a little discomfort, yes, but no pain. Never was I stopped from walking again. In the next two weeks I increased my range from a quarter mile to a half mile, and then to a mile, two miles, three miles, four miles, five miles. Ah, what a thing it was, nothing short of wonderful – almost miraculous – that instead of being seated cheesed off in an armchair as I had been for days on end for more than three weeks, always cordoned off from life by four austere walls, I should be wandering freely in autumn sunshine and through showers of little translucent leaves that left the lane I paced speckled with crisp yellow flakes, while larger ones leap-frogged over each other in their rush to pass me by. I felt like I’d come back from the dead.
A week or two later, I was in Doctor Ahmad’s office again.
“The tablets you prescribed me worked,” I told him, “but I still get some discomfort in my stomach. Is there anything we can do to get a solution sorted out in the long term, so I don’t have to take tablets for it?”
“Which doctor is it you’re under at the hospital?” he asked.
“Doctor Verma.”
“When do you see him again?”
“December eleventh.”
He told me that if I explained the matter to Doctor Verma, he, Doctor Verma, could refer me to a specialist for a gastric investigation.
“Right,” I said. “Oh, by the way,” I went on innocently, “I’ve discovered that I’ve got blood in my semen.”
I half expected he’d be alarmed and rush me back to hospital at once, but he seemed not even surprised. He told me that could happen sometimes and said that probably it would go away.
Well, that was good to hear, and I found that over the next few weeks, to my boundless relief, it did go away.
Friday, 16th November found me plodding Chorley Hospital’s long corridor once more, but instead of turning left into the C.C.U., I turned right into the waiting room of the Department of Cardio-Respiratory Measurement, and took a seat in company with a chap glancing through a magazine. I was there by appointment at 11.30 AM to have an Echocardiogram, or scan. Moments later, an elderly lady in a wheelchair was wheeled out of an adjoining room and several minutes later I was ushered in by a lady technician who asked me to remove my shirt and stretch out on a black vinyl couch spread with a long length of plain paper towel.
She requested me then to turn on my side and face the wall, while she settled into an adjacent seat before a computer screen and reached over my right arm with the splayed end of a black cable which she held over the area of my heart and sort of stroked in circles from time to time. Peering up at the rows of video tapes stacked on shelves in a corner of the darkened room and squinting over my shoulder at the dancing and dissolving patterns on the screen put me in mind of the scan I’d had during my recent stay in the place.
At that time, I had been wheeled in wearing pyjamas and dressing gown with wires and tube attached, and I was laid out on this very couch and leaned upon rather heavily, I thought, by a hard-faced female of about forty who let not a word slip from her pursed lips during the entire procedure. By contrast my present attendant was young, not unattractive and pleasant, qualities that disposed me to talk.
“Am I not having that grease on I had last time?” I asked, for I recalled that my pyjama top had stuck to my chest when I had put it on after the scan, and that, when I felt underneath it, my fingers touched something sticky.
“Have you been here before?” she asked, in mild surprise.
I said I had. When? she wanted to know. I told her I had had a scan after my attack several weeks ago.
“It’s not usual to have a second one done,” she said.
She got up now and turned to her desk behind and flipped through some files in the light of a lamp. She opened one and studied it for several seconds and then, satisfied, she resumed her former seat and went on with the scan.
It turned out the ‘grease’ was on the end of the probe, a detail I’d forgotten from my first visit here. At the end of the session my young lady suggested I wipe my chest with the strip of paper towel, and then she asked me to take a seat in the waiting room. No sooner had I done so, when my interest drifted to a notice board opposite and a poster that showed a photograph of two young girls sitting on a carpet playing with toys. A sentence above stated: ‘One of these girls will be abused before she is eighteen.’ Another below said: ‘Male aggression is a crime!’ I wondered if this was supposed to mean that fifty percent of girls were abused before age eighteen. A bit ambiguous for such forceful language, I thought. I wondered too what abuse had to do with cardio-respiratory measurement. And then I found myself wondering who had stuck this poster up. Her with the pursed lips perhaps? I’d taken her for a man-hater anyway.
My train of thought was broken when Sharon Clarke appeared and asked me if I’d like a cup of tea. I said I would and, stepping through one of the three doors on my left and returning with the tea several moments later, she asked me to step into her office, motioning me through the doorway to my left.
Inside she said, “I’m afraid I’ve got some disappointing news for you. Your scan shows that you have a small clot in one of the chambers of your heart.”
A Clot......? - No! Hadn’t I’d been through enough without that?
She ploughed through my stunned silence, telling me that ‘they’ would prescribe a drug called Warfarin. That would dissolve the clot, she said, or ‘calcify it’.
“Calcify it?” I aped, dazed. An image of a tiny grain bouncing in a blood-swirl whirled in my brain.
“Yes, it would either dissolve or calcify, rendering it harmless,” she said with authority.
“A clot?” I said, like a child trying out a new word.
“Yes, it’s only small,” she pursued. “The technician wasn’t sure at first because it can sometimes be difficult to tell, but she got a second opinion and they both agree that there is a small clot clinging to a chamber wall.
A clot? I thought. - A clot! Wouldn’t I ever be free of the fate that had struck me on October seventh?
“Unfortunately,” she went on, “your ECG on the treadmill that’s scheduled for next Friday will have to be cancelled now, and you’ll need to have another scan in three months’ time.”
“And the rehabilitation program?” I urged. But I already knew the answer to that one.
“If the scan is okay we’ll make you an appointment for an ECG on the treadmill.”
It was all clear now. My rehabilitation program, which should have started the following Friday, would not even begin now till late February at the earliest.
“I’ve paged Doctor Amora,” she said. “He’s busy at the moment, but he’ll come as soon as he’s free. If you’d like to have a seat in the waiting room he’ll come and see you as soon as he can.”
When I was seated once more before the picture of the girls on the carpet, a man whose face I recognised stepped through a door on my left. It was Tony, my fellow patient of four weeks before.
“Have you been for a scan?” I asked.
“No – treadmill test,” he said bluffly, looking the very picture of health.
A further sprinkle of dolefulness settled on my head then, for I recalled how I had left him in the hospital in the denouement of a ‘substantial’ heart attack, but he was obviously well on the way to recovery today and even ready to begin his rehabilitation program, while I – well – would there never be an end to all this?
“Well, take care of yourself,” he burbled buoyantly and breezed out the door.
Which swung open again ten or fifteen minutes later, intruding upon my gloom to disclose the dusky figure of Doctor Amora clutching a file of papers.
“Can you follow me,” he said, turning about and heading down the inclined corridor with me in tow. He turned into a door on the left designated ‘Medical Assessment Ward’ by a sign which stuck out overhead. I tracked him into a small room lined with chairs of varnished wood upholstered with pink fabric, two of which were occupied by women, a middle-aged one and one in her twenties. He sat himself in a chair at the opposite end and motioned me to take another. Then he opened his file and spread it on his knees and bent forward over it for several seconds. Now he got up and went out, returning almost immediately with a blue-uniformed nurse with curly reddish hair and freckles whom he introduced as Sister somebody-or-other. I couldn’t quite make out the name, as I sometimes had trouble understanding his words, but the plastic nameplate clipped to her breast read ‘Sister Ruth Byrne’.
Sister Byrne ensconced herself in the corner between us and then she and he consulted together for several moments about matters mysterious to me. Then, turning to me, she asked pleasantly:
“Would you like a cup of tea and a sandwich, as you’ll be missing your lunch?”
“I’ve just had a cup of tea,” I said, “but I’ll have a sandwich, if I may.”
At that, she got up and walked off, asking, “Any particular kind?”
“Tuna!” I called after her.
Doctor Amora poured over his file – or rather my file, as I suppose it was – while I waited, looking down at his dusty black light loafers, a type of shoe I would never wear as my preference is for heavy ones. Southern peoples like light shoes, I mused, while northern peoples generally prefer heavier ones. Now I gave my attention to his heavily-patterned socks. Southern peoples also seemed to go in for colour and pattern more than their northern counterparts, but these speculations were cut short when the owner of the shoes and socks leaned back in his chair and looked at me.
“I don’ know how to play this,” he said. “I normally admit a patient that ....” He paused.
“Has a condition like mine,” I finished the sentence for him.
“Unless you can come to the hospital for injections.”
“Oh, I will,” I said eagerly.
I doubted he had a spare bed to put me in anyway, but I didn’t want one if he had. I’d had enough of hospital imprisonment.
Sister Byrne returned with a packaged tuna sandwich that she handed me, and then conferred once more with Doctor Amora before vanishing again. Now Doctor Amora’s command of English was not really adequate for the discharge of the duties had to perform, but by means of a session of question and answer, I established that he would prescribe for me a drug called Warfarin, the taking of which would thin my blood to a degree sufficient to dissolve the small clot I harboured in my heart. I was to begin taking the drug that very day at ten milligrams a time, but as it would not have the required effect immediately, I would need to have injections of the stuff for three days beginning today, while on Monday I would have to return for a test to assess the thinness of my blood, so that the daily dosage could be adjusted to the correct level.
“It’s a good thing you had this scan,” he grinned, “otherwise we would not know...”
“Why did I have it?” I asked.
“Because on the first one everything was not quite right.”
He wrote out a prescription then and handed it to me and then left me to eat my sandwich.
I think the middle-aged lady had gone by then but my attention was drawn by the woman seated one space to my left. Plain-faced and gloomy-looking, she had black hair and she was wearing a black coat, faded blue jeans and trainers. Her legs were crossed and she was looking at a magazine propped on them. When one of the white-uniformed nurses appeared in the doorway the magazine reader looked up.
“I’m sorry,” said the nurse, “but I’m afraid you just can’t go in if he doesn’t want to see you.”
The nurse went off then, but was back several minutes later.
“I’ve just spoken to him,” she said, “and he definitely does not want to see you.”
The nurse disappeared again and the woman gloomed over her magazine once more. She was glooming over it still when Sister Byrne called me into the ward. She led me past a curved counter where a nurse was busy writing and went to a bed opposite where she asked me to take off my jacket. This done, I placed it on the bed while she pulled a curtain round. Now she handed me a booklet with an amber cover bearing my name and the title ‘Anti-Coagulant Therapy Record’. This contained information on Warfarin and the dosages I was to take over the weekend, beginning with ten milligrams that very day. She asked me to bring the booklet to the Pathology Department of the hospital at 3.00 PM on Monday, and then she produced a syringe and asked me to pull up my shirt.
“It has to go into the stomach,” she said simply.
“The stomach?” I said in surprise and a little trepidation.
I was not altogether comfortable with that idea. The stomach is rather a sensitive place and I’d never had a needle injected into my belly before. Still I considered myself quite a veteran of injections in general and lifted my shirt and tee-shirt underneath in stalwart style. But Sister Byrne was more veteran and stalwart still. Pleasant lady as she was, she fronted me face to face and rammed the needle into my guts like an assassin with a dagger. It fair doubled me up. Jacket back on, I hobbled down the corridor and was still stooping and clutching my guts as I collected my drugs from the dispensary. Undressing for bed that night I saw a round purple patch of skin next to my belly button about the size of a bullet hole.
In the Medical Assessment Ward next day a different sister in a blue uniform sat at the curved counter.
“I’ve come for a jab,” I said. “My name’s Wingfield.”
She rose and reached for a pile of records on a shelf behind and placed them on the counter. I loitered beside a notice board while she leafed through them.
“Colin Wingfield?” she asked at length.
“Yes,” I said, stepping up to the counter.
She returned to studying the records while I gazed aimlessly about.
“Colin, what is this injection for?” she asked after a time.
Sister, what sort of a hospital is this that asks the patient what he’s getting an injection for? I felt like asking, but merely explained that I’d had a heart attack some weeks ago and a scan yesterday showed I still had a small clot so I had been prescribed Warfarin.
Now the sister conferred with a nurse in white uniform and spectacles who went away and came back and showed the sister a packet she had in her hand. Both nurses peered at it closely and then the blue nurse nodded. The white nurse then led me to the bed, drew the curtain round while I took my jacket off, and then she asked me to lift my shirt and sit on the bed. There, I was skewered again. This time I noticed the experience consisted of two parts: first the pain of the piercing itself and second a burning sensation caused by the invasion of this ratsbane. That is by no means a metaphor. I learned later that Warfarin is indeed a kind of poison commonly used to kill rats.
On Sunday, Sister Byrne was on duty again. I gave my name and, without reference to any records, she led me to the bed and drew the curtain round while I took my jacket off.
“Why does it have to go into the stomach?” I asked.
“It works faster that way,” she said, “but I can see you have a little aversion to it, so I’ll give it to you in the arm if you like, since it’s the last one.”
I did not demure, but rolled up my sleeve in readiness while she stepped up with the syringe. First I felt the burst through the skin and then the burning inside. Jacket on again and out the door with my arm heavy and sort of hanging down, I clumped up the corridor like Quasimodo.
On Monday, the waiting room of the Pathology Department was crowded with people, some in wheelchairs, all of them older than me. I handed my amber booklet in at a counter and was asked to take a seat. I took one at the back where I could survey all these cardiac patients. At intervals, a name was called out by a man with a handful of amber booklets. When he called out mine, I rose and followed him into a room where two women in white coats sat at desks facing each other with empty chairs adjacent.
“Take the farther chair,” said the man, handing me my booklet.
I did so and the woman at the desk took my booklet and handed me a ticket with a number on it.
“Selling raffle tickets?” I asked.
She smiled and then swabbed my thumb with a wad of cotton wool. Then she administered a standard prick of the skin by means of a mechanical device designed for the purpose and squeezed out a tiny scarlet drop of blood. This, she drew into a tiny plastic pipe. With one hand she handed me a second cotton wad to press to my thumb, while with the other she conveyed the scant sample she’d taken to a device with a digital read-out.
“One-point-nine,” she said, writing down the result. “That’s good. That means your blood is now about twice as thin as it was before. The aim is to keep it between two and four, but as you’re a new patient you’d better go next door to see Doctor – xxx, and here she pronounced a name I’d forgotten the start of by the time she’d got to the end.
“What do I do with this ticket?” I asked.
“Give it to the doctor,” she replied.
He, another Asian, was sitting at a desk in the next room when I looked in.
“Come in,” he said, motioning me to a chair next to his desk.
He took my record booklet and opened it down flat while I tossed my ticket into a litter of similar ones in a dish on the desktop.
“How many milligrams did you take yesterday?” he asked.
I glanced at the open booklet and saw that Doctor Amora had written ‘10 mg’ for Friday and ’10 mg’ for Saturday, but noticed for the first time that he had written ‘5 mg’ for Sunday. Oh, oh. I had mistakenly taken ten yesterday, that is, two five-milligram tablets. I flushed. Why didn’t I check things properly?
“Ten,” I said.
“Ten!” he declared with a bounce.
Just for a second, I thought he took this to mean ten tablets.
“Ten milligrams,” I hastened to say.
He curled his lip and stared straight at me.
“Why?” he cried, taking the tail-end of the word right up high.
“I made a mistake,” I said, matter-of-factly. I was not going to be cowed.
“This is a dangerous drug!” he said, prune-faced.
“Anyway,” I smiled brightly, leaning forward and pointing to the ‘1.9’ in my booklet, “it’s not as high as it should be.”
“You are lucky!” he said disgustedly, staring me straight in the face again as though I’d done something really loathsome.
“I won’t make a mistake again,” I grinned with gritted teeth.
He turned slowly away as if loath to leave off this admonishment and hovered over the booklet with his pen for a second.
“We’ll continue on five milligrams a day,” he said, writing, “and you can come back next Monday.”
I agreed with the clerk at the counter to come at the same time next Monday and wandered out the door with my tail between my legs.
Next Monday, after the pin-prick, the technician said, “Two-point-four. You won’t need to see the doctor, as it’s busy today, so you’ll be sent an appointment in the post.” At that, she put my booklet aside.
By the Thursday of the following week, the hospital had still not contacted me, so I rang the Pathology Department. A woman answered.
“I had a blood test done a week ago last Monday,” I told her, “and I was told then that I’d be sent an appointment in the post. I still haven’t got one.”
“Name, please,” she said.
I gave my name and she asked me to hold the line. Following a pause, she said,
” You had an appointment for Monday which you missed.”
“It was not sent to me!” I said in some irritation.
“Well, you’ll need to come in as soon as possible,” she retorted.
By arrangement over the phone, I was waiting again that same afternoon amongst another great gathering of aged patients when who should I see this time but Malcolm, the landlord of the Farmers Arms Public House at Heskin. Cardiac complaints were a lot more common than I’d thought.
The read-out this time was just 1.3, strengthening my suspicion that I’d missed a tablet in the week, and when I voiced this misgiving to the Asian doctor on duty this time, a different, more pleasant one, he bumped up the dosage to just six milligrams a day and told me to come back in a week’s time.
The date of my appointment at Doctor Verma’s clinic came round at last on December 11th. At the Outpatients Department, I was shown to a small waiting room and sat for only five minutes before being moved on to a bench in a corridor already occupied by a middle-aged couple. The man was reading jokes in a Reader’s Digest magazine and snickering to himself and swivelling in his seat now and then to relate to his missus some little gem he’d found.
Presently, a door opened and a woman came out. Doctor Verma stuck his head into the corridor briefly and then a nurse sent the couple in. Ages later, the door at the end of the corridor opened and Doctor Amora came out. He picked up a file from a ledge on his left and read out my name.
“How you doin?” he asked when we were seated at his desk.
“I feel fine,” I replied.
“You taking the Warfarin?”
“Yes.”
He listened to my heart with his stethoscope.
“Good,” he said. “Are you wokking?”
“Oh, yes,” I said with enthusiasm, “I can walk as much as five miles.”
“No,” he said, “are you wokking?
What did he mean? It seems he didn’t mean ‘walking’. And surely he couldn’t be asking if I were making Chinese meals. So what did he mean? I arched my eyebrows and made swinging movements with crooked arms and fists.
“No,” he said again, “wokking!”
Ah, I had it at last!
“No, I’m not working,” I said, “and I don’t intend to work any more.”
“You got enough money, eh?” he grinned.
“Well, I’m on full salary for six months and then I’ll be on half salary for another six months and by then I’ll be retired.”
“Because it doesn’t multiply,” he grinned again, nodding.
But I had to ask him a serious question. I didn’t like having to take this Warfarin. It made me feel tired sometimes and tense at others. My sleep was unsettled as well.
“If my scan in February is okay, can I come off this Warfarin?”
“Yes.”
Good. - Good.
On the Thursday of that week I attended at the Pathology Department once more. The blood thinness count was 2.4, and I was told that I didn’t need to come back for a fortnight, so it seemed I was running on a smooth track – at last.
_______________________________
This experience has been a watershed in my life. It was a great shock to me at first, and caused me a lot of soul-searching since. But it has not been all bad. It has taught me to slow my life down and to savour it more for the precious gift it is, rather than go on devouring it thoughtlessly. It has also taught me some patience and tolerance. Death has taken me aside, so to speak, and put his arm round my shoulder and whispered into my ear something concerning my fate. How many others know anything at all about theirs?
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