Sanjay's Story

“Those kids’ll be the end of me, for sure” I muttered under my breath as I counted to three and willed them, by the power of the veins sticking up on my forehead, to appear at the front door. I had to be at the hospital by eight am so it meant an early start for my two boys, aged five and seven. The reason? What had the specialist called it after I’d been referred to him by my GP?

A “precautionary angiogram that we insist upon due to your family history and background”. So that must have meant it was just routine, right?

My GP had been similarly laid back when I asked to see him the day after my return to work following the Christmas/New Year break. My journey to work would involve a ten to fifteen minute walk to the station, yet even before that landmark day when I first noticed the tell-tale signs that something was amiss, a clutching in the chest, that walk was beginning to take nearer fifteen minutes than ten.

Being the kind of person I am, or in fact most people are, I brushed it aside as a sign of being unfit. I’d given up playing cricket years before due to the time constraints two young sons place on you at weekends. Some may say cricket won’t especially keep you fit; yet I defy anyone to suggest golf is a better exercise and there was a social aspect to that agreed with me and by my enthusiasm rather than inherent talent, I managed to be enjoy the game. It was a fairly healthy distraction from the pressures that would ultimately be the only possible cause for my premature contact with cardiac issues.

The walk was on a level piece of road then a slight incline where, on that day, I would be walking into a stiff, cold headwind. My dislike for hats added to the wind in being two factors that exacerbate angina symptoms. As I trudged up that hill thoughts of the injustice of having to return to work faded as the tightness increased a few notches and my customary brisk walk slowed to a stroll. Still no good, I had to start pottering, OAP style, to ameliorate the discomfort of the sensation. By then it was clear it was not just a lack of fitness.

As a result of what I felt that morning I contacted my GP’s surgery the following day and surprisingly my GP insisted I came in as soon as possible, within half an hour if possible. Had I been of a more superstitious and aware persuasion I would’ve seen this eagerness to see me on my GP’s part as a sign of the impending misfortune. So there I’d sat, outlining the symptoms I’d felt the previous morning to my heavily-jowelled and stout GP yet when he performed a stethoscope check on my lungs. No alarms raised there ostensibly, my lungs were fine (and so they should have been as I was a non smoker) and my heartbeat was regular too, yet again “as a precaution” I was to be referred to a specialist. My portly GP suggested I would in all likelihood be asked to undergo a treadmill test while being hooked up to an electro cardiogram (ECG) as a result of him contacting the specialist at my local hospital.

Sure enough the day of the treadmill test arrived and as a foretaste of things to come my chest was shaved, in patches only, so the ECG probes could attach themselves cleanly while I walked increasingly quicker on the aforesaid treadmill. The banter of a young male assistant with an older, motherly nurse a pleasant distraction from the mundane aspect of walking and not getting anywhere as tends to be the case on treadmills; a metaphor for a great deal of life’s necessary, but futile, endeavours. After this exercise there was another test and another nurse to fuss over me with plenty of “do this for me lovey” and “just breathe out again, darling”. She was in her forties and had a disarming friendliness and warmth that helped me to relax and temper the impatience I may have felt otherwise. I felt as being in hospital for any reason, other than the birth of my boys, was a new and unwelcome experience. Perhaps because I was about twenty years younger than the usual men who would be seen by her made me stand out, either way a little female attention of that sort would always be appreciated. The nurses chirpy south London tones and manner seemed to be aimed at pacifying me, making me think most people who went through my series of tests had more of an idea how diseased they were than I did, in my blithe, optimistic ignorance. More mumbled conferring amongst other staff members and next on the agenda was a blood test after the first minor bombshell had been dropped by the duty senior house officer (who, aside from having the surname of a striker from my most hated football team, was also non-alarmist and insisting that the blood test was a precaution as “something we’re not sure about has shown up on the ECG”). He stated I needed to start medication of four varieties of heart-related drugs, all of which I was familiar with as my father had been taking them for over ten years since the time his angina was diagnosed as requiring surgery. Again the eternal optimist in me wanted to believe all the “It’s only precautionary” caveats on what I should have recognised as indicators of the seriousness of what lay ahead. Without really thinking too deeply about the significance of my need for cardiac drugs I set off to the hospital pharmacy, which fortuitously was located next to the blood test section, my next port of call.

Another sign of the seriousness of the situation, which any one else would have seen for the actuality of the circumstances, was the senior house officer searched me out just as I sat down in the pharmacy to wait for my prescriptions. Another bombshell dropped: “It looks very likely we’ll have to ask you back for an angiogram, I’ll check this with the Consultant but it looks a strong possibility” He then went on to describe the procedure: it involved a fibre optic cable, with a camera at one end, being inserted via a hole in the skin in the groin, into an artery then inserting a probe through the artery and travelling up to the heart where a dye would be released to show up the extent of the blockages in the arteries leading off the heart. “Are there any alternatives and would it matter if I decided against the angiogram?” I asked, mainly to fill the silence that ensued.

A question I knew the answer to.

The answer to which then placed me in my drive way that late February morning. Breaking me out of my reverie my boys appeared, finally, out of the house.

Sitting in the front passenger seat of my Saab, while my wife drove, in her usual late braking fashion, staccato with the accelerator pedal, I stared out of the window at the accumulating rush hour traffic; the effects of the school run would lead to the clogging up of the roads, traffic would be pumped around the roads a deal slower as the clock neared eight am. For a brief moment the potential enormity of what I was about to undergo began to gnaw away at my cocksure confidence, confidence that I would be out of hospital later that day with nothing worse than pills to take for the rest of my natural life and maybe with advice to cut out cheese and dairy products from my diet, the only discernible vice I believed I was guilty of lifestyle wise. At that point the chattering of the boys seemed to quieten as subconsciously I tuned out of the moment to contemplate.

Then I returned to the moment and the hospital loomed ahead, our arrival being two minutes after my scheduled appointment time. Bounding out of the car, something I’ve yet to be able to do since, I let my wife know I’d call when they were finished with me I casually said my goodbyes to the boys over my shoulder, then stopped.

Something drew me back.

Almost trance like I turned around and went to open each back door to physically hug both of my sons. Another subconscious sign that I knew I wouldn’t be able to do that again for almost a week? Like I said, I’m not superstitious or particularly religious and thought nothing of it.

Having been greeted at the appropriate department of the hospital by the receptionist, with the sort of fixed grin reserved for latecomers, I was waved through to the waiting area. The start of the indignities began there: being asked if you’d shaved your right groin. Ever eager to please I could pipe up “yes, I did both sides, just in case you guys need to try the other side..and for aesthetic reasons also” although that rehearsed line would have worked better on a female nurse rather than a no nonsense male, African orderly. The next indignity would be the dreaded, and preposterous, hospital smocks, I’d seen on every Carry On film set in a hospital. The saving grace was being advised to use two, one put on front ways and one reversed so that any stray winds wouldn’t lift up the skirt flaps thus exposing my backside. Two other men were to be examined after me, they were both in their sixties and a quizzical look from one confirmed what I was thinking all along: ”I’m way too young to need anything drastic done “ After a word to his trio of charges the specialist in charge of the morning angiogram shift confidently strode in and handed out consent forms. The first thing to leap out from the pages thereon being the disclaimer clause excusing the hospital of all liability in the event of a stroke/heart attack “or some such related eventuality”. It was good to know the hospitals confidence in their “routine procedures” was so unshakeable.

“See you later” I called out to the other two elderly gents, almost mimicking the royal wave as I was wheeled past them, into the operating theatre.

Another give away that something serious was about to happen was the number of doctors, nurses, orderlies and related staff on the other side of the theatre doors. Always a quaint term for the site of work on the human body: a “theatre” I thought. Not where make believe was enacted, either with skill and passion or hammed up to ludicrous degrees for laughs or to mask lesser talents. None of medical staff would be likely to intone “And it must follow, as the night the day, thou canst not then be false to any man”. The words they would exchange subsequently sounded equally incongruous. The lead role in this particular play showed himself, the specialist whose name would have made me chuckle had he indeed felt the spirit of Polonius moving him to speak as such in keeping with my previous flight of fancy. As a prone figure on an operating table I was merely a “prop” to the show of skill he would exhibit.

And so the pain would start here.

First the local anaesthetic, injected in the only area to be self-shaved, many more were to be shaved shortly thereafter, but not by me. A stinging sensation followed by a sharp pinch as the catheter’s point of entry was made. Then, a slow numbness crept from the area of the puncture, fanning out in waves of sedation.

All so good, so far.

“Now we’re inserting the probe, tell me if you feel anything uncomfortable,” the perhaps distant relative of the bard asked me, his voice clear above the background muttering of his team and the bleeps and bloops of the scanning monitors.

It was at this point I realised things were not going as they should.

Without any forewarning I felt two separate immense pressures on each of my brows, splitting the agony on distinct, equal divisions of my forehead. Then what followed was that old time chest tightness I would feel, as my morning walk to work would start its upward incline, yet at a severity increased many fold. The voices of the hospital staff rose in pitch and speed as numbers and readings were demanded and supplied. Groaning I mumbled incoherently, attempting to articulate my discomfort yet my distress was by then already known to all present. At that point I felt I was drowning, sinking into unconsciousness.

At no point did I feel I lost time via a black out yet my notes would go on to indicate a cardiac arrest of “a minute or two”. Bad note taking or loss of memory from the medical staff, I’ll never know. Or perhaps my brain still functioned on the reduced oxygen supply as a result of the cardiac arrest and I felt the pain while my heart stopped. Or maybe my brain attempted to conceal the black out by blocking them from my memory. Then some west African female tones: ”Let me put this under your tongue” as a spray jet was placed there and two squirts of the remedy used to instantly dilate arteries was introduced into my system the quickest way possible. Relief from the pain was the next sensation yet while my head felt like it had been hammered by Thor’s own mallet my chest muscles loosened and I felt as I was coming back to the surface. “Right, we’ve got to get out of there” I heard one voice say. Great, the sooner the better, I thought. Within minutes drafts of fresh air rushed over my prone body as I was wheeled quickly out of theatre. The main performance was to follow, that was just a short play, before the main feature. Still bleary I heard more voices discuss my situation. Voices that came to the conclusion that would have made me slack jawed with incredulity if I’d been capable of facial, muscular control at that point. “He’s going to need an emergency bypass soon, better still this morning” said one voice. “Arrange an ambulance to get him to the operating hospital as soon as possible” came back another. So that was it, I was to beat my father to being a heart patient by more than twenty years! Lucky me, no sense in hanging around! The ambulance duly arrived and a plain looking nurse, who had been with me most of the morning apparently, was to act as my escort at the handover from the local hospital to the operating one. As I managed a cursory sweep of interior of the ambulance it became clear I shared one thing with the ambulance, we were both 1960’s models. Unfortunately too the suspension showed its age as we rattled our way over the city roads bumps and potholes, siren wailing at a volume quieter than I’d imagined it should have been. “We’re only blue-lighting you because of the traffic, not because you’re dying” my nurse of the ordinary countenance re-assured me. A quarter of an hour more of bumps and shakes and I was at the operating hospital.

The question was, when I would be operated on."

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Sanjay's Story

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