I had almost missed autumn. The leaves had turned orange and fallen from
the trees, and the days had shortened by the time I finally made it out to the
Peak District on a grey, slightly damp day.
There were still haw berries and rosehips on the stripped-back branches,
each fruit holding a bleb taken from the damp air and reflecting the overcast
sky back at it. The red fruit stood out against
the fields’ limestone walls, against the fading trees and the pale grass.
Three months earlier I had been
running in the gym, tired from a recent visit to the Lake District, when I felt
a terrible crushing sensation in my chest making it impossible to
continue. I cut the run even shorter
than I had planned to and was pleased to soon recover my composure. It was an unexpected type of tiredness, I
supposed, and assumed it would go away with some rest. It didn’t.
Each time I ran, I felt the same crushing discomfort, and when I walked
up hills, I would feel the pain move up into my jaw, as though I had been
chewing too hard on some particularly crusty bread. I knew this wasn’t good, having foolishly
looked up the symptoms of angina, and called the doctor.
While waiting for appointments and
calls back, I tried to pretend nothing was wrong and carried on walking, only
with the expectation that I was going to have to go a bit easier. Perhaps it might just be a chest infection
that would be cleared up by a course of antibiotics. This didn’t prove to be a great plan, as I
struggled up gentle slopes, gasping and dizzy in some distress. Having warned Martin, my walking companion,
about my state, he said, ‘Yes, it’s the first time I’ve heard you breathing going
uphill.’
Eventually I had an ECG at the GP’s
and was told to continue waiting for my consultation at the NHS Rapid Access
Chest Clinic at Stepping Hill. When I
spoke to the clinic, I was told there was a nine-week waiting list to be seen. This condition was affecting my life too much
though – just walking to the shops would leave me sucking hard on inadequate
air – so I invoked the company private medical scheme to speed things up. It felt odd, having to choose a hospital and
a doctor for yourself – what did I know?
My choice was based on location, specialisation and availability.
It was all booked and, as part of
the handover to the private hospital, I was sent the ECG and notes. It was here that I first read, ‘The
possibility of an old inferior myocardial infarction.’ A heart attack? When did I have a heart attack? Why didn’t anyone tell me? The shocking revelation was dizzying in
itself and was hard to believe, given that I had kept on walking and running. Had it happened in the Lake District? Was it that first time in the gym? Was it months ago and I never noticed?
It’s funny how clear things can
seem some days. On that autumn walk the
colours zinged out at me. Climbing out
of the valley, the limestone outcrops had sharp, hard lines around them, the
multi-hued greys of the rocks and lichen glowed out from the surrounding greens
and browns. The world seemed alive and
full of beauty, welcoming me and offering me these sights. On some other days, it’s all just grey,
nothing is clear and you pass through it without seeing a thing. That walk was in technicolour.
The private consultation came about
quickly. I was trembling with nerves as
I walked into the hospital, unsure what I would be told, and unsure what
outcome I wanted. The consultant
cardiologist had a pleasant, confident manner, quizzing me about my state and
reading my notes. He took another ECG
and, on reviewing everything, switched into action mode. He immediately prescribed a whole string of
drugs and seemed very keen that I should start on them without the slightest
delay. He said he would run more tests
but felt I should be put forward right away for an angiogram (injecting dye
into the blood and viewing the state of the arteries via x-ray) with an
expectation that I would require a stent.
All this sudden decisiveness and
action had me reeling. Perhaps the shock
showed in my face because he twice said to me, ‘I’m sorry to have to tell you,
I’m just saying how things are.’ I staggered
out of the hospital in a daze, thinking, ‘Well, there you are, you’re a
condemned man, damned for what you’ve done.’
I slumped into my car and burst into tears.
Despite this shock, I still wasn’t
quite accepting the situation and went ahead with a short break to the Lake
District, after consultation with Jill, with whom I was travelling. I had a short walk in mind, though it did
involve climbing a hill. On the day, that
plan proved impossible to fulfil. I set
off up the gently-climbing valley track but was soon having to stop to let
dizziness pass me by. The awfulness of
the situation was overwhelming in itself, but it was the thought of how my
friends would offer me sympathy and help, were I to open up to everyone about
my condition, that actually brought me to tears – though crying while walking, when
you’re gasping for air anyway, isn’t a good idea. My turnaround point was at Lingcove Bridge, a
beautiful old packhorse bridge over the rocky burble of the River Esk, deep in
the heart of the most impressive hills in the area. I sat on a rock by the stream, wondering
about my future and trying to recover something for my immediate present. Through the anguish I vowed, ‘I’m going to
come back here. When this is over, I am
going to return and remember how this felt.’
Weak and despondent, I returned down the valley.
We cut the holiday short by a day
and I drove home on my birthday for a consultation with the cardiologist who
would be performing my angiogram. He had
the same calm, self-confidence as the other doctor and passed some of that
composure on to me, leaving my feeling better about what would happen. I
started telling a few more friends and family what was happening, now I had
something decisive to say, and it felt a relief to do so.
A familiar reaction on hearing the
news was, ‘But you’re so fit’. What
could I say? Yes, I know, beats me too. The Icelandic singer, Prins Polo, had just
died. One of his big hits was ‘Lif, ertu
að grinnast?’, or ‘Life, are you kidding?’
That seemed an appropriate response.
All this time in the gym, all the hills climbed, the streets pounded,
and still I end up here. And what would
it mean for the future? My ambitions
were all to do with long walks, multi-day trails, a wish to revisit the Himalaya. Without all these things, who was I, what was
I for?
There’s an Emily Dickinson poem
that begins, ‘Because I could not stop for Death – He kindly stopped for me’. I had been busy doing things – going to the
gym, cooking healthy meals, drinking beer, going on holiday, going to the
rugby, walking, walking, walking. I had
no plans to stop and yet here were Death’s dark wings fluttering around
me. Life is only provisional, things can
come to a sudden stop without warning, without caring what gets upset. And yet we must continue as if we’re eternal,
what else can we do?
I went back to the first cardiologist
for an echocardiogram, an ultrasound scan of my heart using the same technology
they use to scan a pregnancy. Afterwards
he reassured me that everything was fine, the heart attack had left no
noticeable damage and so a fix to the blocked artery should return me to full
fitness. He showed me the images and
videos he had captured. A coloured still
of my heart was made of red and green swashes, like the aurora borealis. A grainy black and white video showed a
shadowy valve, fringed in the image as though encrusted with lichen, flapping
up and down in the dark. But all was
well, that was the message I wanted to hear, and I positively skipped out of
the hospital.
On the day of the procedure, Pete
kindly gave me a lift to the hospital. I
had been slightly affronted at first when it was suggested that I should get
someone’s help rather than just take a taxi, as I had planned, as if I could
suddenly no longer cope on my own. It
was a welcome lift, nonetheless. The room
I was led to at the hospital looked rather like a chain hotel, a Premier Inn,
say, but for the unusual equipment at the head of the bed, all wires and
sockets and dials. Someone came in to
take my meal orders: post-op, evening and breakfast. Then I was left to watch cycling on the telly
while I waited to be called.
It was some hours before I was
asked to change into a gown and was then escorted to the operating theatre, a
room full of equipment and darkened corners where gowned individuals
conferred. The figures loomed over me in
rotation as I lay on the table, in a scene that I imagined was like a Joseph
Wright painting with me at the bright centre. I was pronged, clipped in and slooshed around,
while complicated layers of material were folded over me like some ritualistic swaddling. The usual route to the heart for the catheter
that would insert the dye is through the wrist and up the arm but, after some
uncomfortable poking about, the doctor appeared above me and said my artery was
looped at the elbow so they couldn’t get past.
Instead, the route to my heart was via my groin, something many people
have previously suspected. The femoral
artery is much wider but carries higher risk hence why they prefer to go
through the wrist.
The whole procedure took 90 or more
minutes to go through and I started to feel chilly and uncomfortable on the
slab, not least because the dye makes you want to go to the toilet, despite
seven hours without liquids. There was a
discussion of hardware (‘Have you got a 36 mill?’, ‘There’s 32?’) before the
stent was fed in and expanded correctly.
‘He wants to get it perfect,’ one of the assistants explained as the
time ticked by. At the end, the doctor
wheeled a screen over to show me the x-rays, before and after. The blockage was clear and almost
complete. My poor heart had done its
best to compensate with the left artery but the right was a starveling
mess. There was my problem in plain
black and white, incontrovertible, a killer in waiting. Thankfully the ‘after’ picture was much better
and the artery had filled up hungrily with flowing blood. It was hard to believe that I now had some
alien metal embedded inside me, in such a significant and symbolic organ as the
heart too.
In recovery I was kept horizontal
for some hours while the femoral wound was monitored. In that position I was told sadly I would
have to forgo my pan-fried salmon as I wouldn’t be able to eat it lying down. Slowly over the evening I was raised up until
I could eat a sandwich, the first food for 12 hours, and watch TV. I’m not sure what the medical staff made of
the evening of TS Eliot that I chose to view.
‘When, under ether, the mind is conscious, but conscious of nothing’
(The Four Quartets). It feels dreamlike
looking back, constantly monitored, a canula in one hand, a pressure bandage on
the other wrist, my legs still covered with the rugs from the operating
theatre.
The next day, after a good
breakfast, they checked my signs, changed my dressings and gave me the green
light to leave. Pete once again gave me a
lift. I spent most of the day dozing,
having had a disturbed night and being slightly under the effects of the
sedation. I kept returning to the
thought of the blocked artery and how close I might have been to suffering
something worse than I did. It’s odd,
having spent so many years feeling ‘half in love with easeful Death’ (Keats) and
then being confronted with it in reality.
In a poem by Emily Brontë, each stanza ends with a variant of ‘I cannot,
cannot go’. And that was me, with one
wrist bandaged like a failed suicide, I had clung onto life. I had been touched by grace, that generous
form of contingency, or perhaps had just been the recipient of simple luck. Or had it actually been something in my will? ‘I will not, cannot go.’
Looking back now, I think of the
times during the year when I had struggled more than I had expected to – on
Nethermost Pike’s east ridge, on Win Hill after the second day of backpacking,
on Hall’s Fell and Sharp Edge, on Harter Fell and Green Crag. Rather than instances of my lack of fitness,
as I had thought at the time, these must all have been skirmishes in the lead
up to the main attack, or perhaps consequences of an unnoticed attack. Now I’m slowly rebuilding my fitness with the
hope that one day I can take on such challenges again.
The autumn air in the Peak District
was full of seasonal smells: damp earth, damp wood, rotting vegetation. The countryside air seemed to be literally
breathing life back into me after my touch of Death. ‘Every leaf speaks bliss to me,’ says Emily Brontë
of autumn. To be out there amongst it,
to be able to walk there again, filled me with such joy that tears filled my
eyes. Down by the River Wye, just beyond
Ashford in the Water, the bright blue blur of a kingfisher streaked along the river
ahead of me, leading me on to my destination.
