When the attack comes

Sunday in early February dawns bright and clear with an achingly blue sky. It’s the first fine day for some considerable time and I want to make the most of it. Outings on the bike have been less than I would like this winter.  As I pedal off up the dale, I think that coffee and a bacon sandwich at my favourite café on the way back is a reward for which it’s worth exerting myself for.  My breath is making clouds in the freezing air and I’m loving it.

I have been a cyclist since my early teens and have managed to keep this healthy hobby going throughout the many years of hectic travel.  Apart from the health and fitness benefits I have always found that I do some of my best thinking in the saddle.

Heading towards the junction with the A59 is a short but sharp climb and, feeling good, I decide to take it out of the saddle, in a sprint.  But, “Christ!”  The climb puts me out of breath.  “You’re getting old,” I tell myself but quickly add the reassurance, “but then you haven’t been out for a while.”  Down the steep slope towards the roundabout, I try to get my breathing back under control.  I don’t, so (with the excuse of adjusting a brake) I stop for a few minutes.  It doesn’t seem to help and my breathing is still not back to normal.  I tell myself I just need to get my second wind, so I set off once more.  Half a mile later I am still breathing heavily, trying to catch my breath, so I stop again, telling myself it’s just to get some life back into my frozen hands.

I sit on a bench in the middle of the little green at Bolton Abbey, under a bare tree, hoping to get my breathing back to normal.  Feeling like an old has-been and glad that no-one is around to see me, I try to warm up.  After 5 minutes, I still feel like I need a really good, deep breath or two to get back to normal.  “Bugger it!” I tell myself, “I’m off and the breathing can sort itself out on the way.”  On I push, certain that I need simply to get the lungs used to working at the normal rate for the bike.

It’s just past 9.00am as I start a long climb up out of the valley bottom.  Normally this is a climb that I would attack out of the saddle but today I decide to take it easy.  I am already in the lowest of my gears but it is hard work as I push on up the long hill.  After another half mile, I stop yet again.  “Fuck it!” I exclaim to a field of grazing sheep, “You’re a useless, unfit old fart and you just have to accept that you can’t do the things you used to do.”  I check my watch and decide it’s not long until the cafe opens.  I will have the coffee and bacon sandwich a bit early and amble back towards Ilkley, bowed but unbeaten.  I turn and head back.

Coasting back down the hill, my body doesn’t warm in the sun and I tell myself that it is probably still below freezing.  After the long descent, I am colder than ever as I pull up outside the café; it isn’t open yet.  I leave the bike propped against the wall outside and decide to sit on a bench opposite, where I tell myself I can warm in the sunshine.  Even in February the sun’s bound to have some warmth.  I sit and face the sun, hugging my hands under my armpits, trying to get some warmth into them.  It doesn’t happen and I feel colder than ever, still trying for that elusive, deep breath.  I tell myself that I’ll warm up soon and then there’s the hot coffee to come.

Suddenly, I feel an overwhelming urge to empty my bowels, not just the normal sensation in the morning, this is really urgent.  I hurry over to the gents and, thank God, it is open.  Inside I struggle with my layers of clothing, cursing bib tights not designed for rapid toilet manoeuvres.  I manage just in time.  It is so cold in the loo I am feeling completely frozen and desperate to get out in the sun once more for that elusive warmth.  I waddle back to my bench and looking up at the clock above the door, I see that it’s 9.40am.  Another 20 minutes before I can get hot coffee inside to warm me up properly.

I sit hugging myself, face towards the sun in an attempt to extract some warmth.  I realise that I am completely frozen; not chilly, not cold but deep, down frozen.  There is no warming effect from the sun.  I am still desperately trying to yawn and get a deep breath into my lungs but something new has happened.  My chest has tightened and I realise… I am in pain.  I am absolutely frozen, unable to get enough air into my lungs and the pain is increasing.

“You’re having a heart attack.”  I tell myself, quite calmly, the realisation being almost a relief.  I congratulate myself on this obviously astute and accurate diagnosis but the pleasure is short-lived, very short lived.  Seeing a young lad cleaning tables outside the café, I decide to enlist his help and try to move off towards him.  It is a colossal effort, crabbing across to him, and the pain and cold are getting worse.

“Can you help me?” I ask in what is intended to be an authoritative request but which emerges from my oxygen starved lungs merely as pathetic pleading.

The young lad is very efficient.  “What’s the problem? Have you had the pain before?  Sit here and I’ll get the manager.”  I sit and don’t think.  Soon an attractive, young, blond lady appears and asks similar questions, also in a very efficient manner.  Later, I know her as Helen and I call her my guardian angel.  Helen tells me she is taking me inside and will call an ambulance.  They both take an arm and help me into a very small back room.  Walking is an effort and the pain is getting worse.

“Is there anyone I can call for you?” Helen asks as we wait for the ambulance.  I suggest she calls my wife but the effort to remember the number is too great.  “Just give me the phone,” says Helen in her calm and capable manner, “I expect you’ve got it listed under home?”  I am grateful not to have to be in charge of anything, least of all me.  I feel like shit and it is getting worse by the minute.  Helen isn’t able to get a reply.  I remember that Kate will be walking the dogs.  “Don’t worry,” Helen tells me, “I’ll try again in a few minutes.”  “Will you look after my bike?” I manage to ask.  The ever-efficient Helen informs me that it will be put in their garage and not to worry.  Helen makes small talk and tells me again that the ambulance won’t be long.  But I am cold, so bloody cold and in pain.

Soon the little room becomes full of two cheerful ambulance guys and their equipment. I see that it looks like a miniature, portable hospital.  The questions start whilst clothing is rearranged to fix electrodes on my chest.  “It hurts.” I say.  “We’re going to give you some morphine in just a minute.” they tell me.  I look forward to morphine.  I have never taken recreational drugs but it seems like a good thing; to be going to have morphine in just a minute, makes me sure that it will take the pain away.  I don’t notice the injection as I am too busy looking forward to the pain going away and trying my best to answer questions.  I think that I am doing well with my answers and being very grown up about the whole thing.  It hurts though.

“We don’t think that you have had a heart attack.” the one hovering over me informs me.  I feel vaguely disappointed that my astute diagnosis is wrong.  “We’re going to take you to Airedale hospital,” I am informed; “they’re expecting you.”  I am then shuffled into a wheelchair and am soon being pushed through the café under the curious gaze of those lucky enough to be having coffee and breakfast.  I don’t have the energy to feel jealous or embarrassed at my depleted state.  I am simply concentrating on my pain.  I am surprised to see that the ambulance is backed up close, doors already open and I am soon inside and lying strapped onto a stretcher.  It feels cold inside, like a deep freeze.

We set off and I soon summon the energy to curse aloud the stupid, ignorant, thoughtless fuckers who invented speed bumps.  I am vaguely conscious of the siren as we finally get onto the main road but the sound is far away.  The pain is getting worse.  I decided that I don’t know what drug addicts see in opiates; they are doing fuck-all for me.

I try to work out exactly where we are at any one time; this is both so I can concentrate on something other than the pain and because I really like to know where I am.  It doesn’t work and I am conscious of the pain being, well, very painful, crushingly so.  Why is it taking so long to get to the bloody hospital?  I tell myself everything will be alright once we are there.

Finally, we stop outside A&E and the doors are opening.  I am being wheeled out when I see Kate.  I am encouraged to see that she is not breaking down or in tears at my depleted state; she gives me a very welcome kiss and holds my hand all the way down endless corridors.  Finally, we enter a small room filled with lots of people in medical gear who started adjusting my clothing once more.  I catch a glimpse of myself in a mirror and see my skin is white, perfectly, corpse-like white.  Things are happening to me whilst I am in pain and Kate continues to hold my hand all the while.  My clothing is designed for cycling not hospitals but somehow, I am soon wired up like Frankenstein’s monster and I notice lines on computer monitors out of the corner of my eye.  I don’t want to know what they mean and look away, trying to control the pain.  It doesn’t work.

The activity around me continues.  I feel like a third party to the process but it doesn’t bother me.  I am far beyond caring.  I’m not scared but believe that ‘they’ are responsible for me and will shortly make me feel better; ‘they’ will make me feel better.  Please?

I am somewhere inside Airedale hospital and in acute pain, the worst pain I have known in my life.  A stern but sensible looking female leans over me and informs me that I am having a heart attack.  I feel nothing except pain as she goes on to tell me that I am to be taken to Leeds where they have a specialist unit and they will perform angioplasty and insert a stent if necessary.  I am to go in the same ambulance.  Some conversation is going on with Kate.  I am glad not be involved.

“I’m in pain!” I tell the assembled throng.  They tell me that they can give me more morphine and soon a needle is in me again and then I’m being wheeled down those corridors again with Kate telling me she will see me later.  I feel alone but relieved to see my two ambulance men; they are good guys and I trust them.  We soon set off and I hear the siren again.  I try, once more, to work out where we are and succeed some of the time.  I am surprised at how fast the ambulance can go and how it doesn’t have to slow very often, when I’m not thinking of the pain.  My chest is being crushed.

I’ve always prided myself on what I feel is a stoic like ability ‘to hang in there through the worse times’ and I concentrate on doing this now.  I feel like I’ve been doing it forever; hanging in, holding on.  It’s not working.  I pull down the oxygen mask that has been placed over my face and I am ashamed to hear myself suddenly pleading.

“Make the pain go away!”

I have no shame.

I get a squeeze of the hand and stern instructions to replace the oxygen mask but they can’t make the pain go away.  I decide that all morphine can do is slightly blur the pain, perhaps take it down half an octave but the volume stays the same. The oxygen is about as much use as a chocolate teapot.  The pain rises to a crescendo and then gradually it reduces, ever so slightly it dulls a little and then a terrible wave comes again.

I’m going to be sick!

I vomit into a paper bowl.  It doesn’t feel better the way a good chunder usually makes one feel.  The ambulance man tells me that morphine can have that effect.  On goes the journey.  I dimly perceive that the sun has faded and been replaced by dark fog.  And it’s colder still.  How much colder can I get?  I think we must be going up Otley Chevin and try to work out how much longer it will take.

I vomit again.  I feel like the worse kind of shit.

We speed on ….it’s taking forever!

I want to writhe around to ease the pain.  I do and it doesn’t.  I try being even more stoical but it’s becoming a hard role to play.

Dully, I sense we must be nearing wherever in Leeds we are going, as I am vaguely aware of a cycle of braking, slowing, turning and acceleration.  And the fucking speed bumps again, the cruel, fucking, stupid speed bumps.

Suddenly we have stopped and I am being wheeled out of the ambulance.  I feel cold as I am wheeled down corridors once more and then into a large room with a group of people – waiting for me, I don’t have to wait, I must be important.   I am transferred from the stretcher onto another gurney-like bed where soon people are working on me.

“Lie still!” I am instructed.  This is difficult, as I have found (relative) comfort (mental not physical) in my writhing.  Something is happening in my groin.  I distract myself by looking at a bank of monitors to my left and over my head.  I decide I don’t like what is going on and concentrate on the pain.  From the bit of my brain that is still able to function I start to recall the comments made to me by my business partner, Roger, who had angioplasty and a stent inserted 6 weeks earlier.  Roger is a big, tough guy who has battled MSRA and terrible pain for many years due to spinal damage, before falling prey to angina.  I recall him telling me that the insertion of the stent was the worse pain he had ever experienced.  “Oh, fuck!”

“You really must lie still!” one of the hovering team sternly instructs me (I have decided to award them this description as they seem to be indulging in some sort of co-ordinated behaviour). I wonder if he’s ever had a heart attack, knows what the pain is like. I think I stop moving for a moment before resuming a sort of slow, rocking, writhing and wait for the pain to get worse as I now believe it will.  Will I be able to cope I wonder?  This pain is bad, very, very bad.  Will I be able to withstand much, much worse?  Fiddling is still going on in my groin area, I am aware of this but it no longer has relevance to me.  I am detached, properly detached, not the semi-detached variety; I am lost in my pain and the expectation of worse to come.

A slap on my shoulder brings me out of the depths.

“You’re done!” he tells me, whilst briskly ripping plaster about the size of the Isle of Wight from my chest.  “They’ll take you up to recovery now.”  I am shocked.  The pain didn’t get worse.  I am aware of being moved on the gurney by following my progress across the ceiling.

Somewhere between the room where they did things to me and the recovery ward, I think it occurs in the lift, something happens.  I am not sure at first, I have not been sure of much for some considerable time, except the certainty of the pain.

The pain has gone.

I feel normal.  The pain has not eased – it has gone.  I have no pain.  I HAVE NO PAIN!

I am soon wheeled into a small recovery room where a chatty nurse tells me she is going to attend to the incision in my groin where the entry was made into a main artery.  Soon I am sporting a large clamp-like apparatus over the wound that looks like something Lakeland sell for various kitchen tasks, only bigger.  Then follows a short lecture on the dangers of moving too much and how I am to inform them if I feel a damp sensation in my groin.  I realise that my sense of humour has returned when I hear myself telling her that they would probably notice the blood on the opposite wall first, it being a main artery we’re talking about.

They then show me a couple of before and after screen prints of my heart.  The before shot shows one main artery completely blocked and another one almost closed.  The after shot shows the main one flowing clear and unblocked.  Amazing.  I ask for copies but am informed that is against some regulation or other.  I begin to feel like a third party again for a moment.

Soon a very cheerful male nurse comes and tells me that they have saved me some dinner – am I hungry?  My brain is working once more and I calculate that I must have been having my heart attack for something like…I don’t know…many hours.  My sense of humour really returns when I see that the meal they have saved for me is macaroni cheese.  I have had a heart attack and they’re feeding me cheese!  It tastes like the best bloody thing I have ever eaten.

Shortly my affable male nurse arrives proffering a pair of PJs at least two sizes too small.  He tells me it’s all they have and I accept them as they seem clean and better than the gown I am wearing.  We laugh together and it’s a great feeling.

I lie back and a wave of unbelievable relief and gratitude flows over me.  I am alive and I feel great.  I have survived a heart attack.

I speculate that this is how soldiers wounded in battle must feel when they know they have come through it and won’t have to return to front line duties.

Author: Tony

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