Tuesday, 19 April 2016

The Spoils of Time

It has taken me a while to write this. It should be obvious why.

We all know the effects of ageing on a runner. A 2% annual decrease in VO2 max from age 30 onwards means slower times. And then the struggle to accept that you’ll never achieve another PB, and the strategies you implement to minimise the effect of this: different distances, measuring yourself against your age group, or against yourself within this age group. All well known.

I experienced a new one, as my forty-eighth birthday whistled towards me (yes, you’re allowed to say it: in fact, say it aloud, so I can hear you). I don’t have a name for it yet, but I hope to explain it.

A prologue, which I’m afraid contains a spoiler (skip to next paragraph if you don’t want to know): in the unlikely event that my mother is reading this, it has a happy ending, though during the middle section this isn’t evident ...

First some context. I was out on the streets of Paris when the terrorist attack took place in November. I didn’t see any violence or blood, heard no gunshots, only a cacophony of sirens: I just had to get home with a couple of dear friends who were anxious, and, being French and Parisian, grasped what this meant in ways that I couldn’t. We got a taxi, and the taxi driver grew frightened in what was already a very circuitous route. But eventually we got back. That’s just background. I’ve had things on my mind.

A couple of weeks later I am at work, a few days before the said birthday, sitting at my desk doing some routine admin. Which is to say sending emails, which is about a third of my professional life at the moment. Yes, dear student, of course I’ll happily send you a summary of what we talked about in the two hour seminar you missed because you weren’t feeling very well when you woke up. I make a cup of tea (that’s about 3% of my professional life), and as I walk back to my office I notice that, yes, that ache in my left shoulder just isn’t right, is quite painful in fact. Don’t know what that’s about. More emails. I’m not even fancying the run home. Worse, I’m getting short of breath because there is a tightness in my chest. And my left shoulder and arm are aching more. And quite soon I can’t focus on my work any more, because I’m struggling to breathe and my arm hurts.

I think about calling 999, but call 111. I describe to the nice man the symptoms. ‘Any family history?’ he asks. Yes: my mother’s side of the family, many have died of heart attacks while young, possibly linked to high cholesterol levels. Does he think I should go to A&E, I ask. He tells me that he’s already despatched an ambulance and I’m not allowed to move. I have to take some paracetamol, but must stay sitting down.

Fortunately I have a cup of tea, but I have to phone the school office to ask them to tell the porter three floors down that there’s an ambulance on the way. It causes some concern and two solicitous colleagues come and sit with me. We make small talk. B tells me I’m hot (not in a good way: in fact, in rather a bad way if you have the other symptoms of a heart attack).

The paramedics come, Raoul and Gwen. They bring a wheelchair. I plead with them to let me walk, because – isn’t vanity a strange thing – I don’t want my colleagues to see me looking vulnerable. I think of myself as fit and healthy, and as preserving a smidgeon of youth precisely because I’m healthy. It’s one of the small things that can put a wedge between you and the institution that employs you. I run to work, whatever the weather, and sometimes I take a long route. I can always run away again.

I pass a colleague in the corridor. I scowl.

In the ambulance on the Mile End Road Raoul fits me up to an ECG. You look pretty fit, he says. He frowns when he sees the ECG reading, and tells me that he thinks we’ll have to go into hospital. He takes another reading and turns pale. It should be Barts, he tells Gwen and then me. ‘Best facility in the country’. He tells Gwen to put the blue light on, and starts to put a stent in my arm. These people are extraordinary, and I am overwhelmed by the virtue and virtues of paramedics.

Three minutes a couple of pricks and some blood later Raoul asks Gwen to pull over while he finishes putting the stent in. And before long I’m in the heart facility at Barts being prepped for an emergency angiogram. There’s a Houdini-esque routine by which I am assisted in the removal of my suit and into a gown, surrounded by cardiologists at various stages in their careers, a radiologist and various others. They’re at work, and it’s routine. It’s odd to watch people at work as your body moves away from you, into the realm of object.

The insertion of a catheter into the arm presents a cold tickle, not a pain, but a chill internal slither. It wriggles up my arm and then I lose all sense of it. The cardiologist adjusts the big screen, rorschach shapes sly by, and then there is a tree’s roots, static and crisply focussed.

‘Wow. What’s that?’
‘Just passing out of the aorta,’ he says, or something like that. Actually I made that up. I can’t remember. The mood drugs are quite powerful. For a few undefined minutes, lacking beginning or conclusion, I lie on my back and watch the inside of my heart from various angles, and at the same time feel it beating to the psychedelic rhythm in my head.

‘You have the heart of a twenty year old.’ He says. ‘It’s big and powerful and undamaged.’
‘So what’s happening?’
‘I don’t know. We’ll need to do some more tests.’

I’m taken to the ICU. I lie in bed and accept I’m not going to die. Though it’s true I don’t know the way in which I’m not going to die. It’s now early evening. And only then do I turn my phone on and call F and tell her what’s happened. I think the drugs are still in my system, and it helps me be reassuring. I don’t call my mother. She didn’t even know about the scare I had about the rapid rise in my cholesterol levels last year (brought down through a diet of low carbs and high protein), and this would be a more difficult conversation. I call my younger son, who still lives at home. He’s on his way home from a volunteering job. I explain that I’ve had some kind of cardiac event he needs to bring me something to read, and something to snack on, in case I get hungry. He puts up only the faintest resistance.

When you’re going to be in hospital for an unspecified period without a sense of an ending the choice of reading is an important one. I plump for Tom Jones’ autobiography, plus a book I’ll be teaching in a week’s time. The 18-year old is spooked. He puts on 18-year old nonchalance, but there’s a stiffness in his eyes that gives him away. He brings me a sandwich and some chocolate and stays for half an hour. I tell him to cycle home safely. ‘Yeah,’ he says, and is gone.

In the night I am taken, rigid upon a sacrificial trolley, through a tunnel to the ward in the Grace building. I spend the next two days lying in a bed and wired up to an ECG. Three other men are in the room, all seriously unwell. One sleeps. He is much younger than me. Another man is a little older than me. He’s had a heart attack, but is waiting to be discharged. He’s anxious about what’s going to happen to his driving licence. A third is a very old man, who can barely move unassisted. His resting heart rate is about 113, his blood pressure perilously low. I watch my heart rate, I watch and watch. 70. It doesn’t move.

I do not sleep.

The next morning the young man, an American, is moved to another ward. His blood tests show fearful levels of the same hormone for which that morning I am tested, and found to be free. His heart is damaged. There will be consequences. He is replaced by an old man, whose heart rate soars whenever he moves. He has stories of adventure. I spend two days watching heart rates, feeling vulnerable and strong at the same time. The men are pinned to their beds.

I pass various tests until only one more scan remains, but for that I have to wait and wait. I remain connected to various machines by wires that are clipped to me, or pierce my skin. I have 18 patches sticking to me. Both arms are punctured and bruised from elbow to wrist. By a nod the nurse eventually indicates to me that she’s willing for me to disconnect myself in order to visit the bathroom, so I no longer have to ask her to do it. Later she gives me some shower gel. ‘Just don’t get those wet.’ I walk, almost a free man, to the shower. Tom Jones has had his first big hit, and it follows me silently down the corridor.

I am panicking about work. I have an event to do the following evening, an ‘in-conversation’ with an indie rock-musician about the inter-relations between songs and history. No one else can do this. I need to be discharged by the following night. The consultant comes. ‘You look fit,’ he says. I explain that I run marathons, and try not to complicate that with any qualifications or stories. ‘You’re in good shape.’ So what’s wrong? Perhaps nothing. The initial ECG showed a troubling arrhythmia, but that’s not uncommon, and it’s not dangerous until it becomes too frequent.

My heartbeat syncopates. I am hospitalised by listening to too much jazz.

I need an ultrasound scan and then I am free, but the day begins to wane. Tom Jones becomes disillusioned, whiling his days away in Las Vegas shows, eating, drinking, knowing what to expect. He buys one Home Counties property after another, while the green grass of home still grows on him. He discovers meaningful duets and soon it is night.

The woman with the food trolley is solicitous. She keeps on giving me extra food. I’ve not stayed in hospital since I was a small child. It reminds me of aeroplane food, that’s all.

The nurses have begun to look upon me as a fraud. Not just because I am to all appearances brutally healthy, but because I have claimed to have a partner and children, and there have been no visitors. I lie in bed slowing my heart – today it is 62 – and reading. And I think about how I have used my days. This is not a good thought, because half of them are spent, and the books I have not written pile up faster than those I have. I can see the mental furniture know, know what those books are meant to do, but the frailty of the body is vying with my mortgage to be captain of my soul.

I resign myself to sleep. I am a poor sleeper, and the bed is unfamiliar and the room full of murmuring, but somehow this happens. And the alarms go off and the nurse arrives with a crash trolley. I drowsily look at her. She looks back, pauses, presses a button on one of my flashing machines and leaves. It happens throughout the night. After the first few times she doesn’t bother with the trolley, but sticks her head through the curtain and presses the button.

In the morning she explains: I had triggered an alarm on the machine because my heart rate had fallen too low. She couldn’t turn the machine off or recalibrate the level at which the alarm was triggered. ‘What was it?’ I ask. 37 she said, and I feel quite pleased. And a complete fraud, again.

The day withers. Tom Jones did some TV programmes, the book ended. I've always felt a close affinity with Tom. There is talk of a portable ultrasound machine. Then she arrives: a doctor with an ultrasound machine and a shock of red curls. We talk about late-life marriages and her imminent honeymoon. She is the faint odour of life in the unchanging routine of our managed decline.

And I am discharged. The consultant is an irritable Italian. He stands with me at the end of my bed, flicks through the papers and declares: ‘whatever you die of, it’s not going to be a heart attack.’ I put on my crumpled suit, polished shoes, become a different person. And I head straight to work.

Not the right thing to do, however necessary. I took something with me from the hospital without realising it, and it has stayed with me for weeks. I haven’t given it a name, and it would be easy if it were the black dog, because I know him. It stayed with me through, and probably had a hand in, my birthday, which I spent alone and partly with my head down a toilet, an infection probably picked up in hospital. Then it stayed with me, slowly evolving, through Christmas. It bared its fangs when I was listening to the Today programme at about 6:50 one morning, and the presenter said that news was coming through that David Bowie had died.

And it has stayed on. It is one of the effects of ageing. Now, like my much mourned dog Mercury, it runs with me. I don’t think it is going away. I am working to invent a name for it.