Chapter 6 : The Surgeon

“you know how you hear of young people just dropping dead? Well this is why!”

One day a letter arrived in the post from the hospital, I was getting used to these by now but this one was unlike any I’d had before.

As I read through the opening paragraph the words ‘bicuspid aortic valve with severely dilated left ventricle and regurgitation’ jump out the page at me. I carried on reading to see that a meeting with the surgeon would be ‘soon’. What did that mean? It didn’t make sense to me, what were they talking about and what did ‘soon’ mean?

The letter went on to mention that the size of my heart was a major factor in the decision to operate as it was now larger than what they considered to be a normal safe size.

I didn’t know how to come to terms with this information, I still didn’t really know what was going on. It was now obvious none of the tests had brought back good results and it became clear that it was a major problem.

The next day another letter arrived. I sat down and opened the envelope as if I was going through the same routine, although I felt nervous. What would this letter reveal after the shock of yesterday’s news. I started reading and found that a date was set to meet the surgeon to discuss options. It appeared ‘soon’ was in fact ‘very soon’.

I made my way to St. Bart’s Hospital in central London. It was an old building with big stone walls at its flanks and a courtyard in the centre adding to the grand feeling of the place. It was like an old relic of the British Empire standing tall and mighty in a fast moving and developing city.

Barts
Barts

I had been here once for an examination and as I had done so many times before at other hospitals I navigated through endless corridors to find the level, and then the room, that I need.

The waiting room had an old musky smell and feel to it. The decor didn’t seem to have changed since the sixties. The walls were a dull, pale brown. The seats were large with faded pink plastic covers and there were two large tall windows with a view straight out onto a wall. The air was thick with sad and bad news.

I settled in a seat hoping I wouldn’t be there for long and played on my phone. The room felt like the embodiment of depression, and I felt the occasional glance from the other people waiting. They were old and seemed inquisitive about why I was there, sitting on my own in the corner.

I didn’t wait long before I was called into a room where I was introduced to Dr Li and Nurse Emma.

The room was small and narrow with a bed on one side. It was in stark contrast to the grand exterior of the building. Dr Li was directly opposite me and Emma to my left as I sat down.

Dr Li introduced himself as the surgeon and quickly went into the results from all the tests, saying they needed to operate and remove my aortic valve as its was not working due to a defect, so open heart surgery needed to take place. He came across as a firm decisive man with a strong presence in the room.

He went on to briefly explain that I needed to make a decision on the type of operation they would perform. The valve could be replaced with either a mechanical titanium valve or a tissue valve. If I chose the mechanical valve I would need to be on a drug called Warfarin for the rest of my life and the valve would ‘outlast’ me, whereas if I decided on the tissue valve it was not certain how long it would last and so they would need to do the whole procedure again, facing the same decision further down the line.

The difference with a second open heart surgery operation is that I would be less likely to make it through due to the trauma. This all rolled off his tongue like he was reciting it for the thousandth time and it was all perfectly normal.

He then explained that Emma would be my one-on-one twenty-hour nurse throughout the process. I could call her at any time to ask questions. She would see me a few more times for various tests and help prepare for the operation. Despite the dominance of Dr Li in the room with his authoritarian knowledge, Emma added her own subtle presence which I felt strongly. She was a soft and gentle soul who sat patiently in the corner.

“Oh. Right OK…” was all that I managed to say.

He asked if I had any questions. In a confused and nervous state I said, “have you done this many times before?”

In a quick unfaltering way he chuckled to himself and told me he has been doing it for many years.

“There is lots of information about me and the procedures online. It would be best to check it all out and then come to a decision.” Pausing for a moment he continued; “we want to get you in in eight weeks’ time.”

This final sentence felt like he was putting an end to it and the matter had been dealt with. It was time to move on, ‘pack your bags and get on with it lad’.

The first thought I had was of my parents who I knew where arriving back from a holiday on that date so I naively asked, “can we move it?”

He gave me a surprised look. I could sense his disbelief at requesting the date be put back.

“How about the following week?” he said.

“Ok thanks,” and it was done, the date was set.

I asked if there is anything I should be doing or not doing. By now it seemed he felt the need to impress the seriousness of what was going on and calmly said, “you know how you hear of young people just dropping dead? Well this is why.” A sudden weight of air slammed down on me and it became very real.

I realised then I should stop riding my bike and do everything I could to help ease my heart on any level.

The meeting took no longer than fifteen minutes. It was quick and to the point which I appreciated, although shaken up by it. At last I had someone who was being upfront with me and had laid it bare in simple language; no covering up with medical terms or test results.

In a nutshell he explained, “your heart has had enough. It’s over stressed and we need to operate on you ASAP otherwise it will stop working, and that could be at any moment.”

I thanked them for their time and got up to leave in a haze. I walked down the corridor like I was gliding smoothly along, a few inches above the ground, sailing along on an air of uncertainty. People were moving around me and I was in the same space, although I felt like a distant shadow.

I unlocked my bike from the hospital railings and gently rode home.

Advertisements

Chapter 16 : Twenty-Four Hours Before The Operation

“it’s a good thing you’re here, you wouldn’t have made it to Christmas.”

After the operation I would need someone to take care of me for at least a month, so we had worked out who was going to look after me on a week-by-week basis. I would need help with everything from showering, to cooking and getting dressed; any activity required supervision as I would be totally dependent on whoever was there that week.

My parents were going to do the first week to ten days, my girlfriend would be with me the following week and my sisters were each allocated a week thereafter. 

Things had been tense in the home for some time; my girlfriend and I were not communicating well and no doubt I was coming across as distant.

Mum and Dad were on their way up to stay in the flat with us and the lounge had been turned into an impromptu bedroom for them.  I was getting the room ready and went downstairs into the bedroom to grab some sheets where my girlfriend was watching a TV show, and as I grabbed the sheets I made a passing comment along the lines of “you’re not watching that crap are you?” and was very firmly told to: “shut up, I want to watch the program in peace before putting up with all the family.”

I stood there in stunned silence and we both paused for what felt like a long moment. I had overstepped the mark and cautiously apologised, realising there was something else going on. She sat and focused intensely on the screen and I could sense that she wanted to say something but perhaps was in shock at her own abrupt outburst, as if she didn’t know where it had come from.

With no acknowledgment from her I left the room and unfortunately that horrible air lingered without getting resolved. It made for a tense environment and once I had finished preparing the new bedroom I wanted to go and talk to her to clear the air. All of us were under pressure and the situation wasn’t easy. I desperately wanted to see what the real reason for the outburst was but felt I should give her space, it wasn’t long before my parents arrived and we hadn’t managed to speak.

The next day I had arranged for friends and family to have lunch near the hospital. I was told to have a big meal before going in as I wasn’t allowed to eat anything from then on.  I coined the phrase ‘the last lunch’ for the meal. We had a table booked in a gourmet burger diner nearby which seemed like a nice and easy option. I sat at one end with my dad opposite me and two mates either side. My girlfriend’s sister had come too as she worked close by.

My mates were chatting with Dad about what they do and sharing their stories while my mum, sister and friends giggled at the other end of the table. This was the first time my parents had met my girlfriend’s sister so there was added excitement to the meal.

There were no toasts and no announcements made, we carried on as if everything was normal. It was so lovely to hear general chatting and laughing and no mention of the operation at all.

When we were done and it was time to leave we all hugged and said good bye. My family, girlfriend and two friends walked over to the hospital with me. 

The Entrance
The Entrance

At the entrance to the doors of the lift, which would take me up to the ward, I said goodbye to my mum, sister, dad and mate Ben.

I turned to embrace them and tears were flooding as I hugged them individually.  My sister rushed over and gave me a desperate hug whispering: “it’s ok, this had to happen to you as you are the strong one of the family and only one who will survive”.

It was an incredible, loving embrace that paused the surrounding mayhem and gloom for a moment. As we hugged with heads planted firmly on each other’s shoulders with eyes closed, the blackness offered some peace and calm.

I could feel the tears building behind my eyelids which were doing there best to act as dams, although the pressure was mounting to release the floodgates. 

Ben came over and told me softly: “don’t cry, it’s OK” and gave me a kiss on the cheek as he hugged me.

My Mum couldn’t bring herself to come near me: “this isn’t goodbye’’ she forced through spluttering tears and a jittering jaw. Dad was quick, saying: “OK Guysee” before patting me on the arm smiling as he rushed back to Mum to offer some support.

There was no point dragging out the moment any further so I got into the lift with my girlfriend and my mate James, I was staring vacantly at the lift, eyes fixed on the space between me and the doors.  As we went up I laughed and joked with them both saying: “I’m glad I am not in the taxi with them. Poor Ben!”.

We got out of the lift with our tears dried and went into the ward. The nurses greeted us and showed me to where I would be staying for the night. It was a room with four beds and the other three were already occupied by older gentlemen. It was an old room which, like all the other rooms in this building, needed a good coat of paint and some life brought into what is otherwise a depressing and sombre environment.

I settled down and took in my new surroundings. My girlfriend, James and I joked and laughed about things for a while, filling the time with what conversation we could muster. Occasionally a nurse would come over and check on us to see if I was settled in. Then came the time when James felt he should leave so Tiana and I could be alone for the last hour or so. I was perched on the side of the bed and stood up to embrace him.  We hugged, patting each other twice on the back.  “See you later” was all I could muster as he left.

Tiana and I hadn’t really spoken at all since the night before. There was a lot going on with people coming and going and the impending circumstances hadn’t left any time to clear the air.  When we had spoken there was no substance to it, just simple offerings of help and discussing times of events to come.  Even without the incident the night before, what do you say in that situation?

The distance between was palpable. I was putting some of my things away when she turned to me and in a soft, anxious voice asked: “are we ok?”

Not knowing how to respond I looked at her and said: “yeh… we’re fine,” and smiled to offer some reassurance. I meant it, we were ‘fine’ although I felt confused and disappointed and I wasn’t really sure how I was supposed to respond. I was perplexed by the timing of the question and then quickly realised she needed to know and feel at ease with ‘us’ before leaving.

There were two times for the operation the following day, either 7am or early afternoon.

I was hoping for the 7am slot. I didn’t want to wake up and hang around waiting all morning. This in turn would have meant people coming back to the hospital to be with me.  The nurse came over and said I would be operated on first so they would wake me up at 5am to prepare. I felt a small bit of relief, it wasn’t much but seemed a great deal considering the situation. There would be no more waiting.

Then came the time for Tiana to leave so I could settle in for the evening with various physicians coming to see me. We kissed, hugged for a few moments taking a last breath close to each other and then she left saying she would call me at 6am to speak just before I went into surgery.

I brought my laptop, book, iPod and speaker with me but before I had the chance to open my laptop a nurse came over and asked some questions followed by another physician and then the anesthetist who discussed the drugs and went over everything again one last time.

They were all friendly and good to chat to. I always did my best to have a conversation with whoever I was with so it wasn’t just medical speak and scenarios. I wanted it to be personal and to relate to who I was talking with.  The physician went over the procedure one final time and in mid conversation he smoothly asked “which valve would you like?”

Here was the question I had been pondering on for so long, causing so much torment and making everything seem more complicated than it needed to be; the moment had finally arrived.

With ease and some relief, I answered: “the tissue valve please.”

A momentary silence fell inside of me; a pleasant void of stillness filled me and I couldn’t hear what anyone was saying. I realised that I had said it and it was done.

Abruptly I was pulled out of this peace, as if by an angry alarm clock early in the morning, and back to reality by a document thrust towards me titled ‘Consent Form 1’. Together we read the document word by word going over everything it had to say. It detailed what was about to happen, who the physicians were, the associated risks and that I wouldn’t hold anyone responsible in the event of it going wrong.  I am providing my consent.

Right above where I had to sign my name in handwritten words it said ‘Death, Stroke, DVT, Bleeding, Wound Injection, Arnthynium, Pacemaker, Blood Transfusion and other procedure.’

Smiling at these words I chose not to dwell on them and signed my life away.

Consent Form 1
Consent Form 1

For a moment I contemplated the document and I realised the full consequences of what could happen. It was written right in front of me and I signed.  I never thought too much about all the other possible scenarios, just that I would either wake up or I wouldn’t. This scared me slightly, although I took reassurance from accepting whatever would come. The decision, the choice, had been made.

We carried on chatting for a few minutes and the physician made this casual off the cuff remark: “it’s a good thing you’re here, you wouldn’t have made it to Christmas”.  It was said in such a quick way, in the middle of flowing conversation, that I almost didn’t register what he had said. I then realised how lucky I was, to be here at the hospital and not dead already. It was the 11th November.

When things had quietened down for the night and the three gentleman and I were alone in the room, we started talking to each other but there wasn’t too much to say, I got the usual ‘you’re young’ tossed my way like so many times before.

We discussed our operations; they were in for various procedures. The gentleman to my right paid particular attention to me and came over to my bed to speak to me. He was Asian, younger than the other two and slightly overweight.  We had a good conversation, talking mostly about business, and he told me this was his fourth operation, having had kidney and liver operations already. He was now in for the last time to hopefully get rid of cancer which had continually spread. I admired his spirit, he came across as a seasoned pro of operations, what courage he had to be back again I felt.

I then thought of his family and remembered how sad they looked as they left. They too were going through this for the fourth time, would he be ok? Would he survive?  Would the cancer finally be gone?  I felt their pain for a moment as if I was a member of his family and saw it from the perspective of being on the other side of all this.  Watching a loved one go through pain and torment, wanting to help but not being able to and saying goodbye whilst wondering if it would be for the last time.

I lay on my bed and rolled over to one side staring out of the window next to me onto a brick wall, doing my best to clear any thoughts.

I mediated briefly and drifted off into a much needed sleep.