The two articles in this section describe big events for me in 2006, a heart attack follwed some months later by a triple bypass.  The first was published in full with the picture in Twenty Four Seven, the paper for the Somerset Ambulance Service. The second, the CABG Patch was asked for and copies given to the medical team who treated me at the BRI.

When you have read either of these you may be interested to go to Poems and read This I See is Certain.

An Afternoon in the Somerset Sun

Well, that was how it started.  I am a photographer, and Tuesday in Wincanton was a lovely sunny afternoon.  After parking in the High Street to collect some computer supplies I found I had a few minutes to kill before driving to an outlying village were I was booked to photograph  a family in their home. It is important to arrive neither early nor late for such things so I decided to sit in my car and dip into my copy of the Independent.  It was just after three pm.

By three-fifteen I started to feel odd. An unfamiliar constricting pain was spreading across my chest and there was an unpleasant ringing in my ears.  I certainly stopped reading the latest story about global warming.  Definitely something peculiar was happening to me.  Was it perhaps the chilli powder I had added to my lunch-time  helping of Morrison’s Mexican Soup or was it something else? Better be safe, I thought, and take some aspirin.  I started the car and drove down the road to our nearby home, but a panicky search of the bathroom cupboard failed to reveal any. The odd feelings were becoming most uncomfortable so I made a crucial decision..  I rang the family and told them that I had no idea what was happening to me, but I would have to cancel our appointment and go and see a doctor..  I then jumped back into my car and drove as fast as was safe (I hope) to the Wincanton Health Centre.  I got there just after three thirty.

Receptionists are naturally a protective lot, but at the risk of upsetting them I insisted somewhat forcefully on seeing a doctor immediately.  They moved quite quickly and the practice nurse was alerted to see me in a medical consulting room while the only doctor on site who was with a patient was alerted.  By this time the discomfort in my chest and ringing in my ears was so acute I knew this was not chilli powder.  I was told to get on the bed, my shoes and shirt removed, an ECG machine wheeled in and the nurse taped me to it.  The doctor, a blonde woman I had not met before, examined the print-out and calmly told me I was having a heart attack. Immediately the nurse went to phone the ambulance service. I asked if aspirin might be a good idea and that I preferred to be told straight what was happening.  She said that yes they were about to give me aspirin and that it meant I had a blood clot in my heart.  By that time my discomfort was really acute and they were mentioning morphine.

Almost immediately it seemed three enthusiastic young women arrived, smiling brightly.   Dressed in  fresh, crisp, green and white uniforms they announced that I had got  “the all-women ambulance team.”  They introduced themselves by first names and asked if they should call me John.  Formalities over I was rapidly moved onto their  mobile stretcher, an oxygen mask pushed over my face, and I was wheeled out through the Health Centre waiting area to the evident surprise of the assembled walking wounded.  I thought I must look like Hannibal Lecter. I was then loaded into the waiting ambulance.

The paramedic in charge was Nicola and as she and her technician Emma unpacked shiny metal boxes of complicated equipment they explained that they would now take a second ECG with their machine, as this, unlike the Wincanton one, was linked to a computer in the Coronary Care Unit at Yeovil Hospital (some twelve miles away)  This would enable the consultant there to tell them what to do next.  Again I was wired up, and immediately the Wincanton doctor’s diagnosis was confirmed.  I think it was then that I was given a shot of morphine which immediately reduced the discomfort..

Next Nicola explained that the recommended treatment was an injection of a thrombosis busting drug,  Tenectoplase, which would go into my heart and dissolve the clot.  Rather gravely she went on to say that this treatment, while strongly recommended, incurred an element of risk as it was possible that in some people it could cause massive bleeding in the head.  This – rightly or wrongly – I interpreted as meaning that the results could be fatal.  Before proceeding then, she said, my consent was needed.  Recognising  immediately that I was being faced with a choice between possible, but unlikely death and less heart damage if I said yes, and likely severe disablement and possible death if I said no,  I did not hesitate and  agreed that she go ahead.  At twelve minutes past four (as the record shows) the drug was injected and I was “thrombolised.”

Moments later Emma climbed into the driver’s seat and we roared off, siren blaring through the streets of Wincanton, then on to the A303 bound for Yeovil.

Nicola sat close by me, steadying me and issuing instructions to the others and checking how I was.  She emanated calm and authority as the ambulance bumped and swung about which was very impressive in someone who looked so young.  She asked how, on a scale of one to ten, I would rate the pain.  I said four – for it was nothing like as bad as acute toothache..

That drive though was unforgettable for I was acutely aware that I might never arrive and that my life was hanging by a thread.  This could be it.  She asked if I felt frightened and rather to my surprise I had to say  no.   Fear was not what I was experiencing, rather feelings of irritation and anger at this terrible intrusion into my rather happy life.  I thought of Elizabeth and the things we planned to do together – how much more she deserved and how much I wanted to share with her.

My past did not flash by me as it does for some, except for my recent experiences at my old college in Oxford and the photographic project I had done there.  At least, I thought, my images will remain  in the Trinity archive.

There was though little time for such reflection as we bumped across Somerset.  I knew I faced wipe-out – just that – a complete end – a full stop – nothing – and it felt as if it was only seconds away and that it was irritatingly meaningless.  The thought that clearly came to me was, “How banal.”

Next to that black void it was easier to enjoy talking and looking at Nicola, noting that  though so calm and in control, her face was flushed and excited and it was good and re-assuring to feel the touch of her hand on my shoulder.  It amazed me how strongly I reacted to the professionalism, concern and sympathy of this young stranger even as I was acutely aware of possible imminent extinction.

As we neared Yeovil I realised that the pain and tightness in my chest and the ringing in my ears was diminishing, so that by the time the ambulance came to a stop at the entrance to the A&E Department I almost felt like a fraud as they gently unloaded me.  I chatted easily  to the three of them thanking them for the impressive and efficient way they had worked.  They said they loved their job and it gave them a huge sense of satisfaction being able to help.  It was then, as I was being pushed down corridors and loaded into a lift, that Nicola confided that I was in fact the first person she had treated like that for thrombosis  since qualifying as a paramedic.

With that revelation we arrived at the Coronary Care Unit where my attempt to climb on the bed from the stretcher was brushed aside and I was given a full ceremonial slide across from the one to the other by a team of six, ambulance crew on one side, nurses on the other. Logs handed over, the ambulance team’s work was done, we said quick goodbyes and they withdrew as the nurses took over.  Immediately I was being hooked up  to various drips, bleeping machines and yet another ECG.  By then I felt sure my proximity to death was receding and I would see another day.

My arrival on the ward was timed at four-forty, an hour and twenty-five minutes after the onset of the attack

Tuesday 30th May 2006
3.55 Wincanton contacted Yeovil Ambulance Service
4.04 Ambulance calls Yeovil from Wincanton.
4.06 Yeovil returns call for check list and ECG
4.12 Thrombilised
4.40 Admitted to CCU

Asssitance over details in writing this from paramedic Valerie Godfrey seconded  for observation to the CCU and members of the nursing staff.  First version of this written on my second day in the CCU
Nursed on CCU by among others Lucy Davies, Karen White, Judith Williams and Sophie
Paramedic Nicola Woodland, Technician Emma

Diagnosed in Wincanton by Dr Zoe Fox and practice nurse Liz Corley.

Consultant in  Yeovil, Dr Chung.

Follow-up in Yeovil

The care I received on the CCU and subsequently in the cardiac ward was excellent.  I was of course immediately assessed on admission  by the doctor on duty and later by Dr Chung the consultant who explained that what had happened was very serious, but initial reading s seemed to show that the damage done to my  heart was, as a result of the prompt action taken by all concerned, relatively restricted – though I should expect to take four medications for the rest of my life, but should after a few months get back to my pre-attack fitness.   He said he had no idea what had caused the attack, and this happened with about two cases per month.

I was to stay in hospital for at least five days, initially in the CCU where in addition to being constantly monitored for heart beat, I was on a drip with an anti-coagulant, frequent ECGs, and completely prohibited from moving off the bed for the first 48 hours as this was the time when a second attack was most likely to occur.  Luckily I was spared that..

There are only four beds in the unit with three nurses on almost all the time and they all came across as the A team – intelligent, sensitive, sympathetic and completely focussed on what they were doing. They were also quick to be ready to come over to talk and to listen and help us explore our feelings about the trauma we had been through. Everything was  carefully logged and at the end of each shift they briefed each other meticulously.   On the second day I wrote my account for it had been writing itself in my head and I wanted to make sense of what had happened and as a thank you to those  who had clearly saved my life.

Turnover in the CCU was high and I was told from the second day to expect to be moved on to the general cardiac ward which I was on my third day.  There the standards were different with one encouraged to “self-medicate” and move around and of course there were far more patients per nurse.  Again however the nursing care was pleasant, friendly and treatment thorough and consistent with everything carefully checked.  Food was good and as important as the nursing care (as in the CCU) a team of excellent and very methodical cleaners were constantly on hand washing and wiping everything when they were not cheerfully serving us with tea and coffee.

Twice I saw Dr Chung, the second time for a very full interview before I left and he explained that in about six weeks I will have an exercise test on a treadmill and if that shows problems, an angiogram, if not I might not need that.  I was also visited twice by members of the cardiac rehab team and given detailed advice on what to do, to eat and to expect. They also quietly pointed out, just before I left hospital, how lucky I had been, for twenty-five percent of those who have heart attacks never make it to hospital.

In all I feel better care could not have been given .