Road to a (Heart) Bypass

‘Angina, it’s probably Angina,’ the doctor said, as I climbed off his couch. Not a word I’d expected to hear in my 60th year, being reasonably fit and healthy. Hadn’t I been pounding the promenades of the Fylde Coast only three months earlier? St Anne’s Pier to Lytham Windmill in little more than an hour! And without the slightest hint of breathlessness or chest pain.

Angina was something my paternal grandfather had from his late sixties; but he smoked unfiltered roll-ups and put a pile of salt on his food. (He’d served in the Merchant Navy in both world wars, so he’d been taught to.) And he was overweight. I remember the new Indian doctor visiting him; he wasn’t impressed at being told to quit smoking and salting. “If that bu**er talks to me like that again, I’ll nuzzle him,” he said, with his customary Lancashire humour.

For the past few weeks, back home in Malta, I had been feeling a burning pain in my upper chest and throat while walking more than about 200 yards (I don’t care – I was brought up thinking in yards, feet and inches). Heartburn? I’d never had it, so it was possible. Then, one day during the Christmas break, I was walking up a moderate hill when I suddenly felt yuk. My mouth suddenly filled with liquid – saliva? Horrid! I scooted behind a rustic wall and spat it out before leaning on the wall and resting for a few minutes. What the hell was happening to me?

Strangely, the next time that occurred was on my walk back from the doctor’s clinic in Gudja, the next village. After hearing the word ‘angina’, I’d been determined to show myself it wasn’t, setting off uphill at a fair lick. I kept up the pace, but by the time I was passing the Maypole shop, now on a downhill slope towards our village school, I was in trouble. Before entering the pharmacy to book an appointment with the cardiologist (the following evening), I had to disgorge the contents of my mouth in the public toilet. Maybe Dr Chircop had a point.

ON THE HEALTH TREADMILL, OR NOT…

I left the consulting room of Dr Elton Pllaha with a prescription for Atenolol and two instructions: book a blood test at the polyclinic, and book a treadmill stress test at the nearby private hospital – it would be quicker. As I paid for my consultation, I handed over the prescription. “No, take it to the other pharmacy, where you usually get your medicines.” Okay.

Thursday 7.30 a.m. – the appointment for the bloods. I booked a time because I had to go on to work. Arriving at 7.20, I was told to take a numbered ticket and wait. And wait. ‘But I have an appointment.’ Tough! We are doing the best we can. So, what’s the point of making a bloody appointment?

Of course, due to Covid, the waiting was outside in the cold. At 8.20 I was still outside; slowly the numbers called in were getting closer to mine. At 8.25, with no progress, I gave up. Once inside, there would doubtless be a further wait in a holding bay. There would be students waiting. I left.

I limped back to the car. Limped because I had started having quite acute pain in my left knee. Teaching a three-hour morning class and 90 minutes after lunch was none too comfortable. I got through Thursday and Friday, fortunate to have my partner to chauffeur me. But over the weekend, the knee worsened; and by Monday, the day of the stress test, I could barely walk from the bed to the bathroom. Reluctantly, I postponed the treadmill.

On the Tuesday, I spent eight and a half hours sitting and limping around a corridor, waiting to see someone in A&E. After four doctors had prodded, twisted and yanked my knee, I emerged shortly after 3 a.m., with a prescription for Codeine and a referral letter to hand to reception on the way out. Three and a half months later, I still have no appointment.

Eventually, I phoned a sonographer, who is also a sports physiotherapist. He gave me some exercises and a disk with images of my patella, etc. If you ever wondered why people stopped buying CDs, this one cost 84 euros, on top of the consultation fee.

I was in for another wallet raid when I had my treadmill session at the private hospital. At more than 200 euros, I thought I’d bought the machine. After that, it took a few weeks for further tests to be arranged at Mater Dei, beginning with another treadmill slog, this time while being injected with radioactive dye.

In the meantime, teaching had all gone back online after the government, concerned at the stubbornly high Covid case numbers, closed all schools, non-essential shops and restaurants.

WE HAVE A PROBLEM…

Ahead of the angiogram booked for Monday 26th April, I had a Covid swab test and an echo-cardiogram on the Saturday. By 6.45 on the Monday morning I was in the appropriate area; of course, the first duty was to wander through the hospital and queue at the Billings Section, which opens at 7.30.

A couple of hours later, with a tube shoved inside my right arm, I monitored the conversation, which seemed to focus on words like ‘landing site’. The consultant then looked down at me, saying, “We have a problem.” Basically, one of my arteries was 95% blocked; another two were in trouble. Forget stents, the next phrase was ‘by-pass’. He disappeared for a moment to make a call; when he returned, he said that the surgeon could do it on Friday and so I was to be admitted into the Cardiac Medical ward immediately.

While recovering and waiting for the bleeding to stop, I made calls home and to work. I wasn’t going to be teaching the rest of the week, as planned. The wound was reluctant to heal, possibly on account of the bits of hardware being removed from my arm in the wrong order, a criticism I overheard as an Indian gentleman was trying to force six large tablets down my throat while I was in a completely horizontal position. I was the last patient in the section, long after the cleaners and most of the staff had left.

They wheeled me to a bed by the window in a bay of six, which seemed pleasant enough until I discovered that the window was draughty. Never mind, at least I had something to look at. They brought some food at five o’clock, expertly synchronized with the beginning of the one hour per day of visiting time. Rather like people timing their arrival at the monkey house in the zoo for when the animals are being fed.

My only previous stay in Mater Dei hospital, some eight years earlier, had been thoroughly satisfactory. I had frequently praised the place as being far better than the UK hospitals I had known. How I was about to be disabused of such notions…

THE RIGHT HAND DOESN’T KNOW WHAT…

The farce really began the next day. After the customary 5.15 waking, the blood taking every few hours began. Is it really necessary to take blood at two or three a.m.? Is the 15-year-old work placement kid left in charge of the Pathology Lab really a vampire? I digress.

My cardiologist and his little team came by shortly before eight, checking how I was and that I was all set for Friday’s op. Two hours later, a pair from the surgeon’s team arrived to say that the full op might not happen on Friday. “The professor is on call this week,” one explained. ‘What does he normally do, then?’ I wondered. Is he a professor of economics or archaeology at the university next door, and heart surgery is something he does as a hobby? They left saying that I might just have a stent in the worst artery this week, then they could do the by-pass at a later date.

When the Japanese colleague of my cardiologist arrived on Wednesday, I relayed the conversation. He nearly fell through the floor. “What’s the point in that?” he asked. I shrugged. They’re the surgeons. I’m just the person they’re practising on. They left, assuring me that the by-pass would be done on Friday.

Thursday was even more entertaining. The cardiologist came and pep-talked me up for the next day, saying that during Thursday I would be transferred to the adjoining Cardiac Surgical Ward. Later that morning, two different people from the surgeon’s team rolled up with a sheaf of papers and permissions for me to sign, including one authorizing the use of a clotting agent not approved by the EU but used with relish (not that kind of relish) in Britain. Red lights flashing, warning bells ringing in my brain.

“It may be tomorrow, but we’re not sure. It could be over the weekend,” the tall, bushy-bearded man said. My lower jaw hit the bed, even though I was standing. He’d had to borrow my pen to complete the forms. Nothing like Covid-conscious. But that’s for the next instalment.

Would I be moved before my other half visited at five? Would I miss my dinner or get something I hadn’t ordered? During the early afternoon I was wheeled off by a young porter for a chest X-ray; an hour or so later, another wheelchair was parked by my bed. “We’re going,” a rather elderly porter said. “To the next ward?” I asked. “For a scan,” he replied. We traversed a large portion of the hospital and rose three levels in a lift. At one point, the guy seemed to be struggling so much that I almost suggested he should sit in the chair and I would push.

Shortly before five, a woman in full PPE came and took a swab from my nose. The food arrived; my other half arrived. I had prepared for THE CONVERSATION, but it still wasn’t easy. However, I did say that if it went badly wrong, I had made full notes about money, plans for publishing completed manuscripts and that I didn’t want anybody at my funeral reading that awful tosh about me being in the next room. I would probably vomit in my coffin, a medical first. Possibly.

Lights out usually happened around 8.30. I listened to some music before settling down at 10, wondering what time they would wheel me through to ‘the next room’. It was about 11 p.m. when I was woken by the nicely-spoken young English doctor who had been two or three times during the week. She wanted some blood for the leech in the Path Lab; and then she dropped the bombshell…

“I’m really sorry about your operation.”

“Sorry?” I mumbled, only half-awake.

“Didn’t anyone tell you?” she asked, registering my bewilderment. “It’s off. The surgeon can’t do it. He said he would come and tell you.”

Obviously, he hadn’t. The next morning, a posse of doctors and students gathered around my bed; some were apologetic, others downright shifty. The bypass had now been slated for next Tuesday. I was to remain on the ward until Monday. And that’s where the trouble really began.

I emerged from one of the bathrooms to be told by a cleaner that I shouldn’t use the two at the end of the ward; a Covid-positive woman was using them. Both of them? When about a dozen other patients are sharing one?

On the Sunday afternoon, during the medicine dole-out, a nurse began injecting a clear fluid into the cannula in my left wrist. Suddenly, there was a horrified cry from across the room: “NO! Not THERE! Bed 19!” A sharp pain shot to the tip of my middle finger. Heaven knows what I had just been wrongly administered.

Soothing myself with Albinoni oboe concerti as night fell, I had drifted off into a pleasant sleep. Which made the awakening at around midnight all the ruder.

WHAT THE [EXPLETIVE] !

“Get up! Get up!” My startled eyes were greeted by what I can only describe as a ‘being’, or a ‘thing’, dressed from head to toe in plastic, mostly yellow. “You’re Covid positive! You have to move.” I was thrust into a wheelchair; my belongings were thrust onto my lap. We began a high-speed dash through corridors to a lift, reaching a dark room on the top floor. In a side room, someone was coughing.

They stuck me in the bed nearest the door, only to make me get up and move to the other bed when they dragged an elderly woman in, fifteen minutes later. The poor creature was in a bad way, coughing and moaning all night. “Even if I didn’t have the bloody virus before tonight, I frickin’ well will have it by daybreak,” I muttered. By this time, I was beginning to process the ramifications.

These were confirmed by the Japanese cardiac doctor who appeared about eight o’clock. Even shiftier than he had been three days earlier, he denied any possibility that I had caught the lurgy in the hospital. “There’s nobody with Covid on that ward,” he lied, unaware of my conversation with the cleaner.

I would be transferred later that day to ‘Boffa’, the old Royal Navy hospital, just outside Valletta. Needless to say, the scheduled bypass was off.

Rather incongruously, it seemed at the time, I shared the ambulance transport with a young Englishwoman, in her early twenties, who was being discharged after spending ten days ‘inside’. She had been quite ill; and I wondered whether she felt afraid that I might re-infect her.

The isolation ward contained only two other patients, one of whom was a pleasant young Indian man scheduled for discharge the following day. He introduced me to the veranda, with its vista over the inner Grand Harbour. My bed was beside the window, with a view of the outer harbour and the walls of the city. The next week, for two days of which I was alone with my laptop, was restful and untroubled – not even by any symptoms of the dreaded disease.

But then, on Monday 10th May, I received an email that provided me with a problem…

IT’S GO! GO! GO!

The publishers wanted to release Roses of Lace on 27th May, in two-and-a-half weeks’ time. And they needed a wad of publicity material and other stuff very quickly. My material was mostly at home, in my study. There I was, stuck in an isolation hospital, possibly for another week – with zero symptoms. A thought struck me. Three or four phone calls later, I was cleared for release home, provided that I confined myself to one room plus the bathroom.