You Look Bewildered

 You Look Bewildered

“Resistance is futile” - The Borg, stardate 43989.1

 

Much has happened, and perhaps the last week or so could best be described as a blur.  A dream?  A nightmare?  Perhaps both.

For the purpose of a starting point however, it begins with nothing more than a vague, distant hissing sound.  Like that of a compressed air line in a workshop, but far more clinical.  Cold.

“Stephen.  Stephen”, says a female voice from somewhere far away.  “Can you hear me?  Stephen.  You’ve had an operation”.  

In my previous experience with anaesthesia, and mercifully throughout my 52 years, such times are few, it always seems the same.  Hissss…..

This time things seem a little different though.  I know there’s lights on somewhere in front of my face, but my eyes don’t want to open, so I figure I’ll let this lady know verbally that I can hear her.  But well, nothing seems to some out and I can feel some kind of plastic device filling my mouth on one side.  Tubes maybe?

At this juncture the logical side of my brain I’m sure would’ve been saying rather calmly, “Hello. You have a breathing tube installed.  Nothing to worry about.  All is fine.  Just wave”.  Which of course would’ve been fine, but here on Planet Steve this fine day, the situation is a little noisier.  We’re flying perhaps….nose pitched down, the master caution is clearly illuminated, both engines have failed, and all is lost.  Clearly time to panic. 

To be frank, I don’t understand the concept of asking someone who’s intubated to say anything really.  How are you supposed to respond?  It makes no sense to me, but hey, I’m just a train driver with a podcasting habit, so maybe someone with greater knowledge of this can enlighten me.

For now though, the only things on the relevant emergency checklist are:

1. Do not panic
2. Await removal of tubes
3. Refer item 1

It wouldn’t have been long but it seemed like an eternity.   I can’t seem to concentrate on what they’re saying to me, and now it’s noisy.  Maybe I’ll open my eyes and assess the situation.  There’s people all around, I see now, and they’re moving with deliberate haste.  Wherever we are, it isn’t the relatively comfortable confines of room 18 in the Coronary Care Unit, which had been my home for the past week.  I decide to close the shades again because my brain clearly isn’t being fed reliable data. 

Now someone is tugging on this device in my gob, so I’m madly trying to find that checklist again.  Do not panic.  

Not as easy as it seems, for me at least.

So, there’s a ton of coughing and gagging, and then the hissing sound fades away.  And now I can talk…sort of.   I open the shades again to find myself staring at the faces of my mum and my brother.  

Ok, we can put that checklist away now.  We’ve landed in the Intensive Care Unit.

                                      

There are so many who have walked this journey before me, and many more who have endured far more traumatic surgery than this.  I’ve been the beneficiary of so much support from many of them in the preceding week, as they’ve touched base to try to reassure me.  Anyone who knows me well knows I have an awful habit of overthinking everything, and everyone who’s taken the time to talk or text or email probably knew that my brain would’ve been in overdrive.  It was.  But drawing on inspiration from one person in particular; a man I’ve long respected and who I’m proud to know as a friend, I am doing what I can to stay in the best possible mindset.   I had the good fortune of interviewing this man earlier in the year,  discussing his own approach to something similar that’d affected his own life.  The subject matter was profound to me at the time, and contrasted sharply with the way I figured I’d have probably tackled such a challenge.  How little did I realise at the time that I’d be walking the same path just a few months later.

The purpose of these posts are not to paint myself as some kind of hero or crusader.  I am neither.  They are simply a record of my experience that I hope others can learn from.  The point here is that if at some point in time you’re forced to stand there and contemplate your own mortality, it becomes very, very personal.

Some people won’t cope with it, others will seem to bound straight back up, and yet others, at least in the early stages of this, might not know exactly what to feel.  

Right now, on day six, post-op, that’s where I am.  Bewildered.

                                

In any other circumstance, room 18 in this wing of the hospital would be a nice little spot to take a break and contemplate the world.  The Coronary Care Unit at Mulgrave Private Hospital is tucked away at the end of a couple of other wards in what seems a proverbial rabbit warren of corridors.  It seems at first glance a little dated, but if 80’s style is your thing, even that’s not an issue.  Room 18 is right at the end, so it’s rather quiet, has a comfy bed, good meal service and a pleasant view out the window.  Also, I miss the 80’s.

The hospital sits about 30 kilometres east of Melbourne and is only 10 minutes drive from where I grew up.  Being a private hospital, its a pay-to-play thing, but it boasts an excellent Emergency Department and became our hospital of choice when the kids were younger, for all those situations that pop up for parents along the way.  And in any event, we pay a fortune for private health insurance, and the paramedics were more than happy to bring me here.

It has been my home for the past two weeks.

A lot can be said for the power of solitude.  In the right circumstances it can be something perfect and healing; just like everyone imagines it.  On the other hand, solitude in a time of shock can tend to do bad things to your soul, unless you’re determined enough not to let it.  And I use the word “shock” quite deliberately because nothing else can describe the feeling of being abruptly disconnected from your otherwise normal weekday routine, on an otherwise perfect morning and being carted by ambulance into a hospital to be told you’ve suffered cardiac arrest.

Far from the planned night of operations on Victoria’s regional rail network, perhaps the usual stop for a coffee on the way home, and the current audiobook playing away for company on early morning roads, instead I’m sitting here in a receiving bay in CCU on a rather uncomfortable hospital bed, and told I cannot even so much as stand up without supervision.  

Cathey is sitting with me and at this stage, all we know is that levels of an enzyme called Troponin have spiked over a series of hourly blood tests, and that they’ve booked me for an angiogram in the morning.  I’ve had “dots” plastered all over my chest, connected to a wearable box that is transmitting various heart rhythm data to a screen at the end of the bed.  Consultations are made, conversations are had and eventually we’re told I’m here at least for a day or two, pending further tests.

Cathey eventually needs to head home to tend to the house, dogs, etc, and make further arrangements with my boss to cover some sick leave.  So now its just me here in this multi-bed ward, in the semi-darkness, staring at the monitor ahead and starting to think I may just be in a spot of bother here.  There’s curtains on either side, and the bays around me are occupied.   To the left lays an elderly gentleman, clearly unaware of his surroundings and moaning away randomly, while to the right we have a man who’s apparent high level skill set features the ability to flatulate at various frequency levels at an impressively constant rate.

No solitude here so far.  It’s going to be an even longer night than I thought.

With the morning comes first an ultrasound scan of my heart, followed a little later by an angiogram.  If my troponin levels here high, they’re surely now being matched by adrenaline as my anxiety begins to ramp itself up.  The hair on my right wrist has been shaved, and more disturbingly, most of the hair around my nether regions.  I’m told a wire will be inserted into an artery and fed toward the heart.  The most preferred route is via the wrist, but if for some reason that’s not doable, then they’re going in via the groin.  

Super.  Might be time to get that checklist handy, I think.

1. Do not panic

I really don’t want to do this.  It scares me.  What I’ve been told so far scares me even more, so hey, it’s not too late to make the choice to cut and run.  Take my chances perhaps.  Relax.  Go back to living in denial and hope for the best.  The reality though is far different.  What’s coming has to be done.  I can sit here and wish it all away as much as I like, but the procedure must happen.  As the saying goes, resistance is futile.

I know this procedure is done a zillion times a day around the world, but for me it’s a first.  I was nervous.  The cardiologist explains three possible outcomes.  They may not find anything, in which case they’d look to treat with medication.  Or they may find a narrowing which they’d repair on the spot using stents; most likely outcome.  Or in the worst case, there’s something clogged so severely that only open heart surgery can fix it; least likely option, but cannot be discounted.

Faced with that information, my mind now locks itself firmly onto option two.  Easy!  Quick fix, a stent or two, maybe a lecture about losing weight, and I’ll be out of here by tomorrow.  After all, that’s what the good doctor said, right?

Some local anaesthetic is applied to my wrist, an incision is made into my radial artery and in goes the wire.  Ok, we can relax a little.  Turns out I can’t feel a thing and they’re chatting away among themselves in short order as they take image after image of the plumbing around my heart muscle.

It wasn’t too long before the cardiologist is back by my side.  And he’s wearing that look on his face.  I’m starting to get rapidly tired of seeing that look, but there’d be a few more of those to come yet.  The news isn’t good.  He spins me around so I can see my heart on the big screen.  The blockage is there, and it’s significant.  I see it even before he explains it.  It’s sitting at the top end of the heart at a kind of squiggly branch end, restricting supply to a bunch of smaller vessels beyond.  I’m told its a 90% blockage and to even attempt to fashion a stent into this area would produce only a “sub-optimal” outcome at best.   I can’t seem to catch a break here.  We’re going for option 3 - a coronary artery bypass graft….a heart bypass…open heart surgery.  It gets worse though.  They’ve seen some other areas they want to further analyse, and the possibility of a double bypass is also on the cards.  

I honestly don’t have adequate words to describe how a moment like this feels.  No more denial; the reality was staring me in the face.  I really could’ve died.  

The high speed procession of emotions coursing through my mind ran from disbelief to anger to guilt and to shame.  Had I done this to myself?  Had I really degenerated to such an unfit human specimen?  I’m apparently known for being hard on myself, but right in this moment I had to wonder, did I have no-one else to blame for this but myself?  And so it went.

In the end, all I could manage was, “Oh.  Umm, wow”.

The cardiologist on the other hand is calm as he takes in my obviously stunned expression.  This man is a gentleman.  Kind, soft spoken & respectful.  “I know this wasn’t the outcome you’d hoped for”, he says.  I ask him some of the self depreciating questions above and he is compassionate in his responses.  Yes, fitness levels had been a small factor perhaps, but with my significant family history of heart disease, it was almost certainly genetics at play.  At some point, this was always going to be inevitable.  Some small comfort, I suppose, but I knew now that I had a huge mental task ahead to try to deal with this in some kind of resilient manner.  I thought then back to that podcast interview I’d done.  Might be time to make a phone call.

There was talk of finding a cardio thoracic surgeon, booking a theatre slot, and probably more.  It was a forgettable blur to me by now.  The only notion being processed upstairs on Planet Steve right now was open heart surgery.

How was I going to break this to my family?

I’m moved back to the ward, this time in a different shared area, and a short time later I’m on my own in room 18.  Time to settle in for the long haul and try to process all the information that’s come at me in the past 24 hours.  It is overwhelming.  More than that, it is emotional.  These were to be the theme for the week I spent in that room, and the longer it went on, the greater the depth of the roller coaster between them.

I could dispense with all the what-if’s easily enough.  They didn’t matter because they hadn’t happened.  But what I think back to from here now is just being in shock.  This wasn’t supposed to happen to me, surely.  A heart attack?  A coronary bypass?  Try as I might to reason it all away, you’re just dragged back to the enormity of it every time.

And the solitude of that little room gives you a lot of pause to think about things such as the journey ahead.  I won’t chronicle every time the emotions got the better of me and the tears flowed freely.  Those times were too numerous to mention, and to be honest, they’re still in free-flow now.  

                                                       

Being faced with the reality that you’d almost died on that day, and indeed, still could at any moment, does tend to swiftly change the order of the things you consider important.  That moment on Thursday in my study, at the conclusion of a nice walk with my dog Benson, is now inexorably a dividing line between “before” and “after”.  

I’m 52 years old, a father of two and grandfather of two.  I have a beautiful wife who loves me, a good job with a recent promotion, I’m making very good money, living in a very nice house with a couple of relatively new cars in the driveway.  I’ve just returned from a nice overseas holiday in fact, and other business dealings had seen me up on the Gold Coast just a couple of weeks prior.  I have a successful little side business running as well, doing audio production, and had even recently been indulging in a bucket list item by appearing on Melbourne’s highest rating talk radio station.  In the railway industry, I’m apparently well known enough, and people say nice things about me, mostly.  All good fuel for the ego, I suppose, even if you don’t want to openly admit it.  I was cruising.  Go me.

In the blink of an eye I’m now laying in a hospital room, staring at the ceiling and wondering if that next heartbeat I’ve recently become so hyper focused on will be my last.  Right now, none of those ego stroking factors seem to matter to me at all.  They can wait.

How will all the podcast editing work get done?  Would I ever be able to referee basketball again?  What about all those things that were bothering me or competing for my time?  All of a sudden I find that I don’t even care.  It’s all in the “before” column.

All that matters to me right now are the “after” times.  You hear of other people having their priorities changed by life threatening events, and now it seems I’m that guy.  In the before times, I only understood the concept at face value, but now I’m starting to live it.

That week of solitude in room 18 is one I’ll never forget.  It was at times informative, painful, sad, and even angry.  I had to reconcile the shock of it all, face the reality of the surgery to come, deal with the incredible fear, and still appear strong for the benefit of those I love.  This has been immeasurably hard on them, and I will carry the guilt of that with me for the rest of my days.  Having to remain neutral as the surgeon calmly explained the upcoming procedure in slow, deliberate detail, the look of stunned shock on my wife’s face and my daughter crying in my arms, was a moment in time that has so deeply scarred me, I cannot adequately begin to describe it.

Then there’s the nicer things.  There were actually a few, but in particular, a moment with my elderly mother.  I wasn’t a religious man in the times before, and I won’t pretend to be one now, but I always try to be respectful of those who are of faith.  The concept kind of fascinates me in an odd way, and I know many take great comfort from their faith.  My mum is one such person.  On the night before the surgery, mum and I found ourselves sitting in the hospital’s central garden area.  It’s a nice quiet spot, and a place to get away from the noise of everything going on inside.  It is dusk, it’s quiet and we’re just sitting there together.  Mum is a survivor herself, having walked this journey 34 years prior.  Now at 77 years of age, I can’t begin to imagine how my circumstance has affected her.  She puts her head on my shoulder, I put my head on hers, and she starts to pray.  I listen to her words and then we just sit there in silence for a few minutes.  Just me and my mum.  It was an absolutely beautiful moment, and I will never forget it.

I’ve had surgical procedures in the times before.  They were all physical things.  But the prospect of having your chest cut open, your heart stopped and your lungs deflated, relying on a machine to keep you alive while this team of enormously skilled surgeons work to give you a second chance at a long life - that is emotional.

It doesn’t matter how tough you think you are, facing major surgery of this magnitude is terrifying.  The date was set for the following Thursday, one week after my heart attack, in the afternoon.

I’ll share one more moment before we look for the signal to proceed.

On the morning of the surgery, I found myself in an odd state of calm.  My body has been shaved of all its hair from neck down, I’ve held my wife and told her how much I love her, and now sent her off to keep her mind occupied.  I’m at peace in the knowledge that our large and gracious support network of family and friends are surrounding my loved ones, and I actually think I might be ready to face this.  Emotionally, I’m spent.  I can’t cry any more, and I can’t try to logically reason my way out of this.  It has to be done, or I will certainly die a young man.  I fall asleep on my bed.

I’m woken by a soft tap on my shoulder.  It’s an orderly here to take me to theatre.  I remember this man clearly although I cannot recall his name.  He waits while I strip off and don my blue hospital gown, then climb onto the bed.  Off we go.  I’m staring at the ceiling tiles passing by, and I can’t help it - I start to shake.  The orderly notices this and stops the bed.  He looks down me and asks, “How you doing, brother?”

“Mate, I am absolutely terrified”

He smiles and says, “You know, this journey you’re making right now;  I’ve done it three times myself.  In fact, one time I even arrested on the way to surgery!”

I open my eyes and look at him.  “So you know?”

He nods.  I notice he’s put his hand on my forehead. “Brother, I’m a survivor.  And so too will you be”

He smiles and then we’re on our way again.  I wasn’t shaking anymore.  Doesn’t sound like much perhaps, but to me it was powerful.

We’re in the entrance area of the operating theatres.  The anaesthetist is there, and four very large gauge needles are inserted.  Two in each hand.  I feel a cold sensation in one hand, and then…..nothing.

In railway parlance, the train has been moved to the shops.  The fitters are gathering and repairs are about to commence.  Once they’re finished, the train will require a test run.  When that is though, is undetermined at this time.

The road is locked out for now.