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Wednesday, 12 March 2014
Tuesday, 18 February 2014
ICU - Part Two
“How was the night?” Alex asked.
“It was bloody awful actually!” I replied, now sitting up in a steep backed armchair, my head drooped.
I felt tired, desperately tired.
It was 9.30am on Friday 13th of December, 16 hours after the operation.
Most of the wires were still linked to the large monitor above and behind me. To my relief, the new day nurse had just taken out 2 of the 3 intravenous cannula’s in my arms. Heather’s shift had started at 7am, and since then she’d been busily caring, sorting, organising, and feeding me. The first thing she had done was to remove the catheter, which I had been lobbying for since 5am with the previous nurse. As soon as it was out, I felt a sense of control and dignity return. But I hadn’t yet put the night fully behind me. Not yet.
Like yesterday, Alex looked like one of those black and white prints with a red London bus splash of colour across. He wore his bright pink Gaza Italia racing jersey which contrasted with his grey pallor and black cycling leggings. He looked shattered and concerned. I’ve only recently pieced together his appearance that morning, with what he had encountered on his walk to my room. Of course he was tired from looking after the kids and still anxious about how I was coping after the operation, but there had been something else that had rattled him - When the lift had opened to take him down to ICU, a young nurse had stepped out, sobbing into her hands. As Alex continued his journey to my room, he grasped the news that a child had not made it through the night, and an elderly patient in the room next to me remained critical. “I couldn’t feel my own relief either”, Alex later told me. “A hospital is just so wracked with emotions.”
I had no appreciation of what or who lay beyond the four walls of my room. I could only focus on my own survival, of getting through the night. My curiosity was limited to understanding why it took my nurse 25 minutes to respond to the call button each time I buzzed it. On one occasion it took 42 minutes. Every time I pressed the buzzer for help, the repetitive bleeping would soon be joined by the louder bleeps of the monitor, which was set off each time that my blood pressure went above a maximum target. Funnily enough, this would happen every time I cursed the nurse’s slow response, and the reverberating noise pounded the fragility of my head, like the January storm waves that would soon break up the old harbour wall at Portreath, (our little Cornish village). I quickly came to realise that it was a hopeless viscous circle, and that the nurse was probably thinking that I’d soon learn not to hit the buzzer again. I wondered if there was a parallel with sleep training Harriet - each time I guiltily leave her for a few minutes of crying, I hear my mum’s advice ‘She won’t remember Sophie’. Maybe the nurse had a Gina Ford style manual ‘the contented patient’ which instructed her to wait before running to the buzzer. Either that or she was deaf, or simply beyond apathy. Only this situation wasn’t about getting a baby into a routine, it should have been intensive care!
“I must be intolerant to morphine, Al, like my Mum. I’ve never been so sick! And the nurse must have been distracted by something. I don’t know why she didn’t come when I buzzed. The fucking bed kept moving – it’s like a lilo, filling with air every few minutes, I felt so travel sick. I just wanted to sleep through it, but I couldn’t – I managed to drift off once, and the last time I looked at the clock it was 2am, so when I woke up again, I crossed my fingers, thinking and praying that it was at least 5, but when I saw the clock, and it was just ten past 2. I couldn’t believe it - 10 bloody minutes of respite, it was a killer. And that was it; all night.... Aghhhhhhh.... I couldn’t take my eyes of the clock for a second. The first time I threw up, it wasn’t too bad; I caught it all in a kidney dish and felt a bit better afterwards. I didn’t understand where all the liquid came from, because I’d only managed small sips, but Heather just explained they were probably pumping fluids into my veins to bring my blood pressure down. When I begged the nurse not to give me morphine again. I literally pleaded with her - any pain relief but morphine, I said. I tried to spit it out after she’d given me a vile to drink and I tasted it at the back of my throat, but it was too late, I’d already swallowed most of it. She said the anti- sickness drip would work this time, but it didn’t. I knew it wouldn’t. Waves and waves of nausea came over me until I filled up the kidney dish again, but there was more to come and I just threw up all over myself. And still she didn’t come. I just lay there tasting the morphine in my throat and lying there saturated in my own sick for half an hour. 30 minutes Al! She tutted under her breath when she came in and saw the mess I’d made, sizing up the task of disconnecting and then reconnecting all the wires to change my gown; and then...
“Was it harder than Himal?” Alex sensibly interrupted.
I brought my lips together to answer, but paused and took a few moments - I wanted to do both experiences justice before I answered.
****************************************
In 2008, my friend Ali and I decided to go in search of an intrepid adventure. I was married and living in Madrid at the time, and Ali was single and living in Balham in London. The idea started with a random opening of the Lonely Planet country by country guide, and ended with the successful climb of Mardi Himal, a peak of 5588m. (I later worked out that it was a few meters higher than Alex had reached when he had trekked to a ridge above Everest Base Camp the year before). Satiated by the accomplishment on my return, I would tell Alex that I was finally ready to start trying for children.
The final altitude itself is by no means remarkable, the challenge I reflected later was that we climbed and descended the mountain far too quickly, with minimal time to acclimatise.
Mardi Himal at the time was a lesser- known peak in the Annapurna range, which we’d chosen based on our desire to conquer a summit that required minimal climb experience and if possible, we didn't want to see anybody else on route. Thanks to ‘Major Ramm’, a retired Ghurkha in Kathmandu whom Ali had tracked down via an army friend in London, Himal fitted this bill perfectly, and apart from the beautiful village people we encountered on day 1,the only other person we would see on our trek was an elderly goat herder at ~ 3600m. As our plan started to take shape, Ali’s friends Laura and Andy decided to join us.
So in October 2008, we started our trek in Ghachok as four, with a mere entourage of 18 Sherpas (or porters as they liked to be called) to carry an embarrassing amount of kit to our last camp at 4600m and back again. One poor porter had the uncomfortable responsibility of carrying an impossibly heavy black metal toilet seat. At each camp he would set it up on a base of 3 crossed sticks and dig a latrine below. As I crouched above the seat, at high camp, on the night before our final ascent, I dwelt on how bonkers it was that (a) we had a toilet seat, and (b) it was huge, heavy and made out of metal, so it would always be too cold to sit down on.
By now we were down to three, as Andy had decided to return from base camp on the previous evening, due to his fear about a shoulder injury recurring, and generally feeling low in the cold and the wet. At that stage, we had been trekking through swirling blizzards, which we were reliant on to scrape up for drinking water, since all the high streams had dried up following no rains for the last 6 weeks.
As I hovered above the toilet seat, my knees were exposed to the blizzard outside, with the blue sheeting of the make shift toilet tent flapping against my arms. It was about -15 degrees C, and the blizzard was horizontal. At 11pm, I had just made my second sprint across to the toilet, somewhat unsuccessfully after taking too long to zip up the sleeping tent properly to ensure I didn't freeze Ali who was sleeping inside. Well-travelled, I was familiar with these gripes in my stomach, but I didn’t know if my body’s need to empty itself was due to the altitude, my nerves after climb equipment training (at 4600m the night before; Kathmandu might have been more sensible when we’d arrived); or due to drinking the water that we’d melted from grotty snow that we scooped up with our bare hands after doing our best to sift out dirt.
The cause didn’t really matter, the point was that when I decided through gritted teeth to join the ascent when we all got up at 2am, I took the partial decision on no sleep, an emptied stomach, a cocktail of Immodium and Norfloxacin and fuelled only by a cup of tea, a spoon of peanut butter and half of a poor man’s digestive biscuit. I also had to strap my water bottle within one thin thermal layer from my skin to use my body heat to melt it, as it had frozen and I knew that rehydrating would be critical. The decision was helped when I managed to wake up Goran - the other guide and persuade him to join us to the bottom of the ice climb, so that he could guide me back if I couldn’t go on. That was the clincher, as I couldn’t handle the idea of ruining the ascent for the others.
When we set off, I was completely wired, and focused on copying every foot placement of Karma – our amazing mountain climbing guide. I could feel my pulse thumping through my temples as I maintained pace, terrified of tripping over in the darkness. I turned everything into a positive - my empty stomach distracted from the discomfort of wearing the specialist climbing boots that were too small, I told myself that the exertion of each step served to melt the ice pack around my body, and the total concentration of watching Karma’s boots helped me block out the sheer drops on either side. So when I arrived at the spot where we needed to attach the crampons and rope on the climbing gear, I had lost all awareness of Ali and Laura’s progress.
Karma and I turned back, horrified to see Ali lying on her stomach - straddling a ridge, with Laura behind her trying to coax her into continuing. The aptly named Karma quickly danced back along the ridge to them, impervious to the effects of the 5,000m altitude, whilst I took my first sips of ice melt.
The sun far below us, was just beginning to cast light on the sacred peak of Machapuchare (the fishtail), the mythical mountain face which had towered above us throughout our climb and now seemed within touching distance. We’d seen the iconic fishtail shape from the air when we’d flown past it on our flight from Kathmandu to Pokhara. Machapuchare is one of the few places on earth that has never been touched by man, and it served to draw me in that morning, like a magnet. I felt imbued by the spirituality of the place, uplifted beyond the weakness of my mortal body, and completely exhilarated by the challenge of making it to the summit of Mardi Himal.
Over the next hour, we sweated profusely as we took huge steps through deep snow which came up to our arm pits if we paused. I found it fun, and somehow the subsequent ice climb up Mardi Himal’s last stretch, seemed relatively easy, because the visibility was perfect and our goal was in sight. We attached and reattached our caribenas to ropes, used our ice picks to get a grip, shuffled first hand and then leg upwards, easing into a simple, repetitive rhythm. We worked together, checking on each other after each section, whilst the super human Karma pranced ahead fixing the ropes into the rock, and skipping back down again to check our progress. We had total trust in him, and after 7 hours from starting that day, Ali, Laura and I held our ice picks above our heads, feeling truly at the top of the world, huge smiles splashed across our faces.
‘It’s 9am’, I said. ‘People will just be arriving at work now!’
I was completely hyper at the top, and felt delirious with the sense of extraordinary achievement, complete fulfillment, and humbled by the beauty of it all. The blanket of bubbling clouds below us was starting to dissolve into wispy balls of cotton wool, giving way to majestic snow-capped mountain ranges. We took our time to drink in every detail around us, whilst Karma pointed to 3 of Annapurna's nearby 8,000m peaks that he had climbed, before speaking dreamily about one day travelling to the Alps to climb there. Having been completely awestruck by the Himalayas, it sounded odd to our ears to hear this incredible Nepalise mountaineer talk about how he revered the great climbs in our European back garden, ahead of a quest to climb Everest. Except for one photo cue, Ali remained on her hands and knees throughout our 10 minutes at the top, too fearful to stand up on the highest rock whilst we weren't 'roped on'.
So at 8.55am on October 31st, 2008, we were the first and potentially only group to make it to the peak of Mardi Himal that year. Would anything ever compete with this dizzy high again?
But it was getting down again that was the real challenge.
Abseiling down one rock face in the Mendips on a work development course 15 years earlier, was not quite adequate preparation for abseiling down an ice face wearing crampons in the Himalayas at ~ 5600m. And if there had been anything at all left in my stomach, I expect it might have come out as I hung back over the first vertical drop, with my crampons skidding against the rock like a dog on ice skates. I found out that when you really don’t have a choice, when the rest have gone ahead and when nobody is watching, somehow you just find a way, even if it isn’t pretty. The problem was that I would use up the last drops of adrenaline during that abseil, and shatter my arms with the tension of trying to hold my body weight by clinging onto the rope as I lowered myself, rather than relaxing my grip and trusting in gravity and the process.
When we made it back to camp at about 10:40am, we found that the tents and porters had disappeared. All that remained was Karma's anxious girlfriend and Goran (the not very good guide) who’d returned at the base of the climb, and was now sitting down waiting to explain the change in plan: The porters were tired of melting the dirty snow to drink, and wanted to get down quicker to a level where the streams were still flowing.
“OK” I said, using my climbing stick to keep me upright. How much further?
“Just a few hours” he said
We all turned to Karma and asked him to find out how far it really was.
“Maybe 8 to 9 hours if we keep to the same pace” he replied after conferring."
The picture above captures my face (far right) moments after hearing Karma’s honest assessment. Behind us, the peak to the right is Machupacare, and Mardi Himal is just poking above the cloud to the left. At that stage, I didn’t feel I had anything left to give and I still couldn’t stomach any food without now, vomiting it back up again.
So the ten hours (we didn't quite keep pace) that followed were my breaking time on Mardi Himal, and the passage of time that I was trying to compare with my night in ICU. After making it the crest of our mountain, then all the way back down to camp on no sustenance at all, I found out that there was still at least 9 hours of hard walking on difficult ankle breaking terrain to go. As I stumbled forward, my mind seemed to fold in on itself, losing all awareness of the people around me. Throughout, I trailed at the back, head dipped down listening to tunes from my yellow 1980’s headphones; I lost the horizon, only daring to look at the ground a foot or two in front like a Himalayan yak. Karma diligently followed right behind me, deployed to try and catch me each time I fell, which I did regularly towards the end. I’m still not sure if I tripped over or blacked out on each occasion.
I remember clearly reaching a plateau at around 5pm with the light fading. We were on a section that could almost be described as a path. The guides agreed we could rest for 5 minutes, and so I sat down and looked out at the vastness around me, sipping from my camel water pack which I’d recently added a couple of outdated purple diarolite sachets of salts too. It tasted mildly better than the bile that kept coming into my mouth.
When the guides were ready to go again, I called them back:
“Sorry, I can’t go on another step. That’s me done for the day I’m afraid. No more!”
“We have to!” Ali knelt down to talk to me: “Come on you can do it. We’re almost there Soph, we’re all hurting.”
“No I really can’t” I replied. Either the sherpas need to come back and set up camp right here, or someone needs to call for a helicopter to take me off this damn mountain.”
Ali and Laura laughed, nervously.
“I’m serious, when Alex trekked to Everest base camp, the travel company arranged for a helicopter to take one of the team down because she was too ill to go on. You need to ask them to call for one for me, I can’t make it down”.
Ali laughed more naturally this time. "Soph, this isn’t Exodus, this is Major Ramm’s adventures. I doubt the guides’ satellite phones even work!"
At least they humoured me and spoke to the guides, before Laura came back and sat down next to me. “Take this!” Laura said. "It’s my last boiled sweet, it won’t make you sick. It will get you down to there", she pointed, "one of them is going to run down ahead and ask the porters to wait for us, and send some back to carry you.”
Hmm, that’s not really the same as a Helicopter, I reflected.
The sweet was red, raspberry flavoured, and I made it last a good twenty minutes. Laura was right, it didn’t make me sick and it did get me down to a point where two porters had scrambled up to meet me. They took it in turns to pick me up and sling me backwards over one of their shoulders like a sack of potatoes. There my body jangled against the Porter’s bony shoulder as he jumped down rocky steps in a stumbling fashion. It was a much more effective tactic than the sweet, and got me back on my feet very quickly, repelled by the body odour, sickened further by all the jolting, and realising the indignity of not making it down on my own two feet. I pretty much jogged down after that, even with the light beginning to fail.
It had been dark for a few hours by the time we arrived at camp. A meal of lentil dahl had been prepared, and as we sat down, Ali placed an elbow on the makeshift table and rested her head in her hand, her whole body quivering as she started to cry in relief. I recorded a video diary in my own tent that night, trying inadequately to describe how hard the last 19 hours of climbing, abseiling and trekking had been for me. ‘I can’t imagine I will ever do anything as hard as that again in my life!’ I said to the camera lens.
Two days later, we were relaxing in Pokhara restored to full health, I rowed my great climbing companions across the stunning lake. It was the spot where I officially announced my retirement from mountaineering, and where Ali and Laura began plotting a climb of Mont Blanc.
************************************
“Yes!” I finally replied to Alex.
“Last night was worse! …..There just wasn’t anything to lift me”.
I thought of how I couldn’t seem to cope with lying there passively feeling sick, dry mouthed, terrified to move my neck, my headache engulfing me. Himal was physically harder, but the beauty of it all was so inspiring, it warmed my soul, so that when I felt so close to the edge, something otherworldly seem to propel me onwards. Whereas in ICU, I just couldn’t get beyond the four white walls, or the slow ticking of the clock and I couldn’t tap into my emotional toolbox or cut my mind on happier places. All I wanted was for the nurse to remove stuff: I wanted her to take out the warthog like oxygen tubes that went up into my injured nose and irritated my inflamed left nostril; to take out the 3 lines of tubes in my veins that caused a hideous sensation in my finger- tips, each time they flushed them clean before pumping me with something; to take away the large plastic bottle filled with stale maroon deoxygenated blood which rolled side to side on my chest, the catheter line that kept snagging and confusing me, the clip that measured saturation on my left finger, restraining me each time I tried in vain to reach the water jug, after the nurse had accidently knocked the table away as she left the room; and the maze of wires which were everywhere. I wanted her to turn off the unnecessary bed motion designed to help blood circulation in elderly patients, to bring me some entertainment like a radio, or talk to me, or give me a drug to knock me out and not make me sick. I just wanted some help through the night actually! Laura wasn’t there to offer me a boiled sweet, nor Ali to tell me there was no helicopter.
Yes! Thursday night in ICU was definitely worse.
***********************************
Sitting upright with Alex, it was a new day at last, and Heather was already talking about a return to the ward, I was able to comprehend that perhaps I didn’t have brain damage after all. It must have been the physical shock that would continue to numb my emotions until the kids visited on Sunday afternoon.
Soon after my parents and Alex had left the night before, just a few hours after surgery, the shock revealed itself in the form of tremors that started with a crescendo of teeth chattering and ended with my legs shaking violently on the bed. The night nurse had shown her technical competence by wrapping me up in a sort of canvas blanket that she then inflated by attaching it to an electric pump, filling the tubes in the blanket with hot air. My teeth chattering and shaking successfully abated soon afterwards, but unfortunately the nurse left the room, and ten minutes later when she finally returned I was streaming with sweat, thinking that I was going to suffocate. It made it a tough call to motion towards the blanket a few hours later, when my trembling got out of control again. I begged her to stay this time.
It wasn’t until the nurse had got a clean gown onto me, and was reconnecting the last of the wires that I sensed a little of her cold detachment melt away: Ever since putting on the blue surgical gown after my shower on Thursday morning, I’d been preoccupied with the placement of two breast pads underneath. I’d stopped breast feeding Harriet completely one month earlier, but the taps were not completely shut, and whatever the surgeons might be privy to when they performed their operation, I didn’t want them distracted by 2 damp circles.
“How old’s the baby?” the nurse asked in a West African accent, still concentrating on unravelling some wires.
“6 months now” I replied. “A little girl – Harriet” I said.
It wasn’t exactly a conversation, but shortly after her next disappearance, she returned bringing with her some gauze and white tape for me to use as a substitute for the sick saturated pads.
“Thank you so much, I really appreciate this” I said as our hands met.
“You’re welcome!" She drawled. "Now, you’ll need to get some food inside you. I’ll go get you a yoghurt or something.”
The tension in the room seemed to lift a little after that, and although the nurse didn’t actually get round to bringing me any food before her shift ended an hour or so after, I felt calmer and hopeful that a new day was not so far away.
Professor Thompson came through the doors shortly after Heather’s shift begun, and just after she had removed the catheter. The first time the doors swung open with his entourage in toe, it was pretty embarrassing. I sat up in my chair, poised to be grateful, to remember the big picture and not mention the small insignificant details from the night. Only as soon as he stepped inside the room, he turned away and put his big surgeon’s hand up, motioning for the group to follow him back outside again. Looking around, I spotted the arm chair next to me, and realised that I was still sitting on the commode. SHIT!! For all intensive- purposes the commode looked and felt like an arm chair, only it wasn’t. At least my knees were covered up by the gown.
So when he returned I cringed even more when he apologised for coming by the first time without first checking with the nurse.
“No I was ready, I mean I wasn’t actually doing.. I forgot it was a ……anyway”
If not sad, or happy or gloriously relieved, at least I could feel embarrassment, I thought.
“How was your night?” he asked.
“Yeah – erm, OK, well I didn’t get on with the morphine, but it was OK really, it was fine. Thank you, Thank you so much……”
“Good to hear. Your readings all seem fine, so with any luck, they should be able to get you back to the ward later today”.
“Oh thank you, thank you so much Professor, for everything, I mean everything seems to work...”
“Yes it went very well. Everything that could have gone right, did! I’ll see you back on the ward tomorrow morning, take care!” and the doors swung closed again, as they rightly turned towards their more critical patients.
That short dialogue was probably why Alex got an earful when he arrived a couple of hours later, because I mustn’t have had the strength to hold back a second time. I kind of regret unloading my honest account to him, but it led to him following up with Heather to find out the name of the night nurse, and in turn she sensed there had been something wrong and urged us to feedback to her manager.
“No, no, it’s fine, it was just one night, I’m sure I’ll get over it quite quickly, I just want to move on, I don’t want to say anything, I know you all have such difficult jobs here, and you’ve been completely amazing, and my parents said the nurse yesterday was fantastic too…. Maybe I’ll write a letter in a few weeks.”
“No Soph” Alex interjected “it will be much better if you feedback in person now, otherwise you’ll dwell on it. I don’t want any anger lingering and a cloud hanging over you - Heather’s right, I think she should get her manager here this morning, I don’t like what you told me, it’s not OK. It’s not OK for the next patient.”
So I nodded reluctantly, and shortly afterwards Heather brought the ICU manager to sit down and hear my account. I have to say, he couldn’t have been more professional in the way he listened, asked follow up questions, thanked me for the information and offered the most sincere of apologies, assuring us that he would deal with it. I in turn tried to emphasize my hugely positive experience with the other nurses on ICU, the surgical team, the ward and the overall St Georges experience that I would be eternally grateful for.
“Will you be coming back here to ICU for your next surgery?...Because if you are coming back to St Georges, you should ask for me, or the other shift manager and we will make sure you have impeccable care here in ICU.”
“Sorry, what surgery are you talking about. I…..?..”
“Oh, I was just reading your notes, and read about the prolactinoma in your pituitary gland, I just didn’t want last night to put you off having surgery here in St Georges, and well I hope it hasn’t, and if you were to choose us again then…”
“No, no" I said, "I mean I haven’t thought about that yet, It might not even come down to surgery, well I hope it doesn't, it's just too soon to..."
Christ, this isn’t a Mr and Mrs Smith hotel, I thought. Can’t fault the guy for his customer service, but what a time to try and sign me up for some kind of ICU loyalty scheme!
Later, after Heather had removed almost every tube and wire that she could, and I’d stood up on my own steam to walk down the corridor to the toilet and back, she came in to tell us that she’d spoken to the ward, and that they would prepare the same private side room for me to return to that afternoon. At that moment, the idea of returning to my side room on Cheselden ward sounded about as fabulous as the Copacabana Hotel did on route to Brazil for our honeymoon. And I think that was the first time I broke into some sort of smile after surgery.
“I can’t believe you!” Heather said looking first at me, and then Alex. It’s funny but you don’t look anything like the patient I expected when I read your notes and your surgical disclaimer form. I mean, most people in intensive care don’t just stand up and walk off to the toilet by themselves – you seem…so young and well - Before I came into your room this morning, I was reading your form, and I’ve never seen anything written so bluntly about your need for surgery – there in black and white…. You’ve probably seen all the pages of surgical risks that you’d signed, but I presume you didn’t see what Professor Thompson wrote on the form on the back?”
Alex and I both looked first at each other and then back to her inquisitively. “Oh yes?” Alex said.
“On the last page it reads ‘What are the risks of non - surgical intervention?’
Just to the right, Professor Thompson has written in black ink ……..‘DEATH’
Then he’s asked what the probability is of that risk, and he’d written…. ‘100%’.
It’s the first time I’ve ever seen that written down so starkly.”
So however much the physical shock had numbed my senses, and whatever feelings I couldn’t yet express or draw on, I looked back at Alex after she'd spoken, and we both knew that I was incredibly lucky indeed.
******************************************
Links to video's of the team at the summit of Mardi Himal, and of Laura beginning her abseil down are here:
http://youtu.be/sbxy4pPJ4HM
http://youtu.be/3l1MtZrJdZc
You should also be able to navigate to them from my Google + profile, or searching for 'Sophie Orme' in YouTube.
After note
I deliberated hard about including the negative account of the night in ICU, because I am so indepted to the amazing cast of medical staff at St Georges, together with the GP, and radiology staff that came beforehand. I truly have them to thank for my life. With only one brief exception, I experienced fantastic care throughout. In all walks of life, and professions we come across the occasional bad apple, and I’m pretty sure the manager had plans to sieve this one out, so I hope I don’t in anyway unsettle anybody who might require subsequent medical treatment who is reading this blog. It was also very difficult for me to cast my mind back to that night, because I really had put all the detail to bed as soon as the wonderful Heather put me back together again and pushed me back to the ward. I have indulgently interwoven the story of Mardi Himal to help motivate me to write this, as that was a very special place to return to in my mind. I guess the judgement call I made in writing this post is to stay true to the honest and open narrative that I have used so far.
I plan to write one more post in this series titled ‘post op’ in the next fortnight to conclude. Thanks for getting this far.
“It was bloody awful actually!” I replied, now sitting up in a steep backed armchair, my head drooped.
I felt tired, desperately tired.
It was 9.30am on Friday 13th of December, 16 hours after the operation.
Most of the wires were still linked to the large monitor above and behind me. To my relief, the new day nurse had just taken out 2 of the 3 intravenous cannula’s in my arms. Heather’s shift had started at 7am, and since then she’d been busily caring, sorting, organising, and feeding me. The first thing she had done was to remove the catheter, which I had been lobbying for since 5am with the previous nurse. As soon as it was out, I felt a sense of control and dignity return. But I hadn’t yet put the night fully behind me. Not yet.
Like yesterday, Alex looked like one of those black and white prints with a red London bus splash of colour across. He wore his bright pink Gaza Italia racing jersey which contrasted with his grey pallor and black cycling leggings. He looked shattered and concerned. I’ve only recently pieced together his appearance that morning, with what he had encountered on his walk to my room. Of course he was tired from looking after the kids and still anxious about how I was coping after the operation, but there had been something else that had rattled him - When the lift had opened to take him down to ICU, a young nurse had stepped out, sobbing into her hands. As Alex continued his journey to my room, he grasped the news that a child had not made it through the night, and an elderly patient in the room next to me remained critical. “I couldn’t feel my own relief either”, Alex later told me. “A hospital is just so wracked with emotions.”
I had no appreciation of what or who lay beyond the four walls of my room. I could only focus on my own survival, of getting through the night. My curiosity was limited to understanding why it took my nurse 25 minutes to respond to the call button each time I buzzed it. On one occasion it took 42 minutes. Every time I pressed the buzzer for help, the repetitive bleeping would soon be joined by the louder bleeps of the monitor, which was set off each time that my blood pressure went above a maximum target. Funnily enough, this would happen every time I cursed the nurse’s slow response, and the reverberating noise pounded the fragility of my head, like the January storm waves that would soon break up the old harbour wall at Portreath, (our little Cornish village). I quickly came to realise that it was a hopeless viscous circle, and that the nurse was probably thinking that I’d soon learn not to hit the buzzer again. I wondered if there was a parallel with sleep training Harriet - each time I guiltily leave her for a few minutes of crying, I hear my mum’s advice ‘She won’t remember Sophie’. Maybe the nurse had a Gina Ford style manual ‘the contented patient’ which instructed her to wait before running to the buzzer. Either that or she was deaf, or simply beyond apathy. Only this situation wasn’t about getting a baby into a routine, it should have been intensive care!
“I must be intolerant to morphine, Al, like my Mum. I’ve never been so sick! And the nurse must have been distracted by something. I don’t know why she didn’t come when I buzzed. The fucking bed kept moving – it’s like a lilo, filling with air every few minutes, I felt so travel sick. I just wanted to sleep through it, but I couldn’t – I managed to drift off once, and the last time I looked at the clock it was 2am, so when I woke up again, I crossed my fingers, thinking and praying that it was at least 5, but when I saw the clock, and it was just ten past 2. I couldn’t believe it - 10 bloody minutes of respite, it was a killer. And that was it; all night.... Aghhhhhhh.... I couldn’t take my eyes of the clock for a second. The first time I threw up, it wasn’t too bad; I caught it all in a kidney dish and felt a bit better afterwards. I didn’t understand where all the liquid came from, because I’d only managed small sips, but Heather just explained they were probably pumping fluids into my veins to bring my blood pressure down. When I begged the nurse not to give me morphine again. I literally pleaded with her - any pain relief but morphine, I said. I tried to spit it out after she’d given me a vile to drink and I tasted it at the back of my throat, but it was too late, I’d already swallowed most of it. She said the anti- sickness drip would work this time, but it didn’t. I knew it wouldn’t. Waves and waves of nausea came over me until I filled up the kidney dish again, but there was more to come and I just threw up all over myself. And still she didn’t come. I just lay there tasting the morphine in my throat and lying there saturated in my own sick for half an hour. 30 minutes Al! She tutted under her breath when she came in and saw the mess I’d made, sizing up the task of disconnecting and then reconnecting all the wires to change my gown; and then...
“Was it harder than Himal?” Alex sensibly interrupted.
I brought my lips together to answer, but paused and took a few moments - I wanted to do both experiences justice before I answered.
****************************************
In 2008, my friend Ali and I decided to go in search of an intrepid adventure. I was married and living in Madrid at the time, and Ali was single and living in Balham in London. The idea started with a random opening of the Lonely Planet country by country guide, and ended with the successful climb of Mardi Himal, a peak of 5588m. (I later worked out that it was a few meters higher than Alex had reached when he had trekked to a ridge above Everest Base Camp the year before). Satiated by the accomplishment on my return, I would tell Alex that I was finally ready to start trying for children.
The final altitude itself is by no means remarkable, the challenge I reflected later was that we climbed and descended the mountain far too quickly, with minimal time to acclimatise.
Mardi Himal at the time was a lesser- known peak in the Annapurna range, which we’d chosen based on our desire to conquer a summit that required minimal climb experience and if possible, we didn't want to see anybody else on route. Thanks to ‘Major Ramm’, a retired Ghurkha in Kathmandu whom Ali had tracked down via an army friend in London, Himal fitted this bill perfectly, and apart from the beautiful village people we encountered on day 1,the only other person we would see on our trek was an elderly goat herder at ~ 3600m. As our plan started to take shape, Ali’s friends Laura and Andy decided to join us.
So in October 2008, we started our trek in Ghachok as four, with a mere entourage of 18 Sherpas (or porters as they liked to be called) to carry an embarrassing amount of kit to our last camp at 4600m and back again. One poor porter had the uncomfortable responsibility of carrying an impossibly heavy black metal toilet seat. At each camp he would set it up on a base of 3 crossed sticks and dig a latrine below. As I crouched above the seat, at high camp, on the night before our final ascent, I dwelt on how bonkers it was that (a) we had a toilet seat, and (b) it was huge, heavy and made out of metal, so it would always be too cold to sit down on.
By now we were down to three, as Andy had decided to return from base camp on the previous evening, due to his fear about a shoulder injury recurring, and generally feeling low in the cold and the wet. At that stage, we had been trekking through swirling blizzards, which we were reliant on to scrape up for drinking water, since all the high streams had dried up following no rains for the last 6 weeks.
As I hovered above the toilet seat, my knees were exposed to the blizzard outside, with the blue sheeting of the make shift toilet tent flapping against my arms. It was about -15 degrees C, and the blizzard was horizontal. At 11pm, I had just made my second sprint across to the toilet, somewhat unsuccessfully after taking too long to zip up the sleeping tent properly to ensure I didn't freeze Ali who was sleeping inside. Well-travelled, I was familiar with these gripes in my stomach, but I didn’t know if my body’s need to empty itself was due to the altitude, my nerves after climb equipment training (at 4600m the night before; Kathmandu might have been more sensible when we’d arrived); or due to drinking the water that we’d melted from grotty snow that we scooped up with our bare hands after doing our best to sift out dirt.
The cause didn’t really matter, the point was that when I decided through gritted teeth to join the ascent when we all got up at 2am, I took the partial decision on no sleep, an emptied stomach, a cocktail of Immodium and Norfloxacin and fuelled only by a cup of tea, a spoon of peanut butter and half of a poor man’s digestive biscuit. I also had to strap my water bottle within one thin thermal layer from my skin to use my body heat to melt it, as it had frozen and I knew that rehydrating would be critical. The decision was helped when I managed to wake up Goran - the other guide and persuade him to join us to the bottom of the ice climb, so that he could guide me back if I couldn’t go on. That was the clincher, as I couldn’t handle the idea of ruining the ascent for the others.
When we set off, I was completely wired, and focused on copying every foot placement of Karma – our amazing mountain climbing guide. I could feel my pulse thumping through my temples as I maintained pace, terrified of tripping over in the darkness. I turned everything into a positive - my empty stomach distracted from the discomfort of wearing the specialist climbing boots that were too small, I told myself that the exertion of each step served to melt the ice pack around my body, and the total concentration of watching Karma’s boots helped me block out the sheer drops on either side. So when I arrived at the spot where we needed to attach the crampons and rope on the climbing gear, I had lost all awareness of Ali and Laura’s progress.
Karma and I turned back, horrified to see Ali lying on her stomach - straddling a ridge, with Laura behind her trying to coax her into continuing. The aptly named Karma quickly danced back along the ridge to them, impervious to the effects of the 5,000m altitude, whilst I took my first sips of ice melt.
The sun far below us, was just beginning to cast light on the sacred peak of Machapuchare (the fishtail), the mythical mountain face which had towered above us throughout our climb and now seemed within touching distance. We’d seen the iconic fishtail shape from the air when we’d flown past it on our flight from Kathmandu to Pokhara. Machapuchare is one of the few places on earth that has never been touched by man, and it served to draw me in that morning, like a magnet. I felt imbued by the spirituality of the place, uplifted beyond the weakness of my mortal body, and completely exhilarated by the challenge of making it to the summit of Mardi Himal.
‘It’s 9am’, I said. ‘People will just be arriving at work now!’
I was completely hyper at the top, and felt delirious with the sense of extraordinary achievement, complete fulfillment, and humbled by the beauty of it all. The blanket of bubbling clouds below us was starting to dissolve into wispy balls of cotton wool, giving way to majestic snow-capped mountain ranges. We took our time to drink in every detail around us, whilst Karma pointed to 3 of Annapurna's nearby 8,000m peaks that he had climbed, before speaking dreamily about one day travelling to the Alps to climb there. Having been completely awestruck by the Himalayas, it sounded odd to our ears to hear this incredible Nepalise mountaineer talk about how he revered the great climbs in our European back garden, ahead of a quest to climb Everest. Except for one photo cue, Ali remained on her hands and knees throughout our 10 minutes at the top, too fearful to stand up on the highest rock whilst we weren't 'roped on'.
So at 8.55am on October 31st, 2008, we were the first and potentially only group to make it to the peak of Mardi Himal that year. Would anything ever compete with this dizzy high again?
But it was getting down again that was the real challenge.
Abseiling down one rock face in the Mendips on a work development course 15 years earlier, was not quite adequate preparation for abseiling down an ice face wearing crampons in the Himalayas at ~ 5600m. And if there had been anything at all left in my stomach, I expect it might have come out as I hung back over the first vertical drop, with my crampons skidding against the rock like a dog on ice skates. I found out that when you really don’t have a choice, when the rest have gone ahead and when nobody is watching, somehow you just find a way, even if it isn’t pretty. The problem was that I would use up the last drops of adrenaline during that abseil, and shatter my arms with the tension of trying to hold my body weight by clinging onto the rope as I lowered myself, rather than relaxing my grip and trusting in gravity and the process.
When we made it back to camp at about 10:40am, we found that the tents and porters had disappeared. All that remained was Karma's anxious girlfriend and Goran (the not very good guide) who’d returned at the base of the climb, and was now sitting down waiting to explain the change in plan: The porters were tired of melting the dirty snow to drink, and wanted to get down quicker to a level where the streams were still flowing.
“OK” I said, using my climbing stick to keep me upright. How much further?
“Just a few hours” he said
We all turned to Karma and asked him to find out how far it really was.
“Maybe 8 to 9 hours if we keep to the same pace” he replied after conferring."
The picture above captures my face (far right) moments after hearing Karma’s honest assessment. Behind us, the peak to the right is Machupacare, and Mardi Himal is just poking above the cloud to the left. At that stage, I didn’t feel I had anything left to give and I still couldn’t stomach any food without now, vomiting it back up again.
So the ten hours (we didn't quite keep pace) that followed were my breaking time on Mardi Himal, and the passage of time that I was trying to compare with my night in ICU. After making it the crest of our mountain, then all the way back down to camp on no sustenance at all, I found out that there was still at least 9 hours of hard walking on difficult ankle breaking terrain to go. As I stumbled forward, my mind seemed to fold in on itself, losing all awareness of the people around me. Throughout, I trailed at the back, head dipped down listening to tunes from my yellow 1980’s headphones; I lost the horizon, only daring to look at the ground a foot or two in front like a Himalayan yak. Karma diligently followed right behind me, deployed to try and catch me each time I fell, which I did regularly towards the end. I’m still not sure if I tripped over or blacked out on each occasion.
I remember clearly reaching a plateau at around 5pm with the light fading. We were on a section that could almost be described as a path. The guides agreed we could rest for 5 minutes, and so I sat down and looked out at the vastness around me, sipping from my camel water pack which I’d recently added a couple of outdated purple diarolite sachets of salts too. It tasted mildly better than the bile that kept coming into my mouth.
When the guides were ready to go again, I called them back:
“Sorry, I can’t go on another step. That’s me done for the day I’m afraid. No more!”
“We have to!” Ali knelt down to talk to me: “Come on you can do it. We’re almost there Soph, we’re all hurting.”
“No I really can’t” I replied. Either the sherpas need to come back and set up camp right here, or someone needs to call for a helicopter to take me off this damn mountain.”
Ali and Laura laughed, nervously.
“I’m serious, when Alex trekked to Everest base camp, the travel company arranged for a helicopter to take one of the team down because she was too ill to go on. You need to ask them to call for one for me, I can’t make it down”.
Ali laughed more naturally this time. "Soph, this isn’t Exodus, this is Major Ramm’s adventures. I doubt the guides’ satellite phones even work!"
At least they humoured me and spoke to the guides, before Laura came back and sat down next to me. “Take this!” Laura said. "It’s my last boiled sweet, it won’t make you sick. It will get you down to there", she pointed, "one of them is going to run down ahead and ask the porters to wait for us, and send some back to carry you.”
Hmm, that’s not really the same as a Helicopter, I reflected.
The sweet was red, raspberry flavoured, and I made it last a good twenty minutes. Laura was right, it didn’t make me sick and it did get me down to a point where two porters had scrambled up to meet me. They took it in turns to pick me up and sling me backwards over one of their shoulders like a sack of potatoes. There my body jangled against the Porter’s bony shoulder as he jumped down rocky steps in a stumbling fashion. It was a much more effective tactic than the sweet, and got me back on my feet very quickly, repelled by the body odour, sickened further by all the jolting, and realising the indignity of not making it down on my own two feet. I pretty much jogged down after that, even with the light beginning to fail.
It had been dark for a few hours by the time we arrived at camp. A meal of lentil dahl had been prepared, and as we sat down, Ali placed an elbow on the makeshift table and rested her head in her hand, her whole body quivering as she started to cry in relief. I recorded a video diary in my own tent that night, trying inadequately to describe how hard the last 19 hours of climbing, abseiling and trekking had been for me. ‘I can’t imagine I will ever do anything as hard as that again in my life!’ I said to the camera lens.
Two days later, we were relaxing in Pokhara restored to full health, I rowed my great climbing companions across the stunning lake. It was the spot where I officially announced my retirement from mountaineering, and where Ali and Laura began plotting a climb of Mont Blanc.
************************************
“Yes!” I finally replied to Alex.
“Last night was worse! …..There just wasn’t anything to lift me”.
I thought of how I couldn’t seem to cope with lying there passively feeling sick, dry mouthed, terrified to move my neck, my headache engulfing me. Himal was physically harder, but the beauty of it all was so inspiring, it warmed my soul, so that when I felt so close to the edge, something otherworldly seem to propel me onwards. Whereas in ICU, I just couldn’t get beyond the four white walls, or the slow ticking of the clock and I couldn’t tap into my emotional toolbox or cut my mind on happier places. All I wanted was for the nurse to remove stuff: I wanted her to take out the warthog like oxygen tubes that went up into my injured nose and irritated my inflamed left nostril; to take out the 3 lines of tubes in my veins that caused a hideous sensation in my finger- tips, each time they flushed them clean before pumping me with something; to take away the large plastic bottle filled with stale maroon deoxygenated blood which rolled side to side on my chest, the catheter line that kept snagging and confusing me, the clip that measured saturation on my left finger, restraining me each time I tried in vain to reach the water jug, after the nurse had accidently knocked the table away as she left the room; and the maze of wires which were everywhere. I wanted her to turn off the unnecessary bed motion designed to help blood circulation in elderly patients, to bring me some entertainment like a radio, or talk to me, or give me a drug to knock me out and not make me sick. I just wanted some help through the night actually! Laura wasn’t there to offer me a boiled sweet, nor Ali to tell me there was no helicopter.
Yes! Thursday night in ICU was definitely worse.
***********************************
Sitting upright with Alex, it was a new day at last, and Heather was already talking about a return to the ward, I was able to comprehend that perhaps I didn’t have brain damage after all. It must have been the physical shock that would continue to numb my emotions until the kids visited on Sunday afternoon.
Soon after my parents and Alex had left the night before, just a few hours after surgery, the shock revealed itself in the form of tremors that started with a crescendo of teeth chattering and ended with my legs shaking violently on the bed. The night nurse had shown her technical competence by wrapping me up in a sort of canvas blanket that she then inflated by attaching it to an electric pump, filling the tubes in the blanket with hot air. My teeth chattering and shaking successfully abated soon afterwards, but unfortunately the nurse left the room, and ten minutes later when she finally returned I was streaming with sweat, thinking that I was going to suffocate. It made it a tough call to motion towards the blanket a few hours later, when my trembling got out of control again. I begged her to stay this time.
It wasn’t until the nurse had got a clean gown onto me, and was reconnecting the last of the wires that I sensed a little of her cold detachment melt away: Ever since putting on the blue surgical gown after my shower on Thursday morning, I’d been preoccupied with the placement of two breast pads underneath. I’d stopped breast feeding Harriet completely one month earlier, but the taps were not completely shut, and whatever the surgeons might be privy to when they performed their operation, I didn’t want them distracted by 2 damp circles.
“How old’s the baby?” the nurse asked in a West African accent, still concentrating on unravelling some wires.
“6 months now” I replied. “A little girl – Harriet” I said.
It wasn’t exactly a conversation, but shortly after her next disappearance, she returned bringing with her some gauze and white tape for me to use as a substitute for the sick saturated pads.
“Thank you so much, I really appreciate this” I said as our hands met.
“You’re welcome!" She drawled. "Now, you’ll need to get some food inside you. I’ll go get you a yoghurt or something.”
The tension in the room seemed to lift a little after that, and although the nurse didn’t actually get round to bringing me any food before her shift ended an hour or so after, I felt calmer and hopeful that a new day was not so far away.
Professor Thompson came through the doors shortly after Heather’s shift begun, and just after she had removed the catheter. The first time the doors swung open with his entourage in toe, it was pretty embarrassing. I sat up in my chair, poised to be grateful, to remember the big picture and not mention the small insignificant details from the night. Only as soon as he stepped inside the room, he turned away and put his big surgeon’s hand up, motioning for the group to follow him back outside again. Looking around, I spotted the arm chair next to me, and realised that I was still sitting on the commode. SHIT!! For all intensive- purposes the commode looked and felt like an arm chair, only it wasn’t. At least my knees were covered up by the gown.
So when he returned I cringed even more when he apologised for coming by the first time without first checking with the nurse.
“No I was ready, I mean I wasn’t actually doing.. I forgot it was a ……anyway”
If not sad, or happy or gloriously relieved, at least I could feel embarrassment, I thought.
“How was your night?” he asked.
“Yeah – erm, OK, well I didn’t get on with the morphine, but it was OK really, it was fine. Thank you, Thank you so much……”
“Good to hear. Your readings all seem fine, so with any luck, they should be able to get you back to the ward later today”.
“Oh thank you, thank you so much Professor, for everything, I mean everything seems to work...”
“Yes it went very well. Everything that could have gone right, did! I’ll see you back on the ward tomorrow morning, take care!” and the doors swung closed again, as they rightly turned towards their more critical patients.
That short dialogue was probably why Alex got an earful when he arrived a couple of hours later, because I mustn’t have had the strength to hold back a second time. I kind of regret unloading my honest account to him, but it led to him following up with Heather to find out the name of the night nurse, and in turn she sensed there had been something wrong and urged us to feedback to her manager.
“No, no, it’s fine, it was just one night, I’m sure I’ll get over it quite quickly, I just want to move on, I don’t want to say anything, I know you all have such difficult jobs here, and you’ve been completely amazing, and my parents said the nurse yesterday was fantastic too…. Maybe I’ll write a letter in a few weeks.”
“No Soph” Alex interjected “it will be much better if you feedback in person now, otherwise you’ll dwell on it. I don’t want any anger lingering and a cloud hanging over you - Heather’s right, I think she should get her manager here this morning, I don’t like what you told me, it’s not OK. It’s not OK for the next patient.”
So I nodded reluctantly, and shortly afterwards Heather brought the ICU manager to sit down and hear my account. I have to say, he couldn’t have been more professional in the way he listened, asked follow up questions, thanked me for the information and offered the most sincere of apologies, assuring us that he would deal with it. I in turn tried to emphasize my hugely positive experience with the other nurses on ICU, the surgical team, the ward and the overall St Georges experience that I would be eternally grateful for.
“Will you be coming back here to ICU for your next surgery?...Because if you are coming back to St Georges, you should ask for me, or the other shift manager and we will make sure you have impeccable care here in ICU.”
“Sorry, what surgery are you talking about. I…..?..”
“Oh, I was just reading your notes, and read about the prolactinoma in your pituitary gland, I just didn’t want last night to put you off having surgery here in St Georges, and well I hope it hasn’t, and if you were to choose us again then…”
“No, no" I said, "I mean I haven’t thought about that yet, It might not even come down to surgery, well I hope it doesn't, it's just too soon to..."
Christ, this isn’t a Mr and Mrs Smith hotel, I thought. Can’t fault the guy for his customer service, but what a time to try and sign me up for some kind of ICU loyalty scheme!
Later, after Heather had removed almost every tube and wire that she could, and I’d stood up on my own steam to walk down the corridor to the toilet and back, she came in to tell us that she’d spoken to the ward, and that they would prepare the same private side room for me to return to that afternoon. At that moment, the idea of returning to my side room on Cheselden ward sounded about as fabulous as the Copacabana Hotel did on route to Brazil for our honeymoon. And I think that was the first time I broke into some sort of smile after surgery.
“I can’t believe you!” Heather said looking first at me, and then Alex. It’s funny but you don’t look anything like the patient I expected when I read your notes and your surgical disclaimer form. I mean, most people in intensive care don’t just stand up and walk off to the toilet by themselves – you seem…so young and well - Before I came into your room this morning, I was reading your form, and I’ve never seen anything written so bluntly about your need for surgery – there in black and white…. You’ve probably seen all the pages of surgical risks that you’d signed, but I presume you didn’t see what Professor Thompson wrote on the form on the back?”
Alex and I both looked first at each other and then back to her inquisitively. “Oh yes?” Alex said.
“On the last page it reads ‘What are the risks of non - surgical intervention?’
Just to the right, Professor Thompson has written in black ink ……..‘DEATH’
Then he’s asked what the probability is of that risk, and he’d written…. ‘100%’.
It’s the first time I’ve ever seen that written down so starkly.”
So however much the physical shock had numbed my senses, and whatever feelings I couldn’t yet express or draw on, I looked back at Alex after she'd spoken, and we both knew that I was incredibly lucky indeed.
******************************************
Links to video's of the team at the summit of Mardi Himal, and of Laura beginning her abseil down are here:
http://youtu.be/sbxy4pPJ4HM
http://youtu.be/3l1MtZrJdZc
You should also be able to navigate to them from my Google + profile, or searching for 'Sophie Orme' in YouTube.
After note
I deliberated hard about including the negative account of the night in ICU, because I am so indepted to the amazing cast of medical staff at St Georges, together with the GP, and radiology staff that came beforehand. I truly have them to thank for my life. With only one brief exception, I experienced fantastic care throughout. In all walks of life, and professions we come across the occasional bad apple, and I’m pretty sure the manager had plans to sieve this one out, so I hope I don’t in anyway unsettle anybody who might require subsequent medical treatment who is reading this blog. It was also very difficult for me to cast my mind back to that night, because I really had put all the detail to bed as soon as the wonderful Heather put me back together again and pushed me back to the ward. I have indulgently interwoven the story of Mardi Himal to help motivate me to write this, as that was a very special place to return to in my mind. I guess the judgement call I made in writing this post is to stay true to the honest and open narrative that I have used so far.
I plan to write one more post in this series titled ‘post op’ in the next fortnight to conclude. Thanks for getting this far.
Monday, 27 January 2014
ICU Part One
After nearly a year of build up to the operation, I thought of how I'd react to every positive scenario, including how I might feel if I woke up from the general anaesthetic in one piece: If there were signs that I could both swallow and speak, then I knew that any pain would be swept beneath a surging wave of emotional relief. And in the event that I’d wake up with the ability to swallow, but not to speak; then I wouldn’t panic, and I would draw on the perspective that it could be worse, and that with time and patience, the voice might return one day. As eyes would close under the sedation of pain killers, my mind might flow from one close shave to another, from the memories of my dangerous Central and South America travels in 1999 and 2001 - Each time I would wake up just before I drowned, or the coach crashed, or the dengue fever gripped me, or the Shamen in the jungle turned on me.
But that is not how it was at all.
When I opened my eyes, I felt something around my neck like the metallic grey rhino folds of the MRI casing. But my frayed nerve endings were playing tricks on me, as later I found that there was only a white gauze dressing that was touching the skin.
I turned just slightly to my left to see my parents who were waiting eagerly for this moment. They looked like an elderly couple sitting there, as if on Brighton pier looking out to sea in an old black and white film clip. As I blinked, I saw the blood return to their faces, their improving complexions brought them into technicolour, and they leaned forward with hopeful, purposeful smiles.
Almost inaudibly, I remember asking if the bed was moving; if they had opened my groin up, and then later with a dry mouth from the Oxygen mask; I asked for water.
I must have fallen back to sleep before all of the answers arrived, because I recall one response came from the foot of my bed, where they were now excitedly reading the hand written surgical notes from the operation with one of the doctors.
Returning to my side, my Mum and Dad told me that the operation had been extremely successful, and that I would be just fine. When the nurse agreed that I could try a little to drink, I remember being able to open my mouth just wide enough to pull the end of the straw between my dry lips, then I swallowed a little bit of water, slowly, gently.
I lay back flat, peering forward at the clock and then back up to the ceiling. The pain wasn’t too bad. I waited for the beach images of Harriet, Barnaby and Alex to flood my mind, and a tsunami of emotions to carry me through the night.
But nothing came.
I realised that I didn’t feel anything. No emotions. Nothing at all.
I had rational thoughts, I heard good news, I knew that the surgeons who I’d put all of my faith in had saved my life. The coloured wires around my neck reminded me that the ticking bomb had been defused; the danger was over, the aneurysm removed. But still I couldn’t summon the smile that I had dreamed of for so long.
It was not what I had expected.
I remember thinking about the documentary film that I'd watched recently – ‘The Crash Reel’. In that film, a handsome American snowboarder crashes onto his face from a great height in training for the Vancouver Olympic half-pike. Kevin Pearce didn’t get to compete for the Olympic Gold with Shaun White, as was anticipated by the sponsors. Instead, just before millions were tuning into that event, Kevin came out of his coma, and his family celebrated. Instead of Burton commissioning a film about the Olympic journey, the production team shifted their focus to tracing his slow partial recovery over the next few years. I was fascinated by watching how close family members dealt with the impact of Kevin’s inability to make good decisions, and by seeing his personality change due to the irreversible damage to the right frontal lobe of his brain.
So before Alex arrived, looking anxious and tired, when I was still unable to feel any emotion at all for the first time in my life - I wondered if I might have some frontal lobe damage too.
Then later when everybody had left, and the excellent day nurse handed over to a rogue night shift nurse, I would go to hell and back, the ordeal not yet over for me. Quite the contrary! I had reached the summit with a successful operation and my parents would rightly begin their celebration, knowing from a medical viewpoint, that in time, their youngest daughter would likely be 'just fine'. But I knew from my experience of conquering a Himalayan peak and taking myself to the physical and mental limits of my very being in the process; that it’s the descent that you need to hold back some strength for: Strength to keep going when the fuel has run out and you are running on the fumes of the past adrenaline rush; when the taste of bile builds up in the back of your throat and when you start to sense that your journey is endless. Strength when you’ve been focused on a finishing line, only to find out that there is still a considerable way to go when you get there. Those hours beyond the point that you have prepared for, are what I refer to as the ‘breaking time’.
Perhaps thanks to the hormone rush and the wonders of the outcome, I didn’t experience breaking time during a marathon labour when Barnaby was born; but I definitely hit it on the descent of the mountain 'Mardi Himal' in Nepal in 2008, and again in ICU at St Georges when I couldn’t bend time forward, or skip an hour through sleep, or shift my mind to anywhere other than the present situation in the ICU room. ICU that night was the place where the rogue nurse failed in her care for me, and when nausea and headaches overwhelmed me for hour, after hour, after hour. Looking back it was only 12 hours of my life, and I would recover quite quickly from the trauma afterwards. But as I was going through it, it was my Abu Ghraib, my hell. And it was brutal.
**********************************
I will return reluctantly to that dark time and the start of the recovery in my next post, after my Dad’s insightful guest blog below which tells Thursday’s story from the perspective of a parent as well as his sharp medical viewpoint.
*********************************
ICU by Chris Evans
That I didn't sleep well was unsurprising, but the nightmare interview with Sophie was perturbing:
"Are you really happy to be going ahead with this operation?" I asked her, and she was as sure in the dream as she had been three weeks earlier when I had challenged her on a car journey.
Breakfast in our Wimbledon common B & B was hearty: Juices, muesli and fruits, toast, bacon and fried eggs and coffee. A long day was ahead. There had been overnight frost.
We travelled to St George's in Tooting, along a route planned previously by Sophie. London traffic was congested, and we finally found a car park space. The vascular unit was on the 4th floor and Sophie's side room overlooked the rooftops of the hospital; South London was emerging through the mist and to the North, the ethereal roof arch of Wembley Stadium could be defined occasionally.
She was composed, having seen her surgeon and we wished her well, admiring both her and Alex's bravery and courage. We left to learn that surgery was planned for 12:00 and we drove to Wimbledon village and walked aimlessly past shops selling nothing that took our fancy. We enjoyed Cappuccinos opposite the roundabout and overheard 2 elderly women discussing the virtues of the University of the third-age.
After this fortification, Susie reverted to type and she bought some greeting cards, Sellotape, tiny cyclamen for a pot in Liverpool, and a Wimbledon priced waist coat for Joanne's dachshund!
After feeding the parking meter, we went for lunch at Cafe Rouge: minute steak, pommes frites and a glass of red wine.
In the afternoon, the clock was ticking by so slowly, we met up with Alex, Alison (Alex’s mum), and Barnaby on his bike and Harriet in the pram. We walked through the Cannizaro woods and past the red sweatered golfers on the Wimbledon course.
It was getting colder and darker; the Chelsea tractors were collecting infants from the prep school, so we went into the Fox and Grapes pub for a cup of tea. The farmhouse wall clock was advancing so very slowly, when eventually Alex's mobile rang. He rightly went outside and was gone an age.
Sophie was out of theatre and in medical parlance, was as well as could be expected. Alex was understandably reserved; had everything gone Ok? I didn't dare ask.
We arranged for Susie and I to visit the ICU and Al would follow after returning the family to Putney. It was commuter time again, but parking was easy.
The ICU was one of three adjacent to each other and we eventually established by telephone where she was. Her dedicated nurse invited us in, but not before we had heard other relatives being told bad news.
Sophie was in the first large cubicle and to each side of the bed multiple vital functions were being monitored on large coloured TV screens. To my trained eyes, they were all reassuringly normal. Sophie was sleeping or doped with nasal oxygen specs in position, drips in both arms, urine bag filling and neck drain containing stale blood. So far so good.
The specialist nurse was very pleased with her patient who was so relatively young and doing so well. Alex arrived and stood in amazement viewing his precious wife in this ever so alien setting.
The next 10 minutes were very revealing to a clinician:
First of all, Sophie scratched her left forehead with her left hand: i.e. no stroke.
Then she coughed normally i.e. vocal cords not damaged.
She opened her eyes without a droopy right eyelid i.e. the sympathetic nerves were intact.
And finally she sipped water from a straw and was therefore able to swallow ok.
All of these potential complications had been discussed with Alex and Sophie by Prof Thompson at consent signing.
Whilst these observations were encouraging to us as doctors, Alex remained near spell bound at the complexity of the situation .The scenario was an extreme example of the difference between worried medical parents and a worried lay husband.
The surgical team came round, pleased with Sophie's progress, and explained the nature of the surgery to us when the aneurysm had been skilfully excised and the carotid artery re- established with an end to end join.
Susie and I returned to Putney, leaving Alex on duty.
Barnaby had his bed time story and we enjoyed Alison's supper with Alex and a glass of champagne, praising the St George's team and texting and phoning all our family and supportative friends who had, like us, been on tenterhooks. As we returned to our Wimbledon B&B we left Alex still dazed, whereas Susie and I were nearly euphoric, for which I apologise to Alex unreservedly.
Our artists’ hosts were so pleased to learn of the result and I went to sleep for the first time in 6 months, without the image of the walnut aneurysm in my visual or emotional cortex [picture below].
Our youngest daughter and the mother of our youngest grandchildren had been rewarded for her courage and bravery so brilliantly supported by her proud adoring husband.
Top marks and huge thanks to all at St George's: Brilliant Result. My heartfelt thanks.
***********************
But that is not how it was at all.
When I opened my eyes, I felt something around my neck like the metallic grey rhino folds of the MRI casing. But my frayed nerve endings were playing tricks on me, as later I found that there was only a white gauze dressing that was touching the skin.
I turned just slightly to my left to see my parents who were waiting eagerly for this moment. They looked like an elderly couple sitting there, as if on Brighton pier looking out to sea in an old black and white film clip. As I blinked, I saw the blood return to their faces, their improving complexions brought them into technicolour, and they leaned forward with hopeful, purposeful smiles.
Almost inaudibly, I remember asking if the bed was moving; if they had opened my groin up, and then later with a dry mouth from the Oxygen mask; I asked for water.
I must have fallen back to sleep before all of the answers arrived, because I recall one response came from the foot of my bed, where they were now excitedly reading the hand written surgical notes from the operation with one of the doctors.
Returning to my side, my Mum and Dad told me that the operation had been extremely successful, and that I would be just fine. When the nurse agreed that I could try a little to drink, I remember being able to open my mouth just wide enough to pull the end of the straw between my dry lips, then I swallowed a little bit of water, slowly, gently.
I lay back flat, peering forward at the clock and then back up to the ceiling. The pain wasn’t too bad. I waited for the beach images of Harriet, Barnaby and Alex to flood my mind, and a tsunami of emotions to carry me through the night.
But nothing came.
I realised that I didn’t feel anything. No emotions. Nothing at all.
I had rational thoughts, I heard good news, I knew that the surgeons who I’d put all of my faith in had saved my life. The coloured wires around my neck reminded me that the ticking bomb had been defused; the danger was over, the aneurysm removed. But still I couldn’t summon the smile that I had dreamed of for so long.
It was not what I had expected.
I remember thinking about the documentary film that I'd watched recently – ‘The Crash Reel’. In that film, a handsome American snowboarder crashes onto his face from a great height in training for the Vancouver Olympic half-pike. Kevin Pearce didn’t get to compete for the Olympic Gold with Shaun White, as was anticipated by the sponsors. Instead, just before millions were tuning into that event, Kevin came out of his coma, and his family celebrated. Instead of Burton commissioning a film about the Olympic journey, the production team shifted their focus to tracing his slow partial recovery over the next few years. I was fascinated by watching how close family members dealt with the impact of Kevin’s inability to make good decisions, and by seeing his personality change due to the irreversible damage to the right frontal lobe of his brain.
So before Alex arrived, looking anxious and tired, when I was still unable to feel any emotion at all for the first time in my life - I wondered if I might have some frontal lobe damage too.
Then later when everybody had left, and the excellent day nurse handed over to a rogue night shift nurse, I would go to hell and back, the ordeal not yet over for me. Quite the contrary! I had reached the summit with a successful operation and my parents would rightly begin their celebration, knowing from a medical viewpoint, that in time, their youngest daughter would likely be 'just fine'. But I knew from my experience of conquering a Himalayan peak and taking myself to the physical and mental limits of my very being in the process; that it’s the descent that you need to hold back some strength for: Strength to keep going when the fuel has run out and you are running on the fumes of the past adrenaline rush; when the taste of bile builds up in the back of your throat and when you start to sense that your journey is endless. Strength when you’ve been focused on a finishing line, only to find out that there is still a considerable way to go when you get there. Those hours beyond the point that you have prepared for, are what I refer to as the ‘breaking time’.
Perhaps thanks to the hormone rush and the wonders of the outcome, I didn’t experience breaking time during a marathon labour when Barnaby was born; but I definitely hit it on the descent of the mountain 'Mardi Himal' in Nepal in 2008, and again in ICU at St Georges when I couldn’t bend time forward, or skip an hour through sleep, or shift my mind to anywhere other than the present situation in the ICU room. ICU that night was the place where the rogue nurse failed in her care for me, and when nausea and headaches overwhelmed me for hour, after hour, after hour. Looking back it was only 12 hours of my life, and I would recover quite quickly from the trauma afterwards. But as I was going through it, it was my Abu Ghraib, my hell. And it was brutal.
**********************************
I will return reluctantly to that dark time and the start of the recovery in my next post, after my Dad’s insightful guest blog below which tells Thursday’s story from the perspective of a parent as well as his sharp medical viewpoint.
*********************************
ICU by Chris Evans
That I didn't sleep well was unsurprising, but the nightmare interview with Sophie was perturbing:
"Are you really happy to be going ahead with this operation?" I asked her, and she was as sure in the dream as she had been three weeks earlier when I had challenged her on a car journey.
Breakfast in our Wimbledon common B & B was hearty: Juices, muesli and fruits, toast, bacon and fried eggs and coffee. A long day was ahead. There had been overnight frost.
We travelled to St George's in Tooting, along a route planned previously by Sophie. London traffic was congested, and we finally found a car park space. The vascular unit was on the 4th floor and Sophie's side room overlooked the rooftops of the hospital; South London was emerging through the mist and to the North, the ethereal roof arch of Wembley Stadium could be defined occasionally.
She was composed, having seen her surgeon and we wished her well, admiring both her and Alex's bravery and courage. We left to learn that surgery was planned for 12:00 and we drove to Wimbledon village and walked aimlessly past shops selling nothing that took our fancy. We enjoyed Cappuccinos opposite the roundabout and overheard 2 elderly women discussing the virtues of the University of the third-age.
After this fortification, Susie reverted to type and she bought some greeting cards, Sellotape, tiny cyclamen for a pot in Liverpool, and a Wimbledon priced waist coat for Joanne's dachshund!
After feeding the parking meter, we went for lunch at Cafe Rouge: minute steak, pommes frites and a glass of red wine.
In the afternoon, the clock was ticking by so slowly, we met up with Alex, Alison (Alex’s mum), and Barnaby on his bike and Harriet in the pram. We walked through the Cannizaro woods and past the red sweatered golfers on the Wimbledon course.
It was getting colder and darker; the Chelsea tractors were collecting infants from the prep school, so we went into the Fox and Grapes pub for a cup of tea. The farmhouse wall clock was advancing so very slowly, when eventually Alex's mobile rang. He rightly went outside and was gone an age.
Sophie was out of theatre and in medical parlance, was as well as could be expected. Alex was understandably reserved; had everything gone Ok? I didn't dare ask.
We arranged for Susie and I to visit the ICU and Al would follow after returning the family to Putney. It was commuter time again, but parking was easy.
The ICU was one of three adjacent to each other and we eventually established by telephone where she was. Her dedicated nurse invited us in, but not before we had heard other relatives being told bad news.
Sophie was in the first large cubicle and to each side of the bed multiple vital functions were being monitored on large coloured TV screens. To my trained eyes, they were all reassuringly normal. Sophie was sleeping or doped with nasal oxygen specs in position, drips in both arms, urine bag filling and neck drain containing stale blood. So far so good.
The specialist nurse was very pleased with her patient who was so relatively young and doing so well. Alex arrived and stood in amazement viewing his precious wife in this ever so alien setting.
The next 10 minutes were very revealing to a clinician:
First of all, Sophie scratched her left forehead with her left hand: i.e. no stroke.
Then she coughed normally i.e. vocal cords not damaged.
She opened her eyes without a droopy right eyelid i.e. the sympathetic nerves were intact.
And finally she sipped water from a straw and was therefore able to swallow ok.
All of these potential complications had been discussed with Alex and Sophie by Prof Thompson at consent signing.
Whilst these observations were encouraging to us as doctors, Alex remained near spell bound at the complexity of the situation .The scenario was an extreme example of the difference between worried medical parents and a worried lay husband.
The surgical team came round, pleased with Sophie's progress, and explained the nature of the surgery to us when the aneurysm had been skilfully excised and the carotid artery re- established with an end to end join.
Susie and I returned to Putney, leaving Alex on duty.
Barnaby had his bed time story and we enjoyed Alison's supper with Alex and a glass of champagne, praising the St George's team and texting and phoning all our family and supportative friends who had, like us, been on tenterhooks. As we returned to our Wimbledon B&B we left Alex still dazed, whereas Susie and I were nearly euphoric, for which I apologise to Alex unreservedly.
Our artists’ hosts were so pleased to learn of the result and I went to sleep for the first time in 6 months, without the image of the walnut aneurysm in my visual or emotional cortex [picture below].
Our youngest daughter and the mother of our youngest grandchildren had been rewarded for her courage and bravery so brilliantly supported by her proud adoring husband.
Top marks and huge thanks to all at St George's: Brilliant Result. My heartfelt thanks.
***********************
Friday, 24 January 2014
Thursday
The sun was just starting to break through the morning mist, revealing an expansive sky hovering above the smoggy air that clung to the roof tops of 3 different South London boroughs. There was a clatter of vehicles and ambulance sirens below which had been building in volume since 5am. A nurse walked into my room to tell me to get out of bed and get ready for a visit from my surgeon - Professor Thompson who had already started his ward round.
It was 7.30am on Thursday 12th December, and the start of the longest 24 hours of my life.
I should have been dressed in the surgical gown by now, but I was putting that moment back - cocooned in the sanctuary of my private room, wearing soft newly bought Cath Kidson pyjamas and accompanied by Helen Fielding’s now 50 year old Bridget Jones in my earplugs.
I was smiling.
A cup of tea arrived just ahead of Professor Thompson’s entrance, who was once again dressed in green scrubs.
“You OK?” he asked, as he grabbed a chair opposite mine.
“Yes, quite good” I said, “Ready, I think. What time do you think I’ll be in?”
“About 12.30, it’s dependent on Pete as he’s got to fit in two operations this morning”
I felt familiar with ‘Pete’, though I’d never met him, which felt odd now as it was his name against all of the most likely risks that Thompson ran through again. ‘Pete’ was to be the ENT surgeon and a specialist in neck oncology. It would be his role to provide ‘access’ through the neck to present the aneurysm to the vascular surgeon.
“He will enter the neck and peel away the nerves as he goes in. The nerves may be stuck together, particularly around the throat and that’s where there is the highest risk of serious damage, as we discussed last time”.
Post Op, my Dad would speak to a plastic surgeon who specialised in neck operations and his quote now sticks in my mind:
"Did you say they removed it from her Carotid? Christ - That's tiger country!"
Unaware of this analogy at the time, I sat there calmly. Interjecting with a question occasionally, but mostly just listening and absorbing as Professor Thompson reiterated all of the risks we’d previously spoken about and then introduced a few more that he hadn't mentioned until now:
“He’ll cut through the main nerve to your face, and so you’ll lose feeling here” He pointed to the chin area and right hand side of my face.
“It’s a bigger deal for men who have to shave!” He said.
“You’ll also have a droopy right shoulder from the nerve damage”
“I might or I will definitely have a droopy shoulder and numb face?”
“Er.. I'd say definitely”
I breathed in slowly, but it was what it was. There was nothing to fight; nothing that was in my control to change. I stayed relaxed, drinking the new detail in.
“What stitches will you be using”? I asked when he seemed to be finally running out of damage expectations.
“Probably clips! Pete will probably want to use them in case you get a blood clot just behind the skin. Clips allow us to re-open the wound easily.
“Will I have to come back to hospital to have them taken out?" I asked
“Either here or your GP’s. You’ll need to get them out in about 10 to 12 days’ time”
Hmm, Christmas eve I calculated.
“Pete will probably start the incision in front of your ear here, and then run up the face, over the back of your ear and down the neck along the crease line.”
I paused just a little bit, it was the first time he mentioned the cut along the front of my face.
“So how long do you think the scar will be?”
“Not too bad, depends on the location of the aneurysm. We can see a lot from the CT scan, but we can’t work out the orientation of the swelling, if it’s close to the skin then your scar will be pretty small and discreet, but if it’s inwards towards your throat, then Pete will have to come down lower towards your collar bone.”
“How likely do you think it is that you’ll have to use vein from my groin to stitch the artery up again?” I asked
“About 50:50, I reckon. Also, when you come round you will have a sore bloody nose as the anaesthetist will need to put the airway through there. Normally he’d feed it through your mouth, but we need your throat to be clamped shut whilst we work around it.
“Right, sore nose. How long might that hurt for?”
“Just a few days.”
“Fine!” I replied.
“If all goes well, you’ll just need a few days post ICU in here, but your family need to understand you’ll need complete rest after that at home.“
“Good!” I said, “It’s just that if everything did go really well, I’d love to see my son in his nativity play next Tuesday.”
“Right!” he replied, “best wear a big scarf to that then.”
Sensing he was agitating to leave, I shook his hands, and with a turn of his head, he was off to see the next patient.
Within a couple of minutes a more junior doctor came into the room with a clipboard, biro and black marker pen.
“Are you happy that the surgeon ran through all the risks of your operation?” he asked.
“Oh yes” I replied. “I can’t imagine he left anything out!” I said, picturing him doing a final brainstorm of every possible risk with colleagues before he’d entered the room.
“Good, can you sign here?”
I immediately obliged.
“It’s the right side of your neck isn’t it?”
As I confirmed this was the case, I was asked to unbutton the top buttons of my pyjamas so that he could draw a large black arrow on my chest pointing to the right hand side of my neck with his marker pen.
My God, I thought, they don’t ever get the wrong side do they?
With the signature and black ink dispensed, he was off with a clipped ‘Good Luck’. And on the return swing of the door, a stoutly nurse entered with a neatly folded stack in her hands.
She asked in her Jamaican accent: “You not showered yet darling?”
I’d seen the sign on the bathroom door instructing me to take the large bottle of red antiseptic liquid and scrub myself the night and morning before theatre.
“Er… no, well I only got the bed late last night". I replied.
“Well, here’s a fresh surgical gown, towel and another bottle of antiseptic. You need to scrub hard, right. Want some help in the shower?”
“No no, I’m fine, I’ll go and do it right now.”
As she left the room, I pulled the green curtain around the windowed door, and took the crisp package in between my hands and entered the bathroom, wondering if prisoners went through a similar procedure when they entered jail.
I stood in the corner of the room naked, scrubbing the red liquid hard around my neck and body, whilst I stared at the reflection looking back at me. The rectangular mirror was in landscape and captured my head down to my collar bone. Lest I forget; the not so subtle black arrow reminded me of what I was embarking on. The scene made me think of the intense cinematic moment when the actor Edward Norton unleashed an angry monologue at the mirror opposite him in the film 'The 25th Hour'. Only I maintained a straight poker face as I scrubbed, and even I couldn’t decipher what I was feeling. As droplets continued to run down, I traced my finger along the front of my face, up over the ear and then down to my collar bone, and considered that this was the last time I would see myself without a scar. I expected they might need to shave some of my hairline behind the ear, and I almost laughed at the image of my face with a Glen Hoddle 80’s style mullet hairdo. I then stared at my muscular symmetrical shoulders, realising for the first time, how much I liked them, especially the right one. That shoulder was probably responsible for my greatest sporting triumphs – it’s where all the power came from in my fiercest shots at goal in lacrosse, my big serve and smash in tennis. It had pulled me up the last section of the mountain face in Nepal, and balanced my skis as I climbed to the top of a ridge from which I had launched into glorious powder below.
The thought of skiing now propelled me back to March 1995, and the foolish ski jump that as University friends we had spied from the chairlift going up a peak in Les Arcs at the British University Ski Championships. I was next to my new friends Claire Castell and Ginger Nic. Nic had turned to me, cajoling somewhat:
"Soph, you're not going to try that jump up on the right are you?"
I had watched as a pro skier spun his skis to the left and back again, landing his jump perfectly as he plunged into powder below. I sized it up, reasoning that even if I took a big wipe out, it was soft powder, and what was the worst that could happen? I had pulled my tongue out as I turned back towards Nic on my left. I was the 'fresher' amongst them, eager to impress. Well I didn't want to say 'no'.
I was the only girl to dare attempt the drop that day, just behind ‘Jez’, so nick named because he was the spit of Jeremy Guscott. Jez had gone first, just dropping out of view and into whiteness. 30 seconds later I could make him out again much lower down this time, his trouser seat covered in snow where he had touched down. When he raised his pole I followed without pause, but I was only able to gauge the distance of the drop once I was on the precipice. Looking down as I fell through air, my body had frozen, and my knees locked in position as astonishing fear and shock took over my body, with the ground getting closer. The snow was soft on landing but my body was stuck in a rigid tuck position, and as first skis, then my bum hit the hard stuff underneath, my knees had shot up into my chin, which must have caused by head to fly backwards. I’d picked myself up and received the plaudits from the chairlift, before making my way back down the mountain gingerly. I was the talk of the bar scene that night. But the next morning I would go in search of a neck brace.
Even on ski trips today my body still remembers the pain and stiffness in my neck and back during the endless coach journey back from the Alps to Bristol the next day. I have avoided ski jumps ever since that trip.
I was twenty. Young and careless.
I could never have envisaged that I would be standing in front of a hospital mirror contemplating the implications of that jump nearly 19 years later, with a cheeky toddler and a gorgeous 6 month old baby at home. And even if that incident was the cause of the aneurysm - the ticking time-bomb in my neck that the surgeons were about to attempt to diffuse. Well even now I couldn't muster the feeling of regret. Daring to do that jump was part of who I was back then.
Back in my hospital shower, if the water had been about 5 degrees hotter, then I might have stood there until the porters came to take me to theatre a few hours later. I would have liked the heat of a steamy shower to wipe out any thoughts, to cleanse them; much like the Atlantic does as it crashes over my head in the surf. I wanted to close my eyes and feel the seabed under my feet, but I couldn’t conjure up that feeling in the luke warm shower. The only place I could throw my mind was the potential writing of this blog, so I walked across to the chair in the corner, picked up my iPhone and captured the scene. It was only then that I realised that the black arrow had mostly disappeared with the antiseptic scrubbing.
Just after I returned to my arm chair, this time wearing my surgical gown with red scrubbed neck and body, my parents arrived. Conversation flitted around – I relayed the conversation with Professor Thompson, including the advice that they really shouldn’t hang around the hospital during the operation. We talked about their lovely bed and breakfast on Wimbledon Common and aware that Alex was on his way in, we said our goodbyes. I went back for a second hug with my Dad, but this time he gave me a stronger bear like embrace, like the ones he used to give me as a child. 'Tighter' I would say.
Ahead of Alex’s arrival, I passed the time by listening to Ben Howard’s soothing guitar chords from my red and black Dr Dre, giant headphones, - much like Usain Bolt prepares for the 100m. There were two successive tracks that had got under my skin in the run up: ‘The Fear’, followed by ‘Keep your head up’. I loved how the guitar would crescendo after the chorus and Ben's rasping voice and the drum beat would rouse me into a faster paced run on a jog. But more than that, the lyrics resonated with my inner thoughts:
‘I’ve been worried…. that my time is a little unclear..
I’ve been worried…… that I’m losing the ones I held dear,
I’ve been worried…. that we all live our lives, in the confines of fear'
And then just as those words would begin to get into my psyche, the guitar strumming of the next song soothes and transports me to the surf where Ben describes his soul searching. And if I was running fast with the pheromones pumping, from the end of ‘The Fear’ then I’d get the heart rate back down again dropping to a happy gentle jog to these lyrics:
'With the strength of a turnin' tide
Oh the wind's so soft on my skin,
The sun so hard upon my side.
Oh lookin' out at this happiness,
I search for between the sheets
Oh feelin' blind and realise,
That All I was searchin' for was me.
Keep your head up, keep your heart strong.
No, no, no, no.
Keep your mind set, keep your hair long.
keep your head up, keep your heart strong.
keep your mind set in your ways, keep your heart strong.
I saw a friend of mine the other day,
And he told me that my eyes were gleamin'.
Oh I said I had been away, and he knew,
Oh he knew the depths I was meanin'.
And it felt so good to see his face,
Or the comfort invested in my soul.
Oh to feel the warmth of a smile,
When he said "I'm happy to have you home.
Ooh I'm happy to have you home.
Keep your head up, keep you heart strong.
Keep your mind set in your ways,
Keep your heart strong.'
As I listened to those words a video arrived from Alex on my iPhone of Barnaby dancing in front of Harriet in her high chair, both were in fits of giggles, a messy breakfast scene played out behind them as Alex joined them, laughing back into the camera.
I smiled at this happy gaggle before letting the first tear since Monday and the last tear until church on Christmas day, roll down my cheek. I reached for the sealed letter that Alex had given to me the night before, the one that I’d resisted opening in the middle of the night. On the front he suggested that I might want to save it until after the op. Wondering if that would be possible, I opened it tentatively, read the first line and feeling more tears arriving, I put it back into the envelope to carry out the instruction as Alex intended. I didn’t want to get emotional again.
So when Alex arrived in his cycling gear, we kept our last exchange upbeat. In fact before we’d managed to get into any detail, the porter team arrived to take me down to the anaesthetist' room, connected to theatre by a sliding door.
It was 11.30am, and I felt Alex’s warm lips on mine as he sneaked in a quick kiss, before looking back at him from the moving bed. I called out a funny cheesy quote that Coach Taylor gets his American Football school team to say before a match in Friday Night Lights (our favourite TV series).
We both smiled and I sat up on my elbows as the porter team raced me towards the lifts. Ironically, it felt like my Birthday or Christmas Day or something, I felt excited that things were finally in motion, and as the team around me shared a private joke, I closed my eyes and prayed that I would be OK.
*******************************
Next up ‘ICU (Intensive Care Unit), including guest blog from my Dad, and the CT scan image of the aneurysm.
It was 7.30am on Thursday 12th December, and the start of the longest 24 hours of my life.
I should have been dressed in the surgical gown by now, but I was putting that moment back - cocooned in the sanctuary of my private room, wearing soft newly bought Cath Kidson pyjamas and accompanied by Helen Fielding’s now 50 year old Bridget Jones in my earplugs.
I was smiling.
A cup of tea arrived just ahead of Professor Thompson’s entrance, who was once again dressed in green scrubs.
“You OK?” he asked, as he grabbed a chair opposite mine.
“Yes, quite good” I said, “Ready, I think. What time do you think I’ll be in?”
“About 12.30, it’s dependent on Pete as he’s got to fit in two operations this morning”
I felt familiar with ‘Pete’, though I’d never met him, which felt odd now as it was his name against all of the most likely risks that Thompson ran through again. ‘Pete’ was to be the ENT surgeon and a specialist in neck oncology. It would be his role to provide ‘access’ through the neck to present the aneurysm to the vascular surgeon.
“He will enter the neck and peel away the nerves as he goes in. The nerves may be stuck together, particularly around the throat and that’s where there is the highest risk of serious damage, as we discussed last time”.
Post Op, my Dad would speak to a plastic surgeon who specialised in neck operations and his quote now sticks in my mind:
"Did you say they removed it from her Carotid? Christ - That's tiger country!"
Unaware of this analogy at the time, I sat there calmly. Interjecting with a question occasionally, but mostly just listening and absorbing as Professor Thompson reiterated all of the risks we’d previously spoken about and then introduced a few more that he hadn't mentioned until now:
“He’ll cut through the main nerve to your face, and so you’ll lose feeling here” He pointed to the chin area and right hand side of my face.
“It’s a bigger deal for men who have to shave!” He said.
“You’ll also have a droopy right shoulder from the nerve damage”
“I might or I will definitely have a droopy shoulder and numb face?”
“Er.. I'd say definitely”
I breathed in slowly, but it was what it was. There was nothing to fight; nothing that was in my control to change. I stayed relaxed, drinking the new detail in.
“What stitches will you be using”? I asked when he seemed to be finally running out of damage expectations.
“Probably clips! Pete will probably want to use them in case you get a blood clot just behind the skin. Clips allow us to re-open the wound easily.
“Will I have to come back to hospital to have them taken out?" I asked
“Either here or your GP’s. You’ll need to get them out in about 10 to 12 days’ time”
Hmm, Christmas eve I calculated.
“Pete will probably start the incision in front of your ear here, and then run up the face, over the back of your ear and down the neck along the crease line.”
I paused just a little bit, it was the first time he mentioned the cut along the front of my face.
“So how long do you think the scar will be?”
“Not too bad, depends on the location of the aneurysm. We can see a lot from the CT scan, but we can’t work out the orientation of the swelling, if it’s close to the skin then your scar will be pretty small and discreet, but if it’s inwards towards your throat, then Pete will have to come down lower towards your collar bone.”
“How likely do you think it is that you’ll have to use vein from my groin to stitch the artery up again?” I asked
“About 50:50, I reckon. Also, when you come round you will have a sore bloody nose as the anaesthetist will need to put the airway through there. Normally he’d feed it through your mouth, but we need your throat to be clamped shut whilst we work around it.
“Right, sore nose. How long might that hurt for?”
“Just a few days.”
“Fine!” I replied.
“If all goes well, you’ll just need a few days post ICU in here, but your family need to understand you’ll need complete rest after that at home.“
“Good!” I said, “It’s just that if everything did go really well, I’d love to see my son in his nativity play next Tuesday.”
“Right!” he replied, “best wear a big scarf to that then.”
Sensing he was agitating to leave, I shook his hands, and with a turn of his head, he was off to see the next patient.
Within a couple of minutes a more junior doctor came into the room with a clipboard, biro and black marker pen.
“Are you happy that the surgeon ran through all the risks of your operation?” he asked.
“Oh yes” I replied. “I can’t imagine he left anything out!” I said, picturing him doing a final brainstorm of every possible risk with colleagues before he’d entered the room.
“Good, can you sign here?”
I immediately obliged.
“It’s the right side of your neck isn’t it?”
As I confirmed this was the case, I was asked to unbutton the top buttons of my pyjamas so that he could draw a large black arrow on my chest pointing to the right hand side of my neck with his marker pen.
My God, I thought, they don’t ever get the wrong side do they?
With the signature and black ink dispensed, he was off with a clipped ‘Good Luck’. And on the return swing of the door, a stoutly nurse entered with a neatly folded stack in her hands.
She asked in her Jamaican accent: “You not showered yet darling?”
I’d seen the sign on the bathroom door instructing me to take the large bottle of red antiseptic liquid and scrub myself the night and morning before theatre.
“Er… no, well I only got the bed late last night". I replied.
“Well, here’s a fresh surgical gown, towel and another bottle of antiseptic. You need to scrub hard, right. Want some help in the shower?”
“No no, I’m fine, I’ll go and do it right now.”
As she left the room, I pulled the green curtain around the windowed door, and took the crisp package in between my hands and entered the bathroom, wondering if prisoners went through a similar procedure when they entered jail.
The thought of skiing now propelled me back to March 1995, and the foolish ski jump that as University friends we had spied from the chairlift going up a peak in Les Arcs at the British University Ski Championships. I was next to my new friends Claire Castell and Ginger Nic. Nic had turned to me, cajoling somewhat:
"Soph, you're not going to try that jump up on the right are you?"
I had watched as a pro skier spun his skis to the left and back again, landing his jump perfectly as he plunged into powder below. I sized it up, reasoning that even if I took a big wipe out, it was soft powder, and what was the worst that could happen? I had pulled my tongue out as I turned back towards Nic on my left. I was the 'fresher' amongst them, eager to impress. Well I didn't want to say 'no'.
I was the only girl to dare attempt the drop that day, just behind ‘Jez’, so nick named because he was the spit of Jeremy Guscott. Jez had gone first, just dropping out of view and into whiteness. 30 seconds later I could make him out again much lower down this time, his trouser seat covered in snow where he had touched down. When he raised his pole I followed without pause, but I was only able to gauge the distance of the drop once I was on the precipice. Looking down as I fell through air, my body had frozen, and my knees locked in position as astonishing fear and shock took over my body, with the ground getting closer. The snow was soft on landing but my body was stuck in a rigid tuck position, and as first skis, then my bum hit the hard stuff underneath, my knees had shot up into my chin, which must have caused by head to fly backwards. I’d picked myself up and received the plaudits from the chairlift, before making my way back down the mountain gingerly. I was the talk of the bar scene that night. But the next morning I would go in search of a neck brace.
Even on ski trips today my body still remembers the pain and stiffness in my neck and back during the endless coach journey back from the Alps to Bristol the next day. I have avoided ski jumps ever since that trip.
I was twenty. Young and careless.
I could never have envisaged that I would be standing in front of a hospital mirror contemplating the implications of that jump nearly 19 years later, with a cheeky toddler and a gorgeous 6 month old baby at home. And even if that incident was the cause of the aneurysm - the ticking time-bomb in my neck that the surgeons were about to attempt to diffuse. Well even now I couldn't muster the feeling of regret. Daring to do that jump was part of who I was back then.
Back in my hospital shower, if the water had been about 5 degrees hotter, then I might have stood there until the porters came to take me to theatre a few hours later. I would have liked the heat of a steamy shower to wipe out any thoughts, to cleanse them; much like the Atlantic does as it crashes over my head in the surf. I wanted to close my eyes and feel the seabed under my feet, but I couldn’t conjure up that feeling in the luke warm shower. The only place I could throw my mind was the potential writing of this blog, so I walked across to the chair in the corner, picked up my iPhone and captured the scene. It was only then that I realised that the black arrow had mostly disappeared with the antiseptic scrubbing.
Just after I returned to my arm chair, this time wearing my surgical gown with red scrubbed neck and body, my parents arrived. Conversation flitted around – I relayed the conversation with Professor Thompson, including the advice that they really shouldn’t hang around the hospital during the operation. We talked about their lovely bed and breakfast on Wimbledon Common and aware that Alex was on his way in, we said our goodbyes. I went back for a second hug with my Dad, but this time he gave me a stronger bear like embrace, like the ones he used to give me as a child. 'Tighter' I would say.
Ahead of Alex’s arrival, I passed the time by listening to Ben Howard’s soothing guitar chords from my red and black Dr Dre, giant headphones, - much like Usain Bolt prepares for the 100m. There were two successive tracks that had got under my skin in the run up: ‘The Fear’, followed by ‘Keep your head up’. I loved how the guitar would crescendo after the chorus and Ben's rasping voice and the drum beat would rouse me into a faster paced run on a jog. But more than that, the lyrics resonated with my inner thoughts:
‘I’ve been worried…. that my time is a little unclear..
I’ve been worried…… that I’m losing the ones I held dear,
I’ve been worried…. that we all live our lives, in the confines of fear'
And then just as those words would begin to get into my psyche, the guitar strumming of the next song soothes and transports me to the surf where Ben describes his soul searching. And if I was running fast with the pheromones pumping, from the end of ‘The Fear’ then I’d get the heart rate back down again dropping to a happy gentle jog to these lyrics:
'With the strength of a turnin' tide
Oh the wind's so soft on my skin,
The sun so hard upon my side.
Oh lookin' out at this happiness,
I search for between the sheets
Oh feelin' blind and realise,
That All I was searchin' for was me.
Keep your head up, keep your heart strong.
No, no, no, no.
Keep your mind set, keep your hair long.
keep your head up, keep your heart strong.
keep your mind set in your ways, keep your heart strong.
I saw a friend of mine the other day,
And he told me that my eyes were gleamin'.
Oh I said I had been away, and he knew,
Oh he knew the depths I was meanin'.
And it felt so good to see his face,
Or the comfort invested in my soul.
Oh to feel the warmth of a smile,
When he said "I'm happy to have you home.
Ooh I'm happy to have you home.
Keep your head up, keep you heart strong.
Keep your mind set in your ways,
Keep your heart strong.'
As I listened to those words a video arrived from Alex on my iPhone of Barnaby dancing in front of Harriet in her high chair, both were in fits of giggles, a messy breakfast scene played out behind them as Alex joined them, laughing back into the camera.
I smiled at this happy gaggle before letting the first tear since Monday and the last tear until church on Christmas day, roll down my cheek. I reached for the sealed letter that Alex had given to me the night before, the one that I’d resisted opening in the middle of the night. On the front he suggested that I might want to save it until after the op. Wondering if that would be possible, I opened it tentatively, read the first line and feeling more tears arriving, I put it back into the envelope to carry out the instruction as Alex intended. I didn’t want to get emotional again.
So when Alex arrived in his cycling gear, we kept our last exchange upbeat. In fact before we’d managed to get into any detail, the porter team arrived to take me down to the anaesthetist' room, connected to theatre by a sliding door.
It was 11.30am, and I felt Alex’s warm lips on mine as he sneaked in a quick kiss, before looking back at him from the moving bed. I called out a funny cheesy quote that Coach Taylor gets his American Football school team to say before a match in Friday Night Lights (our favourite TV series).
We both smiled and I sat up on my elbows as the porter team raced me towards the lifts. Ironically, it felt like my Birthday or Christmas Day or something, I felt excited that things were finally in motion, and as the team around me shared a private joke, I closed my eyes and prayed that I would be OK.
*******************************
Next up ‘ICU (Intensive Care Unit), including guest blog from my Dad, and the CT scan image of the aneurysm.
Wednesday, 15 January 2014
Pre Op - Wednesday
The team on Cheselden ward would later confirm that Wednesday December 11th was their busiest day of the year.
If there was a rule for minimum distance between beds on a ward, like there is a rule for gaps between seat rows on airplanes, then I’m sure Cheselden would be contravening that rule on that day. Likewise if there was a rule for minimum hours of sleep full rest for the surgeons in between 12 hour shifts in theatre, as there is for pilots after 9 hours of flight, then I don’t think they would be compliant either. I remember thinking that if Lowry had painted a scene of a hospital ward; he might have chosen this vision of dense humanity laid out on a grey backdrop. It wasn’t chaos per se, as the nurse in charge, marked out by the red piping on her grey uniform, somehow just about kept everybody and everything in check. And by 6.30pm, when there still wasn’t a bed available for me, and when my Surgeon, the ‘Prof’ strode past us in the corridor in his scrubs looking burned out, responding to my query with the palm of his huge hand, clarifying: “Not now, I’ve just come out of theatre, we’ll speak tomorrow Sophie “.
Well, on the day before my operation, the omens didn’t feel good.
I played back the texts in my head, like the one that my boss had sent that morning:
“Good Luck, I’ve just got a feeling that everything is going to go really well.”
My only saving grace was when the Prof also raised his giant hand to the Jewish looking Doctor when he motioned to go for a pint and he responded: “Not tonight mate, I’m knackered!”
“Thank God!” I muttered to Alex, aware that it was Christmas party season.
********************************
Hospitals evoke different memories for different people. For me, when I enter a hospital, I think of Christmas day.
Christmas day for the Evans kids growing up meant digging into our stockings in a race to grab the chocolate coins and tangerine, before dressing neatly and bundling into Dad’s brown Allegro to be driven to the Royal Liverpool hospital in town, known simply to Scousers as ‘The Royal’.
After a row about who was old enough to get out of singing Away in A Manger at the hospital chapel (As the youngest, I never was), we’d stare out of the windows, watching excited kids in new Liverpool and Everton strips ride their spanking new bikes, or scooters of skateboards, or whatever the craze was that year. We’d always argue about why we were the only kids in Liverpool who had to wait until after lunch to open our presents (nearly 5pm); but for some reason we never dared question why we were obliged to shake the hands of every one of Dad’s patients, on 3 different wards, on 3 different floors, on Christmas morning.
It wouldn’t happen now. I mean I don’t think you would be allowed to get the Consultant’s children to dispense a shot of Sherry to elderly patients at 10am, much less get those same kids to guess the age of each patient. Jo and I would guess the age in our heads, and then take off 5 to 10 years before saying it out loud. Matt wouldn’t take any years off, and so more often than not, he would end up offending the patient.
“Well she did look like he was 81” Matt would say.
“Yeah, dirrr, but you don’t say that in case she’s not that old. That’s rude!” Jo would say knowingly, admonishing her little brother.
And if a patient raised their hand to turn down the shot of 40% proof alcohol, we’d join Dad in shaking our heads in disappointment. “Come on it’s Christmas day; it will do you some good, are you sure?” Dad would say.
It was an induction into hospital wards really – the sterile smells, the tubes, the kidney shaped dishes, the wee sacks, “that’s a catheter Sophie!”; the tilting beds, the transparent plastic cups, the green curtains, the high backed chairs, the stairwells and long endless corridors with double doors, oh, and all the old people looking ill as they waited for visiting hours.
The doctors tried to discharge as many patients as possible ahead of Christmas, so I was never struck by a sense of overcrowding, not like it hit me at St Georges on Wednesday morning some thirty years later. The one similarity was that it always took Dad ages to find a space in the car park at The Royal even though he had a staff badge.
********************************
Arriving at St Georges on Wednesday morning, Alex and Harriet would spend a good 45 minutes tailing people in the hope of poaching their space, whilst I raced ahead on foot. I would find Sam at the ward reception, stooping behind the classy SHO – Cordelia, who couldn’t have been more incongruous on this old school ward in her high heals and height of fashion outfit.
Sam thankfully had located my notes, and led me straight to the lab down the corridor whilst I estimated that I was 30 to 40 years younger than anyone else on the ward.
“Right, you need a couple of tests in the vascular lab first. When that’s finished, come back to reception and find me so we can get you ready for your CT scan which will be in the building next door.”
***********************************
I’d actually managed some sleep on Tuesday night, which I hadn’t expected, and I put it down to going to bed smiling: Earlier, as Alex and I were sitting down for dinner, and conversation had eluded us, my iPhone alerted me to an incoming email. It was from my colleague – the lovely Susannah Wood who is Marketing Director at Solarcentury - the brilliant Company that I've worked for over the last 10 years. The short email linked me to a video on YouTube entitled:
“A song for Sophie”.
So we fetched the iPad and propped it up in between our two plates to watch together. We saw in turn: the Chairman; the CEO; some clever editing, and most of my favourite colleagues staring back at the screen and mouthing the words to “You’ll never walk alone”. I’d rarely managed to get all of these people in a room together for an important meeting, because their diaries were always too busy. Yet here they were on YouTube, finding time for me, letting me know in an incredibly creative way, that they were thinking of me at a time I felt so distant on maternity leave. And it really made us both laugh and smile. That video banished the awkwardness from our last supper together at home, and would also make my wider family smile as they went to bed too: “You must be very well thought of Sophie!” my mum had said on the phone that night.
************************************************
I was relaxed and had some sleep under my belt when I called Cheselden ward on Wednesday morning to confirm they had a bed for me and that I should arrive at 2pm.
“Yes, absolutely, see you then”, someone had replied.
Thank goodness! I’d thought, I’m not sure what I’d have done if they couldn’t locate my name on a list.
I'd just confirmed to my parents that all was going to schedule as they set off from Liverpool to visit me, when a woman called Sam called to explain that it was crazy on the ward and they didn’t actually have a bed for me after all. She suggested getting a good night’s sleep at home, fasting from midnight and coming in at 7.30am on Thursday ahead of the surgery a few hours later.
“Buttttttt” I said. Buying some time to work out what my but was
“BUT.......what about all the scans that the Surgeon said I needed to have the day before?”
There was some checking on the other end of the line.
“What do you think you need?” Sam asked.
"Well the surgeon mentioned having another ultrasound and CT and some checks on my brain or something?"
“OK, the Duplex! “Right, well come in at 3pm then”
“Well are you sure?” I asked, I mean I think that’s what the surgeon mentioned, but presumably you have some notes?”
“Yes, I’m sure we’ll find them, see you at 3!” She responded, trying to hang up, but I interjected:
“So the surgery’s definitely still on for tomorrow?”
“Yep, you’re down to go in third into theatre, probably not until the afternoon.”
“THIRD!?...But the surgeon said the operation will take about 10 hours, surely I’d be scheduled first thing?”
“Err no, well, they might bring it forward, but it says you’re third here. I imagine 10 hours is worst case, it might not be that long. See you at 3!”
And she was gone.
I hung up and puffed my cheeks out, looking up at Alex as I relayed the message to him, frustrated, worried. I mean in my working world, I prefer to tackle all the hardest problems in the morning, when my brain is at its most alert, especially if I want to start and finish something in one go. I save up all the easy tasks and reactive working for about 3pm, when my concentration is wavering. So it worried me to think that I was third in line, for Prof Thompson’s ‘big one’, my big one come to that - recalling him saying -
“The operation might take ~ 10 hours. Well I’d say I’d do about one of these operations every 1 to 2 years, 10 in my career maybe, it’s incredibly rare!”
*********************************
The lab technician seemed quite young but she was clearly very competent. I lay on a bed, a bit like a Dentist’s chair, as she probed up and down the right side of my neck with the ultrasound equipment, taking various measurements. When she appeared to be finishing, I asked her what measurement she had recorded for the aneurysm diameter.
“2.2cm” she said.
“That’s interesting” I replied. “That’s very similar to the size the Neuro lab had returned in January, but my CT scan had it at 3.5cm in July. So I wasn’t sure which technique was more accurate, or whether the aneurysm had grown dramatically after pregnancy?"
She clearly explained the reason for the difference – the Ultrasound could only measure the lump in one plane across the neck, but the CT scan could measure the diameter in multi dimensional planes, and hence in terms of an accurate measurement for the largest diameter, unfortunately the CT scan was the reliable source. Given the cap for a ‘giant’ aneurysm range was defined as 2.5cm, this later measurement had been quite a shock.
“What are you doing next?” I asked as she pulled out more equipment.
Do you want the technical explanation?” She asked.
“Yes please, I like understanding the technicalities” I replied.
“Right, well I’m going to put these probes onto your temples and push quite hard. What we’re trying to do is to see whether we can get a signal through your skull to measure the flow of blood around your brain. Some peoples’ skulls are too thick and so this might not work, but if it’s not too thick, then we’ll be able to track the readings in theatre."
“So how do you use that info?” I queried
She explained that there was a circular network of blood vessels that provided blood to the brain as a back- up supply, in case one of the main arteries became blocked. This network, known apparently as ‘The Circle of Willis’ sounded like the equivalent of the thin tyre you have in the boot of your car, in case you get a puncture - Most of the time it will do the job if you drive a bit slower, but it’s just a temporary fix and you should get it changed as soon as you make it to a repair centre. Actually as the lab technician explained it, it sounded a little less reliable than the tyre in your boot, and that’s why they wanted to get some information about it in theatre if they could.
“So will you be in theatre tomorrow during my operation?”
I gathered that she would be, and her role would be to provide timely information to the Prof, once he had clamped my internal Carotid artery (ICA) down. Basically, she would be indicating how much time the surgeon had once he’d stopped the blood flow to the right side of my brain, to the effect of:
'Err, there’s not much flow, you need to hurry up NOW!', or
'Right take your time, we’ve got a nice steady flow here, the brain is being well fed, I’ll let you know if that changes'.
The Prof had kicked up quite a lot of fuss about having this instrumentation available to him in theatre with my health insurance company, as they had challenged why the operation had to take place at St Georges, and not one of their pre- approved private hospitals. So I was very relieved to hear that I had a nice thin skull, and the flow readings were loud and clear.
After the lab, I caught up with Alex and Harriet in the visitors room, before finding myself in the medicine store room where Cordelia the SHO volunteered to quickly put a cannula into my favoured vein (inside right elbow) so that the radiologist could later pump dye into my vascular network for the CT scan. As she concentrated, one of the Doctors came in and out with his hands on his head. “aghhhhhhh” he said, before spotting me there.
Sam’s instructions took me along one white corridor after another, punctuated by sets of large glass double doors. The scene of busy hospital workers and lost visitors in front of me went past my eyeline as if flicking between fast forward and pause, like Peter Gabriel’s Sledge Hammer video.
Recently, I’d been to a number of London hospitals, and each time I’d been struck by the corporate sponsored freshly painted corridors and brightly coloured framed prints adorning the walls, which I imagine, just subtly acted to lift the spirits of patients, staff and visitors alike.
Not so St James Wing at St George’s.
Weaving my way towards the CT unit, I noticed that nothing had been done with this building to lift the spirits at all.
I finally made it to a door covered in radioactive warning stickers, and realised that I was in the right place.
“Hi, I’ve come from Cheselden Ward for a CT scan, Sophie Orme?”
I was pleasantly surprised to find that Brenda the receptionist had my details and ushered me through to the waiting room. I soon realised that Brenda was a one woman band, performing the roles of receptionist, patient prep, radiologist, and patient supervision through various states of undress and dress afterwards (most of whom needed help). I was once again quite shocked by the intensity of people’s role in the NHS.
“They told us to prepare for the busiest winter” Brenda had told me ahead of my scan. “But It’s been like this since August! I don't think I'll make it to Christmas!”
She explained the scan procedure and told me to expect the nasty iron taste in my mouth once the dye was injected, and the intensive heat sensation, including the feeling that I’d wet myself, but the assurance that I wouldn’t. I knew all this from my previous scan, but I appreciated the warning. It is a horrible sensation actually – the heat! The sense that you are on fire, and that every droplet in your body is about to boil over; but I knew this time that it would be over very quickly, much like scanning your food items at a supermarket checkout. In contrast to the MRI, it held no fear or anxiety for me.
After the scan was finished, I returned to the ward, determined to drink pint after pint of water so that my kidneys could process all the dye in my system before the fasting deadline kicked in.
Back at Cheselden, I found that Harriet was beginning to query the quality of the playdate she’d been brought on. She had her Daddy, and a sick looking elderly man for company, together with a blaring quiz show from the large TV opposite, it was hosted by Alexander Armstrong - the guy who had been sitting at the table next to us at a recent wedding. Alex had gathered that the poor old man was just getting to the end of a second day in the waiting room as he waited for a spare bed. His daughter would pick him up at the end of her working day and bring him back again tomorrow to try out his luck once more.
I took Harriet on a tour of the ward, introducing her to the staff, hoping to endear them further to me, and trying to get a smile out of line of patient beds. “I’ll come over in 10 minutes”, one of the doctors motioned to us:
“Right, we’ve got everything we need from you today. I’ve just been told that we’ve got a discharge coming up, and if you want it, they should be able to get a bed ready for you at some point tonight. But if you live nearby, I’d get a good night sleep at home if I were you, and come back first thing, it’s pretty noisy here.”
“Thanks”, I said, but I’d like to take the bed if that's ok”
The Doctor and Alex both looked at me, slightly perplexed by my decision.
I turned back to Alex and said “I’ve said my goodbyes now, I can’t face going through them again. I just want some solitude”
Alex understood, and realising the limitations of the visitor waiting room, he dropped me off at The Crooked Billet on Wimbledon Common to have dinner with my parents and my brother Matt who had intended to visit me in hospital post work. There I had sat letting the hectic Evans conversation fly past me, too tired to engage. My only contribution was to ask the waitress to put more logs on the fire which nobody else seemed bothered about. When I went to the toilet I realised I was shivering involuntarily, which probably had more to do with the needle and procedures I’d had that afternoon, rather than the draft coming from the window. I called Alex to ask him to come and pick me up. I was done. I wanted to go back to hospital now and I couldn’t force any more food down.
The night shift had brought some quiet and order to Cheselden Ward on our return, and either it was my private patient status or the gods that were finally shining on me. For not only was a bed available when we got back at 10pm, but it is was a bed in a private side room, which we hadn’t realised existed earlier, complete with an en suite and a large window from which I could see a London rooftop nightscape. I blue tacked 3 large photos on the wall at the end of my bed, and unpacked my stuff, before Alex wrapped me up in a goodnight kiss. As my head hit the pillow with my Bridget Jones Audiobook ringing in my earphones, I didn’t expect to find any sleep at all. But I must have dropped off for a few hours at least because I had a 9 chapter gap in the book when I woke up at 3am.
Those three hours or so would be the last proper sleep I would get until Saturday night. And when Professor Thompson came to speak to me at 7.30am the next morning to reiterate the two groups of risks and to introduce some previously unmentioned ones. I wasn’t unnerved this time and I knew I was ready for the operation. I felt completely calm and at peace.
*******************************
If there was a rule for minimum distance between beds on a ward, like there is a rule for gaps between seat rows on airplanes, then I’m sure Cheselden would be contravening that rule on that day. Likewise if there was a rule for minimum hours of sleep full rest for the surgeons in between 12 hour shifts in theatre, as there is for pilots after 9 hours of flight, then I don’t think they would be compliant either. I remember thinking that if Lowry had painted a scene of a hospital ward; he might have chosen this vision of dense humanity laid out on a grey backdrop. It wasn’t chaos per se, as the nurse in charge, marked out by the red piping on her grey uniform, somehow just about kept everybody and everything in check. And by 6.30pm, when there still wasn’t a bed available for me, and when my Surgeon, the ‘Prof’ strode past us in the corridor in his scrubs looking burned out, responding to my query with the palm of his huge hand, clarifying: “Not now, I’ve just come out of theatre, we’ll speak tomorrow Sophie “.
Well, on the day before my operation, the omens didn’t feel good.
I played back the texts in my head, like the one that my boss had sent that morning:
“Good Luck, I’ve just got a feeling that everything is going to go really well.”
My only saving grace was when the Prof also raised his giant hand to the Jewish looking Doctor when he motioned to go for a pint and he responded: “Not tonight mate, I’m knackered!”
“Thank God!” I muttered to Alex, aware that it was Christmas party season.
********************************
Hospitals evoke different memories for different people. For me, when I enter a hospital, I think of Christmas day.
Christmas day for the Evans kids growing up meant digging into our stockings in a race to grab the chocolate coins and tangerine, before dressing neatly and bundling into Dad’s brown Allegro to be driven to the Royal Liverpool hospital in town, known simply to Scousers as ‘The Royal’.
After a row about who was old enough to get out of singing Away in A Manger at the hospital chapel (As the youngest, I never was), we’d stare out of the windows, watching excited kids in new Liverpool and Everton strips ride their spanking new bikes, or scooters of skateboards, or whatever the craze was that year. We’d always argue about why we were the only kids in Liverpool who had to wait until after lunch to open our presents (nearly 5pm); but for some reason we never dared question why we were obliged to shake the hands of every one of Dad’s patients, on 3 different wards, on 3 different floors, on Christmas morning.
It wouldn’t happen now. I mean I don’t think you would be allowed to get the Consultant’s children to dispense a shot of Sherry to elderly patients at 10am, much less get those same kids to guess the age of each patient. Jo and I would guess the age in our heads, and then take off 5 to 10 years before saying it out loud. Matt wouldn’t take any years off, and so more often than not, he would end up offending the patient.
“Well she did look like he was 81” Matt would say.
“Yeah, dirrr, but you don’t say that in case she’s not that old. That’s rude!” Jo would say knowingly, admonishing her little brother.
And if a patient raised their hand to turn down the shot of 40% proof alcohol, we’d join Dad in shaking our heads in disappointment. “Come on it’s Christmas day; it will do you some good, are you sure?” Dad would say.
It was an induction into hospital wards really – the sterile smells, the tubes, the kidney shaped dishes, the wee sacks, “that’s a catheter Sophie!”; the tilting beds, the transparent plastic cups, the green curtains, the high backed chairs, the stairwells and long endless corridors with double doors, oh, and all the old people looking ill as they waited for visiting hours.
The doctors tried to discharge as many patients as possible ahead of Christmas, so I was never struck by a sense of overcrowding, not like it hit me at St Georges on Wednesday morning some thirty years later. The one similarity was that it always took Dad ages to find a space in the car park at The Royal even though he had a staff badge.
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Arriving at St Georges on Wednesday morning, Alex and Harriet would spend a good 45 minutes tailing people in the hope of poaching their space, whilst I raced ahead on foot. I would find Sam at the ward reception, stooping behind the classy SHO – Cordelia, who couldn’t have been more incongruous on this old school ward in her high heals and height of fashion outfit.
Sam thankfully had located my notes, and led me straight to the lab down the corridor whilst I estimated that I was 30 to 40 years younger than anyone else on the ward.
“Right, you need a couple of tests in the vascular lab first. When that’s finished, come back to reception and find me so we can get you ready for your CT scan which will be in the building next door.”
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I’d actually managed some sleep on Tuesday night, which I hadn’t expected, and I put it down to going to bed smiling: Earlier, as Alex and I were sitting down for dinner, and conversation had eluded us, my iPhone alerted me to an incoming email. It was from my colleague – the lovely Susannah Wood who is Marketing Director at Solarcentury - the brilliant Company that I've worked for over the last 10 years. The short email linked me to a video on YouTube entitled:
“A song for Sophie”.
So we fetched the iPad and propped it up in between our two plates to watch together. We saw in turn: the Chairman; the CEO; some clever editing, and most of my favourite colleagues staring back at the screen and mouthing the words to “You’ll never walk alone”. I’d rarely managed to get all of these people in a room together for an important meeting, because their diaries were always too busy. Yet here they were on YouTube, finding time for me, letting me know in an incredibly creative way, that they were thinking of me at a time I felt so distant on maternity leave. And it really made us both laugh and smile. That video banished the awkwardness from our last supper together at home, and would also make my wider family smile as they went to bed too: “You must be very well thought of Sophie!” my mum had said on the phone that night.
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I was relaxed and had some sleep under my belt when I called Cheselden ward on Wednesday morning to confirm they had a bed for me and that I should arrive at 2pm.
“Yes, absolutely, see you then”, someone had replied.
Thank goodness! I’d thought, I’m not sure what I’d have done if they couldn’t locate my name on a list.
I'd just confirmed to my parents that all was going to schedule as they set off from Liverpool to visit me, when a woman called Sam called to explain that it was crazy on the ward and they didn’t actually have a bed for me after all. She suggested getting a good night’s sleep at home, fasting from midnight and coming in at 7.30am on Thursday ahead of the surgery a few hours later.
“Buttttttt” I said. Buying some time to work out what my but was
“BUT.......what about all the scans that the Surgeon said I needed to have the day before?”
There was some checking on the other end of the line.
“What do you think you need?” Sam asked.
"Well the surgeon mentioned having another ultrasound and CT and some checks on my brain or something?"
“OK, the Duplex! “Right, well come in at 3pm then”
“Well are you sure?” I asked, I mean I think that’s what the surgeon mentioned, but presumably you have some notes?”
“Yes, I’m sure we’ll find them, see you at 3!” She responded, trying to hang up, but I interjected:
“So the surgery’s definitely still on for tomorrow?”
“Yep, you’re down to go in third into theatre, probably not until the afternoon.”
“THIRD!?...But the surgeon said the operation will take about 10 hours, surely I’d be scheduled first thing?”
“Err no, well, they might bring it forward, but it says you’re third here. I imagine 10 hours is worst case, it might not be that long. See you at 3!”
And she was gone.
I hung up and puffed my cheeks out, looking up at Alex as I relayed the message to him, frustrated, worried. I mean in my working world, I prefer to tackle all the hardest problems in the morning, when my brain is at its most alert, especially if I want to start and finish something in one go. I save up all the easy tasks and reactive working for about 3pm, when my concentration is wavering. So it worried me to think that I was third in line, for Prof Thompson’s ‘big one’, my big one come to that - recalling him saying -
“The operation might take ~ 10 hours. Well I’d say I’d do about one of these operations every 1 to 2 years, 10 in my career maybe, it’s incredibly rare!”
*********************************
The lab technician seemed quite young but she was clearly very competent. I lay on a bed, a bit like a Dentist’s chair, as she probed up and down the right side of my neck with the ultrasound equipment, taking various measurements. When she appeared to be finishing, I asked her what measurement she had recorded for the aneurysm diameter.
“2.2cm” she said.
“That’s interesting” I replied. “That’s very similar to the size the Neuro lab had returned in January, but my CT scan had it at 3.5cm in July. So I wasn’t sure which technique was more accurate, or whether the aneurysm had grown dramatically after pregnancy?"
She clearly explained the reason for the difference – the Ultrasound could only measure the lump in one plane across the neck, but the CT scan could measure the diameter in multi dimensional planes, and hence in terms of an accurate measurement for the largest diameter, unfortunately the CT scan was the reliable source. Given the cap for a ‘giant’ aneurysm range was defined as 2.5cm, this later measurement had been quite a shock.
“What are you doing next?” I asked as she pulled out more equipment.
Do you want the technical explanation?” She asked.
“Yes please, I like understanding the technicalities” I replied.
“Right, well I’m going to put these probes onto your temples and push quite hard. What we’re trying to do is to see whether we can get a signal through your skull to measure the flow of blood around your brain. Some peoples’ skulls are too thick and so this might not work, but if it’s not too thick, then we’ll be able to track the readings in theatre."
“So how do you use that info?” I queried
She explained that there was a circular network of blood vessels that provided blood to the brain as a back- up supply, in case one of the main arteries became blocked. This network, known apparently as ‘The Circle of Willis’ sounded like the equivalent of the thin tyre you have in the boot of your car, in case you get a puncture - Most of the time it will do the job if you drive a bit slower, but it’s just a temporary fix and you should get it changed as soon as you make it to a repair centre. Actually as the lab technician explained it, it sounded a little less reliable than the tyre in your boot, and that’s why they wanted to get some information about it in theatre if they could.
“So will you be in theatre tomorrow during my operation?”
I gathered that she would be, and her role would be to provide timely information to the Prof, once he had clamped my internal Carotid artery (ICA) down. Basically, she would be indicating how much time the surgeon had once he’d stopped the blood flow to the right side of my brain, to the effect of:
'Err, there’s not much flow, you need to hurry up NOW!', or
'Right take your time, we’ve got a nice steady flow here, the brain is being well fed, I’ll let you know if that changes'.
The Prof had kicked up quite a lot of fuss about having this instrumentation available to him in theatre with my health insurance company, as they had challenged why the operation had to take place at St Georges, and not one of their pre- approved private hospitals. So I was very relieved to hear that I had a nice thin skull, and the flow readings were loud and clear.
After the lab, I caught up with Alex and Harriet in the visitors room, before finding myself in the medicine store room where Cordelia the SHO volunteered to quickly put a cannula into my favoured vein (inside right elbow) so that the radiologist could later pump dye into my vascular network for the CT scan. As she concentrated, one of the Doctors came in and out with his hands on his head. “aghhhhhhh” he said, before spotting me there.
Sam’s instructions took me along one white corridor after another, punctuated by sets of large glass double doors. The scene of busy hospital workers and lost visitors in front of me went past my eyeline as if flicking between fast forward and pause, like Peter Gabriel’s Sledge Hammer video.
Recently, I’d been to a number of London hospitals, and each time I’d been struck by the corporate sponsored freshly painted corridors and brightly coloured framed prints adorning the walls, which I imagine, just subtly acted to lift the spirits of patients, staff and visitors alike.
Not so St James Wing at St George’s.
Weaving my way towards the CT unit, I noticed that nothing had been done with this building to lift the spirits at all.
I finally made it to a door covered in radioactive warning stickers, and realised that I was in the right place.
“Hi, I’ve come from Cheselden Ward for a CT scan, Sophie Orme?”
I was pleasantly surprised to find that Brenda the receptionist had my details and ushered me through to the waiting room. I soon realised that Brenda was a one woman band, performing the roles of receptionist, patient prep, radiologist, and patient supervision through various states of undress and dress afterwards (most of whom needed help). I was once again quite shocked by the intensity of people’s role in the NHS.
“They told us to prepare for the busiest winter” Brenda had told me ahead of my scan. “But It’s been like this since August! I don't think I'll make it to Christmas!”
She explained the scan procedure and told me to expect the nasty iron taste in my mouth once the dye was injected, and the intensive heat sensation, including the feeling that I’d wet myself, but the assurance that I wouldn’t. I knew all this from my previous scan, but I appreciated the warning. It is a horrible sensation actually – the heat! The sense that you are on fire, and that every droplet in your body is about to boil over; but I knew this time that it would be over very quickly, much like scanning your food items at a supermarket checkout. In contrast to the MRI, it held no fear or anxiety for me.
After the scan was finished, I returned to the ward, determined to drink pint after pint of water so that my kidneys could process all the dye in my system before the fasting deadline kicked in.
Back at Cheselden, I found that Harriet was beginning to query the quality of the playdate she’d been brought on. She had her Daddy, and a sick looking elderly man for company, together with a blaring quiz show from the large TV opposite, it was hosted by Alexander Armstrong - the guy who had been sitting at the table next to us at a recent wedding. Alex had gathered that the poor old man was just getting to the end of a second day in the waiting room as he waited for a spare bed. His daughter would pick him up at the end of her working day and bring him back again tomorrow to try out his luck once more.
I took Harriet on a tour of the ward, introducing her to the staff, hoping to endear them further to me, and trying to get a smile out of line of patient beds. “I’ll come over in 10 minutes”, one of the doctors motioned to us:
“Right, we’ve got everything we need from you today. I’ve just been told that we’ve got a discharge coming up, and if you want it, they should be able to get a bed ready for you at some point tonight. But if you live nearby, I’d get a good night sleep at home if I were you, and come back first thing, it’s pretty noisy here.”
“Thanks”, I said, but I’d like to take the bed if that's ok”
The Doctor and Alex both looked at me, slightly perplexed by my decision.
I turned back to Alex and said “I’ve said my goodbyes now, I can’t face going through them again. I just want some solitude”
Alex understood, and realising the limitations of the visitor waiting room, he dropped me off at The Crooked Billet on Wimbledon Common to have dinner with my parents and my brother Matt who had intended to visit me in hospital post work. There I had sat letting the hectic Evans conversation fly past me, too tired to engage. My only contribution was to ask the waitress to put more logs on the fire which nobody else seemed bothered about. When I went to the toilet I realised I was shivering involuntarily, which probably had more to do with the needle and procedures I’d had that afternoon, rather than the draft coming from the window. I called Alex to ask him to come and pick me up. I was done. I wanted to go back to hospital now and I couldn’t force any more food down.
The night shift had brought some quiet and order to Cheselden Ward on our return, and either it was my private patient status or the gods that were finally shining on me. For not only was a bed available when we got back at 10pm, but it is was a bed in a private side room, which we hadn’t realised existed earlier, complete with an en suite and a large window from which I could see a London rooftop nightscape. I blue tacked 3 large photos on the wall at the end of my bed, and unpacked my stuff, before Alex wrapped me up in a goodnight kiss. As my head hit the pillow with my Bridget Jones Audiobook ringing in my earphones, I didn’t expect to find any sleep at all. But I must have dropped off for a few hours at least because I had a 9 chapter gap in the book when I woke up at 3am.
Those three hours or so would be the last proper sleep I would get until Saturday night. And when Professor Thompson came to speak to me at 7.30am the next morning to reiterate the two groups of risks and to introduce some previously unmentioned ones. I wasn’t unnerved this time and I knew I was ready for the operation. I felt completely calm and at peace.
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Wednesday, 8 January 2014
The Run In
“Mummy, why is your face red?”
“Because I’m cross, I’m cross that your lesson got cancelled.”
“Mummy I don’t think you’re cross, I think you’re sad, you look really sad mummy!”
And I looked up at the wing mirror to see Barnaby’s concerned face in the back seat. Through tears now cooling my inflamed face, I turned to him with raised eye brows, and a defeated smile.
“Barnes it’s OK, it’s going to be fine. I’ve got a plan. We’re going to zoom back home, meet Aunty Jo-Jo, hand over Harriet, get mummy’s swimmers and then I’m going to race you to the leisure centre. Much more fun swimming with mummy anyway”
“I think I’ll win mummy!”
And my angry sadness receded as I made the short drive home from the Roehampton Bank of England Sports Club for the last time.
************************************************
It is Monday 9th December 2013, and my last day of quality time with Barnaby before the op. I’ve been thinking about this day for a long time, wanting it to be perfect, filled with the simple happy things that we like to do together when it’s just Barnaby, Harriet and I.
Throughout the year, I couldn’t really embrace the notion that I might die during the operation or let myself think about how Alex might cope alone to bring up the kids. On a practical level, I had thought about re-drafting the generic Will that we had pulled together a few years earlier, and I had also thought about writing letters to Alex, Barnaby and Harriet to hand to my brother for safe keeping – in the unspoken event….but that whole sequence of activities felt too emotionally destructive and defeatist. Pragmatic though those thoughts were, I knew it would be too upsetting to write and hand the letters over for both myself and my brother receiving them. So I’d decided to bury that scenario, with the conclusion that I really couldn’t prepare for that outcome, except to be further emboldened with a Carpe Diem attitude and make precious lasting memories for us as a family. For a few months at least, this meant upping my game a little as a wife and a mum: Turning my iPhone off on Mondays to fully focus on play time with Barnaby and Harriet, and biting my lip if a silly every day irritation came up. Actually, I think I’d made a pretty good fist of it, but looking back I must have built this last Monday up too much in my mind.
***********************************************
The weekend had gone very well, I had wanted to keep busy and I certainly achieved that. On Saturday night I had been out at a girls’ drinks gathering ahead of the tennis club Christmas party. It was great actually, the room had been filled with single girls, steadily getting drunk on champagne, exchanging very amusing calamitous online dating stories and I felt relaxed knowing that nobody knew of my upcoming operation. It had been good to keep it away from this sparkling room of laughter and tipsy high heels, and to accept each refilled glass of champagne; presiding as the wise married one, regaling stories of a wilder past, asking innocent question after question about which website, which rule, which guy. At the pre drinks and briefly later at the Christmas party I was glowing, feeling attractive, funny and almost care free. But I checked myself and went home shortly after getting to the club, conscious of the week ahead, and wanting to snuggle up with Alex to watch Match of the Day.
Sunday had been glorious: Slightly frosty but with the sun beaming through, casting brilliant winter light on to the orange and red hues of Richmond Park and moistening the ground underfoot. We got Barnaby’s red bike out of the car, bundled Harriet into her buggy and strode off happily towards a lake; Barnaby’s muscular calves were popping out of his short trousers as he pushed his balance bike with dogged determination up a small hill.
“What about that log there? “ Alex suggested
I called over to Barnaby. “Stop Barnster, come over here and sit with me on this log, let’s just take a little rest, I’ve got something to tell you.”
Barnaby came bounding over, wondering if there was a present or holiday coming up that I needed to sit him down to tell him about. Alex picked up Harriet and walked away to give us some space.
My head was still a little dusty from the night before, but after the line about mummy going to hospital so that the Doctors could fix her headaches, I’d prepared a few phrases in my mind. I was armed with a rally of “but’s and ands” – “BUT Granny’s going to be here on Wednesday, so that’s fun, AND daddy’s going to look after you, he won’t be going to work for a while, AND you can help Daddy with Harriet because you’re really good at that. AND I need you to be strong and make everybody giggle."
He’d gone quiet in a pale concentrated way as I spoke, and he kept repeating a short clipped ‘Yus’ when I got to each comma. I thought I’d detected his eye lashes glistening over with a hint of a tear and I was braced for the lower lip to wobble. But he took a pause, and then bounced back up, grabbed his bike and returned to the continuity of his racing from one tree to the next.
Alex came back, stooped and extended a warm hand to pick me up with.
“I think he understood what I was saying”, I said. “At least we’ve laid down a marker anyway; I’ll bring it up again tomorrow.”
I felt quite relieved, and we had a delicious lunch at Petersham Nurseries café just outside the park, before returning home to an ever filling house to share a great big vat of mulled wine for our “very casual really, just pop in for mulled wine, bring the kids, but maybe don’t stay too long” Christmas drinks do. Despite later finding that Barnaby’s room had been turned completely upside down with his side party of toddler rabble, and half the kids did end up staying for tea, it had felt good to make the house all Christmassy and fill it with friends and happy smells and sounds.
*****************************************
Monday started pretty well – a positive weigh-in for Harriet for which I could handover a mark on a graph to Alex in the red book, then a handsome hair-cut for Barnaby, ensuring they kept a few surfing curls to lap the tops of his ears; a lollypop, a quick whizz down the orange helter skelter slide by the river, and then on to Carluccio’s by Putney Bridge, my banker for a convivial lunch with Barnaby. Awaiting his meat balls, Barnaby looked up and said:
“Mummy, I don’t like you!”
I gave Barnaby a quizzical eyeball back.
“Barnaby, you don’t mean that, come on, you love your mummy”
He seemed distracted for a moment, thinking, contemplating what to do or say next, and then he said:
“Mummy, stay there, I’m coming across” and he jumped up, came over to my seat and gave me the tightest, longest hug he’d ever given me. “That hug’s for when you’re in hospital mummy”. Then he skipped back to his seat, smiled at me and said “I love you mummy”.
I was bowled over.
And the emotional valve that I’d try to keep shut for so long opened just a little as I tried to hide behind the breadsticks the shield a few tracks of tears that were escaping down the side of my cheeks, before thanking Barnaby very much.
After lunch, we went home for some TV downtime to regroup before Barnaby’s last swimming lesson at the club. On the way home, I’d picked up a bloody irritating email from the sports club’s membership secretary on my iPhone. I’d scanned it at the same time as pushing the pram, pulling faces at Harriet and coercing Barnaby along the road: The week before, the same lady (I’m guessing she is without children) had sent us a fairly aggressive email pointing out that we’d just finished our 3 month membership trial, but she’d noted that Barnaby had attended a swimming lesson one day after the month end. Should we wish him to attend his next and final swimming lesson then we’d need to pay the £920 joining fee, and a quarterly membership fee.
Are you serious? I’d asked Alex.
“Let’s just leave it”, Alex said: “he’s had a good run, he won’t notice if we stop there”.
But I knew he would notice, and Alex hadn’t been taking Barnaby to his lesson each week, and seen how this little ball of determination kept facing up to each fear that he had in the pool, then bubbling over with self-pride and looking up to see my reaction each time he conquered the challenge that was set in front of him. Or how, if he’d come up short, it would build up inside of him during the week, and he’d sort of practise in the bath and tell me what he was going to do the next week in his lesson. Nor had Alex been there last week to witness Barnaby swim unaided for the first time, dragging his little body to Edward the teacher who had backed up some 10m away from him, whilst I danced a jig with Harriet in the balcony above, thumbs up each time he looked up, pride engulfing me.
“We’ve got just one more lesson with Edward, Mummy, I’m going to swim underwater next week and do all the hoops at the deep end. Then I’ll be able to swim with you and daddy and I’ll know everything I need to know!”
I’d paid in full for the bloody swimming course anyway – above market rate in addition to the membership fee. Why should we walk away from the last lesson? And the tiger mother in me had come to the fore, determined for Barnaby to have his last swimming lesson and for me & Harriet to be there with him.
So I’d written a rather long winded reply querying why we needed to stop ahead of the last lesson when I’d paid in full. I described how well the lessons had gone and the joy in watching Barnaby swim unaided and I attempted to explain why the last lesson meant a great deal to me – My last day of quality time with my son ahead of going into hospital on the Wednesday for major surgery. I also explained that we were considering the full membership but needed to pause until after the op. I ended with a suggestion that unless I heard to the contrary, I would go ahead with the last lesson, and get a friend at the club to sign Barnaby and I in as guests.
She’d sat on that email for a week and waited to reply until just a few hours before the lesson when I of course now had my hands full with a screaming Harriet (Barnaby had woken her up with a bang on her head so he could sing to her as we left Carluccios), and a tiring Barnaby who’d just had an ice cream sugar hit.
The first paragraph in the email triggered me to the point where I had to stop reading it and bury my phone in my pocket. Apparently we could pay a month’s pro rata membership to attend this one lesson, or she could discount the joining fee by 20% if Alex could show proof that he was acting as a single parent and I was genuinely to be incapacitated. “You’ll understand that the proof is needed for auditing purposes” she’d clarified.
I was furious. Well, I guess that’s some consolation for Alex I thought, 20 bloody percent off the joining fee if he loses the mother of his kids. Wow! Tension built up in the back of my head, the start of the inevitable blinding headache that always follows tears and tension. I didn't get to the end of the email unfortunately. Not until after the event anyway.
We got home, put on the TV, and I threw across some alternative suggestions to Barnaby in as upbeat a tone as I could muster:
“It’s such a lovely day, let’s go to the duck pond in Barnes and we’ll do races around the triangle track on your bike.” Pause. “Or we could wait for Jo-Jo to arrive at 4, then I could take you to the leisure centre and we could swim together, that would be much more fun, wouldn’t it? Barnaby?”
But on each suggestion I got a dead pan look - “No mummy, I need to have my last lesson with Edward. Let’s swim together later in the week, shall we?
“OK” I said jollily, resigning myself to the extortionate supplementary ‘pro rata’ fee.
I called the club swimming pool office via reception to check that Edward was still scheduled for our 3.30pm lesson, and they said that he was, so I thought we’d either go to reception before or after the lesson depending on timing to pay the extra charge.
At 3.29pm, I was sitting pool side bare foot in the white plastic chair that Barnaby had brought for me and Harriet. We were positioned next to the shallow end and directly opposite the pool office window at the other end of the pool where we could also see the big white clock. Barnaby was pacing from one foot to the other and his bloated meatball and strawberry ice cream tum rested above his bright red surf instructor swimming shorts.
“Where’s Edward?” Barnaby asked
“It’s not quite 3.30 yet” I responded, nervously, worried. “Let’s wait until the big hand gets to 3.31 and then we’ll go and ask where he is.
“That hand mummy?” Barnaby pointed.
“Yes, the big one, there” I said.
We diligently waited in silence whilst the big hand made it around to the agreed point and then I got up, feeling sick, and holding Harriet with one arm in between her legs, and the other hand outstretched to hold Barnaby’s, we walked the length of the 20m pool to make the doomed enquiry. A haggle of nervous looking instructors and lifeguards busied themselves, none of them wishing to return my eye contact. The youngest guy stepped out.
“Hi, is Edward on his way? My son Barnaby was due to have his last lesson at 3.30”
“I’ll just call him up and check”.
I let go of Barnaby’s hand whilst we waited and told him to stand back from the pool, just as the first tears started to roll down my hot cheek as I made out the gist of the conversation playing out on the phone. Finally he turned back to face me
“Sorry, Edward says that he was told not to come to the lesson, that he’d just received an email to say it had been cancelled. He was told that you hadn’t paid your membership fees.”
“Really?” I replied, tears now cascading down my face which was contorting into a red blotchy mess, at the same time, hyper aware of Barnaby still waiting hopefully behind me.
“Nice of somebody to tell us! It’s his last lesson for God sake, I paid for it!”
“I’m really, sorry, I’m just…”
“I know, I know, it’s not your fault I said, it’s just…well it’s really bloody sad that my son can’t finish his course."
And as my lips moved, I dropped to the tiled floor onto one knee, extending the tips of my right fingers and steadying Harriet into an upright position. I desperately tried to hold the next wave of sobs back, to not cry out in this echoing space, but it was too late, the valve had fully opened. Why now? Why in front of Barnaby on our last day together. Christ, I’d held it together for so bloody long, a year almost, but now on the one day I’d tried to choreograph, I was losing it, and I knew it wasn’t all about the swimming lesson, it was so much more than that and I also knew this particular situation was mostly my own fault.but it didn’t stop the anger building up inside like a furnace, and the desire to hit out at someone. It was humiliating, but at that precise moment, I didn’t give a shit about how I looked to the young life guards in their red shorts, how OTT they must had found my reaction. I only cared about dealing with Barnaby. What to say next? Aware of him still waiting just behind me, still waiting for his despairing mummy to turn around and face him with her screwed up red face and crushed expression.
“Barnes, Edward’s not coming” I said, turning around, still crouched on the floor.
“The lesson’s been cancelled…… it’s, well it’s partly mummy’s fault I’m afraid, but…. it doesn’t matter, because we’re going to head back to Putney, see Aunty Jo-Jo and go swimming just the 2 of us……..I’m very sorry, but let’s go and get changed, let’s do it really quickly so we’ve got more time to swim together. Come on give me a little hug”
And Barnaby looked at my fire engine red face and then back at the pool and said:
“No!”
“Sorry Barnes, I really am” I said reaching for his hand and pulling him back towards the shallow end and the changing room. “He’s just not here, there’s nothing we can do, he’s not coming.“
He resisted a little, but somehow I got him back to the changing rooms.
“Right let’s get your clothes back on, I’ll put Harriet down and help you take your swimmers off”
“No mummy, I’m not taking my swimmers off”
Shit, I thought, not wanting to start a physical battle with him and trigger a tantrum, and at the same time catching the horrendous state of my face in the mirror.
“Well ok” I said, “stay in your shorts, we’ll just put your shoes and hoody on.” Never mind that it was winter outside.
He seemed much happier with this, so we made progress and finally we were able to leave the pool area.
“Barnaby, I just need to speak to somebody at reception” I said, unsure if I was really going to turn right towards reception or left towards the car, and not thinking through my next move.I turned right, walked to the desk, holding both children, making no attempt to wipe my nose or reassemble my blotchy red face.
“Is the membership secretary here?” I asked the blond 50 something receptionist. “No, I’m afraid she left at 3pm, Can I take a message?” She asked with a concerned look.
“Er yes, can you say that Sophie Orme was here, and that I was very upset that she cancelled my son’s last swimming lesson.“
“Right, gosh”, she said scribbling my name down and looking back up, but I’d already turned away, rushing Barnaby to the car, where he would correctly identify why I had a red face. Rushing to put this awful episode behind us and get on with making it right, as my headache started to close in and wrap around my forehead.
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My poor sister had just travelled to Putney from Liverpool, in a last minute impulsive decision to see her little sister one more time before the operation. Given the emotion she felt, she might have expected a warmer welcome when she arrived, but instead I just said:
“Hi Jo, great to see you, Harriet’s asleep, can you feed her when she wakes up? I forgot earlier! Barnaby and I are just off to the leisure centre for a swim.“
And that was it, no instructions re milk feed, no thank you for coming, no proper explanation for enraged face,. We just scarpered, and making good on his prediction, Barnaby won the race to the leisure centre.
I was slightly disappointed we didn’t see a cockroach in our cubicle at the leisure centre (one of the reasons that Alex had cited for the 3 month club trial). I bought some coloured ‘sinkers’ at the counter with smiling seals heads on, and we were both stripped and ready in record time before plopping into the freezing cold grown-up swimming pool. Barnaby immediately swam by himself to me and back to the steps with cold hyperactive breaths and grinning from ear to ear:
“Mummy, mummy, you were sad before, weren’t you, but now we’re both really happy aren’t we, So that’s good isn’t it?”
I swam over and gave him a little hug, resisting the urge to cling on so tightly that I might crush him, and I felt an unbelievable surge of love and depth of prayer that things would be alright, before obediently complying with every game sequence that Barnaby came up with, until my eyes were stinging so much with past tears and present chlorine that I could barely see.
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Tuesday had been unseasonably warm and sunny, and after dropping Barnaby off at nursery, my sister Jo and I began a very long but relaxed walk along the Thames to Barnes. I’d turned down the short cut to the village by the Barnes Elms rowing club, as we were both enjoying the rhythm and the freedom of strolling together. We crossed a resplendent bright green Hammersmith bridge in the morning sunshine, and joined the riverbank on the North side, meandering past ancient pubs, stunning Chiswick houses and countless little blue signs of famous past proprietors. I explained that this was my favourite walk, and recalled anecdotes as we went.
We finally made it over Barnes Bridge, exhausted from carrying the pram up and down the bridge steps, and found a charming little café at the end of White Hart Lane. This was to be the site of our deep and meaningful and our farewell to each other. Or it would have been had Harriet not chosen this time to be inconsolable, with Jo and I, two normally capable mothers, botching up her feed and failing to calm her into contented sleep. With the time slipping away, Jo needed to run for a train and so I placed a still crying Harriet back in her pram and we embraced. I could feel Jo’s sobs on my shoulder, and I pushed her away smiling.
“I’ll be fine poppet, just fine, I feel really confident, please don’t worry”!
As soon as Harriet lolled to sleep in her pram on my walk home through a beautiful Putney common, I sat down on a bench and sent Jo a text where I pointed out that pre-Op, I knew it was much harder for those around me than it was for myself. I knew this first hand because the roles had been reversed years earlier. I vividly remember the phone calls I received, first when I was working in Barbados with British Airways, aged 21, Dad had tracked down my apartment phone number to tell me Jo (aged just 25 at the time) had breast cancer and they would operate in 10 days. Then 11 years later, when this time I stood on top of a mountain near Madrid (where I was working with my solar company), Dad called to explain that the cancer had spread all over her body and they were looking into treatment options. I remember being inconsolable on both occasions, and I couldn’t really move forward and focus on anything until I’d seen her face to face. It was only Jo who could pick me up, and not the other way round. I’ll never forget how strong she was. It was quite inspirational, and I knew that it was my turn to take on that role
And that’s really how I felt – confident and positive arriving at St Georges Hospital at 3pm on Wednesday 11th December.
I didn’t know then, that the hospital wouldn't have a bed available for me, nor that I would be only third up in theatre the following day, to commence the planned 10 hour operation.
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3 final blogs on this subject to follow shortly: ‘Pre Op’, ‘ICU (where my Dad is threatening to guest blog), and 'Post Op'.
“Because I’m cross, I’m cross that your lesson got cancelled.”
“Mummy I don’t think you’re cross, I think you’re sad, you look really sad mummy!”
And I looked up at the wing mirror to see Barnaby’s concerned face in the back seat. Through tears now cooling my inflamed face, I turned to him with raised eye brows, and a defeated smile.
“Barnes it’s OK, it’s going to be fine. I’ve got a plan. We’re going to zoom back home, meet Aunty Jo-Jo, hand over Harriet, get mummy’s swimmers and then I’m going to race you to the leisure centre. Much more fun swimming with mummy anyway”
“I think I’ll win mummy!”
And my angry sadness receded as I made the short drive home from the Roehampton Bank of England Sports Club for the last time.
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It is Monday 9th December 2013, and my last day of quality time with Barnaby before the op. I’ve been thinking about this day for a long time, wanting it to be perfect, filled with the simple happy things that we like to do together when it’s just Barnaby, Harriet and I.
Throughout the year, I couldn’t really embrace the notion that I might die during the operation or let myself think about how Alex might cope alone to bring up the kids. On a practical level, I had thought about re-drafting the generic Will that we had pulled together a few years earlier, and I had also thought about writing letters to Alex, Barnaby and Harriet to hand to my brother for safe keeping – in the unspoken event….but that whole sequence of activities felt too emotionally destructive and defeatist. Pragmatic though those thoughts were, I knew it would be too upsetting to write and hand the letters over for both myself and my brother receiving them. So I’d decided to bury that scenario, with the conclusion that I really couldn’t prepare for that outcome, except to be further emboldened with a Carpe Diem attitude and make precious lasting memories for us as a family. For a few months at least, this meant upping my game a little as a wife and a mum: Turning my iPhone off on Mondays to fully focus on play time with Barnaby and Harriet, and biting my lip if a silly every day irritation came up. Actually, I think I’d made a pretty good fist of it, but looking back I must have built this last Monday up too much in my mind.
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The weekend had gone very well, I had wanted to keep busy and I certainly achieved that. On Saturday night I had been out at a girls’ drinks gathering ahead of the tennis club Christmas party. It was great actually, the room had been filled with single girls, steadily getting drunk on champagne, exchanging very amusing calamitous online dating stories and I felt relaxed knowing that nobody knew of my upcoming operation. It had been good to keep it away from this sparkling room of laughter and tipsy high heels, and to accept each refilled glass of champagne; presiding as the wise married one, regaling stories of a wilder past, asking innocent question after question about which website, which rule, which guy. At the pre drinks and briefly later at the Christmas party I was glowing, feeling attractive, funny and almost care free. But I checked myself and went home shortly after getting to the club, conscious of the week ahead, and wanting to snuggle up with Alex to watch Match of the Day.
Sunday had been glorious: Slightly frosty but with the sun beaming through, casting brilliant winter light on to the orange and red hues of Richmond Park and moistening the ground underfoot. We got Barnaby’s red bike out of the car, bundled Harriet into her buggy and strode off happily towards a lake; Barnaby’s muscular calves were popping out of his short trousers as he pushed his balance bike with dogged determination up a small hill.
“What about that log there? “ Alex suggested
I called over to Barnaby. “Stop Barnster, come over here and sit with me on this log, let’s just take a little rest, I’ve got something to tell you.”
Barnaby came bounding over, wondering if there was a present or holiday coming up that I needed to sit him down to tell him about. Alex picked up Harriet and walked away to give us some space.
My head was still a little dusty from the night before, but after the line about mummy going to hospital so that the Doctors could fix her headaches, I’d prepared a few phrases in my mind. I was armed with a rally of “but’s and ands” – “BUT Granny’s going to be here on Wednesday, so that’s fun, AND daddy’s going to look after you, he won’t be going to work for a while, AND you can help Daddy with Harriet because you’re really good at that. AND I need you to be strong and make everybody giggle."
He’d gone quiet in a pale concentrated way as I spoke, and he kept repeating a short clipped ‘Yus’ when I got to each comma. I thought I’d detected his eye lashes glistening over with a hint of a tear and I was braced for the lower lip to wobble. But he took a pause, and then bounced back up, grabbed his bike and returned to the continuity of his racing from one tree to the next.
Alex came back, stooped and extended a warm hand to pick me up with.
“I think he understood what I was saying”, I said. “At least we’ve laid down a marker anyway; I’ll bring it up again tomorrow.”
I felt quite relieved, and we had a delicious lunch at Petersham Nurseries café just outside the park, before returning home to an ever filling house to share a great big vat of mulled wine for our “very casual really, just pop in for mulled wine, bring the kids, but maybe don’t stay too long” Christmas drinks do. Despite later finding that Barnaby’s room had been turned completely upside down with his side party of toddler rabble, and half the kids did end up staying for tea, it had felt good to make the house all Christmassy and fill it with friends and happy smells and sounds.
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Monday started pretty well – a positive weigh-in for Harriet for which I could handover a mark on a graph to Alex in the red book, then a handsome hair-cut for Barnaby, ensuring they kept a few surfing curls to lap the tops of his ears; a lollypop, a quick whizz down the orange helter skelter slide by the river, and then on to Carluccio’s by Putney Bridge, my banker for a convivial lunch with Barnaby. Awaiting his meat balls, Barnaby looked up and said:
“Mummy, I don’t like you!”
I gave Barnaby a quizzical eyeball back.
“Barnaby, you don’t mean that, come on, you love your mummy”
He seemed distracted for a moment, thinking, contemplating what to do or say next, and then he said:
“Mummy, stay there, I’m coming across” and he jumped up, came over to my seat and gave me the tightest, longest hug he’d ever given me. “That hug’s for when you’re in hospital mummy”. Then he skipped back to his seat, smiled at me and said “I love you mummy”.
I was bowled over.
And the emotional valve that I’d try to keep shut for so long opened just a little as I tried to hide behind the breadsticks the shield a few tracks of tears that were escaping down the side of my cheeks, before thanking Barnaby very much.
After lunch, we went home for some TV downtime to regroup before Barnaby’s last swimming lesson at the club. On the way home, I’d picked up a bloody irritating email from the sports club’s membership secretary on my iPhone. I’d scanned it at the same time as pushing the pram, pulling faces at Harriet and coercing Barnaby along the road: The week before, the same lady (I’m guessing she is without children) had sent us a fairly aggressive email pointing out that we’d just finished our 3 month membership trial, but she’d noted that Barnaby had attended a swimming lesson one day after the month end. Should we wish him to attend his next and final swimming lesson then we’d need to pay the £920 joining fee, and a quarterly membership fee.
Are you serious? I’d asked Alex.
“Let’s just leave it”, Alex said: “he’s had a good run, he won’t notice if we stop there”.
“We’ve got just one more lesson with Edward, Mummy, I’m going to swim underwater next week and do all the hoops at the deep end. Then I’ll be able to swim with you and daddy and I’ll know everything I need to know!”
I’d paid in full for the bloody swimming course anyway – above market rate in addition to the membership fee. Why should we walk away from the last lesson? And the tiger mother in me had come to the fore, determined for Barnaby to have his last swimming lesson and for me & Harriet to be there with him.
So I’d written a rather long winded reply querying why we needed to stop ahead of the last lesson when I’d paid in full. I described how well the lessons had gone and the joy in watching Barnaby swim unaided and I attempted to explain why the last lesson meant a great deal to me – My last day of quality time with my son ahead of going into hospital on the Wednesday for major surgery. I also explained that we were considering the full membership but needed to pause until after the op. I ended with a suggestion that unless I heard to the contrary, I would go ahead with the last lesson, and get a friend at the club to sign Barnaby and I in as guests.
She’d sat on that email for a week and waited to reply until just a few hours before the lesson when I of course now had my hands full with a screaming Harriet (Barnaby had woken her up with a bang on her head so he could sing to her as we left Carluccios), and a tiring Barnaby who’d just had an ice cream sugar hit.
The first paragraph in the email triggered me to the point where I had to stop reading it and bury my phone in my pocket. Apparently we could pay a month’s pro rata membership to attend this one lesson, or she could discount the joining fee by 20% if Alex could show proof that he was acting as a single parent and I was genuinely to be incapacitated. “You’ll understand that the proof is needed for auditing purposes” she’d clarified.
I was furious. Well, I guess that’s some consolation for Alex I thought, 20 bloody percent off the joining fee if he loses the mother of his kids. Wow! Tension built up in the back of my head, the start of the inevitable blinding headache that always follows tears and tension. I didn't get to the end of the email unfortunately. Not until after the event anyway.
We got home, put on the TV, and I threw across some alternative suggestions to Barnaby in as upbeat a tone as I could muster:
“It’s such a lovely day, let’s go to the duck pond in Barnes and we’ll do races around the triangle track on your bike.” Pause. “Or we could wait for Jo-Jo to arrive at 4, then I could take you to the leisure centre and we could swim together, that would be much more fun, wouldn’t it? Barnaby?”
But on each suggestion I got a dead pan look - “No mummy, I need to have my last lesson with Edward. Let’s swim together later in the week, shall we?
“OK” I said jollily, resigning myself to the extortionate supplementary ‘pro rata’ fee.
I called the club swimming pool office via reception to check that Edward was still scheduled for our 3.30pm lesson, and they said that he was, so I thought we’d either go to reception before or after the lesson depending on timing to pay the extra charge.
At 3.29pm, I was sitting pool side bare foot in the white plastic chair that Barnaby had brought for me and Harriet. We were positioned next to the shallow end and directly opposite the pool office window at the other end of the pool where we could also see the big white clock. Barnaby was pacing from one foot to the other and his bloated meatball and strawberry ice cream tum rested above his bright red surf instructor swimming shorts.
“Where’s Edward?” Barnaby asked
“It’s not quite 3.30 yet” I responded, nervously, worried. “Let’s wait until the big hand gets to 3.31 and then we’ll go and ask where he is.
“That hand mummy?” Barnaby pointed.
“Yes, the big one, there” I said.
We diligently waited in silence whilst the big hand made it around to the agreed point and then I got up, feeling sick, and holding Harriet with one arm in between her legs, and the other hand outstretched to hold Barnaby’s, we walked the length of the 20m pool to make the doomed enquiry. A haggle of nervous looking instructors and lifeguards busied themselves, none of them wishing to return my eye contact. The youngest guy stepped out.
“Hi, is Edward on his way? My son Barnaby was due to have his last lesson at 3.30”
“I’ll just call him up and check”.
I let go of Barnaby’s hand whilst we waited and told him to stand back from the pool, just as the first tears started to roll down my hot cheek as I made out the gist of the conversation playing out on the phone. Finally he turned back to face me
“Sorry, Edward says that he was told not to come to the lesson, that he’d just received an email to say it had been cancelled. He was told that you hadn’t paid your membership fees.”
“Really?” I replied, tears now cascading down my face which was contorting into a red blotchy mess, at the same time, hyper aware of Barnaby still waiting hopefully behind me.
“Nice of somebody to tell us! It’s his last lesson for God sake, I paid for it!”
“I’m really, sorry, I’m just…”
“I know, I know, it’s not your fault I said, it’s just…well it’s really bloody sad that my son can’t finish his course."
And as my lips moved, I dropped to the tiled floor onto one knee, extending the tips of my right fingers and steadying Harriet into an upright position. I desperately tried to hold the next wave of sobs back, to not cry out in this echoing space, but it was too late, the valve had fully opened. Why now? Why in front of Barnaby on our last day together. Christ, I’d held it together for so bloody long, a year almost, but now on the one day I’d tried to choreograph, I was losing it, and I knew it wasn’t all about the swimming lesson, it was so much more than that and I also knew this particular situation was mostly my own fault.but it didn’t stop the anger building up inside like a furnace, and the desire to hit out at someone. It was humiliating, but at that precise moment, I didn’t give a shit about how I looked to the young life guards in their red shorts, how OTT they must had found my reaction. I only cared about dealing with Barnaby. What to say next? Aware of him still waiting just behind me, still waiting for his despairing mummy to turn around and face him with her screwed up red face and crushed expression.
“Barnes, Edward’s not coming” I said, turning around, still crouched on the floor.
“The lesson’s been cancelled…… it’s, well it’s partly mummy’s fault I’m afraid, but…. it doesn’t matter, because we’re going to head back to Putney, see Aunty Jo-Jo and go swimming just the 2 of us……..I’m very sorry, but let’s go and get changed, let’s do it really quickly so we’ve got more time to swim together. Come on give me a little hug”
And Barnaby looked at my fire engine red face and then back at the pool and said:
“No!”
“Sorry Barnes, I really am” I said reaching for his hand and pulling him back towards the shallow end and the changing room. “He’s just not here, there’s nothing we can do, he’s not coming.“
He resisted a little, but somehow I got him back to the changing rooms.
“Right let’s get your clothes back on, I’ll put Harriet down and help you take your swimmers off”
“No mummy, I’m not taking my swimmers off”
Shit, I thought, not wanting to start a physical battle with him and trigger a tantrum, and at the same time catching the horrendous state of my face in the mirror.
“Well ok” I said, “stay in your shorts, we’ll just put your shoes and hoody on.” Never mind that it was winter outside.
He seemed much happier with this, so we made progress and finally we were able to leave the pool area.
“Barnaby, I just need to speak to somebody at reception” I said, unsure if I was really going to turn right towards reception or left towards the car, and not thinking through my next move.I turned right, walked to the desk, holding both children, making no attempt to wipe my nose or reassemble my blotchy red face.
“Is the membership secretary here?” I asked the blond 50 something receptionist. “No, I’m afraid she left at 3pm, Can I take a message?” She asked with a concerned look.
“Er yes, can you say that Sophie Orme was here, and that I was very upset that she cancelled my son’s last swimming lesson.“
“Right, gosh”, she said scribbling my name down and looking back up, but I’d already turned away, rushing Barnaby to the car, where he would correctly identify why I had a red face. Rushing to put this awful episode behind us and get on with making it right, as my headache started to close in and wrap around my forehead.
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My poor sister had just travelled to Putney from Liverpool, in a last minute impulsive decision to see her little sister one more time before the operation. Given the emotion she felt, she might have expected a warmer welcome when she arrived, but instead I just said:
“Hi Jo, great to see you, Harriet’s asleep, can you feed her when she wakes up? I forgot earlier! Barnaby and I are just off to the leisure centre for a swim.“
And that was it, no instructions re milk feed, no thank you for coming, no proper explanation for enraged face,. We just scarpered, and making good on his prediction, Barnaby won the race to the leisure centre.
I was slightly disappointed we didn’t see a cockroach in our cubicle at the leisure centre (one of the reasons that Alex had cited for the 3 month club trial). I bought some coloured ‘sinkers’ at the counter with smiling seals heads on, and we were both stripped and ready in record time before plopping into the freezing cold grown-up swimming pool. Barnaby immediately swam by himself to me and back to the steps with cold hyperactive breaths and grinning from ear to ear:
“Mummy, mummy, you were sad before, weren’t you, but now we’re both really happy aren’t we, So that’s good isn’t it?”
I swam over and gave him a little hug, resisting the urge to cling on so tightly that I might crush him, and I felt an unbelievable surge of love and depth of prayer that things would be alright, before obediently complying with every game sequence that Barnaby came up with, until my eyes were stinging so much with past tears and present chlorine that I could barely see.
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Tuesday had been unseasonably warm and sunny, and after dropping Barnaby off at nursery, my sister Jo and I began a very long but relaxed walk along the Thames to Barnes. I’d turned down the short cut to the village by the Barnes Elms rowing club, as we were both enjoying the rhythm and the freedom of strolling together. We crossed a resplendent bright green Hammersmith bridge in the morning sunshine, and joined the riverbank on the North side, meandering past ancient pubs, stunning Chiswick houses and countless little blue signs of famous past proprietors. I explained that this was my favourite walk, and recalled anecdotes as we went.
We finally made it over Barnes Bridge, exhausted from carrying the pram up and down the bridge steps, and found a charming little café at the end of White Hart Lane. This was to be the site of our deep and meaningful and our farewell to each other. Or it would have been had Harriet not chosen this time to be inconsolable, with Jo and I, two normally capable mothers, botching up her feed and failing to calm her into contented sleep. With the time slipping away, Jo needed to run for a train and so I placed a still crying Harriet back in her pram and we embraced. I could feel Jo’s sobs on my shoulder, and I pushed her away smiling.
“I’ll be fine poppet, just fine, I feel really confident, please don’t worry”!
As soon as Harriet lolled to sleep in her pram on my walk home through a beautiful Putney common, I sat down on a bench and sent Jo a text where I pointed out that pre-Op, I knew it was much harder for those around me than it was for myself. I knew this first hand because the roles had been reversed years earlier. I vividly remember the phone calls I received, first when I was working in Barbados with British Airways, aged 21, Dad had tracked down my apartment phone number to tell me Jo (aged just 25 at the time) had breast cancer and they would operate in 10 days. Then 11 years later, when this time I stood on top of a mountain near Madrid (where I was working with my solar company), Dad called to explain that the cancer had spread all over her body and they were looking into treatment options. I remember being inconsolable on both occasions, and I couldn’t really move forward and focus on anything until I’d seen her face to face. It was only Jo who could pick me up, and not the other way round. I’ll never forget how strong she was. It was quite inspirational, and I knew that it was my turn to take on that role
And that’s really how I felt – confident and positive arriving at St Georges Hospital at 3pm on Wednesday 11th December.
I didn’t know then, that the hospital wouldn't have a bed available for me, nor that I would be only third up in theatre the following day, to commence the planned 10 hour operation.
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3 final blogs on this subject to follow shortly: ‘Pre Op’, ‘ICU (where my Dad is threatening to guest blog), and 'Post Op'.
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