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.

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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.

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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.

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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.

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Next up ‘ICU (Intensive Care Unit), including guest blog from my Dad, and the CT scan image of the aneurysm.

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.

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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.

*******************************

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.

************************************************************

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.

**************************************

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.

**************************************************


3 final blogs on this subject to follow shortly: ‘Pre Op’, ‘ICU (where my Dad is threatening to guest blog), and 'Post Op'.

The Surgeon

Shit! - she’s in the wrong car seat, I realised, looking back at Harriet consumed in Barnaby’s bright blue Toby chair - the seat belt loose, facing the wrong way, looking startled and ridiculously small.

It is Wednesday, October 3rd. I’m running late to meet with the Surgeon again, and my head doesn’t work.

As I grabbed Harriet and switched her to the other car seat, I closed the door and leaned my head against the door frame, taking a few seconds to regain my composure. In my moment of calm, I pictured my diary on the sofa back in the house with the list of questions that I had been scribbling down all week for today’s appointment.

"You should take a month or so to digest this". The surgeon had said in our last appointment as he stood up and stooped to shake our hands goodbye.

"This is not a trivial operation, not trivial at all. Look up everything I’ve told you. Take some time and prepare any questions that you might have."

I was sure that I had digested it all pretty quickly, and once again felt fully composed and resolute. But as I looked at Harriet in her oversized seat, and ran across the road to a friend who happened to be passing by at that moment to ask her to drop Barnaby’s pyjamas off at his nursery (without any explanation, thank you Sarah Carson) - clearly I wasn’t. It was just the one line he said that had cut through my composure like a knife, and would repeat like a bad curry every time I woke up to feed Harriet in the middle of the night, preventing me from returning to sleep.

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We first went to see the surgeon at the end of August, the day before our holiday to Cornwall. The original plan was to see him the day after our holiday, and that is the date that we had told our friends and family. But his secretary called us to say that he had returned from holiday that day and had seen the latest scans. He felt he needed to see us immediately and that he could juggle appointments. Were we available tomorrow?

Of course we were.

The night before the appointment, Alex was cooking dinner, whilst I took advantage of the down time to google the Surgeon.

“Al, We’re going to see ‘The Professor' (Barnaby's previous nick name at nursery) - Check out his CV". Amongst other things we learned that he’d written the Oxford text book on vascular aneurysms.

We continued with this up beat style of banter the next day when we arrived at the waiting room, on the third floor at Parkside hospital. I was a little high I guess, flitting towards the tea machine, shouting the choice back to Alex, acting like I owned the place because of my greater familiarity with the surroundings. I think I was perversely excited to be getting somewhere. Alex listened to chatter around us, noting people who had travelled a long way into London to see the Oxford text book author.

Then a giant of a man entered into the room, towering over the reception desk and grinning before turning towards the crowded room. Soon our eyes locked, before he said to the only mother in the room with a baby in a car seat (the right one this time):

"Sophie Orme? Step this way"

I walked ahead whilst Alex followed with Harriet.

"I think my father knows you" I said to the giant walking in front. He turned gently, tipping his head down.

"Oh yes?"

“Dr Evans, I said, Dr CC, 'MDU’".

A smile tugged at his lips, I could tell he was storing up those details to look up later.

"Small world" he said. And I have no idea how that sat with him - if a bit of pressure had ratcheted up in his professional mind or not.

It was quite a large room, and he reclined in a huge high backed leather arm chair, pushing back from his desk and folding his legs, hands clasped behind his neck.

"So what do you know about your aneurysm?" he asked me.

My Dad would later laugh as I relayed his opening question.

"About as much as you, Professor", Dad had imitated.

Thankfully I didn’t quite say that, though my monologue met with a lot of nods of agreement, even when I exaggerated my understanding of the size.

I liked that he had opened with this question, I had 8 months of research under my belt and I thought I did understand every scenario. But in the next few minutes I made a new discovery which perhaps others can relate to: No matter what research you do independently on google or otherwise, no matter what pre conversations you might have had – you cannot possibly prepare for the gravity of that first face to face conversation with your surgeon – the guy whose hands you are putting yourself into. Whatever stats you have read, you can always tell yourself that you’ve probably got it wrong, that you’re choosing to dwell on the worst case scenario, you haven’t got the context right, and that medicine has probably moved on such a long way since that report.

He gave us some numbers. The first probability was for stroke, also referred to as ‘morbidity rate’ and it was quite a good number really – it was low in my mind, indeed lower than most of the reports – but an integer all the same and delivered with an incredible air of serious-ness. It didn’t however disturb my flow of questioning.

"And what about the risk of the nerve damage", I asked. "The neurologist mentioned the risk of losing my speech?"

"Yes, that’s the highest risk with this operation" and he inferred particularly in my case because of where the aneurysm is sitting and the size of it.

"There is a danger that you will lose your speech and your ability to swallow."

He gave a percentage probability, and he caught me by surprise.

The dialogue continued, but I tuned out. I recall that my voice had wobbled on the next question in the way it wobbles at in-opportune moments at work when I feel under fire. This time the wobble gave my inner fear and surprise away. I ploughed on not knowing what else to do, and tried to get my voice to iron out, pushing the clammy palms of my hands into my thighs, willing my normal – I’m not about to burst out crying voice to return, which finally it did.

Through the fog of my memory, we had moved to his computer screen where he’d highlighted what was going on. It was the same 3D image that I had sent my Uncle and Dad to get opinions from their network, only it was highlighted in a different way, and seemed larger, and more ‘interesting’ – the word the Professor kept using. Sitting in front of his screen I was transported back to the early eighties and my parent’s dining room in Liverpool, aged 6:

The central heating is dialled to an impossibly high setting, the lights are dimmed, dust particles jostle for position in front of the projector light, heating up the room still further. A slide carousel rotates around, as each awful medical image clicks on to the next, up and down and around. The slides are projected two thirds onto the ivory patterned wall paper and a third onto a framed print of Liverpool hung on the wall to the right of centre. Dad’s slides show anonymous sets of clogged up lungs, but it is mum’s dermatological images that would etch into my mind. They were quite grotesque. If dad caught me gazing at them, I'd be challenged to identify the problem.

My parents never asked us why we didn't follow them into medicine!

Back to the Professor's computer screen, and my 6 year old self would have had no trouble identifying the obvious deformity and could have guessed at the consequences simply by glancing at it. Only this image wasn’t anonymous. I could clearly make my name out in the top right corner.

"Your aneurysm will certainly be well published when we’ve got it out".

Well there's always that, I had thought.

After an awkward moment of silence, with Harriet looking up at me. I asked the question that was really on my mind - the elephant in the room:

"Might that be permanent?", I asked: "The swallowing, the voice?"

“Yes, it might” he had replied.

A pause.

We moved onto timings, and no – the Professor didn’t want to wait until next year. He explained that he would always advise treating a giant aneurysm greater than 2cm diameter. Mine was now sized at 3.5, and the less invasive and lower risk treatments were not available to me. We should get it done before Christmas he told us. He had performed 8 similar operations before and expected maybe 2 more in his career. Another Surgeon would be doing similar numbers in central London, and that was about it in England.

"Have you got any questions?" I turned to Alex.

And he’d gone quite white.

Apart from the timing he hadn’t really got any questions. He had come straight from work, for him there hadn’t been endless search strings in google, and diaries to write in. He was fully in listening and absorption mode, and even 6 foot 3 of him seemed dwarfed by the surgeon that day.


And that’s when the Professor had suggested the next steps: the month to digest, the question gathering. And no I shouldn’t go surfing, and I should use my common sense – "don’t do exercise that pushes your heart rate up!". And with that instruction I wished that we had waited until after our Cornwall holiday to see the giant in an oversized suit with his swinging red tie. As I shook his hand, thanking him again for his time, I swallowed the sticky nothingness in the back of my throat, contemplating for the first time what it actually takes to do that – to swallow, and what your world looks like if you can’t do that on your own.

“Let’s not pick up Barnaby just yet” I said as we got into the car.

"You ok?", we both asked back and too, and we both agreed we were.

“I liked him", I said. "Straight talker”.

“Me too” Alex replied.

When we got home, Alex bathed Harriet and returned her to me. He sat on the other couch and we talked about the practicalities, the timings, how we might manage the month or so that the surgeon suggested I needed to not be a mum for post op. We didn't talk about the swallowing, the negative possibilities. Looking back I don't think we could - not out loud. As I sat there breast feeding, Alex left to pick up Barnaby who was at his best friend Famke’s house, he opened the door to leave and remarked:

“We’re lucky you know, the people next to us had travelled up from Bournemouth".

And as the door closed behind him, I wondered if they would have their problem published one day too.

I had bedded Harriet down and called my dad to relay most of the appointment, for the first time holding some details back from him. I sat in our front room alone. It felt strange to be a mum of 2 children, nearly forty. I just felt like a little girl, a daughter with a nasty injury who wanted her mum and dad. Who wanted that simplicity.

Seconds later, the peace was shattered as a despairing Barnaby returned, still screaming as large droplets of blood from his chin leaked onto the floor and had splattered all over Alex’s shirt. Alex had been chatting to Famke’s mum about the appointment, distracted whilst Barnaby took a big crash in his girlfriend’s bath, gashing his chin, which possibly needed stitches. It would fully absorb our attention for the next hour or so until Barnaby snivelled himself to sleep with his dad close by. I was a mum first and foremost again, and I had held him tight, reassuring him that it would be fine in the morning and we would be off on holiday soon enough.

Soon we had begun the long journey to our new home in Cornwall where we would host the majority of our 2 families and throw a pretty funny Cornish housewarming. The sound, smell and taste of the elements would once again heal us after the shock of the appointment. The rogue theatre production set in the wild Tehidy woods [pictured] would send minds to far happier, wondrous places.

Before that magical evening had captivated us all, I had slept quite badly, and there were times when I wanted to share my night time conversations in my head with Alex, but each time I stopped myself, fearing I would de-bounce him like Winnie the Pooh's tigger. I feared that the wheels might fall off our little unit, if I pulled that pillar of positivity down with me. Anyway, I soon bounced back myself - I don't know if it was the morning spent blackberry picking with Barnaby around the back of the house, the sound of cousins running up and down the stairs playing hide and seek in cupboards and cubby holes. Or maybe it was when I seized on Alex's suggestion that surfing would more likely lower my blood pressure than drive it up: I quickly found peace in my head when I returned to the noise and salty bustle of the Atlantic Ocean that I so love and makes me feel so brilliantly alive.

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Returning to Parkside in October felt quite hard with what had gone before. Once again the Professor was prompt, leaving us no time to compose or even get to the water fountain to wet dry throats. We both had questions this time and we ran through them one by one. Alex asked a question about how they would remove a plastic tube used as a bypass whilst they set about cutting out the aneurysm.

"Honestly", our straight talking surgeon had said, "that concern doesn’t even make page 3 of my list of things to worry about in the operation".

I drew a mental line through most of my remaining questions after that.

Apart from that comment he seemed to downgrade the more serious risks, and when I returned to the swallowing and the voice, he was much more upbeat about the probability that potential damage would be recoverable in time and this was quite a relief to hear. He seemed genuinely quite surprised when we insisted that – yes – we still wanted to go ahead, and it transpired that no progress had been made at his end in planning a date. He promised to get back to us within 10 days, but it would take over 5 weeks for a date to be returned, hopefully the only downside of having a world renowned surgical team assigned.

We returned home again to the same routine, this time slightly agitated by the goal posts shifting on the timing. With Alex off to pick up Barnaby from another bath in another Putney street with another girlfriend, I sat and gazed into Harriet’s eyes as I breast fed her. With the overhead light glinting in her iris, I could swear that I could make out shards of hazel, slowly turning her eyes from blue to brown, and I returned her smile as she pulled away from my nipple to look back up at me.

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I’m due to have the operation on Thursday 12th December at St Georges, and we’re very relieved to have a plan in place, despite non ideal timing ahead of Christmas & events that I'll now miss like Barnaby's first nativity, my brother's 40th etc. I'm also aware of the ripple effect for family members who will also need to sacrifice events too. We’re feeling positive, upbeat and I’m looking forward to returning to Cornwall for some more healing post op if everything goes well. Alex will take time off work and look after the kids for a few weeks, and we’re grateful for all the offers of support to that end. I still feel very lucky and blessed that I get to have this sorted out in a non-emergency situation by the best surgical team available, and that I have a wonderful family and friends to support.

I only now realise the responsibility I have in writing this blog, with > 5000 hits in the last few months just from a link on my facebook profile. There is of course the risk that this is a live blog, and I don't know how this story will unfold either.

Poor Alex - I have never sought his permission, and he must never have anticipated that I would share this level of detail of intimate thoughts and feelings. Nor did my wider family (sorry). Although Alex fully acknowledged during his wedding speech, that his wife could be a 'little too honest' at times. So sorry to him for broadcasting our story to the web, and thank you to him for not holding me back in what has been a cathartic process for me in writing so far. Actually, I find it far easier than talking about it. Alex you are my rock, my anchor, a beacon of positive light, and a quite wonderful dad to our adorable children. It is 8 years on from our vows and I love you terribly.

Thank you also to Harriet for your long lunch time sleep just now, for getting into a fit of giggles last night when Barnaby was wiggling his bottom at you, for presenting your legs up each time I change your nappy or put tights on you, rarely crying, sleeping well, making the transition from breast to bottle pretty easy, and enchanting everyone with your smiles. You make me look good as a mother, and it is mostly undeserved. Barnaby - thank you for just getting the sliding scale right on your ratio of loveliness to naughtiness and being a gentle, loving and amusing big brother to H and somehow empathetic to me when I have a sore head, despite just being a toddler.

I intend to pick up this blog post op, God help us when I learn how to tweet.

Thank you for reading.

Shit Happens...in-it

I remember when it was just Barnaby and I, the first few months had been marked out with all ‘the firsts’. Not the first smile, but the first bloody difficult unaided task – like fitting the car seat in with a screaming baby, or going swimming, or taking on the endless steps at the train station with the pram. I would tend to dread the challenge ahead of time, and then it would either go swimmingly well, or so spectacularly badly that any future recurrence would seem relatively easy. Second and third times would be child’s play, relatively.

Now there were two of them, the first 'first' that stands out in my mind was bath and bedtime with Alex away.

Barnaby seemed to recognise my sense of challenge when we returned home from nursery. In fact for once he was looking forward to it, and rather than a battle to get his clothes off, he whipped them all off in seconds unprompted in a determined effort to get in the bath first before a naked leg kicking Harriet followed.

It must have been a Wednesday, because the white tiled floor in the bathroom was exactly that, a tell tail sign that our cleaner had been, and our lovely Missoni bath mat, bought as a wedding present, had just been washed and was drying over the bath. With one arm clasping Harriet in the nook of my elbow, and Barnaby ahead of me, I pulled at the bathmat and dropped it on the floor, straightening it with my foot. It was at the point when the eruption happened.

Shit happened actually. Quite literally.

I don’t know if it was the sound, smell or touch that caught my attention first, but I quickly worked out that the machine gun mustard fire was coming from Harriet, and the bathroom and my body were very much in the line of fire. Instinctively, I straightened out my arms and held her away from me, inadvertently putting Barnaby in jeopardy below. Within seconds, pellets of bright yellow pooh treacled down his blond sun bleached hair, spraying his arm, tummy and leg, and splattering his face just below his eye. For a moment I was frozen to the spot, as if waiting for the firework display to come to an end.

When all was still, there was a split second where I tried to work out what to do first. Reaching for some toilet roll with my right hand I had to decide whether to clean the slippery bathroom floor and mat; myself; Harriet, or Barnaby first. In the end, my self-preservation instinct triumphed over my maternal one, as I cleaned myself up first, then moving swiftly onto Harriet’s bottom so that I could place her on her blue deck chair in the bath water. Finally I turned to Barnaby who was still obediently frozen is some kind of ‘urghhhh’ shock, his eyes fortunately glued to the mess on his tummy and leg, seemingly unaware that his left ear hole was completely filled with yellow liquid, nor did he have a clue that yellow splatter marked his face and hair alike. I wiped the areas he could see and got him into the bath opposite the perpetrator. Sitting there he looked at me, and back at Harriet and together we burst out laughing.

“Harriet’s pooed all over us mummy, and it’s sooo yucky!”

It’s pretty funny isn’t it” I replied, at the same time taking the flannel to his face, and reaching for the orange plastic tea set to pour water over the sheen of pooh on his hair and in his ear.

“It’s not hair wash night mummy. Stopppp!”

“That’s funny too, isn’t it” I replied – now shaking his mucky hair with my hand to try my best to get it out, but stopping shy of provoking a battle with the shampoo. Harriet is beaming back at Barnaby from the other side of our rather tiny bath, delighted by the release.

And I wondered then if Kate Middleton had been splattered with mustard coloured pooh yet.

The one NCT class that I have always remembered is the one where Cathy recounted an anecdote with the vivid lesson that you should never leave a baby in the bath alone, whatever cradle or deck chair you have them in. With thanks to her near miss story, it’s one of the few rules I have not broken, together with the Madeleine rule that Crime Watch reminded me of last week.

Scooping Harriet in her white eared towel, I decide that Barnaby however was now big and confident enough for the rule to no longer apply to him. But his desire for constant social interaction led me to return to our cramped chaotic bathroom with Harriet. I closed the toilet lid, crossed my legs and began breast feeding her. Splash and Barnaby’s incessant chatter bounced off the walls and led to a pretty unsuccessful last feed, and of course a win for Barnaby in his attempt to get Harriet to smile at him, whilst she should be concentrating on feeding. This staging would not be repeated in future, but nevertheless, by 7.15, a near record in our household – the two were in bed content and more importantly quiet. I trundled downstairs to discover we had run out Gin and Tonic. I’d be more prepared and at ease on both counts the next time.

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In September we reduced Barnaby’s nursery hours to 3 days per week. It was something that I always felt we should do, and I’d felt guilty that I hadn’t done it sooner. I know countless mothers (not least my sister) who seem to breeze through summer holidays and those times where you have your 2+, 3+ kids around your feet, and entertaining them appears effortless to an outsider. Not for me though, or so I had forecast on the day before the honeymoon period ended, when it had just been me and Harriet. And I guess a sense of fear had dawned on me on that car journey home from our blissful holiday in Cornwall. It was the fear of entertaining my toddler full time for 2 extra days per week, when he’d been used to a full time diet of structured stimulation at nursery. Harriet and I were on the precipice of peace, simplicity and relaxation and I knew that the other side would be filled with noise, classes, Harriet neglect, and that killer comment from Barnaby:

“Mummy, I’m bored, where are all my friends?”

Along with the prospect of interrupting my relatively easy rhythm with Harriet, was the deep seated fear that I might not cut it with Barnaby as a mum, or Alex as a wife, when he would come home to find a messy house and no food prepared. My brain especially would be out of its comfort zone - addicted to a manic working environment pre maternity leave – jumping from dealing with my
Outlook inbox, to crisis phone calls from my team out in the field, to preparing to deliver a presentation to a large audience, laptop and iPhone hovering under my finger tips, blurting out noises to signal an update or overdue meeting. Switching my iPhone to silent mode and truly putting it down in order to spend hours of concentrated playing, and tuning my mind to toddler chatter for 13 hours per day is one of the most challenging things I’ve had to do in my thirties. I didn’t anticipate then, that I would have an infinite urge to correct his speech, which I would blame equally on the irregular verbs that clutter the English language and on Barnaby’s key workers at nursery – most of whom seem to stem from Croydon and have pretty useless English - slightly aggravating given the extortionate fees they charge, init!

“Today we was playing a lot in the garden, wasn’t we Barnaby, and we done some writing practise”.

ALMOST £90 A DAY FOR THAT SUMMARY, THANK YOU PUTNEY!”

Anyway, I digress. So it was the car journey home from Cornwall, devoid of a plan of structured entertainment for Barnaby for the next day, coupled with a desire to make the most out of London before we say goodbye to it - when I came up with the ambitious and stress busting plan to arrange a trip to the Horniman museum in South East London for our first Monday together in the new regime.

Tomorrow I’ll pen the story of that ill-fated trip and I’ll keep The Surgeon story buried for another week, as Harriet and I have only just returned to a decent sleep pattern at night (hence blog gap), and so not ready to evocatively re-open that wound just yet.

C Section and the happiest moment

We arrived at Kingston Maternity Wing at 10 am on Monday 10th June with no contractions and no stress.

I felt a bit like an imposter, walking unaided to the reception desk, not stooping over clutching my back, not in agony, not wondering how long labour would last. I carried my overnight bag over my shoulder laden down with that day's newspaper, a fat copy of Vanity Fair magazine, as well as the essentials for a 3 day stay in hospital. It would be a completely different experience to the 5 day ordeal of natural labour to introduce Barnaby to the world.

Just 35 minutes before the delivery, I had entered theatre with my iphone glued to my right ear as I took our first booking for our yet to be completed Cornwall house. I relayed the pre-booking to Alex excitedly, as I bent on my side in a foetal position on the bed, whilst a huge giant of a man called Jack inserted a needle into my back to deliver the epidural. And not for the first time I wondered why I hadn't opted for this magic numbing liquid the first time round.

The worst bit of the whole procedure was just inserting the catheter into the top of my hand. I remembered it really hurt with Barnaby, but I had so many other pain triggers and exhaustion to contend with, that it got lost in the mire. For those who haven’t and will never have a Caesarean Section, it is very hard to describe the feeling and sensation other than to assure that it doesn’t hurt and it’s incredibly quick.

Dressed in blue scrubs, Alex was at my head end (of course), together with the anaesthetist and his junior, and 3 others whose role I couldn’t confirm. I looked above to the ceiling and in front to a blue curtain which hung above me and dropped down to just below my chest, leaving me with my breasts which I cupped with my hands, not sure of what else to do except to flex my hand which was still irritated by the catheter. If that’s the worst pain, then this is a synch, I thought.

For the first 15 to 20 mins after the epidural, the anaesthetist had sprayed my body from my feet to my chest with an icy compound to check the function of the drug. On my left hand side, I could tell the epidural was working well, but on the right hand side, the numbness stopped mid-way up my body. Like with all medical procedures, I started to doubt myself as to which was the right answer when asked.

"What do you feel? What do you feel now?"

“Air, cold liquid, nothing” were my answers.

The Consultant Obstetrician arrived just 5 minutes before delivery and left shortly after, to cross the corridor to the other operating theatre where they were tag teaming deliveries that morning to catch up on their schedule.

Everyone involved in the procedure had read my notes, and so the small talk of choice was:

“so what’s going to be done about the aneurysm?"

At least it gave me an identity, I had reflected, in this ‘one born every minute’ maternity ward conveyor belt. The other question was of course

“Do you know if it's a boy or girl?"

To which I had replied “not really, but we’re both convinced it is going to be another boy”.

Only Barnaby would be proved right.

There was no sense of pain as the Doctor and midwives prepared to pull out our second born. I could sense a fair amount of ‘shoving’ going on, which climaxed with the sensation that all of my internal organs seemed to be shoved up towards my breasts which I was still clinging onto. Just as I was beginning to get concerned with this crescendo of activity, I heard a baby’s cry, and saw a tiny bundle covered in white gunge, held aloft the blue curtain.

"Do you want to see what you've got" the mid wife said.

The next words were from Alex:

"It's a girl!" he exclaimed, and a huge smile lit up both our faces.

It was a complete shock, and I think this was the happiest moment that I have ever felt. And the sense of wonder and joy, that had been absent during my second pregnancy, instantly came coursing back, like a shot of adrenaline into my heart.

Of course the day we got married, and the birth of Barnaby, were extremely happy occasions: but the wedding was spread over a period of a day, and when Barnaby was born, as happy as I was when he latched onto me, I was quite delirious with exhaustion and pain. Whereas, when Harriet arrived, just 35 minutes after entering the operating theatre, I couldn’t have been more lucid, more shocked that it was a little girl, and more appreciative that she appeared so perfectly well, after the assault course of MRI’s that she had joined me for.

The night before, Barnaby had gone for a sleep- over at his best friend’s house, and as my head had hit the pillow at our home in Putney, I had looked up next to Alex and said

“A healthy girl with brown eyes please”.

Her eyes were blue at birth, but no matter, like the rest of her tiny features they were gorgeous, her cry already seldom and I felt an instant protective bond. I couldn’t have felt more blessed, and a summer of great sport, sunshine and family happiness would follow.

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I write this blog from the same buzzing café in Putney that I wrote my blog for 5 continuous days in the hormone laden week preceeding Harriet’s birth. Today, Harriet sleeps beside me in her slightly tatty blue Bugaboo pram, satiated from a good slurp of milk post 16 week vaccination at the clinic opposite, fuss free as usual.

I reflect that I feel completely relaxed on each day when it is just Harriet and I. Maternity leave on these days truely feels like a holiday and her mellow nature is contagious. My heart is full with the sense that we have been blessed with our hilarious, demanding and happy Barnaby, and his smiling, placid sister. But all the while in the background I have the thought of saying goodbye to my family ahead of the impending operation that I need. By the time I get the aneurysm dealt with, it will likely be fully 12 months since it was first accurately diagnosed and I became aware of a 3cm diameter time bomb in my neck. I long to get it over with, and return to this café to describe the moment of emotional relief when I wake up from the operation and realise the surgery had gone to plan. I pray for that moment and hope that it will come soon. In the intervening days, weeks and months, I will continue to bury thoughts of the alternative scenarios in a pocket deep in my mind.

“The Surgeon” up next, when Harriet’s lunch time sleep, and a day at nursery for Barnaby next permits.