Not tickety-boo

Joseph Connolly had never suffered a day’s illness — until he was felled by a “very unglamorous stroke”

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This article was taken from the September issue of The Critic. To get the full magazine why not subscribe? Right now we’re offering three issue for just £5.

It’s not every day you have a stroke — and knowing now as I do of all the subsequent folderol, this is really just as well.

At 6.30 in the morning of Friday 12 June, I woke up in need of the lavatory, as bloody usual. But when I attempted to stand, all was not well. My left foot, hitherto an always thoroughly dependable plinth, was behaving as if it was just in from a night on the tiles — horsing around as if it were composed of aspic. I sneaked down an exploratory hand in order to sort it out, but that too appeared to have been whooping it up at the same shindig, and was also evidently drunk and incapable.

My wife at this point put two and two together and arrived at quite the right conclusion. An ambulance was summoned, and arrived extremely quickly, which rather amazed us both. The two chaps were kind and efficient, saying they thought it was a stroke, and therefore they would take me not to my local hospital, the Royal Free in Hampstead, because if they did, I would only be transferred to UCH, who specialise in this sort of thing, and so that is where we were bound.

I was wheeled out and loaded up; I learned from my wife the following day that all the neighbours were very much aware of all that was occurring: a bit of bonus street theatre at breakfast time. At UCH I think I underwent a CT scan and that drugs were administered (I was not at my most alert — terribly tired) and at some point was shipped across to their sister hospital, the National in Queen Square, Holborn, where they have a dedicated stroke unit: this, I was assured, was exactly the place I wanted to be. I actually wanted to be back at home, but never mind.

The following morning I was told that I had indeed had a stroke — but it was relatively minor, and “very unglamorous, quite common or garden”. I didn’t know whether to feel relieved or rather slighted. There are two main sorts, apparently: those caused by a blood clot shooting up to the brain, and what are called the “bleeders” – a brain haemorrhage, basically, which can cause untold and lasting damage. I was in the former camp, thank the Lord. And so, then — where do we go from here?

I asked questions in the wide-eyed and unsuspecting manner of a child, for I am wholly unused to illness of any sort at all. Apart from a few days as a child (with suspected meningitis, which turned out not to be) I had never spent a day in bed or taken a day off work through illness — and certainly I had never spent a single night in a hospital — not even visited one as an outpatient, and nor did I ever take drugs (prescribed or otherwise — even paracetemol). The exception was a very low dosage (5mg) of a blood pressure pill recently expressly prescribed in order to fend off any danger of all this sort of thing: had I been in the mood, I might even have laughed, but settled instead for a sardonic and rather grudging snigger, while remaining unamused.

I found I could walk reasonably well, though with that slight lollop that actors habitually affect when depicting the old

When 2020 dawned, none of us, naturally, had the least idea of what sort of a year it might turn out to be — true every 1 January, of course. All I knew was that there were a couple of significant dates looming, the first of which was a landmark birthday for me, for which we had only modest plans, the Picasso exhibition at the RA followed by lunch at the Wolseley, but even these were scuppered by the lockdown, which began on the very day of my seventieth: 23 March. The date still to come is our golden wedding anniversary in December: I wonder how that will go?

And in the meantime, how was I faring in an NHS hospital? For a fair while, I just wanted to be left alone, but I quickly saw that the staff’s refusal to countenance any such thing was not a sort of sadism, as initially I had assumed, but an essential early part of the therapy. “What is your name?” “What is your date of birth?” “Do you know where you are?” “What year is it?” “Do you know the date?”

My correct and immediate responses to this ceaseless bombardment made us both feel considerably better, I think: there seemed to be no cognitive defects, for which I was almost tearfully grateful. On the second morning I completed The Times crossword, as I habitually do — the nearest I get to a morning work-out — which cheered us all up no end. Then there was the physical side: “Can you raise your arm?” “Your leg?” I could. Then they want you to grip their hands, pull them towards you, push them away. All this seemed to be OK.

And soon I began to see this succession of earnest nurses and therapists (what I could see of them, anyway, all corona-masked as they were) as a valiant army of determined and dedicated troops, unswerving in their task, which I then decided must not be thankless: I put into it all the effort I had. I found I could walk reasonably well with assistance, though with that slight lollop and those small and tentative baby steps that actors will habitually affect when depicting the old and frail.

It is a huge mercy that I am right-handed, as it was my left hand that was affected: I continued to make notes and record my thoughts, observations and feelings, as they struck me, while striving to excise any sort of drivelling self-pity, not always successfully — it is hard to totally expunge that nagging question: why me? One nurse asked me, when seeing my usual array of identical rollerballs: “Why do you have so many black pens?” Oh, I said, I scribble a bit (manfully resisting the urge to forcibly reply: “Because black pens matter!”, which I deemed to be on the whole inadvisable). I have always written all my books and journalism with a pen — even in the days of the typewriter, I could never create on a keyboard. I later transfer my scrawl to the screen, and edit it there. The system ain’t broke — so why fix it?

This ought to be called a strike, not a stroke.  It has nothing of the caress

I then am delivered of something of a bombshell. The senior registrar to a very eminent (I later discovered) cardiovascular consultant surgeon is showing me a picture of my latest neck scan. It turns out that the carotid artery on my right side (which, wouldn’t you just know it, controls the functions of my affected left side) is rather severely furred up — probably the cause of all this.

He says that there is an operation which will reduce the likelihood of a recurrence (always a worry with strokes — and sometimes they can happen within months, or even weeks) from the current rather alarming 25 per cent to as little as 1-2 per cent. He goes on to say that there are risks, most notably that of a further stroke on the operating table, “although this is extremely rare”, and that if I agree, this operation ought to be performed soon.

How soon, I wonder? The day after tomorrow, he says. And I thought: oh, bloody hell. I have a few doctor friends, one of them a consultant anaesthetist, and so I canvassed their views. The latter turned out to know the surgeon, and was all for it. This surgeon is the go-to man, he said, and in these extraordinary times, it is amazing that you have been offered instant surgery.

Everyone else seemed to agree with that, so of course I said no — turned down the offer flat: “You have got to be joking! What do you take me for? I am as weak as a sheet of paper as it is!” I had never had an operation — not for so much as an ingrown toenail — so how could I contemplate serious surgery when I was still in so diminished a state from the initial attack?

And then — I said yes, because I suppose I had always known, instantly understood, that it was really the only course of action. In this smallish ward, I was opposite two stroke victims who were in variously awful states, and I simply couldn’t risk succumbing to all that.

Everyone tells you to rest, relax and recover – but you cannot sleep in an NHS ward: literally, not one wink. The noise and disturbances are constant and varied — everything from being roused at 11pm for a blood pressure test (roused again one hour later for an antibiotic) to bleeping machinery, which alone can send you mad. The lunatic melody, like a Fisher Price My First Moog Synthesiser endlessly fooled around with by a vacuous and demonic child, invades your brain like a trilling and malignant worm.

Then there is the fizz, crackle and tinkling of mobiles, the snoring, the groans of pain, the nightmare yelps and the perfectly heart-rending and anguished sighing. Overlaying it all is the ceaseless talking of the staff: the ward doors are never closed, the lights in the corridor never dimmed, let alone turned off (in common with the television) and whoever is passing by — cleaners, nurses, doctors — hail each other with far more gusto and enthusiasm than they tend ever to show to us, and they always have time to enjoy a good old giggle, as if it is first day back at school: they are certainly not going to allow the grim proximity of old, sick people to diminish their fun.

You cannot sleep in an NHS ward: literally, not one wink

In the middle of the night before my operation, a truly ancient man was admitted, and a huge kerfuffle immediately ensued. It was 4 am. I was due to undergo major surgery in seven hours, so I felt I had to tut. The tutting did not go down well. I was angrily told that they had a sick patient here: I have no idea what they imagined me to be — possibly some sort of curious tourist who had just popped in to absorb a little local colour and maybe take a few snaps.

Doctors seemed to enjoy chatting loudly to other staff. One female registrar, I learned (whether I wanted to or not) was thinking of going to practise in Europe. “Germany, possibly. Neurology is so different and varied there. In the UK, it’s just stroke, stroke, stroke, stroke. So boring!” And I was thinking this: you want boring? Try it from this side, matey.

It is the morning after that most horrendous and utterly sleepless night. My major surgery is due at 11 o’clock. Then I am told that it might have to be delayed because, due to Covid, they are allowed to perform only three operations per day, and an urgent brain injury has just been admitted. Having dreaded this thing for 48 hours, I now most desperately wanted it. If it were done when ’tis done, then ’twere well it were done quickly, if you know what I mean.

I stewed for a bit, and when later in the day (by which time I had bitterly resigned myself to having to undergo a further night of dread anticipation) I was brightly informed that we were to go ahead, I think I even wept in quite piteous gratitude. I’m telling you: navigating solo these uncharted waters, it affects you in unimagined ways. Also, I was pretty light-headed from not having eaten or drunk (even water) for 20 hours, on instruction. In these circumstances, you become so highly emotional: well-wishing emails from friends and family bring a quiver to the lip; anything from my wife made me tearful.

I while away the afternoon catching snippets of other people’s sufferings: an old man on whose arms they cannot locate a “good” vein in which to install a cannula. He whimpers at the touch of the needle. “So sorry, my lovely, but it’s only small.” Another who is asked his date of birth. “December,” he says. “When, exactly?” “Well — it was a very long time ago.” Then, as I am wheeled away to the theatre I hear a nurse say, “You can cross Joseph Connolly off.” What can she mean?

In 99 per cent of cases, you feel a little swelling – I just had to be Mister 1 Per Cent, didn’t I?

It turns out that the very affable anaesthetist is a chum of my consultant anaesthetist chum. He gave me a “pre-anaesthetic” which, he said, would make me feel gently woozy. Disappointingly, it made me feel nothing at all. The real thing, he said, works immediately, and the next you know, you’ll be awake again, and it will all be over. Both true, as it turned out.

When I did come round, it was as if I had been cast as a non-speaking extra in a 1950s B film about a leak in an atomic reactor. Everyone was wearing a bright blue floor-length plastic anorak, a red hard hat and a Perspex visor over a mask. So, if waking up in an NHS hospital is shocking, then waking up to the sight of this little lot, having just undergone a major carotid operation following a stroke — well that is absolutely shocking: full stop.

Because I have a small mind, my first thought was for my beard: they had kindly agreed to shave just the underside and the bare minimum, and my groping fingers told me they had been true to their word. This buoyed me up most awfully. You see, I told you: small mind. I felt fine: a bit of an ache in the neck, but nothing more. Later on, despite my being still half-anaesthetised, they said they would give me liquid morphine, which would make me feel great. Once again, nothing, nothing at all: I make a very unpromising junkie — simply don’t seem at all able to enter into the spirit of the thing.

And afterwards? I had been told that in 99 per cent of cases, you feel a little swelling, it throbs a little and there might be a little exudation. Yes well — for all those “littles” read one big large. For, naturally enough, I just had to be Mister 1 Per Cent, didn’t I? The haematoma (bruise with accumulated blood, since you ask) was modelled upon an ostrich egg, it hurt like hell, and the floods of engorged blood into immediately charged dressings was a constant, day and night. All rather frightening, actually, though all the doctors seemed pretty calm about it. But to coin a phrase — it’s my neck. Even after I was discharged, I had to return nearly daily to have it attended to, and even spent a further three days in the Royal Free, to save all the to-ing and fro-ing, I suppose.

As I write, I am properly back at home. They discovered something amiss with the platelets in my blood, and after a bone marrow test (not one of life’s more beautiful experiences) decided it could be managed with yet more medication. I am still very tired (“only to be expected,” says everyone on the entire planet) but I do feel that things are going in the right direction. The wound has finally knuckled down and is listening to reason, my mobility and dexterity are good. It will still take a while, but I hope reasonably soon to be able to scamper on those damned elusive sunlit uplands.

A thought: this affliction, coming as it does as a bolt from the blue, ought to be called a strike, and not a stroke, for it has about it nothing of the caress.

An observation: everything for everyone is always completely tickety-boo right up until the split second when it ain’t.

A moral? Only the usual: don’t get old. But if you find that somehow you must already have inadvertently done so — well then, don’t get ill.

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