• Philip Bryer

A Gasper

We are approaching the anniversary of this event - a Sunday when I cough nervously and won't have roast lamb for lunch.


A Sunday

9AM - Violent coughing fit after 20-minute walk through freezing village to get Sunday Times. Feel like I'm getting a cold

12.01PM - Pour gin and tonic as part of regular lunch preparation routine.

12.15PM - Experience strange pain on left side of chest from top of shoulder almost down to hip. Go outside for fresh air and finish G&T.

12.30PM - Sandra suggests calling for an ambulance. I decide that having a cold drink in such cold weather has probably given me some sort of internal shock and I attempt to reverse the process by having a hot cup of coffee.

12.45PM - Sandra suspects that I don't want the fuss of an ambulance and offers to drive me to A&E. I decline, as I am now convinced that I have a chest infection.

Pace up and down for a while, but seem to be a little short of breath. Sit and read paper.

2.00PM - Eat roast lamb and drink some red wine.

3.00PM - Have dose of bicarbonate of soda. Shortage of breath increasingly noticeable. Go for a lie down. Which hurts, a bit. Unless I get into the wrong position, then it hurts a lot.

5.00PM - Watched Ratatouille and drank a large homemade damson gin. Either of which, in all honesty, didn't help.

9.00PM - Bed. The climb up the stairs left me gasping and it took a while to calm myself and catch my breath.


A Monday

6.00AM - Feel fine until attempting the stairs. Decide to stroll round to the doctor's when they open. Sandra diagnoses pleurisy, but I think I might have pneumonia. 'You know you might have to stay in hospital if it's pneumonia?' she says. Couple of days in hospital? No problem.

8.45AM - I had to stop 3 times on the way to the surgery. It's a 5-minute walk. The splendid Dr Jonathan is kind enough to squeeze me in.

8.47AM - 'Is your blood pressure usually this high?' he asks. Well, no.

8.50AM - He listens to my chest. Then he informs me that he can't actually hear anything from the left side of my chest, and declares himself to be 'worried'. I decide to be 'worried' too.

He asks if someone can swing by and take me down to A&E. My wife, I said, but don't worry, I'll walk back and....

Jonathan states quite firmly that he'd rather I didn't walk anywhere. He asks the receptionist to ring Sandra, tell her it's nothing to worry about but to whizz by like, now, and shoot down to A&E sharpish. I like the bit about there being nothing to worry about, but it doesn't quite match up with the mercy dash to A&E.

While we wait, he types an introductory letter and tells me that he thinks I have a spontaneous pneumothorax. I attempt to look back at him with a concerned and enquiring expression. However, I feel more like a goggle-eyed, mouth-breathing puppet with my head mounted on a wobbly stick. It's also known as a collapsed lung, he says. (Reading about this later, I see that it's also known as a 'medical emergency').

10.30AM - I'm in the Resus room and the A&E doc is plunging a needle into the top of my chest, left side. She spends about 20 minutes trying to draw out the air which the X-Ray showed was gathering in the chest cavity. This smarts a bit.

10.45AM - It is plain that the aspirating needle plan didn't work and they're going to 'pop in' a chest drain. This involves being pummelled about the ribs while she hunts for a likely stab spot. It takes much longer than one would wish. I'm given a dab of local anaesthetic and the digging and pushing begins. I invoke the names of the Son of God in all of their variations as the tube is hammered home and stitched to the skin. At the other end of the tube there is a large plastic jar which has a couple of inches of water in the bottom. The presence of bubbles in this water on breathing or coughing confirms that the leaking lung is going to need time to heal, at least. Twelve hours they say, minimum. So, I'm in for the night.

6.00PM - I'm in an A&E ante-room now. The ward is being double deep cleaned as it has recently been invaded by the norovirus.

10.00PM - On the ward, in bed. They do a round of blood pressure, pulse rate and temperature checks, and I doze off quite quickly. Looking forward to getting out of here tomorrow.


Call That A Drain?

I overhear a doctor advising the man in the next bed that both time and options are pretty much exhausted. Shame, he seems like a nice chap, although his features are generally obscured behind a large oxygen mask. It seems he should prepare for the worst and this signals a steady stream of visitors who have plainly paused on the way and supped deeply at the well of Dutch Courage. I don't blame them, but it is quite overpowering in such an antiseptic environment and rather like having a large and portable boozer deposited in the middle of the ward. And one from the days when you could smoke in them, to boot.

One man comes alone and, even for two men in such an environment and circumstance the conversation is awkward and stilted. He speaks to my brave and uncomplaining ward-mate, "You look like shit," he says. I don't hear the reply. He follows this up with, "Looking on the bright side, I've had a bit of interest in the Rover. A bloke was coming to take a look this afternoon, he sounded keen on the phone but I don't know how definite it was because I had to come up here and see you."

Fair took my remaining breath away. What a shame I couldn't wave a magic wand and make them swap places.


Walter, the patient, died the next day.


I spent the next few days kicking my heels in between scare stories. 'Noticed any unexplained weight loss?' Quite the opposite, actually, since I gave up the tabs. 'Loss of appetite?' I refer the honourable gentleman to the answer I gave a few moments ago. 'Damage, emphysema, smoking, air pockets...” The words washed over me. “Anyway, we're going to send you to specialist unit where they'll carve two bloody great holes in the front of your chest, break a few ribs and rip out most of your innards. On the off chance that you survive we'll see you back here in 2 months. OK?'

Anyway, I was shunted off on a fifty-mile trip to the specialist unit where they booked me in and laughed at me.

"Call that a chest drain?" said one.

"We use proper ones in here," said another.

"Thick as your finger," added the first one.

I didn't like the way this was heading.

Within 24 hours a hole you could - should you wish - feed a sausage through had been punched into my left side, the smaller drain pulled out, and a bigger tube led to a jar to a tube to another jar, and finally to a wall-fixing where maximum suction did its thing; which feels like bony fingers are pulling and dragging at your lungs, lights, shoulders and stomach. I can take it, I thought, if it means I don't have to have an operation.

The following morning, I am informed that I've been put on the surgery list. The increased drainage hasn't worked and I'm to take nil by mouth from midnight tonight. On the upside, tales of smash and grab surgery, of horrid lung damage, and of ops on both lungs at once prove to be wildly inaccurate.


Goodnight Dennis

Dennis had been installed in the opposite bed a couple of days ago. I've taken to talking to him, but he hasn't answered me yet. He came in from a nursing home and he's being supplied with food and oxygen from a network of tubes, although he appears to be keen to rip off the oxygen mask at regular intervals. He sleeps most of the time and doesn't respond to anything apart from when the nurses try to clean his mouth, change his bedsheets, or give him a wash. Then he grunts and moans in barely discernible tones, but his meaning is clear; leave me alone.

"Alright Dennis?"

His eyes are open now, he seems to cast a gaze in my direction but gives no indication that he has heard me or wants me to shut up. He's in his late sixties, I guess. A niece has been in once for a brief visit and a nurse tells me that he has no other family.

"Alright Dennis?"

I don't think he is, though.

I'd been trying to get to sleep but had a visit from my third pep-talking, pre-op-form-delivering anaesthetist of the day. This was followed by Nurse Gemma who insisted that my height and weight had to be confirmed at 9.30PM or the middle of the night, if you please. My 'what now?' and 'is this really necessary?' and blunt 'trust me, six-one and twelve-and-a-half-stone' are ignored and I hope she put it down to my suddenly feeling rather alone and really quite frightened. She accepted my apology, at least. A surgeon nudged me awake at midnight with a consent form and a tip-off as to tomorrow's proceedings.

"Keyhole surgery?" I asked.

"Not exactly," he replied cheerily.

I was dozing, or practising my own version of TM, perhaps, when they came for me the following morning. It was 10:30 or so, as promised, and I had washed in the pink, foamy antiseptic lotion, donned my gown and DVT socks.

"Why have they got holes in the toes?" I asked, as I lay waiting for the off in the theatre ante-room.

They told me the answer, but I don't recall what it was. Strangely, I was talking to a fellow patient afterwards and he'd asked the exact same thing and also had no recollection of the answer. We agreed that it was because it was discussed during one of those conversations that only take place with a mind to taking one's mind off what was about to happen.

There were three or four people clustered round and if I looked dead-ahead I could see activity taking place through the round windows of the swing doors to the theatre. I stopped looking dead-ahead. A nice young lady introduced herself by saying that she'd be helping out in theatre today and was going to pop a needle into my hand. I looked away.

"Ooops, I've made a mess of that," she cried.

"You'll be in trouble if he sees it," said another.

I felt warm liquid running down my hand and fingers.


"Hear the ping?"

No

"Hear it now?"

Sorry, but with this oxygen mask on I can't hear a thing.

"You click this switch and when the morphine's been delivered the machine pings, OK?"

The nurse in the recovery room had my full attention.

"You can't overdose and you can give yourself a hit every five minutes or so, but as you won't have any idea what the time is you might as well just hit the switch whenever you wake up and feel like it. OK?"

Got it.

Ate my full quota of disgusting food-slop this evening prior to getting plumbed into my morphine machine.

I bid Dennis goodnight and slip away, although I'm careful to keep a tight hold of my pain-relieving switch and click regularly through the night until 8AM when they disconnect me from the juice and make me get up. Recovery starts here. I'm pleased to see that Dennis's cheeks have taken on a hint of colour.

It turns out that during surgery they removed the offending air pockets, trimmed out the dead tissue, then stripped off the lung's lining to expose the highly adhesive lung tissue, roughed up the chest wall to aid adhesion and then stuck the lung to the chest wall. I was clearer now as to why Christmas Eve was proving to be so painful. My lungs want me to cough, but my ribs, chest drain, and stitches cannot suppress their squeals of protest, and half-an-hour of nervous heaving and retching brings forth barely a teaspoonful or two of bloodied muck. I inadvertently discover a way of taking my mind off the chest pains when, in the process of hauling myself around the bed in an attempt to find a position of comfort, I sit firmly on my genitals and subject them to an impromptu press, drag and squeeze. An early night is favourite, and when the narcotics nurse wheels in the goodies and announces that I could, 'have the lot tonight', if I could have moved I'd have kissed her like I dreamt I'd done the night before.


"Merry Christmas Dennis."

In the spirit of getting the walking wounded home for the festivities and clearing the wards, just Dennis and I remain in our four-bed suite.

There's a present on my bedside table. The gift label says 'male'. Toiletries. I thank the night nurse, Susan. Susan is wearing antlers and advises me sternly to address my thanks to Santa, as it was nothing to do with her. She brings me tea and tells me the story of a colleague who spent twenty minutes one morning washing and reapplying pyjamas to a seriously ill patient only for someone else to discover shortly afterwards that he had actually been dead for several hours.

Christmas lunch arrives at 11:45AM and, on the grounds that it’s a teeny bit like cider, I choose apple juice to wash it down. The pudding is OK, but I can't eat much of it. I call Sandra and ask her to bring me sandwich later. I read, watch a bit of TV and check on Dennis from time to time.

Sandra visited for an hour or so, they are really strict on visiting hours (one hour, to be precise) and there was no relaxation in recognition of Christmas. It doesn't matter though, I'd rather she was at home with the family as I don't feel it's like Christmas anyway. It's more like I'm in some sort of limbo or locked in the purgatory described in a C S Lewis story we did in R.E. back in the last century.

Don't remember too much about Boxing Day. Except being told that I can't go home because I'm still leaking air and being encouraged to ask for extra codeine.

I comply.

2AM - Dennis died tonight. There's been a flurry of activity since midnight and it doesn't take much to work out what's going on. We never had a conversation, he never actually acknowledged my presence, but I raise a glass of water to him and wish him all the best. Blessed release said Nurse Karen later when I asked her about it. Dennis had been ill for a long time and there was a non-resus thing going on. Which is why I didn't hear a load of drama, counting, and thumping.

I met a man today who, it appears, went in for similar operation to me but ended up with half as many lungs as he went through the surgery doors with. I breathe deeply, cough severely and do both with gratitude. However, bubbles appear in my drain jar, which is not a good sign.

I voice my concerns but am told not to worry. All could well be OK by tomorrow.


Tomorrow

I test-cough prior to the ward round. No bubbles. I double-check. No bubbles. I call Sandra. “I'm not saying I'm coming out but I haven't got any clothes here and as they're likely to do their rounds while you're on your way, well, it makes sense to get the clothes organised doesn't it? Even if we have to wait another day or two.”

Two hours later Sandra walks into the ward and I shake my head. We'll have to wait for the consultant's round in the morning.

Two weeks ago, I left the house for what I thought might be half-an-hour. I hadn't been home since and much had happened. I felt oddly detached from Christmas. The nurses had asked me to join them on Christmas Day for mid-morning coffee when I stuck my head around their rest-room door, but as I'd only called round to request assistance for an old boy who sounded like he had got himself into a little local bathroom difficulty, and I was shirtless and sprouting a tube from my chest with a bloodied jar in my fist, and my hair hadn't been washed for a few days, and I had a nasty outbreak of eczema around the face, I quietly and shyly declined. New Years Eve wasn't a particular attraction. All I wanted was to be at home and to be with my wife and hang the rest. Apart from the lung not springing another leak, of course.


Day 15 - I went home.







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