Gamboling happily into my late forties, i felt like my body was in reasonably good shape, not battered too much by abuses or life, and would continue to support my being fit and active for another couple of decades yet. I was planning for these years lots of big walks in the regions near where i live – Kosciusko national park, the Budawangs, Ettrema, and further afield too in the Himalayas and who knows where else. I also hoped to keep caving with my club the canberra speleos, and learn properly a bit of ropework and exploration. Late last year i went to Tuglow caves and did also a few big pitches and prusiks at Wee Jasper – up the daylight hole at Dip and in and out of Punchbowl on an interesting route both trips led by my friend Alan Silva who is an adventurer some leagues beyond me..
Well it was on this last trip in particular after hauling myself out of the daylight hole that i just felt so smashed and i had to wonder what was going on with my body. A few weeks later my heart was giving me strange feelings and then i had a few trips to hospital as it didn’t seem to be working properly. I knew already that i had a leaky mitral valve and indeed as the months rolled by and i did more tests, eventually my doctors decided that i needed a mitral valve repair and this meant full heart surgery – and it had to be open heart because of my concave chest. So i was booked in at Prince of Wales with Dr Hugh Wolfenden as my surgeon, and four weeks ago i went off an got it done.
Well there’s something about going in for major surgery like that. As we drove to the hospital at 6am I could see the full moon hanging over the Sydney sky and I felt overall, calm about it all. I’d sort of tidied up my life as well as I could. I’d looked at things as if it might be the last time. Of course, it probably wouldn’t be, there were encouraging statistics given me by the doctors before i went in. But if nothing else i knew it was going to be a great threshold of my life that i was about to pass over. I was also bracing myself for the immediate days afterwards which i knew would be very tough. So shaved and well washed, naked in my hospital gown except for some red socks i said bye to mum and entered the surgical suite and its bright lights as the drugs began to kick in..
It’s amazing what they do in surgery like that. I was on ventilation, and they sawed through my sternum and opened up my chest like a present. Then they hooked me up to the heart lung machine with large tubes going into veins and arteries in my groin and neck. They cooled my entire body down to 32 degrees C and stopped my heart. Then they did the repair on the heart valve – i assume they had to cut a hole in the side of the heart to get to it. It was tidied up (the notes say it was looking a bit flappy) and a sort of bracing small plastic ring was put around it and some stitches to hold it in place better, including to some of the sort of little fleshy strings from the wall of the chamber. Then they slowly started the heart again, checked using an ultrasound that the repair was working well enough (it was), and stapled and stitched me back up. The whole thing took 4-5 hours.
Mum and my sister Evie came to see me not long after the operation while i was still under anaesthetic and i was a bit of a mess all full of tubes and drains and things. I think they found it a bit of a shock. Then around 4 or 5 o clock in the afternoon, i re-emerged to consciousness. The first thing i noticed was the breathing tube down my aesophagus which made me feel that i was suffocating, although i could tell there was some oxygen getting in but it didn’t seem enough. A very uncomfortable moment but i thought to myself “well they probably know what they’re doing”. After a few minutes i managed to signal a nurse that i was awake and she took the tube out which was a huge relief. It was at that moment that i felt like i’d made it through. I was still very high on fentanyl though and it was enough to just breathe and exist. Mum and Evie came back and i was able to say hello but because of all my discomforts it wasn’t very easy and after a few minutes i actually said something like “ok you can scram” meaning I am alive but none of this is very pleasant so let’s do talking tomorrow.
The first 24 hours was very hard. The pain was managed by drugs but all the discomforts were overwhelming. I had two drain tubes coming out of my abdomen, i still had the arterial tubes in my neck and groin (the first big neck one came out early the next day), plus it seemed like dozens of drips and other tubes and bags n things. I was in an intensive care ward and had a nurse allocated to me who worked a 12 hour shift. I had some wonderful nurses, and they worked so hard. The nurse who took out that first tube from my neck was so gentle about it. I don’t know how they manage to do it – to be so caring and compassionate but also so busy all the time. One of my nurses name was actually “Angel” and she was an angel. Another nurse Catherine i had for three days in a row she was from North Carolina of all places and she was so kind to me. The ward was full of people recovering from various heart surgeries and everyone was groaning and in pain and needing to use the bed pan and get injections and sit up and take their pills and “try to eat something”. One old chap i had seen in the waiting room when i arrived for surgery was on the ventilator for the whole time i was in there and it looked like he wasn’t going to wake up.
The first day the physiotherapists came thru and got me to stand up and pace on the spot. That took an enormous effort. I was nauseous and couldn’t eat anything without vomiting, i thought it might be the opiates i was on, even though part of me liked the idea of being able to take opiates more or less on demand, and i quite enjoyed the spacey feeling of them. After coming off the fent drip i was variously on tapentadol and endone but I had to stop taking all these after the second day and make do with panadol to try and control the nausea. It did pass after that and i was able to eat after i stopped the opiates. Nana (who had been a nurse in the 1950s) had the same nauseous reaction to morphine she once told me, so perhaps i inherited that? Anyway its amazing that after the second night i was able to manage the pain of open heart surgery with just a 1000mg dose of panadol every 5-6 hours. Before that i’d always thought panadol was a pretty lightweight pain killer but for me then it actually wasn’t.
My first four days were basically spent in meditation. My eyes were funny so I couldn’t read or operate my phone for more than a few seconds and I didn’t feel like trying to get my music going so i just sat with my eyes closed and pretended i was at a very intense zen sesshin. I also imagined myself at Arunachala where i’d been on my India trip a few years ago and took comforts from visualising myself there, walking on cool stones in the Ramanasharamam. I was munching on “the iron firm nutrition/of the great realisation”. That was what got me through those days. I remember something i’d read about suffering being a kind of meditation in itself. It certainly does make you focus on the moment. The mind doesn’t wander in the same way. Maybe it weakens the mind? Well. the mind squirms and wants anything else. It helps to be able to take yourself somewhere mentally out of the instant. Every few hours someone would approach me with a needle to take another blood sample for one reason or another. It was a good opportunity each time to practice meditations on “I am not the body” – that old advaitic truism. In a strange way, in the midst of all those discomforts i found a kind of happiness. But it wasn’t easy.
In fact when i got out of the intensive care unit and into an ordinary cardiothoracic ward on day four i cried with relief. It felt like i had been liberated from a kind of deep lower level of hell. Even though i have incredibly fond memories of the nurses who would fetch me a warm blanket from the cupboard and lay it over me when i asked, and cheerfully do any other miniscule or revolting thing which i had to bother them with from time to time. I was also struggling with a very irregular experience of reality where dreams would sometimes seem to never end, and waking from them never seemed complete. When i closed my eyes i had strange hallucinations of geometric or granular patterns that would slowly revolve or zoom in. I got strange crazed flashing visual migraine like patterns whenever there was some bright light which were mesmerizing and a bit unpleasant. When i got into the cardiac ward the first thing i did was get my music going on my headphones again and listening to Sandy Denny sing “who knows where the time goes?” i cried again.
Those headphones were a tool of my survival in that ward because there were four of us in a fairly small room and there was noise all night and day. Beeping machines, patients arguing with nurses and grumbling and talking on the phone, there were no secrets. But at least I could slip on my headphones and be in another world of my own control. My appetite came back with a vengance about day five and my sister and brother-in-law kindly brought me some delicious meals they’d foraged from the real world outside which brought me back to life faster than anything else. As the tubes all came out I began to take short walks up the corridor to look out a window that pointed towards Botany Bay. I gazed out into the world, and gradually began to imagine myself in it again. All those busy people driving cars up and down the road and living in buildings. It seems comical when you are apart from it, and it’s hard to reintegrate after having had to wait and see if one was allowed by the gods of fate to continue living in this world at all. Then, and even now, the readmission seems a bit uncertain, and like it could be whisked away. The valve repair might not hold, or something else could happen at any time to break our connection to this world. And of course it has always been so.
Now it is nearly four weeks later. There is a full moon in the sky again. I’m at home reading books and getting better slowly – there is a “long tail” to heart surgery recovery, unsurprisingly. This is the first substantial thing i’ve written since the operation. In hospital i had big plans for writing poems but i only managed one kind of tortured fragment. And since then it has been a lot of work to re-emerge into wanting to create things and be productive but every day is a little better. The pain is getting milder, the tiredness not so overwhelming. And i have an impressive scar, long and very slightly off centre down my chest. It’s all healing up, amazing what the body can do. Amazing that i’m here at all.