Scrap Book

A personal view

I have called this a personal view because general medical assumptions and statistics are only as I understand them to be and probably not as they are.

A year ago, whilst on an SCGB run to the new Montfort area of Verbier I had a heart attack. It happened at the bottom of Tortin. Tortin, as those who have been down it know, is a slightly hairy run and it is inadvisable to fall, particularly at the top. So to an intermediate skier like myself there is bound to be tension and this is probably what triggered off the heart attack.

The first reaction is one of disbelief, unacceptable even. Indigestion, a pulled muscle from that last fall, a minor irregularity that a couple of drinks will put right, and so on. After all, I had had a complete BUPA check up only a month before and given the thumbs up. I actually queued up at Haute Nendaz, took the drag back to Tortin and had a couple of drinks. It didn’t work and only then did I accept the bitter truth. I went down in a snow cat which was interesting and on by taxi to the new and superb hospital and Sion. I was there a week and must have had 20 electrocardiographs, 30 blood pressure readings, three X-rays and five blood tests. If you have a heart attack or break a leg, make sure you are within helicoptering distance of Sion. There is a helicopter pad on top of the hospital, which – as an insurance broker – I was distressed to see was in constant use.

Is it painful? Well, in my case, it was. Not to start with, as I have already indicated, but it got worse and I had to put up with it for six hours. This was not because of any Swiss sadism, but because the ‘knock-out drop’ was kept in reserve for a possible second thrombosis. The pain in my case, apart from the chest itself, was in the wrists whereas it is normally, I believe, in the upper arms. I felt rather proud to have asserted my individuality.

The statistics of survival after a heart attack are interesting and certainly, to quote Dr Johnson: ‘concentrate the mind’ – particularly when you have nothing to do but lie in bed for ten days. I understand that your chances of survival on a first heart attach are about 70%. Not bad, not good. But if you have another one within the next few days the odds definitely shorten. On the other hand. If you survive a year (as I have done – hence the timing of this article) things are very much brighter.

However, you have to work at the physical problem (I will come to the psychological one later). You used to work on four cylinders and now you only have three. The human body, unlike a motor car, is adaptable and so the three can take over without loss of power. The body does this automatically but is greatly helped if you take a lot of exercise. Walking is the best and, failing that, ten minutes a day on a static cycle. One way it is time consuming and the other way a frightful bore (it is surprising how long ten minutes is). The second thing you have to do is trade in your Rolls Royce (this article is specifically tailored for Kandahar members!) for a Mini Minor. In other words, you slim. There is a dichotomy here. Heart stimulants, caffeine, tannin and above all nicotine are bad. Alcohol is a depressant and artery dilator (I resist the obvious pun) and is good. Particularly Scotch Whisky, so the Scots say, and they must be right because Edinburgh is a very eminent medical university. The trouble is alcohol put on weight. So we have a Catch 22 situation.

When you have a heart attack you have a psychological problem which has to be faced in greater or lesser degree. First of all you realise that you are now a second class citizen and this is heightened by the fact that in the first few months you are very tired indeed. Secondly, you ponder on mortality more than normally because a heart attack is a catalyst. In extreme cases this can destroy the personality. Conversely, it can increase the intensity of living as it has done in my case. Eat, drink and be merry is a true adage.

An aspiring reporter once rang up Evelyn Waugh when he was in one of his tetchy moods. “Don’t ring, write,” snapped Waugh. All my friends instinctively obeyed this injunction and wrote letters of sympathy. The morning mail brought hand-addressed coloured envelopes in addition to the usual typed brown ones. It was thrilling. I felt I was back in the 19th century. I replied at length with as much literary panache as I could command. I got replies. Correspondences began, but only to flicker out fairly soon. I had leisure, they hadn’t, and you need leisure to keep up a correspondence.

It was a pity. I enjoyed those few weeks.

May I end with a few lines of doggerel

The stethoscope tells
What everyone fears
That I’m likely to go on living for years
With a housemaid’s waddle
And a shopgirl’s simper
And the style of my prose
Getting limper and limper.

The first lines are hopeful: the last two are, of course, factual.

PS: If you have a heart attack whilst skiing it is useful to be insured – otherwise the sight (and size) of the bill might give you another one.

From the Kandahar Review, October 1983

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