A sneak peek into Room 101

The Scream by Edvard Munch

Part of The Scream by Edvard Munch

A harrowing read

Ever watched that TV show where celebrities vie to dump their pet hates into Room 101? Anyone who has read George Orwell’s Nineteen Eighty Four will know of course that Room 101 was the torture room, the place wherein lurked the thing that most horrified the prisoner of Big Brother. Forget “Ve haf vays of makink you talk” accompanied by a handy Anglepoise directed into the eyes. In “1984” ordinary common or garden torture was used merely to coerce the victim into revealing his one true pet hate, the single most abhorrent horror the victim feared, the thing guaranteed to break him, to reduce him to a gibbering wreck incapable of further resistance.

No, I cannot really recommend 1984 as a Good Read despite its legendary status in the literary cannon. Apart from Animal Farm I’ve never been able to read Orwell since being traumatised by 1984 forty years ago.

But I recently had a sneak peek into my personal Room 101. It happened like this…

Anatomy of a heart attack

“You’ll need a TOE and angiogram,” said Dr Cardiac-Specialist.

“Oh, right. And what are they?” I asked in all innocence.

My GP had said a week or two earlier that he could hear a murmur, and there had been Other Signs. Signs that I ignored: a weird gripping feeling about the heart followed by a pain penetrating to the back, up into the shoulder and further up into the neck. I ignored it a couple of times. Too busy to darken the doctor’s door, I told myself. Besides it wasn’t exactly a pain, just a weird feeling that something was not quite right. I didn’t clutch at my chest and keel over in agony like you see on the TV. I took an aspirin and carried on working. The pain faded away in a day or two.

When Dr Cardiac-Specialist had explained what a TOE and angiogram were I shrank back into my chair and said I was none too keen on invasive tests. Besides, I felt perfectly well just at that moment. No chest pain. Getting a bit puffed out sometimes. Maybe I should just do some more exercise?

Dr Cardiac-Specialist was not best pleased. I got the impression he was just a tad irked by my failure to salute his superior knowledge and jump to it with a will. We compromised on non-invasive X-rays and a treadmill test.

I’ll walk that, I thought. And I do hope you enjoyed that pun. The X-rays said my lungs were okay but I lasted a piffling five minutes on the treadmill, at very nearly the easiest gradient the machine was capable of simulating. Dr Treadmill, in charge of the apparatus, pointed to something of significance on her ECG trace. Her assistant nodded sagely and promptly stopped the test. A prescription for heart supporting drugs was issued on the spot along with an unalloyed command to go see the bloodsuckers at the phlebotomy department.

“Well, but I’m not too keen on…” I began.

Dr Treadmill all but slapped me round the lugs as she pushed me out the door and pointed me in the right direction.

But… but… I don’t need drugs, I thought. That’s ridiculous. I’m not that ill… And a blood test? But dimly it began to dawn on me that although I had worked hard all summer I seemed to make little progress on the project in hand. Once a week I’d hone my sickle hopefully and contemplate the weeds encroaching on my boat mooring. “But I’m knackered,” I thought time and again. “Maybe next week…”

On the other hand, what’s the point of consulting experts if you don’t take their advice, I reasoned, dragging my heels along the corridor to the phlebotomy department like a guilty schoolboy sent to experience the headmaster’s best tongue-lashing. (Even in my day the cane was frowned upon if not actually banned.)

So I endured the bee sting in the crook of the elbow, collected my drugs and went back to work on my current boatbuilding project, pushing the heart issue to the back of my mind. Next thing there landed on my mat two unrequested appointments for the very TOE and angiogram tests I had already resisted, along with a letter from Dr Cardiac-Specialist that made it pretty plain what the likely outcome would be if I failed to submit to his sadistic torture.

(Oh, all right then, his Wise Advice. Hmph!)

Wrinkling my nose and grumbling about the inconvenience I recruited my big sister’s help (…must have someone with you for 24 hours after the tests the letter said) and she marched me back into the hospital for the TOE on Friday and the angiogram the following Monday, practically with my earlobe between thumb and forefinger. I was still planning to be back at work Tuesday. But something nagged at the back of my mind. I mean, bearing in mind this is the NHS about which we are daily blasted in the TV news regarding long waiting lists and disgraceful queues I figured Dr Cardiac-Specialist must be pretty keen not to let me skid out of it. And in this at least it turned out I was right.

Horrendous… Worse…

TOE stands for trans-oesophageal echo scan. “We need to see your heart from behind,” explained Dr C-S, “without any pesky ribs getting in the way.” It was horrendous. They sprayed my throat with what they had the cheek to call local anaesthetic. Local nuclear explosion, more like. It felt like I had a golf ball stuck in my throat that I could neither swallow down nor cough back up. But then the sedative knocked me over sideways. Ultrasound gizmo down throat, doctor wangling levers on the end of the thing, peculiar swishing sounds and a video monitor I couldn’t quite see out of the corner of my eye. Job done.

“How about administering the sedative before the throat spray next time,” I suggested to Dr Cardiac-Specialist afterwards. Maybe it was the tone of my voice but Dr C-S seemed no better pleased than before and muttered some non-committal (but probably medically valid) excuse for doing things his way. Or maybe he was just not accustomed to people answering back. Whatever…

The angiogram was worse. “I don’t think the sedative has worked this time,” I bleated as Dr Cardiac-Specialist inserted his drain rods into my veins and proceeded to poke about inside my heart, measuring pressures and locating blockages. I quaked on the table the whole time in spite of trying to get interested in the vague x-ray or ultrasound images (don’t know which. I’d lost the plot by this time) on a huge monitor screen that a madman might possibly interpret as various of my heart valves doing what heart valves do. In all honesty I cannot say that it actually hurt. But that uncontrollable quaking turns out, in hindsight, to be significant.

Bedside manner

Dr Cardiac-Specialist came to my bedside after the angiogram to deliver his verdict and sentence. He brought with him another doctor doubtless versed in the headlock and full Nelson to make sure I didn’t get away. After some considerable spiel, most of which washed right past my ears without penetrating but during which I was thinking …doesn’t sound too bad… might need some sort of treatment but there’s bound to be a waiting list. Maybe after Xmas if I can find time… Dr Specialist finished with words to the effect of, “So you cannot go home. You must stay here in the hospital until we can get you a bed (in another hospital where they specialise in heart surgery.)”

“What, not even to turn off the central heating?”

“No. Absolutely not.”

“But… but… I haven’t finished writing my will yet…”

“ You’re going up to the ward now, Mr B, and you are staying there until the job is done.”

Doctors are wonderfully decisive, aren’t they. I think the assistant doctor saw how shocked I was because she came back later and spoke very kindly to me. “If you were my dad I’d really want you to have this operation,” she said kindly. Sigh! Doctors, like policemen, look terribly young to me these days. I dare say she was sent to check I had not done a runner in the meantime.

So I spent a fortnight on the cardiac ward resigning myself to heart surgery. The ward was on the third floor. The windows were rigged so that they could not be opened sufficiently to throw oneself out. Forming escape committee, I texted my sister. Bring hacksaw and ropes… But my fellow prisoners (Um… patients, all undergoing treatments for various sorts of heart failures) were, I have to say, a pleasure to spend time with. One guy had had an artificial heart valve for 23 years, he told me. A childhood illness had precipitated his present troubles which he bore with such dignity as to put me to shame. He had known all his life what was coming for him. And here was I whinging that no sooner do I get my pension than…

That man was an inspiration to me and I told him so when the guards came to escort me to the place of execu… I mean the operating theatre. I’m very glad to have met him. He was of a generation a little older than me so I won’t mention his name. I doubt he would thank me for it.

I needed coronary artery bypass grafts and a replacement aortic valve. Strangely, the main operations never bothered me much. I even watched a You-Tube video of something similar via the NHS website. They slice you open from neck to navel, saw the breastbone in half with a tool that resembles my Black and Decker, and force the ribcage apart for access to the heart. Then they connect a heart bypass machine while they stop the heart to do the repairs. Finally they wire the breastbone back together with stainless steel wire twists, sew up the surrounds with dissolving stitches and superglue the skin back together again. Simples… not! It still astonishes me how surgeons can furtle about in your vitals and not manage to kill you!

I figured they would take a few inches of spare vein from my leg for the heart bypass grafts but nobody mentioned beforehand the scar from crotch to ankle that now decorates my left leg. Hey ho!

But this is where Room 101 comes in

So for nearly three weeks I was in storage awaiting the op. I’m a bed-blocker, I thought, disgruntled. There were daily takings of blood for testing. No great problem the first time. Grit the teeth and take it, I told myself. Look at all these other patients patiently doing exactly that.

By the third day I was muttering mutinous sentiments when the phlebotomist’s trolley came rattling into the ward complete with its multi-coloured sample bottles and prominent yellow sharps bucket. Each day the reaction grew worse. At first just a slight trembling of the leg as the phlebotomist turned to my bed. Each day the trembling started sooner and lasted longer. Each day it seemed my veins became harder to find and harder to get into and harder to get the blood out of once they had been got into.

By the end of two weeks I quaked uncontrollably at the mere sight of that trolley. It was a strange experience. Though I could talk to the nurse/doctor/phlebotomist (whichever lost the draw and had to attempt the job that time) in a perfectly sensible manner and apparently calm voice giving permission for the daily dracularisation of every visible vein in my forearms from knuckle to elbow, yet I could not stop the shaking of my legs that lasted an hour or more afterwards.

Occasionally the phlebotomist would have a lucky strike, straight in, gather the spoils and out again before I could say “Aaarrrgghhhhh!!!!!”. Astonished, I awarded 10 out of 10 to one young lady and began a less flattering score table for the rest.

Then I realised that, without really thinking why, I had never gotten round to donating blood. It seemed painfully obvious why at this stage. I have a previously unsuspected needle phobia. An abnormal or morbid fear or aversion, as my OED defines it.

I tried to talk to a passing cardiac specialist, Dr Verybusyman, about it. I won’t give his real name. That would not be fair since he was well respected by other patients and had the reputation of being on the ward earlier than any colleague and staying later every night, and of giving a straight answer to a straight question, a fairly rare quality in doctors of my previous acquaintance. I think the mistake I made was in not putting my question to him in a straight enough format. I tried to inject a note of humour, hoping for advice on how to cope with a needle phobia, but he was evidently A Very Busy Man. He shrugged. “You have the right to refuse,” he said as if I was too stupid to have known that perfectly well beforehand. I did not want to refuse whatever was necessary. I was just hoping for advice on how to cope. He walked away. Maybe he had a row with the wife that day, or maybe he’d watched too many episodes of Doc Martin, but at any rate it was pretty clear he had no time for my piffling needle phobia and I’m sorry to say his halo slipped somewhat in my estimation at that moment. Probably my own fault.

Anyhow… transferred to the other hospital and duly sliced and diced I discovered that even more blood tests seemed necessary after the op than before. Strange that nobody had mentioned that to me beforehand! The daily torture of the phlebotomist’s trolley got worse day by day until I was eventually reduced to that gibbering wreck from 1984, cringing on the bed in tears and begging to be left alone, even if just overnight, even just for an hour or two before the next demand for blood. It reached a stage where I openly questioned the wisdom of driving a person to such a level of stress after a heart operation just to get another blood sample, as compared to the risks of letting them rest and recover in peaceful ignorance of their detailed blood chemistry. I even asked at one stage whether any research was known on the subject. If there is not I suggest it would make a good subject for some budding doctor in search of ideas for his degree.  Or hers.

Finally, having reached the stage of actually refusing any more needles on pain of death (mine or his) the ward doctor and I looked each other in the eye and agreed a compromise. One more blood test. If that was okay they would discharge me to go home early. Even then it took another three goes before they got the sample needed.

So I’ll make no bones about it. I won’t try to hide it nor will I apologise for it: the fact is that I’m frightened of needles. I still can’t decide if it only started recently or if it has always been with me, unsuspected I suppose because there has never been an event in my life before that would have brought it to notice. Why, my GP once wrote to me threatening to strike me off his list since I had not seen fit to be ill enough to visit him in twenty five years.

But here’s the point

I used to laugh at people with what I thought were silly phobias – spiders, mice, frogs, whatever. Well I can tell you now I’ll never laugh at anyone’s phobia ever again. It’s not that the thing so feared is actually dangerous or terrifically painful. The phlebotomist, patiently poking about with her needles to find my recalcitrant veins was only doing her job and it was perfectly plain that others tolerated her ministrations (it usually was she) far better than I did. No, it’s the outright horror of mind that does for you, the over active imagination that sees the very jaws of the spider chomping into your flesh, or the point of the needle mashing flesh and fibre into a bloody pulp in its quest for the vein that eludes every effort. That’s what does for you. The problem lies not at the point of the phlebotomist’s needle but in my head. Like Dr Verybusyman despite his eminence, until you experience such a thing you can have no idea or understanding just how bad it can be.

Long live the NHS

But finally, nothing above should be construed to imply criticism of anybody mentioned. Throughout my stay at both hospitals everybody did their utmost on my behalf. From surgeon to nurse, specialist and ward doctor, students, domestic cleaning staff and volunteer dinner ladies, even, yes, the dreaded phlebotomists, they all performed their often difficult and sometimes distasteful duties faultlessly and with great skill and responsibility. I’m very grateful to everybody who had a hand in my treatment for all they did on my behalf.

As I write this with the NHS once again under fire in the nightly TV news for queues at Accident & Emergency all I can say is Long Live the NHS. For all its faults, mostly so far as I can tell too many chiefs and not enough Injuns, it has to be the best thing ever invented, and it is the front line staff, the doctors, nurses, cleaning ladies and dinner ladies who make it so.

My heartfelt thanks to everybody concerned, not least my wonderful sister for all her on going help and encouragement. I’m on the mend now.

One Thought on “A sneak peek into Room 101

  1. Jennifer on January 21, 2017 at 8:32 pm said:

    My goodness what a time you’ve had. And yes, Long Live the NHS

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