Spectator – Carla Carlisle

A little fear resides in the back of my mind: that in an emergency I will dial ‘911’. Which might alert the emergency services in Hudson, Ohio, but won’t be much use here in Suffolk. A card saying ‘999’ taped above the kitchen telephone reminds me where I am, along with memories of the television 999, with its re-enactments of life or death emergencies. It was the warning voice of Michael Buerk that pushed me to take a course in first aid.

On the first day, the instructor asked how many people died in the Hillsborough Stadium disaster. We gazed silently at the rubber woman on the floor. ‘Ninety-six,’ came his solemn reply. ‘And if people there had known the basic “head-tilt, chin-lift” technique, 70 would have survived.’ I don’t know if he was right, but the head-tilt, chin-lift is tattooed on my brain: lift the tongue away from the back of the throat and open the airway. Place the patient on his back, then put one hand on the fore-head and the fingers of the other hand on the point of the chin. Push down on the fore-head and lift up and forward on the chin.

For years, I’ve been ready to save lives with my head-tilt, chin-lift, although the Heimlich and mouth-to-mouth have faded with time. After I read Joan Didion’s account of her husband’s heart attack in The Year of Magical Thinking, I vowed to take a refresher course, even though his was an instant, massive heart attack that even defibrillating paddles wouldn’t have helped. Then one Saturday morning a few weeks ago, my husband quietly mentioned that he’d been awake at 3am with a chest ache (‘Not a pain, an ache’). He then got up early and went for a six-mile bike ride to collect the Saturday papers. The ache had returned.

In fact, I didn’t call ‘911’ or even ‘999’. I called our GP’s surgery, got one of those weekend call centres. Within 10 minutes, an ambulance was in the drive, the reluctant patient apologising for taking up their time as they attached the ECG tabs to his chest. Minutes later, they were off to the West Suffolk Hospital where the Coronary Care Unit was waiting for him.

As heart attacks go, it was mild. And lucky: the angiogram showed that his main arteries were seriously clogged. Three weeks later, he was at Papworth, where Prof Wallwork performed a coronary-artery-bypass-graft operation, sometimes called a CABG or ‘a cabbage’, a four-hour procedure where short segments are harvested from a leg vein and attached to the aorta and to points beyond the obstructed areas in each of the narrowed coronary arteries. ‘It’s like rerouting traffic around a motorway pileup,’ explained the Professor.

That was six days ago. Today, I’m bringing him home. A few weeks ago, the only people I’d heard of who’d had quadruple bypasses were Henry Kissinger, Dick Cheney and Bill Clinton. Now everyone I meet knows someone who has had a ‘cabbage’ and the Born Again stories sound like biblical miracles. A staggering 28,000 are performed in the UK each year.

More troubling, 270,000 people have heart attacks in the UK each year. A third of these die before reaching hospital. When I’m not Googling ‘heart disease/coronary bypass’, I re-play the scene: me insisting, the English stiff upper lip husband arguing that he’d rather ‘wait and see’. I uncovered a letter written in 1628 by William Harvey M. D. to Charles I: ‘The heart of creatures is the foundation of life, the Prince of all, the Sun of their microcosm? from when all vigor and strength does flow.’ I’ve taped it in the kitchen next to ‘999.’

This article first appeared in Country Life magazine on June 22, 2006.