After my weeks in intensive care, where I had decided to keep everyone on their toes by first being more of a broken jigsaw on the operating table than anticipated, then by trying to rip out all my breathing and feeding tubes and finally by contracting a chest infection that turned into pneumonia, I was taken down to the High Dependency ward. Before I left, finally actually conscious for the first time in a fortnight but still as high as a kite, a collection of people pitched up at the foot of my bed to say goodbye. Most of these people, it seemed, had been part of the operating team under my consultant and all of them, including the consultant, said something along the lines of “Well , you’re looking a LOT better. We were quite worried about you there for a while”. I didn’t have a mirror but it wasn’t a huge leap to guess that after two weeks in an induced coma and all of the above adventures, none of which included a shower, I was looking pretty terrible so I must have been looking REALLY terrible earlier in the fortnight. I soon concluded that such British understatement as “we were really worried about you there for a while” from seasoned professionals to patients in intensive care basically translated as “Bloody hell, are you still alive? Who knew? That’s ten quid I owe Figgins.”
So it was that, newly imbued with my near brushes with death, I felt a sense of hope and relief as the orderlies body boarded me into my new bed and then trundled me off to the heady uplands of High Dependency. The HD ward is a halfway house between the ICU and general wards for people who are judged not so imminently likely to turn up their toes that they require one on one 24hr supervision but nonetheless are still poorly enough that they need close, medical supervision and a certain amount of kit. In my case the HD ward had four beds and two specialist nurses on duty at all times. The nurses’ station was at one end of the ward and I was wheeled into the space closest to it as the one to keep an eye on if there wasn’t to be a tedious amount of paperwork. It was from this space, for the first few days, I proved to be a complete pain in the arse.
First, I was still unable to speak or eat due to both my trachea and oesophagus having tubes down them but I was now conscious more than I was unconscious. The last time I had been properly conscious was before I had so inconveniently hit the ground from the horse so I had never had my brain operating in an environment where it couldn’t feel my body. Since my brain couldn’t feel my body touching any part of the sheets but it could feel the nerve pain in my feet, it, not unreasonably, concluded that I wasn’t therefore touching the bed and from that it was short, cognitive jump to the conclusion that I had been hung upside down over it. This may seem crazy and yes, I was still full of morphine at this point but anyone who thinks it’s entirely crazy has clearly not been slung upside down and jumped on by physios to clear their airways. I took umbrage at my imagined predicament but, unable to express my concern and therefore have someone explain that I was in fact horizontal and not trussed up like the Spanish Inquisition’s next project, I could only thrash one arm and my head about and refuse to go to sleep. This did not make my point very lucidly. I did this for the first 24 hours.
For the second 24 hours I hyperventilated. My new ventilator was much more powerful or turned up higher than the one I’d had for weeks in the ICU. Therefore when I eventually gave up being a loony and settled down I discovered that my lungs were being pumped full of air like a farrier’s bellows. After weeks of not having them filled with air, this was alarming and disconcerting
(A small aside on ventilators. The main aim, understandably, is to keep you appropriately oxygenated and blood oxygen levels are carefully monitored accordingly. However, there is a world of difference between ‘appropriately oxygenated’ and a lungful of air. I can tell you from experience that a nice nurse can be pointing to your safe 98% oxygenated number on your monitor and you can be flailing like a landed fish with barely any air in your lungs and your brain screaming at you to breathe. The problem with breathing is that, if you try to take over, what you actually do is fight the ventilator and stop it from getting any air into you. so, ironically, you actually then get nothing and start suffocating. I heard one nurse crossly telling a fellow ICU patient also on a ventilator and struggling to breathe that he was and I quote “doing it wrong”. Personally, I just couldn’t stop myself breathing all together so my ventilator and I reached a compromise where I worked out that if I just breathed *really* shallowly this would allow me enough ‘breathing’ to keep my brain from fighting me and little enough that the ventilator could put air in. This was, to put it mildly, a horrible struggle and honestly, the most difficult thing I encountered in this whole experience.)
Where was I? Oh yes, having my lungs filled with air like a party balloon. I objected in my customary fashion – by thrashing one arm and my head about and refusing to go to sleep. Eventually someone worked out what was going on and turned it down a bit.
In my third 24 hours I made a valiant attempt to die which nearly succeeded. In ICU and HD patients are attached to machines monitoring their essential functions and these machines emit a cacophony of beeps at all times. ICU is a noisy bedlam and not at all the quiet, restful place usually depicted on the telly. Even now the sound of a beeping machine brings me out in goosebumps. These machines are also equipped with alarms to attract attention when one of the vital things they are monitoring hits a glitch.
In my case the alarm on my ventilator was not working – a fact I discovered on my third night at around 3am when the tube connecting me to the machine just dropped off. You’d think that something so important would be slightly more firmly attached but it appears not. I awoke abruptly, suffocating. The lights were off in the ward, save for around the nurses’ station, where our two nurses were chatting away quietly. I was in the darkness and, turning my head, I could see that both of them had their backs to me. I frantically waved my arm and desperately tried to make some noise but, to function, the voice box needs air running over it and mine had none thanks to the tube down my trachea. I continued to suffocate. The conversation between the nurses murmured on. I can’t remember what they were talking about now but I can remember that it was inconsequential compared to the fact that I was completely unable to breathe. I suppose, to be fair, most conversations would be unless they were of the “Oh crap, this one’s not breathing. Quick, reattach the tube” variety. Anyway, flat on my back, I remember staring at the ceiling and banging my working arm against the bars of the hospital bed trying to attract their attention. Part of my brain was gibbering with fear. Another part was unable to process the fact that, after all I had survived, I was about to die 15 feet away from help from something so utterly stupid and another part was coldly calculating that I had been without air for about 90 secs and, in my weakened state, I probably didn’t have much more than another 60 before I passed out from lack of oxygen and went back to looking like I was peacefully asleep when, in actual fact, I would be very much unpeacefully dead. I kept banging my arm against the bars. It made a dull thudding noise that could not be heard over the chat. An overwhelming sense of utter hopelessness swept over me combined with pure fury. I kept banging my arm and, suddenly, the nurses’ chat reached a natural pause. Then I heard “What’s that noise?” and one of them turned round, peered into the darkness and, thank God, spotted my waving arm. She made her way over where, presumably she saw the machine flashing something (but very much NOT making any alarm sounds) and quickly reconnected the air. I cried and gibbered for quite a long time afterwards. The nurse kindly stroked my hair and promised that they would keep a very close eye on me for the rest of the night.
I made it through without the tube falling off again but at the morning’s ward round my escapade was a hot topic. Now, those of you who have not spent a lot of time in an NHS hospital are probably imagining that the solution was that my murderously faulty ventilator would be retired to a large dustbin stat and replaced with one that was much more reliable. Hahaha. Those of you familiar with the NHS will already have guessed that the reason that one so faulty was still there at all was because there were no shiny, new ones to replace it and no money to buy them with either. So the nursing staff came up with a lateral answer that was pure brilliance – practical, effective, entirely cost free and quick. They bandaged a metal dessert spoon into my hand so that when (not if, you note, when) the ventilator disconnected itself again I could bang the spoon on the metal bars of my bed and this would make a much louder noise than my fist.
The following night I drifted off to sleep, one arm resting outside the covers and ending in a vast swathe of crepe bandage within which nestled the spoon. It had to be bandaged in because I had no grip in my hands at the time so couldn’t grab and deploy my new alarm at will. Sure enough, in the depths of the night, I awoke again gasping for air. I clanged my spoon loudly against the metal bars and was reattached within seconds. I felt great relief and and a flood of positive emotion towards my trusty spoon. Presumably my fellow ward mates, rudely awakened out of their slumber, felt entirely the opposite way. I’m sorry to relate that my spoon and I slept together happily for the rest of the week and, during that time, I woke them all several more times with my impromptu alarm. It occurs to me now that I’m probably one of the few people around who owes their life, in part, to a dessert spoon.