Patient Read online

  Praise for Patient:

  ‘Many people suffer the pain and indignities of intensive medical treatment, but few have written about it with quite such alarming vividness or clarity’ Daily Telegraph

  ‘A fine testimonial to [Watt’s] fortitude, his powers as a writer and the NHS’ William Boyd

  ‘In conversation Watt is an articulate and thoughtful speaker, disarmingly humorous but sensitive to even the tiniest nuances. It is a talent that is much in evidence on the pages of Patient and one which gives the book its tremendous cathartic impact’ Scotsman

  ‘Laced with nostalgia for childhood and the life we take for granted, Patient is as gripping as an airport novel and as gruelling as a horror story. ****’ Q

  ‘A harrowing record of the fear, pain and humiliations which make up serious illness and hospital stays’ Nursing Times

  ‘Remarkable and moving ...What emerges is a testament to one man’s courage and the ability of the human spirit to find solace and healing in the middle of despair’ Muzik

  ‘A fascinating book ... Simply, poignantly and unsentimentally told’ List

  ‘An extremely vivid description of the effects of illness and the feelings of hopelessness and mortality it invokes. ****’ Maxim

  ‘Patient is a remarkable literary journey: the quest to understand the physical self ... His survival makes compulsive reading’ Arena

  ‘Compelling ... An eye-wateringly harrowing and candid account of his near-death from one of the world’s rarest diseases’ Mail on Sunday

  ‘An understated, unemotional account of illness made all the more effective by its matter-of-factness’ Sunday Times

  ‘Watt is made of particularly fine stuff, possessed of a shining intelligence that allowed him to transcend his horrible circumstances ... I cannot think of any book that so clearly describes the gap between sickness and health’ The Times

  For Tracey

  Special thanks to Tracey, my parents Tom and Romany, Jennie, Charles Mackworth-Young, Rod Hughes, Chris Wastell, Nick Law, David Lindsay, Silé (Sheila) Taylor and the National Health Service. Additional thanks during the book’s completion to John Collee, David Godwin, Tony Lacey, David Eldridge and Alexandra Pringle.

  Contents

  Preface

  One

  Two

  Three

  Four

  Five

  Six

  Seven

  Eight

  A Note on the Author

  By the Same Author

  Preface

  Everyone is shocked by their first real hospital experience. When I was seven I fell off a wardrobe trying to find an Action Man and I remember a green-stick fracture in my arm, the trip up to Queen Mary’s, Roehampton, and the excitement of proper plaster of Paris to take to school the next day. And I remember the three hours waiting with a severely twisted knee after a football match as a teenager, the same injury a few years later when I needed physio, and the occasional winter chest X-ray. But none of these instances can count as a real hospital experience: I didn’t really make it on to the mountain. I saw Accident & Emergency (or Casualty as it is often called) and witnessed put-upon nurses, senior house officers and doctors called in from elsewhere with their ties loosened and top buttons undone, daytime drunks, kids with their mums, sweating relatives, people with nothing wrong with them, people with something seriously wrong with them but they didn’t know it yet. I didn’t even get a proper bed – I didn’t need one – just a chair or maybe a hard trolley. (I always wondered why they had to be so hard until I found out it’s to help them get their hands under you to flip you over in theatre, should you get that far. They are not meant to be beds. They are meant to be worktops.) And the trolley would have had a strip of green absorbent paper for a sheet, pulled off a wide roll, and I probably stared at the back of a piece of curtain material half-pulled across my cubicle and caught sight of someone doing exactly the same across the corridor. And mostly I got away within a few hours, out on to the cool street again, not really very unwell, real people walking by, buses, super-sensing the journey home, maybe bandaged with any luck – to at least show I’d been in the wars.

  I was in a bad car crash when I was eight. That took me a little way up the mountain. The crash happened in Scotland, on the way to the swimming-baths in a suburb of Glasgow. I was on holiday. My mum and dad were in London. My grandfather was driving. My grandmother was in the back seat. I was in the front, my feet up on the dashboard. We were in a Mini. We approached the lights at the crossroads, the lights went red, and my grandpa just seemed to accelerate. I heard my grandma shout, ‘Will!’

  When I came round, there was a crowd around the car. A tiny trickle of blood was on my ear. Hundreds of small crystals of glass like transparent cane sugar were all over my lap. The car wasn’t in the middle of the junction but pushed well over, as though we’d turned left but sideways. There was a double-decker bus stopped too. My grandpa wasn’t speaking. The bus had hit his side of the car on the junction, side on. The steering-wheel was very near me, touching against my leg. It seemed odd to have the steering-wheel that close to me, like it had been positioned in the middle of the car for use by either passenger. My grandma was lying on her side on the back seat. She was saying something to me. Her shoulder seemed tucked behind her back. An egg yolk was dripping off the seat, and there were peas on the floor. My legs were scrunched up on the dashboard. I always travelled with my feet up. They had stopped me being thrown out of the car.

  I couldn’t tell how much time had passed. It felt like a minute, but it must have been a while for the ambulance to have already got there. A woman I’d never seen before helped me out with an ambulance man. I was barely marked. She’d been a passenger on the bus. We had to wait while they cut my grandpa out. In the ambulance he opened his eyes for a second and said everything would be all right, but then he closed them again. He was very pale. The liver spots on his balding head stood out. His fine, wispy white hair was messed up like he had been sleeping on it. He didn’t have his glasses on any more, which made him look less like him.

  I didn’t see him again after that. The woman who helped me out of the car stayed with me at the hospital until Great-auntie Peggy arrived from across town in Knightswood. Grandma and grandpa had been taken away. A nurse put a sticking-plaster on my ear and they X-rayed my skull. I talked to some men in the day-room and fingered the bump on my head. I thought it was odd that they were in dressing-gowns and pyjamas in the middle of day, all men together watching TV. Watching TV in the middle of the day with my pyjamas on was something I only dreamt of One of them bet me a bottle of Scotch that Chelsea wouldn’t beat Real Madrid that night. I didn’t know what Scotch was.

  Back at Peggy’s, later on, I was allowed to stay up and watch the match. The European Cup-Winners Cup Final 1971. Chelsea were my team. Ossie, Charlie Cooke, ‘The Cat’, Chopper Harris. I’d been looking forward to it, but Peggy only had a black-and-white set with a funny fish-eye picture. I didn’t enjoy it much, but I was allowed to eat sausages in front of it. My dad arrived. He had flown up. I heard him talking to Peggy in the kitchen. I remember him being furious – not with her, but with my grandpa for endangering my life, his son. I didn’t often hear him raise his voice.

  The next day he sent me home on a plane on my own. I was looked after by an air-hostess. She gave me a BEA keyring. My grandma had dislocated her shoulder. My grandpa died in the hospital on Intensive Care.

  Even bearing in mind the impression that it made on me as a young boy, I still regard this story as a mild hospital experience, only one foot on the mountain. Much in the same way I look on my wisdom-teeth operation in my mid-twenties, when I went in for the day but as an out-patient only. All four wisdom teeth were to come out in one go. I had my first general ana
esthetic – I felt like a big shot – and found myself recovering on a day-ward with two other people my age, with a mouth and tongue like shoe leather and a head like towelling. By the end it had been an adventure. I had even put a jacket and tie on to go down to the hospital and had treated it like a special day out. I was charming to the nurses because I knew I would be home by teatime, and I was too – over-pampered when I got in, flowers from Tracey, an unnecessary bed made up and ready should I have felt poorly, which of course I didn’t. The teeth had almost fallen out. ‘Like honeycomb,’ the surgeon had said. I was out at the pub by eight o’clock.

  It is the first time they keep you in that really matters. Overnight is when you are really on the mountain. It makes you lose your bearings a little more. It is the unfamiliarity and the institutionalized accessories that first get to you – starched pillowcases with the hospital’s name on, theatre gowns, walls of fake-gaiety get-well cards, tablets served in a tiny plastic cup like the top off a bottle of Night Nurse, the smell of heavily washed floors and sterilization. It seems so primitive, so unlike home, so barely adequate. And how those reassuring words from the doctors who send you in (‘Oh, you’ll be in and out in twenty-four hours. You won’t notice you’ve been in’) seem so misleading as you lie trying to sleep for the first time in a room with only half the lights turned off at night and nurses whispering. And the little things we’re in for turn out to be not so little after all. An endoscopy. A laparoscopy. A miscarriage. Keyhole surgery. ‘It’s nothing,’ they say. But they all bring invasion. Scraping around and needles; disorientation and sutures. We can’t wait to get home.

  One

  It’s June 1992. I am lying perfectly still on top of the sheets on a wide, clean bed in a private hospital near Harley Street. I have my shirt off. I am having a heart test – an electrocardiogram. The nurse has just left and sent a doctor to see me. The doctor has just popped her head round the door and asked me if there is any history of heart disease in my family. I said no. She tells me she won’t be a moment. The door closes. I am twenty-nine. A few minutes pass. A man enters. He is wearing a crisp pink shirt with a white collar. He has kind eyes and a racing-driver’s moustache. He looks like he knows a thing or two. He smiles and sits on the edge of my bed. There is bad news and bad news. The bad news is he thinks I am in the middle of a long, slow heart-attack, and the bad news is, if not, then he thinks I am about to have a massive one. I smile back.

  I have had difficulty walking and breathing for ten days. Pains in my chest. Pains in my belly. Aching pains in the joints in my left ann. In my calves. I’ve been clutching hot-water bottles, sitting under a blanket staring out at the garden. I’ve been rocking back and forth on the kitchen chair for sometimes three-quarters of an hour, pressing my hands against my ribs, crying, talking to myself out loud, telling Tracey not to worry. She has stood before me, pale, not knowing whether to act. Later, I have lain in bed with the light out, Tracey beside me, and stared up at the dark ceiling, and listened to her staring too.

  My lungs feel raw. I am taking massive doses of inhaled steroids. My asthma has been chronic. The other day I cried in front of my GP and walked out. I am seeing an acupuncturist twice a week. Yesterday I cried in front of her. She says my energy is alarmingly low. Last week I saw a homeopath. I told her all I know. I began at the beginning. She gave me tablets. Since then my asthma has improved but the pains have increased. Is this meant to happen? Is it even connected? I don’t know what to do. The taxi was late. I had to rush. I had no breath. I walked like an old man. In the waiting-room, I had to ask the nurse for a glass of water. I read the property pages in an out-of-date Country Life, and now I have been told I am having a heart attack.

  In many ways that appointment at the London Clinic was really the end of a beginning that had been going wrong since Christmas. I’d been a mild asthmatic for a few years, but as the new year came I was unable to climb the stairs and my lungs were just aching all the time. I would often wake in the night gasping for air, inhaling as though through thick gauze, and for a week in January I had to stay in bed all day, weak and still, frightened to breathe. I was treated with three strong antibiotics for a possible chest infection. They did nothing. Probably viral, my GP said. All the same, I moved from the basic Ventolin inhaler to the harder stuff – Intal, Serevent then Pulmicort. When my GP finally referred me to a consultant chest specialist, after four more bad weeks and two short courses of oral steroids, my symptoms were confirmed as still nothing more than those of a recognized asthmatic with a history of hay fever – I’d had skin-prick tests in 1989 following bad sinus problems, which had detected a not-uncommon hypersensitivity to household dust mites. The chest specialist gave me turbohalers. The big ones. The 400s. My GP didn’t want to pay for them.

  Things improved temporarily. I took a week’s holiday in Crete, thinking warm fresh air would help, and even flew to Japan with Tracey and the band to play ten days of concerts where I couldn’t take deep enough breaths to sing all the words. But within another fortnight I was home again and in trouble. I went back and asked the chest specialist how serious he thought things were. He said four out of ten. I couldn’t believe him. I was up to 3,200mg of inhaled steroids a day.

  At home we tried to keep the house scrupulously clean, vacuuming and dusting three times a week. We bought a special vacuum cleaner for asthmatics, as well as bedding and pillows that discouraged house dust mites. I bought my own peak-flow meter to monitor the strength and puffin my lungs and just watched my breath get shorter. I would flake out early in the evenings, my body gripped by lassitude and viral pains in my shoulders and my elbows. All day I would monitor my food intake, trying to find a pattern that might link my asthma with something I was eating. I avoided dairy produce, caffeine, red wine, shellfish, oranges and tomatoes. I tried supplements – multivitamins, evening primrose oil, garlic oil.

  By May, all evening meals were leaving me wheezing badly. My eyes would be shot with blood for twenty or thirty minutes at a time. I would have fast furious sneezing attacks – repeated sneezes one after the other, bang, bang, bang, for four or five minutes. I took up the Alexander Technique to try to relax and to open my lungs a bit more. I had a few lessons and would finish supper by lying on the floor with my knees up, trying to calm the pounding in my chest, the palpitations in my arms and my flushed neck and face. Friends would come round and I’d say it was normal.

  In the days running up to my electrocardiogram my asthma suddenly seemed to ease off. It was like a storm passing over. I thought maybe the homeopath’s tablets were working, but on the afternoon before the test I had forty minutes of chest pain like never before. I called the chest specialist myself and told his secretary I had to see him. I thought it was an emergency. I’d pay privately. She fitted me in that evening. I went down with Tracey. The taxi-driver thought we must have just argued we were so quiet. We were both scared. The consultant was measured and calm. My distress seemed to make no impression on him, but he arranged a private chest X-ray and an ECG for first thing in the morning. That night at home I lay curled up in the middle of the bed and thought if I took one more breath my chest would burst open.

  Even so, looking back on that morning at the London Clinic I couldn’t help thinking I was being wheeled fully clothed to a waiting ambulance for the wrong reasons. A heart attack seemed so removed from my experience and, moreover, the homeopath had said I’d get worse before I got better. I was a young man, a treatable asthmatic, not an old man with a weak heart. A bed had been found for me in the Coronary Care Unit at Westminster Hospital. The unit at my local hospital, the Royal Free, was full, with three waiting. Coronary Care? How old was I? It must be a mistake. Cruising through central London I felt bewildered. The ambulance man asked if I felt OK. I said I supposed so. It was summer outside. Tracey was on her way.

  When we arrived it was midday. The place was humming with people. I was checked in by a receptionist and left against the wall by the men’s loo.

  ‘
You be all right?’ said the ambulance man as he was going.

  ‘Yes. What now?’

  ‘Don’t try and get up. Sit quiet and someone will be down in a minute. Take it easy.’

  He left.

  Take it easy. Don’t try and get up. I sat calmly in the wheel-chair, expecting a seizure at any moment. He’d left me facing the wall. I felt humiliated. Disabled. A pool of water was seeping from under the loo door.

  A nurse came for me. Up on the heart unit I was told to get undressed ‘slowly’ and to lie down ‘gently’. Curtains were pulled round the bed. It was close and hot. I listened to voices, and watched the feet below the curtain as they hustled back and forth. A male nurse in a white tunic arrived with a trolley and another ECG machine. He took out a yellow Bic razor and began shaving little tufts off my chest with no water or soap. I was fitted up with half a dozen suckers, each wired into a multicore leading to the machine. I thought of little toy bows and arrows. Some of the suction pads wouldn’t stick, so a bit more hair was shaved off. I could feel my heart beating. I kept thinking I could hear it stopping.

  Tracey arrived. She had my soft grey shorts in a carrier bag. We sat behind the curtain. She had chased me across town, arriving at the London Clinic expecting a calm chat with a doctor only to be told I’d just been taken to Westminster Hospital in an ambulance.

  My pulse was taken and a thermometer was slipped in my mouth. My blood pressure was read through a huge black Velcro tourniquet. The male nurse left. He asked if I wanted anything. I said not really, but then stopped him as he was going and said a wire coat-hanger for my clothes. He looked surprised but said he’d fetch one. I thought everyone was talking about me – such a young man on a coronary care unit.