‘I went home and prayed... then the hospital rang’
Covid-19 meant Roderick Gilchrist’s urgent heart operation was cancelled – until his ‘genius’ doctors fought to find another way
Along with the rest of a grateful nation, last Thursday I joined the now ritualistic 8pm applause for our NHS workers. I have more reason to cheer than most. Recently, I was discharged from one of the big London hospitals at the centre of Covid-19, after they found a way to cure my life-threatening illness – which had initially seemed impossible, with the Government order that only emergency, not elective, surgery was to take place.
Without their ingenuity, genius, and deep desire to save lives I would not have survived the year. I believe I owe these heroes my very existence.
My problem was that one of my heart valves was calcified, or, in laymen’s language, blocked. It needed replacing immediately, otherwise the heart could stop completely. This followed a series of dizzy spells, correctly diagnosed at first by my GP as a heart murmur. Without the new valve, I could not survive for long.
“It’s like holding your thumb over a hose so that just a trickle comes out instead of a pulsing flow,” as the cardiac consultant put it. “Eventually, even that trickle will stop.”
Open-heart surgery was prescribed and I was admitted to Hammersmith hospital. Over three days, the medical team tried valiantly to get me into theatre, only to be overwhelmed constantly by the Covid-19 tsunami.
National Health England insists that virus victims must be given the first call for all ventilators, which keep the body breathing when its immune system has broken down, yet are also vital for open-heart surgery patients.
Each morning, just before I was due to go under the knife, with the surgeons gowned and ready to operate, I was giddy with nerves. This is a five-hour operation in which the heart is stopped, and fatalities on the table are not unknown. You have a five per cent chance of meeting your maker.
But, literally just after dawn each time, my procedure was cancelled because there weren’t enough ventilators. My medical team were also increasingly concerned that if I was admitted to intensive care, with the virus raging, I stood a very real chance of contracting it from victims in the next bed. My nerves were shredded.
It was a perverse irony that Covid-19 had left operating theatres dark, the cardiac surgeons frustrated, filling time by sending emails in their offices.
It seemed there was nothing more to be done. Although my condition was described as critical, I was classified as “elective surgery” and the hospital had no alternative but to discharge me. They could not say when my operation could take place, but probably not this year. By the time they could operate, my condition would have deteriorated with potentially fatal consequences.
Bidding me farewell, the surgical team urged me to take great care and self-isolate. Back home I wrote my will, said a prayer and prepared for the possibility of the Hereafter.
What I didn’t know was that the hospital was still fighting to find another way to save me. It was at this, my lowest moment, that an urgent call came from the cardiac wards. Could I come in for an immediate heart scan followed by a meeting with doctors?
The best brains at Hammersmith hospital had decided that as long as I wouldn’t need a ventilator and intensive care, there was nothing to stop them using a different procedure. This involved inserting the replacement valve into an artery in my groin, threading it through my body with a catheter to the heart, guided by a computer screen. It’s called Tavi – transcatheter aortic valve implantation
– and has replaced open-heart surgery in many countries. It’s the same op that Mick Jagger had last year when he had a heart scare, so I was in good company.
With this option, there was no need to cut the breastbone and put my body on a lung machine while surgeons stopped the heart, and there was no need for a long recovery period in intensive care. Jumping Jack Flash was up and dancing about on tour with the Stones in no time after his Tavi.
Why did they not recommend this option originally? The answer is that surgeons in the UK (though not, for instance, France and America) recommend open-heart surgery if the patient is fit enough because they say they can see with their naked eye the valve that needs replacing while guiding it into place. What was remarkable was when that was no longer an option, consultants kept working to find an answer.
This is how I found myself being wheeled into the blinding light of the operating theatre, all screens, computers and mysterious humming machines, around which eight greengowned nurses, doctors, anaesthetists and consultants moved with a relaxed air as if it was just another day at the office, which I suppose for them it was.
The anaesthetist said I would be operated on under local anaesthetic.
“Please put me right out,” I begged. “I don’t want to know a thing.”
My surgeon, Dr Iqbal Malik, soothingly responded: “You will be in a Zen-like state, I promise, but I like to talk to my patients while I am operating.” My God, please, I didn’t want a conversation!
As I lay on the operating table, he talked me through each procedure in a calm voice. Incredibly I felt quite relaxed and even began to take an interest in what was happening.
Twelve hours after the operation, I walked out of the hospital, a new organic £20,000 valve pumping inside my heart, with the promise that I could start jogging again soon. The next day, walking on newly mown grass in Holland Park in spring sunshine under blossomy boughs, felt like a rebirth. The world had acquired a heightened intensity.
I felt like a star patient, which in many ways I am. Dr Malik filmed an interview with me before the op. As I lay on the trolley before they wheeled me into theatre, he asked how I felt – “nervous, what do you think?” – and explained what was about to happen.
An assistant also filmed the screen that showed the journey of my new valve, as well as a post-op interview. That video is now on Youtube and, while I can’t claim I look my best, it demonstrates perfectly our NHS’S heroic endeavours. I think the hospital wanted to send a visible
It’s the operation that Mick Jagger had last year, so I was in good company
I felt quite relaxed and even began to take an interest in what was happening
message to others with lifethreatening illnesses that they had not been forgotten.
I am now on a national shielding helpline, and kindly officials call up to ask if I can manage my own shopping, and whether I have people to talk to if I get depressed.
All of this makes me feel like a huge fraud, as I feel fitter than I have for ages. I’m getting plenty of exercise on bike and foot, even light jogging again. Strict lockdown? Not when you’ve just got your life back. Before Dr Malik’s healing hands I was suffering dizzy spells, fatigue and breathlessness. Now I no longer get exhausted running up four flights of stairs in our thin terraced house.
I know how lucky I am. I don’t think it’s too fanciful to say that Dr Malik, a charismatic physician, may well have saved my life.
And yet it was a seemingly small act of kindness as I was being wheeled to the theatre that helped me recover my courage before the operation.
A saintly nursing sister, aware of my terror, smiled and whispered: “Good luck. You’ll be all right.” She then offered her gloved hand in a high-five. I weakly raised my arm and we slapped protected hands. The incongruity of this unexpected kindly gesture, a very human act of connection, made us both laugh and lightened my mood.
Somehow it seemed emblematic of all the medics’ sensitivity and care for the endangered. It was deeply heartwarming, and I make no apology for the pun.