Homage to Gaia (56 page)

With the decline of this alternative medical treatment from Jenny and from her world, I began to seek conventional medical advice. In
October I asked friends from my days with the MRC who might be the best cardiologist for me to see. They replied unanimously that Dr Douglas Chamberlain was the one. I was about to arrange to visit him when an invitation came from the United Nations University in Tokyo. They offered travel costs and a fee for a lecture on Gaia. This was too good a chance to miss and it enabled me, by travelling on a round-the-world ticket, to fulfil my United States obligations to Hewlett Packard and NOAA. It also allowed me to make the whole journey in the kind of comfort that would be no stress. Soon after accepting the Tokyo invitation I arranged also to visit NCAR, which is one of my favourite United States laboratories, and is sited magnificently on the side of a mountain overlooking the town of Boulder in Colorado. There I looked forward to exchanging ideas with old friends on atmospheric science and, as always, seeking new discoveries that might point towards the self-regulation of the Earth and Gaia. I also accepted an invitation from my friend, Bill Thompson, the Irish-American historian and founder of the Lindisfarne Fellowship. The Fellows of Lindisfarne were an eclectic mix chosen, mainly by Bill himself, from a global elite. They meet annually and include Dean Morton of the Cathedral of St John the Divine in New York, the economist Hazel Henderson, Amory and Hunter Lovins, and John and Nancy Todd. I am a Fellow of Lindisfarne and so is Lynn Margulis. The organization has its base near Crestone in Colorado and the Lindisfarne house was up on the mountain slope. The Lindisfarne fellow and architect, Keith Critchlow, designed it according to the principles of sacred geometry, and it had the ambience of a sacred place. I can remember little of my visit to the Lindisfarne house, other than the warmth of Bill's greeting and a walk up the mountain one day with Christina Watkins, another young woman, and the poet Gary Snyder. It was a picnic: Christina Watkins and her friend carried wine and food for us in their rucksacks, and we climbed to a point just above the tree line, which in that part of the world was about 10,000 feet in height. I popped my trinitrin as we climbed and felt no distress in spite of the thinner air. Perhaps my American companions were walking and climbing more slowly than I was accustomed to do: anyway, it certainly did not seem stressful. It was good companionship, healthy exercise, and fine food, the flavour heightened by the picnic atmosphere and by our hunger. Bill Thompson retired in the mid-1990s and the Fellowship is now led by the author and physicist, Arthur Zajonc.

From Lindisfarne, I flew to San Francisco, and then took the long fourteen-hour flight to Tokyo on Northwest Airlines. There is no question that first-class travel by air greatly diminishes the stress of long-distance travel. It has little to do with the food, drink, and personal attention from the cabin staff; it is simply that in first class there is space to lie flat and sleep—something impossible in business or tourist class. I have often wondered if an airline might be courageous enough to put in bunks, perhaps stacked three high, and so provide the blessings of proper horizontal sleep to business, even tourist-class passengers. It was about 5 pm local time when my plane set down in Tokyo. I was anxious, for I had no words at all of Japanese and expected Tokyo to be the most alien place that I had yet visited. As I walked along the corridors linking the disembarkation point from the plane to customs and immigration, I felt a strong sense of the familiar. Suddenly, it came to me that Narita was just like Heathrow, and not at all like any American or European airport. What constituted this familiarity was hard to pin down. Partly it was the shape and layout of corridors, partly the voice of the lady speaking English-style English and Japanese instructing us on what we should do, and also perhaps the body language and movement of the Japanese themselves. Suddenly, whatever it was, I felt a sense of being at home. It was a feeling for Japan that was to persist and strengthen right through my most recent visit in October 1997.

When I returned home in mid-November I resumed my regular walking and had a few more of what my grandmother would have called, ‘nasty turns'. This reminded me that it was time to get in touch with Dr Chamberlain. I wrote to explain my problem and tell him why my local medical specialists did not seem able to help me. He replied courteously and suggested that I go to see him the following week. A week later, I went to stay the night with my son Andrew at his home in Warminster, Wiltshire. He had kindly offered to take me to Brighton the next day. Andrew is a tall, good-looking, talented man shaped by the culture of the 1960s; he graduated in physics from Sussex University in the early 1970s and has subsequently worked as an independent computer consultant. Andrew and I find communication difficult, but it does not seem to matter too much. He and his partner took me by car next day to the cardiology department of Brighton General Hospital where, after a short wait in the outer office, Dr Chamberlain called me in. He had a large and comfortable room full of books, and filing boxes, with that air of mild untidiness characteristic
of a busy and productive man. I sat down, went through my all too familiar tale, and wondered, after my experiences with Dr Marshall, the Plymouth cardiologist, if I were making too much fuss over an insoluble problem. Dr Chamberlain listened and made notes and then said, ‘I have to do a ward round now.'

In English hospitals, the ward round is a ceremonial occasion, held every few days, when the consultant physician or surgeon makes his round of the ward and visits personally each of his patients. It is quite relaxed now, but I remember what an occasion it was when that stern figure, the matron, made sure that every bed was spotless, and every nurse was almost standing to attention, rather like a visiting General inspecting a regiment. It still has an air of ceremony attaching to it. Dr Chamberlain said as he stood up, ‘While I am away, I would like you to have a few tests. After the round I'll return, and we can discuss the results.' He showed me into a room full of instruments and apparatus and went off on his round. The room was the sort of place in which I was entirely at home, although I can imagine many patients being fearful and intimidated by its hi-tech ambience. In all of my dealings with the physicians and surgeons of this affair, I have never had any apprehension or fear. Medicine and surgery had been so much a part of my MRC days that the sights and smells of clinical medicine did not disturb me. What I felt, indeed, was a sense of adventure, almost like the arrival at a long-anticipated holiday destination; the senses heightened and the mood receptive.

Dr Chamberlain had introduced me to the nurse and technician before he left. They asked me to stand on an exercise ECG, which was a short sloping path with handrails on either side. The surface of the path was a moving belt, so that as I walked I did not move forward. A bit like
Alice
Through
the
Looking
Glass
where the Red Queen says, ‘Now, here, you see, it takes all the running you can do to keep in the same place. If you want to get somewhere else you must run twice as fast as that.' Soon they joined me to an amazing array of electrical leads, so that I must have looked like the prey of a giant cephalopod. First, I stood still, and they took their readings, watching the paper charts flow beneath their fast-moving pens. They asked me to walk at my normal pace, and I did, while the charts continued to pour from the recorders. Then, like an anticipated acquaintance that one meets every morning walking to work, the angina came back to me. Suddenly, the nurse who was watching the charts said to me, ‘Stop', turned to the technician and asked him to go fetch Dr Chamberlain,
then turned to me, took my arm, and sat me in a chair. She disconnected the leads and I sat waiting until Dr Chamberlain appeared. I knew that something must have happened, for consultants do not normally interrupt their clinical rounds. The nurse took me back to the waiting room, where Andrew and his partner were sitting. They asked me what was the news and I said, ‘I don't know, but I'll soon be told by Dr Chamberlain.' Within a few minutes, I was back in his office. His first words to me were, ‘Would you like your family with you, for I fear I have bad news.' ‘No,' I said. ‘It would probably upset them a lot more than it does me.' He then told me that the ECG suggested that my heart muscle was seriously deficient in blood supply, and that most probably I needed surgery at the earliest opportunity if I were to survive. This was the news I had been expecting all along, and perversely it was good news. My body told me that at last someone had heard its urgent messages, and the year's anxieties lifted. I felt so grateful to Dr Chamberlain: he was someone I knew that I could trust with my life. He went on to say, ‘I will try to arrange a bypass operation in the next two weeks at the latest. Go home and if I have not called you within a week, call me.'

Andrew drove me back to Westbury Station and I travelled from there to Exeter by train and drove home. It was now early December, and the dark days of northern winter with a full gale blowing, as I travelled from the station along the old A30 road. There was little traffic, and the high beams of my headlights merely illuminated the raindrops and not travellers on the other side of the road. I arrived back at Coombe Mill about 7 o'clock in the evening. Helen was anxious and I told her the news as gently as I could. She saw that I was cheerful and looked on the coming operation as both an adventure and a cure; this helped, I think, to allay her fears. The next day, as I walked around our fields, which at that time were open grass, not the forest of trees now there, I wondered if these days would be my last. In spite of the dull skies and drizzling rain, I knew I loved this place, and how much there was to lose. I telephoned Alan Edwards, told him the news, and got his reassurance. Dr Chamberlain was, it turned out, his mentor as a student, and a man he greatly respected. I must declare here my passionate belief in our National Health Service—even if I could have afforded private medicine, I would not then have used it. I also knew enough about the practice of medicine to be aware that in large problems, such as heart surgery, the facilities available to private medicine rarely matched those of the National
Health Service. But excellent though it is, the Health Service is not free of drawbacks, as we shall now see.

After a few days, Dr Chamberlain called to tell me to go to King's College Hospital in London for an angiogram, and prepare for at least two days' stay. Jenny offered to come with me, and I met her at Exeter Station. We travelled together to Paddington, and from there took a taxi to King's College Hospital, where I was put into a pleasant single room with a bath attached, called Stork Side Ward. Jenny stayed a while as I settled in. I assured her that I had no fears, and soon after she had left, I started to read a novel, and then fell asleep.

The next day I was prepared for my angiogram by an intravenous injection of Valium. I did not really need it; I was calm enough anyway to cope with the minor procedure of an angiogram. This consists of inserting a narrow-bore catheter into the femoral artery and then feeding it up through the aorta and into the ventricles. They did it so expertly that I was unaware of the insertion of the catheter, or its passage up through my arterial system, and while they did it, I was lying on the table beneath a monitor that showed a live X-ray-image of my chest and heart. They then injected x-ray-opaque dye into the catheter: the screen showed my heart suddenly darkening, with its blood vessels outlined like black twisted wires. I understood little of what was happening, but I recognized that there was some excitement amongst those around me. ‘Look at this,' one of them said. ‘He's built his own bypass.' They gave me some trinitrin and took another set of pictures of my heart as the dye passed around it. I could now see on the monitor a line of black going transversely across my heart, from the right coronary to the left. They took me back to my room, doubly euphoric from the Valium injection and from the participation in so interesting a physiological experiment, and I soon fell asleep.

After breakfast, three distinguished visitors entered my room—the Professor of Medicine, Dr Jewitt, Dr Chamberlain, and Mr Keates, the surgeon. After a round of good mornings, Professor Jewitt said, ‘I am afraid you have a left main block—the complete block of the coronary artery before it bifurcates. Hardly anyone survives this, but you are fortunate to have a small artery connecting the right coronary to the left main at a point below the blockage, so that blood is being supplied to the left ventricle, retrograde, along this artery.' He did not add, ‘That is why you are here now and not long dead.' He went on, ‘However, it is a precarious state to be in, and we are arranging for a bypass operation to be done at the earliest opportunity, which as it
happens is in a week's time. We would like you to stay in hospital until then. We do not consider that it would be safe for you to leave before the operation.' ‘That won't do,' said I. ‘I must return home first. My wife is severely disabled by multiple sclerosis and it is too much to leave her alone unnecessarily next week worrying about me—especially since I clearly won't be home to see her during Christmas.' At first both Dr Jewitt and Dr Chamberlain were adamant. I could die at any moment, they said, and should not think of travelling. I felt sure they were wrong and said so. Why, only a month ago I travelled around the world—even climbed on a mountain from 8,000–10,000 feet without harm. If I could do that, surely I could go home for the week? They conferred among themselves and then the surgeon, Mr Keates, came away with a smile at me. He said, ‘Okay, I think you'll be safe enough to go home, but you must take care and return here without fail on Sunday for the operation scheduled for Tuesday 21 December.' He then went on to give me some more practical advice such as taking the beta-blocker drug, Atenolol, in large doses every day for the week before I came in.