“You need a cabbage.”
“No doubt about it.”
Cardiologist Dr Judder’s grin seemed to engulf his normally hangdog face as he gave me the news, and he glanced down at the angiography report on the desk in front of him.
A CABG, or Coronary Artery Bypass Graft, otherwise known as a heart bypass operation, was one of the procedures I had been doing myself on thousands of patients with great success for the past thirty-five years. . .
The irony wasn’t lost on me, on that grim cloudy Tuesday morning in Dr Judder’s miserable consulting room. All those bland reassurances I’d given to my own patients:
We’ve been doing this kind of thing for years, only one in a hundred mortality risk, perfectly straightforward compared to the old days. . .
didn’t work when I told them to myself.
The fact was that the only person I trusted to do my heart surgery was myself.
What’s more, I knew the majority of the professionally qualified cardio-thoracic surgeons now practising in England because I had trained them. I knew all their weaknesses and, I’m sorry to say there wasn’t one of them who hadn’t made some very serious mistakes.
“So how about asking Arnold?” Dr Judder said cheerfully. “Excellent surgeon. He was in your team at King’s College at one time, wasn’t he?”
“Yes, he was,” I told him, my hands already shaking with fear. “But he made quite a few mistakes. I remember one morning when he’d been on the beer the night before. . .”
I couldn’t go on with the thought because it was too horrific to contemplate. By a miracle, the patient under Arnold’s care had survived, but only because I had stepped in when Arnold’s hands had been shaking so much he’d almost severed several vital arteries before even starting. I had had to take over, while he excuse himself and ran outside to throw up his breakfast.
“But, good heavens, we all make mistakes, don’t we?” reasoned Ben Judder. “However I can see your point. Maybe it would be better to have someone you don’t know well. Listen, if you don’t fancy anyone in this country, why not go to New York? I know you and Howard Leibowitz don’t always see eye to eye —”
“The man’s an idiot!” I yelled. “Do you know he’s developed this fancy new technique, and made a little film and put it on YouTube! I ask you, the insult of posting a film of yourself doing bypass surgery on YouTube, for all to see!”
“All very well for you to talk, Vincent, but don’t you realise that not all doctors in the world have access to resources and expertise like we do,” Ben Judder countered forcefully. “Think of some poor bloke in a hospital in a clearing in the jungle who’s got an emergency on his hands. Think of operating in a war zone, under fire! That video might very well have saved some lives. . .”
“Rubbish! It’s just titivated a lot of members of the public, who think we should all be on TV shows, grinning at the cameras while we’re up to our elbows in blood! Our profession shouldn’t prostitute itself on the internet!” I shouted angrily. “Medicine should remain a mystery, our techniques should stay secret except for the initiated.”
When I got back to my office, I looked up Howard’s wretched little video, that me and some colleagues had made fun of endlessly, even taking bets on how long we expected his patient to live after his questionable procedure. What on earth was ‘Reverse-reflex revascularisation’, anyway? His own stupid variation on our proper tried and tested technique! With mounting horror, I watched as Dr Howard A Leibowitz’s whining American-accented commentary accompanied the operation that I knew by rote. His ‘new technique’ when it came to the most complex part of the procedure, the grafting of the vein sections cut from the patient’s leg into the coronary arteries, was being done in an entirely new way, and to my mind it was nowhere near as efficient or time tested as our usual method of doing it. Reverse-reflex revascularisation? What nonsense! Like trying to repair a leaking dam with sticky tape!
I thought gloomily over the half dozen top cardio-thoracic surgeons I could think of I could trust to operate on me.
Donald Trasker was too hasty – I’d seen him botch things many times, racing away and missing out on vital parts of proceedings. Henry Baskerville was a notorious womaniser whose wife was getting wise to his ways, and his hands often shook when he was operating, and I had seen him make serious mistakes. Isabel Hetherington was probably about the best of the lot, but then I remembered that as a medical student there’d been some trouble when she’d attacked her boyfriend with a knife and almost killed him because of some argument about drugs. Yes, drugs. I remembered hearing some rumour that Isabel was a regular cocaine user, and it was rumoured that she had been in trouble for prescribing drugs for herself. . .
There was nothing for it but to take a break and think things through, maybe phone possible contenders and try to decide who was the least bad of them all.
My wife had always been keen to go on safari, so I decided to cancel everything and do what she wanted. I knew that if I took the medications, and took care, there was minimal danger of anything happening in the next few weeks, by which time I’d have reached a decision as to who I would trust with my life.
Two weeks later I realised it had not been a good idea to be out in the African bush, a long way from civilisation. And when a lion began to chase our Land Rover, and the driver looked scared, my escalating heartbeat and sudden severe chest pain, presaged what I knew to be a heart attack!
I woke up much later in hospital.
“Don’t worry,” said the doctor who appeared beside the bed. In my weakened, drug-induced state I took note of the primitive building with wooden walls, scarcely more than a jungle hut. The friendly doctor showed a lot of white teeth when he smiled, but he looked to me as if he was about twelve years old.
“Everything is fine,” Dr Thiago assured me. “You’ve had a heart attack, and we had to do an emergency procedure, what we call a CABG, a heart bypass.” He leaned closer, sharing his laughter. “Frankly it’s a miracle it all turned out so well. You see I only qualified as a doctor a month ago, and I’ve never operated at all on my own before now, let alone performed a CABG – I really hadn’t got a clue what I was doing. But luckily one of the nurses found this marvellously helpful video on YouTube. . .”
(Image courtesy Angelo Esslinger from Pixabay)