After enduring an increasingly dull CRM conference in central London, my colleague and I decided to skip the concluding question-and-answer session and make our separate ways into the city. I got hold of my dear friend Tom, and we agreed to meet outside Tottenham Court Road tube station before heading off east to meet up with some more nice folk. I stood under the covered entrance to the Dominion theatre where we had agreed to meet, smoking a cigarette and killing a few minutes until our agreed meeting time. It was wonderful to be back in the hustle and bustle of the city I call home. I remember savouring the noise, the smells, the drizzle.
When Tom appeared, we rounded the corner to the first bus stop in New Oxford Street, and pratted around with the ticket machine before stepping back to wait for the right bus. “So,” said Tom, for we had not had a proper catch-up in a long while, “what’s this I’ve been hearing about you having seizures?” With spectacular comic timing, and part-way through a word in my reply, it happened again.
I remember almost nothing about it, of course, but Tom recalls that I began to stutter as I lost consciousness. At first, he admits, he thought I was taking the piss, but alarm bells began to ring when my whole body went stiff as a board and fell. My descent was broken, in part, by my rucksack containing my MacBook Pro, but I must have hit the back of my head on the pavement. Tom compares my loss of consciousness to a crashing computer, and recalls that my body went into a strange state of overdrive – every muscle had tensed up, I was getting hot and breaking into a sweat, and I was also bleeding from the head. I can only imagine the scene as I lay on the pavement during a cold and drizzly evening rush-hour in the very centre of the city.
By the time my brain had rebooted I was already in A&E, only this time at the shiny new University College Hospital. There was a very different feel to this place – straight away it was clear that, as I was alive, there was a sense of urgency associated with getting me back out to clear space for whatever was to come in next. Tom was still with me, looking concerned. As usual, now conscious again, I got my act together very quickly – in no time at all I was pratting around and being entirely inappropriate. The hospital staff’s keenness to get shot of me was matched by my enthusiasm to get out – I really didn’t fancy another nine hours of having the same conversations and receiving the same tests only for them to come up with nothing.
As I snapped back into my normal, recognisable self, the shock began to release its grip on Tom, who was becoming increasingly uncomfortable. He was recounting the events of the last hour, and the unpleasantness of the experience to which I had subjected him was becoming clear. The “nice” thing, in a way, about being the patient is not having to deal with the situation, but I can only wonder how I would have reacted if the roles were reversed. I’d like to think that two decades of sea canoeing have taught me enough to manage those first five crucial minutes of an emergency, but then nothing is ever how it is in the textbooks. I think most people these days have a basic understanding of first aid (airways; breathing; circulation, right?), but how often do you actually need it suddenly, completely out-of-the-blue, and after a regular day at the office? Most will be familiar with the recovery position, some may have even trained to do it, but what if the patient is stiff as a board? What then?
Once I’d been unwired from the EGC and my head had been glued back together, we made our way. By this time, however, we’d missed our social engagement so opted instead for a meal at a surprisingly good sushi restaurant. Not surprisingly, my recent blackouts dominated the conversation. Tom was visibly shaken and, for a time, quite upset but, as we gorged on expensive food, the situation began to improve. I think I did a pretty good job of being as blasé as usual but, on the train back out of the city later that evening, I worried. This one had come out-of-the-blue – no forewarning at all – what did that mean for the neurologist’s diagnosis?
The following day, I rang the neurologist’s secretary – a spectacularly efficient, well-organised and polite middle-aged lady, with the news. Somehow she got hold of the neurologist straight away, and I did my best to explain what had happened. Clearly I wasn’t the best witness: he asked if he could question Tom directly, and I gave him his phone number. He then said he’d been reviewing my MRI scans, and that I’d be pleased to know that everything was normal. I’d actually forgotten all about this – not that I’d had the scan, but that he’d be using it to look for problems. I was so absorbed by the novelty of having pictures of my own brain, that I’d become completely distracted from the fact that the whole point was to find something wrong with it. As the scan had come back “normal” I didn’t know if I was supposed to be pleased or not, but he reassured me that this was exactly what he had been expecting.
For the second time, the neurologist raised the question of driving. “You know you shouldn’t be driving, don’t you?” he said again. The first time he had mentioned it, I had taken it as advice. The kind of advice that you know is sensible, but it’s down to you whether or not you take it. I know that sounds bonkers, but the casual way in which it was first mentioned, and the massive impracticalities associated with being without a car had put it very low down my list of thoughts. “Yes…” I said, with clear guilt in my voice, “I just haven’t found a way around that yet.” His tone became much more forceful. “Now look,” he insisted, “you can’t drive. It is illegal for you to drive. It’s against the law. You have a duty to surrender your licence, I have a duty to inform you of this, and I also have a duty to inform the authorities if you don’t. More than that: consider the consequences.” Bang. This was not friendly advice. Impractical or otherwise, for the sake of myself and everyone else, I was duty-bound. Like it or lump it, I’d just have to find a way of striking up deals with colleagues to get between my rural home and my even more rural office. I put my licence in an envelope with a covering letter, and off it went back to the DVLA.
A few days later, various items of post arrived. Some were to confirm appointments arranged on my behalf, but there was also one from the neurologist, which read “I spoke with Tom Coates who had witnessed your latest attack and I think there can be no doubt at all that it was a fit”. A fit, I thought. What’s the difference between a fit, a blackout, and a seizure, then? When I think of the term “fit”, I think of the term “epileptic fit”… does that mean we’re talking about epilepsy? If so, what the hell is epilepsy? Hasn’t it got something to do with strobe lights?
More on that… in a bit.