“Unfortunately…”
That is never a word you want to hear from a doctor.
From a dentist, maybe: “Unfortunately, you’ll need a good teeth cleaning.” From a shop assistant: “Unfortunately, we don’t have that in your size.” Or even from a friend: “Unfortunately, I have to cancel.” Great, I’ll have a shiny smile, save €150 and stay home.
But you really don’t want to hear it from a cardiologist.
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In the playlist of my life, this was a needle-scratching-vinyl moment.
Based on my family history, I’d long been on medication for high blood pressure and high cholesterol as directed by my doctor, exercised and tried to watch what I ate.
A few months ago, I visited my doctor for a routine check on my blood pressure.
The doctor said my cholesterol was high, very high. A calcium test and a CAT scan followed. Hours after my CAT scan, I got a phone call.
“Unfortunately,” she said. “You’ll very likely need a triple bypass.”
“That” day was here: my decades-long run of relative good health was over. It was my turn now.
“Can you fix it?”
“Yes, we can fix it,” she said.
“Will I be able to play tennis afterwards?”
“Yes, in fact, we encourage it,” she replied.
Such a funny thing to think about. I was, for now, under orders to avoid sports and not to put my heart under any pressure.
I phoned a friend. “If I die, I guess I’ll be the last to know.”
“You’re not going to die,” he said, “at least not yet.” Best to get on with it, in that case. With a doctor’s note and an overnight bag, I set off for A&E.
‘I’m coming with you’
The thought of me sitting alone in A&E with a pair of pyjamas and a toothbrush was too pitiful for my friend Róisín to bear.
She and her husband, Jonny, two of my favourite people in the world, picked me up at the Luas on Dominick Street.
In a matter of hours, I was lying on a trolley and the A&E doctor was reading my ECG results.
“They’re not great,” he said.
I wasn’t sure if he was talking to me or merely thinking aloud.
I looked at Róisín, she looked at me and we both looked at the doctor.
“Don’t worry,” he said.
Too late.
My body started shaking like a rescue dog in the pound. A delayed response to the shock diagnosis, perhaps. We patiently waited for the tremors to stop.
I was admitted to the Sacred Heart Ward, aptly named, I thought. Most of the other patients were in their 70s, easily 20-plus years older than me. You can’t always outrun your genes.
One consultant told me that my statin dosage was merely “papering over the cracks”. That was hard to hear.
Róisín and Jonny reminded me that this diagnosis can pack an emotional punch.
I tried to lighten the mood.
“I’m up, I’m down, I’m middling and then I’m up again,” I told them, “and that’s just during the credits of It’s a Wonderful Life.”
‘I get to have another human experience’
That was my attempt to put a positive spin on the proceedings for my mother.
“That’s one way to look at it, I suppose,” she replied.
I didn’t always say “bypass,” as it made people send texts with exclamation marks and emojis.
“At our age, we all have to watch our lifestyle,” one friend said.
No one wants to get into a slugging match over who eats more burgers or chocolate digestives, or completes 10,000 steps every day, but it’s easy to see why there may still be a stigma for patients around heart disease.
As far as human experiences go, I wasn’t alone. There are about 2,000 bypass patients annually in Ireland, enough people to fill the convention centre at Dublin’s Spencer Dock.
It’s not exactly an exclusive club, but it’s one I am privileged to have been given the opportunity to belong to.
I was released from Sacred Heart and, after three months, I got the call. My surgery was scheduled for December 18th, just in time for Christmas.
I was nervous, excited and, mostly, relieved. Contrary to popular opinion, I didn’t need to be brave or stoic or strong.
All I had to do was surrender.
‘The hairdresser will be here soon’
The nurse said I should get ready.
I knew the Mater Public had a Starbucks downstairs, but I didn’t know they had a hairdresser. I wondered if they have one in the Mater Private.
“The hairdresser,” I said. “I presume they will come armed with a clipper.”
“Healthcare assistant,” the nurse repeated, “not hairdresser!”
Róisín and I were both sure he said “hairdresser”.
We laughed our heads off, took a breather, and then laughed about it all over again.
The reason for the “hairdresser” was more sobering: the surgeons would require grafts from my leg, arm and chest area, and getting rid of body hair helps reduce the risk of bacteria and prepares the wound sites.
‘I held on to that: ‘A new heart, structurally speaking…’
At 7am on December 18th, I was rolled on to the gurney like a hairless terrier.
A few weeks earlier, my old pal, David, who had a double bypass in 2021, told me, “Your job is done when you go under”.
We met in UCD and had seen each other just once in 30 years, but he was there for me by phone and text as if we’d been besties our whole lives.
“They open you up like a box,” David said.
A coronary artery bypass graft or CABG (pronounced “cabbage”) has an almost 98 per cent success rate. They are good odds.
“It’s like playing a musical instrument,” one of the cardiothoracic-surgery interns said.
“It’s inspiring to see people walk away with a new heart, structurally speaking,” a young doctor with a ponytail said on the eve of my surgery.
I held on to that: “A new heart, structurally speaking…”
I said it to anyone who would listen.
‘Hello, Quentin. Your operation was a success’
![Quentin Fottrell: Based on my family history, I’d long been on medication for high blood pressure and high cholesterol as directed by my doctor, exercised and tried to watch what I ate](https://www.irishtimes.com/resizer/v2/6HPF6VMTSJAO5BA5AVGXHRVBD4.jpg?auth=69e2f9f0fcdc0fcefde413823d88cf9833bb6729a4df97f1a9a83cae48c74118&width=800&height=1066)
They choose their words judiciously for the awakening patient.
It seemed like five minutes, but it was now 11pm and I’d been under since 8.30am. The operation took more than five hours (I heard various estimates from nursing staff).
Thank God, it was over.
I was grateful to have the opportunity to return to the world. I couldn’t talk as I was still intubated: I blinked my best “thank you”.
The doctor-on-duty and his ICU team dropped by the next day to look at my chart. “This is Mr Fottrell,” he said to his team. “He had a CABG-5.”
That was news to me.
I texted David, “I had a CABG-5”.
He replied, “It’s not a competition!”
At moments like this, levity is your friend. What’s more, David reckoned opening up the chest cavity was a bigger deal than the number of grafts. He’s not a doctor, but it helped.
Doctors often talk about “longevity”, and I knew they would do whatever they could to achieve it. I was fortunate to benefit from my surgeons’ expertise, skill and judgment.
I went back to lying motionless, peeping and squinting at the daily troupe of passing doctors from under my blue blanket.
I did, however, knock the sobriquet “Quintuple Fottrell” on the head early on. A couple of friends tried to make it happen.
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Once more, the number five has served me well. I was named for my order in my family. Quentin, a French name, comes from Quintinus, a diminutive form of Quintus, meaning fifth.
If my parents didn’t have a fifth child, I’d be a glint in my mother’s eye.
The number five? Embrace it.
‘I can’t remember how to get out of bed’
I was hoping for a hint. My chest felt like a hot stone, and my muscle memory was gone.
“We encourage independence,” Julius, my HDU nurse, said.
Challenge accepted: my efforts to sit up were ludicrous, valiant and comical, but I did it.
In total, I spent three days in the intensive-care unit (ICU; one nurse for one patient) and three days in a high-dependency unit (HDU; one nurse for every two patients). Both, alas, were windowless rooms, so all I had were the beeps of the monitor to keep me company.
It was a couple of days before I allowed myself to even notice the drains in my torso that collected blood and fluid from the surgical site, and the spaghetti junction of needles and tubes.
Nearly all of the nurses who attended to me in the Mater were Filipino or Indian. They were, without exception, kind and compassionate.
Nurses are the backbone of the hospital system. In a just world, they would be paid more than lawyers and hedge-fund managers.
When members of my surgical team popped by, they were cheerful and casual, as if I just had a tooth pulled. That was reassuring. After all, they do this almost every day.
Sometimes, I felt like a medical experiment, like when a nurse gave me a blood infusion in the middle of the night due to low levels of haemoglobin.
I was not prepared for the smells of the hospital: the metallic saline flush to clear the needle in my neck, the hot flushes from a magnesium-sulphate infusion, or the taste of the chemicals from the hospital tissues every time I coughed up the detritus from the surgery through my stapled sternum.
That’s why, when Róisín brought me a bunch of oranges, I sniffed them with the delight of a 16th century adventurer. “God, I never realised they smelled so good.”
If a friend or nurse offered their hand to help me out of bed, or tried to put a blanket around my shoulders, I quoted Julius and said, “I’ll do it, thanks. They encourage independence”.
‘Hey, Julius, can you believe it?’
I shuffled slowly down the corridor with Julius by my side: it was my first big, post-operative walk.
A man with white hair, who I’d last seen walking in the ICU, gave me a thumbs up as I passed his open doorway.
That little moment of solidarity hit me hard. I had a lump in my throat. I nodded, attempted a wave, and kept putting one slipper in front of the other.
We made it to the glass-covered bridge between the old and new Mater buildings. There was a chair waiting for me. I sat down and finally saw the Dublin skyline – for the first time in a week.
The world outside had continued in my absence.
I felt a wave of anxiety. Would I be able to fit in again? It doesn’t help to look too far ahead about what might happen, or too far into the past about what I could have done differently.
I was now more acutely aware of the strong, fragile heart that my surgeon so dutifully and carefully held in his hands.
Today was a good day. Tomorrow, I will walk again.
My left leg was black, blue, yellow and green, but that leg has served me well.
I adjusted my sad little hospital gown. If I had got this far, I could make it the rest of the way. I sat in the plastic chair, and took it all in – the blue sky, the friendly clouds and the red-bricked buildings of the north inner city.
“Look at you,” Julius said.
“What about me?”
“You’re smiling,” he said, “can’t you see that you’re smiling?”
If you have been affected by the issues in this story, contact the Irish Heart Foundation, which holds free one-on-one heart-health checks. Cardiovascular disease (CVD) leads to around 9,000 deaths in Ireland every year.