From the bottom of my arteries

At a year or so older than the 70 I am now, my father did a satisfying day's digging in the garden, went to bed early and died without fuss in the night from a heart attack.

Way to go, I surmised bravely, at 24, and lit up another Philip Morris on the steps of the crematorium. At that age I was smoking two or three packs of cigarettes a day, sometimes several at once from ashtrays within pacing distance of my typewriter. Deathless prose had its birth in a slitty-eyed, blue-veiled trance common to most inhabitants of the newsroom.

My father smoked a pipe (though never with my later, ounce-a-day-and-inhaling voracity) and suffered from angina as his arteries furred. Family genes for high cholesterol shine out in milky rings in my irises: a clinical giveaway at a glance. When I stopped smoking, almost 30 years ago and from one day to the next, my bronchial tubes cleared within a decade; my arteries, alas, did not.

In the 25 years of the good life celebrated in my Saturday column in this newspaper, I have survived two bouts of major surgery, first for colon cancer that sprang on me out of nowhere almost a decade ago and, now, a quadruple bypass that, only a couple of months back, was nowhere on the horizon. Both pathologies have seemed squalidly at odds with a diet of fish and home-grown vegetables and with long years of ocean air, exercise and soothing birdsong.

Lifestyle has stood to me nonetheless. The cancer remained a one-off. And my recovery from the bypass has been almost a model for conveyor-belt surgery: out from the Mater after seven days and back at my desk soon after. But nothing in the experience has been remotely "fashionable". One patient with whom I shared an evening window seat had just survived his third round of surgery - triple, quadruple, quintuple bypasses, spaced out by the decade. He drank in the hazy sunset like an unexpected gift.

Such traumas send any naturalist back to learn more about man, nature and disease. How ironic, for example, that "three score years and 10" has been a measure of the normal human lifespan since biblical times when most of the human history of these islands came nowhere near achieving it. In the 18th century the average age at death of a London (and probably Dublin) gentleman was 44; that of the slum-dwelling working class was in the mid-20s.

With infections now under precarious control, largely through better living conditions but helped by vaccinations and antibiotics, medical priorities have changed, at least in the advanced countries. They have now to do with the stress of crowded living, with dietary faults promoted by the processed-food industry and with cultural abuses of the body such as smoking, alcoholism and obesity. In an ageing population these have had time to do their worst.

The Society of Actuaries in Ireland's recent proposal that the retirement age be raised to 75 has brought home in cold terms the new artificiality of lifespan achieved by better basic nutrition and increasingly costly medical intervention. I shudder to think what my own survival has cost the nation: this in a fairly routine progression from angiogram to operating theatre. Along with get-well-soon cards we shall need others to reassure us: "Because You're Worth It!"

A week in the public side of the Mater, with X-ray forays into the maelstrom of its A&E department, was hugely illuminating, both of the hospital's relentless pressures and of the buoyant humanity with which its staff endures them. A scheduled bypass operation can still be postponed, almost at the door of the theatre, by one too many car crashes, shootings or other overnight emergencies that change the priorities in intensive-care or high-dependency wards. One wakes up full of gladness that the operation actually happened, only then taking hazy pleasure in having survived it.

On this side of the hospital there are no captains of industry in flower-filled private rooms. Only the great skill of hard-pressed surgeons, forged in the face of a rising public-health epidemic, has achieved a turnover rate that frees most bypass beds within a week or 10 days. From the depths of my disgraceful arteries, my wilfully misspent youth, I can only be humbly grateful.