The Angina Monologues

As is often the way, it started with discomfort; such an everyday feeling, a slight ache, a moment of sinew awareness, of interior. The doctor asked me to categorise the pain and this was at least a familiar request. Pain has its definition and rememberance; in the hospital a few days later the nurse showed me a flashcard with an array of faces from happy through grimace then taut then crying, screaming at the very end. It made sense of course, such visual definition and recognition could be made sense of in a Singaporean hospital but the happy face at the beginning? I guess some people are happy in pain.

The GP should have been on the stage, a stretched Kiwi with a piquant sense of drama. From such dull symptoms she eeked out some bright scenario filled with sparkling dialogue and the set pieces of professionalism (hers) and shock (mine.) Given my description, my family history and my ex everything, I was whisked off to a cardiologist and hooked up to doppler and echogram; treadmilled like a frightened hamster beeping machines with my heart, an organ under such sudden scrutiny. With casual reassurance I was told there was leakage in a valve but it was okay likely. To be born with something does not mean to die of something. The stress test was borderline however and although the cardio guy looked pretty Gauloised by it, laconic in his description of potential risk the GP hit the roof and clung to it and me with her stethoscope.

She was ordering an immediate evacuation to Bangkok with accompanying nurse to undergo an angiogram - I now have a few more words in my vocabulary, the grafted language of medicine that seldom seems to stick for long - but this is, if you want to know, the insertion of a catheter into a vein in the arm ( ouch of course) which is then pushed up until a dye is released and a Chernobyl-like radiance fills the body until it is pissed out like fireworks in a dark bathroom. I kicked in denial, punted downplays and avoided all sense of urgency - after all I had gone simply for a check up while telling Kate I had gone to the dentist. Yuh, I know. The doc was sticking to her training, the smooth procedures and protocols of private medicine that launch symbiotically as soon as you step through the door. As the slogan says, Your Health is Our Wealth.

" I have seen people die of heart attacks. You could die during sexual intercourse."

It was ironic then that her bedside manner was rigid.

I walked out. Signed a form absolving everyone apart from myself of all risk and went home to see Kate, bare some bad tidings and work out what to do next.



A few days later, the urgency of the situation having been reduced by time and bureaucracy, I was given approval by the insurance company to go to Singapore for the procedure. Normally they use Bangkok but the doctor there phoned me and said
he could see wave after wave of red shirts marching down Silom and that they couldn't guarantee my safety. I wasn't allowed however, to travel just with Kate. A nurse was sent from Raffles Hospital ( Yuh, I KNOW) and she, Kate and a bottle of oxygen would be accompanying me from our apartment to the hospital. The nurse declared, as she strapped me into the wheelchair, that I was the healthiest patient she had seen in ages but heart patients are always treated as though they could keel over any moment. To the enduring curiosity of other passengers, I was installed in the unnecessarily wide seats of Singapore Air Business Class and while the medical equipment, leads and masks dangling ominously, was piled next to me Kate took her seat in the narrow confines of Economy class. I felt it necessary - what a bore - to refuse proffered champagne but I did accept the public blood pressure and pulse taking every 20 minutes. The flight attendants whispered behind cupped hands. The nurse asked me if I could look a little more ill.

The journey to the airport had more of sightseeing about it than the evacuation. Anne, the garrulous Filipino nurse cured the world with conversation and reassurance and who managed to talk for 40 minutes non stop in the airport cafe while a segment of muffin perched on her spoon, wilted from expectation. Anne pointed out the parks and landmarks of a journey and I felt as though I had won a competition, my prize the unexpected.

The patients at Raffles were sealed in their rooms rather than displayed on wards; such was the privacy of this medicine that
the only sign of who was in each room was their dietary instructions from soft to nil by mouth; everyone was cocooned within beige walls and crisp hospital linen. It was all ensuite of course with bathrobes, bespoke toiletries and television. The feeling of being hoteled rather than hospitalised grew until each morning I was awakened at 6.00am by the clatter of a trolley and the sudden squeeze of my arm.

What did the angiogram show? That I was fine. A little of this and that but nothing that needed treatment. If I have discomfort it is not to do with my heart. I got to see my glowing core, its pulse strangely distant from me. It was encased in a mysterious, luminous world of shadow and halo; the unseen territory of my own body. The doctor had that brusque air of clinical disappointment, the sigh of an opportunity squandered by health. We checked out. We were discharged. It felt like both. On the last day I paced my guilded cage as I waited for my case to get through the catheter squeeze of insurance payout while the insurers battled against the covert largesse of hospital hospitality. Would you like an x-ray with that Sir? They were old adversaries and I was new at this. But I know enough to be grateful for intervention, to be able to access care however it is administered. Not just harking with misty-eyed expat thoughts of a free and fair NHS back home but knowing that many people much more ill than me don't receive the care they need. Those with Dengue for instance are kept at home because it is hoped time or belief will heal, because symptoms merge undistinguished from less lethal complaints and for some they are kept at home because there is not enough money to pay for a hospital visit or for the drugs to bring the fever down.