Tomorrow, for one night at least, I am going into hospital. I have to have an operation on my foot. Then it’s to be put in a cast which I have to wear for six weeks. I’m not looking forward to it – who would? But it will – at least this is the plan – get rid of a problem which has gradually developed over the last twenty years or more. It is not – I’m happy to say – age-related. I won’t go into detail but it will be good, in a few weeks’ time to be able to walk on that foot without fear of a sudden recurrence of a problem which, when it happens, puts me on my back for two or three days and can be very painful.
The cast will be on the foot only, with a special heel fitted so one can walk – sort of. It sounds a lot less of a problem than crutches which I was on for six weeks some years ago after severing my Achilles tendon during a game of tennis. I was living at the time some twenty miles from the centre of London and had to travel by train into Soho most days of the week for my work in the film industry, carrying my scripts etc. in a back-pack. It’s not until you have to heave yourself bodily around on the heels of your hands and one foot that you realize how useful two feet are. I felt at the end of each day as though I’d been in a road accident. Those who have, through accident or disability, to go through their lives on crutches have my admiration.
The very first operation I had was back in the dark ages when I had my tonsils removed. I remember little of it except I was anaesthetized by means of a pad put over my nose and the drops of some liquid dropped onto it. I was then asked to count up to twenty. What number I actually got to I can’t remember with confidence, but I think it was fourteen. It all seems pretty primitive by today’s standards.
The meddling with our bodies that surgeons do now on a day-to-day basis is just part of life today. And usually, it’s not until we ourselves have to undergo some sort of surgical procedure that we are really forced to think about what it involves. But a few years ago I was forced to think of all the practical aspects of a major operation in an unusually objective way when I was asked to make a film for the British Medical Association. One sequence was to involve an open-heart operation.
My Cameraman – a very well-known film industry figure now sadly deceased – and my Production Manager came with me to the hospital in Manchester where we were due just to watch a triple by-pass operation. This we needed to do in order to be aware of the practical problems we might hit when it came to the actual filming. Not only that, but to be honest, I needed to see an open-heart operation before attempting to film one. If I, the director, fell over in a faint at the time of shooting, it wasn’t going to do the morale of the crew a lot of good. Or my own self-esteem.
The three of us turned up at the hospital on the due day. We were asked to wait for a while in a little ante-room. While we were doing so my Production Manager turned to me and said, “Come the shooting, are you going to want me in the actual operating theatre with you all the time?” Having thought about it, I had to say, “I suppose not. Why?” “In that case,” he said, “there’s not a of lot point my waiting around here, is there? There’s administrative matters I need to be getting on with now. And indeed when we shoot.” “OK” I said, “so go and do them. We’ll see you around lunchtime I guess.” And off he went, back to the hotel.
Then there were two – the Cameraman and myself. We were then ushered into a tiny room where the pre-med was going on. Tubes being put in, instruments being calibrated, etc., a whole medical circus going on around one prone human being. It was a bit daunting. After a few minutes of this, the Cameraman said to me, “You know that curry we had last evening? Well, it was very hot, and I’m afraid I think it’s quite upset my stomach. I’m going to have to go to the toilet. I feel I may unfortunately have to back out of this.” I could hardly object as he seemed to be in some considerable discomfort. So he too left.
So then there was me. And into the theatre I went, latching onto the anaesthetist with whom I’d struck up a working relationship the previous day. For the first few minutes I needed company and kept as close to him as possible. My plan when I got in there, was to start way outside the orbit of what was going on until I could work up the courage to go closer. This, bearing in mind that when it came to filming, I and the rest of the crew, would have to be right up there with the surgeons.
I hung around in the background by the door. One cutter – the word the anaesthetist used for one of the surgeons – was starting to take a vein or veins from the leg which would be used for the by-pass. That, I thought, I could handle. I think I can handle seeing a vein cut from the leg. Then when it comes to the big, bad stuff I’ll have psyched myself up sufficiently.
With a modicum of hesitant confidence I went up to the leg in question and started to concentrate as hard as I could on how this would appear on film. What I hadn’t appreciated however was that the leg cutter was not the main surgeon and that the main surgeon was already getting started on the big stuff. The first I knew of it was when, as I was intent upon the veins being dealt with, I suddenly heard, at the head-end off to my left, the whine of a circular saw. I shan’t go into detail. But there was by then, no escape. I was there, right up-front. Somehow and with great trepidation, I watched it all through, wondering occasionally how the other two were getting on with the ‘administrative matters’ and the ‘toilet’. They were, I was convinced, in the hotel bar.
When it came to the actual filming which we did a month or so later, of another by-pass operation, a strange thing happened. There were no qualms, nerves on anybody’s part when we got into the theatre. This was work; this was our job; this was what we were paid for. And that knowledge intercepted and diverted everyone’s potential for nervousness. It was a job of work, no more, no less. And after just a few minutes of the operation’s starting all of us were treating the situation with almost the same sangfroid as the theatre staff.
After the actual by-pass had been completed, I remember looking down into the chest-cavity of the patient and watching, with complete objectivity, as the surgeon re-started the heart with a small version of a cattle-prod. I had never been able quite to understand how a surgeon can, with sufficient equanimity, cut open, snip and trim, and then stitch up again another human being’s body. I was beginning, I realized at that moment, to get some sort of understanding.
My own operation tomorrow is very modest – I’m glad to say – by comparison. I’ve spoken at length to the surgeon and I like and trust him. It’s at Kings College Hospital in South London, one of the UK’s foremost teaching hospitals. I’ve liked and respected all those there with whom I’ve come into contact in the run-up to this little diversion. I hope to be back here in the bloggery this time next week.