It has to be done. What is – is.


At around 0715 the following morning, before the ward lights had come on and while the night nurse was still busying around, a man turned up pushing an empty bed. He was looking for Bed 24. That was me. And he wanted me off Bed 24 and onto the one he was pushing. We set off down the corridor, with me gazing at the ceiling going past and the upper parts of walls. There came the occasional waft of cold air from outside in the normal world as we passed an open window. There had been no pre-med. This was to be by local anaesthetic. And I was wide, wide awake.

Why a local? I mean, why can’t they do it the way other hospitals do and knock you out before you even get sight of the theatre? Well, in the course of this procedure – known apparently in the trade as a ‘carotid endarterectomy’ – certain nerves in the neck are exposed. These have to be worked around with care. Damage any of them and the patient could lose the use of certain facial, hand and/or foot muscles. Were they to give you a general anaesthetic – and once upon a time that was the way it was done – the surgeon would have to wait until the patient had come round from that anaesthetic in order to ask if they could still move those muscles. By which time, it could be too late. Anyway, I’ll come to the present day way around that in a moment.

So I’m wheeled into the theatre. This is the bit you don’t normally see. I’m laid out on a table with a huge array of monitors and glittering IT gadgets of many sorts being set up on all sides; with about a dozen medical people walking around, chattering as they set up this and that, with a vast circular light like the underside of that space ship in ‘Independence Day’ being arranged right over my face and the anaesthetist somewhere by my right shoulder asking if I’d like just a little medication to ‘take the edge off things’, something equivalent to ‘a glass of wine?’ (‘Yes, please,’ I say, ‘but can you make it equivalent to a large scotch?’) when someone presses into my hand a squeaky rubber toy – the sort dogs chew on and chase about the house. “Every now and then,” that someone says to me, “we’ll ask you to give us a squeak. And if we hear one, we’ll know you’re compos mentis and your fingers and things like that are still working.” There was something homely and comforting about this toy; a refugee from the normal world.

I turn my head to one side, feel the anaesthetic quickly numbing my left shoulder and that side of my neck, and I think to myself, “Let’s do this thing. Let’s just get it over with.” And so it was. I felt an odd tingly sensation in my neck which, I presumed, was the start of things. I was very aware of the risks I’d consented to – one of which was a stroke; the other death. As the surgeon and the medics began their work and a virtual silence descended on the theatre, and as I settled myself into some place inside my own head – I remember seeing in my mind’s eye a sort of wall into which was let a rectangular white panel. If I were to die, that’s where I would go – through that white panel. I had no sense of not continuing to exist if I died; I would simply pass through that panel. I had no sense of what lay on the far side of it. I felt no reason to be afraid.

In its later stages, the operation was quite challenging.  At some point I heard a sound like water being sucked up through a pipe. The anaesthetist who kept up a dialogue with me during the whole procedure, said to me. “You can probably hear that noise. That’s the rubbish being sucked out of your artery.”  I remember calmly replying, “Yeh, I thought so.” And as I heard myself say it, I thought, “Christ, how amazingly one’s values shift with changed circumstances!”

By that time, I was – I was going to say ‘relaxed’ – that’s hardly the word – I was at least reassured the operation was going to plan. There was too much obviously casual chatter going on amongst everybody around me for there to be a problem. A short time later, I heard the surgeon – I presume it was the surgeon – say, “Stitch.”  A few minutes after that – or so it seemed – someone said, “You can sit up now.” With no effort whatever, I did so. There was no hangover such as one gets from having had a general anaesthetic, and sitting up was just like doing so in bed in the morning. I looked around. Everyone seemed to be smiling, and mostly at me! The clock on the wall said 1130 – I had been lying on that table for two and a half hours! I said to the surgeon, “When I go back on the ward will I be able to get up out of bed on my own? Walk to the bathroom for example?”

“You can do whatever you like,” he said. “But I wouldn’t go to the gym for a few days!”

And so it was. There was no pain.  I could get out of bed and walk. I slept well that night, and was out of hospital by mid-afternoon the next day, clutching a plastic bag containing my medication.

It had been an extraordinary forty-eight hours. It felt like the experience of as many days had been crammed into it. Looking back, there are many impressions which remain with me, and always will. One of the most outstanding is that of the extraordinary skill of that surgeon and his team, to whom I may quite possibly owe my life and if not that, then certainly the freedom from a stroke. The other is the operation itself. I recall it as taking place in an intensely hi-tech, high-octane atmosphere; and visually of having an unreal, almost tactile, glittery, graphic quality reminiscent of the very high-contrast black and white images in American films noirs of the ’40’s.

I’d had no reason to expect the day I’d planned would deviate much from that plan. In the event, it bore almost no relation to it. In one sense that was scary – I’d been deprived of my free will; my ability to determine my own actions had been utterly subverted. But in another sense, had that day indeed been as I’d planned I would even now be walking around, unwittingly cooking up, at the very least, a stroke. Fortuitous? Luck? Something else?

Two months now down the line, and I’m completely recovered. I feel incredibly well. I won’t divulge my age – except to say I remember what an air-raid warning sounds like. I feel that somehow and from somewhere I’ve been granted an extension to my life. I have to use that extra time to its very best advantage.


The books I was taking – so I thought – to my friends in central London were, weeks later, still in my backpack. It was only a few days ago that I eventually got around to delivering them. I feel profoundly grateful that I had the common sense or whatever it was to accept, rather than turn away from, a quite harrowing situation that threw itself at me like an oncoming train. It was a hugely powerful, if nerve-wracking, life lesson. There’s an old saying – ‘If you want to make God laugh, tell him your plans’.

What is – really is.





About besonian

Writer, photographer, film director
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2 Responses to It has to be done. What is – is.

  1. Peter Boreham says:

    Hi Besonian. An illuminating account of a somewhat scary and surreal surgical intervention. Loved the bit about the squeaky rubber dog toy (no expense spared in the current climate of NHS cut-backs). If I had known about this ultra sophisticated system of patient monitoring, I could have loaned you my scary Margaret Thatcher squeezable dog toy. Joking apart, it is amazing that surgeons have the skills and training to undertake such delicate procedures calmly and confidently. Glad to know that you are once again in fine fettle and back blogging. Peter

    • besonian says:

      Hi Peter. Thank you for that. Just one of the extraordinary things which came out of that is that the scariness, which is so very obvious, was not apparent until afterwards – i.e. thinking back on it. At the time, from the moment it was obvious it had to be done, I went into what I can only describe as an intensely focused autopilot mode which very fortunately,precluded fears, worries etc. As for the Margaret Thatcher toy – no!! If anything or anyone is guaranteed to overturn my equanimity and send me barking it’s Margaret Thatcher! Jeff.

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