I’d been under the weather for four days. Back then, in mid-November, the government’s pet message was the three symptoms of Covid-19: a persistent cough, loss of smell or taste, or a raised temperature. I had none of these, just the sort of chesty flu that hits me every autumn. My wife, Al, and my daughter, Liberty, both had bouts of something flu-like, so I followed orders. Then, on November 15, things suddenly got very weird, very quickly. I woke feeling unusually short of breath. I’d bought, on the recommendation of a medical friend, a little gadget that measures SAT, the concentration of oxygen in the blood. My score was not out of the ordinary — above 94 — but something felt wrong nonetheless. Just after lunch, I called 111. I felt “out of it” and had an overpowering feeling that life would be a lot better if I could just take one decent full breath. The ambulance was outside in 15 minutes. Two reassuring medics stuck a mask on me, checked a few vital signs and said, “Yep . . . we’re seeing a lot of this . . . looks like Covid.” Addenbrooke’s Hospital, in Cambridge, is a centre of excellence for all kinds of medicine. Everyone here knows people who work there and we live with a sense of reassurance. Even lying woozily in the back of an ambulance, it’s good to know you’re only a five-minute drive from the best minds, hands and equipment in the country. I remember someone introducing herself as a doctor from behind a mask, a visor, apron and gloves — over the next month, I’d get used to recognising people from a single strip, the bridge of the nose, tired eyes and a muffled voice. By 4pm, I was in a comfortable bed, waiting for the results of my first Covid test and “responding well” to oxygen therapy and Dexamethasone. But I wasn’t destined to get off that lightly — at 9 o’clock that night, they called Al to tell her I was being put on a ventilator. Most people need to be knocked out to have a tube put down their throat but somehow, I’m told, I remained conscious, though I have no recollection of this at all. I’ve managed to piece together the timeline from a flurry of cheery text messages I sent, joking about the tubing and the huge bag full of brown gunge they drained from my lungs, relaying to worried family anything positive that any masked medic said. I’ve had to collate the text trail to tell this story because it’s all a merciful blank in my mind. One horrible recollection, though, remains very clear. I am wheeled into a side room with four medics. One introduces himself as an anaesthetist; another, directly and with no hedging, tells me they’re “worried I’ll pull out the tubes” — they need to put me to sleep. There’s no debate . . . I guess that’s the point. But, like every other news junkie and doom scroller in the country, I know what this means. People who go into intensive care, who get anaesthetised and held on life support, don’t tend to have what the news euphemises as “good outcomes”. I’m hit with awful clarity that this is probably the most significant moment in my whole life. “It will just feel like going to sleep,” says the medic. True . . . but I have no idea whether I’ll wake up.
I have no religion. In fact, I remember thinking: “Well, if I don’t wake up, I won’t know anything about it.” Then they offered me my phone. I couldn’t raise Al on voice or text so, almost automatically, I thumbed on to Twitter . .. “So this is hapimji@g In fuve mumutre they piu nr yo sleeo fky tn gayd” Later a nurse tells me I’d become “a legend on the unit” — as I went under, they had to prise the phone from my fingers. An anaesthetic is a cocktail. Some ingredients keep you “asleep”, others paralyse you so that you can’t roll about, dislodging the tubes, or choke. Back in November, every ICU patient still had an individual specialist nurse watching the monitors around the clock. Nourishment comes through a thin tube up your nose and goes out a catheter at the other end. To drain the constant build-up of toxic crap and to relieve the pressure of the other organs on your damaged lungs, you will probably be “proned” on 18-hour cycles — moved to a facedown position. It takes up to nine people to do it safely, keeping all the plumbing and wiring in place.
Most of the time, intensive care is there for people who’ve had massive surgery, traumatic injury or are near to death, and there’s a reason it’s not taken on lightly. It’s hard to imagine a more invasive assault on the body than paralysing it and taking over all its functions. My friend Binks is a specialist intensive care nurse who’s had way too much experience of it for her young years. As she puts it: “People don’t realise how intense intensive care is.” I spent 10 days unconscious in the ICU, but that’s really the wrong word. The drugs, the unfamiliar sensory input, the physical treatment of my inactive body . . . “delirium” during and after ICU is an unsurprising side effect. Those days and a considerable period after were filled with dreams. As soon as I could, I started writing them down. Thousands of words poured out, all of them ridiculous. I recalled 15 discrete dreams, each increasingly surreal. The earliest consist only of things I know or can imagine; later ones involve being injected, restrained, paralysed or frozen. The later dreams refer back to the earlier ones, creating a rigid narrative order. Scenarios include a road that can be driven only one way, a conspiracy of hippy aristocrats, Mossad, black helicopters and being kidnapped and pharmaceutically restrained with blue washing-liquid pods by the beautiful rebel daughter of Recep Tayyip Erdogan. I am to be appointed editor of the FT by MI6 — a proper delusion of grandeur. Men with rubber faces yell: “Do you know where you are?” and stuff things down my throat to the penetrating noises I will later recognise as the pings and beeps of my own monitoring equipment. Sounds quite amusing now, I know, but what’s scary is that I doubt I’ll ever forget any detail of the dreams. I’m not sure I’ll ever recover any of the real experience that they overlaid. On the ninth day, they start reducing my sedation. I don’t immediately recover my own breathing and it’s another day before I come round. Someone yells: “Do you know where you are?” And I try to answer, “Scotland”. I don’t know who or where I am. I’m still delusional. The ICU nurse hooks up a FaceTime call with home in which, apparently, I croak, “Laptop, laptop!” through vocal cords wrecked by the tubes. They tell Al not to worry and that it’s not really me, but she’s terrified by my insane urgency. The next day, they arrange a call with my mother. She says I was so incoherent she was convinced I’d had a stroke.
Finally, I’m considered stable enough to be moved to a small Covid-19 ward that I share with two older men with dementia. They haven’t been in the ICU but their home circumstances mean they can’t look after themselves in isolation. During the days, nurses attend to us and our weird imaginings. At night, we’re woken every few hours to have all our vital signs taken. Drugs, confusion and sleep deprivation blend and I slip back, nightly, into my world of delusions. One of the men on the ward sleeps in a deep cot that seems to calm and partially restrain him. At night, I see the walls change to something imagined by Giger. The man cries out the same name over and over again and weeps inconsolably. I’m convinced by brief flashes, which show over the sides of the cot, that he’s wearing a Victorian nightgown. I dread the nights.
A new patient is brought into an empty bed. A little older than me, wiry as hell and with a collection of what may or may not be rightwing tattoos. He won’t understand that he can’t get up and roam the wards. When the nurses can, they talk him down and back to bed. On the second night, I wake to see him standing at the bottom of my bed, staring at me. I have an overpowering feeling that I don’t want to be mad any more. A couple of hours later, they wheel me into a new ward. The first thing I do is call home and demand my passport and a lift to the airport. Over the next four days, the dreams subside and I begin to understand where I am and what’s going on. Ever-changing shifts of nurses, fully clad in PPE, come into the room to give patients food, administer medicine, change sheets and attend to those who can’t use the lavatory unaided. They are paragons of skill, concern and grace under pressure but there is, apparently, a limit to the time they can be exposed to us. In spite of their kindness and attentiveness, it doesn’t take many hours of mental clarity to begin to feel the sense of being locked up, like prisoners or dangerous animals. The staff, meanwhile, grow more pressured as the weeks pass. One morning, a nurse announces that they’re short-staffed and covering double shifts, so they only have time for “patient safety”. We must not use our call buttons if we can possibly avoid it and it may take them a while to respond. The doctors, on their daily rounds, stop prefacing every interaction with “Do you know where you are?” While I was unconscious, one explains, I “sustained some neurological damage” — this is apparently not uncommon. My left foot is a bit numb, tests show my right arm to be mildly affected, but I have no movement at all in my right ankle and foot. No voluntary control, just very uncomfortable “pins and needles”. I have a “drop foot” that will require a brace to aid walking, a Zimmer frame while I learn to use it and, eventually, a walking stick. In the early hours of the next morning, a nurse notices that my heart is beating at around 200BPM. In seconds, half a dozen masked medics appear. At the bottom of the bed is a big red-wheeled cabinet, with two paddles hanging off the side and “CRASH CART” in screamingly loud caps. Once they’ve explained that they won’t be shocking me, they hook up drugs and fluids, saying it’s probably a side effect of one of the many drugs they’ve used on me. Later, I’m put into a CT scanner where they discover I have a pulmonary embolism, a bloodclot in my lung. They won’t need to operate but instead inject me with “clot-buster” drugs daily. Later, I’ll be able to take these orally . . . for many months. On December 15, I’m discharged with a big bag of pills and an assurance that community teams will be in touch to support my recovery. I was in Addenbrooke’s for 30 days. For about half that time, I was on oxygen; for 10 days, I was fully unconscious and on life support. For 30 days, I didn’t use most of my muscles and spent only minutes out of bed. I lost just over 14kg in weight, around two stone. I’d like to say it was all fat but, sadly, a lot of it is muscle. My legs look like two bits of grey wool, my stomach is pleasingly flat, but so is my chest. I get exhausted after about 10 minutes of anything. My voice has lost its resonance and I’m cold all the time — no muscles working to generate heat, no fat to insulate. All of this, they tell me, is likely to come back with the physiotherapy. The “clot-busters” should get rid of my embolism, though I’ll have to take drugs for it daily, and take precautions to avoid any bleeding. If I nick myself with a kitchen knife, it may well need a tourniquet not a blue plaster.
One month on, with rest and daily physiotherapy, I’m building up strength and stamina, my voice is returning and I’m even beginning to get some limited movement in the “drop foot”. It’s likely I’ll always have to wear a brace and I have to sell my beloved stick-shift sports car. The month inside was the longest I’ve gone without alcohol since I was 16 and, as most of my life is now taken up with re-learning my sense of balance, I’m disinclined to do anything that might interfere with it. I doubt I’ll ever be teetotal but I have a chance to reassess my drinking . . . C’mon, you’ve got to look for the positives. Unlike many who go through intensive care, I haven’t displayed symptoms of PTSD. Being asked to write this and being able to express it, is one of the reasons I can hope that I won’t. For a while, I was uncomfortable watching hospital footage on the news, but that seems to have passed. All the symptoms of actual Covid-19 are gone and I’m left with the injuries and impairments sustained in the process of saving my life — but, honestly, I’m just so bloody glad to be alive that it hardly matters. I do struggle with survivor’s guilt. If I’d gone to sleep in ICU and not woken up, I’d have known nothing of it. My family, friends, the people the pandemic has taught us to call “loved ones”, had to confront the possibility of bereavement, unsure for days whether I was going to live or die in isolation, unable to say goodbye. Like the doctors and nurses in the hospital, I can’t speak for them, but I’m left with the feeling that they all had a worse ride than I did. Since I was discharged, the situation in hospitals and community care has got significantly worse. I’m unbelievably lucky . . . Lucky to have lived and lucky enough to be in a position to contemplate six months “off work” to heal physically. I can’t begin to imagine how tough this is going to be for Covid-19 victims without that luck. But it’s the delirium that I still find most difficult to handle. Some people in the profession have warned that we’re unprepared for the mental health implications of the pandemic and I can’t disagree. I wasn’t expecting to spend two weeks palpably and certifiably insane. I didn’t “die” at any point in my treatment. I didn’t start drifting toward a great white light and have to be brought back by the jolt of the paddles, but — along with a stick and a brace to remind me of 2020 — I will always live with an experience of “madness”, and that is more difficult to come to terms with.
For the original article, click on this link https://www.ft.com/content/2b0dbba3-6fe8-4c2d-8cca-90e87261d436?list=intlhomepage