As he convalesces from a quadruple heart-bypass operation, Ivan Tyrrell provides an inside
view of needs being met, and thwarted, during his NHS experience.
This article was published in Human Givens journal, Vol 20, No 1 (2013). For more articles like this subscribe to the Human Givens journal.
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There is nothing like a heart attack to remind one of how
little time we all have on this earth, and that we waste
most of it. On a damp Tuesday afternoon last October, the
Fates decided that it was my turn to have one. It led me to an
intimate experience of the NHS and also to discovering more
about our innate physical and emotional needs.
This is what happened. I was at the office in
Sussex, writing a letter, when a tight pain in my
chest hit me out of the blue. At the time I had no
idea what this paroxysm, clamminess and awful
faint feeling signified. My first thought was that
I had a sudden case of really bad indigestion, so I
staggered out to my car to find some Rennies. Yet,
on popping two into my mouth, the pain got worse.
I felt so awful I sat still, slumped in the driving
seat, feeling frustrated and decidedly uneasy.
But, after about 10 minutes, the pain stopped as
suddenly as it had started. Shortly afterwards,
feeling a little wobbly at first, I made my way
back to my desk and got on with my work. Being
a bloke, I told no one and quickly became absorbed in tasks, thinking nothing more about it. As
far as I was concerned, the Rennies had worked.
That evening, in torrential driving rain, I made
my way to Ditchling, a few miles from the office,
had supper with an old school friend, then drove
back to our home in the Cotswolds arriving at
about 11.00pm feeling shattered and worn out, but
happy to switch off and go to bed. I slept soundly.
On Wednesday life went on as usual – working,
walking and reading. The next day I took my wife,
Véronique, to catch a train to York where she
would be staying for two nights. Suddenly, at 2am
the following morning, I woke up with that same
squeezing pain, only this time it was worse. I
broke out into a cold sweat and, feeling nauseous,
slowly felt my way downstairs, where I sat in front
of the dying fire, trying to keep calm and attempting to treat myself with a cold laser machine
that I had been experimenting with to improve
my immune system. I began to face up to the fact
that something was wrong with my heart. After
half an hour or so, the pain subsided and I climbed slowly up the stairs and went back to bed.
Sleep evaded me for a while, kept at bay by the
worrying thoughts going round in my head.
I told no one.
Next day I felt fine again and went for a long
walk. I was still feeling fine when Véronique
returned mid-evening on the Saturday. However,
in the early hours, the pain returned yet again,
not quite so severely but enough to make me
resolve to see my GP on the Monday. I mentioned this plan to Véronique on Sunday morning and,
not unnaturally, she wanted to know why I needed
to go. So I explained what had been happening.
Although I told her I didn’t want any fuss, she
called the doctor at once and, between them,
within an hour, they had me admitted to the local
hospital, where I was immediately given a blood
test. During a heart attack, apparently, heart
muscle cells die and release proteins into the blood-stream, which a blood test can detect. I had higher
than normal levels of these proteins, revealing that
I had had a heart attack – or probably three.
The benefits of hindsight
I was asked if I had been doing anything phsically strenuous when the first attack occurred
and I said no. (It was only later that someone at
the office reminded me that, about an hour before
the first attack, I had unloaded two pallets of
heavy books into the store room, which had made
me breathless and a bit weak. At the time I just
thought I was out of condition.) Nurses injected
me with a blood thinner and gave me a statin.
With the benefit of hindsight, my advice to anyone suffering severe chest pains would be to call
the doctor or, at least, tell someone, not foolishly
play down the seriousness, as I did to myself.
Looking back, I still can’t explain why I exhibited
such wilful blindness with regard to my obvious
malfunctioning body, other than that I felt that
I had too much work to do, couldn’t see how I
could take time off and so couldn’t sanction the
possibility of illness. A doctor at the hospital said
that Véronique’s prompt action might well have
saved my life, because the next heart attack could
have been fatal.
I was transferred by ambulance to the Heart
Centre at John Radcliffe Hospital in Oxford for
an angiogram, which revealed damaged arteries.
They couldn’t fit stents and kept me on a ward by
myself for five days while they decided what to
do. Then David Taggart, professor of cardiovascular surgery, came to introduce himself, and said
I needed a triple bypass operation and that there
was a 99 per cent chance I would survive. (Good
odds, I thought.) I was to go home and prepare
myself – and not walk up steep hills or lift anything heavier than a kettle because that might
kill me. Slim as a whippet himself, he added that
I ought to lose some weight as quickly as possible
because being overweight is a prime cause of
heart attacks. I asked him how I could do this
and shall never forget his reply: “You’re obviously
an intelligent man. You don’t need me to tell you how to lose weight; find out for yourself.” Not a
man to mince his words!
A dream
As I look back I can see there were clear signs
well before these events that things were not
right with my heart. A few weeks before, for
example, I had arrived at the B&B in Bristol
where I was staying before giving a seminar the
next day. The room I was allocated was on the top
floor of a five-story Georgian building. Grabbing
my suitcase, I started to climb the stairs two at a
time, as was my wont: first floor, second, third.
Suddenly I caught my foot on a stair and stumbled back into the proprietor, who was following
me. I insisted there was no harm done and continued a few more steps, now taking them one at
a time. Then I stumbled again and this time
crashed into the bannisters. The proprietor
decided to put me in a room on the third floor, so
I wouldn’t have to climb any further. I was quite
shaken by having so nearly tumbled down the
steep stairway. I assumed I was tired because
normally I’m quite nimble for my age. Now it
seems more likely that my heart was not pumping hard enough to get me up the stairs.
Once alone, I sat on my bed musing about how
easily a simple thing like a stumble could change
one’s whole life, perhaps even cause me to lose it,
just when so many possibilities seemed to be
opening up: I had a lovely wife, a beautiful new
home that we had shaped together, and was living
in a quintessentially peaceful part of the English
countryside that I wanted to continue enjoying. I
was also relishing new challenges involved in
bringing the human givens approach into organisations and was writing another book.
That night I had a dream that metaphorically
encapsulated my ruminations. I was high up on a
hill progressing along a difficult path from where
I could occasionally glimpse an amazing view of
a beautiful coastal town down by the sea – a
better world. Someone was with me and I offered
to take a photograph of the view for them with
their camera because they couldn’t quite see it.
Doing so, however, involved me leaning out from
the path into a lot of vegetation that concealed
the cliff edge.
When I looked at the view through the camera
I became aware that the edge of the cliff was
crumbling away and I was beginning to fall to a
certain death, all the time thinking that this
meant I would no longer reach my destination:
the beautiful scene ahead. Then I woke up, sweating, to discover, to my great relief, that I was safe
in bed and it was time to get up and start work.
Hospitalitus
I was given a bag of tablets to take home
with me. I took these pills as directed for six
weeks, until I received a letter giving me the date
of the operation and telling me to stop taking
them seven days before. However, I stopped as
soon as I read the letter (10 days before the
operation date) because I could feel the drugs were dulling my brain,
interfering with my
memory and my
ability to concentrate, and depleting
my energy levels.
They also gave me
a nasty rash. Within a couple of days
I felt much better
and mentally sharper: my ‘mojo’ had
returned to such a
degree that family,
neighbours and colleagues all noticed.
While waiting for
the operation I began reading about
the side effects of
the drugs I had been given, particularly statins
and beta-blockers. I also looked into losing weight.
A few years earlier I had read
The Diet Delusion
by Gary Taubes that tells an astonishing story of
just how much vested interests distort ‘science’
and create harmful public perceptions about
what is good or bad for us. So I decided to read
his later book, Why we get fat and what to do
about it, which shows all too clearly that what
we are so often told is necessary for healthy
living ain’t necessarily so. With my wife’s support, I adjusted my diet. At this point, with the
operation looming, I had complete trust in the
hospital and the swift actions and recommendations of those assigned to care for me.
Chaos ahead
And then I discovered for myself the chaotic way
NHS administration functions, and the severe
distress this causes to both patients and staff. It
started when I received a letter asking me to
attend a preadmission appointment, at which
time an X-ray of my chest and ECG would also be
taken. After the X-ray and ECG, Véronique and I
made our way to the preadmission clinic and
arrived on time at 12.30pm. After waiting for over
an hour and still not being called, we queried
when we would be seen and, at that point,
discovered that I was “not on the list”. When we
showed the appointment letter to the nurse, she
was clearly frustrated that the information had
not been passed through to her and very kindly
stayed late and saw us anyway.
We got back home to find on the doormat the
letter giving the date for my admission for
surgery. Consequently, we booked and prepaid for
a B&B near to the hospital, so that Véronique
could stay close by. We also made a multitude of
other arrangements, including driving the cat to
be looked after by a friend in a different county.
On the appointed day, I duly turned up at 3pm at
the cardiothoracic ward, where they were expecting me, and was put in an overflow ward with
other heart patients. At about 10pm I was told by
a bank nurse that she was very sorry but I did not seem to be “on the list” for surgery the next
day and that she couldn’t understand why. As I
had spent weeks preparing myself mentally for
the operation and its aftermath, I had a frustrating and restless night, not knowing what would
happen the next day but comforting myself by
reflecting that, when something one expects doesn’t
happen, new insights often occur.
In the morning Professor Taggart, a busy man,
took time out to find me and profusely apologise
on behalf of the hospital for the fact that I
couldn’t be operated on that day. He said this
would most assuredly not have happened had he
still been in charge of his list but that was not
how the current system worked. He was, therefore, quite unaware that I was in the hospital until
that morning. Professor Taggart’s evident distress, honourable apology and prompt action impressed me. However, I received no explanation
or apology from the administrator at fault.
An irritated email
I was so inflamed by all this that I emailed the
chief executive of the Oxford University Hospitals NHS Trust, Sir Jonathan Michael, detailing
this series of events. I also caustically pointed out
that, as psychological stress is known to be the
principal cause of heart problems, the way I had
been treated led me to suspect that management
is unaware that their job should involve keeping
heart patients as calm as possible. I suggested
that they were badly in need of basic training
about innate human needs – not just those of
patients but also those of the clinical staff, who
were clearly frustrated by their lack of control
over important aspects of their work.
I concluded by saying, “When an organisation
functions well, it is like any flourishing living
organism: all its systems work together in
a healthy, meaningful way. A mature organic
organisation is not easily taken in; it questions
its own assumptions, is flexible and adaptable
and the people in all departments take full
responsibility for their work, pulling together in
an organic way for the good of the whole. Its
philosophy is that everyone’s emotional needs
should be met in balance, because creating an
environment where that is possible is what moti-
vates people. One incompetent, unmotivated staff
member at any level in an organisation damages
the health of the whole.”
I signed off as director of the Human Givens
Institute, and copied the email to my MP, the local
press and my GP. The very next day Sir Jonathan
emailed me back (at 9pm on a Sunday evening, to
be precise), which was pretty impressive. Other
apologies from various people lower in the hierarchy soon followed during that week and were
profuse. The local paper took my photo and gave
the incident a whole page, with the heading,
“Hospital blunder delays operation”. The article
also featured an apology from the director of
clinical services at Oxford University Hospitals
NHS Trust.
No one engaged with the important points I raised in my final paragraph, however, which
suggests that these executives are so busy ‘putting
out fires’ that they have no spare capacity to step
back and look at the bigger picture.
The operation
Two weeks later, I was back in the John Radcliffe
– and this time all went well. After the operation,
which turned out to be a quadruple bypass,
Professor Taggart told me my heart was in good
shape and it was just the arteries that needed
replacing. During our conversation, he told me of
another shocking hospital management blunder.
Apparently, I and others could have had our surgery a day earlier because his team had been all
set to start work that morning when they discovered that there was nobody on their list for that
day, even though many patients were in the
queue for a bypass. So eight or nine highly skilled
people were paid a lot of money by taxpayers to
sit around drinking coffee, with nothing else to do
but moan about the system of management that
can allow such things to happen.
Support
I was again given drugs to take but felt too weak
to protest. My attention was focused on recovery,
getting home and becoming active again as
quickly as possible. Despite feeling extremely
tired and weak, which I’m told is normal after a
major operation, as soon as I could I started to
walk around the wards once or twice a day. On
my perambulations, I often struck up conversations with other patients. Véronique spent as
much time with me as she was allowed, which
was almost all day, and her company had a greatly
calming effect; my children visited or kept in
touch on the phone. Colleagues and friends also
called. This was in contrast to several patients we
met who had little or no support: consequently,
their anxiety levels were higher than mine. One
man seemed terrified at the thought of being sent
home alone so soon after the operation, with no
one there to look after him.
To know that other people are thinking about
you and care for you is a major factor in recovery
and it was no surprise that the lonely people we
spoke to were the most anxious and unhappy –
something all human givens practitioners would
expect. We know how important it is to feel
positive and how the heart patients who do worst
are those who are depressed or feel ‘out of control’
because their heart let them down. I would tell
anyone in similar circumstances to remember
their own emotional needs; getting them met well
has a major impact on recovery.
The cholesterol myth
One thing that helped me meet my need for
autonomy and control was gathering information. I continued reading books about the life-style causes of heart attacks, diet and the side
effects of drugs, particularly of the statins. I was
particularly impressed by Dr Malcolm Kendrick’s
The
Great Cholesterol Con and Dr Duane Graveline's books,
The Statin Damage Crisis and The
Dark Side of Statins.
Cortisol is the culprit
Dr Kendrick makes the case that it is not cholesterol but cortisol that is the primary cause of the
inflammation of the arteries. Cortisol is the hormone released in response to stress and a low
level of blood glucocorticoids. Its primary functions are to increase blood sugar, suppress the
immune system, and aid in fat, protein and carbohydrate metabolism. Stress levels are raised, as
we know, when innate emotional needs are not
being adequately met. And
a physical stressor that
also leads to increased cortisol production is our un-natural modern diet, over-loaded as it is with sugar-
producing carbohydrates
and processed foods. Perhaps, I reflected, my heart
attacks were the price for
my lifelong addiction to
honey on toast, potatoes
and fruit juice.
Graveline is a highly respected American physician, medical researcher
and NASA astronaut. After
he was prescribed statins to reduce his cholesterol level, he developed transient global amnesia
– he could not even recognise his family. His
memory only slowly recovered when he stopped
taking the statins. NASA physicians prescribed
them again at just half the dose, but the amnesia
returned, so he stopped them for good and has
since become an authoritative critic of them.
Cholesterol plays an important role in the body
and the metabolic pathways in the brain, contributing vitally to the brain’s proper functioning,
including mediating the formation of new synapses. It is the precursor of vitamin D and all our
steroid and sex hormones. It also acts as a vital
component of the immune system and as a protective antioxidant in its own right. Graveline
refers to clinical trials and studies whose data
show that cholesterol-lowering statins have
negligible impact on heart disease in those who
have not been diagnosed with cardiovascular
disease, yet increase mortality rates overall from
all causes.
Statins and saturated fat
The over-prescription of statins over the last 40
years was generated on the back of the ‘diet–
heart’ hypothesis that suggested that dietary
saturated fat raises cholesterol levels, and that
these two substances somehow clog up our arteries, causing heart attacks. This notion would seem
to have been thoroughly debunked by better
science (as well as common sense and experience)
but it still clings on in the collective mind and is
still accepted as true by most doctors, partly, no doubt, because of the PR efforts of the pharmaceutical industry, for whom statins have generated vast fortunes. The food processing industry
has also benefited from the cholesterol myth,
introducing thousands of ‘low cholesterol’ products – cheap to produce margarines and spreads
etc – to sell to an anxious public.
Graveline points out that having ‘normal’ or
even ‘low’ cholesterol levels does not eliminate the
risk of heart attack or stroke. In fact, 75 per cent
of heart attack victims have normal levels of
cholesterol. In the hospital, I was told mine was
‘normal’. Studies show that, while statins do
fairly reliably lower blood cholesterol, taking the
drug brings no improvement in terms of risk of
heart disease or heart attack and no reduced risk of
death, compared with not
taking it. As Graveline
provides evidence to show,
people with high cholesterol often tend to live
longer than those with
low levels, and those with
heart disease tend to have
low levels of cholesterol.
This rather suggests that
the cholesterol levels that
statin drugs are purported to reduce have little or
nothing to do with heart disease in the first place.
Microbiologist, immunologist, and pioneer in
the development of human cell culture technology
Dr Myron Wentz puts it very succinctly: “There is
no part of the body where cholesterol does not
play important roles in physiology and metabolism. Just because it is found in arterial plaques
does not mean it is the cause of heart disease.
Rather, cholesterol is there as a repair molecule,
called on to mend damage caused by inflammation. Because you usually find firemen at the
location of a fire does not mean that they started
the fire. Indeed, there is mounting evidence that
cholesterol is involved in preventing cardiovascular disease rather than in its development.”
Statistics unchanged
Since statins were introduced as a wonder drug
in the 80s, the incidence of heart attacks and
strokes has not changed. If they worked in the way
that the pharmaceutical studies appear to show,
the numbers of strokes and heart attacks should
have fallen dramatically. They have not. However,
the list of officially acknowledged statin side effects
has grown, the main ones being damage to the peripheral nervous system, causing tingling, numbness, prickling of the hands and feet, and burning
pain and paralysis; muscle damage, causing severe
muscle weakness, intense muscle aches and pains,
and disabling fatigue; kidney damage, which can
be fatal; immune suppression; increased risk of
diabetes; increased risk of cancer; heart failure;
and decreased mental functioning, including confusion, memory loss, and transit global amnesia.
Other problems, including cataracts, liver dysfunction,
rashes, hair loss in women, upset
stomach, headache and insomnia have also been
linked to statins. In addition, some GPs have
described side effects such as irritability and
‘generally feeling old’ that are never mentioned
in studies, yet are common.
It would seem that many people are undoub-
tedly being damaged and subjected to premature
degenerative disease and death as a result of inges-
ting statins and I resolved not to be one of them.
Convalescence
On the sixth day after my operation I was discharged and for the first couple of weeks or so I
felt extremely uncomfortable and weak and
experienced a lot of pain in my chest and the leg
from which a vein had been extracted for the
transplant. I kept falling asleep and had to take
paracetamol a few times, especially at night.
It took a while before I really felt on the mend.
My GP encouraged me to resume taking the statins and other medications, which I had stopped
again as soon as I got home (except for one soluble
aspirin daily, which is said to thin the blood and
has the same anti-inflammatory effect on arteries
that statins have). I also began taking vitamin D
supplements to counter the lack of sunshine this
winter and was eating well again, thanks to
Véronique’s care and the information we began
gathering together about eating more healthily.
At home it was a relief to re-engage with work
and colleagues again, albeit gently to begin with.
Between sleeps and short walks I also read a few
novels, something I rarely do these days. The one
I enjoyed most was sent to me by my son, Mark.
This was Musashi, by Eiji Yoshikawa, an epic
samurai tale based on real characters. It was great
to disappear into an exciting, exotic alien world
for a while and mentally disengage from pain and
inconveniences. The main character overcame
great difficulties, including injury, heartbreak and
being endlessly hunted, attaining wisdom from
doing so. Just the tonic I needed.
Not so intelligent now
Six weeks after leaving hospital I was back at
the John Radcliffe for X-rays, an ECG and other
tests, before seeing Professor Taggart for a check
up. He told me that the X-ray results were excellent and all the tests confirmed that the operation had been successful. Moreover, he said, he
could tell just by looking at me that I was well.
“How come?” I asked.
“It’s your colour, your demeanour,” he said, with
a smile.
“You are obviously healthy.”
Then I made a mistake and said,
“That may be
because I’m not taking any of the medication,
apart from the aspirin.”
This did not go down well.
It was a clear example
of his earlier observation conflicting with the
beliefs he held about the value of statins.
When I explained that I had read up on statins
and did not trust the research on which their use
was based, Professor Taggart’s immediate response was to say that trawling the internet for conspiracy theories
was easy to do
but an unreliable way to inform myself. This came across to me as
a bit patronising. He evidently no longer thought
I was “an intelligent man”. I didn’t bother explaining that I was basing my decision on several fully
referenced books by respected doctors and professors, so I promptly shook his hand and thanked
him for his skill and care. He said he would write
to the pharmacist and ask her to discuss my
medication with me.
Dishing out ‘meds’
Doctors, I realise, are obsessed with dishing out
‘meds’. (There were even posters on the hospital
walls featuring TV celebrities, with speech bubbles
coming out of their mouths, saying, “Don’t forget
your meds!”) They seem to assume it is not
normal if, by my age, a person is not taking some
medication or other as a matter of course. I’m not
against drug treatments but I do question ones
where the side effects might be worse than the
condition they are treating, the practice of mixing
several potent drugs together, and the research
funded by drug companies on which these regimes
are based. (The evidence for the unscrupulous
claims that the industry makes can be found in
Dr David Healy’s brilliant book
Pharmageddon.)
At home we got seriously interested in food.
Another book we both read avidly, twice, was
Trick and Treat, by Barry Groves, a real page
turner for anyone whose attention becomes
focused on their physical state – as my heart
attacks made me focus on mine. It was the best
book I came across about looking after your own
health and is well worth reading for its common
sense advice about diet and exercise, much of
which contradicts the absurdities recommended
by ‘nutritionists’ and the health-care industry.
At home we now generally avoid bread, pota-
toes, pasta, rice, fruit juices, skimmed and semi-
skimmed milk (we drink full cream milk from a
nearby farm). We happily eat cheese, fatty meat
of all kinds, fish, eggs, salad and green vegetables.
This keeps the weight down and energy levels up.
We never have margarine, processed ‘yogurts’, or
any product labelled ‘low fat’ or ‘low cholesterol’.
Instead we cook with butter or cold-pressed olive
oil. As a result I have lost over a stone.
If you are interested in health, it is worth-
while remembering that hydrogenated vegetable
oils, and the trans fats they contain, are some
of the most harmful substances you can put into
your body and are the main causes of the epidemic of obesity and diabetes. They are found
in practically every processed food and fizzy drink
including cakes, bread, biscuits, soups, cereals
and takeaway foods.
Fear of dying
After a bodily setback like a non-fatal heart
attack many people become anxious and begin to
worry excessively about the future. As we know,
it is worrying that causes depression. Conventional doctors seem often not to realise that one
leads to the other, but they do take the risk of depression seriously. Despite loading me up with
medicines (and medicines to counteract the side
effect of the medicines), two doctors separately
suggested that I should be prepared to take anti-depressants as well, in case I got depressed during
my convalescence! No attempt was made to find
out if I was worrying or suggest any better way of
keeping depression at bay (such as getting one’s
needs for emotional support, connection, sense of
purpose, status and security met).
Worrying about one’s inevitable demise doesn’t
make for a clear spirit. I take my inspiration from
the words of Mark Twain: “The fear of death
follows from the fear of life. A man who lives fully
is prepared to die at any time.”
A decade or more ago I had an intense near-death experience. During a medical crisis in an
intensive care unit I stopped breathing several
times and, on each occasion, became aware of passing through the REM state portal into a realm
beyond space and time where things that puzzled me were explained. Back in the hospital little
time had passed, only enough for me to eventually gasp in a little breath or two before passing
out again and returning to that place. Since then
I don’t fear dying as I used to do when a child and
will submit readily when my time comes.
Of course, I still think that I have things to do
and enjoy on this earth, but death doesn’t wait to
see if we’ve finished all our projects or had our
fill of earthly enjoyments before it calls us back
whence we came. It is the price we pay for freewill
and having the chance to observe and participate
in the wonders of creation: we all leave this familiar home, stepping out the door as it were, to rejoin the conscious universe, taking with us our
contribution to it. In the meantime, I am grateful
for the continuing ability to marvel at Reality from
my current perspective, whilst preparing for that
event as best as I can. And I thank the doctors,
surgeons and nurses, and my wife and family,
colleagues and friends for the opportunity.
This article was published in
Human Givens journal, Vol 20, No 1 (2013).
For more articles like this subscribe to the Human Givens journal.