The main road is quite wide, so the traffic was managing to get around the ambulance reasonably easily. Perhaps some drivers would have spared a thought for the person the paramedics were attending – so early in the morning, too. But for most commuters streaming past I imagine the parked emergency vehicle represented nothing more than a minor obstacle in the course of their drive to work.
Although it was a long terrace, a sixth sense told me the paramedics must be in John’s house. I’d been there many times over the past few months, after he suffered a stroke from which he was making a chequered recovery. I eyed the ambulance as I drew near, wondering whether to pull over and offer help. But the crew would be more than capable. If, after assessing the situation, they thought my input would be useful, they would ring the surgery. It was better to finish my journey and start seeing my booked appointments. I might need to be back at John’s later in the day. I drove on by.
I hadn’t heard anything by lunchtime, so assumed he must have required admission. Another stroke, potentially, though I’d been giving him an array of drugs to try to prevent one. But he’d been getting bouts of awful indigestion since starting first aspirin and latterly clopidogrel – crucial blood-thinning medications. I’d tried a variety of stomach-protecting drugs alongside them but still the dyspepsia continued.
Just the week before, I’d finally given up and switched him to an old alternative, dipyridamole: not quite as effective at stroke prevention, but hopefully it would be better tolerated. Could the changeover have left him vulnerable to another clot, starving part of his brain of oxygen? Or had those intractable bouts of indigestion been symptoms of a gastric ulcer? Maybe he’d had something like an internal haemorrhage instead.
I thought about Theresa, his wife. She was a gentle person, and incredibly stoic; she’d been steadfastly helping John through his halting recovery while simultaneously adjusting to the fact that her husband was a changed man. This would be a huge setback for her. I resolved to call her the following day, when she should have returned from the hospital.
Notification of John’s death was waiting when I got in the next morning. The 999 call had been a heart attack. He’d been whisked straight to the catheter lab, where a cardiologist had attempted to stent the clot blocking one of his coronary arteries. Mid-procedure, John’s heart had stopped. It had taken 16 minutes to get it restarted. On intensive care, it became apparent that he’d sustained substantial brain damage.
I called round to see Theresa. She had many questions. The heart attack had felt to John just like a severe version of the indigestion he’d been getting daily: had all those previous episodes in fact been warning shots from his heart? I thought it highly unlikely – in recent weeks John had started to get out for short walks, and had even managed an outing to the local café with his fishing pals, without experiencing any exertional pain that might have pointed to a cardiac cause.
I had my uncertainties too: had the switch to dipyridamole been a factor in the heart attack? The aspirin or clopidogrel would have offered more powerful protection for both heart and brain. Yet the apparent side effects had been intolerable and seemingly insoluble; I’d been forced to make the change.
One thing I was certain about. When the intensive care doctors had asked Theresa whether to continue with John’s life support, she had made the right decision. “I feel dreadfully guilty,” she said. She struck me as small and alone, sitting there on one side of their front room sofa. “But he wouldn’t have wanted to have been kept going like that.”
“No,” I said, “he absolutely wouldn’t. You did what was best.”
I left her at the door, and went back to where my car was parked on the road. I had to wait a while before pulling out, until there was a break in the traffic passing by.
This article appears in the 17 Jul 2019 issue of the New Statesman, The Facebook fixer