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23 June 2021

Rachel Clarke’s Diary: Hancock vs Cummings and the medical miracle of the human heart

Every day a heart will beat more than 86,000 times; this powerhouse of evolutionary engineering kicks Teslas, Ferraris and superyachts into touch. 

I’m freewheeling with my husband along the flank of the Thames and skylarks are casting pure joy into the sky. According to legend, Port Meadow – Oxford’s ancient common grazing land – hasn’t been ploughed in more than 4,000 years. And I swear in all that time it has never looked more gorgeous than on this sun-drenched morning in mid-June, as egrets, draught horses, cattle and goldfinches flutter and lope around us.

When we pass the ruins of Godstow Abbey – whose foundations date back to 1133 – I’m suddenly jolted into a world of Dust and daemons. Since being here last, I’ve read Philip Pullman’s La Belle Sauvage, in which an infant Lyra Belacqua, lovingly concealed by the Godstow nuns, is hunted by a bloodthirsty rapist with a three-legged hyena for a soul. This invented world – inspired by these stones – has invaded my head with such force that I can’t unsee it as the ruins rush past. Imagine the moment when an author is the only person in the world who thinks, or dreams, or shapes something. And then – because they set pen to paper – thousands of readers live and breathe their creation, too. That really is a superpower.

Heart of the matter

I read with wonder Danish midfielder Christian Eriksen’s first words to the on-pitch doctor, following CPR for his sudden cardiac arrest. “Well, are you back with us?” asked the medic, to which the prostrate Eriksen – heart just shocked by the defibrillator back into life – reportedly replied: “Yes, I am back with you. For f***’s sake, I’m only 29 years old.”

For f***’s sake indeed. A young person’s healthy heart is a medical miracle. Every day, it ejects around 6,000 litres of blood and beats more than 86,000 times. That’s 2.5 billion beats in an average lifetime. This powerhouse of evolutionary engineering kicks Teslas, Ferraris and superyachts into touch. Nothing we build comes close to a human heart. So when an elite athlete topples without warning, spectators are left reeling.

Happily, the ICD – implantable cardioverter-defibrillator – with which Eriksen has now been fitted should restart his heart if it arrests again. With luck, the CPR he received on pitch has flicked him back, like a switch, into life and longevity.

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But resuscitation rarely works this beautifully. When the heart is the first organ to fail – in the context of a lithe young body like Eriksen’s – CPR stands the best chance of success. Far more commonly, the heart stops because everything else – the liver, lungs, kidneys, brain – is already failing. CPR is not a treatment for so-called ordinary dying, when the heart is the last of our organs to go. Then, chest compressions and electric shocks are not only futile but brutal. “Do Not Attempt CPR” orders spare a person that ugliness. You should tell your doctor your wishes, and ensure you are the author of how your life ends – rather than a medic trying to second-guess you.

Father and son

How has it happened again? As my husband slept in, and my daughter merrily cracked eggs into a well of milk and flour, I struggled in vain to cajole, threaten and even physically wrestle my teenage son into assisting with the Father’s Day breakfast. He finally emerged for the pancakes alongside his dad, two tousle-headed somnambulists. The feminist in me winced as I wondered: what exactly am I teaching my kids here?

Fighting spirit

As a twin myself, I’ve been thinking all week about Georgia Laurie, the 28-year-old from Berkshire who took on a full-grown crocodile after it went for Melissa, her twin sister, while they swam in a lagoon in Mexico. The reptile dragged Melissa underwater, breaking her wrist and lacerating her legs and abdomen. Rather than looking on helplessly, Georgia fought to save her apparently lifeless sister, punching the crocodile over and again on its nose as it kept on attacking. “It was fight or flight,” she told the BBC, “and you have to fight for the people you love.”

How true. But how much fight is a person capable of? It’s a question I’ve mulled, on and off, for the past 18 months. When doctors, nurses, porters and paramedics started dying from Covid last year, it was impossible not to feel frightened. There was no escaping that going to work could cost you – and your family – your life. Yet everyone simply got on with it. Staff stepped up for patients willingly, unwaveringly.

Perhaps the pandemic has revealed there is more Georgia in each of us than we imagine. When I look back to the unfolding horror of last spring, I see a population who rose to the challenges with quiet grit and selflessness, who looked out for each other. Despite all the subsequent toxicity and disinformation stirred by Covid, perhaps catastrophe – in viral or reptilian form – brings out, by and large, our best.

Hancock’s way with words

“Every man, wherever he goes, is encompassed by a cloud of comforting convictions, which move with him like flies on a summer day.” So wrote Bertrand Russell in 1928, but to my mind he’s describing the Health Secretary. For weeks now, Matt Hancock and Dominic Cummings have been trading insults and allegations. I watch with disbelief as Hancock gives evidence to the health and science select committees. He squirms and twists words like a linguistic Simone Biles.

When Hancock has the temerity to insist there was never a national PPE shortage and that, yes, he tried to throw a protective ring around care homes, I hear nothing but the buzzing of flies. Has he actually convinced himself these lies are true? The number of deaths with Covid-19 on the death certificate has topped 150,000 – and here he is, the man in charge of the nation’s health, performing world-beating verbal gymnastics.

Rachel Clarke is a palliative care doctor and the author of “Breathtaking: Inside the NHS in a Time of Pandemic” (Little, Brown)

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This article appears in the 23 Jun 2021 issue of the New Statesman, How Brexit changed us