Note: this is the fourth article in a series that begins with Passing Out.

My work at the time had become concerned with Customer Relationship Management, specifically the rolling out of some systems to support this, and was researching the various options in detail. I was cautious about going for something completely off-the-shelf, since no two businesses are truly alike, but I was equally unenthusiastic about an entirely bespoke one-off solution as the long-term costs would likely be high. Fortunately, more than a few software vendors were well-prepared for people in my position, and could offer a more comfortable mix of the two extremes. One of them was holding a seminar in London the following week, so I arranged for myself and a software developer from my team to attend.

We made our way down by train to the capital in high spirits (a day away from regular duties was a welcome side-effect) and arrived at the classy hotel venue in good time. The morning session started strongly with the top brass, who had flown in from the States, giving confident and evocative presentations on the value of CRM done properly. We sat somewhere off to the side and I made many pages of notes—-much of what was being said aligned with my own views on the subject, and I was keen to glean as much as I could for apparently extemporaneous use in future board meetings. There’s a lot to be said for generating enthusiasm for technical things without having or needing to utter anything even remotely technical.

At lunch, as we challenged ourselves to eat as much “seminar food” as we could in the allotted time, I started to become aware that not all the delegates were prospective customers like me. In fact, the vast majority were the opposite: salesmen—-not of the product we’d come to examine, but of smaller “complimentary” products and services. Over a decade in the industry had made me both wary and weary of IT salesmen. The first couple had a few interesting things to say but, as more and more descended upon us, I started to wonder whether we had be lured to an upmarket corporate incarnation of your local PC “superstore” like flies to the insect-o-cutor.

Stuffed to the gills with canapé, tartina, barquettes and vol-au-vents, we moved back into our table in the shadows (now awash with business cards etc.) for the afternoon session, but it was soon apparent that things were going downhill. The stage was soon opened for many of these looming salesmen to make their various pitches. The onslaught of marketing-speak had clearly lost the interest of my colleague, and I had begun to devise an elaborate point-scoring version of Bullshit Bingo. Synergy; traction; dynamism; comfort-zone; quick-win; empowering; forward-thinking; value-adding; best-practice; critical-path; in-the-zone; out-of-the-box; go-to-market; up-to-speed; moving forward; push-back; headlong; tailwind; on-stream; off-line; heads-up; top-down; end-to-end… all worth a point with a bonus awarded to anything suffixed with -centric. When one speaker managed to rack up 58 points in the course of describing a single slide, I handed my colleague a serviette. “Fuck this!”, I had scrawled, “At the next break let’s do one”.

As the coffee break before the concluding question-and-answer session was announced, we swept as much complimentary stationery into our rucksacks as we could (our colleagues at the office would be grateful for them), and slipped out to make our separate ways into the city. It was too late in the day to return to the office before close, so we both hatched plans of a more sociable nature.

I had managed to get hold of my dear friend Tom, whom I had not seen for over a year, and we agreed to meet outside Tottenham Court Road tube station before heading off east to meet up with some more nice folk. I stood under the covered entrance to the Dominion theatre where we had agreed to meet, smoking a cigarette and killing a few minutes until our agreed meeting time. It was wonderful to be back in the hustle and bustle of the city I still called home. I remember savouring the noise, the smells, the slight drizzle.

I had missed London bitterly. It was the place I’d chosen to make my home for the first decade of my adult life. Then, over Easter of 2006, my relationship of six years ended and I was made redundant, so I packed up and left the city to fall back upon the support of family way out in the sticks. Six months later, armed with a driving licence and more positive outlook, I took a job with a startup in Northampton. At first I camped out with friends, but within a few months I had a flat to myself and things were going reasonably well again.

But all the while I was desperately homesick for the city. London is unlike the rest of the UK—-it is wildly multicultural and diverse. Opportunity is everywhere. People from all sorts of backgrounds, and various statuses, are muddled in together. It hums and throbs and glows with a sense of purpose. They say it’s an antisocial and lonely place, but the dense population brought me in touch with the most interesting people I’ve ever met, and many of my closest friends as a result. Above all, it reminds me of myself in my teens, arriving into the near-anarchic bustle of Paddington Station. I stood in the expanse framed under Brunel’s fine arched roofs now blackened with soot, and watched. Every single person was doing something; going somewhere. There was that forceful sense of purpose hanging, unspoken, amongst the diesel fumes. I, too, could do things here, and I suddenly felt more at home than I had in any place, at any time in my life up to that point.

Now, however, I was living and working more than an hour away. It’s not far, and yet it’s a different world. I told myself London was for the young, and everyone is ultimately forced outwards, but somehow I still felt I’d left before I was ready. Sure, I now had four times the living space for half the cost, but I’d not made a single friend outside of work in more than a year. All social engagements seemed to revolve around drinking too much and, as the teetotaller in the group, I often wondered whether I was invited along as a cheap ride home. Meanwhile, the city charged purposefully onwards. Many of my friends in London were either being picked off by the allure of California, or being invited into evermore interesting enterprises. By leaving London, I couldn’t help but feel left behind.

Once Tom had appeared through the crowds, we rounded the corner to the first bus stop in New Oxford Street, and pratted around with the ticket machine before stepping back to wait for the right bus. “So,” said Tom, for we had not had a proper catch-up in a long while, “what’s this I’ve been hearing about you having seizures?” With spectacular comic timing, and part-way through a word in my reply, it happened again.

I remember nothing about it, but Tom recalls I began to stutter as I lost consciousness. At first, he admits, he thought I was messing around, but alarm bells began to ring when my whole body went stiff as a board and fell. My descent was broken, in part, by my rucksack containing my Mac and a whole load complimentary stationery, but I must have hit the back of my head on the pavement. Tom compared my loss of consciousness to a crashing computer, and recalls my body going into a strange state of overdrive—-every muscle had tensed up, I was getting hot and breaking into a sweat, and I was also bleeding from the head. I can only imagine the scene as I lay on the pavement during a cold and drizzly evening rush-hour in the very centre of the city.

By the time my brain had rebooted I was already in A&E, only this time at the shiny new University College Hospital. There was a different feel to this place from the provincial hospital to which I’d been carted on previous occasions—-straight away it was clear that, as I was alive, there was a sense of urgency associated with getting me back out to clear space for whatever was to come in next. Tom was still with me, looking concerned. As usual, now conscious again, I got my act together quickly—-in no time I was pratting around and being entirely inappropriate. The hospital staff’s keenness to get shot of me was matched by my enthusiasm to get out—-I didn’t fancy another nine hours of having the same conversations and receiving the same tests only for them to come up with nothing.

As I snapped back into my normal, recognisable self, the shock began to release its grip on Tom, who was becoming increasingly uncomfortable. He was recounting the events of the last hour while pacing out a lissajous curve, and the unpleasantness of the experience to which I had subjected him was becoming clear. Once I’d been unwired from the EGC and my head had been glued back together, we made our way. By this time, however, we’d missed our social engagement so opted instead for a meal at a surprisingly good sushi restaurant not far away. Not surprisingly, my recent blackouts dominated the conversation. Tom was visibly shaken and, for a time, quite upset but, as we gorged on expensive food, the situation began to improve. I think I did a pretty good job of being as blasé as usual but, on the train back out of the city later that evening, I worried. This one had come out-of-the-blue—-no forewarning at all—-what did that mean for the neurologist’s diagnosis?

The following day, I rang the neurologist’s secretary—-a spectacularly efficient, well-organised and polite middle-aged lady, with the news. Somehow she got hold of the neurologist straight away, and I did my best to explain what had happened. Clearly I wasn’t the best witness: he asked if he could question Tom directly, and I gave him his phone number. He went on to say he’d been reviewing my MRI scans, and that I’d be pleased to know everything was normal. I’d forgotten all about this—-not that I’d had the scan, but that he’d be using it to look for problems. The novelty of having pictures of my own brain had distracted me from the fact that the whole point was to find something wrong with it. As the scan had come back “normal” I didn’t know if I was supposed to be pleased or not, but he reassured me this was exactly what he had been expecting.

For the second time, the neurologist raised the question of driving. “You know you shouldn’t be driving, don’t you?” he said again. The first time he had mentioned it, I had taken it as advice. The kind of advice you know is sensible, but it’s down to you whether or not you take it. I know that sounds crazy, but the casual way in which it was first mentioned, and the massive impracticalities associated with being without a car had put it low down my list of thoughts.

“Yes…” I said, with clear guilt in my voice, “I just haven’t found a way around that yet.” His tone became much more forceful.

“Now look,” he insisted, “you can’t drive. It is illegal for you to drive. It’s against the law. You have a duty to surrender your licence, I have a duty to inform you of this, and I also have a duty to inform the authorities if you don’t. More than that: consider the consequences.” Bang. This was not friendly advice. Impractical or otherwise, for the sake of myself and everyone else, I was duty-bound. Like it or lump it, I’d have to find a way of striking up deals with colleagues to get between my rural home and my even more rural office. I put my licence in an envelope with a covering letter, and off it went back to the DVLA.

A few days later, various items of post arrived. Some were to confirm appointments arranged on my behalf, but there was also one from the neurologist, which read “I spoke with Tom who had witnessed your latest attack and I think there can be no doubt at all that it was a fit”. A fit, I thought. What’s the difference between a fit, a blackout, and a seizure, then? When I think of the term “fit”, I think of the term “epileptic fit”… does that mean we’re talking about epilepsy? If so, what the hell is epilepsy? Isn’t it something to do with strobe lights?


Afterword

While writing the above, I’d done the odd bit of fact-checking with Tom via instant messaging (he’s since moved to California, the bastard) but the first time he saw the thing in its entirety was when I published it online. He went on to write his account of events by way of response and, given he was conscious through the episode and I wasn’t, it is possibly of greater value than my own:

So, I don’t really think Mo does this experience justice from my perspective, so here’s what happened from my end.

I’m standing there chatting to a friend who has so far refused to explain to me why there are pictures on the web of him covered in bruises and I say, “So what’s up” and he keeps looking straight at me and gets stuck in the middle of a word, with his eyebrows up where they normally are, looking like the whole thing’s a bit of a joke, and then slowly and systematically appears to go totally stiff and solid, before elegantly careering down onto the concrete in the middle of Oxford Street, in the middle of the rush hour, crowds everywhere, rolling backwards on his backpack, and forcibly smacking his head against the pavement.

Initially, just before the fall, I’m all “Oh don’t be a dick” before realising in short order that he’s not taking the piss and there’s something actually seriously wrong, at which point I’m left shouting on Oxford Street to anyone who’s passing for help, while trying to work out how to stop him swallowing his own tongue. He’s stiff as a board, getting increasingly sweaty and hot, froth bubbling out of his mouth, I’m trying to hold his head in my hands (now covered in blood) and a small crowd of interested bystanders are watching the whole thing with fascination.

A woman turns up and I’m trying to work out with her what the recovery position is while everyone watches and observes things, and I’m totally convinced that we’re going to do something wrong and my friend is going to die in my blood-stained hands and I’m not only going to have to make do without him, but it’s going to have been my bloody fault. And we’re frantically running around trying to rearrange him, although it’s bloody hard because all his limbs are completely rigid, and there are people all around us who aren’t helping and we’re shouting for someone to call an ambulance.

At some point I’m completely convinced that someone’s going to take his wallet and I have no idea who to trust. A crowd grows around us but no one actually does anything but get in the way. All these eyes sort of bore into you. What if I make a mistake. What am I supposed to be doing!? If ambient adrenalin would have done anything to help, he’d have been up and running around in no town.

After about two minutes, our hapless hero/victim comes briefly out of his fit. I think this is all going to be fine, although he clearly has absolutely no idea what’s going on or why everyone’s so concerned. Blissfully ignorant he mumbles and bit and then almost grumpily tries to dismiss us before falling almost immediately into a deep unrousable sleep-like state. Again, I have no idea whether this is a good thing or a bad thing. At some point in all these proceedings he’s breathing like a planesaw. I don’t remember when.

Eventually an ambulance arises. The woman who was helping us disappears immediately—-I wonder if she’s an ex-nurse or something who doesn’t have insurance for medical malpractice if Captain Fallover is seriously damaged by the whole situation. The ambulance people growl at everyone nearby and ask me an enormous amount of questions that I can only half answer and then with significant speed and urgency—-clearly really quite worried about the whole thing—-get him onto a stretcher and into an ambulance.

I’m not allowed in the ambulance, and so have to wait outside. The crowd dissipates almost immediately, and within thirty seconds I’m alone by the side of the road, opposite Centre Point next to an ambulance with throngs of people walking by on the street—-the only sign of the whole thing being a patch of blood on the street, right near the Argos, against the wall.

I stand outside on the street for fifteen minutes not having the slightest idea what’s going on, still scared out of my mind, only for the door of the ambulance to eventually open, and Mr Morgan to be sitting there, quite apparently cheerful and mystified by the whole thing, looking entirely bemused—-and not in the least bit horrified—-by all the attention! Swine! Bastard!

The rest of the day is roughly as our hero has indicated, and he’s TOTALLY right when he says that once we’d determined he was initially okay and once I didn’t have to be the solid reliable calming one any more, I sort of freaked out for a few minutes! Lazy bastard slept through the whole thing! What the hell does he know!

It seems obvious to say but, as the unconscious one, I tend to miss much of the happenings. But as I read Tom’s account, I am left wondering what I might have done had our roles been reversed. The “nice” thing, in a way, about being the patient is not having to deal with the situation, but what do you do if someone drops to the ground in front of you? I know now, but what would I have done then, right there in the centre of town? I’ve done my share of first aid training and the like; I think most people these days have a basic understanding of first aid (airways; breathing; circulation, right?), but how often do you suddenly need it, completely out-of-the-blue, and after a regular day at the office? Most will be familiar with the recovery position, some may have even trained to do it, but what if the patient is stiff as a board? What then?

As the neurologist had described these blackouts as “fits”, I came to realise my understanding of such things was marginal at best. While I was pleased he was making diagnostic progress, I realised I was now on a journey of understanding. There would be more tests, more appointments, and more terminology I barely understood.

More on that… in a bit.