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Following three unexplained blackouts, there was no longer any use denying there could be something wrong with me. I wondered if it was a dietary thing or, at worst, side-effects of prescriptions I’d been given for something else. But now, I was tired of guesswork. As good as the NHS is at reactionary care, it didn’t seem that anyone was getting closer to any kind of diagnosis.
To say this was frustrating is an understatement. The only thing worse than having to sit around in A&E for hours at a time, all the while picking up minor infections, was that none of these impromptu visits were yielding any sort of answers. But I did have one last ace to play.
Note: this is the third article in a series that begins with Passing Out.
In a GP’s office once more, the situation seemed quite hopeless. Sitting before him was a particularly frustrated and frankly irritable patient, who was making no secret of the fact he had no intention of leaving without agreeing a solid “next step”. I was trying to be as polite as I could, but I’d more or less had enough of the uncertainty—by far the worst aspect of the blackouts was not anything about the blackouts themselves, but that they could occur without warning at any time and hijack my otherwise fairly normal life. I had stuff to do, for goodness sake—be it building drum kits, fixing fax machines, buying sandwiches or whatever—and I just didn’t need the random interruptions and associated fiddling about. I also didn’t need the same shrugging response from the so-called experts time and again… I wasn’t unreasonable enough to be expecting instant answers from a man armed with nothing more than a stack of inconclusive notes from others, but I wanted at least something tangible that could be done on the road to reaching a solution. In short: what is it, and how do I make it go away.
I probably came across a little menacing. My most recent fall had been face-first onto concrete, so much of my face was covered in cuts and bruises. On impact I’d bitten through the side of my tongue, which had become swollen and lazy, making conversation more challenging. Overall, I’d grown weary and impatient from the pattern of waiting ages to see doctors only for them to do or say little.
“I don’t know what else to suggest”, the GP continued earnestly, “as none of the tests have come back with anything we might pursue. I guess we’ll just have to hope that it doesn’t happen again”. With a sigh, I reached for my rucksack and peered inside. The GP shifted awkwardly. What was I about to produce? A handgun?
“I do have this,” I said, reaching inside, “if it helps”. I pulled out a bright yellow and blue folder. “It’s private medical cover… I don’t really know anything about it but I get it through work… apparently it’s quite good”.
“Oh!” exclaimed the GP, brightening, “well that’s a very different matter!”. Immediately he turned to his desk and grabbed a notepad, scribbled briefly and tore out the page. “This is the number of the neurologist at the private hospital in town. You should be able to get in straight away”. Huh? Was that it? Was it really only a question of money? I sat in mild disbelief—half-delighted at the idea of progress, half-dismayed at the means by which it’d come about. I pried a little more, to be sure I’d understood what I’d been told. But sure enough, with private money on the table, the possibilities were plentiful, and waiting lists no longer applied. Would this, at last, lead to a diagnosis?
Only hours later, I was indeed sitting in front of the chief neurologist at the local private hospital. Neither before nor since have I met a man whose appearance and demeanour were more befitting his professional standing. From behind his desk he emitted a large presence in a surprisingly small office, but was warm, friendly, and somehow irresistibly reassuring. I couldn’t help but notice the two of us were dressed for business—both suited and booted to give that air of professionalism and efficiency. In my case, there were many tell-tale signs that this was just wrapping-paper, but the effect of his expensive suit seemed to course through his entire being. I was also struck by the total lack of visual indication that this was a medical consultation: no stethoscope; no rubber-mattressed bed; no anti-smoking posters; and absolutely no pharmaceutically-branded biros. Just two men in an office discussing the business of the day—and yet the consultation about to take place felt more diagnostic than anything I had experienced before.
He sat back in his chair, twiddling his fountain pen as I recounted my recent experiences, interrupting only to ask me to elaborate on certain details. As my story reached the present day, he paused for a moment, and fixed his eyes on a point on the ceiling. Then he looked down to straighten the already immaculately aligned papers on his desk, and began his questioning. “Tell me…” he opened, before a lengthy pause, “…do you find that not drinking alcohol negatively affects your social life?”. I was more than surprised: this was something I hadn’t told him. Glancing as his desk, I realised the papers in front of him were the reports from my visits to A&E, and he’d done his homework. This surprising question had caught me on the hop—for some reason I automatically kicked into job-interview mode and tried to played it down.
“Oh no, erm… no it’s erm… well, it’s uh…”. He looked at me intently over his half-moon spectacles, willing me to relax back into brutal honesty: “Well… yes, I do believe on occasion it does”.
“Hmm”, he agreed quietly, rocking back in his chair again.
After quizzing me in some detail about the treatment I had received for manic depression, he thumbed through the first few pages of the notes on me, and placed a single cross in a margin. He then moved on to explore my experiences immediately before the blackouts, asking many leading questions to many of which I agreed. Although I didn’t recall anything unusual before the first episode, I could remember something just before the other two. A strange, other-worldly feeling, I suppose kind of like déjà vu, only less connected with the past, and more a dream-like state. It’s a difficult sensation to describe, but he suggested it was like a moment of clarity and enlightenment—of activity and inspiration, and I agreed. The content of this experience is ephemeral, like when you awake from a wonderful dream you can’t recall: you know you had the dream but can’t remember anything of it—and the more you think about it the less you remember. There was something massively reassuring in that he seemed to understand this feeling in some detail.
The more we discussed it, the more I realised these strange sensations had also happened before, and since. That very morning, a similar thing had happened, but I was ignoring such things or passing them off as side-effects of some previous treatment. Looking back, I’m surprised I ignored them for so long—but then if something like that is happening and yet you can only vaguely recall it let alone attempt to describe it, it’s understandable. His questioning came around to the most recent episode, in the office car-park, and whether during this ephemeral period I lost the ability to do anything in particular. I recalled that during these “funny turns” (as I was coming to describe them) it became difficult to understand what people around me were saying, or to say anything myself. He nodded with the manner of a man unsurprised by what he was hearing, before leaning forward to place a tick further down the margin.
Finally he made his diagnosis. He believed I was experiencing seizures or ictal events that were beginning in the language centre of my brain, behind and up a little from my left eye, like the epicentre of an earthquake. He expected these were caused neither by medication nor any form of brain damage but, to be certain, he would arrange for me to have MRI and EEG scans, as well as a 24-hour ECG monitor. When all the results were in, assuming nothing surprising came up, he was confident he could treat the condition by stopping my current medication for bipolar disorder and stepping me up onto a medication to handle both conditions. The precision and confidence of his diagnosis, the information he’d drawn from me that I didn’t know I had, and the personal manner with which he intended to proceed (that he would review the scan results, and then he could get the thing under control) had me on a high. The consultation was clearly winding up, so I went to rise out of my chair.
“You know,” he remarked, “you really shouldn’t drive, don’t you?”. I didn’t, as it happened—the thought hadn’t even crossed my mind.
“Yes,” I replied, “it probably pays to be careful”. We got up to shake hands and I left his office, wished a good day to his secretary on my way by, and then got in my car and drove back to the office. Only as I parked up did I realise I probably shouldn’t have done that, but then how else could I have got back?
The MRI department were in touch first, and once again I had jumped the queue. Also, being a private patient, I was entitled to the pictures of my brain on a CD, with which I was rather chuffed. One of them even went up on the wall of my office to prove beyond reasonable doubt that I hadn’t lost my mind. Numerous people commented that my skull sliced in profile really looks like me, which I pointed out was hardly surprising. This period was both cheerful and novel—something about having a diagnosis-in-progress was relaxing. Several weeks passed with only occasional “funny turns”, but no collapsing. Everything seemed back to normal again.
But there was more to come. More on that… in a bit.