Paul Holmes: Drifting in and out of unreal world

Paul Holmes went into hospital expecting keyhole surgery on his heart. He never dreamed he would instead endure open heart surgery and spend days in a twilight world with machines keeping him alive.

I remember so little and while what I can remember remains vivid and always will, none of it's in order. I have no straight narrative memory of hospital. I remember incidents and thoughts and people and discomfort and surrender and powerlessness and terror when I closed my eyes. The dreams were unspeakably real. Some were so weird I can never share them with you.

It was never going to be open heart surgery. I mean, open heart loomed as a possibility but we thought we were going to be all on for the keyhole surgery. Until the Monday before the operation on the Wednesday none of us, not my wife or my brother or my children or friends had any idea what was to come. We just assumed it'd be keyhole surgery and home. But, as my Auckland cardiologist, Ivor Gerber, would tell me much later, I hadn't realised and never really did, just how sick I was. He tells me I was near the end of the natural history of my illness and I needed surgery to have a chance of surviving, which is a professional way of saying that the wheels were coming off the heart, things were in a spiral and I might have had only a few weeks left.

What was wrong? Well, the heart had come up on the radar mid last year when I went to see my urologist as he sorted out chronic trouble in the downstairs department and he looked at me quizzically and took my pulse, phoned the cardiologist round the road, Richard Luke, and suggested he see me the next day. So the tests began. Richard said he believed I had hypertrophic obstructive cardiomyopathy. In other words, swollen, obstructive heart muscle problems.

To put it even more simply, the septum, the wall between the ventricles had thickened. This put increased pressure on the heart to pump blood out and that pressure had blown the atrium out and caused one of my valves to leak very badly. Instead of shooting blood round my body, the heart was shooting blood under high pressure into my lungs. I began to flood. I couldn't clear it. It was heart failure.

In May this year, with the heart obviously deteriorating, they tested me at Auckland to see if I was a suitable candidate for the keyhole technique. Now, open heart surgery was inevitable. Ivor kept me in hospital until the operation. "My biggest concern," he wrote to me the other day, "was that your heart rhythm would change to atrial fibrillation before the surgery and if you were at home when that happened you would have developed severe heart failure and may well have died."

And sure enough, in the safety of the coronary care unit at Auckland on the Tuesday night before Wednesday's operation, sitting there with [wife] Deborah and [daughter] Millie, both of whom were about to be wonderfully caring through the whole ordeal, the heart went crazy. The nurse came running, her eyes on the monitor screen. Within half an hour I was in the intensive care unit.

Next day, the full drama. I remember almost nothing. I think I have a clear picture of being slid from my bed on to the operating table. The people were friendly. They were so nice. I remember that. Indeed, that would be my experience the whole way through my trip into the faraway land. The people were so nice and they loved their jobs and their service was exemplary.

The operation, performed by one of New Zealand's most experienced heart surgeons, David Haydock, is described by Ivor Gerber as "challenging". They stopped the heart and transferred my life's essence to machines that performed the necessities of life for a few hours. It seems incredible. They stopped my heart. That's what they do with open heart surgery. I never realised this. No wonder we all get a bit spiritual afterwards.

So they sliced the excess tissue off the septum, cut half of my atrium out and did some remedial electrical work, all of which went very well. But, Ivor tells me, there were some very worrying days to come.

Deborah was warned that someone coming out of such an operation could often appear to have had a stroke. Around five that afternoon she got the call that I was out of theatre. Machinery kept me breathing and dispensed the powerful drugs. There was a large hard plastic white pipe inserted into my throat sticking out of my mouth.

So that was Wednesday and that's how things stayed 'til Saturday and the induced coma was maintained. Deborah and Millie sat there patiently. On the Sunday it was back to theatre. Big danger. My heart was leaking and they sucked about half a litre of blood from round it.

Do I remember coming back to the surface? I don't think so. But I do recall the lovely Filipino male nurse with his broad American-accented English saying to Deborah and Millie, "He can't hear you yet." But I could.

I squeezed their hands. And sometime after that, I opened my eyes and there they were. I couldn't speak though. Not with a half inch pipe down my throat.

I couldn't sleep. Not for days. The staff urged me to try. But when I closed my eyes I saw only nightmare visions. It was unbearable. I was exhausted.

Somewhere along the line in those early days, they took out the pipe. When I spoke to Deborah, she couldn't understand me. My voice was a rasp. After a few days she began to wonder if the stroke thing had set in. Then, when both she and Millie could understand me, everything I said seemed to provoke gales of laughter. I was doolally.

One day towards the end, my nurse, Gina, was giving me a full wash in the bathroom while I hung off rails old people use. She told me that what happens in hospital stays in hospital but last night I was weird. She told me that a couple of the nurses had found me at three in the morning splayed out face down on the floor, having jumped over the walls of my bed. I told her I'd had to jump out of my aeroplane. I told her I had warned my brother that this was going to be rough. She said, "It's not an aeroplane, Paul. It's a bed." I said, "And it's a wreck after it hit the other bed." She said "There's no other bed in your room, Paul. And your bed is not a wreck." She carried on with the warm soapy flannel and I wondered what the hell was happening to my mind.

Two nights after I came home to the farm, there was another vivid dream. Deborah had gone to a spare bedroom because I was too mad to sleep with. That night, Queen Elizabeth asked me to stack into piles all the broken Lancaster bomber tail guns I could find. It was terrifically hard work pushing those round. Eventually I found myself awake sitting on the edge of the bed trying to get my breathing under control.

By that afternoon I was in coronary care in Hawke's Bay Hospital. Another ambulance ride, poles on wheels and plastic bags of fluid spiking into my arms and the wonderful relief of the morphine again.

During that stay in hospital a very nice man showed up in my room one day. From Kapiti Coast Health, he said, a counsellor. He told me that if I wanted to talk about what I'd been through or if I wanted to cry he was available to listen. When he left I realised that while I am a lucky man who can talk to his wife about anything, I hadn't cried. And I wanted to cry.

I don't know why but I wanted to cry. And that afternoon, I cried a little.

I've written this not to suggest I'm the only person who's ever had open heart surgery. Not at all. But I've written it in good health, full of beans again, looking out on a golden spring day, the cold wind has gone and there is so much love in my life. What more could a man want?

And it's all because of brilliant cardiologists and nurses and a brilliant surgeon, David Haydock, and a team of men and women of extraordinary training and skill. Many people, I know, contributed to my restoration. Auckland has a proud history with a tradition of excellence, a lot of it pioneering.

I thank you all with, well, all of my heart.

Yes, it's a beautiful day. As Joe Biden might say, the wind has died and I'm alive.