Heart Attacks, Ruminations & the Mental Health Crisis

Stuart Russell with a personal account of a heart attack leads to a reflection on the systemic issues contributing to the mental health crisis in the UK, highlighting the need for collective action and open discussions about shared struggles.

 

The Main Event

About a month ago my body decided it had had enough of supporting me through the drudgery of everyday life and in its tantrum an actual heart attack ensued. No longer was overseeing the functionality of my vital organs top of its agenda. Surprisingly though, I was blissfully unaware that a heart attack was in fact happening inside my body; the mild chest discomfort wasn’t enough to distract me from the immediacy of cooking a curried fish pie.

One rainy Friday evening whilst mechanically performing tasks around the flat I stopped to take a well-deserved sip of brandy that had been lovingly poured for me an hour or so earlier. Unconvinced that I really needed an alcoholic beverage after attending a soirée the evening before, I drew in the aromas emanating from the glass to overcome any doubt that alcohol was in any way a bad idea. How wrong could I have been?

Now I’m confident that a sip of an alcoholic drink didn’t lead to one of the gravest health concerns anybody could ever face, but the fact that as soon as I had taken a sip my chest immediately began to ache with a sort of dull uncomfortable pressing, shows that the decision to drink alcohol that evening probably wasn’t the best one I have made in my lifetime.

Thinking that I had just overdone it recently I shrugged the mild pain off. I convinced myself that I had been under a lot of stress for several months at work, I hadn’t been sleeping great for a long time and a mid-week night out had well and truly pushed me over the edge. Especially as I had been to work during the day after a severe shortage of robust sleep. Who has a heart attack at thirty-nine anyway?

My partner and I went to the cinema to relax, we came home, went to bed early and I assured my inner self that this would all be fixed with a good night’s sleep and some rest. It always did the trick before, right? When I awoke the discomfort was still there, however. So understandably I started to panic in a mildly restrained way. I called 111 and advised them of my symptoms and an appropriately genial healthcare worker advised me that a doctor would call me back to discuss the problem within the hour as unfortunately everybody was busy currently due to the overwhelming demand. Not a problem I said, furtively thinking that if somebody isn’t screaming down the phone in a panicked way that I in fact must be ok.

I moved a sofa around, made some lunch, and had a leisurely drive to the local supermarket to get provisions for the rest of the weekend. I had started to notice that tasks were becoming more laboured; my breathing was strained and arduous. Eighteen hours after the original event it appeared that my initial assessment was probably inaccurate. I received a phone call around 5pm from a doctor who advised me in a semi casual way that it would probably be beneficial to go to the hospital and get checked out. Withholding a sigh I agreed whilst simultaneously trying to block out the horror stories I had seen plastered all over the news about extremely long wait times in accident and emergency departments. My nearest A&E is Good Hope in Sutton Coldfield, the hospital I had been born at nearly forty years earlier. Locally, it has been referred to as ‘No Hope’. Although I completely disagree with the nickname, it didn’t mean that an ounce of fear hadn’t allowed itself to penetrate my emotional defences. I managed to shrug it off with angry ruminations about why I couldn’t just drop in to the Sir Robert Peel hospital not far from my flat. Worry overcame unfortunately so I parked those thoughts.

My partner and I decided that I did need to go to the hospital but due to the perceived waiting times we would go home, grab something to eat, freshen up and take supplies enough to get through the possibly lengthy evening. Afterwards we drove to Sutton Coldfield, checked in, reported my symptoms, and waited patiently whilst listening to drunken tales pouring in from the surrounding crowd. I was called in for a blood test and vitals check by a doctor and then swiftly sent back to the waiting room so the next patient could be seen in an impressively nimble fashion. The ‘long’ wait began and I once again convinced myself that I was wasting the NHS’s valuable time, and I would now have to spend hours sat on a chair that I had a feeling performed a secondary role as an implement of torture.

Within two hours of arriving at the hospital I had been called back through ahead of pretty much everybody else who had been sitting in the waiting room prior to me even getting there. A rather worried looking young Doctor with a fatigued countenance asked me to sit down and explained that my blood results had shown something extremely troubling. I would need to be moved into the resuscitation ward, attached to a defibrillator, and monitored scrupulously until they could determine what the issue was. He desperately tried to insert a cannula, in three different locations, and then eventually gave up and asked for a senior doctor to attempt the insertion. An ultrasound was conducted of the area to find a vein which had all apparently retracted in fear, and eventually, although somewhat uncomfortably, it was fitted.

Several nurses came by to look at my results and after pretending to not be shocked, offered me support and affection. The doctor explained that my troponin level was concerning. I then asked for more detail which I regretted immediately. Troponin is a protein that is contained within the heart and is generally never floating around in a person’s bloodstream. A worrying level would be anything over 50. Mine was currently at 28,000. Panic and shock had well and truly settled and made themselves comfortable. I began to discuss writing a will. I held back a potential eruption of cascading tears. My partner was now visually distraught although heroically remaining calm and supportive. I essentially entered a state of disbelief and acceptance of death all at the same time.

After avoiding a potential shock to the heart because somebody had accidentally turned on the defibrillator machine, I was wheeled out of the hospital and into the back of an ambulance. “Heartlands is the best place for you” I vaguely remember hearing. An amiable young Geordie strapped me to some more machinery and began chatting to me about the different types of resuscitation pads they used in the ambulance in a soothingly jovial way. I smiled and sarcastically discussed how I must be getting old as once again a health worker couldn’t believe my condition and my age were in fact in violent conflict.

Once settled in an unnervingly quiet part of Heartlands a nurse came over to me and explained I had had a heart attack, and I was now in the process of recovering from that. There shouldn’t be anything worse than what had already happened, and I would now need to be monitored until I can have a procedure known as an angiogram. (Someone later explained to me that this is a camera inserted into your arteries to check for blockages or areas of collapse). 

A wave of euphoria engulfed me momentarily as I outwardly expressed the most intense elation I had ever experienced, knowing that I would now probably be alive at the very least. For the moment the ordeal was over, and I could attempt to process what had happened in the previous few hours.

Alone with my thoughts

According to his most devout followers, Heraclitus, the Greek philosopher active around 500 BCE, once said, “I am, as I am not”. In my opinion when experiencing trauma a person will fundamentally remain the same, but from that moment forward there will most certainly be a radical shift in that person’s perspective, changing them from what they originally were. It is certainly what I experienced anyway.

As a result of this shift, questions about my health started to flood my brain whilst lying in bed in the CCU. Why have I remained silent about the conflict in my life? Why do I use alcohol to deal with the laborious task of getting through the working week? Why have I allowed my employer to push me to my physical and mental limit? Over and over I questioned myself about how I as an individual was responsible for my current tumultuous circumstances. But as the fog of self deprecation began to dissipate and I allowed myself to focus on the objectivity of the situation I deliberated on whether I was looking for answers to the wrong questions. In addition, I started to think about whether the questions I was initially asking reveal something about me and the society I cohabit as a whole.

In a still largely male dominated society, the pressure felt by men in the UK (as elsewhere in the world) to be the person in control of a family unit, the ‘breadwinner’, is exceptionally high. Scores of masculine imagery are plastered through the halls of our daily lives. Whether it’s a video news feed on Facebook showing endless streams of dedicated gym goers, or an action packed blockbuster on Netflix depicting the lone hero saving the world from disillusioned foreigners, the ideology we are exposed to seems to tell us the same thing. If you aren’t a ‘man’ you are weak. Weakness would also imply asking for help which is evident in the statistics for male suicide for those under the age of 50; This being the largest cause of death for men in that age group. Is it right that men feel ashamed to ask for help, to the extent that death is actually a preferred solution?

“In a still largely male dominated society, the pressure felt by men in the UK (as elsewhere in the world) to be the person in control of a family unit, the ‘breadwinner’, is exceptionally high.”

Isolation from other people and connections to them plays a major role in debilitating mental health issues as well. This in itself can lead to a greater risk of using drugs and alcohol to alleviate the symptoms, especially in men. Two in five men admitted to feeling low according to Mind’s ‘get it off your chest’ report, and a large percentage reported that isolation, deprivation, financial insecurity, debt and social media contributed significantly to this level of poor mental health. This reality is not just experienced by men alone either as a massive 20.7% of women experience mental health issues as well. With one in 10 men reporting getting angry when they are worried, women will also be directly impacted by the actions of men when they experience violence as a result of this anger in certain circumstances.

“Isolation from other people and connections to them plays a major role in debilitating mental health issues as well. This in itself can lead to a greater risk of using drugs and alcohol to alleviate the symptoms, especially in men.”

Mental health issues aren’t just experienced individually or in the home either, they also exist in the workplace. According to the organisation CIPD in its health and wellbeing at work survey, the biggest concern raised by participants was stress. 76% reported a stress related absence in 2023. Although stress is not considered a mental health problem as such, it is recognised as contributing to a person’s mental health problems and can exacerbate pre-existing conditions. Stress also pushes people to use drugs and alcohol as a coping mechanism, and all of these attributes combined contribute to a greater decline in physical health in general. Stress, although not specifically linked to heart attacks, can be responsible for an increased risk of debilitating symptoms such as high blood pressure and high cholesterol which can increase the risk of a heart attack. As stress generally leads to an unhealthy lifestyle, the chances of one of the above symptoms occurring become greater the more somebody seeks out ways in which to deal with increased stress levels.

Work related stress can develop because of workload and the ever increasing ‘needs of the business’, but it can also become apparent when people aren’t being paid enough to cover their immediate bills. With a cost of living crisis plaguing UK society since early 2022 and wages remaining stagnant since the 2008 financial crisis, what I started to realise, when considering all of these problems as a whole, is that all of a sudden, all of these issues don’t seem to be specifically individual. They all seem to be interrelated in some way; an interrelation which connects all of us together in our shared experiences which all contribute towards shaping our society as a whole.

At this point I have no idea whether any of these issues apply to me, despite the fact that a lot of the information I have found rings true. I am starting to realise, however, that a culture that blames individuals for their ‘failings’ seems unreasonable. There are many reasons why we are in the positions we find ourselves in and the majority of them don’t indicate that it’s because as individuals we don’t take enough responsibility over the problems we face collectively as a society.

‘Personal responsibility’ is a hotly contested issue these days. Is that person drinking too much? Does that person eat the wrong types of food too often? Are we all just lazy and don’t want to work anymore? Whilst I have some sympathy with people who laud the tenets of personal responsibility, I also find it difficult to believe that we are all individually responsible for every action we take. Sure, I could have drank less and attended the gym more often to help with my health. Was I doing these things as a reaction to the stress/mental health issues I was experiencing though? Even if I did manage to overcome these specific problems, could I have dealt with the issue of masculinity in society on an individual level? Am I responsible for the amount of stress distributed by the company I work for? Am I able to change the pay scale my company sets for its employers all on my lonesome? The answer to these questions, as I’m sure you will already know, is resoundingly no. The main issues we all face in life are systemic. We are disgruntled by our economic circumstances and use coping mechanisms to blank out how unhappy we are in our current situation. Rightly or wrongly we make choices that help us deal with what turmoil we face in our everyday lives and no matter how much ‘responsibility’ we take for them, how will the essential nature of these problems ever really change unless the very structure of our society is altered fundamentally?

“The main issues we all face in life are systemic. We are disgruntled by our economic circumstances and use coping mechanisms to blank out how unhappy we are in our current situation.”

Once I had received phenomenal news that my angiogram showed no sign of obstruction in my arteries and that I had a relatively healthy heart, I became so emotional that I nearly burst into tears whilst being wheeled through a corridor back to my ward. This was mainly because the overwhelming nature of having a heart attack is a burden on the mind. The anxiety I felt whilst waiting for the procedure was gargantuan and hard to convey in words. I had also received confirmation that I would most likely get through this era in my life which is also pretty emotional. There was another aspect to the intensity of feelings that I was experiencing though, which was the fact that blame had been lifted from me. My heart was healthy and I had been looking after myself. Maybe it was the result of something larger than me as an individual afterall?

I had further confirmation of this when chatting with the staff working in the NHS as they received the main bulk of my emotional ramblings and listened with the utmost care despite working 13 hour shifts, numerous days in a row. They took the time to sit and listen to me, to help me through the situation I was in whilst struggling to keep going themselves. Calm, composed and always willing to help the numerous patients that kept pouring in through the doors, these people showed me how compassionate we all really are deep down. They also showed me that alot of us are all experiencing the same dilemma. What we perceive as our own ‘personal responsibility’ being inadequate is in fact, in the majority of instances, a failing in the structures that pin our society together.

Looking at all of the healthcare workers whilst lying in bed contemplating life I noticed that all of them looked visibly harassed. None of them seemed to stop for lunch breaks or to chat jovially with colleagues and they all had very deflated looks on their faces. The 2022 annual NHS survey revealed that 44.8% of staff reported feeling unwell as a result of work related stress. This was the main reason given for absence when unable to attend shifts. I myself spoke with two people who had worked one and a half hours over their shift, unpaid, as there weren’t enough people on the ward they were working on to relieve them so as they could finish on time. According to the Royal College of Nursing there are 43,339 vacancies currently posted for nursing roles. With conditions like these, is it any wonder?

When these people are working 13 hour shifts, how do they find the time to cook healthy meals? Or go to the gym for regular exercise? How do they avoid the temptations of fast food, alcohol and cigarettes which is the only thing getting them through the day? Are their working conditions contributing to their existing mental health problems? Looking at context reveals a different picture to the one painted by the dominant voices in our country.

This epidemic most certainty exists outside of the NHS as well. I’m sure there are numerous people out there who keep quiet and try not to rock the boat just like me. As the fight to even retain a decent job gets harder every year, it’s understandable why people don’t speak out. Obtaining a pay rise to match the ever rising cost of living seems impossible for most people. What I now realise though is that the more time I dedicate to working and the more I keep quiet about how hard I am finding life, the more the company I work for will expect of me. Thousands of people across the country are experiencing hardships and in silence there doesn’t seem to be any solace.

Whatever issues we are experiencing we are all experiencing them together. These are the things that connect us. When we share our thoughts with other people we realise that we have far more in common than we were led to believe, despite the way we look or whether we pray to a God or not. What divides us is the people who seek to benefit from our disunity. Our Prime Minister and other people in his government would have us believe that mental health issues are a fallacy and far too many of us are skiving off work because we are all just lazy and want something for nothing. The people on my ward didn’t look very lazy. They looked like they had given far too much in fact.

“Whatever issues we are experiencing we are all experiencing them together. These are the things that connect us. When we share our thoughts with other people we realise that we have far more in common than we were led to believe, despite the way we look or whether we pray to a God or not.”

Having a heart attack is a horrible thing to go through and far more people have come off a lot worse than I have. There are also many other debilitating conditions which people have to go through everyday of their lives which will be in a large part due to their current environment and economic circumstances. The more we talk about these issues together, the more we realise that the current way of living doesn’t really agree with the majority of us. With no real promise from any political party of any significant changes on the horizon, maybe it’s time we stopped keeping our problems to ourselves and discussed with each other how we can make our own lives better. The one we are currently being promised doesn’t really seem that great.


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