MY SIMPLE HEART
By
Braden Stevens
SMASHWORDS EDITION
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My Simple Heart
Copyright (c) 2011 by Braden Stevens
Smashwords Edition License Notes
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My Simple Heart
Chapter One: Saturday
Mary Jackson stood in her kitchen, little more than a cupboard compared to most folk’s homes, but then she and Ronnie only lived in a modest terraced house at the end of a modest street in Manchester
Busying herself with a pile of ironing, she listened to the local news, coming from a radio set, sat on the window sill. The reporter was detailing a story, of an elderly lady who was mugged in broad day light, while passersby watched on, like frozen statues. Local police were looking for a teenager wearing a black coat and hood, witnessed running away from the scene.
Where had it all gone so wrong she thought, how could the world have slipped in to this dark abyss When she and Ronnie first met, back in their teenage years, respect for your elders, was a unspoken religion, an act like that - unthinkable.
“Discipline”, she muttered. Obeying the wishes of your parents was never questioned in her day, not hard –but rules were there to abide by. Can’t touch anyone today - streets full of feral kids - is it any wonder people don’t feel safe on their own streets.
Mary quietly slipped through to the lounge, where Ronnie was settling down in front of the television, sat in his favorite armchair - like some expectant father awaiting the birth of their first born, he was waiting on the start of a football match, featuring his beloved City.
Mary knew from experience- that football to Ronnie was like religion, it wasn’t something you interfered with; just let it be- until the final whistle she judged. He had followed City since he was a boy, a tradition his own father had skillfully nurtured.
But like so many wives with over forty years of marriage- Mary drew upon a skill, which helped in matters of decision, she would stand in the door way remaining absolutely still, that was until Ronnie couldn’t stand the suspense any longer and ask if there was a problem. “Just checking if you want that Cuppa now or after the game she exclaimed”! I will have it now thanks love” Ronnie replied
As she turned and shuffled towards the kitchen, she heard him call out, “bring a couple of Rennies”- Having a little heartburn are we- Too much time spent down at the Dog and Duck last night, no doubt!
Mary had recently celebrated her sixtieth birthday, which Ronnie and their three children had secretly combined with their Ruby anniversary. It was a wonderful day, with so many friends and family including-.old school mates, who had travelled across the country to attend.
Copies of funniest photos, taken back in there teenage years, were hung around the room. The children and grandchildren screamed at the faces and funny clothes, in the fifty year old black and white photographs. Never ending stories were recited and old friendships rekindled
She stood before the boiling kettle reflecting on a wonderful year. Perhaps they had been blessed she thought; the three children and two grandchildren had all turned out fine.
The blue Ford Fiesta of Helen Thomas, the elder of the three children, pulled up outside Mary’s and Ronnie’s home.
Most Saturday’s, Mary’s two daughter’s alternated their time, in taking Mary out for some shopping and bite to eat, leaving Ronnie to enjoy his football. This was the only quality time they could find keeping up with all the gossip
As Helen made her way down the narrow hall, she heard the familiar roar from a football crowd echoing around the front room- clearly the match had started. “Hello Mum - Dad” –“in here love” Mary replied just making Ronnie a cuppa tea, would you like one? “No thanks, just had one” she rounded the corner armed, with a handful of old Hello magazines to pass on to her mother.
“One day Dad you are going to sink in that seat, the amount of time you spend sitting there.”Ronnie smiled and kissed his daughter on the forehead; as she bent down to greet him
“How’s my little angel” he asked without looking away from the television “always asking after you two, and growing into a little madam” offered Helen, Ronnie hadn’t seen his grand daughter Emily for over two weeks,
Both Ronnie and Mary had been besotted with their two grandchildren, Helens daughter, Emily, recently turned twelve, had just started taking horse riding lessons
Clare (their second daughter) had her own daughter Eva, just turned six. Two very different angels, as Ronnie often called them
The two grandchildren often had sleepovers, which were the most rewarding nights of the week and Ronnie couldn’t help but spoil them both. They often spent most of the evening riding around on the back of Grandpa Ronnie, who on all fours, pretended to be Black Beauty. In the morning Mary would keep them busy in the kitchen baking cakes, that is, until their parents arrived
Although the girls were growing up fast and even though Ronnie had retired Black Beauty, they both still looked forward to a sleep over at Gran and Granddad’s
Mary stood in the mirror trying to arrange her hair, in a fashion, her daughter would approve of. Tutting to herself under her breath for allowing the grey take hold - like the weeds in Ronnie’s allotment down at the end of the street- that’s it!, she mumbled - and promised herself a color down at her local hairdressers the following week
Ok Ronnie “see you later, won’t be long love” assured Mary what sounded like a call of acknowledgement, came from the front room as they closed the front door.
Helen made steady progress though the busy Manchester traffic on the way to the town centre., while Mary mostly sat quietly in deep thought, for most of the journey . She was trying to make sense of the morning, Ronnie had complained of a growing pain in his chest and although the Rennies seem to help, he kept saying it was indigestion and nothing to worry over.
He couldn’t fool her so easily, after forty years of marriage to the same man; you get a sense of things not being quite right. Ronnie may call it indigestion-, but the ashen color of his face said something else
Helen always made a fuss over her mother and today was no exception, she treated Mary to a new pair of shoes and over a light lunch, they talked family, for most of the afternoon.
During the trip home, Helen sensed her mother had been brooding over something - “Mum are we going to talk about what’s troubling you”? She asked
“You have been distant for most of the afternoon” Helen questioned
“I don’t want to worry you love and spoil the afternoon” Mary replied
“Don’t be daft, I cannot go home and leave you like this” Helen urged
“Its Ronnie he’s had this pain all morning and I’m worried” Mary explained
“Ok”- I’m sure It’s nothing to worry about, let me speak to him about it, when we get you home” Helen added
They rode the rest of the way home in silence –like a chess game - the pieces were in play-Helen was planning out a health check for Ronnie - while Mary was busy sorting out a call to Doctor Smith, their GP.
Ronnie was still sat in his chair, when the girls arrived home, He hadn’t moved since the game ended a draw and now he faced questions from two quizative females.
“Pains gone” he declared, rising out of his chair on the way to the bathroom. “Two Rennies and a cuppa have seen it off” Ronnie explained, disappearing around the door.
Helen waited until he came back and delved deeper, questioning when and where this pain was. Satisfied - that it sounded like indigestion, she instructed Mary to phone her if it came back.
“I am still going to ring the doctors first thing Monday and get him booked in for one of those MOT’s”, Mary said impatiently
“I think that’s a good idea” Helen added as she got back into her car, “I will give you a ring Tuesday Mum after he’s been”
“Ok love take care”
The Ronnie and Mary spent the evening watching their usual programs and in between the breaks, had their customary cups of tea. Although Ronnie had a light meal he didn’t suffer any further bouts of indigestion and retired to bed along with Mary around 10.30pm
Chapter two Sunday
In the morning the pain had returned, it had gradually surfaced after a restless night, and no amount of Rennies helped
Mary decided to ring Helen for advice, but thought better of it, when she realized the time; she would wait an hour until it was 9.0 am
Suddenly in mid thought, there was a muffled cry from the front room. As she rounded the door, the sight of Ronnie writhing around in his chair, made her vision collapse as if she were driving through a dark tunnel.
Sweat was pouring down his forehead and the color had drained from his face. As she moved closer, she could hear the breathing rasping sounds, coming from his chest.
Ronnie “what on earth is the matter” she said moving closer.
“I can’t breathe” he rasped, as tried to sit up. Suddenly without warning, he vomited all over her skirt, still clinging on to his chest; he slumped back down in the chair.
Mary felt helpless and confused, nothing she did, seemed to help and she slowly realized she needed help.
Leaving the room she rang Helen
Helen answered to the sobbing voice of her mother; she listened quietly, between the sobs, to a confused story, and soon realized her father was likely having some form of heart attack.
Calmly she suggested her mother go back to Ronnie and simply comfort him, by holding his hand, she reassured Mary help was be on its way
As Helen dialed 999, the thought of losing her father swirled around in her mind. My god she thought, he was only seventy two years old, too young to die from a heart attack. “Hello emergency services, which services do you require”? The female voice offered.
Ambulance service please Helen said without hesitation. In the few seconds that passed, her mind was cast back to a childhood memory - Ronnie swinging her around in their small garden and tickling her, as she tried to escape. Tears were now running down her face, as she realized a truth, nobody wanted to face, the inevitable loss of your parents.
The click on the line and the calming voice of an operator suddenly sounded, “Ambulance service, how may I help”. Helen quickly detailed Ronnie’s symptoms, followed, by their address. Within seconds the telephone call ended and an ambulance dispatched.
Helen sat down at the bottom of the stairs drained of any thoughts, she felt numb and a growing feeling of sickness began to rise from her stomach.
Across the other side of Manchester, the familiar yellow and green colors of an Ambulance navigated the busy roads. Weaving through the heavy traffic, it made its way to Ronnie and Mary’s home. On board were two very experienced Para Medics- John Rainer, the driver and seasoned Para medic for over ten years. He had trained at the Local Manchester General Hospital as a general nurse and during his fifteen years of training, had worked in the accident and emergency department, before qualifying to become a Para Medic. His colleague Stacy Owens had recently qualified as a Para medic, having worked in a Medical emergency ward, for over eight years. With blue lights flashing and siren blaring, they continued to battle the traffic.
Within ten minutes, they arrived outside the front door of Ronnie and Mary Jackson’s home and quickly set about unloading all their equipment, including a stretcher trolley bed.
It didn’t take long before all the neighbors started spilling out of their front doors, mingling at gates and on pavements, as if waiting for a sidewalk show to begin.
Mary like most of her neighbors couldn’t help to hear the siren as the ambulance made its way up their street and was at the door, long before the Para medics had time to knock
“Hello Mrs. Jackson?” John said greeting Mary at the door,” my name is John and this is Stacy, we have come to help your husband Ronnie” he declared.
Although still confused and considering they hadn’t met, Mary was quietly impressed by the Doctors knowledge of both her and Ronnie. “He’s in here Doctors” she added as she led the two Para Medics into the front room. John pushed the Trolley up and over the small front step in to the hall, carefully trying not to spill all the equipment, they had arranged on the light green bed sheets.
“The Doctors are here Ronnie” Mary said, as she shuffled in to the room.
Call it intuition or just plain experience, but as soon as John and Ronnie’s eyes met across the room, John new straight away Ronnie Jackson was in trouble.
Both John and Stacy knelt down either side of Ronnie’s chair and began to check his pulse and respiration.
Airways look clear Stacy noted, as she gently examined Ronnie’s nose and mouth
“Arrhythmia” (irregular heart beat) John continued, as he removed a stethoscope from Ronnie’s chest
They lightly unbuttoned Ronnie’s shirt, which clung to his body, like a film of plastic, silently they guided him to the Stretcher trolley stationed in the middle of the room. After removing all the equipment, they helped him on to the bed, taking off his slippers.
Mary gently squeezed Ronnie’s hand, as he lay ashen faced on the trolley.
“Ok Mary, we need to take Ronnie to hospital for more tests, but before we go, can you tell us if he has ever taken Aspirin” John inquired. “Only for headaches and his arthritis” .Mary replied”
“That’s great, we need to give Ronnie a few tablets to ease his pain, could you get him a small glass of water, please Mary”
Before her return they had treated Ronnie to a small spray of GTN (Glyceryl trinitrate) given under his tongue, to help ease the problems with his heart, quickly followed by a combination of Aspirin and Diamorphine tablets, washed down with the water
As John administered the medication, Stacy was busy attaching a twelve lead ECG monitor to Ronnie’s chest and within seconds the image of the trace clearly confirmed their suspicions, that Ronnie had in fact suffered a full blown ST elevation Myocardial Infarction ( Heart attack) and now the clock was running down within the Golden hour of treatment .
The telemetry of Ronnie’s ECG (Electrocardiogram) had been wirelessly sent over the airwaves, to the Para Medic head quarters, where a resident expert was on hand to interpret the data. Confirming that Ronnie was indeed suffering a heart attack, he telephoned a number, which would set in motion an alert system to call in a team of interventional cardiologists to treat Ronnie within the hour.
As Ronnie was being moved in to the waiting Ambulance, Helen appeared in the doorway, looking worried and full of questions, she kissed Ronnie on the forehead, before turning to the Para Medic’s “how is he” she asked? “Doing well and stable, but we do need to get him urgently to the hospital, for treatment “John declared.
As the Ambulance retraced its path to the hospital, Stacy was busy attending to Ronnie in the back.
The pain in Ronnie’s chest had eased, but a kaleidoscope of memories raced through his mind - one minute he had indigestion –next a crushing pain in his chest, his mind had cast him back thirty years, when as a foundry worker, he was racing through a crowd of fellow workers, his clothes ablaze-a giant cauldron had exploded and a rain of deadly molten metal had showered the workers. He had suffered third degree burns to parts of his arms and legs, the pain of that day had haunted him all his life.
But this was different- a pain that radiated throughout his body-gnawing at his very soul fighting for every breath, helpless and sweating held down in his chair, by a hidden force.
Helen sat with her mother, both trying very hard to make sense of the last hour.
”Let me make us a nice cuppa tea, before we go to the hospital mum-best let the ambulance get there first-so the Doctors can treat Ronnie- no sense rushing through all that traffic.”
At the hospital a team of Interventional Cardiologists and Nurses specializing in treating Heart attacks, had assembled in a theater, known as a “Cardiac Catheterization Laboratory”
Doctor David Willard a Consultant Cardiologist was heading up the team alongside his trainee, Doctor Suresh Patel. Both Doctors studied the ECG trace of Ronnie Jackson, sent electronically by the ambulance crew.
“Leads V2 and V5 clearly show “ST” Evaluation, looks like it may be from the Left Vessel” Dr Willard offered.
“I agree” added Dr Patel
“How old is Ronnie Jackson”, Dr Patel inquired
Seventy two, No previous history (of Heart problems) and non Diabetic, Sister Anne Hopkins replied
“Ok Team, I think were agreed, we have a Primary PCI on the way let’s get everything ready” Dr Willard urged
A Primary Percutaneous Coronary Intervention (PCI) is a treatment given while a blood clot is forming in one of three main Arteries of the Heart - known as the Left, Right and Circumflex. This is an urgent procedure performed to open up the Arteries and restore the flow of blood. Oxygen supplied via the blood flowing through these Arteries is essential for the Heart muscle to function normally.
The Ambulance quickly made its way through the Manchester traffic on route to the hospital, in the back Ronnie lay quietly as Stacy monitored his condition,
“Not long now Ronnie nearly at the hospital” she reassured him.
Ten minutes later, the ambulance entered the grounds of the hospital and went directly to the Accident and Emergency doors. The trolley holding Ronnie was gently lowered from the Ambulance.
“Ok Ronnie you’re in expert hands now” said John as he passed the paper work of Ronnie’s treatment to waiting staff.
“Thank you for all your help Doctor” Ronnie added as he was whisked away from the stationary Ambulance.
Two minutes later Ronnie’s trolley arrived through the doors of the Cath Lab and in to the care of the Cardiology team
Sister Hopkins took charge of Ronnie as he was gently transferred on to the operating table and began to explain, in simple terms what was happening around him.
“We think there is a small blockage somewhere in your Heart Ronnie and Doctor Willard and Doctor Patel are going to correct the problem” she explained.
“But before we start we need to ask you some questions” she added.
As Sister Hopkins and Ronnie exchange details about his medical history.
Doctor Patel quietly administered a local anesthetic to a small area of Ronnie’s Groin, followed by a small incision in his Femoral Artery, in to which, he placed a small plastic sheath.
Sister Katie Rowley gently arranged a small cannula into the back of Ronnie’s hand and then attached a bag of ringer’s solution to maintain his fluid levels.
With everything going on around him, Ronnie’s mind was at sea, drifting on a mist of memories. Images of his daughters drifted before his eyes, giggling and screaming as he chased them around the garden.
His wife Mary standing in the background watched on, with an approving smile.
A heavy weight was pressing down on his chest, as if the hand of God were trying to force his last breath, he found himself making a private appeal, offering up some sort of bargain, in the hope of coming though his ordeal.
Seventy two years- I have so much more to offer my grand children he pleads silently.
A tear gently rolls down his face as he realizes the gravity of his situation
Lights please, a voice calls out, somewhere in the room and slowly the mood changes, as the fight to save Ronnie’s life begins.
As if the matinee in local cinema were about to start, the light gently fades.
A mechanical whirring noise sounds around Ronnie’s head, a large imaging device in the form of a white drum attached to arm, moves slowly - gliding like a ballerina, across his chest.
Standing beside the operating table, the green gowned figures of Doctors Willard and Patel are now gazing at the television monitor hovering over the table.
Slowly the grey and black x-ray images of a beating heart come in to view.
A road map of Arteries surrounding Ronnie Jackson’s Heart spread out across the screen.
“There”! Doctor Willard exclaims, as he points at the image, I think we’ve found our culprit.
A large Artery to the left (the circumflex) of the image, clearly shows, a series of obstructions down its length, interrupting the flow of blood around Ronnie’s Heart.
.
Doctor Patel gently and skillfully, threads a very fine wire in to the plastic sheath and guides it through Ronnie’s Femoral Artery. As the wire approaches Ronnie’s Aorta the thin dark line of the wire, becomes visible within the Arteries on the screen.
Nervously, as if by its own intelligence-the end of the wire probed for the opening within Circumflex Artery, with a few twists, from his hand Doctor Patel, steers the wire slowly towards the offending obstruction.
“Ok Ronnie we have found the problem- there is a small blockage in one of your Arteries which is causing the pain in your chest” Doctor Patel said.
“We are going to open up the blockage in a few minutes and ease the pain” Doctor Patel added
Once the wire was in place, Doctor Patel carefully threaded a thin hollow catheter over the end of the remaining wire in his hand, and guided this though, in the direction of the blockage.
He continued to push the catheter down this guide wire until it came to the site of the first blockage.
Doctor Willard then proceeded to attach a small handheld pump on to the other end of the catheter, being held by Doctor Patel.
“Ok Ronnie, we are going to treat the blockage now - you may feel a little pressure in your chest - just for a few seconds” Doctor Willard announced.
As Doctor Willard slowly turned a small plastic wheel held in his hand , a small dark shaped image, began to appear in the centre of the Circumflex Artery, a balloon had begun to inflate on the end of the Catheter, before Doctor Willard released the pressure, Ronnie could feel a slight build up of pain, somewhere deep within his chest.
As the balloon was slowly deflated, the obstruction had gone, leaving the flow through the Circumflex fully restored.
The catheter was now removed and replaced with a similar looking wire, but this one had a “Stent” a small expandable tube of wire, held in place over the balloon
Gently Doctor Patel, positioned the new balloon holding the Stent, over the original blockage site, again he warned Ronnie to expect some chest pain. Using the pump they slowly raised the pressure in the balloon and the Stent began to unfold, like the wings of an emerging butterfly.
When both Doctors were satisfied that the stent had fully deployed in to the walls of the Artery, they removed the catheter and deflated balloon.
“Ok Ronnie- all finished and all sorted Doctor Willard Judged
When all the lights came back on, the pain in Ronnie’s chest had all but disappeared and he began to think more positively, one of the nurses came over and squeezed his hand and offered to make him a cuppa tea once he was back in recovery.
As they wheeled Ronnie out towards the recovery ward, both the Doctors set about detailing his treatment and recommending to his General Practitioner, in a dictated letter, that he stay on Antiplatelet therapy for at least twelve months.
Helen, Mary and her other daughter Clare all sat outside in a reception area, all very anxious and eagerly awaiting for news on Ronnie’s condition.
“Mrs. Jackson, I have just come from the Cath Lab where Ronnie was treated, everything went well and you can See Ronnie in a few minutes” Anne Hopkins said reassuringly.
“Thank you” Helen said before her mother could answer
They all held hands and smiled with relief
Ronnie was transferred to a bed in the Coronary Care Unit (CCU) and was hooked up to a drip and ECG monitor. A nurse on the unit made him comfortable and suggested a little rest, before seeing his family
“Have they fixed my Heart” he said before she could turn for the door
“Yes I think they have Mr. Jackson” she replied
The Doctors will be along shortly to explain everything” the Nurse added
Doctor Willard had been informed by Anne Hopkins that Ronnie’s family was sat in reception.
He quietly made his way down the corridor checking his notes.
He introduced himself and went on to explain what they found and how they had treated Ronnie’s condition. He wasn’t expecting any complications, but nothing can be ruled out, until things settle down he said. Ronnie is likely to be with us for the week
Helen listened to the Doctor, but silently noted the walls were full of posters, showing the anatomy of the Heart. Must be there to answer the many questions, people have she thought.
Funny how you don’t notice them, when you first arrive.
After the Doctor had left, Helen sensed that the tension in Mary had eased and suggested they all get a cup of coffee down at the hospital café. Clare had been tasked, with calling up and passing on all the news, to the rest of the family, while Helen continued to reassure Mary
It had been a long day and as Ronnie sat upright in bed reflecting on events, with his family sat at his bedside, he quietly smiled to himself.
“You are going to cut down on those nights out down at the Pub and lose a bit of weight Ronnie Jackson” Mary urged
“Scaring me like that” she added
“Now mum don’t go upsetting him” Helen said in Ronnie’s defense
“Doctors said I have to stay here till Friday” Ronnie Replied
They sat and talked for nearly an hour when suddenly a nurse appeared and reminded the family it was time for Ronnie’s rest.
Ronnie Jackson spent the rest of the week recovering during his five days in hospital. He enjoyed all the fuss from his family and got to thank all the Nurses, Doctors and Para Medics, involved in his treatment.
He went on to enjoy a full recovery.
With all the advice he received from both the Hospital and his dear wife Mary, he spent his remaining years spoiling his grand children, Emily, Eva and Samuel
The End