Walking through London King’s Cross Station on my way to London Heathrow, on Tuesday morning, I see a message scribbled in black felt-tip on a white board:
It reminds me that here in London, there are many organisations constantly raising awareness of heart disease. Raising the public consciousness that Coronary Heart Disease (CHD) is a global killer that needs to be defeated. Actually, it is the world’s Number 1 Killer. So, even in our haste to get to our destination, rushing as we are through the nation’s train stations and other public places, we see the signs, subconsciously, subliminally, that tell us what we need to know: “The British Heart Foundation wants your help and needs you to engage!”
It’s a timely reminder, because in a couple of hours I shall board a flight to Accra where I am teaming up with my friends, Professor Nicolas Ossei-Gerning, Dr Enoch Anaglate and David Okai to tell the story of how close David came to leaving us when he had a major heart attack four months ago.
You can read Part 1 of David’s story They always say it’s impossible. Until it’s done! and, if you aren’t moved by the tale of human courage, endurance and passion, you are one tough individual.
This is Part 2 of that story.
The Story of the Cake!
But first, the Story of the Cake. Whilst Nick and I were racing to Accra on the morning of Saturday, 5 June 2016, David was lying in the ICU at the Military Hospital in Accra, his breathing shallow and weak. Drifting in and out of consciousness, David heard a nurse quietly say to her colleague.“
“You know, it’s my birthday, tomorrow but I don’t think anyone is going to remember.”
“Still”, she said after a pause, “at least I have my health.”
This last, a poignant reminder to herself that, unlike David, she had a full and good life ahead of her.
The next day, as David lay in the ambulance on his way to the clinic where he would have an operation that would save his life, he whispered to his wife:
“Pam, you need to buy a birthday cake!”
She looked at her husband, uncomprehending, and wondering if he had completely lost the script.
“David“, she asked, “why do I need to buy a birthday cake?” Her husband, to put it bluntly, was dying; and he was asking her to buy a cake. David explained about the nurse and how she thought no one would remember her birthday.
Send it to her from us with a message to say “Happy Birthday!”
Pam was incredulous. “Maybe“, she thought, “David knows he isn’t going to make it and doesn’t want me to be here at the end.”
The nurse got her cake and put it in the fridge “until David comes back and we can eat it together…“.
It was yet another surreal, touching, Moment in the amazing account of David Okai’s remarkable battle to beat advanced cardiac disease.
Cardiff and a blocked L.A.D.!
Nick operated on David in Accra and “got him out of jail”, but David was badly in need of a follow up operation to open up the arteries that were still blocked. The UK Home Office reversed its earlier decision and, finally, approved a visa for David to travel to Cardiff for the op. I was at a conference in Edinburgh so I flew down to Cardiff, arriving at University Hospital of Wales just as Nick was about to start David’s operation. When I tell you that the next four hours were every bit as remarkable as that June afternoon in Accra, I am not exaggerating.
As Nick sent the camera deep into David’s heart, he could see, for the first time, how extensive the damage was. Worse, in fact, than it had appeared in Accra. David’s Left Anterior Descending artery (the L.A.D.) was completely blocked with a chronic total occlusion. Placing the stent into the L.A.D. was going to be a challenge. Nick needed to to thread a stent through one of the stents he had placed in Accra.
That was demanding enough. But David also had a blocked right coronary artery, also with a Chronic Total Occlusion. On any normal day, Nick would have repaired the L.A.D. and left the right coronary until a later date. It’s a huge operation in its own right. But David lives in Ghana and so Nick decided to do the right coronary at the same time. That’s like finishing one marathon and then setting off on another as soon as you cross the finishing line.
Four hours later, Nick completes the procedures and David was on his own, personal, Long Walk to Freedom!
Once again, I am transfixed throughout!
Into the Sphere of the Miraculous
I am not a heart specialist. I’m not even a doctor and (full disclosure) my medical expertise is strictly limited to what I have observed through windows, and hours spent at the edges of the operating theatre. To me, there is something spellbindingly magical about someone arriving in hospital breathless and in mortal danger with extensive heart disease, walking out with a set of arteries that have been opened up and repaired, the patient coolly strolling around, taking great lungfuls of fresh air for the first time in years; that’s when I wish I was a doctor. I’ve done a lot of interesting and useful stuff in my time, but nothing comes close to the life-saving wizardry, technical expertise and bomb-disposal calmness of the interventional cardiologist.
Imagine, if you will, the setting. The patient, anxious and afraid, with heart disease and the knowledge that this is the stuff of life and death. The cardiologist tells the patient not to worry; that they have done this procedure a thousand times: “You are a passenger on board an aircraft. It’s my job to fly the plane. All you have to do is enjoy the ride!”
Then the procedure begins as “the wire” is threaded through a catheter inserted into the radial artery and up into their heart. (Note that the patient is awake the entire time!) The wires carry tiny, scarcely visible, “balloons” that the cardiologist inflates at the narrow or blocked points within the arteries of the heart. Sounds simple? Throw in a chronic total occlusion and the game changes. Now, it’s impossible to see the outline of the arterial channel and the cardiologist is relying partly on technology but mainly on 10,000 hours of experience in the field of conflict to work out precisely where to steer the wire (from the patient’s wrist!).
As the stent is inflated and, micro-millimetre by micro-millimetre, the blocked artery is opened up, life-giving blood begins to flow, perhaps for the first time in years, to the front wall of the heart or wherever just got unblocked. When you see it on a monitor, all the tiny blood vessels flickering into being, you choke up. I defy you to watch a complex angioplasty operation and walk out unmoved. Not going to happen.
Afterwards, talking to the patient, back on their feet sipping a cup of tea with sugar, so relieved and thankful, hardly daring to believe they have come through it safely, it seems scarcely possible that this is the same person who, just a few hours earlier, was in serious trouble. So, when I say Nick is the most impressive man I know, it’s not hyperbole. If anything, it’s an understatement.
A few weeks ago, David Okai – Runner Number 46696 – competed in a mini-marathon in Accra. Tell me a better story than that, and I’ll find it hard to believe you!
The Big Question
All this begs ONE question: How are the other 1.2 Billion inhabitants of Sub-Saharan Africa going to gain access to the miracles that are accurate cardio-diagnostics and world-class angioplasty procedures? I’m totally serious! How?
Because, right now, here’s what it looks like for a significant percentage of those 1.2 billion people:
Chest pain! Getting worse, can’t climb stairs or walk any distance without getting out of breath. Used to be physically active – not now. Doc says it’s probably a heart condition. Feels bad. No way of knowing for sure, but doc suggested taking aspirin every day. Apparently, a bypass is possible. If I can get to India. And if I have access to $50,000. I haven’t got $50, so $50,000 is going to be a stretch. Pain very bad all the time. Cannot breathe. No way out!
How do we change that terrible scenario from playing out every day in multiple countries?? That scenario in which you know you are dying of CHD aged 49 but you can do absolutely nothing about it!?
Awareness and Action!
First thing is to tell 1.2 billion people about Coronary Heart Disease. Make them aware of the factors that influence the likelihood of developing CHD: genetics; diet, sedentary life-style, check-ups.
When you know stuff, you can do something. Eat better, live healthier, jog a little. Make a change!
Second, we need to make it possible to diagnose CHD. Right now, it’s hard to even find out whether you have tachycardia, angina or a blocked left main with a distal trifurcation.
Third, we need to get the world’s best heart specialists to devote serious time to Sub-Saharan Africa. Some are already here doing fantastic work. But they are few and far between and the facilities aren’t in great shape. I’ve had conversations with Ghanaian cardiologists and with heart surgeons working in Europe and the US, who would willingly relocate to their home country if viable cardiovascular facilities were available. I’ve had discussions with the world’s leading pharma corporations and the manufacturers of sophisticated operating theatres. I’ve even spoken to the largest foundations and benefactors on the planet. Last week, in London, I had breakfast with the European MD of the largest global benefactor foundation operating in Africa today.
They all get it and are all willing to be involved. But it’s a challenging task requiring multiple stakeholders and governments, (many with competing interests), to work together in perfect harmony. That’s hard.
But hard, as we all know, does not mean impossible.
And please join the HeartbeatGhana Campaign. We have raised over £8,000 towards a target of £100,000. We haven’t spent a penny of that so far. Next year, I hope to host a conference of key Finance and Health stakeholders who can help to drive forward an education program of “healthy hearts”; David, Pam and I are planning a short documentary film about David’s epic journey and most of it will be shot here on location – we met the film makers and, subject to finance, we are good to go; and I recently met two immensely wealthy benefactor Foundations who would like to see evidence of traction, after which they will commit to providing “meaningful” resources to the initiative.
On this trip, we are seeing the British High Commissioner, several doctors and a large pharma corporation, visiting a new hospital and an old hospital, appearing on a TV show (think Graham Norton in Ghana), getting interviewed by one of the national papers and getting interviewed on Joy FM. And, hopefully, meeting a Government Health Minister. My friend, if it can come together in Ghana, it can come together in other countries too.
On 8 December, Ghana will elect a new government. It’s a time of change and renewal. #HeartBeatGhana! is moving forward and we shall get there. With your help!