No one will ever know exactly what happened inside my head on the night of 28 July 1995, but probably it went something like this. First, for reasons that remain mysterious, a surreptitious clot began to form in one of my cerebral arteries, cutting off the blood supply to part of the one organ in the body that, after the heart, is most greedy for blood. Eventually, perhaps some hours later, like a breaking dam, the clot burst into the right side of my brain, causing an uncontrolled “bleed” that would achieve the irreversible destruction of cerebral tissue deep inside my head, in the part of the cortex known as the basal ganglia. In medical textbooks, this is “a severe insult to the brain”; in everyday conversation “a stroke”; and in my own life, an exceedingly close shave.
My first reaction, when I came round in University College hospital, drifting in and out of consciousness, was a kind of weird exhilaration. I had no idea about what had happened to me, but whatever it was, I seemed to have survived. Lying naked under a pink blanket in the intensive-care unit, wired up to the monitors, I was aware of being in the antechamber to the grave. Even now, years later, I can still recall the eerie fascination of this experience and of having, by great good fortune, returned to tell the tale.
Physically speaking, I’d been poleaxed. My left leg was paralysed, and my left arm hung from its socket like a dead rabbit; the left side of my face, which drooped badly for about 10 days, felt frozen, as if my dentist had just given it a massive novocaine injection. I could not stand upright, or even think of getting out of bed; besides, my penis was attached to a Conveen, a condom-like device that drained my urine into a plastic bag. My speech was slurred; every few hours, a team of three nurses would turn me over in bed, as if I was a slow-cooking roast. In place of pain – I was never in any pain – there was a hallucinatory sense of detachment, as if I was outside myself, looking in.
That was the day I should have died, but didn’t. Thankfully, within a year, I was on the road to some kind of physical recovery. Since then, a fortunate convalescent, I had lived from day to day as if nothing had changed. Call it carpe diem, or call it denial. In the back of my mind, I always knew there had to be a reckoning.
That eventually came one fine summer’s day in London, Friday 27 June 2014, when I tripped and fell while crossing the uneven pavement outside a row of shops – an antiques store, a hairdresser and a 24-hour grocery – in Notting Hill. At 1.30 in the afternoon, I was leaving my weekly session of pilates/physiotherapy with Dreas Reyneke, a retired dancer from the Ballet Rambert, renowned for his healing ways. When I came out of his anonymous black door, I was thinking about going home to shower and change for a long drive to Devon, where I was due to attend a wedding. Three steps later, I was pitched headlong towards the opposite of joy.
The fall itself – my fall – occurred in an instant, but also in a kind of slo-mo. That old weakness on my left side, the residual deficit from my stroke’s paralysis, had long been a source of vulnerability, and now my worst fears from two decades were coming to pass. My first thought as I hit the kerb with my face was Tintin not Kierkegaard: “Oh, *@?%$*!” Then the menace kicked in: this was what people meant by “a fall”, an Anglo-Saxon word that’s as old as the hills, rooted deep in our past, and edged with fear.
It’s just a tumble to a child, or a pratfall to a clown, but falling is the curse of our later years, and a troubling one, too. The failure of the human frame, even in a fall, is a deep humiliation to our sense of ourselves. In the UK, per annum, about one in three people over the age of 65 will thereby break a leg, or a wrist, or, worst of all, a hip. That fall can be a gateway to incapacity and decrepitude: about 40% of these fallers will end up in a nursing home; 20% may never walk again.
In khaki shorts and scuffed trainers, it was not until I saw the blood splashed on the pavement as well as on my white T-shirt, and found its sinister metallic taste in my mouth, that I realised how badly I was bleeding from my head. Just a few days before my 61st birthday, here I was passing into a new world in which (as I lay full-length on the pavement) concerned passers-by were bending over me with “Are you all right?”, and a smiley young West Indian woman on a quad bike was phoning for an ambulance.
“We’re at the junction of Kensington Park Road and Pembridge Road…”
While she gave directions, I was groggily getting to my feet, and staunching the flow of blood, gingerly feeling the cuts on my forehead. Mixed with gratitude, my main reaction was to be massively pissed off. I was bloody, bruised and disoriented, but otherwise OK. Perhaps I was concussed, but I didn’t think so.
My next thought was: I do not want to go to hospital. (I’ve seen enough of those, thank you.) I want to go home. But then the ambulance arrived, a pantechnicon of rescue, lumbering into view like one of those cranky Red Cross vehicles from my 50s childhood. While two paramedics began their first inspection, time swept me forward on a tide of questions: Date of birth? Profession? Home address? Medical history? And, of course, they wanted to take my blood pressure. Every medic in the world wants to take your blood pressure. For the record, after years of readings, I’m always Mr Normal: approximately 125/80.
Now we were inside the ambulance, which was crazily tilted across the kerb, blue lights blinking, and they were radioing back to base about someone I really did not want to know about, “a 60-year-old man with head injuries…” Was that me? I could hardly believe it. But it was.
My third thought, as the ambulance with its siren wailing began the short, almost stately, drive to St Mary’s Paddington, was, “This is injury time”, an inevitable prelude to the last exit. By accident, by chance, without warning, and when we least expect it, in a blink between opening a simple black door, and taking three steps into a summer afternoon: this is how we go. Here I was in this NHS ambulance, with old memories roaring into consciousness after a sleep of many years – and the sense of life itself hanging by a thread.
Suddenly I was back in that Islington street on 29 July 1995, taking the emergency route to University College Hospital on the edge of old Bloomsbury. I can recall looking through the window of that long-ago ambulance to watch the weekend world outside: shoppers crowding; cars inching through traffic; people with pints standing outside pubs.
Now, seated in another emergency vehicle, that moment of reckoning I had feared had arrived. I had fallen off my perch.
Such a fall is a kind of failure, and an intimation of that final and bigger crash. As the ambulance turned into St Mary’s, the paramedics renewed my passport to infirmity by asking if I could walk into A&E, or “would you prefer a wheelchair?” Would I, hell! This Friday afternoon was becoming a civil war between two kinds of self, the proud v the vulnerable. From 20 years’ experience, I was reluctantly being reminded of something I had come to know so well: we live in our bodies.
As I made my way down a long linoleum passage to check in with A&E, as though at a Holiday Inn, I found myself contemplating some alarming “what ifs?”. What if my fall had resulted in concussion, or worse, brain damage? What if it indicated a more sinister problem? What if I was no longer immune, as hitherto, to neuro-degenerative side-effects? What if I was not discharged? What if…?
As my equilibrium returned, I wondered how I might seem to the others waiting patiently next to me. As the victim of an assault? As a middle-class professional with an unexplained head-wound? A posh vagrant? We were a strange and ill-assorted bunch, rather less afflicted by the evidence of “accident” or “emergency” than you might imagine: an overweight Iranian businessman in a shiny suit, nervously engrossed with his BlackBerry; a pregnant woman and her mother, both in black; a small, ferrety, white-faced boy with his right hand wrapped in a dish cloth; and Brendan, a stage-Irish drunk, well known to the staff of St Mary’s, who was now singing quietly to himself as he carefully removed his shoes and socks to inspect his very smelly feet.
Ever since, as a teenager, I first stumbled on the unforgettable opening line of Murphy (“The sun shone, having no alternative, on the nothing new”), Samuel Beckett has been a favourite writer. At this moment, in the aftermath of my fall, I knew that Beckett would become my guide to life in the foreseeable future, whatever that turned out to be. Words are still the best weapons with which to come to terms with ageing, and what Beckett calls “failing better”.
In the more than 40 years since I left college, like the schoolmaster Holofernes in Love’s Labour’s Lost, I have eaten paper and drunk ink; at first, as the editor-in-chief of the publishers Faber & Faber from 1980 to 1996, and then as literary editor of the Observer from 1996 to 2008. Books and print have been a guide, a consolation, and a modus operandi. For me, experience has often been refracted through novels, poems, and plays.
Turn a page, and you find a new distraction, or another version of reality. Is this not the search for a fuller kind of experience? Art, which helps us focus on our quality of life, also inspires a richer understanding of our mortal existence.
Here, at St Mary’s, in the short run, the waiting was over. After a couple of tedious hours, my number came up and soon I was admitted to the treatment zone, lying in a private cubicle, behind a flimsy blue curtain, being examined by a very practical, friendly young doctor whose refreshingly down-to-earth approach was to offer a choice between a) a full scan and a battery of diagnostic tests, or b) a bandage for my head injuries (no stitches needed), some painkillers, and a taxi home. “What you probably want,” she said, with a winning smile, “is a nice hot shower.”
There’s nothing so soothing as that old English cocktail of normality and no-fuss, also known as the sweet illusion of continuity. So of course I chose b), and went back to my regular life. By seven o’clock that evening, while the long summer day was still burning in the late afternoon streets, I was back in my flat, and showering off the bitter aftertaste of A&E. But I didn’t go to the wedding, and something had changed.
As Petruchio puts it in The Taming of the Shrew, “Where is the life that late I led?” On this day, I had passed a fateful frontier of experience, and was no longer as blithe or as nonchalant as once I’d been. The afternoon of 27 June 2014 had witnessed a decisive personal transition: in this new world, where the endgame must be played out, nothing would ever seem quite the same again. I had survived my fall, and was still 100% myself. And yet… Together with the crossing of that immense psychological frontier – turning 60 – my own consciousness had experienced a subtle shift.
My fall had dumped me, metaphorically, outside an almost tangible threshold. Through a door, at the end of a sinister corridor is a glittering and majestic jet-black arch from which there can be no turning away. Perhaps, in the shower, I hoped to drown the apprehensions of old age. Yet, in some secret chamber of self-awareness, I was conscious that, like Prospero in The Tempest, I should now begin to acknowledge an inevitable rendezvous. Shakespeare’s magician is talking about retirement, and I have no plans to retire, just yet, but the mood that governs his return to his dukedom is one that any sixtysomething can relate to:
Go quick away: the story of my life
And the particular accidents gone by…
I’ll bring to your ship, and so to Naples…
And then retire me to my Milan, where
Every third thought shall be my grave.
There’s no getting away from the tick-tock of biological life. In the words of the Psalms, “The days of our years are threescore years and ten; and if by reason of strength they be fourscore years, yet is their strength labour and sorrow.” When I turned 60 in 2013, my first reaction was to fudge it. For about a year, I pretended I was 59 or, if I could get away with it, 57. Secretly, I made a simple and sobering calculation on my iPhone of how long I’d got. Assuming about 10 years left of my biblical span, just how many days, hours, and minutes remained? My score (give or take some leap years) looked something like this: 3,650 days 87,000 hours 5.25m minutes
With that data in front of me, things seemed alarmingly finite. Look closer, if you want. Humanity has a clever way with the kind of introspection that might otherwise disable the will to live. It prefers to tell stories, at first through myth and religion, and lately through culture and psychoanalysis. Thus the bright, irrepressible dreams of youth morph into a more subtle communion with time’s reckoning, a roster of regrets which, in certain lights, can look like a catalogue of failure.
Most of these regrets are trivial (wishing I’d spent more time in the Australian outback; wondering about skiing the Alps, or trekking to the Forbidden City); some are sentimental expressions of wishful thinking (what if I’d stayed studying in Cambridge; what if I’d not at first married so young; what if I’d lived in New York; what if…?). A few are more painful, sombre re-evaluations of personal shortcomings.
With the onset of these later years, the fragile self finds that “less is more”, and learns to moderate its youthful egotism. Young people think they are immortal, and that the world revolves around them. Older people know they are mortal, that their future is not infinite, and also that they must take their place in the scheme of things. On my visit to St Mary’s, Paddington, after my fall, I was forced to acknowledge this. Was I, for instance, the same person who had been wheeled, semi-conscious, into hospital in 1995?
Well, yes and no. For 20 years, thanks to a lucky spin of the genetic lottery, my recovery had been good. To outward appearance, I was comparatively unchanged. I would always walk with a mild limp, but my left arm (paralysed in 1995) was now, in physio-speak, quite “useful”. Indeed, my physical strength, stimulated by whatever exercise I could manage, had probably increased.
Unlike many stroke sufferers, I had been able to return to work, in the competitive arena of the British media. Here, occasionally, conversation will sometimes default to questions of appearance more readily than to issues of press freedom. Last week, meeting JP, an ex-BBC friend, after some years’ hiatus, the dialogue went as follows:
Me: You look well.
J: Well, I still have hair, and so do you.
Me: Hair is what counts.
J: It’s good to have hair after 60. Hair is what really matters at our age. Etc.
So much for the challenges of “fake news” and the 24/7 news-cycle.
Inwardly, however, I had begun to detect the first hints of a slowing down, a slight but (to me) perceptible loss of acceleration. My daily coping strategies, perfected over many years to compensate for the various small physical deficits attributable to stroke, were no longer as effective as before.
Achingly, my body has wishes it cannot fulfil. In this state of frustration, a movie classic like Singin’ in the Rain becomes a kind of torture, offering an invitation to the spontaneous thrill of a dance that I can neither accept nor even contemplate. When I watch those scenes with Gene Kelly, immobility feels like a prison.
Compared with many stroke sufferers, I’m lucky. My walking disability is minor. I am still my old self, sort of. My progress is often slow and can be laborious, but I’m independent. Lately, I find that in crowds, at airports and train stations, I prefer to use a cane. The upshot is that even the smallest journey each day has to be planned in advance. If I drive to the shops for milk or bread, shall I also go to the bank? Can I park close enough to Barclays to be able to cross the road to Sainsbury’s afterwards?
If I arrange to meet a friend in the West End, can I drive to the rendezvous, or shall I find a “disabled” parking bay and take a bus or taxi for the last mile? What if it’s raining? How will I get back? How congested will the traffic be? On and on it goes: every day becomes an accumulation of a thousand internal transactions in which nothing can be taken for granted.
One of the things about ageing that no one talks about openly, or at best in whispers, is shame, the mortification of being “unfit”. It’s so fundamental that we learn to disguise it. After my fall, I made light of it to friends, and went to some lengths to distract attention from my cuts and bruises. My “forever young” mindset insisted that there should be no scars, and that my body should not let me down.
This was almost certainly deluded. Frankly, I’m not what I was, and it’s beginning to prey on my mind. My inventory of dissolution, north to south, goes something like this. At least, looking on the bright side, as my ex-BBC friend observed, I have hair and it is only hinting at grey. Elsewhere, other exterior parts have become vulnerable to inexplicable moles and growths. So far, on closer examination, these have turned out to be benign. Venture into the interior, however, and there’s trouble brewing: my teeth need regular maintenance, and I’m getting long in the tooth – with receding gums that are prone to bleed. I cannot see this screen without reading glasses.
Further down, my chest will intermittently be seared with heartburn. There’s an inexorable sagging of the pectorals and a thickening of the waist. If I stop to think about it, I feel bad about my bum. From the stroke, my left arm and hand have intractable “deficits” which means that I am typing this with a super-dexterous right hand. Both knees are crocked, my left leg is semi-paralysed (more “deficits” there), and both feet, from soles to ankles, have the tingling pins-and-needles sensation of peripheral neuropathy.
I used to say that, as a stroke recoverer, I believed in celebrating normality and the active life, as far as possible. Towards the end of My Year Off, an account of those convalescent years, I even compiled a list of Dos and Don’ts. Today that list has become distilled and simplified:
1. Try to keep fit
2. Accept your fate/insignificance
3. Live in the moment
To me, the mystery of death and dying is only equalled by the mystery of life and living. Consoling narratives must be patched together from transient fragments of experience. So why not celebrate “nowness” and live in the present? Discover the joy of wisdom and experience. Cherish your family. Celebrate the human drama in all its magical variety.
In truth, there is no other sensible narrative available. Unless you believe in an afterlife – which I don’t – this must be the only way forward. It may be a hard lesson but, as Flaubert pragmatically once observed, “Everything must be learned, from reading to dying”. On the other hand, there are also the mysterious revolutions of luck, the wheel of chance – and thereby hangs a tale. This is where I close, with a new and unexpected kind of love story.
We met under a crab-apple tree, just outside Salisbury, in the garden of some mutual friends, during a summer lunch party. It was a long time ago: about 10 years.
I was contentedly married to [my wife] Sarah, going full tilt with family life. Our daughters, Alice and Isobel, who can’t have been much more than nine and seven, respectively, were tearing up and down the grass with their friends.
And there I was, sitting at a garden table, watching these tiny riots of childhood breaking out around me when this rather elfin, smiling woman, almost “a girl” (the word she would shortly use to describe the other mums on the grass), came up to say hello. She had just read my (1997) memoir My Year Off. Her mother was recovering from a stroke, she said, with swift, disarming candour. Perhaps we could talk?
What did I say, and what did we discuss? I have no memory, but I cannot forget the sensations of that conversation with Emma – she had introduced herself very easily as she sat down opposite me at the table.
I remember the sunshine bursting round us through the green web of overhanging branches. I think I remember drinking rosé, and feeling stunned and slightly exhilarated by Emma’s effortless and gracious manner. We were talking about matters of life and death, and she was mixing gravity with laughter in the most infectious way, drawing me out, and opening me up with a deft sequence of highly personal questions about the aftermath of my “brain attack”.
I have never minded to share the experience of my stroke, but this was more than sharing. This was in danger of becoming self-revelation. I remember thinking: I will tell you everything. Ask me any question, and I’ll answer, yes and yes, I will… Oh, whistle and I’ll come to you. And so we talked.
At some point, distracted by the children, I turned round to discover that Emma had vanished as silently as she had appeared. I recall wondering if I should ask our hostess about this mysterious guest, but thought better of it: don’t go there.
Lunch ended; the long summer’s day faded into twilight; we all piled into family cars to go home, and everyday life filled the void once more.
Ten years passed. Everyday life turned cold and bitter. I cannot explain the sad end of my marriage to Sarah except to confess that our love died, for no obvious reason, a painful admission. A break-up is like a death in the family. We went through the stages of denial, anger, bargaining, depression, and finally (yes, there was counselling: a fruitless attempt to scramble into a lifeboat long after the ship had gone down) acceptance. Somehow, we survived, salvaging scraps of parental continuity and coherence from the wreckage of family life in London and New York.
I had always known that the life of the stroke survivor is often cursed by divorce and depression. To begin with, I believed I had somehow escaped these furies. But now the professional frustrations of midlife, mixed with the rallentando of getting on in years, contributed to an overwhelming sense of decline and failure. Sarah’s departure for her former New York home in July 2013 seemed to set the seal on a vicious downward spiral in my life cycle. The third act that beckoned hardly seemed to be an enticing prospect.
Alone in a new flat in west London, I began to negotiate an uncertain way forward as a single man in his late 50s. Solitude has its attractions, especially after the catastrophe of a failed marriage. Having time to read and reflect, to re-evaluate the important parts of my life and career, was quite appealing. We all need a room of our own.
At the same time, while the security of my bachelor apartment was a liberation, it was also a prison. I was lonely. In darker moments, I imagined that it would be my fate to be ageing and solitary for years to come. In this defeated mood, I was grateful for any distraction, and quickly came to accept weekend invitations.
In retrospect, I was too numb with sadness to understand what was happening. Single friends, who understood how to navigate this stage of life, had advised me to book up my weekends, and to make good plans for Christmas. I understood that they were right, but had so far done precisely nothing about it.
But then, in the autumn of 2013, about three months after Sarah’s departure, my friends, the —s, under whose crab-apple tree I had conversed with Emma all those years before, suggested a weekend in Dorset at the beginning of November. Why not? Better start somewhere.
As the date approached, I found a message on my mobile: could I give one of their weekend guests a lift on Friday evening?
I thought no more about it, conducted a brief exchange of texts about a possible departure time and suitable rendezvous, and answered the buzzer in my flat late on a Friday afternoon with only the most fleeting speculation about my passenger, a woman whose unfamiliar name had become attached to an anonymous mobile phone number.
I took the lift down to the gloomy hallway, and hurried into the street through the heavy glass doors of the apartment block in which I was now living. Outside, it was cold and grey, with imminent autumn rain. There was, apparently, no one waiting. I turned to look round, glancing down the pavement. This was the moment – a scene from an improbably romantic movie – I will never forget.
Standing there, with a single suitcase, beneath her umbrella, slight and solitary and self-possessed, was the girl from the crab-apple tree. “Hi,” said Emma, lighting up with her lovely, heartbreaking smile. “Haven’t we met before?”
• Every Third Thought by Robert McCrum is published by Picador (14.99) on 24 August. To order a copy for £12.74 go to bookshop.theguardian.com or call 0330 333 6846Free UK p&p over £10, online orders only. Phone orders min p&p of £1.99
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