Month: September 2014

The eye of an eagle, the heart of a lion, the hands of a woman

When it was time for FA to express herself, she would ask her husband to open the cabinet drawer for her and look for her tools. She would slowly get the long tubes of paint and use her elbow to squeeze out their colourful contents. She would hold the brush with both her deformed hands and apply masterful brushstrokes of her talent on the blank canvas, one painful movement at a time. The distinct hissing sound of the oxygen device would be clearly audible in the room. Her routine had become more or less a second nature by now. Breath in deeply, a single brushstroke, breath out, and at last, a 10-second break. FA’s rheumatoid arthritis has been slowly deteriorating over the last few years. She had several treatments but most of the damage had already happened in her younger years, when the modern, more advanced treatments were not available.

Rheumatoid arthritis is an autoimmune condition. This means that the immune system is misdirected, and will attack her own joints as if they were foreign intruders in her body. Several other conditions are thought to arise from a similar process, such as Crohn’s disease, multiple sclerosis, coeliac disease, lupus and diabetes. When the joints are attacked, the body will respond with inflammation and, as the inflammation settles down, the joints are left damaged and often deformed. For this reason, treatments are designed around one principle; to calm down the immune system in order to prevent these attacks from happening, or to limit the damage once the attack has started. This is called immunosuppression. Rheumatoid arthritis can also often affect other parts of the body, such as the lungs, heart and bone marrow.

Some of the treatments have devastating side-effects. As part of her disease, FA also developed lung scarring, which made parts of her lungs ineffective. This process is called pulmonary fibrosis. As a result of this, her heart was struggling to pump blood towards her lungs, which had become stiff and non-compliant. This constant pressure and pushing of the heart muscle to do its job and send oxygen-depleted blood towards the damaged lungs, resulted in heart weakening and she consequently developed heart failure. The medical term for heart failure due to lung problems is cor pulmonale. For these reasons, FA  needed to be on oxygen at home for at least 18 hours daily.

I tried hard to explain to her the “biology” behind her problems. All she wanted to hear was that she could be home again with her husband and children. All she could think about was the theme of her next painting. Despite her illness, she could draw quicker than I could spell “hope” on the same canvas. She was hoping to go back and start mixing her acrylics to the rhythm of the hissing sound. To her, her medical problems were insignificant. She managed to derive her inspiration not from the things that would sink most people into despair, but from all the things she still had to live for. Each handicapped-but-artful brushstroke would poignantly reaffirm her remarkable perseverance: in finding the strength to apply the paint on the canvas, she was also expressing her determination to keep going and be alive, all the while bravely ignoring the continuous hissing sound in the room.

The open interpretation of a falling star

It was not the fact that he was famous that made me wanting to stay more. His presence was not there to add an inch to my worth.  It was rather his inviting and benevolent spirit that encouraged those 30 minutes I spent at his bedside. We talked about Hollywood and his recent Oscar award. He said that he was fascinated by my Greek heritage and started reciting the prologue from Euripides’ Medea with closed eyes. He put himself at the centre of the stage and asked me to imagine that I was sitting at the upper tiers of the Epidaurus. “That’s where we played it last year”. His voice commanded the same robustness we all met in his earlier movies. There was something odd but mystical about this thespian. Something serene, that allowed this old man to slip into the role of the sick patient without complaining about his state of inability.  He continued to serve his ever-lasting duty to entertain at the stage of his own hospital bed. The curtain was up again and the show was sold-out.

As he spoke to me, he touched his chest in agony. His face became pale and he started sweating. He picked up the red spray from the side table and quickly directed the nozzle into his mouth. He had ischaemic heart disease and he was experiencing angina. Just like all parts of the body, the heart also requires blood and oxygen in order to function properly. The coronary arteries supply the heart with this vital blood and they run their course through the muscle of the heart; the myocardium. Ischaemic heart disease describes a condition where the coronary arteries struggle to supply the heart muscle with oxygen. Furring of the arteries due to old age will lead to narrowing but sometimes complete blockage can occur. When an artery is completely blocked, the condition is called myocardial infarction and this is a medical emergency. There are two types of myocardial infarction, STEMI and NSTEMI, and they carry different prognosis. When the arteries are narrowed, the myocardium is not supplied with enough blood and the tissues receive little oxygen. This leads to a heavy chest pain. The symptoms are much worse when the heart has to work harder, for example on exertion or during times of emotional or physical stress e.g. very cold weather. The experience of this intermittent, heavy chest pain is called angina. The same principle applies when an athlete runs a marathon. The leg muscles receive reduced amounts of oxygen during the race and this can lead to painful cramps that can last for hours. The aim of the medication for angina is to relax the muscle around the coronary arteries so that more blood can flow through them. As more blood and oxygen flow into the heart muscle, the pain eases off. Though not a permanent fix, these drugs can improve the quality of life of patients with ischaemic heart disease and angina.

It only took two puffs under his tongue and 20 seconds in waiting. His relief was almost certain as he quickly found his normal self and his pale face met its original glow. The pained expression of the distressed facial lines slowly relaxed and gave way to a more tranquil exterior. He didn’t complain and carried on talking. What is it that makes some people so great and dignified that they never allow you to be sucked into their own problems?  What internal flame fuels some of us to keep positive and creative even at the darkest and most ill of hours?  Clearly, it takes a bigger person to be able to shield the audience from the troubled persona of the “star” and yet, remain able to connect. Whenever I am looking for these answers, I too try to close my eyes and apparate to the centre of a stage. He is watching from the upper tier in a reversal of roles. I perform and I share. The chorus chants and the curtain goes up once again. My show may not be sold-out but his certainly is.