Social Distancing

It’s now just over 50 years since Pink Floyd released their seminal album Dark Side of the Moon and as I write this I am listening to the latest re-mastered edition as I’m also celebrating an anniversary – a 15^th.

Speak to me

Every January, I remember how lucky I am to be here. In the UK, people are advised to follow the FAST (Face, Arms, Speech, Time) model for reacting to what they may believe to be a stroke in someone else. Fifteen years ago, on a cold winter’s January evening in Tokyo, I was suffering from a heavy cold and my partner had already told me that my ‘face looked funny’, which I thought it had for the previous 50+ years so nothing new there. But when I lurched against her on the sofa, she began to suspect something was wrong. I don’t remember if I said anything but if I did, I was probably pretty incoherent. However, I do have this image of the face of the Joker staring at me from the TV screen as we were watching the Dark Knight Batman movie at the time. And it was no joke as it turned into a very dark night for me with my partner summoning an ambulance.

Breathe

My heavy cold meant that I was bunged up and not breathing that easily so it was a great relief when the white-helmeted paramedics clamped an oxygen mask over my face. I vaguely remember being lifted up from the floor, which is where I had ended up, and being carried out of the house into the waiting ambulance thinking that we might have to postpone our plans for a big shopping trip the next day, a public holiday in Japan.

On the run

Although I speak Japanese, I am by no means fluent, especially in the state that I was in at the time. But, in the back of the ambulance, I recall a lot of chatter as the crew were trying to locate the nearest Emergency Ward capable of admitting the foreigner with the funny face. And to the sound of sirens, it all went very fuzzy.

Time.

The fourth word in the four-letter acronym indicates that time is of the essence when responding to and treating suspected stroke cases. Tissue Plasmimogen Activator (TPA) is a protein involved in the breakdown of blood clots. As long as it is administered within the Golden Hour of the onset of stroke symptoms it can improve the stroke outcome. So, I was most fortunate that on arriving at the A&E of the Toho University Hospital in Ohashi, Shibuya ward, I was thrombolysed as well as being connected to various tubes and devices. Our neighbour, Tim, who’d followed the ambulance to support my partner in her hour of need said that so rapid was the effect of the TPA in clearing the blockage, that I acknowledged him as I was wheeled towards the Intensive Care Unit, although I don’t remember that.

Great Gig in the Sky

But I do remember Tim and Carol being two of my first visitors in ICU where I was connected to the machines that went ‘ping!’ as I gradually became aware of what had happened to me. A whole series of doctors and nurses asked me numerous questions and had me performing simple tasks like raising my arms in a banzai salute. Simple? But not when only my right arm would go up. And the lovely nurses who asked me to squeeze their hands with my left. Administering angels, so maybe I was in heaven after all? But not for long as the reality was that a blockage in my carotid artery had led to a serious ischemic stroke leaving my left side paralysed, so when a senior official from my office called on me, interrupting his own birthday celebrations, he must have had a wry smile when I apologised for having to take a couple of days off work. Those days would become weeks and the weeks would stretch into a couple of months as the long road to recovery started.

Money

Just at the time when I least needed to worry about the practical and financial aspects of my incapacitation of course I was getting extremely anxious about my future and the career implications, especially during the first four weeks of lying in a hospital bed being closely monitored in case of relapse. As an employee of the British Government, I was covered by the NHS which meant that I could take 6 months sick leave before going on to half pay, but what about the longer-term future? Would I be ‘sent home’ from Tokyo to London? Where would I go if I were sent home? Could I travel? Could I work? Could I walk even? A lot was going to be up to me.

Us and Them

But I had a lot of support and help. With access to email and an international phone card I was able to keep in close contact with my family back in England. My sister, an NHS nurse and my son, a first-year medical student had a professional interest in the treatment I was receiving and would often comment ‘You wouldn’t get this in the NHS’. Friends and colleagues in the Embassy visited regularly to remind me that my recovery was more important than worrying about work. Ironically the latter would have involved organising an official visit by the UK Secretary of State for Health to Japan. My team gracefully declined my suggestion that he bring grapes to my bedside but Alan Johnson’s memoirs are still on my ‘to read list’ not just because I admire him as a politician but also because I’m curious to learn whether the Honourable member gave me a honourable mention. My partner visited on a daily basis rushing to get to the hospital during visiting hours after her own busy day at work.

Then there was the medical team at the hospital from the neurosurgeon consultant, who was keen to carry out tests to determine the cause of my stroke, to the head physiotherapist who would put me through my paces to get me walking and using my left arm again. I soon discovered that we had a mutual interest in rock music, so instructions to ‘push, stretch & lift’ etc., were punctuated by the names of our favourite bands. And the nurses with whom I would flirt and joke extending our mutual vocabulary of each other’s language, ‘Poo’ & ‘pee’ proving that an interest in bodily functions extends to the nursing profession worldwide.

Any colour you like

After a month, I was discharged from the hospital for another six weeks of physical and occupational therapy at the Hatsudai Rehabilitation Hospital. The main purpose of this phase of my recovery was to prepare for ‘normal life’ again. Although it was a hospital with ward-type beds we had to get dressed into our normal clothes, and take our meals in a dining room with our fellow patients. I was paired with Nagai-san and Honda-san, who started by complimenting me both on my Japanese and use of chopsticks. But being right-handed meant that I found eating the Asian way easier than trying to co-ordinate a knife and fork but I did not tell my new friends that, formed a good friendship, and I’m still in touch with the latter after all these years. The physical rehabilitation was a mixture of gym work and strength and flexibility exercises to build up strength and stamina. I was also allowed outside for a daily walk with one of the care workers monitoring my physical progress as well as my attentiveness when crossing busy roads. These walks got longer over the weeks and I was encouraged to remember the different routes they took me to get the memory cells functioning again. Memory and number/word association tests formed a large part of the occupational therapy which for me had the additional challenge of being in Japanese. The weather was getting warmer and as the cherry-blossom started to emerge, I was told that I had ‘graduated’ and could be let loose on the outside world again. The cherry blossom season is short-lived and soon those pretty pink petals begin to fall reminding us how tenuous our hold on life really is, as if I needed reminding.

Brain damage

During rehabilitation, we were encouraged to set some personal goals. My son and daughter had retained faith in their old man by going ahead with their plans to visit me during the UK academic Easter holidays. So my goal was to be fully resurrected to go to meet them at the airport for two weeks quality family time. Which I did.

The recovery though was an ongoing process, with follow-up physio and clinical tests to get to the heart of my stroke. And get to the heart they did with a trans-oesophageal endoscopy examination, which involved putting a camera down my throat to examine the heart from behind. Fortunately, this was carried out under sedation so the process was not as difficult as spelling it. With an ultrasound scan of my carotid artery and series of brain scans which revealed the extent of the damage caused when the blockage (now cleared) in the artery had caused the original stroke my very friendly cardiologist declared ‘The exact cause of your stroke will remain a mystery. Don’t work long hours and avoid mental stress. Look after yourself!’

Eclipse

If anything, the mental stress (the unseen damage) was more difficult to handle than the physical recovery. I suffered, and still do, from over-anxiety and loss of confidence prone to tearfulness as I was unable to perform at the high standards I’d previously set myself. So, I applied for an early retirement package, married my partner who’d saved my life, and retrained as a coach and teacher of English to adults, and remained in Japan working as a freelance business communications skills trainer and English writing consultant managing my own time and workload. I’ve renounced alcohol, try to follow a healthy diet and exercise regularly and am looking forward to many more such years ahead of me indulging in my love of extensive and eclectic reading as well as listening to progressive rock music such as Pink Floyd.

But then Covid happened. I was very lucky that in ultra-cautious Japan where mask-wearing is common in any case and most people avoid physical contact, infection, and subsequent death rates were lower than in many other countries especially as working from home quickly became the norm and previously overcrowded commuter trains soon resembled ghost trains, But it took its toll as the demand for training soon dropped off and I found myself, in my early 60s, unable to find new work. So, in trying to turn an obstacle into an opportunity, I decided to focus more on my own writing and took to the streets – keeping physically active discovering little used routes through parks and alongside rivers thus observing strict social distancing. Dark days indeed but whilst looking inwards to my own dark side, it was soon time to seek the light and maybe, just maybe, use the extra time given to me to start work on that childhood ambition to write a novel, or at least a fictionalised version of my memoirs whilst I could still remember.

That’s where I am now, four years after the onset of Covid. I’ve been lucky but, at times when life seems grim, just have to remind myself to:

Shine on you Crazy Diamond

(from Pink Floyd’s follow up album ‘Wish You were Here’ and my favourite track of all times. Therefore this is the long version – most will want to skip!)

This blog is dedicated to fellow Stroke Survivors and Floydies wherever you are

Coming up to four years ago, the phrase ‘lockdown’ developed serious undertones of not being able to go outside without wearing a facemask; being restricted as to the number of people with whom one could meet; curtailing travel and certainly having to adopt a lifestyle most of us born in the post-World War years would never have dreamt of. But today fortunately, with some exceptions, that is now behind us and we can once again enjoy what our ancestors have built for us.

We have much to be proud of in the UK – and some to be ashamed of, but I won’t go into that now- but being the first country to develop a nationwide canal network, must be one of our finest achievements. At its most extensive, this stretched to 4,000 miles or 6,000kms from the beginnings in the 16^th and 17^th centuries when work began to canalise our waterway network to improve local and nationwide transportation systems. Work started in earnest during the industrial revolution. Whereas previously a horse and cart could carry around one or two tons of cargo on the deteriorating roads a horse drawn canal barge could carry up to 25 times that amount and the period from 1770 to 1830 was sometimes known as the Golden Age of canals with barges being used to transport raw materials and finished goods around the country more efficiently.

But, we know what happens – progress! And that gave way to a faster and more sophisticated rail network and heavy- duty road haulage especially in the 20^th century. Fortunately, although some of the canals, most of which were built by manual labour alone, fell into disuse and disrepair, the end of the second world war saw a revival. The formation of the Inland Waterways Association by LTC Rolt and Robert Aickman revived interest in their use for leisure purposes and the restoration of some of the canals by a group of volunteers. Before too long, hiring or buying a narrowboat for a holiday in the slow lane became a very popular holiday activity as a way of exploring the countryside or even as a permanent way of life for some whom wished to opt out of the rat race.

And in recent years, it has been seen as some as the perfect form of social distancing where, with the help of technology, it is possible to work ‘remotely’ from home for some people running a business from their boats or as an ideal retreat also for artists and writers seeking creative inspiration away from daily distractions.

But, for those of us who have not yet taken to the waterways in order to write our first book, it is still possible to observe and enjoy all that the canals have to offer from walks along the footpaths along which the horses used to tow the boats (ie towpaths) to the nature of the surrounding countryside.

Another engineering feat was to design a way of moving down or uphill in the waterways which were built to correspond to the elevations of the surrounding environment. Locks were the answer where the boat entered a fixed chamber in which the water levels were raised or lowered through a system of opening and closing underwater ‘paddles’ and allowing the boats to proceed.

I am fortunate that my UK home base in the East Midlands is close to the Grand Union Canal, which stretches 147 miles (235km) from Paddington in West London to Gas Street in Birmingham passing through Northamptonshire and Leicestershire including an ‘arm’ into Market Harborough.

A popular tourist attraction is Foxton Locks with its flight of 10 locks from the ‘Top Lock’ where there’s also a cafe serving light refreshments to the Bridge 61 pub and Foxton locks Inn at the bottom with a wider range of food and drinks. Much needed by the boaters for whom it can take from 45-60 minutes to navigate the whole flight.

It’s only a 10 minute bus ride from Harborough to Foxton, but the winding route of the canal travels through 6 miles (10km) of the Leicestershire countryside making for a very pleasant stroll which I often do starting with a ‘bacon butty’ at the Top Lock and finishing at the Waterfront Restaurant at the Union Wharf in Market Harborough.

The Union Wharf in Market Harborough – nearly home!

While it can usually be a solitary walk there’s sometimes plenty of company along the way.

For the less energetic, standing and watching the hale and hearty navigate their vessels either up or down the flight, or visiting the canal side museum can also be an interesting day out and I try to do so when I have visitors who don’t fancy the walk. A young Japanese student friend who was visiting me recently was offered the chance to follow the locks down and ride the flight with a kindly couple aboard their houseboat the ‘Nightingale’ watched and encouraged by visitors from near and far who are collectively known as Gongoozlers.

As a ‘local’ I try to be more active and help the process opening or closing gates as required. And, as I’ve discovered on my return to the UK, so do an organised band of volunteers giving up their free time to work for the Canal and River Trust (https://canalrivertrust.org.uk/) either in the operation of the locks or in regularly cleaning and maintaining the canals themselves for our continuing pleasure and recreation. But, once again the politicians intervene and the Trust has been subject to recent Government spending cuts, and the debate over funding for the country’s transportation whether that will be for a high-speed rail network, expansion of an airport or better use of low emission vehicles will rage on into the next General Election and could even affect its outcome.

I’ll watch the politics from the sidelines – a true Gongoozler.