Paul Bruins – I call him the Man With Legs Like A Flamingo, as he is all of 6′ 5″ tall – is a Cape Town based photographer. I met Paul at a (Facebook) Cape of Storms photo meeting a couple of years ago and we’ve kept in occasional touch, culminating in my attending one of his workshops in nearby Greyton last August. At that point he disappeared for several months, reappearing to bid us farewell, with no explanation more than that.
I like Paul, so I contacted him and over a couple of cold ones, coaxed the rest of the story out of him. Some months later, I asked him to write about it for DearSusan. This is it:
The last Saturday night of October 2017 started off like any other Saturday night. It ended up being a life-changing experience. One minute I was lying relaxed on the couch watching a movie, and the next minute I was clutching my chest in agony, trying to crawl to the phone and call for help. There was no question about it; I was having a heart attack.
There was no gradual build-up of discomfort, or any doubt what was happening to me. This pain was much worse than any kidney-stone (and I’ve had a few of those), this was the kind of pain that makes people pass out. I was at home alone and I had to get help. Since it was impossible for me to drive anywhere with pain so severe, my first thought (and only hope) was to phone for an ambulance.
Fortunately I live less than 3 km from a major hospital, and thankfully the ambulance arrived within 5 minutes of my distress call. I was also most fortunate that there was a cardiac surgeon on call who arrived at the hospital at the exact same time as I did. They rushed me into the cardiac unit, shoved a catheter into my groin and up my artery, and cleared the blockage, all within an hour of my first pangs of pain. I was one of the lucky ones.
This was not my first experience with a catheter and an angiogram. A little more than 2 years ago I also suffered from intermittent chest-pains. But while these pains were quite severe, they didn’t last very long, and they were more central in the chest than where my heart was. Those pains were caused by a restriction in one of my arteries, which meant that the heart was being starved of blood (and oxygen). So the doctors inserted a stent to ensure that the artery would always remain open at that particular spot. The doc also prescribed a bunch of pills to help keep my blood thin, and to lower my cholesterol and high blood pressure. No problem!
That should have been a wake-up call for me, but it wasn’t. I continued my life just as I’d lived it before. The only lifestyle adjustment that I made was to switch from smoking cigars to smoking cigarettes. I’ve always been a fatalist, believing that my end will come when that time comes, and there is actually very little that I can do to change that. I’ve always believed that as long as I do things in moderation, the only way to fully “live” my life was to do everything in moderation. I never want to be lying on my deathbed with regrets about the things that I’d dreamed of doing but never attempted. I’ve never been frightened to try anything at least once. I’ve surfed, water-skied, micro-lighted, skydived, bungee-jumped, and paddled grade-5 rapids (among other things). For me it has always been… the more adrenaline pumping through my blood, the better. Not anymore.
Angiography is a really amazing technology. These days’ doctors are able to send tiny cameras through all your major blood-vessels, measuring their width and wall-thickness. The blockage that starved my heart of oxygen and caused the attack was caused by a partial-collapse of my first stent, which then trapped small blood-clots, and then blocked-up completely. Once the clots had been cleared and my heart was beating regularly again, the doctor then had to decide whether it was better to bypass the old stent completely (major surgery), or to insert another stent into the first one, and then force them both fully open with compressed air.
By this stage you’re probably asking yourself… “What the f**k has all of this got to do with photography?” I’ll get to the main point of this blog-post soon, I promise.
So after a few days of lying calmly in the ICU waiting for my heart to start beating regularly again, the doctors finally decided to go with the (more unconventional) stent-within-a-stent option. I was overjoyed! Although bypass surgery would most certainly have offered a more permanent solution to my problems, I dreaded the idea of open-heart surgery (with months of post-op recovery-time). The stent-within-a-stent procedure was fairly safe and simple, and the doctor pulled it off flawlessly. It felt great to be completely fixed again!
But the doctor was much less thrilled than I was. To fully open the first stent with the second stent, he had to use 12 times the recommended air pressure. He was extremely concerned that everything would start to collapse again over the next few days/weeks, so he suggested that for the next 6 months (at least), I remain within 15 minutes of a hospital with a capable cardiac unit. He also informed me that my heart muscles had suffered serious damage during the attack, but that there was a chance that they would partially recover with regular exercise. I was alive, but only just.
All I could think about in the days following my procedure-within-a-procedure was how easily everything could have been so different. While I enjoy watching movies from my couch on Saturday evenings when I’m at home, I’m not often at home on a Saturday night. Weekends are when I like to spend time away from my home. As a passionate landscape photographer who also has a day-job, most of my photographic explorations happen on weekends. As a landscape photographer, the further you travel off the beaten track, the better your chances of capturing unique and interesting images. Over the past few years I have travelled to some extremely remote destinations in an attempt to capture unique images. The harder it is to get to a particular spot, the greater your chances of finding something new and amazing to photograph there. While the majority of my photographic excursions do not require me to travel too far from civilisation, unfortunately there are only a very small minority of these excursions which fall within the “15 minutes from a major hospital” requirement.
Of course I realise that absolutely anyone can suffer a heart-attack anywhere at any time (even when they’re fit and healthy and in the prime of their lives), but our best chances of having one are when we are unfit, and/or smoking, and/or eating too much salt, sugar and fat. I was doing all of the above. Stopping smoking was easy. There’s no better incentive to quit than a heart attack (though I wouldn’t wish that on anyone). My last cigarette was the one that I smoked about an hour before my attack. But stopping smoking would not repair my damaged heart muscles. For that I had to start exercising regularly and eating more healthily. I used to jokingly tell people that I got enough exercise walking between locations on my photo outings, but I knew that nobody was buying that line, least of all me. Who was I kidding? It was blatantly obvious to everyone that I was unfit. If I didn’t drastically alter my lifestyle soon, I might not even reach retirement age. That thought was a great incentive for me to get fit and healthy again. I am too young to die now. I have to do everything possible to stay alive as long as possible. I felt extremely frail and fearful in the first few weeks after my attack, but I also felt more determined than ever to end my unhealthy lifestyle.
I drew up a diet-plan and an exercise regime, and have managed to stick to both for the past seven months. I’m being very careful what I eat and that I don’t eat too much. I have already lost 10 kilograms! I can also now walk my daily 5 km without breaking a sweat. Sometimes (on rare occasions) I even feel an urge to jog and/or sprint! I haven’t felt this good physically since my mid-30s!
I’d hoped that as my body got stronger, so my fears of suffering another sudden attack would begin to diminish. Unfortunately this was not the case. I have tried to push myself on a couple of occasions and go further than 15 minutes from a hospital. But even then, I was always following a carefully prepared route, only stopping in towns which had the required medical facilities. The further I travel from a major town or city, the more anxious I become. When I’m travelling between towns, I’m constantly calculating the distance from each town and whether it would be better to continue on or turn back, should I have another heart-attack. I am a rational-enough person to realise that these are irrational fears.
Fortunately I live very close to one of South Africa’s most iconic locations for landscape photography, namely Blaauwberg Beach. From here I can capture Table Mountain looking at its very best, with an infinite selection of foreground options to include in my compositions. I could never get bored shooting here, and the best part is that it is less than 10 minutes away from a major hospital!
So, I am not looking for sympathy from anyone. My current situation is entirely my own doing. My body is on the mend again and I am much more optimistic about my future prospects than I was a few months ago. But will I ever feel comfortable enough again to travel to remote destinations? I’m not so sure about that. I’m a logical guy and I realise that many of my current fears are irrational. But realising something doesn’t necessarily mean that you can do anything about it. If anyone reading this post has any constructive suggestions on how I could begin to feel less frail and more confident, then I’d love to hear from you.
I’d love to feel completely comfortable in any and every environment again. I’d love to continue my photographic explorations to remote destinations without all this constant anxiety and fear of dying. I’d love to be able to continue capturing photographs like the images below.
In closing Paul said: These photos were selected based on the remoteness of their locations, they’re not my all-time favourites.
If I’d had my heart attack while taking any of these photos… well… I don’t need to finish that sentence. 🙂
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