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‘Escargot Pour Trois’ by Beryl Cook
I am interested in the Scottish Government’s announcement that a screening programme is to be rolled out across the nation to scan men aged 65 for signs of an abdominal aortic aneurysm, our main artery.
What caused his aneurysm? It could have been genetic disposition or a disastrous diet. He was overweight, and he told me that several medics had been conferring round his bed about the safer method of treatment. One way is to open the abdomen, find the aorta and remove (excise) the aneurysm, before sewing into place a synthetic Dacron tube to replace the removed piece of aorta. The less invasive procedure is endovascular surgery, allowing the graft (stent) to be guided within the blood vessel itself to the site of the aneurysm without the need to cut open the abdomen.
On the morning when he was allowed to get out of bed the patient in my ward made for the canteen and returned with an outsized sandwich crammed with fat, sinking his teeth into it in feral ecstasy. That afternoon when I was visited by the consultant surgeon with his troupe of medical students I wanted to say to them: ‘That fellow across from me with the aneurysm that could rupture at any time has just added to his body weight with a triple decker of cold cuts. Here’s the lesson of the day for you students: if the vascular surgeon decides to cut open the abdomen, he will have to peel back the fat before getting to the bulging aorta’.
Five days later, and 20 pounds lighter through starvation, I was wheeled along the corridors for an ultrasound scan to see if my acute pancreatitis was caused by stones. I lay in the soothing half-light of the room, until, stage left, the consultant radiographer entered, a most stately lady who could have played Cleopatra. Having made herself comfortable at the screen, she squirted lubricant on my abdomen and began to locate the pancreas. It looked in order to her. Then she said factually: ‘You have an aneurysm on your aorta at abdominal level. As far as I can see it’s about 3.3 cm’. Then she rose, straight-spined and charismatic, to exit left.
I am approaching the biblical cut-off point and have enjoyed a privileged life compared to most of the men who were in my ward, so living with an unpredictable aneurysm isn’t a big deal. As Thomas à Kempis cautioned: ‘what else does anxiety about the future bring you but sorrow upon sorrow?’. My sympathies are with the surgeons to the future generation who will have to cut through the fat barrier to get to the aorta to repair it if inserting a stent is too dangerous.
Obesity is going to cost the health service billions in the coming decades. In the supermarket I watch with fascination and despair the prodigious guts in tracksuit bottoms behind the shopping trolleys heaped with junk food that will increase cholesterol levels, narrow arteries and make the overhanging belly even bigger.
In this year of the Olympics, with physique at its most beautiful, the human body is becoming grotesque, as in Beryl Cook’s paintings. In St Andrews I see the queues of school pupils buying their lunch, and when I observe what they are stuffing into their mouths, I am witnessing a future generation of patients. The Scottish Government will have to provide surgeons with chain saws to get at the abdominal aneurysm.
In the supermarket, wedged in between the trolleys with their lethal cargoes, I unload my gluten-free bread, soya instead of cows’ milk, the snack bars wheat and dairy free. I read every contents label as though I am checking the proofs of a book. Do I really want to live until 90 and beyond, in a world ruined since my childhood, to read about the hospital beds crowded with the obese, to see on YouTube the gigantic woman, looking more like a pupa than a person, having to be lifted by an industrial hoist, her coffin the size of a small car?
I ignore the arterial menace in my abdomen and continue to dig storm drains and to fell trees in my garden. I will have a salad from my own unsprayed produce this evening, then continue my study of Zen Buddhism. I shall pray to St Luke, patron saint of surgeons, to give them steady hands with the chain saw, before I retire to calm repose.
Lorn Macintyre is a writer and poet
