Sometimes I find myself unexpectedly reliving it. It comes in waves. I`m driving, or I hear a certain ringtone, or I`m staring at little Lucifer meowing up at me in slow motion..then suddenly I see my reflection. Alarm bells.


The whole day is like a hyper-real snippet of time that I can re-visit, where every twitch of every muscle fibre is processed again. Where every tiny instance, every notion, every convulsion and every panicked rationale runs through my mind again.
It`s my own personal Groundhog Day without the hilarious suicides.


An`acute myocardial infarction`. An `MI` to the nurses. I heard the phrase `STEMI` occasionally but in any event, it`s a heart attack to you and me. I`m 35. 


`Myocardial Infarction` does sound cool though and no doubt has a way more dramatic effect on a sick cert than `bronchitis` or `back pain`. If nothing else I`ll raise some fucking eyebrows in that HR office. Silver linings don`t you know.


Of course this was not my first existential crisis. This one did fucking hurt though.


So the total breakdown of all my faculties began gradually but accelerated rapidly.
When I finally succumb to the gridlocked artery, the rate at which I become utterly helpless was fully terrifying and fully humbling. 

This how it unfolded.


It`s snowing in Wisconsin


I`m trying to ignore the nasty aftertaste of that chilli chicken wrap thing as i walk into the meeting. This was a `walk-and-talk` style formal audience with site management, some supervisors and a few reluctant team leaders as preparation for a regulatory audit of the company. 
This is not as important as it may sound though.
We are subject to these government audits approximately every two years in between constant, almost identical, client audits. To say we, as a company, are audit-ready would be a massive understatement.
Readiness and preparedness are frequently used buzzwords around here, as if any day now we will have to defend the building from a tactical military assault.
Of course at this point the actual visit date of the audit was not determined. 
Three months?? Six months?? This year even??!
`Oh definitely this year`. Right so.
In every version, it`s TBC for now. 


So, predictably, the usual grandstanding and hand-wringing begins early. Five years in and I never really could shake the impression that everyone here is kind of pretending, playing a part.The theatre of corporate America. The art of self importance.
To be busy is the goal here, a full calendar is worn like a badge of honour. It`s that legendary `crazy` work ethic of the yanks which us credulous Paddies here try to emulate.


And so today’s gathering will kick-start the inevitable merry go round of meetings. Prep-meetings, follow up meetings about prep-meetings,`linking-in` with people for sub-meetings, follow up meetings to discuss the previous meetings and on and on and on. All of these circle jerks are structured around late Friday afternoon long distance conference calls in which a slow, patronising American drawl slowly bores a hole through your brain and will to live, inevitably ending your week on a depressing note. 
Its snows a lot in Wisconsin you know. 
But I digress.. 


So we get the site survey underway.This is a large group and we walk slowly in an awkward cluster, obstructing everyone and everything, caring not for the staff doing the actual day-to-day work of running this place. We move through like visiting dignitaries touring a slum. Within our bubble though, my department, as usual, is charged with the most questions and work requests. As the local lead I would be batting away most of these queries which range from genuine technical and procedural queries to inane requests and irrelevant observations. In this formal environment though, all questions are created equal and as such it`s usually a considerable challenge to conceal your annoyance.

But it was a familiar routine; we are facilities management, the corporate whipping boys of sorts.The whole gig is really about mastering a diplomatic dance around conflicting personalities. The trick is to know who needs to feel important, and what actually is important. All of this will though be crucial in a couple of months when an FDA `agent` is grilling me about pest control laws in the EU. Or some equivalent nonsense.

But these kinds of meetings are fairly benign affairs in the broad scheme of things and this was why I have charged my (relatively) new colleague with assisting me. She was young and capable and so I wanted her to witness some `normal` scenarios following a particularly chaotic and stressful previous six/nine months. We were in one of those rare, brief periods of peacetime right now and she`s earned a regular non-dramatic day I reckon. 

As I bang the automatic doors open, I`m hit with a pang of nausea and I curse the chicken wrap again. I need to eat more fruit.  



Greek Mythology


I`m using my tongue to try move a strip of red pepper from between my teeth as we file into the warehouse.
This is a temperature and humidity controlled area full of various client drug product. You are immediately hit with a toasty 24°C of barely-filtered, re-circulated air that is regulated by equipment that I am responsible for. It always takes a few seconds to adjust to the breathless dead heat in here. The technicians barely register our presence aside from a smirk and an eye roll I exchange with Johnny as he passes by.


I didn’t sleep well last night and I`m starting to feel more and more bogged down with each passing minute. But I`m actually somewhat pleased because it means my mechanical and electrical systems are working well. It`s stifling in here at the best of times so I`m happy to write it off as general fatigue within a stuffy warehouse. 
I think I`ve finally removed that strip of pepper from between my teeth. Life`s little victories.
A strange heaviness now weighs in on my brain.


So we shuffle sideways. Always sideways, never forward. It occurs to me now that even the way we move in here reflects our uselessness, just spinning our wheels, forever pushing that rock up a hill in a modern Sisyphean torture.


A flurry of scribbles and a handful of standard questions are dealt with.
My leg muscles suddenly contract, tightening as if I had just sprinted a mile for the first time in years. Odd.
I look over at Peter and despair. His fresh-from-the-bag SOP mandated warehouse gown is buttoned all the way up to the neck, making it painfully obvious how little time he spends down here at the `coalface` as he likes to call it. He`s smiling proudly, like a child modelling a new superhero costume, oblivious to the subtle expressions and body language of the staff as they try to conceal their contempt for another manager with a superiority complex.
But really I`m just trying to ignore the fact that I`m feeling increasingly lame. I`m half-listening to one of the QA guys as I lay my left elbow on a nearby shelf and allow myself a long exhalation. He`s talking in circles.
The fan motor above starts to whirl into life and a blast of warm air hits the back of my neck. As I straighten my head I feel a little off-balance. 2am-at-a-wedding off-balance.
This fatigue is getting out of hand.
Fucking chicken wrap has poisoned me. Has to be it. It just tasted...wrong. Like an artificial version of itself.


Then, without warning, I`m winded. A static shock burns the back of my throat and I drop my head again trying to catch my breath. 
My wrists, knees and ankles feel like crumbling chalk and I push my body against the frame of the racking to stop from sinking to the floor.
Shit...what is this?
My breathing is getting more laboured and my legs are increasingly weak. I notice my heel scraping against the laminated floor and I realise that my head is now entirely too heavy for my neck. All my muscles feel like they`re withering away. Instant atrophy.


As I struggle to compose myself, I wonder if this is what a panic attack is supposed to feel like.


The group shuffles a few feet towards the stairs to the second level. I`m trying to focus on my breathing as I drag my feet along.  I remember reading about SAS trainees in which the exhausted hopefuls, adrift on the welsh mountains with 30kg`s on their back, are reduced to simply repeating to themselves,`left foot, right foot, left foot, right foot` to avoid focusing on anything other than physically moving forward. That may be a good tactic. I`m on battery saver mode here, limited functionality.
Another query comes my way. As I begin to speak my throat instantly dries up. I hear my voice crackle. In this instant my brain seems to disconnect from my body; I feel a sort of out-of-body timelessness and fully expect to watch myself collapse to the floor.
I sound like a hungover best man; unprepared and failing gloriously, helplessly going down in flames. 
Somehow I’ve finished my answer but I have no idea what I’ve just said. Verbal muscle memory I guess.  
I quickly scan the faces in the group for a flicker of concern. A raised eyebrow? A follow up question? A snigger from the back of the class? Nothing. I`m surprised but it kind of re-enforced my growing belief that I`m either mad dehydrated or beginning a psychotic episode.
Suddenly I feel the blood draining from my face and the first beads of sweat start to form on my forehead.
A strange, heavy gloom washes over me, instantly gutting the dopamine in my brain.
All of the faces in front of me morph into an unreal version of themselves. My mind is now trying to decode a swirling, fleshy mess as the walls start to move closer and closer together.


I feel utterly exposed now, genuinely frightened and somewhere between outright panic and outright tears, weak and ashamed. An immeasurable weight of guilt and sadness is bearing down on me.


But I`m fucked if I’m going to let anyone know how I feel. My balls and male pride in my position of authority strictly forbid that. So I manage to abruptly shove my clipboard into my new colleagues` grip and excuse myself. Peacetime and all that.


She`ll be fine  for a few minutes, I need to shake this off...I need to puke or piss or bleed or something. I wonder will my legs work well enough to get me out of sight.


The Sub-Aqua Club


The walk from the warehouse is not real. 
I can fucking see the air as I pass through it, a wavy mirage muting my senses, further disconnecting me from the world. The haze around me slowly turns to liquid and I start to drag.
I make it to the Disabled WC close by. 
Trying to remember my own name, I move around in decreasing circles on the spot. My head is rolling around on my shoulders and my mouth hangs open as my muscles run out of fuel. Empty. It seems I am simply disintegrating. I am about to turn to dust.


I stumble back out and into the adjacent first aid room. I catch a glimpse of my reflection as I float past the mirror. Alarm bells.
My face is a white mask with two throbbing red slits for eyes. The sweat noticeably races off my nose. I am Guy Fawkes on meth.
Gripped with an sudden, overwhelming panic, I can hear myself try to speak.I manage a pathetic muffled choke. I`ve heard this death rattle in a cat once. 
I`m drowning now. Fully immersed.


The heat overwhelms me, I need to get my clothes off. I weakly pull at my collar and my belt. As my body temperature skyrockets, I instinctively move across to the nearby Comms room, knowing we keep it cool to protect the networking and security systems within. People don`t like spending too much time in there as the chill starts to become uncomfortable after a few minutes. No joy.
I fall into the chair nonetheless and lay my face against the chipped white table as I tug at my belt again. I sense a vibration through my cheekbone as I manage a deep moan in an attempt to shout to someone.
I pull my work mobile out and push it near my face. I manage to dial four colleagues from the speed-dial. No answer. Of course not, they were still in the meeting so their phones were on silent or at their desks. Then Maxine, my fucking hero, answers from the other building.
`Hey, listen I`m not quite feeling the best at the minute, could you find me someone with a medical background that could troubleshoot an issue for me?` The urgency in her response tells me I may not be as calm or as articulate as I think.
I leave the comms room and fall back through the door of the First aid room. I manage to drag myself onto the treatment table.
My body curls itself up into a foetal position, a crumpled shaking mess. I moan hopelessly and can taste my own sweat as it creeps onto my lip and into my mouth.
All my mental and physical capabilities have now abandoned me. My subjective reality is falling away and a wave of terror sweeps over me as I realise I am no longer in control.


Suddenly, my jaws freeze and an icy shiver rattles my entire body.


Then the pain kicks in.


God is a woman.


This is a relentless pressure; a heaving mass is now pushing down on my chest with everything it has. Every desperate gasp for breath seems to only make it worse.  An unstoppable, invisible Boa Constrictor slowly wrapping itself around my chest.


I think I can hear someone shouting at me.
Maxine reaches around, grips my hands and I start to cry.


The crush is excruciating. A wrecking ball slamming into my abdomen in between unstoppable, twisting pinches that tear me apart from the inside. I am trying to saviour the milliseconds between convulsions as the wall of my heart muscle suffocates. These milliseconds become shorter and shorter until the concept of time just ceases to exist. The lack of respite is unbearable. 
I know nothing, I know nobody. I have no memories, no future, no present, no past, no thoughts of hope or despair. Infinite mental vacuum. Nothing. Everything now existed in this single moment of relentless pain and inescapable horror.


The paramedics face is best described as `off-white` as he registers the data from the ECG. His eyes widen as he looks at the print-out and looks back at me.
Sinead, the driver is now looking down at me, `So we`re going to Galway. You may feel a few bumps in the road` she smiled. I liked her calm. The only way we don`t break a new land speed record is because we have to stop to switch the `regular` paramedic in the ambulance with an advanced paramedic (AP). You must be an AP to administer morphine. We crash land on the side of the motorway to carry out this changing of the guard. Hello Ivan. His nonchalance is actually reassuring on some level.
At this point my father appears and disappears as a fleeting reminder of a reality I`ve forgotten.


Ivan keeps measuring my blood pressure but it`s too low to deliver any morphine. I bang my head repeatedly off the back of the trolley and try to slam it from side to side as a childish means of dealing with the pain. I`m not sure if I`m tasting sweat or tears at this point.


My trolley is now crashing through doors in the hospital as I briefly become aware of the drama swirling around me. Ivan had allowed himself administer a tiny dose of morphine just before we reached the hospital. Safety in proximity I guess. I can sense eyes on me as outpatients and punters are briefly disturbed by my rushing trolley. My perspective is strictly skywards though so I could not acknowledge my fans.  I note the suspended ceiling tiles, the heat detectors, CCTV cameras, Intruder alarm sensors, service hatches and ventilation grilles as I slip underwater again. My head is gone.


Cath and mouse


`Your arm is going to feel like it’s on fire`
Before he finishes the sentence, an intense blast of searing heat consumes my right arm and I`m sure that I am about to combust. 


When the paramedics pass me over the threshold into the Cath Lab my concept of linear time is briefly restored. The slow motion underwater bounce I was experiencing suddenly becomes a kind of violent high-speed dervish. There are now a lot more faces peering directly into my eyes.
`My Name is Louise` says one of the faces as she touches my arm.
Hands are placed, clothes are lost and I`m swung onto a new trolley. Barely having time to appreciate my new blue frock, I am bombarded with queries about cocaine use and if I know where I am.


I forget to mention the sweet chilli chicken wrap.


The burning arm phenomenon is mercifully brief as more tablets are pushed down my throat. A large rigid plate swings across and rests just above my chest which practically pins me to the table and forces my face to the right. Another tablet is pushed down my throat.  
`You`re going to feel a bit sick` I hear, as a nurse runs over with a white bag. The ensuing wave of nausea is intense and dizzying. My head spins off my shoulders but I can`t vomit.


The twisting knife inside my chest continues to turn. No longer `on fire`, my right arm is now screaming, as if it has been cut to the bone.
Every few seconds my breath is taken away by a heavy, sweeping sensation across my chest. This drives a panic response in me and I instinctively try to move my body to escape only to find myself firmly pinned to the table. Each of these panic spasms are followed by a further wave of nausea that never materialises into relief. This sequence repeats ad infinitum.


It now occurs to me for the first time that I might actually die. I don’t know why it took this long to consider. Perhaps some deep down dumb optimism had buoyed me throughout. Not anymore.


Just then, I notice how dimly lit the room is. I see a small red flashing light and hear a crackle of distortion as someone speaks through a microphone. A switch has tripped in my head. I am sinking again. I find Louise. I lock onto her gaze through the distorted air between us. She acknowledges my fear. She is almost an unreal figure, the maternal archetype come alive. For a second she shares my pain and it helps. I want to bawl my fucking eyes out on her shoulder. I will do anything for this to end. I am now a 35 year old child.
This is a sober ego-death.


`You`re doing really well`. I suspect the surgeon sensed my misery.


I see a yellow shaft of light shimmer down through the dark water. I`m pulled towards it until I can take a huge gasp of air. The endless internal crush is slowly replaced with a heavy ache. No more gridlock.

No epiphanies. 
I am pushed from the Cath lab and into a spacious room with a lot of windows. A pigeon stares blankly at me from the sill outside. He hops twice and flies off.


Little Lucifer would fucking have him for breakfast.