Paul Howard: ‘I thought I was having a heart attack. That was how it started’

I’ve been drawing up a list of all the things I plan to eat after my operation has been completed

Deathbed regrets? I’m not sure that it’s going to be true for me. Instead, I’ve been drawing up a list of all the things I plan to eat after my operation has been completed.

I thought I was having a heart attack. That was how it started. Actually, no, that’s not completely true. It started the day before, when I read an article about Sniper Alley, a phrase invented – probably by health insurers – to describe the period of midlife when all sorts of diseases, afflictions and maladies are wont to pick you off.

I turned 50 this year. Statistically, I was about a third of the way up the alley, according to the article, and this was very much on my mind when I woke in the night with a pain in my chest.

I’ve never been neurotic about my health. No man-flu sufferer am I. Quite the opposite, in fact. I have quite a high capacity for pain and discomfort, which has always led me to ignore the body’s warning signs. When I was younger, I had glandular fever but did nothing about it for a week until a purple rash appeared all over my body and I was rushed by ambulance to hospital suffering from septicaemia. A doctor’s office has always been a place of last resort for me.

I got up at three o’clock in the morning, put a mug of milk in the microwave and Googled “Sniper Alley” and then “chest pain causes” and then “is it ever too late to think about life insurance?” just to put my mind at ease.


I eventually saw a doctor. It turned out we knew each other. There's no describing the relief of seeing a friendly face when you've convinced yourself it could be the last one you see

It turns out that there is a whole medical encyclopaedia of illnesses – some serious, some not – that present as chest pain. By the time I’d drunk the milk, though, I’d convinced myself that it was probably just a severe case of heartburn, which I suffer from anyway, and I returned to bed.

Later that morning, I was doing a Zoom cook-along with celebrity chef Rachel Allen to raise funds for Goal. After a largely sleepless night, the pain had gotten worse and I had to keep stepping out of the camera's range just to clutch my chest and grimace. We were cooking, amongst other things, shakshuka, a dish of poached eggs swimming in a sea of fried tomatoes, onion, garlic, cumin, paprika, cayenne and nutmeg. And, while delicious, it contained at least five ingredients that definitely should not pass the lips of someone suffering from heartburn.

But, yes, I ate it – hey, it was for charity – and I enjoyed every agony-inducing mouthful.

I suffered on through the afternoon. That night, I was watching the first half of the European Champions League final, lying on the bed in the foetal position, when I couldn't take the pain anymore. I left the match, drove to St Vincent's Hospital and placed myself in the care of the good and hardworking people in the A&E ward.

I was seen by a triage nurse, who quickly ruled out a heart episode, but asked me about my scar. I have a thick scar that runs like a zip right up the centre of my abdomen, from my waist to my sternum, the legacy of a hiatus hernia operation I had in my twenties.

I explained that I've always had stomach problems – indigestion, acid reflux and chronic heartburn – but lately they'd been getting noticeably worse. The pains were in the front and back and I could recall at least five times in the previous year when I'd woken in the night and had to be winded like an infant.

I eventually saw a doctor. It turned out we knew each other. There’s no describing the relief of seeing a friendly face when you’ve convinced yourself it could be the last one you see. An ultrasound confirmed his initial suspicion.

Evolution just hasn't got around to Marie Kondoing it yet

I had a gallstone – a whopper, it turned out – 4cm wide, which is about the size of a table tennis ball. It was trapped in my gall duct, resulting in an infection that had caused my gallbladder to blow up like a helium balloon.

I was admitted to the hospital immediately. I remember little about the night, except that a man in the bed opposite me was watching You Tube videos of a religious preacher – “No one on their deathbed says they wished they’d worked more!” – and I kept pressing the emergency bell to request more painkillers like I thought I was in some kind of pharmaceutical tapas bar.

That thing about deathbed regrets, by the way? I’m not sure that it’s going to be true for me. The following morning, I rang my wife Mary and asked her to send in my laptop so I could, well, “work more”. I started proof-reading my latest book Normal Sheeple while I was placed on a drip and given intravenous antibiotics to bring down the infection.

I was told that my gallbladder would have to be removed. The gallbladder is a small, pear-shaped organ that produces bile and squeezes it like a mustard bottle into the intestine to break down fats. It turns out that, like the spleen, appendix and tonsils, it's one of those body parts that we can live perfectly well without. Evolution just hasn't got around to Marie Kondoing it yet.

Mine, I was told, would have to go. The surgery would be scheduled for 10 to 12 weeks later. In the meantime, I should avoid using the thing by following a strict fat-free diet.

At the end of my week in hospital, I met with a very helpful dietician, who urged me to focus not on the things I couldn’t eat, but on the things I could. As she listed them, I was disconcerted by how quickly we arrived at seeds. You know those things you put in the bird feeder? You can eat those. Who knew?

But what I can't eat has defined the summer for me. I'm now one of those dietary requirements people I used to roll my eyes about. I'm the one who asks the waiter if there's oil in the dressing. I'm the one in the coffee queue who asks to see the milk just to satisfy himself that it's definitely slimline. I'm the one who arrives at your barbecue with his own hake fillet in a Ziploc bag. I've been a lot of fun to be around.

We spent a week in Kerry before the return of indoor dining. It was almost impossible to get a table outdoors. While some in our party feasted on delicious, deep-fried fish from some of Dingle’s wonderful chippers, I actually considered, in my famished state, eating smoked salmon straight out of the packet, standing on the street outside Garvey’s supermarket. Then I was reminded that, for someone who earns his living sending up the foibles of the Irish middle classes, the optics – as the spin doctors say – might not be good.

A wise man once said that we spend our first 40 years thinking that life is about acquiring things and the next 40 discovering that it’s actually about losing things. And the longer you live, the more you lose. I’m losing a bit of me this week. It only weighs two ounces – about the same as a couple of AA batteries – and I won’t miss it when it’s gone.

A friend of mine and Sniper Alley comrade-in-arms told me that I'll probably be offered the gallstone as a sort of macabre souvenir of the episode, though I'm not sure if this is an urban myth. I know that, after a hip replacement, Roald Dahl kept the old bone on his desk, but I doubt I'll want to look at a table tennis ball of hardened digestive fluids floating in formaldehyde while I work.

This week, like a death row inmate considering his final meal, I’ve been drawing up a list of all the things I plan to eat when this is over. The route home from the hospital will take me on a long detour to Sheridan’s cheesemongers.

There will be Epoisses. There will be steak and red wine. There will be chicken wings. There will be sausage sandwiches and Double Deckers and ice cream. And, who knows, I might even give Rachel Allen’s shakshuka another go.

Normal Sheeple, the new novel by Ross O'Carroll-Kelly, is in shops now

Paul Howard

Paul Howard

Paul Howard, a contributor to The Irish Times, is a journalist and author, and the creator of Ross O'Carroll-Kelly