'Doctor, we've got bad news'

When Richard Dobson, a young doctor of 28, took part in routine heart-scan research, a shock discovery led to him undergoing life-changing major surgery

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The Independent Online

It took a while for the words to sink in. I was standing, staring at the people opposite me, having just had my body scanned for a routine medical project I was working on with my colleagues. They had something to tell me and I was a mixture of curiosity and anxiety.

People go to see a doctor because they suspect something is wrong with them. They usually display symptoms. I had nothing that would lead me to believe there was anything wrong. There were no signs that the day would start with me being a doctor and end with me also being a patient.

The doctor's tone was gentle. It had come from years of experience of reassuring patients. "We have some bad news," he said, with compassion. "You have an atrial myxoma: a tumour in your heart." Being told you have a life-threatening illness is quite surreal. It's even more so when you have just spent 30 minutes innocently taking part in medical research as part of your job.

It was 17 February, 2011, and I had been helping my colleagues perform cardiac magnetic resonance imaging (CMRI) scans of the heart. Healthy volunteers were being scanned in the machine but there was a sudden cancellation, which left a spare slot. I was asked if I would mind spending some time inside the scanner.

MRI scans work by using extremely powerful magnets and radio waves to create images of the body. They can provide amazing detail regarding the structure and function of organs such as the heart and brain, and have revolutionised the assessment and management of so many medical conditions. After half an hour, I came out of the machine and almost immediately two of my colleagues said they needed to speak to me in a nearby room. I could also feel my palms becoming a little clammy as I followed them.

Then the bombshell was dropped. Initially my reaction was one of disbelief, then shock. Somebody so fit and healthy as myself had a heart problem? And a serious one at that? I was scared. Would I die? I was being diagnosed with myxoma. We'd barely touched on the condition at medical school because it is so rare it affects around one in 100,000 people. And I knew what was to come: open heart surgery.

Three days earlier I had enjoyed a lovely Valentine's night with my wife, Donna, who I met while working at a hospital in Dumfries in Scotland. I was still buoyant about the day and we were looking forward to a planned weekend break away to the Isle of Arran, just off the coast of Ayrshire. My career as a clinical research fellow at the Golden Jubilee National Hospital in Clydebank near Glasgow had been going extremely well.

All my life I had been dedicated to keeping fit and healthy. Studying was tough, but I always made sure I had time to train and I really enjoyed throwing myself into 10k races and marathons. I couldn't believe that at the age of only 28 I would have to undergo a major operation where the surgeons would have to stop the heart beating for almost half an hour.

Myxomas are not malignant, they do not invade other tissues and spread to other parts of the body as lung or breast cancer does. But they can cause complications, some of which can be devastating. The greatest risk is when the myxoma fragments and enters the bloodstream. These fragments could occlude an artery supplying one or more organs of the body with blood. From the left side this may mean it occludes one of the arteries supplying the brain, causing a stroke. It could also affect the limbs, leading to ischaemia, and a possible need for amputation, and the gut, causing ischaemic bowel. From the right side it can cause a pulmonary embolus, which can lead to sudden death. The myxoma could also obstruct a heart valve, which generally leads to breathlessness and reduced exercise capacity among other features of heart failure.

So surgery is the only option. It was hard to absorb the diagnosis, but I had a decision to make, and fast: whether to have the operation in Clydebank or go to the one closest to my parents, Southampton General Hospital. I decided on the latter and it was booked for just 10 days after the diagnosis. Although I trust my colleagues in Clydebank, I felt having my operation there would have put them under too much pressure.

While I waited for the operation to take place, Donna and I did everything we could to make the time as normal as possible. We went to the cinema, had meals out and I made the most of my time off. I knew recovery would be long, and I that I would have to spend seven days in hospital.

The surgery was done under general anaesthetic. I awoke in the intensive care unit with plethora of drains and lines attached to my body, and I was sore. Five days later I was back at my parents' home. But a few days after that, I developed an abnormal heart rhythm – an "arrhythmia" – and had to go back into hospital to get an electric shock across the heart from a defibrillator, also under general anaesthetic. The tablets I had been taking to prevent arrhythmia occurring weren't quite powerful enough. A couple of weeks later, I was back in with the same condition.

The next few months were marked by attending cardiac rehab to build up my fitness. I was back in Glasgow by this time and attended my local hospital. It wasn't without its moments of excitement. A lot of the other patients who attend the class tend to be older and have recently had a heart attack. One gentleman experienced a cardiac arrest just after the warm-up and collapsed in the middle of the exercise hall. The staff were grateful when I was able to assist with a defibrillator to bring back his normal rhythm, and establish IV access. He made a complete recovery after just a minute of CPR.

But one thing I really wanted to do was run again. I signed up for the Helensburgh half marathon and a few 10ks. A few weeks ago, I ran in the Cologne marathon. This was very tough but I crossed the line in around four hours. That was slower than my personal best of three hours and 24 minutes but, more importantly, I raised around £1,000 for Médecins Sans Frontières.

My experience has certainly helped me relate better to my patients, many of whom will need cardiac surgery, and it has made me much more aware of how frustrating it can be to be stuck in hospital, even though the care I received from everyone was excellent.

Today I feel much better and have a lot to look forward to. Last November, our baby Lucy arrived, and that is the best present I could ever wish for.

 

Interview by David Crookes

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