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The date of my first heart attack is not noted in my diary — nor is much else in late October 1994. It came early in the day: I had walked the dogs and had a shower and was sitting in a white towelling dressing gown sipping coffee and attempting to write, but feeling slightly out-of-sorts in a way that could be attributed to jet lag, for I had returned from Pakistan only the previous day. Out-of-sorts turned to nausea and I took to my bed; there, to nausea, a dull, constricting pain in my chest and a different pain in my left arm were added; I was alarmed enough to telephone my doctor. At just after nine he was already seeing other patients and [his surgery said he] would call back between noon and one. “I might be dead by then,” I said, “I think I’m having a heart attack.” Allowed to disturb him, his response to my symptoms was that I was indeed having a heart attack, that he would both call an ambulance and come himself, “and if the ambulance gets there first, go with it”.

Alone in the house, I thought it sensible to open the front door while I still could, but when I got out of bed my feet were dead and my legs gave way. On hands and knees I crawled to the door, opened it an inch or two and retreated to the hall, closing the glass inner doors behind me; I then lay exhausted on the floor where I could at once be seen. One thought excluded all others, even anxiety and hope; it was that no one should die while experiencing such pain, for it was of a quality that obliterated all composure and the quiet business of the commendation of the soul. Many years have passed since I abandoned the beliefs and observances of Christianity, and yet I cherish the notion of dying easily and with my wits about me, hands folded as in a medieval effigy, my dogs about me on my bed, farewells done, sins remembered and confessed, affairs in order, and the ritual comfort of prayers murmured in Latin as in the fading light my consciousness departs. [My dogs] Mop and Titian surged about me in silence until the ambulance men arrived and then put on such a show of raised hackles, growling and snarling that they would not come in. “Call off your dogs,” they shouted through the glass, but by then a stricture had developed in my throat and I could not speak. My dogs, I thought, are putting on such a brave defence not realising that they may be killing me. A passing policeman solved the problem; recognising that Mop was the leading dog, he took off his tunic and, holding it wide open, wrapped it around her head and shoulders and, pushing against her thrust, tossed her backwards down the stairs to the kitchen; when Titian meekly followed, he shut the door on them.

I remember nothing else until we reached the hospital, the then spanking new Chelsea and Westminster with its absurd collection of contemporary art. There I had the clearest vision, not of the conventional tunnels and lights of the near-death experience, but of my brain leaving its skull; it hovered just out of reach of my right hand and then slowly drifted away towards a door. “For God’s sake, bring back my brain,” I shouted — at least I think I did — and again lost consciousness.

For a long week I lay in bed attached to instruments. People brought food but left it out of reach and, eating nothing but some peas that I could just touch with my fingertips, I lost half a stone in weight. The curatrix of the hospital’s pointless paintings (sick or well, no one stops to look at them, but to decry them is politically incorrect), one of the art world’s signatories to the notorious letter demanding my dismissal from the Standard [on January 5, 1994, 35 members of the art world wrote to the newspaper demanding Sewell be dismissed for assorted offences ranging from “homophobia” to “class hypocrisy”] earned a shoddy shilling or two informing the gossip columnists. I wanted only to sleep but friends came, with the best intentions, to sap my energy. When the cardiologists decided that they needed only to open the arteries with a balloon (an angioplasty) rather than to operate — a procedure they could not offer for some weeks and for which I might wait at home — I was released. A nurse I had not seen before came with instructions not to eat red meat, chocolate or oysters, not to drink coffee, not to have sex. “What precisely do you mean by not to have sex?” “Well, you know …” she replied. “No, I don’t — sex comes in many guises. Am I allowed to masturbate?” To this she made the sort of whimper-cum-splutter that a maiden aunt might make and scuttled off puffing with affront.

I left the hospital in the clothes in which I had arrived — underpants and the white dressing gown, unshod, unshaven and with not a penny in my pocket. The first three taxi drivers would have nothing to do with me but the fourth recognised me as a writer for the Standard, took me home, saw me through the door and would not take payment. I went to bed and very warily, almost enquiringly, I masturbated. Why should this puerile and much mocked activity seem so important to a man in his sixties? I do not know: I know only that it was an indication that, in spite of the heart attack, my body was not in other aspects malfunctioning, that I was still a man and had not become a vegetable. Why is it not to be mentioned in polite society, unless by a stand-up comic whose audience will, at the mere mention of it, fall about with laughter? As a subject of serious discussion it is taboo; is this because it is far more common among adult men than we admit or suppose? As all my married friends confess to it but keep it from their supposedly disapproving wives, it is still a secret pleasure in which they must not be too absorbed for fear of the wife at the bathroom door with her, “Darling, what are you doing in there?” Wives can demand privacy without rousing suspicion, but men cannot. Is masturbation the real reason for the garden shed?

When the widening of my arteries took place it was not quite the calm and insignificant procedure promised — “You will feel nothing,” they said, “just watch the screen above you and see it all.” The Dies Irae from Verdi’s Requiem echoed through the operating theatre — not the most comforting of music in these circumstances — and I subsided into a private twilight gloom; but then I felt something deeply unpleasant and the violent shaking of surgical shock began, with nurses and my cardiologist leaning heavily on me to prevent me from falling from the table. Only when the anaesthetist deepened my twilight to unconsciousness could they continue. The heart is reached by way of an artery in the groin and the incision must clot closed when all is done; I emerged from my drowsing to find the most handsome of young doctors — head boy and captain of the first XV rolled into one — pressing hard on the small wound and shut my eyes again to prevent any reaction, not quite as successfully as I had hoped. “You’re enjoying this,” he said with a grin.

The angioplasty did not last and within a year I had another heart attack. Had a friend from Bath not been in the house to hear the thump of my collapse, I might well have died; it was eight in the morning and as the nearest ambulance was trapped in traffic, he lugged me out to his car and drove me to the hospital. I was only faintly aware of things as the doctors did what was necessary, but quite clearly heard a young man ask, “Why are we doing all this? This man is sixty-five and whatever we do he won’t have much quality of life when he recovers. Why don’t we let him go?” “Mr Sewell may be inert and not responding,” said an older voice, “but he’s not dead yet and I suspect that he can hear. What you’ve just said will not encourage him.” I saw that young doctor some months later and reminded him. Now that I am eighty I am grateful that his superior bade him continue whatever it was that he was doing to me.

The surgical response was, eventually, a quadruple bypass; at some point I was enough awake to feel frozen with cold and with an almighty effort summoned the words to ask why — or so I thought — but heard no answer and lapsed back into comfortable unconsciousness. The impression of that chill remained with me and later I asked again, “Why was I so cold?” “Because you were; you were in a bath of ice; we were lowering your temperature. Were you conscious? We thought we heard you mumble something.”

Everything hurt. My ribcage had been ripped open and stitched together with titanium wire; every muscle, tendon and ligament along the spine had been uprooted, stretched or crunched; every pulse in my skull and neck was beating loud as the drummer in Led Zeppelin, the noise intolerable, the metal structure of the very bed on which I lay seeming to reverberate in time with them. In the recovery room I would have welcomed death to end such torments, but I had things to do — such absurdly unnecessary things as seeing a painting at Sotheby’s and going to the opera. It was these that drove me to recover.

I did both. The opera was Sophia Larson’s debut in Turandot at the ENO. I had not heard her before, nor have I heard her since — a mystery, for I found her the most dramatically convincing singer in the role, her fine rich soprano perfectly suited to a production that, for the first time in my experience, made sense of an improbable and rather silly plot; her natural body language too lent it conviction. The later of my two small ambitions, and far the less stressful, I have no doubt that it contributed to my recovery; not for one moment did I sense the discomforts of the Coliseum’s seats. Discharged on the fifth day after the bypass, on the seventh I tottered on a stick into Sotheby’s to see, perhaps for the last time, Orazio Gentileschi’s Finding of Moses, to be sold on December 6, 1995, lot 61A, a masterpiece irrecoverable if bought by a foreign museum. Painted by Orazio while at the court of Charles I and hung in the Queen’s House, Greenwich, it encapsulates a sublime moment in the history of British art and patronage, and I believe its distinctly unclassical landscape to have been inspired by the Thames. I gorged on every brushstroke. As I turned away, “My God, you look ill,” said an Italian dealer I had known for thirty years, a friend of Claudio. To my “Oh, I’ve just had a heart bypass,” his response was, “That was a mistake — it was not your heart that needed to be bypassed, but your tongue.” I wished I had that sort of command of any language but could only murmur the insulting: “Vaffanculo.”

On my way home, over-confident, I stopped at the V&A on some foolish errand now forgotten and, on leaving, was stopped by a guard and accused of shop lifting my substantial and glossy catalogue of the Gentileschi sale. I refused to accompany him — “You’ve made an accusation in public. You will apologise in public. Fetch the manager of the bookshop.” This he could not do without leaving me, so took my arm. I furiously forbade him. And then the manager appeared, took one look at the catalogue and apologised. I was shaking and thought I might faint when I tottered down the steps to the street but, unsummoned, a taxi driver stopped and took me home — it was another reason to respect the intelligence and responsibility of London cabbies, and not the last. Years later, when somehow the leads of my first pacemaker broke and I had a blackout in Pimlico Road, it was again a taxi driver who picked me up, literally carrying me, and took me to the Evening Standard; the Brompton Hospital would have been a better destination, but he had assumed me to be drunk after too good a lunch.

Blackouts were frequent after the bypass, sometimes with just enough warning to find myself a tree in Kensington Gardens or a sheltering gatepost, and I learned not to stand on the kerbs of pavements or on a platform’s edge. I became a guinea pig for Dr Richard Sutton’s tilt-table, an instrument of torture to which one was tied prone and then, deeply relaxed, tilted into the vertical to induce a faint, the nauseating consequence of a drop in blood pressure. There were, too, all the usual effects of swollen ankles, fingers drained of blood and other circulatory problems, and there were days when my blood pressure was so low that I dared not leave the safety of the house. The bypass quite certainly saved my life, but it also changed it — I could no longer ski or play tennis, the regular annual breaks in the pattern of my life, never again could I scramble about in mountains or walk twenty miles every day for a week, and I found myself breathless — with anxiety, I suppose — when driving even short distances, yet I had been a driver who enjoyed the skill, planning and endurance involved in covering eight hundred miles in a long day. My life changed radically from irregularly active to regularly so sedentary that even walking the dogs any serious distance was out of the question. The point was rammed home to me when, on a trip to Venice with friends from the V&A, we went to Possagno to see Canova’s museum and I could not walk up the long slow slope to the great church above the village, but sat at the bottom and miserably watched my companions meander into the unattainable distance half a kilometre away.

For a while I became something of a zealot about matters of the heart. We should all, I preached, know enough to recognise the warning signs, foolishly believing that had this been my case I might not have had the attacks nor needed the disabling surgery — for that is what it was, disabling. Now I am not so sure that I would have believed the preliminary messages from my body, nor am I sure that I would have acted on them — one must have the heart attack to know how much it hurts.

A slow change I would have borne more easily and without the anger and resentment. I had always been reliably fit, my stamina exceptional, but the sudden removal of my toys, as it were, occasioned nagging rancour that I could no longer do what I had done so easily. At the same time, to others I became more indulgent and less critical, not towards the art and artists of my work, but to the failings of more ordinary people, and I no longer particularly cared if things went wrong. I became, I think, an oddly softer, kinder and more generous-minded man after the heart attacks — except where television is concerned.

The second volume of Brian Sewell’s autobiography, Outsider II, will be published by Quartet Books on November 1, price £25