United Kingdom

I'm convinced those poison pen letters triggered my heart attack

The symptoms crept up on me. I’d had chest pain for a week — when I lifted heavy pots or sacks of soil from the garden centre or climbed the stairs to the children’s rooms.

Ironically perhaps, given our hypersensitivity to such things right now, it felt like a bronchial infection — a sharp pain in the centre of my chest that I felt only when I exerted myself.

But otherwise I felt fine. I was 52, and at the peak of my career: I’m the author of five bestselling biographies, with a new novel about Marlene Dietrich and the Golden Age of Hollywood.

Even when my husband begged me to see a doctor, I ignored him, telling myself the chest pain was due to a lingering infection after a bout of flu. I was too busy, too stubborn, too convinced of my own invincibility.

Author Paula Byrne (pictured) who experienced a heart attack earlier this year, revealed how stress contributed to her condition

Surely I was the least likely candidate for a heart attack? Anyway, this was March 2020, Covid-19 was starting to cast a shadow over hospitals — was I ill enough even to risk a visit?

My family had recently moved from England to Phoenix, Arizona; a place full of promise and wide, open skies. Life was good here. I’d had a rough time at stuffy Oxford, where my husband, Shakespeare scholar Sir Jonathan Bate, was head of one of the colleges.

In the eight years we lived in college, several dons never introduced themselves, or even acknowledged my, or my children’s, existence.

Was it because I was a working-class girl from Birkenhead, lacking the requisite posh accent? Or because they simply did not know how to deal with a mother of three young children tearing around the hallowed grounds?

I was frowned upon for placing photographs of my children in the drawing room of our tied accommodation. In other words, keep to the upstairs rooms and don’t make this your home. But it was my home and the students loved seeing the little ones. I felt proud when the president of the Junior Common Room made the children honorary members.

Early on, I was shocked when a representative of the dons came to the door to make a complaint. At a formal meal in the college hall (think Hogwarts) someone had had the temerity to turn up at high table (reserved for senior fellows and their guests) wearing a Liverpool PhD gown. That someone was me!

I am proud of my doctorate from that great university, and wore my gown into hall out of respect, but, sadly, I was asked to remove it. I was not one of them, that was for sure.

Paula began receiving hate mail mocking her accent, clothes and body-shaming after her husband Jonathan Bate (pictured) was knighted 

Then my husband was knighted and the hate mail began, mocking my Scouse accent and my clothes — I dressed like a Wag apparently — body-shaming me for allegedly being overweight (I wasn’t), and berating me for writing popular history books for a wide-ranging audience instead of an academic elite.

The poison pen letters, I began to realise, were symptomatic of a deep-rooted misogyny and malice that characterised a faction of embittered Oxford dons.

Eventually I informed the police and the story hit the national news.

The college porters had my back and did everything they could to protect me, but those with real power did nothing. Why should they? I did not exist.

Kindness and good manners were to be found among the staff, especially the gardeners. The students and alumni were a constant delight — they were, and still remain my friends. They had no idea about the behaviour of the group a kindly senior don called The Awkward Squad.

I had no idea the toll it had taken on my body 

So when my husband got the offer of a dream job in America, I urged him to accept. He hesitated, but a wise friend told him: ‘Happy wife, happy life.’

So off we went to the Arizona sunshine. I thought it was all behind me. But I had no idea of the toll it had been taking on my body, the stress that had been tightening the arteries around my heart. It took a week of chest pains for me to decide to get it checked out.

Paula was advised to go to ER after a series of tests for her chest pains. Pictured: the Mail, March 2018

At the local drop-in clinic, a young nurse took my blood pressure and found it hard to get a reading. Her brow wrinkled as she finally saw the sky-high numbers.

‘I think you need to go to Urgent Care,’ she said. ‘Can you go now, please?’

Urgent Care was closed because of coronavirus, so I found another clinic and wandered in. It was eerily empty. I explained my symptoms to the young woman at the desk. When the doctor came over, he took a quick look at me and asked why the first doctor didn’t just send me away with antibiotics for a chest infection.

The receptionist persisted. ‘She has chest pains. Why not give her an ECG test?’ They gave me two readings, just in case, and when the doctor returned with the results, he looked sombre. Something was showing up.

Why not pop along to ER? They could take a blood test, and then they would know more.

‘I’m not having a heart attack?’ I joked. He smiled and said that if he was really worried he would be sending me in an ambulance. I paid my bill — this is America, after all — and drove to ER, where I got lost and wandered around endless corridors.

By now, the chest pains were worsening, but I was still in denial. Women in their early 50s, with no family history of heart disease, do not have heart attacks, I told myself.

Paula (pictured) said the presence of covid-19 could be felt throughout the hospital and the nurses wore face masks

Eventually, I was sent to a ward where, after several hours, I met the brilliant doctor who would save my life. Dr Lui looked about 12 years old. He shook my hand and told me he liked my English accent. He was a Wimbledon fan.

Then it was down to business. He would run some tests, but he wasn’t worried. I was young and healthy. I’d need to stay in overnight, but nothing should keep me awake.

Yet during the night the atmosphere changed; it was hard to pin down, but I could feel it in my bones. Covid-19 was making its presence felt in every part of the hospital. I could hear whispers, soft footsteps in the corridors.

When my blood was taken in the night, the nurse was wearing a face mask. There was a weird kind of energy on the ward.

Even while sedated, I talked about Oxford 

Despite Dr Lui’s reassurance, sleep was impossible.

The next morning was full of tests. I was prodded, pricked and poked until I was full of bruises. It was all looking good.

My heart and lungs were strong, and my blood pressure had come down with a cocktail of drugs. My husband had come with me, but when I came back from a CT scan, I found a note from him saying he’d been told to leave.

A new rule banned all visitors. The nurses kept telling me I’d be safer at home.

And yet Dr Lui wanted to give me one last test — a stress test. He gave me a choice. I could go home, where it was safer, and then do the extra test as an outpatient. But he didn’t advise it.

Paula was pumped with adrenaline to mimic the effects of a treadmill for a stress test  (file image)

Things were changing by the minute, and he wasn’t sure they’d even let me back in again. Or I could stay one more night and do the test in the morning.

I desperately missed my husband and children. I did not want to stay in hospital. But I trusted Dr Lui. I looked him in the eye, and said I would do whatever he wanted.

‘Then stay’, he said.

Under normal circumstances the stress test would involve me running fast on a treadmill.

My blood pressure would be taken, and then they would do a scan of my arteries to see if they were in good order.

But in these frightening new times, it wasn’t safe to leave my room. They would conduct the stress test from my bed, pumping me with adrenaline to mimic the effect of the treadmill.

It was a grim and distressing experience, though mercifully short-lived. As my heart rate rose, a weird fuzzy sensation flooded through my whole body. It created a terrifying feeling of losing all control.

The heart nurse stayed by my side, exuding comfort and confidence. She praised me for listening to my body: ‘Most women just carry on when they’re in pain.’

Paula (pictured) was taken straight to surgery after tests revealed that she had a blockage and needed to two platinum stents to unblock her arteries

She also said something that has stayed with me — that women present differently to men, and sometimes show false positives. This means that women often score well on tests, even though they are having a heart attack. It’s a reason why heart disease in women often goes undetected, often with fatal results.

She said, for 20 years, she had been nagging cardiologists to keep checking female patients with signs of heart attack, as it was not just overweight men who had heart attacks. She was a goddess.

So I guess I wasn’t surprised when Dr Lui returned with the bad news. There was a blockage, and he was taking me straight to surgery to insert two platinum stents to unblock the arteries. I would need to be awake throughout, but would be sedated.

I felt very alone with no family allowed in the ward. No one’s hand to hold as I was wheeled away. No one there, with relieved eyes, when it was all over.

Women need to know stress is an invisible killer 

Dr Lui knew what I was feeling and he took my hand: ‘I am your family now. You are not alone. We are in this together and I’m not letting you leave your three children motherless.’

After the operation, he was calm, thorough. He told me I was one of the lucky ones as the heart attack had been discovered before it did lasting damage. But I would need a cocktail of drugs and would have to take serious measures to reduce stress. Not easy in a pandemic.

He told me my arteries were ‘gripping’ with tension, a direct result of stress. When I was sedated, he said, I had talked about the stress of living in Oxford. It was as if the sedation was allowing me to release the tension I had been holding in all those years. Allowing me to tell my story.

It began to sink in that stress had brought me to the point of near-death. How could a healthy woman have suffered a stress-induced heart attack?

Paula (pictured) who has made new friends in the United States, said those who supped at their table in Oxford have not sent a word

My family and I decided to move to America for our second act. To find new adventures, to enjoy the sunshine and to meet positive, like-minded people.

The friends I have made here are unparalleled. My all-female book group has been life-saving. I am surrounded by love and affection. I am lucky.

But I was a fool, too. I ignored my chest pains, kept working and lifting. I thought fit and healthy women were immune to the damage from stress. Now I know it is vital to take steps to combat this silent, invisible killer.

On the surface, midlife women are good at dealing with our many caring roles and the difficult times we all face in life — we are copers — but often it comes at a cost to our health. It’s vital that in our efforts to keep the show on the road for everyone around us, we don’t ignore any physical symptoms of stress.

I have learned who my true friends are, too; many of those colleagues who supped at our table in Oxford have not sent a word. Their silence is deafening.

My friends made on Twitter have been kinder. But my real friends are golden.

The last person I spoke to on the phone as I was wheeled down to surgery was a doctor friend from back home. Someone once described him as ‘the goodest man in the world’.

That is also the phrase I would use for Dr Lui. Later, I lavished him with presents. He bowed and thanked me.

The best one, he said with a gentle smile, is the thank-you letter from your children.

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