Leave me with a scar

I'm tired of waiting for this operation.  I just want it to be done and to get on with the process of recuperating, so I can do all the things I want to do with the rest of my life.

But there is the issue of the scar.  Right now, I don't have one.  But in a week's time I will have a big red vertical gash in my chest.

Until now, I've felt quite philosophical about this.  For one thing, I'm grateful that there are people who are willing to do this work.  When I was a young Law student, I was offered an opportunity to witness an autopsy.  I took up this offer, because it was a unique life (or death) experience.  It was quite confronting.  So I've heard what it sounds like to cut through the sternum.  I'm glad I don't have to do this for a living, or be involved in the process.  All I have to do is lie there.  I'm glad that there are courageous people who can fix me.

Intellectually, I've accepted that this scar will be very visible, and will form a part of me for the rest of my life.

But I'm not sure how I'll feel when I see it and when the realization kicks in.

I try not to be vain and superficial.  But I recall that a few years ago I noticed a sun-spot on my chest and decided it was ruining the appearance of my decolletage.  I went and had it removed, and after that I felt much more attractive in my evening gowns.

But this scar will remain.

What do you do to conceal a huge cut in your chest?  I'm not very keen on high necklines.   I've got a wardrobe full of low-cut dresses and tops.  I'm not going to throw them out.  I've got lots of scarves, but it seems a bit coy to always have one strategically draped.  I'm thinking of getting some large, "bib-style" beaded necklaces to distract the eye from the wound, so it won't be quite so confronting for people to look at.

But ultimately, I'm not planning to cover it up.  I like wearing low necklines, and I intend to keep wearing them.

My surgeon tells me that the scar will fade, especially if I cover it with tape this summer when I'm out in the sun - while it's healing the scar can absorb pigment in the sunlight.  He is advising me not to "tan" my scar.

He tells me that he will keep it as small as possible, and that some film stars have had this operation and you can hardly see the evidence.

Which ones?  Are they aged under 80?

So here's hoping.  But it could present quite a challenge to my self-image.

Time Off

I've never had much time off.

When I finished school, the "Gap Year" did not exist.  You were encouraged to go straight into University in order to maintain momentum.  The thinking was that if you took time off, you would never feel like going back to study.  I finished school at 17, went straight to University and at the age of 22 was unleashed upon the public as a fully-fledged lawyer, albeit a terrified newbie.

I worked during most school and Uni holidays, although during one vacation I spent a wonderful three months travelling around Europe on my own.

When I had my children, I took 3 months' maternity leave with each of them, then returned to work part-time.  This time off was not exactly a holiday.  Sleep deprivation, feeding, changing of nappies, washing clothes, cleaning the floor; repeat as required.  Much as I loved my babies, my brain yearned for stimulation, yet even reading the newspaper was a challenge.  Going back to work felt like a holiday.

I'm going to be off work for at least two months.  For the first month I won't be able to drive, or do anything very much.  This is not exactly going to be a holiday, but at least I don't have to look after anyone.  I can do whatever I feel like doing, when I feel like doing it.

I'm very bad at doing nothing, but I want to get well and avoid any unnecessary setbacks.  I'll have to think of some sedentary things to do.  How can I fill in this time?

Things to do during two months' recuperation:

• Watch Series 4 & 5 of Mad Men (and is there also a 6 & a 7???)
• Paint my toenails
• Sort my jewellery and put it into the organizer box I bought two months ago
• Finally bring out all my winter clothing before Winter is over.
• Back up all of my music CD's onto I-Tunes
• Edit the video of my cabaret show "Adventures with a Brazilian"
• Pitch the show to the Butterfly Club in Melbourne
• Make a showreel to help me get some voiceover work
• Do the breathing exercises that my singing teacher gave me
• Read all back-issues of Harvard Business Review
• Write the e-book I've been fiddling about with
• Read "War and Peace"
• Listen to the 12 x 2-CD set of "Remembrance of Things Past" by Proust
• Learn Portuguese
• Learn the Portuguese lyrics for my Brazilian songs
• Get my piano tuned
• Teach myself to play piano and/or guitar.

Maybe this list looks ridiculously ambitious (or just ridiculous), but I believe in the value of lists.  I reckon that if you make a long list you are likely to get at least some of it done.  Writing a list makes you expand the range of possibilities.  And ticking each item off the list gives you a sense of satisfaction and progress.

Never Say Never Again

It's time to attend to practicalities.  It seems pessimistic, but I have to face up to reality.  I've been given my "odds".  

I already have a valid Will.

Now I decide to put in place Powers of Attorney and Enduring Guardianship, in case anything happens to me while I'm having the operation.  These will enable Bill to act on my behalf if I am unable to handle my own affairs.  

It's a good idea for everyone have these documents, and without such a catalyst we would probably never get around to it.  Both of us should have these documents, and they can remain in place for whenever they may be needed in the future.  I ask a local solicitor to prepare the documents in draft and I give these to my husband to look at.  

One of the documents provides an opportunity to give "special directions" as to how the power is to be exercised.  The example given is "I would like to live near my sister".  Playfully, I say "Can I specify that you won't instal a girlfriend here, while I am still around?"  He laughs, and says "OK, and to what extent do you want to be kept alive?"  This is too close to the bone.  We'd decided not to have a Medical Power of Attorney - that's the one that that allows the Attorney to decide when to switch off life support.  

Suddenly I feel wobbly.

And then I read an article in the newspaper about Warfarin, the blood-thinning medication which I'll have to take for life, if my heart valve needs to be replaced with a metal one.  The medication is required to prevent clotting; blood tends to stick to the metal.  This article mentions that people who take Warfarin cannot eat leafy vegetables such as spinach.

Or drink alcohol.

Really?  Never?

That would not be OK, although of course, it would have to be.  I suppose it would be better than the alternative.   Both my children say that they do not need alcohol to have a good time.  Nor do I, really.  But I like it.  And I regard it as a privilege of adulthood which I would not like to have taken away from me.

How would I feel if I could never again enjoy a lovely glass of wine while watching a cabaret show at La Boheme?  If I could never try their gorgeous cocktails again?

Of course, I should not believe everything I read in the papers.  Later I hear a different version - that if you're taking Warfarin you can drink alcohol, but you have to drink the same amount every day.

So alcohol-free days could be a thing of the past?

I'm sure it's more complicated than that.

I don't like complicated - I like freedom of choice.

That night I drink quite a lot.  After all, I might never be allowed to drink again.

The Golden Jubilee

Suddenly it is easy to communicate the severity of my condition.  "Open heart surgery" is a dramatic term that leaves no room for doubt.  "Heart valve replacement", on the other hand, suggests some sort of minor, key-hole procedure.  You might even think that maybe a big needle could do the job.

No, they need to open me right up.

I'm not taking the statistical risks too seriously, but occasionally in darker moments I reflect that the risks that I've been told about must be real, and these next two weeks could actually be my last.  It feels surreal.

Then it hits me.  Even if you're not having an operation, you never know if it's your last two weeks.  In fact, every day when you get up, it could be your last day.  You just don't know.  Of course, you can't dwell on this; all you can do is try to make the most of each day.

Mark Twain said "I have known a great many troubles, but most of them never happened." 

I can either spend the next two weeks paralyzed by anxiety, or I can try to enjoy those days.  

When I turned 49, I realized that I was entering my 50th year.  I recalled the Queen of England having a "Golden Jubilee Year" celebration to mark her 50th year on the throne.  I decided that the coming year would be my own Golden Jubilee.

The idea of my Golden Jubilee Year was that I would strive to enjoy each day.  Every day I would wake up and resolve to enjoy it, taking the view that it's my day, and no one can spoil it.

Over the course of that year I established a habit of enjoying my day, and made the effort to carry that attitude with me into subsequent years.  I would seek out enjoyment; not wait for it to find me.  When you make the effort, you can find enjoyment in whatever you are doing, or choose to do something you enjoy.

Now I draw upon this philosophy to look for something nice in each day.  Even the medical appointments and tests have their good points.  Some of the staff are nice to talk to, and each time I complete a step, I can tick that one off the list, and it brings me closer to being healthy again.

I feel like a silly Pollyanna, but the alternative is to hate each day as it comes.

It feels weird to be so close to the edge, but not scared of falling.

It's my mitral valve that needs to be repaired or replaced

Ain't it awful!

During the two and a half weeks while I am waiting to have my operation I begin to spread the news about my surgery.

Reactions range from "You poor thing!" through "You'll be fine" to "Could be worse".

My revelation also draws forth a slew of competing claims of disaster and doom.  People tell me about past medical adventures, current ailments, and other bad things happening in their lives.  I'm not sure if the purpose of this is to express sympathy or to win attention.  I do my best to listen and express interest, because I do realize I'm not the only person ever to face a life-threatening condition.  I do understand that a conversation needs to be balanced between the parties.

Everyone seems to be dealing with some sort of unwelcome event in their lives.

After the cathartic effect of the first few discussions, I start to find these conversations a bit draining, and try to change the subject as soon as reasonably possible.

I could keep quiet about it, but that doesn't feel right.

When someone asks "How are you?" you are not supposed to take the question literally.  But I feel the need to let people know what is happening.   I won't be around for a while, and I don't want anyone thinking that I have the unmentionable "something worse".  I don't want people to gossip about what might possibly be wrong with me. Also, I don't want anyone feeling excluded and thinking that I was secretive and withheld information from them.  It would be very insincere to say "Really well, thanks", when I'm not well at all.  I want to be open and honest about it.  But I am very much aware that there is a limit to this topic as an interesting subject of conversation.

Repair or replace?

I settle into my chair, prepared for a long wait to see my surgeon.

But he is right on time.  He bounds into the Reception area and greets me enthusiastically.  Instantly I warm to him.

He explains the problem with the mitral heart valve, using pictures to illustrate.  He hands me a sample of an artificial valve replacement - it's a metal ring about the size of a ten-cent piece.

I say that I am resigned to having the valve replaced.  I have been receiving very strong messages that the valve is a mess and probably beyond repair.

He jumps in:  "But I believe it can be repaired.  In fact, I'm 90% sure."

He goes on to say that if he gets in there and it can't be saved, he will have to replace it, but at my age it would be better not to have to take blood-thinning medication.

I had never thought much about this.  I'd heard about this medication and had regarded it as part of the deal (oh, well, I'll have to take tablets).  I knew that I'd have to test my blood regularly.  Again, I thought this would be OK.  Diabetics have to do it.  I would cope, too.

But now my surgeon explains that this medication would compromise my health.  If I get a paper-cut, it could be hard to stop the bleeding.

Really?

I will have to consent to a replacement in the event that the he can't repair the valve.  He assures me he won't do bad surgery; he will ensure that this operation will have good, long-term results.

He praises my arteries - "pristine", he calls them.  Apart from the valve problem, I'm healthy.

He tells me what to expect.  It will be a two-hour operation.  I'll spend at least a week in hospital, and for the next week at home I must not be left alone.  I won't be allowed to drive for a month.  However, by the time I leave hospital I will not be in a lot of pain.

He will cut through my sternum.  Surgeons sometimes go in through the side of the chest and between the ribs ("minimally invasive"), but in his experience this can cause greater ongoing pain and also lung problems.  I certainly don't want that.

So, I'm having open-heart surgery.  Right.

I mention that I'm concerned about the scar, though I'm aware that this is a pointless thing to say.

He says "Wear it with pride".

He looks me straight in the eye as he informs me of the risks; a 1-2% risk of death, stroke or heart-attack.  This scarcely seems relevant; I don't have any choice but to have this operation.

I sign the consent form, and my fate is sealed.

Testing, testing...

The evening before the hospital tests, I feel a bit apprehensive.  A vision of myself as a sick person looms in my imagination.  I don't want to think of myself as an invalid.  I decide to do some singing practice.  The swelling in my heart has tightened my breathing, and I've had a bit of a cough, which my doctor thinks is connected with my heart condition.  But it seems to have improved a bit with the medication.  I start on some vocal exercises and find that when I make a big effort I can breathe deeply and my voice comes out quite well.  It makes me feel powerful and in control, whereas in hospital you have no choices and are subject to the control of others.

Next morning, my daughter takes me to the hospital at the crack of dawn.  I'm not allowed to eat anything or even have a drink of water.  I am escorted to the day clinic.  A nurse, Anna, bounces over and inquires "Hello, are you a patient?"  She sets me up in a bed and she and her colleagues Adrian and Marty attend to all the preliminaries.

They call the first test a TOE (trans-oesophageal echocardiogram).   The doctor sprays an evil-tasting anaesthetic into the back of my throat.  Then they bundle me over onto my left side and help me to swallow a mobile-phone charger (at least, that's what it feels like).

The second test is a coronary angiogram.  A tube is inserted into the artery in my groin and snakes its way to my heart, where it releases its cargo of dye to illustrate the interesting bits.  An action-replay of the video reveals that my arteries are clean and healthy, with no narrowing.  There is a lot of "back-wash" of blood through the valve, but there is a chance that it might be repaired rather than replaced.  This would mean I would not need to take Warfarin (blood thinning medication) for the rest of my life.

I can see the surgeon tomorrow.  He will advise me of my likely fate.

Back in the recovery room, I eat a pumpkin scone with strawberry jam and a ham salad sandwich (in that order).  I phone my mother and let her know the good news from the tests.  I ask the doctor if it would be OK to sing in the meantime.  He says "If you can breathe, yes, go right ahead."  I text my singing teacher "Put me on the program for next week's concert, pls!"

My son collects me from hospital and for the rest of the afternoon I watch videos, including Diana Krall in Rio.  Bill phones to say he has spoken to the cardiologist.  He sounds much happier now that he has first-hand information.

One way or another I will be fixed.

Video from the concert

Time for some R & R

Still days to go before I have the hospital tests.  The palpitations are impossible to ignore.  Over the weekend, I rest quite a bit, and I'm surprised how good it feels simply to give in and relax.

I visit my mother and tell her the news about my heart operation.  I try to play down the issue and make it sound like a routine procedure.  The main point is that I will be out of action for a while and won't be able to do the things I normally do for her.  But she is not silly; she knows it's serious.  

On the way home, I notice a big CD sale and go in and buy a few discs.  I'll have plenty of time to listen to new music.

On the Saturday night we go to a party.  After standing up for two hours I've had enough.  I can feel my heart labouring.  I give my husband a shove and we make our excuses to leave.

I'm allowed to do my yoga, so I go to my regular Sunday class and take the easier options, avoiding any exercises that are likely to raise my heart rate.  I enjoy moving to the music, the stretching and flexibility exercises and the guided meditation at the end.

In the afternoon, I go to a musical event called "Floating Melodies" on an iconic little river boat called Popeye.  I invite my friend Deb.  In the past year she has had surgery to remove a brain tumour.  I watched Deb remain positive, brave and strong throughout her ordeal.  I tell her about my heart problem.  It's very helpful to talk with someone else who has faced a life-threatening condition.  We have a philosophical discussion about how good it is to be alive.  

This show is organized by pianist Emma, and some other friends are there, too.  It's relaxing and enjoyable to be serenaded while we cruise up and down the river, enjoying a glass of wine and a cheese platter.

Dark chocolate is good for the heart

By Friday I'm in limbo.  I'm having the tests on Tuesday, so I have four days to wait.

There's no point trying to drum up business, as I'll soon be having the operation.  I will just finish off what I'm doing at the moment.  I page through my diary and make a list of the commitments that I'll probably have to cancel.

I break the news to the people in my office - Justin, Craig, Greg and Reg.  They are shocked, but offer me positive encouragement.  It's July, and I crack open and share the giant Easter egg that is still on my desk.  We joke that dark chocolate is good for the heart.

The pounding in my chest has become a constant companion.  But the medication starts to calm it a little, and from time to time it goes away.  Bizarrely, I miss it when it's not there.

My husband is in denial.  He wanders around the house, shaking his head, sighing and asking "Why?"

We can't think of anyone we know who has had a mitral heart valve operation.  Then he recalls that our friend Christine had this problem.  Shortly after giving birth to her second child, she collapsed and had to have emergency surgery.  The baby was 13 days old.  That would have been much more alarming.  And after her surgery, she had to go home and take care of a baby and a toddler.  Nearly twenty years later, Christine, a doctor, is fit and healthy.  She's works out at the gym several days per week.

It's reassuring to know this.

Although the doctor has told me that I can continue my daily walking, I find I don't really want to.

By Friday night I'm feeling quite tired.  I sit down and watch television - something I don't spend a lot of time doing.

Might as well get in practice.

Aim Beyond the Goal

At lunch time on Thursday I slip away from the office, to keep my rendezvous with the sad-faced cardiologist.

He tells me my condition is serious.  The valve is badly damaged: "There is quite a lot of leakage".  The mitral valve, which regulates the flow of blood (between the left atrium and the left ventricle) in one direction, is allowing blood to wash backwards, causing the heart to swell.  Pressure is building up.  He shows me the movie of my mutant heart.  I can clearly see a ragged flap, flailing ineffectually.

I accept that I'll need surgery.  I don't feel right at all.  He asks "When would you like to have this operation?" I tell him "As soon as possible, please".  He prescribes some medication to ease my symptoms.

He quizzes me about my general health (Exercise? Coffee?  Tea?  Smoking?  Alcohol?), my occupation and my leisure activities.  I tell him about the singing.

I'll have to go for some diagnostic tests, so they can decide whether to repair or replace my faulty heart valve.  I have to be at the hospital at 6.45 am, having fasted and and having nothing to drink, not even water.  I might be sedated for these tests, and someone will need to drive me home.

And I might need to go for these tests on two different days, which would be a nuisance, and would mean two days of fasting.  I can't do anything about it.  But as I wait at the Reception desk for my hospital forms, he suddenly materializes at my side, and says "We can do both tests on Tuesday morning".  He casts a small smile in my direction.

Leaving the clinic, I visit my hairdresser, whose salon coincidentally is right next door.  I tell Alex the news and ask if he can fit me in earlier than my next appointment, which is two or three weeks away.  A bad hair day would make things much worse.  Alex is astounded at the news and gives me a hug.  He fits me in for the following week.

Then I go to the local shopping mall and purchase a new cabin bag for the trip to Boston I'm planning for a few months' time.  It is a hard-shell four-wheel case, turquoise in colour.  Di, the proprietor, pays full attention to me, helping me select, and wishing me all the best for the surgery.  It's amazing what a difference a bit of caring service can make.

I picture myself after the operation, relaxing on the couch, watching DVDs, reading books and looking at my new cabin bag, planing my trip.  What I'm doing is "aiming beyond the goal".  This is a concept I learned some years ago, at a meeting of the National Speakers Association.  The speaker, Rowland, called for volunteers, to learn how to break a wooden board with their bare hands.  I stepped up to the front, and Rowland coached me in the action required to break the board.  He then held out the board, and told me "Aim at my chest, not at the board - aim through the goal".  I was a bit worried about aiming for his chest - what if I punched him out?  But I followed his instructions, and a moment later he was holding up two pieces of board.  I assumed it had been pre-split, but no, I was the one who had broken it.  I kept the two pieces of wood and had them framed as a reminder of what I'm capable of.

The lesson for me was this: when you have a difficult or unpleasant task coming up, don't focus on it.  Focus instead on what will happen after you've done it, the benefits that will flow, and how great you will feel.  Thinking this way helps me avoid the fear that might come from dwelling on the operation I need to have.

That evening, I go to La Boheme to see the "New Voices" showcase presented by Matthew Robinson. Sixteen singers perform his songs after a two-day workshop.  I know several of the singers, and it turns out I know some of the songs too.  I didn't know of Matthew Robinson before, but it turns out he is a wonderfully talented songwriter and a flamboyant performer.  I settle down in the darkness, right in front of the stage, sipping on a glass of lovely white wine.  I feel happy in the crowded room, listening to the music and contemplating what I'll do when I'm well again.  I don't tell anyone there about my affliction - I just want to escape for an hour.

I find myself thinking - when I'm fixed, the gloves are coming off.  I will not hold back.  I'm really going to go for it.

Minimally invasive, please!

Visiting doctors is becoming a full-time job.

It's Tuesday and I'm at the local doctor again.  A medical student observes the consultation.  He eagerly listens to my heart through a stethoscope and asks me how this heart problem first came to my attention.

The doctor briefly explains the anatomy surrounding my lacking leaflet.  He says he was wrong about the aortic murmur.  It's the mitral heart valve that is damaged.  He says I might need a heart valve replacement.  He refers me to a web site where I can watch a video.  I tell him I don't want to watch it.

Tentatively I ask: what sort of operation is it, what sort of scar do I end up with and how long will I be out of action?  He tells me we have good surgeons here and it's not necessarily open heart surgery.  Some cardiologists will do it themselves.  The cardiologist will advise me whether my condition should be monitored or operated.

From the Mayo Clinic web site:

"Heart surgeons perform many heart valve surgeries with minimally invasive heart surgery, including video thoracoscopic and robot-assisted surgery. Minimally invasive surgery involves the use of smaller incisions, and you may have less pain and a shorter recovery period after minimally invasive surgery. Mitral valve repair is one of the most common minimally invasive heart surgeries performed at Mayo Clinic."

Minimally invasive surgery sounds good.  I'll have that.  I'm seeing the cardiologist in two days.

I worry about not earning any fees for a few weeks.  I'll have to pay my rent and other expenses in order to keep my office open.  Then I remember that I have income protection insurance.  When business dived during the global financial crisis, I'd thought about cancelling it, because the premiums are quite high.  But I was too lazy to contact the insurance agent.  I've paid these premiums for 25 years and never made a claim.  It has a four-week waiting period.  Could I be out of action longer than that?

Because I've recently returned from holidays, I don't have a lot of work commitments in the next couple of months.  I start to realize that I will need to stop for a while.  In fact, there's probably no point firing up new projects.  I should just finish off what I'm doing.

To be honest, I don't feel right.  I'm distracted by my own heartbeat.  Bring on the hospital.  Hopefully the problem will get fixed and I can get on with life, instead of dragging a chronic condition around with me.

On the Wednesday night, I go to my singing lesson.  I tell my teacher the dramatic news.  After he gets over the initial shock, Rohan says "Imagine how much better you'll feel".  He continues, "You seem quite fit and healthy now.  Imagine how much more energy you'll have when your heart is working properly again."

I'll drink to that.

Where to from here?

On Saturday morning, I go and have the blood tests that have been ordered for me.

Then on Monday, I'm at the heart clinic.  I fill out the form for new patients and sit down amongst some elderly folk, until a nurse calls: "Allison?"  I know this is me, because my first name  is Allissande.  Being known by my second name has the bane of my life.  I must always be careful to ensure that airline bookings are made in my full name (matching my photo ID), or they will not let me on the plane.

So I have learned to answer to "Allison".

I explain that my name is Shelley.  I circled it on the form.  The nurse apologizes awkwardly.

"Have you had a good day?"
"It has been fine - just a standard sort of day".  I seriously hope that you are not going to ruin it for me.

At her instruction, I put on a medical gown that doesn't cover much, as it is open at the front.  For the ultrasound, I lie down on the bed on my left side.  She applies pieces of duct tape to my chest and spreads gooey gel onto my skin.

"My heart is really pounding."
"Oh, is it?"  She sounds surprised.
"I feel a little anxious".
"Have you had this test before?"
No.  No, I have not.  I am worried about the test.  

I close my eyes and try to relax.  I use long slow breaths to slow my heart rate.  She asks me repeatedly to breathe in and hold my breath, while she takes photos of whatever monstrosity lies beneath my left breast.  From time to time the amplified sound of my pulsating heart reverberates around the examination room, like theatrical sound-effects.

This process takes a long time.  The nurse leaves the room and returns with a trolley bearing an ECG machine.  She asks me to lie on my back.

"Are you feeling better now?"
"Yes, I have calmed down a bit".
"Oh, have you been racing around today?'
No, I have not.  I have been sitting in my office trying to do my work, whilst simultaneously wondering what is wrong with me.  I am anxious about the test.

She does not seem to understand this at all.

"Was it a routine examination that brought you here?"
"No.  My heart was racing".  As my doctor wrote on the referral form, "Palpitations".

"Have you had this test before?"
"No, I haven't had any of it before".  Grrrr.  I don't even know what I'm doing here.  Do I look like a heart patient?  Or do people of my age normally have these tests for their own amusement?

She wheels the contraption out of the room, saying "Get dressed and wait in Reception, and I will ask the doctor if you are allowed to go".  Or if I have a serious heart condition.

Last week I was on holidays in Russia, walking for miles and climbing steps.  I never felt breathless.  What is wrong with me?

Again, I wait, and after a while a cardiologist calls me in.  So, I am not allowed to go home.

He says, reproachfully "There is a lot of leakage from one of your heart valves.  One of the leaflets seems to have become detached."

Which means what, exactly?  What have I done to cause this?  How many of these leaflets are there?  Does a detached one matter very much?  Do they re-grow?  What are you really telling me?

He tells me to visit my local doctor tomorrow, and I must come back and see him again on Thursday, "to discuss where to, from here."

Where do people with leaky heart valves go to, exactly?

In an effort to participate in the conversation, I punctuate his monologue with contributions like "That is quite concerning"; "Sounds a bit scary".

I am trying to communicate my anxiety.

He offers me no words of reassurance; gazes at me impassively, his face inscrutable.

When I get home, my husband is already there.  I walk through the door and I drop the bombshell.  If I keep quiet about it I'm not sure how I'll broach the subject later.  He's a doctor.

"What do they do for leaky heart valves?"
"You can have a valve replacement".
"How are valves replaced?"
"It's a major operation.  They have to crack your chest open."

But such operations are rare, he adds.  This is both good and bad.  If they are rare, maybe I won't need one.  But if I'm going to have an operation, I'd prefer it to be one that is performed frequently.

Please, I really would prefer not to undergo open heart surgery in the near future.  Or at all.

I don't want to be stopped from doing what I want to do.

I don't want a big scar down my front.  I want to wear nice dresses that show cleavage.

Also, I have a vague recollection of someone who had some sort of heart operation, and after that he couldn't sing any more.  I don't want that.

But I don't want to suddenly drop dead, or become incapacitated.

I want to sing, and I want to do it in Rio.

My doctor and I are going to talk about "where to from here".  I will get answers to my questions.

I want to hear answers that I like.

That evening, I have to go and give a presentation at a public speaking course for my Toastmasters Club.  I arrive a bit late, but then I settle in and deliver what I've promised to do.

By the time I get home, I'm thinking more rationally.  They won't operate on a whim.  Either I'll get the problem fixed, or I'll manage my condition until I need an operation.  Nothing else has changed since this morning.  I go out for a walk and gulp in the fresh, cold, night air.

A successful season

What shall I wear?  On stage I usually wear sparkles, but I can't wear a long dress, because I have to put on pyjamas during my show.  I don't want to wear a short dress, because I want to feel very confident about my appearance.

Pianist Emma thinks I should go for a sophisticated look.  I decide to wear the black dress I'm wearing in the advertisement.

Emma says "It would be so cool if you had a parrot" (on the flyer a macaw has been photoshopped onto my shoulder).  It sounds too hard, but I start looking around in shops, somewhat half-heartedly.  At the Museum Shop, there it is - a Scarlet Macaw, just like the one in the photo.  I decide to bring him on stage with me at the start of the show - I'll look exactly the way I do on the flyer, and that will be a bit of a sight gag.

She also thinks some sound-effects would be funny, such as the sound of drizzling rain to add pathos.  I search online to find something suitable.

I decide to use my Brazilian percussion instruments in the final song.

Both shows sell out.  Before the first performance, I not only do a sound check; I also have to do the "tech run" with the sound and lighting technician.  Jeff and I are still working these things things out when the doors open and the first audience members arrive.  My stress levels start to rise, and Emma and I go upstairs to wait in the dressing room.

Twenty minutes later, Jeff comes to fetch us.  We come down and wait off-stage while the last drinks are served and people take their seats.  The place is packed and the audience is noisy.  The pre-show music is getting me in the mood, but I can't help wondering if I can remember everything.  I'm aware that that this is not a helpful thought, but now I wish I'd had a run-through, on this stage, in front of a small audience, with someone to advise me on what I'm doing.  I feel extremely overwhelmed, and I reflect that I've conceived and written the show, promoted it, organized everything, paid everyone and directed myself, and now it's time to see how it goes.  I don't know if it's any good, or if anyone will find my jokes funny.

We're on.  Emma heads for the piano, and there's no going back.  I step up onto the stage, macaw on my shoulder.   I launch straight into "One Note Samba".  I remember every single thing, in the correct sequence.  There are plenty of laughs.  It all comes together.  There are some places where I could have sung better, but I think I've given people value for their ticket price.

I come off stage, put on a jacket and come back into the room.   Now the lights are on and I can see who's there.  I chat with some of them.  I hear someone say "Do we have to leave now?  We were having such a good time".

In between shows I have the opportunity to sing at two Cabaret Live events.  I sing the two songs that gave me trouble in the first show.  Both of them go a lot better.   I realize I need to "lean into" the problem notes instead of pulling away for fear of cracking on the note.  I discover that if I give it a bit more momentum I sing it better.

I also go to a Cabaret Masterclass and receive a reminder to immerse myself in the lyrics of the song.  Strangely, this usually seems to fix vocal problems.

In the lead-up to the second show, I feel much more relaxed.  This time I sing out more freely, and there are fewer problematic notes.  I engage more fully with the audience, and claim the stage more powerfully.

Following this successful "season" I feel an enormous sense of achievement.

And I'll be better next time.  The experience of performing a full show lifts my confidence and skills to another level.   I've learned how much you need to let out the sound in performance.   It doesn't help to hold it in.  Suddenly I am singing more freely.  Back at lessons, I sing a high G, and don't even realize until my teacher asks "Do you want to go on?"

Without La Boheme and the Cabaret Summer School, it would never have occurred to me to hire a theatre and present my own solo cabaret show.  But it's all been a logical progression.

It's amazing what a little bit of encouragement can do.

I did it here.  I could do it in Rio.

How long is a piece of string?

How many rehearsals do I need?  How long is a piece of string?  I need as many as possible.  I could never have enough.  I could rehearse forever, and never be ready to perform.

But I need to find the answer to this question.  I need to book them with pianist Emma, because she is hotly in demand, and has a tightly-packed schedule leading up to the date of my first show.

Emma has offered me a fixed price for two shows and two rehearsals.  But I'm convinced I'll need more than that.  I book an extra two rehearsals; four in total.

On the day of the first rehearsal, I get lost.  I follow Google Maps and it sends me to the wrong address;  a street with an almost-identical name, in a different suburb.  I feel really stupid when I phone Emma to let her know I'll be late.  Finally I arrive, and we work through about half the songs.

Emma proves to be a good choice of musical partner.  She offers some suggestions for my story.  It is great to be working with someone who is interested in discussing this.  Emma saw my piece develop during the week of Cabaret Summer School, so she has a good understanding of what I am trying to achieve.

But I'm so accustomed to receiving advice, criticism and approval from my mentors, I am somewhat lacking confidence in putting the show together.  It doesn't take long to realize that I've now need to have the courage of my convictions.  I've got to make some decisions about the story.  I've had plenty of advice up to this point; now I have to create my own piece of art.

I start to play a game with myself, called "What would Catherine say?"  I pose the problem and imagine what Catherine Campbell would say.  She is critical and discerning; I hear her words in my head, and make decisions accordingly.  

Gradually, the piece comes together.  I need every minute of our rehearsal time.  I could happily have more.

Cabaret is a high-wire act.  The story has to be engrossing, the jokes have to be funny and I have to sing well.

During the lead-up to the show, I get the opportunity to have a lesson with Johanna Allen, who is in town for a new opera, "Ode to Nonsense" about the life of Edward Lear.   I go to her house for the one-hour lesson.  Johanna is wonderfully encouraging; says I must take some risks.  She thinks I have yet another half an octave, and gets me going for a high B (which I'd never dared to attempt).  She teaches me how to "float" onto the note, instead of pushing with my larynx.  We workshop one of the songs in my show, and she invents some jazz variations for me to try.  At the end, Johanna wishes me well for the show, and advises me "Go for it - don't hold back!"

In my singing lessons, I work on the songs with Rohan.  During this period he doesn't introduce any new techniques, but simply reinforces what I'm doing well and encourages me to do more of it.  My confidence grows, but there are still a few awkward notes that occasionally cause me a bit of trouble.

I practise as much as I can.  I don't care who hears me.

Getting the show on the road

Around Easter 2013, I register my first-ever solo show in the June Cabaret Fringe Festival, and nominate La Boheme as my preferred venue.  It's "Adventures with a Brazilian".  I'm doing two performances - I figure this will be enough, given all the other commitments in my life and the fact that we are going to Russia (conference for my husband, holiday for me) in the middle of June.  Both shows need to be in the first half of the month.  It'll be good to do two shows rather than just the one.

I need a pianist to accompany me.  It's like choosing a partner for the "Prom" - you need to get in quick, or be left lonesome.  There are several candidates.  I dwell on this choice (probably for too long), then approach Emma whom I met at Cabaret Summer School.  Emma is very busy in June; she is already playing for two musicals, and is also developing her own children's opera, "Space Encounters".  She sends me the list of her available dates and times, and I contact La Boheme to work out times for the show.

I begin to wish that I had organized this earlier.  La Boheme has only a few times left.  I try to coordinate their availability with Emma's.  They offer me a time-slot which would have Emma rushing to another theatre afterwards, with too little time to spare.  Eventually they move things around a bit to accommodate us.  Yesssss!  It's locked in.

My show is the first event in the festival, after the opening party.  I need to get my publicity organized.

Last year I had some very expensive glamour photography done, with a view to using one of the pictures as a publicity shot.  Before I can use it, I must first pay more money to the photography studio - a licence to print the photo.  I rationalize that it's cheaper than getting more photos done.

I send the photo to Rod, my graphic designer, and ask him if he could photoshop a macaw into the picture.  I'm visualizing a cartoon bird flying in the corner of the picture, but Rod presents me with a very realistic-looking macaw sitting on my shoulder.  It looks as though he's whispering in my ear.

I order 1000 postcard flyers and a few posters.

A restaurant near my office offers to hand out flyers, and they also laminate a poster and affix it to the coffee machine.  It feels very strange to walk along the street and see my face in there.

I contact a community radio station to see if they would like to interview me.  They would.  This is the first time I've ever been on radio.  When I was about 13, I was selected from my class to take part in a radio program.  The night before the event, I was so nervous and anxious I could not sleep.  By morning I felt so ragged that I couldn't go to school.  Someone else did the interview in my place.  I've always felt disappointed that I sabotaged myself so completely and lost that opportunity.

This time it's easy.  The interviewer phones me a couple of days beforehand, and invites me to submit some questions for discussion.  I send them through, and arrive at the radio station.  I'm expecting a five-minute segment, but he has expanded it.  He has organized "intro" and "outro" music, and also a musical interlude to punctuate our conversation.  He makes me feel entirely at ease and I have no trouble at all responding to his questions.

This is fantastic, because now I'm equipped for next time.  Who knows whether this interview will sell any tickets?  But next time I could approach the mainstream stations with confidence.

I mail flyers to everyone I know.  The Law Society also offers to promote the show in its weekly email newsletter, and I get about four weeks' advertising that way.  And I publicize the event on social media as well.

I place little piles of flyers in various cafes and other places I regularly visit.

Bookings start to materialize.  I monitor the ticket sales about once a week, knowing that most people will probably leave it til a few days before the event.

I feel I've done a good job with the publicity.  No way am I going to be playing to an empty room.

Treasures from Spain

After Cabaret Summer School 2013, we are offered the opportunity to perform our pieces again in the Out of the Square program.

This offer comes while I am holidaying in Spain.  The series spans a two-week period, and because I'm expecting to feel pretty tired after I get home, I put my name down for three shows in the second week.

In Barcelona I come across a music shop with guitars in the window.  Suddenly I have an idea.  I venture into the store, and in my best Spanish ask if they have any Brazilian percussion instruments.  I worry a little about being politically incorrect, because in Barcelona they actually speak Catalan.  You don't really get points for trying to speak Spanish; you may as well speak in French or German, because it's not their language.  But the man behind the counter doesn't seem to be offended.  He leads me through the shop to a back room, where he unlocks a glass cabinet.  He draws out a variety of instruments that shake, rattle and roll.  I select a little drum that you shake from side to side, a bracelet that rattles, a bamboo stick with seed pods and a wooden sleigh-bell rattle.

I know that Australian Customs is very strict, but these items are quite inexpensive, and I'm willing to take the risk.  But as the trip goes on, I start to feel attached to my instruments and I can't bear the thought of them being taken from me.

Arriving in Sydney, I hold my breath as I hand over my treasures to the Customs officer.  He takes them away and I resign myself to losing them.  After a few minutes he returns.  He holds up the little drum.  "This one is made of raw-hide.  We can treat it for $70 if you like".  I look at my husband and he reminds me that the drum cost much less than that.  I let it go, and scoop up the rest of my haul.  They are mine!  Amazingly, I get to keep three of the four instruments.

Back home, I perform my piece "Sex and the City" at three regional theatres.

At the first one, an audience member accosts me as I am leaving the theatre; he wants to discuss the history of Bossa Nova.

Prior to the second performance, a nurse works her way along the front row of the audience, dispensing tablets to people from a local nursing home.

Twenty minutes before the third show, Matthew informs us that 90 percent of the audience are 12 years old; the organizers had trouble filling the theatre, and invited students from a local school to attend.  Wow.  It's a cabaret show.  It's not really intended for school kids.  My heart sinks - they are conscripts; they are forced to be here.  We all need to assess what we are about to present.  Is it child-friendly?  Yet we should not talk down to these young people - they are old enough to have some idea about adult concepts.  Maybe we should pitch it to a level that their teachers might think appropriate?  In fact, the school children are extremely attentive and respectful.  Matthew does a great job of engaging them between segments, and adds a Question Time at the end.  They ask insightful questions, and one of them turns out to be related to a cabaret performer whom we all know.

The varied audiences provide excellent practice in being flexible and adaptable.  You can't simply memorize your patter and head out onto the stage.  It does require some awareness of who is in the audience; you must try to connect with them.

I also learn the importance of being ready.  A performer is unable to attend one of the shows, and Matthew invites a visiting English cabaret star, Tim, to perform in her place.  Tim performs his segment early in the show.  When it's my turn, I'm standing in the wings, but Tim is there too.  Matthew calls him instead of me.  Assuming that he is doing a second ten-minute piece, I go back downstairs to the dressing room.  Suddenly Matthew is announcing me.  Tim has finished, without singing any songs - I have no idea why he was on stage, but now he's off, and I'm meant to be there.  I run upstairs and around the back of the stage, and arrive at the microphone a bit breathless.  I mess up the start of my first song and have to start again.  It's OK - I do it in a conversational way, and the audience is pretty forgiving.  But as a result, I've learned to be prepared and ready for anything.

Overall, the "Out of the Square" series provides valuable experience and an opportunity to experiment with a variety of approaches.

And now, it's time to expand my segment into a full-length show for the Cabaret Fringe.