Health

Life after a stroke: a mountaineer's guide to his biggest challenge yet


One morning last August leading British mountaineer Malcolm Bass woke up knowing something was wrong with him but having no idea what it was. “I remember thinking I was struggling to sequence putting my contact lenses in, getting dressed and going through to the kitchen for breakfast,” says Bass, 56. “That sequence of tasks seemed very complicated to me when it wouldn’t normally be.”

The day before, he’d been rock climbing in the Cairngorms with his close friend Simon Yearsley. Now he found himself lying on the hall floor of Yearsley’s home in Perthshire. He had no idea how he’d got there. “Simon’s wife Sarah came down and said, ‘Are you all right, Malcolm?’ I didn’t feel weird. There was no pain. I kept thinking, just leave me for a moment and I’ll be all right. The next thing I remember was being put on the stretcher and in the ambulance.”

Bass didn’t know it then, but he had just become one of the more than 100,000 British people who suffer a stroke each year – 38,000 of them being fatal. The inner wall of his carotid artery had spontaneously suffered a tear that caused a clot, which had travelled into his brain, cutting off the blood supply to his right parietal lobe, wreaking havoc in the neural networks controlling movement down his left side.

When his partner, Donna James, reached the hospital in Dundee from their home in North Yorkshire, Bass had already been given medication to stop the clotting but she knew something was still badly wrong. Soon it became clear that the stroke had caused Bass’s brain to swell and he was rushed into surgery for a craniectomy, which involved removing part of his skull to ease the pressure on his brain that was about to kill him. James was told that he still might not survive.

READ  High blood pressure: Do you experience this? One early warning sign you may not know about

For his tight-knit group of friends and the wider climbing community, the news was shocking. Not just because of the respect Bass had earned for the hard exploratory climbing he’d done around the world, from Alaska to the Himalayas, but because of his willingness to talk openly about the personal costs of a dangerous sport and its psychological effects. Having trained and then practised as a clinical psychologist for 30 years, he was acutely aware of why his chosen life was so rewarding and the risks from not talking openly about its costs.

Bass wearing a helmet to protect his head where a section of skull was removed.
Bass has to wear a helmet to protect his head where a section of skull was removed. Photograph: Gary Calton/The Observer

Three years ago, in June 2018, Bass had made the first ascent of a difficult unclimbed mountain called Janhukot in the Indian Himalaya. Different teams from around the world had been trying the peak for almost 30 years. Bass himself had made two previous attempts, one of them with Yearsley. This time, climbing for four days and completely self-supported, Bass and his companions Paul Figg and Guy Buckingham made the summit, at 6,805 metres.

The climb was an ordeal: cold temperatures, broken sleep, hard climbing and plenty of danger. But the photograph Buckingham took of Bass and Figg hugging each other on the summit captured something of the philosophy Bass took with him into the mountains. “The psychology lessons that climbing, especially alpine climbing, have taught me,” he once wrote, “are about both the immense power of the human will, and about its utter impotence.” For years, he had felt “ashamed” about turning back in the face of bad weather, feeling that “if I was stronger I would have succeeded. But now I understand that the big forces of the world are far more powerful than even the best versions of us humans”.

Sitting in his wheelchair at the kitchen table, Bass resists easy cliches about using the lessons he’s learned from climbing mountains in dealing with what he faces now. “They’ve not presented themselves massively or obviously to me,” he says with heavy irony. Two-thirds of those who survive stroke are left with a disability and Bass’s has left him hemiplegic and affected his hearing, sight and speech. His sense of humour has somehow survived. “The one thing that stands out is the drudgery of climbing up a big difficult mountain. You have to break it down into little steps, because if you look at the whole thing all at once, it just blows your mind.”

Many who suffer strokes find their emotional selves in turmoil – the medical phrase is “emotionally labile” – and Bass has struggled with severe depression. “My mood’s been shocking,” he says. “I’m attacked by sadness. Fifty times a day. The sadness of missing my old self: my old physical self. I don’t mean climbing hard, I mean being able to stroll down the street.”

Bass grew up near his current home in the village of Great Ayton, on the edge of the North York Moors and the childhood home of the explorer Captain Cook. His mother was a dentist and his father the local GP. “Fly fishing, that’s the thing me and my dad do together. And the trout fishing season is about to start. It’s sad for him, and I feel his sadness too. There’s a thing called post-stroke depression, and nobody knows how much it’s the disturbance caused to your neurochemistry by the stroke or how much it’s to do with the fact that if you’ve had a life-changing injury you’re likely to be depressed.”

Malcolm Bass on expedition to Janhukot in 2018.
Malcolm Bass on expedition to Janhukot in 2018. Photograph: Guy Buckingham/Coldhouse Collective

The depression was at its worst in hospital, and at those moments Bass would text Yearsley: “I’m seeing ghosts.” It was shorthand for mental anguish so crushing that Bass needed to talk urgently. “It’s like a code word,” Bass says. “It means we need help. I had some absolutely desperate times in hospital. I would text Simon that I was seeing ghosts. And he would call me. Every time. No matter how busy he was. I’m immensely grateful for that.”

The phrase was a half-serious joke between them, born from an encounter on a glacier in Alaska 20 years ago. Bass was waiting for a ski-plane to take him out of the mountains after a climbing trip when he met the climber Barry Blanchard, born into Canada’s Métis nation. Blanchard had just come off a difficult climb having failed to reach the top. Bass asked him how things had gone. “Not so good,” Blanchard replied. “We came down early. I was seeing ghosts.” Bass laughs a little. “I would expect Barry meant it literally, because of Métis origins.”

After three months, Donna James finally managed to get Bass home from hospital where, he says, “I’m coping a lot better. My ability to cope with stress and anger has improved massively. That might just be my brain settling after the injury. It might be the acquisition of better skills for dealing with those things.” He has to wear a helmet to protect his head where the section of skull was removed; a ceramic replacement will be fixed in its place in the next few weeks.

As a clinical psychologist Bass would treat people who were suicidal or self-harming. Now he is himself seeing a psychologist from the local stroke team. “I find it very helpful. It’s reinforced my conviction that good psychological treatment is vital. We know that psychological therapies are a very effective treatment for people. We know the public really like it. We know those therapies don’t have many negative side effects. But it’s hard for people to access and there’s not very much of it available. There aren’t a lot of trained psychological therapists in the NHS, that’s the main problem.’

The summit Bass is now aiming for is a return to work in June. Meanwhile he takes pleasure in eating, and in the support of his friends, who have launched a crowd-funder, #MoveMountainsForMalcolm, to help him and his partner adapt. Mostly he talks of the love and support she has given him through what they both describe as a waking nightmare. “I’m massively concerned with the strain on Donna,” he says. “How much she’s put aside. Until you’re actually that vulnerable you don’t know, do you?”



READ SOURCE

Leave a Reply

This website uses cookies. By continuing to use this site, you accept our use of cookies.