A heart attack can divide life into two parts: everything before it, and everything that comes after.
For Tim Westall, author of The Fentanyl Chronicles: Tales of Delirium from Intensive Care, that divide came suddenly in 2024. What began as a cycle ride ended in a medical emergency, weeks of intensive care, and the realization that his heart had been damaged beyond the point where recovery alone could fix it.
His treatment became a fight for survival.
After his heart failed, Westall required advanced life support. He was placed on ECMO, a system that temporarily took over the work his heart could no longer manage. He also needed dialysis and ventilation as doctors worked to stabilise his condition.
Eventually, he became conscious enough to understand the next major decision.
His heart needed replacing.
The question was whether he could wait for a transplant or whether he needed another solution first.
That solution was an LVAD, a Left Ventricular Assistance Device.
For a patient, those letters can sound clinical. The reality is much more personal. An LVAD is a mechanical pump designed to support the heart when the left ventricle can no longer circulate blood effectively. In Westall’s case, it offered a way to keep him alive long enough to reach the possibility of a future heart transplant.
The choice was serious, but the alternatives were even clearer.
Without the device, his chances of surviving long enough for a donor heart were poor. With it, he had a bridge towards the next stage of treatment.
Even in this situation, Westall found humour.
When a nurse showed him the demonstration device, complete with tubes, vessels, and a substantial pump, he joked about whether there was a smaller version intended for a human rather than a Herefordshire bull.
That moment captures much of the tone of The Fentanyl Chronicles.
The book deals with major illness, medical uncertainty, and physical dependence, but it never loses its sense of absurdity. Serious moments sit beside dry observations, strange dreams, and the kind of humour that can appear when circumstances become almost impossible to process.
An LVAD is not simply a piece of medical equipment in Westall’s story. It represents time.
Time to recover strength. Time to remain alive. Time to prepare for the possibility of transplantation. Time that might not otherwise have been available.
The Fentanyl Chronicles takes readers inside that experience from the patient’s point of view, showing what happens when modern medicine keeps the body going while the mind is still trying to understand how dramatically life has changed.
