It was over quickly. While brushing my teeth, I broke into a noticeably cold sweat. Though this had never happened before, I did what I always do when feeling ill and went straight to bed. Now I know that vomiting plus cold sweat can be the first signs of a heart attack.

Unusually, I did not fall instantly asleep, the normal after-effect of food poisoning.

I lay awake for hours, faintly amused at the thought that I could not find an exact phrase to describe the feeling in my chest. A small metal weight hanging off a chest bone? I decided it was heartburn, though I'd never had that.

The slight pains in my left arm were not worrisome. I had spent 19 hours straight in an all-night session at the computer, writing about New Orleans, and attributed the pains to repetitive strain injury (RSI) though I'd never had RSI before.

Now I know that nausea, cold sweat, discomfort in the chest and pains in the arm may very well be evidence of a heart attack . . . and that I was, all unaware, going through a massive one (I've since had a quadruple by-pass).

Heart attacks aren't what they're cracked up to be. Mostly, I was bored because I couldn't concentrate on reading. So I lit a cigarette around four in the morning. Being a slightly sleepy, onearmed smoker in bed is a dangerous occupation. I didn't enjoy it all.

I fell asleep and woke again at six.

Something about my condition must have alarmed me because I wondered what would happen if I called an ambulance. I'd have to sit by the open front door to let them in; or retire to bed, leaving the front door open, and . . . worse . . . the bedroom door unlocked. The latter option seemed dangerous and foolhardy.

I could have called a taxi and gone to accident and emergency in the nearest hospital, St Vincent's. A&E on a Saturday night? I'd heard and read about that . . . drug addicts, drunks, and gang warfare . . . and besides, I once spent hours in A&E with an extremely ill woman who lay on a trolley, in a draught, begging for a hot water bottle which Vincent's couldn't supply.

Also, I didn't want to embarrass myself by rousing the doctor from his weekend sleep to make a house call. ?Doctor, I'm a lousy cook, I was up all last night working. I threw up and I can't describe the pain in my chest."

I rang him at 9am and was told to go straight to A&E for an ECG (electro cardiogram, to do with the heart).

I put on my favourite pink shirt. It was beautiful outside, sunny and crisp.

The cigarette in the fresh air was delightful. I saw the Sunday Tribune in a shop window beside the taxi rank. My photo and article were on the front page. Fame and fortune at last. The ego had landed.

No self-respecting journalist walks by her own work, yet I couldn't be bothered going in to buy the paper. It occurred to me that I must be unwell.

There were two patients in the sparkling, spotless brand new A&E at Vincent's. I mentioned chest pain and was immediately put at the top of the little queue. Within seconds . . . after handing over NUMBER_STRING60, of course . . . I was in an emergency room and the words ?heart attack" were being said.

Well, well, well.

Any pain, they asked?

Yes, I said, a wee bit , and they poured morphine, valium and what not into me.

This was a dream come true . . . loads of drugs in a medically-controlled environment. I congratulated them on their merciful pain-management programme, which I thought you only got in a hospice or in Amsterdam. Mercy had nothing to do with it, they said . . . pain means the muscle in your heart is dying, and we have to stop the pain to prevent muscle damage.

Something like that . . . sure I was high as a kite and peaceful with it, and in a safe place, and by-pass surgery is commonplace.

I would be on my back and useless for six weeks, they said. I am surprised at how gladly I greeted this news. I loved it that I had no control over anything. I was completely powerless. I couldn't play God. I was no longer a member of the working world. I was happy.

Except when Patsy arrived. Marie and Evelyn had taken her firmly in hand and told her there were to be no tears. I burst into floods when I saw her. ?I don't want to live, " I said.

She didn't ask me why I wanted to die. Later I was raging about that. Why didn't she ask me why I wanted to die?

Had she never heard of famous last words? I was on the brink of revealing all about myself, things I'd never realised or didn't want to admit, and she didn't even ask me to expand. ?I was told not to upset you, " she explained. Alice B Toklas, Patsy is not.

There was one wonderful revelation.

Who among us has not fantasised about death-bed reconciliation with whoever?

The one where you lie there all justified and the healthy ones admit to having been wrong all along. Reader, banality barely describes it. I am going to write a novel called Death-bed Fantasies and Other Disillusionments.

A thing I didn't anticipate is that the cost of staying alive after a heart attack is enough to give you another one. They insist on a minimum of six weeks' recuperation. You're not even allowed to do light dusting. (In fact, I came home to find that my neighbour June had cleaned my house from top to bottom. ) The VHI pays half of the cost of the first fortnight in a convalescent home (750 is the cheapest quote) and then you have to pay the full whack for another month.

The wonderful Caritas looked after me when I was initially discharged but the waiting list for Caritas is a mile long and they restrict admission to one fortnight. (I ended up paying 1,050 a week at another place. Physiotherapy was extra at 60 a session. ) You're supposed, I was told, to have family to look after you after discharge (mine is in Derry) or friends (mine are all working), or a partner who will give up work for the duration (add heartbreak to heart attack and even the surgeon is on the verge of tears. Not).

The youthful man in the bed opposite me, who had no health insurance, had an even bleaker future. He had stopped paying health insurance after the horrendous cost of marital break-up.

He was sent home for the weekend, while awaiting his heart operation.

Luckily, he had a good relationship with his daughter.

My Zen Buddhist trip . . . joy in being insignificant . . . never once survived a chat with the ruling medical class. To a man, they hung about my bed and murmured ?cigarettes" to their students.

?Contraception" I murmured back. ?Are you one of the guys who said in the '70s that contraception was bad for women's health?"

Not one of them asked me about stress.

Not one. I had just spent four years looking after my mother, and a year mourning her death in December 2004. I now know that what I thought was massive grief was also a physically dying heart.

Cholesterol levels apart . . . and mine was dangerously high until I belatedly agreed to go on the pill . . . there is apparently no way to predict who will have a heart attack.

Ah, never mind the heart attack . . .they say I'm a new woman now at 62 . . .what about those great anaestheticinduced hallucinations? One night, Russia invaded Ireland and Dolly MacMahon led the resistance from the rooftops in Ennistymon. She was beheaded. Another night I told my sister that Albert Reynolds owed me money and insisted she tell Martin McGuinness to go knock on Albert's door and get my money back, ceasefire or no.

The best was when Lelia Doolin came to visit me the night after the surgeon had taken a chainsaw to my breastbone, in order to get at my heart. I told Lelia that after they had taken a vein from my leg to replace the four arteries, an American newspaper had photographed me peeing all over the pope's hands. The Americans were selling the photo gems for $250,000. Ring my agent, Lelia, I pleaded, and I'll give you a $50,000 cut.

Maybe the hallucinations didn't come from drugs at all. Maybe it's the nightmare of trying to pay medical bills in Ireland.

Luckily, because I'm a hypochondriac, once I came to the Republic from the North I started paying a small taxdeductible monthly insurance to cover stays in hospital . . . you get 100 a day. I'll save the rest on cigarettes, in the long run.

Now there's real pain . . . no more smoking. Crucifying, so it is, but I don't have to stand outside restaurants in the rain anymore. Since 19 February, I have not smoked 2,400 cigarettes and sneaked in 27. I even enjoy the freedom from addiction.