The Liam Mackey interview: Paul Osam talks about overcoming the heart attack that almost killed him

Ireland U16 manager Paul Osam says that once people go past 40, they should know what their blood pressure is. Picture: Seb Daly/ Sportsfile

League of Ireland legend and Irish U16 coach Paul Osam talks candidly about the heart attack which almost killed him five years ago this month, the vital lessons to be learned from his experience, and the psychological barriers he had to overcome to resume a normal life

League of Ireland legend and Ireland U16 coach Paul Osam offers a frightening insight into the heart attack that almost killed him five years ago, the vital lessons to be learned from his experience, and the psychological barriers he had to overcome to resume a normal life

You could say that Paul Osam wears his heart under his sleeve.

He bares his arm to show the little tattoo above the wrist. The image is of a cardiograph spike alongside a heart symbol surmounting a date in roman numerals: January 16, 2013.

In the wee hours of that morning five years ago, Paul suffered a heart attack which, statistically, he should not have survived. It’s the day the League of Ireland legend, who now manages the Irish U16 team, has come to regard as the borderline between a life lived before and after.

“I had that tattoo done about three or four months later,” he explains. “I wouldn’t be into them, it’s the only one I have. I was thinking: Do I want to forget that date or do I always want to remember it? Maybe it was a bit of a mid-life crisis thing as well (laughs). I wouldn’t say it’s therapeutic but what it is, is a constant reminder for me of how lucky I was.”

Osam, one of the most outstanding and imposing Irish footballers of his generation, had no reason to have concerns about his health when he turned 45 in December 2012.

Despite a 10-a-day cigarette habit, the years of stylishly dominating the midfield battle in all those LOI games still stood to him, so when he began to experience a bout of recurring physical discomfort and sleep disruption in the new year of 2013, he assumed it was something irritating but innocuous, like indigestion.

“For three nights before I had the attack, the only symptom was that I’d wake up at half-four in the morning, nearly like an alarm clock, with this burning sensation in my throat,” he recalls. “I was taking Milk of Magnesia, I was taking Rennies, I was taking everything. Then on that Wednesday when I woke up, the sensation was quite strong, so I woke up my wife, Regina. She said: ‘I’ll go down and heat you up some milk’. Then the sensation got worse, like someone was choking me. And I remember putting my head in between hands and rolling back on the bed. I don’t remember what happened next, because that’s when I passed out.

“My wife told me later that I was gagging then, for about 30 seconds, and she thought I was having a fit. Then I came too and I saw that she was on the phone and she was saying to the paramedic: ‘He’s awake, he’s awake’. He told her to put another pillow under me. I’m sitting up now and I’m sweating but I’m saying to her: ‘I don’t need an ambulance, I’m grand’. The classic macho thing: ‘I’m fine, I’m fine’.

“So I’m lying back on the bed when the ambulance man comes in. ‘Ozo!’ A Pat’s supporter. Genuinely (laughs).

‘Are yeh alright?’

‘Yeah, I’m grand’.

He asks me if I want them to bring up a stretcher and I say no. I get up, throw on t-shirt, a jumper, and pair of tracksuit bottoms, walk down, get into the back of the ambulance and he puts the thing on me. Says my heart seems fine.

“That was the first mention I heard of the heart and I was just thinking, ‘of course my heart’s fine’. But he says they’ll still have to bring me in because I’d passed out.

“When I get to the hospital, I’m brought into a cubicle and a nurse puts on what they call a 12-point ECG — feet, knees, everywhere — which gives a real reading of what’s going on. And I’ll never forget seeing her face when she came back and looked at the trace: Her jaw dropped. I discovered afterward that what the graph showed was that there was little or no blood or oxygen going into the main artery.

“She called two porters and they just ran with me down the corridor. I hadn’t a clue what was going on. In hindsight, it was like I had already died and was having some kind of out of body experience. It was panic stations. They burst through a door that said ‘RESUS’. A funny thing: Years ago I worked in the supermarket in Nutgrove Shopping Centre and we used to go from the shop floor into the stores through those hard plastic swinging doors. That was the RESUS. No doors to open and close, just — whoosh — straight in.

“So I’m blasted in through there and I’m lying on this bed, looking around, and there are nurses and doctors everywhere. And this Indian doctor comes over and picks up the graph on the side of the bed that the nurse had printed off. He looks at it, he looks at me and he says: ‘Sir, are you okay?’ I say: ‘Yeah.’ And he says: ‘No, you cannot be. You have had a massive event in your heart.’ That’s when I really knew I was in trouble.

“He’s on the phone then and it’s obvious the cardiologist on the other end is saying ‘he can’t be alive’ because the doctor is saying: ‘Well, I’m looking at the trace and he’s here and he is awake’. Other doctors come in and it’s always the same: They look at the trace and then they look at me like I shouldn’t be there. I’m given a load of tablets, clot-busters. I’m given oxygen. The wife is brought in, she’s sitting beside me. I’m looking around wondering: Am I imagining all this?’

“I’m asked if I take drugs. Cocaine? I say no. And he says ‘are you sure because you shouldn’t have this at your age’ I say definitely not. Then I’m wheeled into the CAT Lab and the doctor, Mr Moore was his name, says: We haven’t time for small talk, I need to get straight in there’. He says: ‘Sign this’. This was a funny one. He says: ‘It’s a consent form and you have to sign this because there’s a risk you could you die while I’m doing this procedure. You could have a heart attack or a stroke. But if you don’t sign it, it’s most likely you’ll die anyway’. So I signed it (laughs). Done. Then I felt a little nick on my arm. And he says to me: ‘You can actually watch this on the monitor’. I said: ‘No thanks’. So I just lay there and I prayed. And I wouldn’t be very holy. But I did pray while two of them were working away.”

The dye which they had injected through Paul’s arm revealed that his main artery was almost completely blocked, and he was told that they would have to insert a stent. He’d never heard of a stent — a small device fed in through a tube which opens up the artery — and feared he was about to undergo open heart surgery.

“I was thinking I would be left with a massive scar,” he remembers. “I was thinking of all the consequences.”

In fact, it turned out he didn’t have much time to think at all before the procedure was done and dusted, just like that.

“It was 11 minutes from the time I was wheeled in to the time I was wheeled back out, that’s how quick it was,” he says now, still marvelling at the astonishing efficiency and ingenuity of the medical intervention which saved his life.

“And when they wheeled me out, my brother and one of my friends had arrived and — another funny one — they both said to me later that they’d never seen me looking so well! And when you think about it, that stands to reason, because there hadn’t been a sufficient amount of blood going around my body for how many number of years I don’t know.

“In hindsight, I used to get a little out of breath when I’d go for a jog with my son Evan (who has gone on to carve out a successful League of Ireland career of his own). I’d be breathing heavy but I used to think it was the smoking or just getting older. But if I go out jogging now I’m like a 10-year-old.

“I gave up the smoking immediately, by the way. Talk about chewing gum or patches or going to hypnotists? Have a heart attack, you’ll never smoke again. I would have smoked 10 a day, right back through my playing days. But the doctor said to me the day they put the stent in: You can never smoke again or you’ll end up back in here’.

“And I haven’t smoked since.”


nd so Paul Osam lived happily ever after, right?

Not quite. It might have taken only a matter of minutes to undo the life-threatening damage to his body but for him to come to terms with all the implications would take months and even years. He doesn’t mind admitting that, initially, his sense of vulnerability gave rise to waves of fear which, at times, could be overwhelming.

“I ended up back in Tallaght Hospital twice thinking I was gone again,” he says. “I wasn’t but I thought I was. I did have an issue once but they don’t think it was related to the heart. They’d given me what they call a GTN spray to use if I thought I was having a heart attack. What it does is open up the vessels. So, this day, about six months after the attack, I was in a bar with Evan and my brother-in-law and I started to feel dizzy and thought I was about to faint. They called an ambulance and Evan ran to the car and came back with the spray. I’m sitting in a chair sweating and gasping. You’re supposed to spray two puffs on your tongue, right, but genuinely I thought I was fucked, so I just sprayed this massive blast into my mouth. And then I got worse. And worse.

“By now I’m lying on the ground and the ambulance arrives. They come in and take my blood pressure. High? It was low, so low, because I’d put so much of the spray into me and the arteries had opened up so much the blood wasn’t pumping around my body enough. They brought me to James’s Hospital and I had all the tests. And it transpired it was an episode that was probably related to my blood pressure medication at the time which was made worse by the amount of spray I’d used in my panic.”

So no physical damage done but the psychological impact was severe.

“My head was gone after that. Luckily I had a good relationship with them in Tallaght Hospital. And to reassure me they gave me another angiogram and showed me the results. ‘Look, Paul, you can see for yourself: Your blood is flowing perfectly there. Where the stent is, is completely open. You’re grand.’ So that was great to hear.”

But it didn’t mean that the fear simply evaporated, never to return.

“A guy I know who lives near me, a big Pat’s fan, had had cardiac issues as well, a few years before me. I met him a couple of months after the attack and he asked me how I was. I said I was alright. And he said: ‘No, how are you really?’ And I said to him then: ‘To be honest with you, it’s fucking difficult’. He said: ‘I was exactly like you and I’ll tell you what it is: The air of invincibility is gone and it will never come back’.

“He was right. And I don’t think I will ever get it back. I’ve recovered hugely and I’m not as consumed with fear anymore. There are still moments but it’s not like the way it used to be. I was having panic attacks, anxiety attacks. There were times when I thought I was going mad, to be honest with you. But at the same time, I knew I wasn’t going mad. I’d had a traumatic event in my life, I’d nearly died, so the way I saw it, it would have been abnormal if I’d felt any different.

“I went to see a psychologist in Tallaght Hospital, mainly because they told me I had to. And, to be fair to her, she was very down to earth and told me I needed mechanisms to cope with the fear. And she gave me the best advice I ever got: She told me that whenever I feel a panic or anxiety attack coming on, to focus on six objects. Then spell the six objects and then touch the six objects. ‘Think of the devil’, she said, ‘666’. And she said: ‘I can nearly guarantee you that if you’re having a panic attack and you do that, it will pass’.

“One place where I was very bad, naturally enough, was if I had to go to a funeral. Mainly, it was the worry that I might have a panic attack and then what would I do? You can’t really get up and walk out of a church in the middle of a funeral. Well, you can, but you don’t want to have to. I mean, sitting here with you, if I felt something coming on, I’d say ‘Liam, sorry, I’m just popping out to the toilet’. And I could do the 666 in there.

“It’s more in a public environment where I start thinking: ‘If something catastrophic happens to me, everyone will know’.

“And yeah, just occasionally, that’ll come into my head on the side of a pitch. It’s not even an anxiety attack anymore, it’s just a thought in my head. And the way I deal with that one is — and this is not a nice thing to say and it’s probably not even true but it gives me solace — I look at the coach of the other team and I think to myself: ‘Well, at least I know what’s wrong with me’. I have a medical condition and I’m on medication and I get check-ups for it. So there’s probably more chance of something happening to him! I mean, there’s probably nothing wrong with him, hopefully not, but he hasn’t had the care I’ve had to know his arteries are okay.”


aul Osam turned 50 just before Christmas and, it has to be said, is looking the very picture of good health, still recognisably the man who won five league medals (four with St Pat’s, one with Shamrock Rovers) and made a clean sweep of player of the year gongs during a senior career which ran from the end of the 80s to the early 90s.

Deep down, he reckons he’s still essentially the same person too.

“I think we are who we are and I don’t think anything will change who we really are,” he reflects. “But I think that landmark incidents in your life can have an effect on what you are at different times. I don’t know if that makes any sense to anyone else but to me it does. I’m no different fundamentally to what I was before this happened to me. I could say: ‘Oh I look at everything differently now, I’ve learned to appreciate every moment in life’. But that’s bollocks really.

“But I’ll tell you what it has done. Something that has changed hugely is that I’ve no fear of dying now. I don’t think too many people can say that because not too many people who are my age think about their own death. But it’s a two-pronged thing for me. I can definitely say that I have no fear of not being here anymore but I do have a terrible fear of leaving people behind. But there’s no fear of death itself. And it’s not because I believe in an after-life. I don’t really think about that. It’s because I know it’s going to happen.

“And it nearly did. With the kind of heart attack I had, it’s an 80% mortality rate. Instant. And of the 20% survival, it’s 90% heart damage and 10% not. I survived and I’ve no heart damage. The muscle of the heart is perfect.”

A lucky man, then?

“That’s another thing. For the first three or four months after this happened to me, I thought I was the luckiest man alive. I honestly did. But then the day comes when the dawn breaks and you think: ‘I’m not lucky. Why did this happen to me in the first place?’

“For the first year after it, I was feeling shock and pity, all those emotions. Still do at times. But I mainly wanted to know why. I’d always be asking at my check-ups. And I was told it was because of different things: Genetics and — not so much lifestyle, because that was decent apart from the smoking — my blood pressure and cholesterol would have been two big risk factors. Two big red flags. But I’d never had them checked. And the doctor reckoned I’d been going around, for maybe the last 15 years, with high blood pressure and cholesterol.

“Had I known that I had that, at the levels I had, they most likely would have done an ECG, an exercise stress test and an angiogram if necessary. And they would have seen this big blockage in my main artery and dealt with it. And I wouldn’t have had a heart attack and I wouldn’t have nearly died.”

And it’s in large measure in the hope that others won’t have to learn the hard way that, as the fifth anniversary of his heart attack approaches, Paul Osam is still willing to give such open and honest answers to questions about his own brush with death, including a bit of bottom line advice from one who knows.

“Once you go past 40, know what your blood pressure is,” he urges. “Because it’s a silent killer.”

See also Liam Mackey’s Saturday column


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