LONG READ Luke Cowan-Dickie: 'I didn’t feel right. I felt like I was going to pass out. Everything was going black in front of me'

The reality of professional rugby makes players blase when it comes to surgery. When Luke Cowan-Dickie mentions he has undergone 14 operations during his career he does so with the flair for the dramatic of someone running through their weekly shopping list.

Familiarity with the inner workings of hospitals is in the job description for a front row forward who has played top-level rugby for 13 years.

Even so, when Cowan-Dickie found himself being checked in just before this season’s Six Nations for a heart issue, it was something new. Concerning too.

The Sale hooker had been named in England’s squad for the championship. Having fought his way back from a career-threatening nerve injury in his arm, he was repaired and ready to go.

Then, the week before England’s opening game in Italy, he started feeling odd during his club’s European game against La Rochelle.

“It was after about 20 minutes. I just didn’t feel right. I felt like I was going to pass out. Everything was going real black in front of me,” he recalled.

“I got to half time but when I came back out my lips started to go a bit numb. I spoke to one of the physios about it and they pulled me off. I went to hospital, had an ECG done and found out my heart had gone into AF – I had no idea what that was.”

AF – atrial fibrillation – occurs when the heart goes into an irregular and abnormally fast beat. It is generally not life-threatening but it certainly not conducive with playing Champions Cup rugby.

Playing on for as long as he did with the symptoms was not the smartest move but at the time Cowan-Dickie did not know what was happening to him.

“They flipped my heart back at the hospital,” he said. “I had a heart monitor on for five days and I had an MRI scan. When the results came back everything was absolutely fine.

“I asked the doctor what might have caused it and he said it could have been a bang but  he wasn’t really sure. He said it can happen when you are run down.

“I have felt absolutely fine ever since but if it ever happens again I have flecainide tablets with me all the time to take to sort it out.

“It was just my luck. I come back from injury, get back into the England squad and am out again with something random like that.”

Cowan-Dickie’s first competitive game since the scare was for Sale at Bath last weekend. He came through without a problem.

He had been able to rejoin the England squad for the latter part of the championship but, frustratingly, did not get onto the field.

When you’re a travelling reserve it’s your job to bring the energy. Sometimes I may go over the top. I’m quite an energetic bloke and that sometimes happens. That’s just the way I am.

Ask him to analyse his role with England as the third hooker in the squad behind Jamie George and the emerging Theo Dan and you are given a glimpse into one of the more unique personalities in top-level rugby.

“When you’re a travelling reserve it’s your job to bring the energy. Sometimes I may go over the top. I’m quite an energetic bloke and that sometimes happens. That’s just the way I am,” he said.

Lively is one way of describing Luke Cowan-Dickie.

Alex Sanderson, his director of rugby at Sale, loves having him in his squad – and it would be no surprise if a contract extension was agreed shortly – but he admits to a degree of exasperation in having to deal with his hyperactive hooker’s excesses.

“He can’t sit still,” said Sanderson. “There’s a necessity to engage him during meetings because if you don’t he probably will drift off. My brother was diagnosed with ADHD and I see similar traits. I don’t know if that’s the case with Luke but it is quite obvious that he is wired differently – the best players are. Tom Curry and George Ford are. But whereas George doesn’t have – at times – anti-social behaviours, Luke does. He has this propensity, because of the man he is, to go wildly off the rails, and then pull himself back in.”

The tale of Cowan-Dickie ending up in a ‘drunk tank’ in Montpellier when he was undergoing a medical with the Top 14 club has been exaggerated, he claims. Going out in Manchester these days means a quiet breakfast in Altrincham, he insists. But he admits he can be a handful.

“For me to have to say: ‘you can’t do that’ to someone who is that good and 30 has been a surprise to me but if that is what he needs then I’m more than happy to give it to him,” said Sanderson.

“We’ve had some difficult and emotional conversions but you have to go there to get a relationship that’s worth its salt.

I’ve asked him [Alex Sanderson] to be honest and he has been. I prefer it like that. You know yourself if you haven’t performed well. Some people might brush over that and some boys might like that but I don’t

“The conversations are a bit cyclical. I struggled with that at the start because I thought: ‘we’ve already had that conversation’ but the reality is we have to have them again and again and again. I don’t mind that. With some players it’s worth it.”

Would Cowan-Dickie like to manage himself?

“That’s a tough one. I think I would,” he says, with a smile.

So how would he do it? Carrot or stick?

“A bit of both. A bit of love – and some stick depending on the time,” said Cowan-Dickie.

“Alex is good. He’s pretty straight talking. He lets you know what he wants from you.

“I’ve asked him to be honest and he has been. I prefer it like that. You know yourself if you haven’t performed well. Some people might brush over that and some boys might like that but I don’t.”

His assessment of his own performances for Sale since his arrival last summer pulls no punches.

“I don’t think I have performed that well,” he said. “One player can’t decide the outcome of the game but what you can do is put the team on the front foot to help them win games and I feel like I’ve not quite done that with Sale yet.”

The nerve injury which led to him missing the World Cup has been a handicap, leaving him to operate on reduced power in his right arm. There has, he says flexing his biceps, been a significant breakthrough over the past month however.

“I’m lifting more and my muscles are firing more. The last four weeks have definitely been the biggest improvement I’ve felt. I’ve gained as much in these four weeks as in the past 14 months,” he said.

“Hopefully I will be back to the performances I have put in in the past. Getting back to the old me would be nice.”

I was at Exeter for so long that to me it felt like a family, but the first time I put the Sale shirt on I felt like I belonged. It is a great place to be and I owe them some performances.

Sale need him at his abrasive Test Lion best over the Premiership run-in if last season’s finalists are to make the play-offs after a debilitating run of five consecutive league defeats.

The players held an emergency meeting at the start of the week to address the issues. They are in a trough but Easter Sunday – against Cowan-Dickie’s former club Exeter – is as good a time to rise as any.

“We are going to treat every game like a knockout game on the run-in,” he said.

“The fact that it is Exeter this weekend is going to be special for me – it will definitely give me a bit more drive.

“I was at Exeter for so long that to me it felt like a family, but the first time I put the Sale shirt on I felt like I belonged. It is a great place to be and I owe them some performances.”