After a blackout on stage, Sir Roger Moore insisted the show must go on. Michele Kirsch talks pacemakers with an old pro.

I had just done a mad song and dance and was about to deliver the next line, when I heard this bang, which was my head,” says Sir Roger Moore, recounting the time he passed out on stage when appearing in The Play What I Wrote, in New York in 2003.

“Fortunately, my skull was protected by my enormous white Marie Antoinette wig,” he says, his beautiful received pronunciation betraying no trace of the absurdity of the situation.

Sir Roger, used to playing suave, daredevil characters in The Persuaders, The Saint and, most famously, the James Bond films, was in the role of the Comte de Toblerone: “Swiss, and a little bit nutty,” he says. He fainted on stage in what he now knows was a syncope attack, the medical name for a faint or blackout. It is a transient loss of consciousness due to the brain being deprived of oxygenated blood. It can be caused, as in Sir Roger’s case, by an irregularity of heart beat.

The curtain went down. Sir Roger came to shortly afterwards, disorientated. “They brought me a chair, I had a drink of water and I said: ‘Come on, let’s finish it.’ It was a matinée and I agreed to see a doctor between houses.”

This jolly the-show-must-go-on account of what must have been a frightening and embarrassing ordeal is characteristic. “Well, I amjolly. I’m British,” says Sir Roger, a Unicef goodwill ambassador. “I have an exceedingly stiff upper lip.You can’t fool around with Bond, you know,” he says, this time with irony.

“After the show, these two giant paramedics came into the dressing room and starting shoving tubes into my arms and giving me oxygen. I was still in costume when I went to the ER. The doctors were running around, phoning my cardiologist in California – like most film actors, I’d had to have one for medical checks before shooting starts – and he said I need to have a pacemaker put in, now. Then I thought: ‘Oh dear, this is rather serious.’ I knew my blood pressure was high, and you don’t get to my age (80) without something that needs watching. If I had known how serious it was before this happened, I would have probably had another blackout and cardiac arrest from fear,” he jokes.

This is an allusion to a self-confessed, and possibly exaggerated, hypochondria. He says it began after a childhood bout of suspected appendicitis (it turned out to be constipation) exposed him to seriously ill children in hospital. But since then, he’s mostly enjoyed good health, which is why the fainting came as such a shock.

Apart from a bout of shingles during the filming of The Spy Who Loved Me, which laid him low for a few days, Sir Roger cannot recall a time when he missed work because of illness. In fact, even when he was about to be wheeled into surgery for his pacemaker operation, he was “working” the operating room, chatting to the surgeon about a fundraising gala he was hosting for Unicef. “I did the pitch and it worked because when I was about to leave the hospital the cardiologist gave me a cheque for $10,000 (£5,000) for Unicef,” he chuckles, adding: “He told me he was more used to handing out bills after operations than cheques.”

Sir Roger plays down the emotional impact of the medical emergency. But he admits it was a wake-up call that illness wasn’t just something that happened to other people. “We all believe that we are immortal, that someone else is going to get hit by the No 77 bus. It was only seeing everybody running around the hospital that made me think, ‘this is more than I thought it was’. I had the pacemaker fitted and within a couple of days I was making a presentation for Unicef,” he says. “I was lucky.I was very fortunate. I happened to be in New York, getting the right treatment.”

He stresses that not everyone is so lucky. As a goodwill ambassador, he is very aware of those less fortunate than himself. “We are all lucky to be born into an affluent society, to be healthy, to be able to get medical attention. If you’ve seen a mother who has had to carry a sick child for miles through the heat to get to a medical centre where there might not be a doctor. . . ”

Now he has become a patron of Stars (Syncope Trust and Reflex Anoxic Seizures), the UK charity supporting people who have blackouts, who asked for his support after reading about his nasty turn on stage.

“I moan when I am ill but only let my wife know I am moaning. That’s what wives are for. You go into the theatre, feel lousy and start putting on the make-up and that is the beginning of the adrenalin rush that works for you when you have to appear on stage and say things. We call it Doctor Make-Up.”

So when you put the make-up on, you are no longer the you who is ill? “Possibly. I never think of it that way,” he says. Nor does he think too long and hard about his pacemaker. “It’s there; it works, despite the secondhand batteries I got for it. I’m cheap. But it ticks away nicely. My father had one for 15 years and he said: ‘I don’t think it’s worth getting a new battery, son’.”

All this dry humour, the stiff upper lip during the health scare. Does Sir Roger borrow from Bond to get though life’s trials? “No,” he dead-pans. “He borrows from me.”

Fade to black . . . What exactly is a syncope attack?

Syncope, or fainting, is a brief loss of consciousness caused by a temporary drop in blood flow to the brain, starving it of oxygen. Usually, people recover consciousness within minutes after an attack if they lie down. Raising the legs can help to increase the blood flow to the brain and speed recovery.

It can be triggered by an abnormal heart rhythm, dehydration, coughing, getting up too quickly, anaemia, or hyperventilation. After an attack, the heart rate can quickly return to normal so getting an explanation can be difficult. Further investigations for an accurate diagnosis include an electrocardiogram to detect heart rhythm disorders, or an electro-encephalogram, to detect abnormal brain activity. Stars, the charity for people with blackouts, has information on its website www.stars.org.uk. It also has a questionnaire to help you work out the most likely cause of a blackout.