Tuesday, 18 November 2008
God knows, Gordon Brown is a dull man, but my instincts tell me he's a man of principle and commited to a socialist (with small s) ethic of free health care at point of need and accessible higher education for all - should they want it. GB has a son with cystic fibrosis, and Cameron, also had a child with special needs. It stands to reason that, with Labour (Labour!) paving the way for a two-tier health service by allowing patients to top up their drugs fund (something I'm still not quite over the fence about), the Tories will tighten the financial screws on cancer treatment even more. Part of me is frightened by this. Part of me rejoices that they are not elected yet, and, until they are, we still have access to a reasonable spectrum of care choices.
PLEASE, PLEASE DON'T VOTE THEM IN AGAIN! I made the mistake, when a naive 19 year old, still at university, and tired of doing my homework in the dark nights of the 1970s, of voting for Margaret Thatcher (just the once...but once was enough). She's a woman, I thought. She must care. But that didn't follow, no more than it follows that Cameron cares for universal health care in this country because of the recent tragic loss of his eldest child, cared for so well at NHS Trust St Mary's Praed St. Never again.
As a note to this: I worked once at an inner London cancer unit (The Middlesex Hopitai), checking in patients on reception in thr morning, typing up notes and doing clinic filing in the afternoons - as part of a summer temping job while at University in London. This place was really Dickensian - but, even then (Thatcher's Second Term), the moves were well underway to dismantle the good old systems of Matron bug cont/total ward managementl, et al. Then the private cleaning r came in - and we all know wherwe that has led us. There were no drivers for chemo patients (and chemo was GRUESOME in those days....) The patients had to wait all day for an ambulance to take them out into the hinterlands of Middlesex itself....The only entertainment was a woman who had had the roof of her mouth removed, and when she took out the prosthetic soft palate (can't spell medical words...), it sounded as though she was in an echo chamber. Used to please the punters anyway. After a day at that place, you'd have been thankful for Simon Bloody Callow and his inane drivel on the X Factor...
Friday, 14 November 2008
HAVE THE BREASTS YOU WANT NOW...AND PAY LATER.
And I'm sure there are plenty of takers in this crazy world who would put a bristling pair of new boobs on their wish-list for Christmas. (Credit crunch? what credit crunch?) Even as I write, the Tonight programme on ITV is running an investigation into those creepy-looking, pill-popping cranks who think it's their inalienable right to live to be 150. One anal-fixated, middle-aged male argues, in defence of the fifty plus supplements per day he's been taking for twenty years, that he aims to avoid 'the diseases of old age'. Is the unspoken one, the one that dare not say its name, a disease of old age? Try telling that to six year old with leukaemia or a twenty two year old with breast cancer and a two year old child to bring up.
Grotesque as they are, I feel mildly sorry for these cock-eyed opitimists who think cosmetic surgery can fix their lives. And what sort of life is one in which you feel obliged to 'restrict your calorie intake' (although the quack who came up with that popped his clogs at the not so ripe old age of 79) or spend your earnings on shed-loads of quackery? Imagine a society like that - a collection of grotesques in which old age doesn't begin untill you're ninety. I'm all for medicine fixing the body (it's fixing mine!), but not beyond its alloted span; and we would all do well to remember that the longterm tally for that is threescore years and ten. It's surely what we do in those alloted years that counts; but I guess I am giving this an unaccebtably moral overtone. Sad though, I think, that those eternal youth-seekers, fixated on 'eternal life', quite fail to see beyond the limitations of this world. It's materialism gone crazy - like a cancer.
The truth is, we are all dealt a certain hand. Some of us get cancer. Some of us don't live to get it because we die in road accidents or are murdered in the cradle by our parents. Do we ever get the breasts we want? The legs we want? The face we want? The height/weight/hair (curly or straight) we want? And when we pay to get what we think we want, we end up wanting something else entirely. That is, of course, those of us who can make those choices. (Credit crunch....what credit crunch?) If NHS funding for cancer care is the postcode lottery it is purported to be (though I haven't found it to be so here in my case....yet), and it came to the choice between spending money on breast reconstruction or some risky new life-prolonging chemo treatment, I think the choice is pretty obvious. In such a case, you'd get the breasts you want (for now, perhaps), but someone, somewhere would surely be paying later.
Friday, 7 November 2008
Wednesday, 1 October 2008
Thursday, 4 September 2008
The National Institute for Health and Clinical Excellence (NICE), the national organisation responsible for providing national guidance on promoting good health and preventing and treating ill health, is currently developing clinical guidelines on the diagnosis and treatment of both early breast cancer and advanced or metastatic breast cancer. These guidelines will help to shape how breast cancer care is delivered in the next few years and which treatments and care are available.
A draft of the guidelines was recently published and NICE is keen for people affected by breast cancer, or interested in breast cancer issues, to feed in their thoughts about the proposed draft. This is your chance to share your views on services and treatments and help inform a joint response from Breast Cancer Care and Breakthrough Breast Cancer. The charities are working together to develop a response to the guidelines, to help us make sure that our response represents the views and experiences of as many people as possible. The Advanced breast cancer guidelines are particularly important to the work of the Secondary Breast Cancer Taskforce and as members of the Reference Panel we would really like to hear your views on this guidance.
To inform our response, we would like you to complete a questionnaire on the topics outlined in the guidelines. The survey can be completed online at; http://www.surveymonkey.com/s.aspx?sm=5zNiZVqyJ95wSnzllJDy3g_3d_3d.
If you would like to read the draft guidance they can be found here: http://www.nice.org.uk/guidance/index.jsp?action=download&o=41615
The deadline for feedback is Friday 12th September 2008. Please return hard copies of the survey to Chris Quince, Policy and Campaigns Assistant, Breast Cancer Care, 5-13 Great Suffolk Street, London, SE1 0NS.
Please note that all responses will be shared with staff from both charities as part of our joint work on the consultation. However, all responses will remain anonymous.
6th September – PINCUSHION by Anne Morgellyn.
The latest in a series of psychological thrillers that chart the adventures of Louise Moon and her precarious love affair with brilliant but unconventional pathologist, Chas Androssoff.
Performance artist August Stockyard, attention-seeking heir to a media and property empire, dies in typically theatrical fashion, after making the bequest of adjoining houses to his pregnant girlfriend, Cressida, and to his former comrade-in-arms, Louise Moon.
But was August's demise simple suicide or was it the result of a kinky sex game that went wrong? Had he cleverly planned to shame his distant father and take revenge on his ruthless uncle, the obese and grasping millionaire who now had his eye on Louise?
Or was it a game from the grave, pitting Cressida and Louisa in a fight to the death as reluctant and mismatched neighbours?
About the Author: http://www.bewrite.net/authors/anne_morgellyn.htm
All BeWrite Books are available from: BeWrite Books, Amazon, Barnes & Noble, Angus & Robertson and other online booksellers and to order from high street bookshops.
Print ISBN: 978-1-905202-82-9
eBook ISBN: 978-1-905202-83-6
ALL ROYALTIES FROM SALES OF THIS BOOK WILL BE DONATED TO BREAST CANCER CARE.
Tuesday, 15 July 2008
Tuesday, 8 July 2008
Tuesday, 1 July 2008
> inspirational healer and martyr.
Not happy with your email address?.
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Sunday, 15 June 2008
Saturday, 17 May 2008
Wednesday, 30 April 2008
Sunday, 27 April 2008
Yes, it is - and it is to be hung onto and treasured for as long as it is given to us. But the comment on what may or not constitute 'a cancer personality' struck me with the force of truth.
Ghislaine Vaughan writes: "I once read a book about cancer in which the author, Bernie Siegel, a surgeon with many years' experience of talking to, operating on and generally supporting people with the disease, had come to the conclusion that people who get cancer have a certain type of personality. He even went so far as to suggest that you could tell whether someone was a likely candidate for cancer by asking them the following question, which he had found to be the bottom line: "If a friend asked you a favour and you didn't want to do it, would you do it anyway?" Apparently, if you say 'yes' to this question, you are far more likely to develop cancer than if you say 'no'.
It became clear from this idea that those with a cancer personality are in general far more likely to give up their own wishes in favour of those of somebody else. Bernie Siegel gives many examples of how his patients recovered or had long periods of remission when they were encouraged to pursue their dreams and aspirations, including one young man whose prognosis was bleak until he began playing the violin. He had always wanted to study music but had been pushed into a career as a lawyer by his family. As soon as he gave up law in favour of the violin, he got better."
All of which strengthens my resolve to keep up my studies in singing and piano and take my music diploma next year. I got ninety three percent in my last theory assignment, which was a boost to the morale in a week when I had an abnormal (well, 'borderline') smear result. I now have to have something called a colcoscopy - ironical, really, since the reason for putting off the smear test for so long, while I was undergoing treatment for breast cancer, was that I thought I really couldn't cope with any more humiliating poking and prodding. Well, now I think I can. And I will. Because it is worth it - it is. It's a wonderful life.
Friday, 28 March 2008
An acquaintance of mine also sent me a dog-eared newspaper clip, dating from 1983, about treatment choices, specifically whether or not to go ahead with a mastectomy in the case of the woman featured. She opted not to have the op, and my correspondent was wondering if she had survived. Twenty five years is a very long time in the story of cancer treatments, and many of the life saving (or life prolonging) drugs available readily now were simply unheard of then - like Herceptin, for instance. Before the discovery of this monoclonal antibody, there was no point in testing biopsy tissue to see whether women were Her2 positive or not - because, if they were, there was no treatment. Now there is, and I don't care whether is it palliative or not, as long as it works.
I remember sitting in the marble bathroom of the 5 star hotel in northern Spain where I was staying just before my operation and wondering whether I should go ahead with it after all. The chemotherapy (FEC) I had had over the previous eighteen weeks had taken out one lesion altogether and shrunk the other down to a size which made it feasible to operate. My poor right breast felt normal again. The puckering had gone, and so had the lump I could feel. As for the other rogue cells at large in my system, I knew removing my breast was not to going to have the least effect on them - their control was down to the chemo and the Herceptin alone. But still I went ahead, two days after sailing back from Spain. I went ahead because my doctors, Duncan and Alistair, had now decided it was 'worth it'. Surgery, though, was without doubt the worst part of the whole business for me, apart from the emotional shocks (disappointment in family members) which were nothing to do with the disease itself (although they may have had a lot to do with its progression). The surgery was bad because it was painful (at least in the aftermath) and ate into my daily routine (I couldn't drive my car for a couple of weeks) and - worst of all, it necessitated a week's stay in hospital, which meant, in theory, a total lack of privacy for me - a state of exposure I thought absolutely couldn't stand. In the event, though, I was only sharing with two other women in the bay after we had conspired to remove the old woman with dementia who kept us up all night with her complaining, and - worse - had a terrible, whingeing daughter who was visiting on the ward from 8 thirty in the morning till 8 pm at night and for some reason lit on me as the patient to badger. This ghoul (for that's what she was) haunted me throughout the day I was waiting to go down for surgery with her tales of people who had died (from breast cancer) and those who ended up with lymphodema. At last, I shook her off and hid in the chapel; but when the time came for me to change into the theatre gown, she stood over my bed and made a running commentary on the progress of my undressing to her demented mother (and father). Boy was I glad to see the back of her. I guess she's badgering someone else now. That's the trouble with whingeing hypochondriacs: they always live to tell another tale.
Still, maybe she chased me into the chapel for a reason. The Gospel was open on the story of the storm at sea in which Jesus (who is sleeping soundly as the sea is raging) admonishes his disciples with the question: 'Where is your faith?' I knew I would be all right after that. I just knew.
Friday, 21 March 2008
The nurse, Sarah, was uniformly charming. The equipment came in a discreet black suitcase on wheels - thanks to the weight of the oxygen cylinder inside and the foldaway chrome drip stand. We set up straight away, me soaking my hands in my kitchen sink while Sarah moved the chair around. She found a vein within seconds and was in it even faster. I have never before had a 'flashback' (haemorrage) into the valve as fast and furious as that. Then we sat and chatted while the drug dripped in under its own pressure. The electronic pumps they use at the hospital are apparently only for monitoring. 'So they can go off and see to other people,' Sarah said. 'But you have me - my undivided attention, for the next two hours.'
It passed really quickly. I was warm, holding my hot water bottle, and completely stress-free in my own armchair with my feet up on the plastic cube. Sarah went out to look at my garden and said she was booking some time out there in the summer months, which made me visualise having my treatment under the trees, with the parasol protecting me from dripping sap.
Sara works for a private company that provides outreach nursing services to both the NHS and private sector - and I felt like a private patient in her care. The Herceptin bag came by overnight courier from Burton on Trent, and I was presented with my own smart blue file, containing the usual protocols, an emergency on-call contacts list, and a copy of Duncan's prescription. Sarah had a hand held gadget that printed out the treatment notes onto a label she stuck into the file. Cannulation attempts: 1, etc, etc. Tolerating it well.
If this is all I have to tolerate from now on, I can live with that.
I am living with that!
Monday, 25 February 2008
Back to the picture: the foreground has buildings on the boulevard done in garish colours, with a cafe-terrasse down below. The right hand of the composition is carefully drawn in, but the left is an impressionistic mess - it could be a rainy pavement, it could be the cafe lights twinkling in the twilight. It could just be that the artist got tired, as patients get tired in the haem clinic, of sitting there and wondering what to do next. But it did its job in distracting me from the blood bags and the needles. It took me back, albeit in a sort of cynical, superior way, to Paris, where I spent so much of my life, first as a student at the Sorbonne and then in a variety of useless jobs. Actually, I spent a lot of time in Paris even before that. I've been doing nothing in Paris since I was about fifteen. I often think about going to live back there, but then I visit again and the same old ennui washes over me: Been There. Done That.
Still...Paris. In the Spring. Paris. Nuits de juin, dix-sept ans, On se laisse griser... (That was Rimbaud, not me, the enfant-terrible of a poet my tutor at University said he would have hated to have in HIS class...) Henry Miller is another notorious liver-in-Paris. (Alistair would not have wanted HM in his class either...) I remember so much about the place - those parties held by American, Jim Haynes, in his atelier in Montparnasse, trying to perpetuate the Paris of long ago, of writers and artists and no-hopers but determined livers nonetheless.
I wonder what it means to the others who see that picture every day? It's more evocative than the other pictures they've got up there, most, I suspect, donated by grateful patients. There are static views of Cornwall ( it's possible to make even the sea here static if you've got no eye) and the odd abstract. But Paris did it for me, even though the Champs Elysees has to be my least favourite part of the city of light. It caught the aspect of the entire city, something of its spirit. And in a haematology clinic in Truro on a Monday in February, that's saying something. That is succeeding in something.
Monday, 18 February 2008
I didn't take any medical insurance, other than my standard cover that comes free for Cara and me through my banking package (if anything from a bank can ever be said to be free), and our E111 forms, of course. When we arrived, though, the driver who picked us up from the airport (recommended - see www.budapesthotels.com Airport Pickup Service) said there had been a demonstration that day about proposals to make Hungary's health service a paid for service. If this happens, I expect it will put an end to free reciprocal agreements with the NHS in Britain. But I didn't take out extra cover when I went to Switzerland either, in 2006, or Germany in 2007 - although I didn't anticipate any problems in either of those places. The most likely problems, relating to my cancer treatment anyway, would have arisen when I sailed to Spain in 2005, five weeks into chemotherapy treatment (and without my hair), or later that year, in Budapest, exactly a month after my operation. Travel insurance for people with 'ongoing' or 'prexisting' conditions like cancer is punitive - although I recently read somewhere that these punitive measures contravene disability rights legislation under EU law.
Anyway, Budapest. It's wonderful. Try it. Sod the insurance - just go.
Tuesday, 29 January 2008
I have my treatment, by intravenous infusion, every three weeks at the haematology clinic in the Royal Cornwall Hospital. The nursing team there are heroines of a different sort, battling with infinite patience against the unseen powers who make so many stupid, arbitrary and ever more impractical administrative decisions at this and so many other NHS hospitals in which the management culture is now a terrible blight. It's a culture predicated on a wish to curse, not cure. The latest decision thought up by this dictatorial crew of outrageously overpaid bureaucrats (whether or not they've got MBAs - and in a cancer clinic, who gives a shit about MBAs?) is to overbook the clinics and take on ever increasing numbers of chemotherapy and blood transfusion patients, without increasing the number of nursing staff or seats in the treatment rooms. By what rationale of time and motion or other redundant studies they see this working, God only knows; but for the cancer patients waiting for chairs, it means a longer wait; and for the oncology nurses, who start at 8am and work till six (or when the last late patient has finished...), it means no lunch or tea breaks. To perform their jobs as well as they do, in such circumstances, with such unfailing patience and friendliness and professionalism, it goes without saying that this team of nurses - Jo, Alice, Rachel, Yvonne, Cass and all their colleagues are something beyond exceptional.
Yesterday (thanks to Management), I waited forty minutes for my chair in the treatment room (and I was lucky - I got a recliner) and was cannulated at twenty to two by poor Alice, who hadn't had a break since clocking on. This time last year, I was having problems with my veins, it taking sometimes as many as 11 cannulation attempts (which means 11 pricks in the arm and hand) to get a line in; but, strangely enough, it's got better since last summer and now I don't worry about it nearly as much as I used to. It's not that the cannulation is particularly painful: a 'sharp scratch' is indeed all it is; it's the anticipation (will they spear a vein this time? will it be over soon?) that causes the most stress. I must now have had close to two hundred 'sharp scratches' - including all the spikes for blood tests, etc, and all in my long-suffering left arm and hand, the right one (my 'operated side') being out of bounds because of risk of lymphodema. I haven't got lymphodema though, and sometimes, it has to be said, they go into the veins on the right. They use the smallest gauge of needle (a paediatric cannula), which is fine for chemo drugs, including Herceptin, but not for CT scans, which require the contrast injection to be given at a faster infusion. But I have found a way around this, like today, by getting the radiographers to put the contrast in through my treatment (paediatric) cannula at a lower pressure. This meant I got away with only two sharp scratches this week - Alice's one failed attempt in my hand and her other successful 'scratch' infusing both Herceptin yesterday and revolting, metal-tasting contrast dye this morning, when they scanned my chest and abdomen.
That's treatment over now for the next four weeks because I am taking a holiday in Budapest on 10 Feb. It's allowed to take the occasional holiday from Herceptin treatment, but what this means in terms of future appointments is that my schedule will be out of synch - and this means more 'sharp scratches'. Usually, I manage to synch a three weekly Herceptin infusion with a three monthly clinic appointment, which means I can get away with one cannulation for both infusion and the dreaded blood test, it being more difficult to get blood out of me than Herceptin into me. But Budapest is more than worth that extra sharp scratch; and four weeks - a whole four weeks - away from the hospital, after all this time, feels like a liberation!
Friday, 25 January 2008
C.S Lewis, The Problem of Pain
For the three years I've been living with this condition I have experienced mostly human kindness and compassion, and this has been at its very best. At its very worst, I've had people avoiding me - and I can live without those people. But last Saturday, when I explained to the woman who recently moved to the house at the bottom of my garden and was berating me about the sight of my builders' heap - only exposed by her illegal felling of some ancient trees - that I was (a) not aware that the builder had left an old loo seat there, in view of her window; and (b) that I was not up to clearing the large items slipping out from under the pile of leaves because I was living with secondary cancer and tired easily, her response was:
I DON'T WANT TO KNOW THAT....
There then followed several abusive fishwife style charges, too silly and petty to mention here, although they left me reeling in amazement. My tendency (a bad one, since it always puts me on the wrong foot) is to feel sorry for such people because they are well, let's say, uneducated LOCAL people (Cornish peasants...) who probably haven't had a quarter of my advantages, etc, etc. But that's politically incorrect of me. Probably illegal even to THINK such things these days...(I hold my hand up, guvnor...) Probably some mental illness there - even if its only a pathological lack of compassion; but isn't that a definition of a psychopath? Oh God - and at the bottom of the garden, too!
Thing is, though, if you live with cancer, you can pretty much live with anything.
Friday, 4 January 2008
So, in case anyone is interested, or might like to take some heart from my experience, the retrospective postings of this journey on this blog are:
Crab and Fishes 1
Hair and Other Losses
‘If you do arrest,’ Thea told me cheerfully, ‘we can always resussitate you.’
And if I arrested, what would happen to my daughter then? She was staying with my mother in the north while I embarked upon the nasty chemo regimen. I was unsure of how it would affect me, and consequently, my ability to care for my child while I recovered from each dose of poisoning. So I let her go, when my mother put it to me as the only option, without thinking too much about what it would mean to lose my little girl, because thinking about it too much would have made it quite impossible for me to wave her off at the station and go home to an empty house, bereft for the first time in ten years of my only child’s presence, her sweetness and her light. When I waved her off, I still had hair, auburn hair, down to my shoulders, although it badly wanted cutting. I had battled with Cara about it throughout our holiday in Budapest. She wanted me to let it grow.
The breast nurse, Janet, had told me about the cold cap, a ridiculous-looking blue helmet that is meant to minimise the risk of hair-loss through chemotherapy. It maximises the treatment time, however, because it needs to be worn for a bit before the drugs are infused, during the infusion, and, I think, for a short time afterwards. My objective was to spend as little time at the hospital as was possible in order to spend as much time as was left to me with my daughter. My hair was a small price to pay for this precious commodity of time, newly precious to me because I had wasted so much of it. Cara, I hoped, would understand.
‘And anyway, it grows back in six months,’ Thea said, ever cheerful, ever sure. ‘The wig lady’s here today. You can get a wig on the NHS. Why don’t I introduce you?’
On the advice of the wig lady, who clearly knew about these things, I went for a pre-chemo crop at an expensive salon with a chair that massaged my back while my hair was being washed and my head massaged. This was the only visit I have ever made to a hairdressers’ when I didn’t feel intimidated by the experience, made all the more enjoyable because the stylist was the first person I had chatted with in over two weeks who did not know I had cancer. A haircut usually lasts me about six weeks, although I figured that, this time, instead of the hair growing out of its style, it would probably fall out altogether, something I neglected to tell the stylist as I tipped her. My next cut was waiting in a box at home: a Raquel Welch ‘pixie’ wig, with a steel brush to groom it and its own special shampoo and conditioning bottles. I hoped it would make Cara laugh, because seeing her cry again, as she cried when she learnt of my diagnosis, throwing herself down on the hardwood living room floor and howling with an existential despair, while my mother went to phone a friend in the other room, and I stood there helplessly, was more than I could bear. That my daughter should come to know despair at the age of ten, because of me, caused me far more pain and grief than the disease itself. How I would get through this, I didn’t know. But I knew that I would get through it. I have breast cancer, I said to myself, as I opened my eyes the morning after diagnosis, knowing that it was going to be like this every morning now, for the rest of my life, ever walking beside me. I have breast cancer, but I will get through it. It was like a mantra.
When I received my diagnosis, two weeks after Cara and I returned from the annual trip to the spa, and a mere twelve days after the GP had referred me to The Mermaid Centre (‘a one-stop shop,’ she said, ‘so at least if there’s anything nasty under there you’ll know the same day’), I thought I was falling off the edge of the world. The world hadn’t ended -- far from it; it was rather that I was being thrown out of it, and not with a bang but a whimper. At the same time, I had the slightly more uplifting thought that all this was an illusion, like the series of tests I had had that morning at The Mermaid Centre: mammogram, ultrasound, needle aspiration, cone biopsy. A series of illusions, one after the other. Throughout these tests, I was thinking of the work I had brought with me: a series of creative writing assignments done by external students at Exeter University, mostly of indifferent quality, and almost as tedious to endure as all these clinical procedures. But, increasingly, I grew all too aware of my surroundings (grounding, I think, is the pop psychologists’ term). I became aware of the radiographer’s blank expression and increasing taciturnity, contrasted with the warm touch of the clinic nurse who came in to assist the kindly, German radiologist who performed the ultrasound. ‘You are right,’ she told me, ‘moving the sensor to the top of my right breast, beneath the collar bone. ‘It’s nothing to do with these superficial skin infections.’
Then the surgeon arrived. ‘I’m Alistair,’ he said. ‘And this is going to hurt you, sweetheart. When I was a junior doctor, I never hurt anybody – but I didn’t get enough material and then the consultant had to go and hurt them. Now that’s me.’
He punched a fine needle into the area below my collar bone identified by Kirsten, the radiologist, and drew out his material. It didn’t hurt a bit, and I told him so. I liked his utter frankness and his Sean Connery-esque Scottish burr.
‘I’ll be back in half an hour,’ he said, grinning at me in a non-committal fashion. The Mermaid Centre has a cytologist on site – which is helpful to those lonely women in the consulting rooms, cowering in fear and anticipation. Needless to say, it was a long thirty minutes, in which I was hyper-aware of the white walls, the half drawn blind, the light breeze blowing in the through the window, the basin on the wall, the MRSA-fighting hand-wash, the needle mark on my chest, which was starting to throb a little, though still it did not hurt.
Alistair came back into the room with a woman dressed informally in a soft grey sweatshirt and trousers. It’s bad, I thought, because they’re bringing in the counsellor.
Alistair sat down next to me on the consulting couch and put his arm around my shoulders. ‘You don’t need me to tell you what it is, do you?’ he said. ‘You know what it is?’
I nodded. ‘The thing is,’ I said, ‘I’ve got a daughter. She’s ten. I’m a lone parent.’
‘And have you any relatives near by?’
‘She has,’ I said. ‘She has her father’s relatives in Hayle. Her father isn’t with us. He isn’t well.’
‘Are they decent people?’ Alistair said. ‘Can you trust them?’
I didn’t know what to reply. I had never had to trust them before – I had never had to trust anybody with Cara’s care. There had been only me and her: a symbiosis.
‘Well this is our problem now,’ Alistair said. ‘My problem, as well as yours, for the next five years. I’ve been to see my colleague, Duncan, just down the corridor there.’ He pointed through the window to what appeared to me as a blank wall. ‘The way we’re going to treat it is to give you some chemotherapy, over eighteen weeks. Duncan will tell you about all that. Then we’ll give you a month off in August before doing a mastectomy. I’d want my wife to have it,’ he added defensively, as though anticipating some protest on my part.
‘And who will do that operation?’ I asked. ‘Will you do it?’
‘Who the fuck else would do it?’ he said. I laughed.
‘You’re a four-letter man,’ I said. ‘I like that.’
He nodded. ‘Then we’ll give you some radiotherapy. You know, when I first came to this hospital, I had to send my fucking patients up to Plymouth for their radiotherapy. Couldn’t be doing with that. This is Janet, the breast care nurse,’ he said, indicating the lady in grey and getting up. ‘She can fill you in. Duncan, will see you tomorrow, nine o’clock, at The Sunrise Centre.’
‘Clinical Oncology, just down the corridor there. That’s where you’ll have the radiotherapy.’
I stared through the window at that blank wall. Alistair went out and Janet hovered. There was a box of tissues on the chair at the foot of the bed. I think she was waiting for me to cry.
Duncan drew me a diagram on a piece of paper and referred to the dots and dashes on it as ‘zapping the buggers’.
‘I’ve got plenty of weapons in my armoury,’ he said. ‘There’s a drug called Taxotere, one of the nastiest poisons we’ve got. We might start with that, although it might make you feel really rotten for a bit. The idea is to shrink the tumour down so we can operate.’
‘Alistair, you mean?’ I said. ‘Why can’t he do it now?’
‘The tumour’s too close to the chest wall,’ he said gently. ‘I’m proposing six doses of chemotherapy to see where that takes us. But before we start, I want to send you for a couple of tests – a chest X-ray. A CT scan and a bone scan, just so I can see what I am dealing with from the very outset. I wouldn’t want to get six months down the line and find we’ve missed something.’
‘OK. And when will this chemotherapy start?’
‘Next week probably.’ He smiled. ‘Oh, and if you agree, we’d like to send some of your biopsy tissue away for testing. It’s for a clinical trial we’re running, to see if you might be suitable for it.’
‘That’s fine,’ I said. ‘It’s no good to me.’
So I signed the consent papers, went for the scans, and looked forward to having a few days’ off from all this, over the week end, before Duncan zapped me with his monstrous regimen.
But he wanted me back before then. He had left a message with the bone scanner to call me over to The Sunrise Centre again. I knew why – not where, exactly, but why.
This time, Duncan had both his research nurse, Thea, with him and another breast care nurse, called Josephine. It’s bad, I thought. Very bad.
‘The bone scan was clear,’ Duncan opened. ‘But unfortunately, the CT scan showed some spots on your lungs.’
‘Metastases,’ I said, smugly citing the clinical word, because words are my job. My whole life, I thought, I’ve been obsessed with what Alistair might qualify as fucking words. And what are words, anyway? Just fancy parcels of received meaning.
‘You mean it’s spread? You told me before that with these drugs – this Taxotere, for instance, and all the rest, the surgery and the radiotherapy, that you could eradicate it, more or less, and I’d have the same chances as any other woman my age, I mean for living to old age…’
‘We can’t cure it,’ Thea said. ‘But we can treat it.’
‘Alistair can’t operate on my lungs?’
‘No,’ said Josephine. ‘It wouldn’t be possible.’
I looked Duncan in the eye. ‘I’m not bothered for myself,’ I said. ‘I mean, I’ve had an interesting life.’ A rich and exciting life by anybody’s standards. Running round the world like a headless chicken, interviewing people for American TV, so that people in the red-necked mid-West could switch on and gawp at those backward Europeans. I had a much more important life now, here in Cornwall, a life that was all my daughter’s.
‘Will I live to see my daughter grow up?’ I asked Duncan, rather fiercely.
‘Yes,’ he said, emphatically. ‘Yes. We’re talking years, not months.’
Years with cancer. I tried not to think how many. I had had forty six years without it; the number I had to look forward to with it was an unknown quantity. But then so is any calculation pertaining to the future, an unknown quantity rubbed in hard on 7 July 2005, in front of the TV set in the haematology clinic. Hooked up to drips, we patients are as desperate to hang on to life as the healthy people caring for us, terrorised by the news broadcast. I am hanging onto life by a line containing the product of outstanding medical research: the monoclonal antibody, trastuzamab (Herceptin). It costs twelve hundred pounds a dose, and Duncan, to whom I am eternally indebted, has put it into my treatment regimen, a mixture of three cytotoxic chemotherapy drugs, a hefty dose of steroids, which send me up high as a kite, and something the nurses in here call ’your cover’ – which has so far stopped me from being sick. I am hanging onto life here in the clinic in Cornwall, while up in London, a group of deeply disaffected, morally moribund, and mortally stupid young Islamo-fascists are blowing themselves to pieces and destroying, willy-nilly, innocent bystanders who happened to get in the way. A bit like cancer cells, really, spreading out in an undercover crab-like motion, seeking parasitically to block out and destroy all that is life-enhancing and life-affirming – all that is life. An anti-culture, a terrible blight.
But I have survived it – up to this point in time, which is the only point any of us really have. I am equal to it.
I am still here.
This place is absolutely not about the body beautiful. Breasts come in all shapes and sizes here, except the uniform. There is not the slightest whiff of the footballer’s wife or silicone babe in the ladies’ pools and massage booths of the once grand and glamorous Gellert Hotel. Today, in fact, is pensioners’ day, and the local grannies bob about like pickled walnuts in the cloudy, sulphurous water, naked except for the well-bleached linen modesty aprons that flap uselessly about above their grizzled pubes. No one is paying the smallest bit of attention to my own well-lived in body, I assure my furiously embarrassed little girl; but I wonder, all the same, as I slip down my straps and climb into the icy plunge if it is noticeable, this strange, slight puckering on my right breast above a strange hard lump I felt there about six weeks before Christmas. There is only room for two in the plunge, and the other incumbent, a naked Austrian woman, looks challengingly at me, to see if I can stick it out. I last about ten seconds.
Cara is waiting for me back in the thermal, not realising that it is her whom the Hungarian grannies are talking about, for skulking too long in the 38 Celsius bath. I swim up to her (another contravention of the rules) and, still defiantly topless, submerge what my new Austrian friend would call my heart and lungs chakra in the dense hot water, hoping that its curative properties will disperse this strange contusion that is keeping me awake. It is possible to reach a state of beatific torpor in these baths, judging from the expressions of some of the women: a transcendent state, where past and present converge in great white hopes for the future. Most of them have been in here for at least an hour, which is fifty minutes longer than the maximum time recommended at this temperature. Cara is rosy as a picture-book apple, and I hate to imagine what the hot spring water is doing for my own face, though it is doing wonders for the circulation in my legs. Watching the clock, fixed high on the wall of green and silverfish grey majolica tiles, I wait out another five minutes before a white-coated masseuse, a relic from Communist times from the look and sound of her, comes to the steps to shout out a number at me. She wants some other hapless tourist, I expect, who doesn’t understand Hungarian; and I briefly consider taking her place, but am frightened of the close scrutiny I might attract perched up on the couch, beneath the harsh bright lights and expert, pummelling hands. There is a hospital on the floor above the spa, purporting to treat cardio-vascular problems. We pass it, Cara and I, as we ride up in the antique lift of the grand old hotel, in which we are thankfully staying, because to go to the effort of drying and dressing and turning out onto the cold March streets after the enervating sensation of the baths must be punishing indeed. A couple of ‘patients’ in hotel dressing gowns get on at the hospital floor; but Cara and I do not get out. Cardio-vascular problems, I guess, are not my trouble.
It is still there, back up in our room, as I peel off my swimsuit again beneath the same sulphurous waters of the bathroom shower. In fact, there is possibly more of it, for besides the hard, tight lump and the puckering, there is now what looks like a slight patch of inflammation beneath my collar bone. The mirror is steaming up, and my image is starting to melt, like one of the damned in hell in Michaelangelo’s Sistine frescoes; but I can see it in my mind’s eye.
It is still there.
It is always there.
It isn’t going away.