Thursday, 30 March 2017

The Adoption

Following a long weekend of gardening, I went for an after dinner walk to try and ease my aching muscles. I was down the lane at the old railway bridge admiring the sunset when I heard a plaintive cry. A ginger cat was walking towards me mewing. It leapt up onto the parapet and began to rub its head against my arm. I stroked the cat and it began to purr. After a while I turned to go back home and the cat followed me.

I knew there were plenty of feral cats in our townland, although I hadn’t seen this one before. They always took the food I put out for them but were very wary of people. You couldn’t normally get within twenty feet of one before it would run away. The ginger cat was different, it seemed used to people.

The journey home was about three-quarters of a mile. The ginger cat trotted along with me. Often it stopped and went into the hedge or a field at the side of the road to explore a scent. I waited for it and called it to come along. It semi-ignored me, behaving a little like a dog, and only came on again when it was ready. At one point it climbed up the trunk of a tree, then backed itself down and carried on along the lane. With all these diversions it took the best part of an hour to get back to our house and it was dark when we arrived.

I opened the front door and the cat followed me into the kitchen. I gave it some cat food, which it ignored, then a bowl of milk which it drank eagerly. I refilled the bowl. The cat drank it all again. Then it started on the food and ate it all. Then it drank another bowl of milk. After four bowls of milk and three of cat food it seemed satiated and headed for the front door and out into the darkness.

The next morning the ginger cat reappeared, jumping up onto the kitchen window sill and mewing. Its hunger was somewhat abated for it only consumed two bowls of milk and two of cat food. When it finished the cat began to explore the house. We followed him as if his retinue. He sniffed around every room, then leapt onto our bed, kneaded the duvet and went to sleep.

T named him Cyril. I have no idea why. We asked around to see if anyone locally had lost a cat. Nobody had. One neighbour said they had seen a ginger cat down the lane recently. Several reckoned that someone from out of the area had driven here and abandoned him

Cyril remained asleep until the evening. Then he had another two bowls of milk and food and went out into the night. The next morning he reappeared for breakfast. But I noticed that he had left the half-eaten carcass of a mouse on the back door step and its entrails on the front door step. With these offerings the adoption was sealed.

Wednesday, 22 March 2017

Thankful for Small Irritations

It has been a normal week. Nothing dramatic has happened to us. Admittedly, there are plenty of small irritations in our lives which cause discomfort. But that is normal too. The smooth flow of life without setbacks is an illusion, perpetuated by lifestyle product advertising. Like most people, we do our best to live with the irritations.

My dearest T is getting accustomed to her breathing machine and it’s helping her a lot, although some nights it works better than others. The problem seems to be with the fit of the mask. During sleep it can be partially dislodged, meaning that the flow of air goes across her face rather than into her mouth to keep her airway open. On the bad nights she hasn’t slept properly due to apnic episodes and is very tired in the morning. She is experimenting with different pillows and has requested a different mask from the hospital.

I am still waiting to see the surgeon about my diaphragm repair. He agreed to delay the surgery until after my scan result was known, but also said that he wanted to see me again before the procedure. That was the best part of a month ago. I’ve rung his secretary to find out what is happening but she doesn’t know and wasn’t able to find out as the surgeon was away. So I feel I am dangling again, having to prepare myself for another hospital admission but having no idea when.

I ought to be used to this situation, given how often I’ve been here over the past six years. But I still find it frustrating and disturbing. As a cancer patient in the NHS, you always seem to be inbetween scans, treatments and reviews. It’s more a permanent state than a transitional one.

When I was first diagnosed, surviving to five years was the big objective. But that is an artificial target. Statistics on cancers and patient survival are only kept for five years. And many cancers, mine included, are known to recur significantly beyond this deadline – even decades later. So you are never really free of the threat.  

But surviving is what matters. All around us are many examples of the opposite: from famine in four countries in Africa caused primarily by wars, to the sudden deaths of family members, friends and acquaintances.

A group from Concern recently came back from the Central African Republic. It is the poorest country in the world, according to UN statistics. This large country, eight times the size of Ireland, has just 5 million people. They reported that outside the capital city there is no basic infrastructure: no roads, no water and no electricity. Most people get by in small-scale subsistence agriculture. There is no famine at present, but they are stuck in grinding poverty with many endemic diseases and virtually no medical care. The country’s mineral resources have been sold to the Chinese by the ruling elite, who also want to be the sole distributors of international aid. They don’t like NGOs. And aid is often distributed only at election time. This sort of fragile state is so easily pushed into famine by war, as has been happening in Somalia, Yemen and South Sudan.

Earlier this week I learned of the untimely death of friend, who I was close to when I lived in Glasgow, but who I lost touch with after I moved here. His partner, expecting him to be at home, had rung him but got no reply. After several attempts she went round to the flat and found him lying on the floor, as if asleep. He had died from a heart attack.

Having to live with a series of small irritations is the stuff of normal life. It means you are alive and kicking. Making the best of your situation, with humour and resilience is what matters. I’m trying to get better at it. I hope that as I progress along this road, bigger problems might become a little smaller.

Monday, 13 March 2017

The Sleep of the Lambs

It has been another tough week. My dearest T has needed to see two different specialists: an Endocrinologist and a Respiratory specialist. The good news is that she got a diagnosis and began a course of treatment; the less good news is that she will probably need this treatment for life.

Around a year ago I was at a clinic waiting for an asthma review when I saw a poster on the wall: ‘Does Someone you Love Snore?’ The poster explained that bad snoring can be a symptom of a dangerous respiratory disease called sleep apnoea, and said that there was a simple test for this. I went home and spoke to T about it.

She snores very loudly. I often found it difficult to sleep in the same room as her, even wearing earplugs. Not only was her snoring loud, it was disturbing in other ways because she sometimes sounded like she was choking. We looked up sleep apnoea; it was dangerous because your airway would become blocked whilst sleeping. Usually your nervous system would kick start your body and wake you from deep sleep to reopen the airway. But when you subsided into deep sleep, the airway would often block again and you would need another kick start. Over time this process would put a lot of strain on your heart and could lead to high blood pressure, a stroke or a heart attack. 

I asked T to go for the test. At first she was reluctant but I persisted. Then she began to suffer other symptoms: extreme tiredness, bad headaches, shaking, occasional blurred vision, pins and needles. She went to her GP who gave her some blood tests. The results showed that her hormone levels were abnormal. After some discussion he referred her to see the two specialists. Then, through an acquaintance of T’s, we learnt that sleep apnoea with disturbed hormone levels can be a symptom of a problem with the pituitary gland. Her husband had a tumour on his pituitary gland which had caused the sleep apnoea. We began to worry a good bit more.

The sleep apnoea test is quite odd. T was fitted with a heart (mini ECG) monitor and finger (blood/oxygen) monitor. A small microphone was also taped to her forehead. She wore this for one night, and returned the kit to the hospital the next morning. Then we waited. Strangely enough both of the appointments came in the same week.

The Endocrinologist was first. He spent the best part of an hour talking through T’s symptoms. His view was that the core problem was sleep apnoea because the majority of her symptoms were intermittent. He felt that if there was a problem with the pituitary gland these symptoms would be continuous. But to double-check he sent her for a suite of blood tests.

The Respiratory specialist told her that she had mild to moderate sleep apnoea. The test showed that she had woken up 15 times an hour for ten seconds or more. She was shocked, that meant she was waking up from deep sleep over 100 times a night. But this had been happening automatically, she was hardly ever aware of it. When your sleep is this disturbed it disrupts your body’s maintenance systems and can cause a whole host of distressing symptoms. No wonder she was feeling so tired and debilitated.

The treatment is a small breathing machine which keeps her airway open at night. The machine pumps in air to her nose and mouth through a close fitting mask. It makes her look like a cross between a Second World War pilot and Hannibal Lecter. We both laugh at it. But, given the dangers, it is a small inconvenience. The first night with the mask on her snoring stopped and, despite suffering from a bad cold, T began to feel a little better the next morning.

Sunday, 5 March 2017

Pickle and Caravaggio

After all of the stress of recent weeks we had a weekend away in Dublin. The weather wasn’t good but it didn’t seem to matter. We wandered the streets in the cold and damp, managing to escape the rainstorms. There were two main highlights: a new Indian restaurant in Camden Street called Pickle and the ‘Beyond Caravaggio’ exhibition at the National Gallery. Both of these experiences were filled with drama and intensity.

I’d lived in Birmingham and Manchester for many years and was used to eating good quality Indian food. These areas had substantial communities from the Indian sub-continent and this meant that they offered a range of authentic eating places. Many were small Indian cafes whose windows were stacked with brightly coloured sweets. There was normally only one curry on the menu. Indeed there was rarely a menu, just the dish of the day, usually a vegetable curry dominated by whatever produce was going cheap in the market at the time. In these cafes, set in the grimy streets of the inner city, the majority of the customers would be from the Indian sub-continent. In more affluent suburbs and in the city centre there would be more upmarket restaurants which would cater for the British customer, but amongst these there would always be some that produced good quality and authentic Indian food.

Coming to live and work in Belfast I was very disappointed to find that there was a very small community from the Indian sub-continent here and consequently very little choice in the Indian restaurants. The only one that I found which produced good quality food was the oddly named Lolita in Stranmillis, which unfortunately closed a few years ago. Sadly I’d not found a good Indian restaurant in Dublin either. But I’d heard that a new one called Pickle was good and was keen to try it. We were not disappointed.

We had the early evening menu, two courses for €22. I had Seek Kebab and Chicken Tikka, two items you would find on most menus. But the aromas and tastes of these dishes were extraordinary. The chef is from northern India. He grinds and mixes his own spices and it shows. As I drank in the flavours, I was back in Saleem’s in Balsall Heath where as a student I had first tasted those intensely rich and heady spices. I was almost expecting to find the dodgy jukebox in the corner filled with Bollywood anthems. But Pickle is squarely aimed at an upmarket customer and is more discreet in its style. On the a la carte menu, which we will be going back for, most of the main courses are over €20. As we left we noticed a plaque in the foyer which showed that Pickle had been chosen as the best Indian restaurant in Ireland.

Richness, drama and intensity also mark out the paintings of Caravaggio. The exhibition, on tour from the National Gallery in London, displays the huge impact that he had on other artists during his short life (1571-1610). There were only four Caravaggios on show. This confirms how highly valued and closely guarded his work continues to be. They included the iconic ‘Boy Bitten by a Lizard’ and the ‘Supper at Emmaus’. The remainder of the exhibition featured paintings by his contemporaries who were seeking to emulate and utilise his powerful new style. Some achieved this so successfully that for many years their paintings were actually thought to be by Caravaggio himself.

What I love about Caravaggio is the extremely skilful composition of each of his pieces. The paintings are intense and dramatic, the human figures are in close up and every gesture connects you to another part of the scene that is realised in an intensity of light and dark paint (called chiaroscuro). Apparently he worked using sketches of live models who posed each figure in the drama, which he then put together into the final rich and powerful composition. You look at the whole painting and then your gaze is slowly taken around and across it by the shape of the bodies, the gestures of the figures and the play of light and darkness.

My favourite piece by Caravaggio is a triptych in the church of San Luigi dei Franchesi in Rome. On three walls of a chapel are displayed episodes from the life of St Matthew. The left wall appears to be a scene in a tavern; it is in fact at a tax collectors. Men are sitting around a table, lit from a window to the right. There is a complex interplay of gestures and sightlines. A bearded man has entered the room and points towards a young man in a feathered hat, brightly lit at the centre of a canvas. Jesus has chosen the disciple to follow him.  On the right wall an assassin in loincloth with rippling muscles is about to thrust a sword into the supine saint, who lifts up his arms in protest. Smartly clothed men look on almost impassively, whilst a young boy turns away in terror. The sightlines, gestures and chiaroscuro of these two pieces on opposite walls interact extremely powerfully and dramatically. The centrepiece is the least interesting, depicting the saint with a halo and an angel above. Apparently it is the second version. The first was rejected because it was considered too radical. The saint and the angel were depicted intertwined around his writing of the gospel. This picture hung in a museum in Berlin but was destroyed during the Second World War.

This triptych, painted in 1600, was Caravaggio’s first major commission and made his name. After that he became patronised by a rich Cardinal and painted many of the great works on religious themes that he is now known for. Unfortunately, you cannot transport a chapel in Rome to an exhibition in Dublin.

The Crucifixion of St Peter