A Good Step Forward

I’ve got the result of my cancer surveillance CT scan. In the words of the radiologist: ‘Stable appearances. No evidence of recurrence.’ They never say ‘all clear.’ Nonetheless, this is a huge relief. However, I did come away from the meeting with my oncologist with an important question that still needed to be answered. For the past three months, I’ve had a pain in my left side, which also follows the line of my ribs. I first went to my physiotherapist. He told me it was a minor muscle tear. But a month later the pain was unchanged. So I went to my GP. He sent me for a series of blood tests and an X-ray. All of these were normal. And still the pain continued. So when I got the appointment for my CT scan, I rang my oncologist’s secretary and reported my symptoms. She was concerned. My left kidney was where the cancer had first appeared. She told me that Radiology would be asked to specifically report on my left side. Unfortunately, their report did not do this.

At the meeting, I explained that I was afraid my left diaphragm had become damaged again. It was surgically repaired with mesh five years ago. My oncologist examined me and concluded that there were a number of possible diagnoses. The repair could have become damaged. Or some scar tissue could have torn. I have plenty of this, and some nerve damage, due to repeated surgery on my abdomen. Or this pain could be an early sign of something malign that had not yet grown enough to show up on a CT scan.

She said she would contact the surgeon who had done the repair on my diaphragm and ask him to have a look at the pictures from my scan. I was delighted she was going to do this. It would have taken me ages to get to see him again. She also booked me in for another CT scan in three months time, to check again whether any recurrence could be seen. I was reassured for now. She had been thorough, covering all bases. And these were good steps forward. I could sleep a bit more easily.

What Keeps You Awake at Night?

I’m still waiting to hear the result of my cancer surveillance CT scan. It’s been two weeks so far. I try and take each day as it comes, but that’s not easy to do. My main coping strategy has been distraction, primarily by immersing myself in other things. This takes a lot of effort, and only seems to work some of the time. I didn’t expect to hear anything during the first two weeks. I know it will get harder from here on in.

My primary distraction has been to work intensively on my crime novel. The report I got from the professional editor was very positive and encouraging. He also gave me a series of suggestions for improving the novel. In particular, he pointed out where I could cut some back-story and some scenes that he felt slowed down the momentum of the novel a little too much.

It’s so much easier for someone else to see where you could make structural edits to your manuscript. I did realize that it needed improvement and I recognized that the opening act was where I most needed to focus my attention. But I couldn’t see exactly what edits ought to be made. If truth be told, I was also resistant to making further structural changes. I had already rewritten a good part of the opening act of the novel over previous months. I’d invested a lot of time and effort in it.

With the editor’s prompting, I took a very hard look at what I had written. I noted down what the key plot points were in each of the scenes that he had identified as potentially cuttable. I soon saw that all of these could be placed elsewhere in story. I thus ended up cutting four scenes and one sub-plot. And now the opening of the novel does flow much better, with a more immersive intensity.

He also pointed out that my narrator tended to use certain exclamations and speech tags rather a lot. Turning to the ‘find and replace’ text command, I discovered that my narrator said ‘bloody hell’ 65 times over the course of the 281 page novel. Rather too many, don’t you think? Even for a crime novel. I ended up removing or replacing plenty of these. As I did for several other words and phrases that were overused.

Oddly enough, I can lie awake at night imagining alternatives to ‘bloody hell’. I’m not going mad. It’s just my distraction therapy in action. If I wasn’t worrying about my novel in the wee small hours, I’d be worrying about the return of the big C.

Alive and Kicking

It’s come around again quickly. Tomorrow, my cancer surveillance CT scan takes place. I currently have a nine month interval between scans. It’s been eleven and a half years since my first tumour was found. It’s been six years since my last tumour was removed. And it’s been five years since I’ve been under a surgeon’s knife. The type of cancer I had does not respond well to drugs. So the primary treatment is surgery. I hope and pray that I never have to be chopped open again. Each time they go in there is collateral damage. This, it seems, is inevitable, however beneficial the purpose of the procedure.

My abdomen was slit open four times in six years. The end result is that the tissues of my torso have been seriously weakened. Indeed, the lower part of an abdominal muscle was removed completely during emergency surgery seven years ago. As the tissues repaired after each of these procedures, I was left with lots of scar tissue and adhesions. These give me pain and loss of function in different parts of my torso. I know each of these sites intimately, especially when they nag at me in the small hours. The worst is my left side, where my ribs were cut open five years ago.

Ah, I hear you say, but you’re still alive. Not many of those who’ve had Stage 4 cancer are still with us. Don’t get me wrong, I am delighted to be amongst the lucky few. Learning to live with the unwanted results of surgery is a luxury, compared to the other option. But I don’t seem to keep this knowledge in the front of my mind. Like anyone else, I naturally try and do things as part of normal everyday life. But when my body brings me up short with a stab of pain, I have to step back. And say, no, I just can’t do this anymore.

It’s a challenge to accept your limitations. In my head, I’m still a younger man. T is doing her best to stop me injuring myself. She has taken on plenty of arduous tasks. And she acts like a conscience, telling me to stop if she sees me embarking on anything too foolhardy. I try my best. But from time to time, I do too much or I go too far, and I end up hurting myself. It’s not easy being a survivor.

In Joyce's Country

This is the view over Lough Corrib from our cottage. We spent a lovely two weeks there. The cottage had a sunroom with a large picture window and we often sat watching the light change on the lough. It was also the only place in the cottage that had an internet signal. There was no phone reception at all. But that didn’t seem to matter. We sat and read, went for walks and bike rides, and recharged our batteries. The nearest village was Clonbur, one mile away, which had a good shop, a bakery and three pubs, two of which served food. The cottage was whitewashed and sat amongst fuchsia bushes and fruit trees. It had been the home of the grandfather of the current owner, who had improved and extended it. We ended up being one of the last holiday lets, as he had recently retired and was moving in there next month.

The surrounding area marks the border between counties Galway and Mayo. It’s called Joyce’s Country, after the Anglo-Norman landowner, and consists of Lough Mask, the Partry Mountains and the densely wooded margins of Lough Corrib. Nearby is Cong, famous for the Augustinian Abbey with its fishing house built on the river, and for the country seat of the Guinness family, which has now become a very posh hotel. But 1000 Euro per person per night does not buy you exclusivity, for the grounds of Ashford Castle contain a number of rights of way and thus are open to the public. We walked there through ancient woodland beside the lough and had lunch in the tea room.

Despite having pulled an abdominal muscle a week or so before our trip, I still managed some good bike rides. There were plenty of quiet back roads to explore around the shores of Lough Mask and across the stone-walled farmlands of South Mayo to the old market town of Ballinrobe. T did plenty of writing. I focused on reading. I’d brought a selection of crime novels with me. I really enjoyed ‘Christine Falls’ by John Banville, the first of his Quirke novels, and ‘The Searcher’ by Tana French, a novel with a frontier feel, set in the West of Ireland. I also enjoyed ‘I Know What I Saw’ by Imran Mahmoud, a novel with PTSD and memory loss at its core, but was jolted by the final twist which left me feeling somewhat cheated. The good thing is that they all gave me inspiration for my next redraft of my crime novel, which is what I should now be getting down to after the holiday.  

Finding Treasure Island

I’ve just bought a secondhand copy of the first book I ever owned. I think I got it as a Christmas present when I was either four or five. It was published in 1956. I really loved this book. I don’t think I could read all of the words at first. But each page of text had dramatic colour illustrations. Like many other children, this book sparked my imagination and stimulated my sense of adventure. I don’t know what happened to my book after I’d finished with it. I suppose it got handed on to my younger brothers and then on to nephews and nieces. It was no longer in the house when we came to clear it after my parents died. I’m delighted to now be reunited with this lovely book.

I was an avid reader as a child. I quickly graduated to the full text of Treasure Island, followed by a series of other classics: The Three Musketeers, Twenty Thousand Leagues Under the Sea, The Coral Island and The Adventures of Tom Sawyer. These would all have been Christmas or Birthday presents. We had hardly any books in the house, apart from a set of cheap encyclopedias, first published in 1922, which I devoured. So I used to read my father’s crime novels after he had finished with them. These were pulp paperbacks that I suppose he’d bought in Woolworths.

Around this time, a teacher asked my primary school class to bring in the book they were reading at home. Many kids brought in picture books, some brought in children’s classics, I brought in a pulp crime novel. The teacher was horrified. My parents were summoned to the school and given a stern lecture by the headmaster about the suitability of reading materials for young children. I would have been seven or eight. There was no mention of my advanced reading ability or that I might have been a gifted child.

The rest of my formal education included many beatings from teachers and regularly being told that I was stupid. It wasn’t until I returned to study at the age of 27 that I discovered I had a good brain. A distinction in my Masters led to a Manchester University award enabling me to study for a PhD, then followed a career in Higher Education that culminated in an Emeritus Professorship.

Treasure Island really did sow the seed of adventure in me. This took me rock and ice climbing, high altitude mountaineering, fell running, wild camping and on long-distance cycle tours in developing countries. These adventures were an education in themselves, and built qualities of resilience and determination in me that I’ve needed to call on many times in my life.

The Big Heat

This film noir, directed by Fritz Lang in 1953, is infamous for the scene in which Lee Marvin assaults Gloria Grahame with a pot of boiling coffee. But I’m referring to the remarkable week of sunny weather with unbroken blue skies that we’ve just had in Northern Ireland. With temperatures of 25 degrees and over, it was more akin to what you’d find in the Canary Islands. In truth, NI only has two real seasons: it’s either ‘boilin’ or ‘freezin’, with the latter holding the upper hand for most of the year. ‘Boilin’ usually puts in an appearance for a day or two at best, before cool conditions return. But this last week has been exceptional and has done wonders for retailers of sunscreen and ice-cream. Indeed the heat built up so much in the house that we had to keep the curtains closed all day. Even so, it was still uncomfortably warm at night. Had the heatwave gone on, we would have needed to commence the Spanish practices of having a siesta and eating at 9 pm. Today our normal summer weather has returned: overcast skies, drizzly rain and only fleeting glimpses of the sun.

I realize that most of Western Europe and Southern England have been suffering from intense heat for many weeks. But the weather is very different here. We don’t have any glaciers to melt, our rivers have not run dry and the grass is still green. Unbroken blue skies and sunshine all of the time sounds lovely. But in fact it becomes burdensome and tedious. I lived in California in 1992 and ended up looking forward to the periodic rainstorms. This taught me that it’s variation in the weather that makes life interesting. It also probably shapes the culture and norms of these islands. I’m just owning up to enjoying a week of bright sunshine amidst the months of overcast skies.

The Joy of Food

A week ago, I got food poisoning on a trip to Derry and Donegal. And since then the runs have continued. So my constant companions have been sachets of Dioralyte and rolls of Andrex. By the fourth day, I was feeling rather weak and exhausted, so I rang my GP. He told me that most food-poisoning was caused by viruses, but there could be other culprits. So he needed a sample to send to the microbiology lab. T went to the surgery and collected a large brown envelope he had left for me. Inside was a small container, a wooden spatula and a pair of surgical gloves.

I put a plastic picnic plate in the neck of the toilet. It wasn’t long before I had to go. The watery diarrhoea collected in the plate. I scooped some of it up with the spatula, screwed the cap onto the container and sealed it in the plastic envelope. I also made a mental note to never look for a job in a microbiology lab.

The doctor also included a prescription for an anti-spasmodic drug. You take one tablet a half an hour before eating. He also advised me to only eat dry toast, mashed banana and plain boiled rice. This is not much of a menu. But at least it was something to munch on. I remembered one of my times in hospital for cancer treatment when I had to fast for twelve days. After four days I lost all interest in food, and by the end I had to learn to eat again.

I have kept to my plain menu and the anti-spasmodic tablets. Indeed, for last night’s tea, I had a very exotic dish: broth with slivers of boiled chicken in it. And this has managed to stay in. So I am hoping that I’m now turning a corner. I’ve heard nothing from the microbiology lab, so I don’t know yet what bug has laid me low. But I am looking forward to maybe trying a bit of boiled carrot with my chicken broth tonight. I don’t think I’ll be taking food for granted again.