Going on the Turn, page 23
After twenty minutes, I heard my name called and a nurse with a clipboard and a resigned smile bade me follow her. Wendy was not allowed to come with us. I was led into one of the two radiotherapy chambers, a sparse yet scientific space with low lighting, dominated by a huge machine very similar to the body scanners I’d only previously encountered when watching Hugh Laurie in House. After confirming my name and a few other health details, the nurse turned and retrieved my mesh mask that I hadn’t seen in three months. I had lost some weight and so she held it to my face to make sure it still fitted where it should. Satisfied it did, she asked me to change into a medical gown and then hop up on to the gurney that protruded from the imposing equipment. I sat cross-legged on it while she went through a speech I suppose they give everybody on their first visit. Claustrophobia seemed to figure predominantly and also how, once the work got underway, I could visually signal either distress or satisfaction. The machine being used on me was called Electra and none of the staff could remain in the room while my dose of radiation was in progress but would observe from a gallery above, rather like George Martin producing the Beatles.
The session would last twenty minutes each day, I would feel no real effects from it for the first week or so but it would become ‘pretty uncomfortable’ subsequently. I asked about the fellow I had seen struggling in the waiting room and she confirmed he had the same illness and, if it was the bloke she was thinking of, he was on week five of the six-week course. She then surprised the life out of me by saying she was an old school friend of my daughter Bonnie and that we had met, briefly, a couple of times before at parents’ evenings. We started to chat informally now, though I must confess I suddenly felt a bit of a berk in my green surgical gown with my hairy old legs hanging out and everything. A second surprise came when she said, ‘I’ll put a Hawaiian beach video on for you to watch – is that OK?’ and she pointed to a TV screen in the ceiling. ‘There are other choices, or some people like to bring in their own ones. Whatever relaxes you, you know?’ I said Hawaii would be just fine.
Next it was down to business. I lay flat on the gurney and the mask was placed over my face. I was told to say when I was completely comfortable because once the mask was secured I would not be able to move again until the treatment was over. Inside the mesh it was like looking at the world through a tennis racket and after a few seconds I signalled I was OK, whereupon my peculiar head façade was bolted down tightly on to the stretcher bed.
‘Right I’m going outside now,’ I heard the nurse say. ‘Don’t forget, if it gets too much wave your hand or give us a thumbs down. You won’t be able to see us, but we’ll be watching you the whole time.’
A few moments later I heard a heavy door thud closed and the lighting reduced still further. I lay there in silence, head totally encased inside the mask, my heart beating faster than it had for some time. Then her voice came through a speaker somewhere.
‘OK, Danny, we’re going to move you in now to the machine and then you’ll hear it start – it’s quite noisy. It’ll seem longer than twenty minutes, but I promise you we aren’t going anywhere.’
Again I lay in silence until the thin mattress on to which I was strapped and bolted began to move backwards into the cavern of Electra. There were some minor jolts of adjustment but soon all was dark and still again. Seconds later, a short shock, as through the lattice across my eyes, the TV screen above flashed into life and there was a palm-lined beach, the fronds waving gently with the sound of waves lapping against the sands. This continued to play for about a minute and I gulped, nervously awaiting the laser beams or whatever it was that I was to be bombarded with. There came one final message from the gallery.
‘OK Danny, sorry for the delay, it’s going to start now.’
What started was a noise almost identical to the squeaks, bleeps and electronic stuttering that used to occur on old Internet dial-up services or on being connected to a fax machine. It was slightly more shrill with a wider range at the lower end, but otherwise that was exactly what it was like. There would be ten seconds of this, then a three-second pause, then another burst. I awaited some sensation to accompany the work in progress but nothing came, not even a slight detection of heat, just the repetitive whine of the device’s robotic rifle sniping away at the individual cells of cancer. Once underway, any nerves I did have vanished completely and back flooded my soothing sense of the absurd. Again I found terrific comfort in the simple thought, ‘What must I look like?’
Contrary to finding the time drag it was all over in what seemed like barely five minutes. Hawaii faded from view, up went the lights, in came the nurses again, I was unbolted, asked how I felt and then told, ‘That was it, see you tomorrow.’ I must say I fairly skipped out and as I passed the sombre huddle still waiting their turn I felt the most dreadful showboater. Compared to the draining monotony of chemo, what I had just been through was a walk in the park and an extremely interesting one at that.
Wendy of course wanted to know all about it and as we exited Guy’s I excitedly babbled like a kid who’d just gotten off Splash Mountain in Disney World. I think I may have even allowed myself to believe that the haggard fellow with the atrocious cough may have been just that – a bloke with an atrocious cough. By the time we had arrived home the adrenalin had levelled out again and I found myself swallowing repeatedly and slowly trying to detect even the faintest glimmer of a sore throat or even a numbness, but there simply wasn’t. A week later there still wasn’t and I started to believe that against all the odds I wasn’t going to have the extreme reaction to radiotherapy that the team had warned me about. In my meetings with the nurses at the Electra machine each day I was positively chipper, not even heeding their caution as they tactfully said, ‘Well, it’s early days yet!’
Early days it may have been but I had now completed one and a half weeks of a six-week course – that left just over thirty days for any notable deterioration to get stuck in, and as far as I could see it hadn’t yet even got its boots on.
Then, at the end of the second week, I woke one morning with saliva overflowing from my mouth. I ran my tongue around behind my teeth where they met my gums and the area felt tender, the tip of my tongue raw. ‘It’s started,’ I thought. Then I made to swallow and in two discernible spots in my throat there came a sharp dragging pain like pulling on tight jeans over recently grazed knees.
Oh, it had started all right. I went downstairs and tried to tell Wendy as brightly as possible that I believed the treatment was ‘kicking in’, but became aware that my tongue wasn’t as nimble in forming the words as it had been twenty-four hours previously. Was this involuntary or was I just taking extra care not to aggravate the parts of my mouth that were increasingly sore? With gentle fingers I felt around my throat. The lump had all but gone, but something else was now definitely going on and in a total reversal of my earlier optimism I started to think, ‘If it hurts like this barely two weeks in – how bad will it be by week six?’ I also remembered that Dr Guerrero Urbano had said that it was once the course of radiation stopped that the worst weeks of suffering began.
Happy days.
I was by now taking the tube to the hospital – a bit of a risk, given the number of people who sneeze like howitzers in every carriage, but the journey took eight minutes from our local underground station, whereas driving could add anything up to another hour and a half. Exiting London Bridge station, I would observe the hordes of people charging for their trains, chatting wildly into mobile phones, queuing for juices or wolfing down thick Cornish pasties on the hoof. The sweet mundanities of their days looked positively exotic to me. Once somebody asked me the way to a church in the area and the pain in my mouth was so acute I just had to wave my hand at them and make an apologetic face. ‘Oh for fuck’s sake!’ they snapped and dashed off to find a local less lunatic. Rather than feeling ostracized by this, I actually found it funny – not that I could physically conjure up anything as taxing as a laugh.
When I got home I would invariably go straight to bed where I would lapse into a pitch-black and dreamless sleep for a couple of hours. When I awoke from this I would lie for a few moments and discern how much the destruction of my oral tissue had progressed in the interim and every time the results confirmed that it was happening with alarming swiftness. By the end of week four, the roof of my mouth arcing down into the tonsils felt utterly excoriated, scorched like a severe sunburn – which, in effect, was not far from the truth. My tongue hurt with every movement and to try and swallow the diminishing amounts of saliva I produced took determined effort, always accompanied by a grotesque wince and dreadful agonized groan. I didn’t talk unless I absolutely needed to. I didn’t move unless it was to make minor shifts in my bedridden posture. I couldn’t even hide the deterioration from the kids any more; the best I could manage was a barely audible ‘All right, mate’ whenever they asked me how I was.
Poor Wend felt helpless, regularly coming into our once beautiful bedroom, now a stuffy shuttered sickroom, to ask if I needed anything. I would reply with a shake of my head without even opening my eyes. And yet all the terrible daily regimens still had to be observed and endured: the shuffling up to Guy’s, the bolting into the mask, the blood tests, the inspections, the injections, the questions, the weighing, the assessing, the invading – sometimes tubes through the nose to shine a light on the devastated soft palate, the ghastly feeding through the stomach, the constant trips to the toilet to blindly vomit until you reached the very limits of consciousness, followed by coughing fits that threatened to rob you of your reason.
By the fifth week I was in an identical condition to the man I had both feared and pitied in the radiotherapy waiting room. I never thought I was going to die but completely understood that this, for many, was how it happened. At the beginning of week six everything above my shoulders but below my eyes was completely broken, dry and useless. That awful prediction about ‘one big blister’ had come to pass and the impairment was now absolute. I could not move my jaw at all, oral muscles atrophied, taste and saliva glands gone, my tongue a useless static piece of wood. On the Monday of week six, I went into the bathroom to feed myself and then, having barely strength enough to put away the equipment again and make my way back to bed, I reached for the bottle of morphine for the first time.
In the years subsequent to my recovery I have been asked a few times to talk to people who have recently been diagnosed with neck and head cancer, but I’ve always hesitated. I hoped that my public return to annoying ebullience would speak for itself. Addressing any gathering of nervous newcomers to the dreaded sect, I knew that the only honest thing I could tell them would be, ‘It is going to be so much worse than anything you could possibly imagine.’ And nobody would want to hear that. At the start of that sixth week I could not conceive of how this appalling torture could become any more acute or distressing. And yet, they had warned me back in October that it was from now on that I was about to enter the truly gruelling period. Surely that couldn’t be right? I was by anyone’s standards at the very limit: stupefied, scourged, done with. This could NOT get any worse.
Which just goes to prove: I am no doctor.
I have few recollections of the final radiotherapy sessions. I do recall that by then I needed assistance to get on to the gurney and that the Hawaiian beach scenes were now deemed too absurd to require playing on the ceiling TV. The staff in the radiation room no longer attempted conversation but instead just made sympathetic faces as I shuffled in to theatre to be locked into my mask. Usually this would have to be delayed as another expelling of matter convulsed me for minutes on end. I use the word matter because I have no idea what it was or from where I could be producing it; it appeared to be simply water, but in such copious amounts that at times made it impossible to grab even a single breath. A nurse would stand beside me as I sat doubled over and retching, handing me wad after wad of paper towels. And yet, even in that degraded moment, I could hear me, the real me, saying from behind the barricades in some deep defiant mental redoubt,
‘Fucking hell, Dan – this must look choice.’
On the last day, when the shrieking laser completed its ghastly song for the final time, I was helped from the machine, told to rest if I needed to, and then got dressed at the speed of a two-toed sloth after an absinthe binge. Exiting the theatre to the genuinely moving good wishes from the team, I stood at the entrance to the waiting room looking for Wendy. Hunched, grey and tight-mouthed, I couldn’t even turn my head to scan the assembled faces, so my eyeballs made laboured progress from left to right then back again. I couldn’t see her and my death’s door demeanour must have truly spooked everybody present. A nurse came and took me by the elbow. With my other hand I motioned toward the small reception desk and though only about twelve feet away I think it took the best part of the day to get there. I reached for a pen and on a piece of tissue tried to write ‘My wife?’ but my hand wasn’t quite up to it, moving like a Ouija board indicator being powered by a particularly clapped-out and illiterate wraith. I also left off the question mark and so the nurse looked at me as though there was more of this spidery message to come.
‘You want me to tell your wife something?’ she asked.
With great effort I managed a small shake of my head and then, in desperation, reduced the preposterous exchange to a game of charades, indicating that I was looking for Wendy by holding my hand above my eyes in the manner of somebody searching the far horizon. This failed to translate and as far as I could tell the nurse now thought, in my delirium, I had taken to saluting her.
‘Come and have a sit down,’ she said. The untouched inner observer in me was scribbling all this comic gold down for later, healthier recollection.
We hadn’t yet made it to a vacant chair before in came Wendy, cursing herself for trying to save time by collecting my latest dispatches from the pharmacy while I was under the light beams. During the drive home she tried to lift my spirits, expressing joy and relief that we were now finally finished with chemo and radiotherapy. We arrived to find all the kids gathered at the front door and gently applauding as I was helped up the front steps.
‘All done now, Dad.’
I couldn’t respond much but began the slow ascent of the stairs to our bedroom thinking that even if I could talk I wouldn’t have dampened their optimism by saying that, far from dispersing, the dark clouds of my sickness were in fact regrouping for the ultimate great storm.
Turning into our bathroom, I closed the door and placed both hands on to the sink top. Lifting my head I looked in the mirror at the sunken travesty of my face with its flat dull eyes, putty-coloured skin and deathly bone-dry lips. Stubble grew only in tiny isolated patches now, the majority of my beard follicles long since nuked into oblivion. I tried to open my mouth but could part my teeth no more than a matchstick’s breadth. Reaching out, I turned on the cold tap. I stared at the powerful torrent until it filled me with an overwhelming desire to plunge my head downwards and let the stream flood directly into my mouth, restoring new life to my desiccated dead teeth, to somehow wash away both the cancer and the devastation of its cure. I now turned the tap on full blast and studied it as though it was some new force of nature. The urgency of the cascade sent occasional tiny droplets on to my arms and even up as far as my face and neck as I became mesmerized by its wild, liberated invitation. This one moment as the water flooded into the sink, peppering me with its exiled magnificence, explosively churning in violent orbit before rushing out of sight, remains for me the single most potent image of my entire illness. I stayed transfixed by the forbidden deluge for quite some time until Wendy knocked on the bathroom door in concern.
I took a syringe full of morphine and repaired to bed where, for the next six weeks, I would exist in a semi-conscious state today only recollected through the various pinnacles of suffering as the two armies, cancer and science, did battle inside my very atoms. There were two soundtracks to this blearily remembered period. The TV in the bedroom remained almost permanently on and tuned to a sports channel, not because I could have cared less about the games shown or indeed possessed the ability to even watch television, but the low burble of something seemingly urgent taking place somewhere gave the otherwise suffocating sick space a glimmer of vibrancy. It also marked time for me, though that had no real meaning. I might fall asleep during a Spanish domestic football fixture but wake to hear a re-run of an old Aston Villa game. If it were a live match I would drift away during the build-up and find myself coming to during the post-match analysis. I might hear a sentence about ‘darts coming up at eleven’ and then next find myself surfacing to the noise of arrows thudding into the board. Another hour gone. I rarely ever lay facing the screen, and even if you were to put a gun to my head to ask me to recall any of the hundreds of events I must have dipped in and out of during this time I would be at a total loss to respond. Tom Waits was once asked about his favourite kind of music and he said, ‘The sound of a ball game on the radio.’ I totally understand that. In my case it was also a whispered, welcome tone poem reminding my fractured spirit of a temporarily lost world.
The only other outside occurrence to find its way on to my radar during the early spring of 2011 was the catastrophic meltdown at the Fukushima nuclear plant in Japan. During the weeks of rolling news about the threat of radiation sickness I managed, while watching the scenes of a panicking population and clogged motorways, to form a pretty good joke about how I had spent the last few months walking towards what these people were now running away from. I heard more than one expert detailing the various signs of exposure to radiation and could confidently tick these symptoms off one by one like the veteran I now was. Had anyone run a Geiger counter over my battered old frame during March, it would have wailed like a Theremin.
My health now declined so dramatically that for the first time I wondered if something was not quite right. My breathing became so disrupted by bouts, sometimes a full hour in duration, of continual vomiting that I was provided with an oxygen tank and mask. Any respite granted by this would be cut short when my mouth began quickly filling up with water that seemed to be drawn from some inexhaustible well near my lungs. Unable to swallow, I just had to let the liquid pour into tissues and soon filled dozens of carrier bags of the disgusting things that Wendy would dutifully clear ten times a day. The constant agony of the blistered mouth and throat made true sleep impossible without my stumbling gratefully toward the morphine bottle. From the bridge of my nose to the edges of my shoulder blades a fire raged under my skin similar to those subterranean coal seams in Kentucky that have been burning since 1931. This resulted in a terrifying development one night when I woke to find I had apparently cut myself below the ear and was bleeding on to my pillow. Limping into the bathroom I turned on the light to see that I was not cut at all but rather one side of my neck was, to all intents and purposes, melting. The skin there, which had been growing increasingly sensitive to the touch, was now simply dissolving and the neck of my T-shirt looked like I’d had my throat cut. Over the next few days the liquefying spread until no part of my neck was unaffected. To make the revolting malady even more exquisite, a visiting nurse warned me I mustn’t cover the area because any gauze or pads would become stuck to the surface and thus later be excruciating to remove. Now I couldn’t even lie normally in bed and securing my oxygen mask in place was as delicate an operation as defusing a bomb. And yet still the sickness. Still the stomach injections. Still the feeding through the tube.
