Cancer 22: an end, and the next beginning
I've been given the all clear on my bowel cancer, bringing this difficult year to a happy end. I want to reflect on what this means, which will entail talking about more than cancer, so please bear with me.
I have been in yet another limbo of uncertainty for the last few weeks, waiting for a meeting with the oncologist which would tell me whether I was finally clear of the disease, or whether having skipped the final chemotherapy cycle (because the third one was so uncomfortable) I might still need further treatment.
When Dr Soultati finally said the words, almost as soon as we'd walked into her consulting room ("I am here to give you good news") it felt both wonderful and unreal. It wasn't exactly unexpected: with everything I knew already it had seemed the most likely outcome, but as long as you don't know for sure the other possibilities weigh on your mind, and you try to protect yourself against the shock by imagining how you'll deal with bad news (even if you know it won't be much of a cushion). As I sat in the waiting area I'd been thinking the hospital surroundings had immediately pushed me back into a patient's frame of mind, where I would simply accept what I was told, and try to get on with whatever needed to be done. At the same time I was telling myself, it was possible I was already beyond that condition, that I could start thinking differently about my life, and so it quickly proved.
Except that I don't know where to begin. Loaded with the good news that the CT scan revealed no sign of metastasis, and my blood tests were all fine, Mary and I came back to Rye, where we'd already arranged to meet an old friend of mine who happened to be down from London for the day. It was lovely to see her, and others, as we proceeded to drink too much in places we had not felt we could frequent for most of the last year. We were absorbing the unfamiliar familiar, not that it's really helped make things seem real again. It's not really about going back to how things were, but coming to terms with however our new reality is going to be.
But in the name of persisting touchstones of things I value, when we finally came home I sat down with a glass of Islay malt, and the third movement of Beethoven's A minor string quartet.
On recovery from illness
I've loved this piece since my early teens: it features notably in Aldous Huxley's Point Counterpoint, which I'd picked up from my parents' shelf of orange Penguin paperbacks. Filled with curiosity I rooted out an LP at a reasonable price from HMV's Oxford Street megastore when I happened to be passing through London, a luckily decent version by the Hungarian Quartet though as technology, experience and finance permitted the CD recording by the Italian Quartet is the one that's been with me most of my adult life.
I've loved this piece since my early teens: it features notably in Aldous Huxley's Point Counterpoint, which I'd picked up from my parents' shelf of orange Penguin paperbacks. Filled with curiosity I rooted out an LP at a reasonable price from HMV's Oxford Street megastore when I happened to be passing through London, a luckily decent version by the Hungarian Quartet though as technology, experience and finance permitted the CD recording by the Italian Quartet is the one that's been with me most of my adult life.
Still, the association with illness has conditioned my response over the decades, a response I could always rely on whenever I listened to it, and which in an admittedly alcohol-fuelled state at the end of this day of recovery seemed a perfect finale to a period of quietly seething emotion.
It's common enough to talk of art as consolation, as if its apparent timelessness could comfort us in the face of our mortality. I've never been sure how much of a consolation that could be, but more arguable is the value of something that seems a constant, an experience we can reliably revisit to remind ourselves of who we are (or at least who we have been), a sense of consistency in our lives that might otherwise be unsettling in its elusiveness.
The return of Covid anxiety
As I write this the headlines continue to fill with fear of the Omicron Covid variant. It brings a different sense of deja vu, because at this point last year we were watching infections spike once again after the laxity of the summer, wondering when the next lockdown would fall. The country at that point was divided into zones of different infection severity, with travel between them restricted, which in the end seemed to make no difference to anything. These details so easily slip your mind, but then there's been something unreal about the whole pandemic period.
As I write this the headlines continue to fill with fear of the Omicron Covid variant. It brings a different sense of deja vu, because at this point last year we were watching infections spike once again after the laxity of the summer, wondering when the next lockdown would fall. The country at that point was divided into zones of different infection severity, with travel between them restricted, which in the end seemed to make no difference to anything. These details so easily slip your mind, but then there's been something unreal about the whole pandemic period.
Of course the zoning didn't stop the spread of the virus. It might have slowed it a bit, and I understand why that might be useful, but if there's one lesson that should have been learned from the last 18 months it's that viruses don't have a lot of respect for borders. It is apparent that the Omicron variant is already in Britain, the rest of Europe and indeed North America. It will spread now. The only uncertainty has to be about its ability to escape the vaccines and the severity of the illness it brings. The evidence so far seems mixed, and we will no doubt know more in the next few weeks.
Small minds, big consequences
All this underlines one inescapable truth: a global pandemic requires a globally coordinated response. Unfortunately this seems to be too big an idea for our small-minded national leaders (much like the challenges of climate change).
All this underlines one inescapable truth: a global pandemic requires a globally coordinated response. Unfortunately this seems to be too big an idea for our small-minded national leaders (much like the challenges of climate change).
In a further twist of the knife Boris Johnson has explicitly promoted the myth that the rapid development of the vaccines reflects the genius of an unfettered private sector, when if anything the opposite is true: it reflects what can be achieved when public and private sectors work effectively together. Such imaginative failures are very much part of the disastrous political small-mindedness which refuses to understand what we're dealing with.
While closing borders has a very short term validity as a way of buying some time, it's clear that within a few weeks it will make no difference whatsoever. The problem then is that border closures stand in the place of effective action, supporting the claim "we're doing all we can".
It's part too of the small-minded notion that the government's first responsibility is to buy up as many vaccines or vaccine variants as it can. But this "genius" of the market ensures that vaccines are not being delivered in the quantities they are needed where they are needed, with the necessary logistic support, to ensure that we are all protected from future mutations: under the current idiocy those mutations are likely to continue to plague us for years to come.
That said, I believe we're at a political turning point, though turning points tend not to feel so significant when you're actually going through them. I have no illusions about the ride ahead being a comfortable one. Never have we needed so much from political leadership (on all sides) and been offered so little. If this doesn't feel like a turning point it's perhaps because there doesn't seem to be anybody at the wheel.
We need to get real
My cancer treatment was delivered through mechanisms laid down by visionary leaders in the wake of the Second World War, some 70 years ago. That radicalism proved closely aligned with the aspirations of the vast majority of the population, so much so that the broad idea of a national health service remains politically untouchable. But for the last forty years our government has been the province of men and women with all the visionary intellect of lemmings, steadily guiding us in the worst possible directions, and surreptitiously undermining the NHS in pursuit of an already-discredited ideology.
My cancer treatment was delivered through mechanisms laid down by visionary leaders in the wake of the Second World War, some 70 years ago. That radicalism proved closely aligned with the aspirations of the vast majority of the population, so much so that the broad idea of a national health service remains politically untouchable. But for the last forty years our government has been the province of men and women with all the visionary intellect of lemmings, steadily guiding us in the worst possible directions, and surreptitiously undermining the NHS in pursuit of an already-discredited ideology.
Change has to come, in spite rather than because of that leadership. The economic orthodoxies of the last forty years already look like nonsense, even if there are plenty of powerful people with a vested interest in pretending otherwise. The impact of climate change will not be mitigated by the same old narrow nation-state thinking.
We are currently hopelessly out of our depth in understanding how the internet and associated technologies can be harnessed for human and political good rather than harm. We need to get real too about the interdependence of public and private enterprise. This is to recognise that both statism and free market dogmatism are based on simplistic and demonstrably false ideas about how things actually work. We need to get real.
It's been interesting, to say the least, to experience a personal path to survival while much of the time in the bigger environment of my life our governments have continued to flounder around the actions on which humanity's survival depends, not to mention the comfortable assumptions of liberal democracy (which I believe are worth defending, but are certainly under strain in our so-called post-truth world). I feel grateful for where I've got to, both to the earlier political visionaries who created the framework that made it possible, and to the consultants and nurses whose skills actually delivered me here.
But while I'm now in a place where I can begin to think beyond my own immediate demise it's hard to feel optimistic about the short term, not least as we struggle through the patent self-harming idiocy of Brexit, and we can only hope that events will force adequate responses in the medium term.
Mortality and focus
We all live with a tricky awareness of our own mortality. It's tricky in the sense that we know there's nothing more certain than our eventual death, and yet we tend to live as if this knowledge was not important. In a way it's not of course, because there's nothing we can do about it. I mean, we can try to live sensibly, with a healthy balanced diet, and sufficient exercise, but so much seems to be down to the luck of the genes, and for most of our lives (if we're fortunate) that mortality will have little beyond a theoretical presence.
Having a life-threatening disease inevitably focuses the mind on the reality of your coming death, and certainly I felt the threat over the course of my illness. But I'm not sure it became that much more real.
Then again, I never got to the point where a doctor was having to tell me, "you've got X months". It was more that for a few critical meetings I knew I was at the point where I might be told this, and somehow had to prepare myself for the possibility. As I noted above, I'd say my abiding impression of the whole experience was the strain of uncertainty, not knowing what was about to happen and trying to think my way through the likelihoods, from the first signs of the problem back in February, to my most recent meeting with Dr Soultati.
With a serious illness it's practically impossible to avoid the feeling that your life has gone on hold. It's a natural consequence of so much uncertainty. But it sits against the heightened sense that each day is precious, and the paradoxical consequence at least for me was a further feeling of unreality. Since June for sure I've been living from one treatment to the next.
It's over now, apart from the regular testing for the next five years, which I imagine will mostly mean a colonoscopy every six months, at least for the next three years. Now there's something to look forward to.
Better than the place before
Although in truth such time-markers are mostly arbitrary, the ending of this difficult year presents itself as a ready-made mental container in which to place the experience, and look forward to something like a new beginning in January. I'll take that, though it's also true that I have achieved some good things this year. I got married, among other things. I finished writing a novel, though I've been less than energetic in trying to get it picked up by an agent. That has to be a resolution for the new year.
Although in truth such time-markers are mostly arbitrary, the ending of this difficult year presents itself as a ready-made mental container in which to place the experience, and look forward to something like a new beginning in January. I'll take that, though it's also true that I have achieved some good things this year. I got married, among other things. I finished writing a novel, though I've been less than energetic in trying to get it picked up by an agent. That has to be a resolution for the new year.
I've talked a few times over the course of this cancer blog about the longing for something like "normal", and its elusiveness. That elusiveness hasn't gone away, something underlined by the return to headline dominance of Covid 19. Then again, normal as in same-as-before would really make the last ten months a waste of time; what I want (what we should all want if and when the pandemic eases) is something better than the place we were before. I believe that's possible, though in terms of the pandemic it's only going to happen when we are gifted with greater enlightenment among those in power.
For my part, I want to find a path forward which somehow doesn't depend on the idiocracy around us. It's not easy. I still hope to begin the year in our French house, and must now negotiate the mostly futile restrictions being imposed so the government can claim it's done what it can (it hasn't and won't).
As I've said (and the point's been made by expert opinion) any border restrictions are already too little too late to halt the spread of the Omicron variant, and while I don't particularly mind having to take a pre-departure test (though again, the hard truth is that such tests mean little unless associated with a known Covid contact, so that incubation periods can be taken into account) I cannot see any rational justification for imposing a second test two or three days later, as is currently the case. Patent irrationality does nothing for government authority or credibility, when the greater good demands such credibility.
The comforts of art, and more
Still, it's where we are, and we have to find our ways of getting through it. My ways will no doubt continue to include the limited comforts of art, both in the things I can create and my enjoyment of other's work, in music, and writing, and visual art. I'll take the obvious comforts too of my new marriage, and in the lives of my children and now my grandchildren.
Still, it's where we are, and we have to find our ways of getting through it. My ways will no doubt continue to include the limited comforts of art, both in the things I can create and my enjoyment of other's work, in music, and writing, and visual art. I'll take the obvious comforts too of my new marriage, and in the lives of my children and now my grandchildren.
I am well aware of how lucky I am to find myself at this point in my life with these good things.
This will be the last of my cancer blogs. I'll continue to write about other things, but this seems a natural point to move on, in so many ways. That said, among the projects for the coming few months I want to use these blog entries as the spine of a book (or more likely booklet) reflecting on 2021, filling in some of the context around each blog entry. and going a bit deeper into things that can or should be said about this turning point in our histories.
So please carry on reading, and thank you for the many messages of support along the way. I don't suppose 2022 is going to be all sunshine, but here's to the hope of better times ahead.
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