Cancer 12: hello pain (the sense of ending)

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Cancer 12: hello pain (the sense of ending)

Paul Brasington 2023
Published by Paul Brasington in Good health · Thursday 01 Jul 2021
Tags: Cancer
Although I've been generally well all my life I developed rheumatoid arthritis (RA) about five years ago. It happened without warning and more or less overnight, and as usual the cause was not apparent.
 
Confusingly RA is neither rheumatism nor the more common osteoarthritis. It's an inflammation of the joints caused by an overactive immune system. It can be completely debilitating (it ended Kathleen Turner's career, and put the artist Tacita Dean in a wheelchair), though happily these days we have more effective drugs which can prevent such long term damage. I was not in a great place for the five or six months it took to diagnose the condition fully, with pain in my hands, legs and feet, but since I've been on the medication my symptoms have become insignificant.

For someone who spends most of his days at a computer keyboard or playing the violin, that's been pretty important.

The drugs work by suppressing your immune system, so it no longer pushes fluid into your joints, fluid which in a healthy body aids healing, but which with RA accumulates around bones and presses on your nerves. At the onset of the Covid pandemic my diminished immune response meant I was theoretically more vulnerable than most so I had to shield carefully. Happily I've not had the virus and I'm now twice vaccinated so Covid is less of a worry.

Unfortunately the removal of my tumour carries with it the risk of post-operative infection, where a section of my colon has been cut out and the loose ends stitched back together. Internal infection trumps joint pain, however debilitating, and so at the same time as I went into isolation I had to stop taking my RA medication.
 
That was a week ago, and until yesterday I had remained pain-free. I was even beginning to wonder whether my condition might have mysteriously righted itself (though I know this doesn't happen: it's for life).
 
But the return of aching joints has suddenly brought back vividly what it was like in those months before I was given the medication, and underlines the old truth that we don't really remember pain. That said, I do know that pain can obliterate us. I do remember when my back has been in spasm (happily at least this hasn't happened for a while) I could imagine how even death might be welcome as an end to such agony.

The prospect of pain
Perhaps I'll think of this inability to remember pain as a blessing in the weeks to come, when I hope I'll be putting the operation and its immediate effects behind me.

It looms large now, with less than a week to go. I'm assuming I'll survive, and statistically at least that's a near certainty. It is not as if I'm on death row (an unimaginable cruelty). It's hard all the same not to be conscious of how far we take our survival for granted. That's not irrational, but while our survival is a diminishing certainty as we get older, as long as we don't feel old (and I don't) it's hard to take the certainty of our death seriously. I have made many plans for the months to come, while knowing they must all be provisional, depending on the outcome of the operation and whether I need chemotherapy.

The pleasures of endings
I
n one of the first blogs from this series I quoted a Mark Antony speech in which Shakespeare plays poignantly with the difference between something being completed and something that's simply over. Ironically though one of the reasons we like fiction and stories generally is that they tend to come to a proper end, where things are resolved.
 
That's partly a function of curiosity. A few years ago a friend was said to have complained on her death bed "now I'll never know what happens in Harry Potter", and it's natural enough to want to know how things will turn out.

But with stories too a sense of resolution is part of their pleasure. Even with the controversial final episode of The Sopranos, there was an aesthetic gratification in the fact that a narrative about the ramifications of "family" in Mafia life should deliberately stop rather than end: as in everyday life we were reminded that things do just go on. Although this refusal of any closure infuriated many viewers, from an aesthetic perspective and given the concerns of the series it had a kind of resolution which will mostly escape us in ordinary life.

Unhappy endings
Netflix needs to be careful here, since it's getting a reputation for cancelling series. In the last few days we've been watching the Icelandic mystery Katla, which ends on a cliffhanger. That's common enough, and fair enough when a second series has already been agreed. But who would invest time and emotional energy even in a high profile series (for instance, topically, Jupiter's Legacy) when you know any further episodes have already been cancelled, or could well be cancelled? I'm not suggesting poor quality should not be punished (Line of Duty should have been put out of its misery long ago), but producers and commissioners need to work out a better way of handling the unknowns of series' endings, as well as being ready to sustain good quality without absolute regard to viewing figures.

On the other hand the DNA of soap operas requires that they can't end. Of course individual storylines may be resolved but by then something else will be pulling your attention forward. This is why I don't watch soap operas: they offer something too much like our own lives (though this has nothing to do with realism, and much the same could be said of so-called reality TV).

I don't suppose my personal story's about to come to an end, or at least it's only marginally more likely than when stepping into your car. But because a serious operation is an unusual elevated risk it seems a more urgent possibility.

Thanks to the Covid-imposed isolation I've not been able to see my family, and I'm dreading the moment when I have to say goodbye to Mary at the hospital door next Wednesday. It will feel like a letting go, even if I'll be simultaneously confident that I'll see her again in less than a week (no visitors are allowed in the ward). It's easy enough for your imagination to frame your life as an unhappy story, approaching a conclusion (though it would be for others to find meaning there).

I just hope in the pain I expect to follow the operation I can hold on to the consciousness that it's the pain that will pass, and not my life itself. Obliteration might be tempting in pain, but it's not the be all even if it would be the end all.


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paul@brasington.co.uk    +44 7798 913129
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