VINTAGE GEMS John HarrisonNWR Issue 103
My Year as an IslandUnattributed quotations are from Shakespeare’s
I began 2012 worrying about my age: I would be sixty in October. In March I contracted a mild sore throat that didn’t bother me, but neither would it go away. In June I started coughing up blood. The locum at my GP’s calmly said it could be TB or lung cancer, as though I wouldn’t mind which. The hospital X-rayed me for tuberculosis. It’s making a comeback; isn’t everybody.
Succumbing to internet curiosity, I checked up on throat cancer survival rates: 90%, not too bad. On Friday I returned to the same doctor for my results. He asked, ‘How can I help you?’ He had forgotten me.
I reminded him I might only have three months to live. He looked shocked. I wasn’t too relaxed about it myself.
‘There was nothing on the X-ray, so you don’t appear to have TB.’
‘Oh,’ he looked hastily at his screen, ‘No sign of it.’
It was a month before I went to ENT to see Dr Parikh at St Mary’s Hospital, next to Paddington Station, for an endoscopy; a tiny camera would tour my throat. Two days before I went, I borrowed my partner Celia’s computer and found she had been consulting too. The throat cancer survival rate was actually 50:50 after five years, which was terrifying. I had found the statistics for a very benign and treatable form.
Dr Parikh showed me how healthy everything looked as the video went into a pig’s ear, that turned out, when I had adjusted my sense of scale, to be my nostril. Then right at the end, behind my tongue, was an area which was not normal: two little nodules. Cancer was back on the menu. I left, shaking slightly, weaving through the shabby backs of the hospital, between its oldest buildings and its cheapest kit-built infills. I phoned Celia from Praed Street, among its downbeat shops, locksmiths, cafes, and suppliers of printer ink refills. The backdrop to these memories, the landscape of this illness, was being formed: low rent. First, I calmed myself down to a relatively philosophical state, but my head was still light and my heart hammering as I told her. When I got home we collapsed in each other’s arms. But a part of me was already standing to one side, watching us.
On 25 August, the Bank Holiday Saturday, Dr Parikh phoned me at home. There was an alien feature deep in the base of the tongue, and the lymph glands on the left side were swollen. One option was cancer, a type that is good at despatching cells to start colonies in other places, especially the liver; then you die. There were two other options, neither very likely. My throat felt exactly like his detailed description of cancer.
They had already booked an ultrasound scan for me that afternoon. There was also a procedure with the gentlest of names, an aspiration. While I was conscious, fine needles were put through my neck to take minute cell samples; on these hung my future. I walked home feeling stunned, emotions put on hold. I felt for Celia as much as I felt for myself. Not long before we first met she lost her husband of forty years after tests for brain tumours kept on, at every stage of diagnosis, revealing that the worst of all the options was the one he had. I was giving her a rerun.
For now, there was still love and life, and both were more precious for the threat of being curtailed. I sketched trees in Hyde Park, thinking of Edward Wilson who learned to draw nature here, his lungs already suffering from TB before he was accepted as expedition naturalist to go south with Scott and share a canvas mausoleum with him.
As background for a long planned trip to Mexico to write a travel book, I was reading Richard Eden’s sixteenth-century translation of the Spanish conquistadors’ self-serving reports. Eden was a fine stylist, raided by Shakespeare for details for The Tempest
. Prospero’s isle was Eden’s Paradise Awry, a secret, a place to engender a new nation. Shipwrecked sailors are thought to come from heaven, a detail stolen from another explorer, Magellan in Patagonia. But after their arrival, Prospero’s island is no longer a fortress against men and the disruptions they bring, no longer a barrier against real life. I feel all my life until now has been spent evading realities such as the one I now face. Uncouth invaders are now at my throat.
Two days later, I was with Celia in the Charing Cross clinic of Peter Clarke, a top throat and head cancer specialist. He also knew some dermatological tricks; he made the skin all over my body tingle in shock: ‘The discoloured tissue around the base of the tongue suggests cancer, and it is not at an early stage.’
‘This isn’t good news, is it?’
Walking back over the Serpentine Bridge, the lake on either side, I suddenly felt utterly empty, my sense of self gone; if I had no future, what was my ‘now’ worth? I stared bitterly at live green plants which would be here next spring, and the next. This was the darkest moment so far. I sensed what it would be like not to exist.
What seest thou else in the dark backward and abysm of time?
Within days I settled down to just being depressed, with passages of emptiness and fear, but there was no despair.
John Donne wrote a much quoted admonition to all of us, to recognise a community of souls sharing a common fate: ‘No man is an Island, entire of it self; every man is a piece of the Continent, a piece of the main’. But from this moment the tide swept in for me, and I looked across the deadly waters separating me from the main. I was now an island. No one, not even Celia, was with me, she was on the continental cliffs, waving, holding her arms out, but a world away. You can go through this with someone at your side, but they are not in the same place, and cannot be.
One of my best friends was increasingly ill. Tan Pearson had been a broad shoulder and a beer-buddy through the years of break-up, when my home wasn’t a fit place to sleep, as my partner started going out with someone else but still lived in our house. It became harder to get news as Tan became reclusive, and replied incoherently to emails in the small hours, posting me web addresses for random trivia. No one saw him around Pontcanna any more. I had seizures about details: they might cut my tongue out and leave me dumb. What am I without words? Another island, no communication. Some people are killed by the tongue swelling until it chokes them. Someone told me that cheery info when Danny, who drank in the same Pontcanna pubs as me, was dying of throat cancer. Was it true?
On 6 September, Celia and I trudged down the Fulham Palace Road past a Mexican restaurant so ruined it could be marketed as an authentic place to be fed, watered and shot. Past a tiny drab garden below the Guinness Trust flats in which a solitary shrub would bloom aromatically all the bitter winter to come, and finally the main hospital entrance, with a Henry Moore statue in a pond, surrounded by benches and low walls where down-and-outs with roll-ups and cans of extra-strength pursued the traditional route to throat cancer.
I saw Peter Clarke who had a kindly caring manner. ‘The samples from the throat tumour and the glands both hold cancerous cells, it’s HPV in origin,’ he was saying, but I was busier with my own feelings: my whole chest cavity had unclenched. HPV was the more benign form for which I had first found the stats: nine out of ten live, not fifty-fifty. I came back to the room and Peter Clarke saying, ‘It’s in a good position to treat.’
On 13 September I went for a PET scan, a misleadingly comforting acrostic for Positron Emission Tomography scan. A week later the results came through.
The scan was expected to show a single bright spot in my throat caused by greater metabolic activity in the cancer. There was always the one in ten shot, that we would see more white spots away from the throat. Celia and I waited for hours in the chaotic day clinic in the central tower block. Peter Clarke had passed me on to the consultant in charge of chemotherapy and radiotherapy planning. When we shuffled into his room of experts we entered the atmosphere of a funeral parlour. An image came up on the computer screen. My neck and chest were lit up like a Christmas tree. There was palpable shock in the air; no one had expected this. I squeezed Celia’s hand and stared out of the window at the drab terraces and the pocket gardens of Baron’s Court in autumn decline. So this was the place where I would learn the terms of my mortality. Time was up. Mephistopheles rising, arms wide in welcome.
The oncology consultant in charge of treatment, who passed on bad news as if it added to the gravitas of his post, instructed. ‘These are the lymph glands which have been affected. It could be sarcoid reaction, which is not nice, but not dangerous.’
‘But if they are cancers it’s bad news.’ It was becoming my catchphrase.
‘Very bad news.’
‘I thought this type of cancer seldom metastasised.’ I’d boned up on the medical word for spread.
He gained momentum. ‘There are two kinds of throat cancer; you may have both.’
I knew the answers to just two questions really mattered: ‘Is it advanced, is it operable?’
The answers were the wrong ones.
‘We’ll test these secondary sites and decide on treatment when we have the results of the new aspiration.’
Celia and I walked in Kensington Gardens and sat under a bench away from other people. I told her I could not be brave without the certainty that I loved her. The arms I held out to hug her felt like visitors from a world that was moving on. Everything had shifted in that short audience from knowing all the signs were pointing to long-term survival, to now, this wretched now, with just a slim chance of survival remaining. I felt physically and emotionally filleted. Pigeons and squirrels gathered waiting for food. Would I live longer than that bird, this rodent? How long did the little fuckers live anyway?
Aspiration: inspiration, the act of breathing, a breath, a sigh. Steadfast desire for something above one. My openness to the possibility of death helped me avoid despair, which I think you feel when you blank out reality, then lower your guard and let it flood in. Fear was under control. I was closer to the simple and brutal truths of life and death than I had ever been, even in the recesses of the mountains, far from any succour. A peace came with that.
Two days into chemotherapy, the hair on my head started falling out. I took clippers to it, and cut to the skull. It wasn’t a good look; I have a strong nose and my ears could have been designed on a less expansive scale, but I was controlling something. I would not need to shave for four months. One night I came out of a light sleep at four in the morning to find my ward neighbor, Patrick, standing beside my island, in the shallows. His brain had been rescanned that afternoon, and they had found more tumours, inoperable ones. He began without preamble, ‘Four months they’ve given me. I thought it would be quick, but four months. Jesus!’ Time’s tide was coming for him. He planned to return to Ireland as soon as he was well enough to travel, and make his peace with all his family.
He that dies pays all debts.
There were rests between sessions of chemotherapy for the healthy parts of my body to recover. My mouth was one big cold sore relieved by the occasional ulcer. I felt the cold keenly, and wore fleeces indoors, doubled my bedding, and slept clutching scalding hot-water bottles. The heating was never turned off. It was a very raw way of feeling my vulnerability. Live mammals are warm. I was cold.
After the first week of chemotherapy, I came out the night before my sixtieth birthday. At seven in the morning I took a mug of coffee into Hyde Park to see rolls of hay standing in the wild flower meadows, a bucolic vision brought to my door. When I returned to Charing Cross it was to a different ward and more worried faces on new snowy sheeted islands. The small wards were called bays and were lettered not numbered; inevitably, on the third visit, I was put on E-Bay.
Some patients arrived in dumb shock. They had been being scanned for something harmless and a shadow or a light had appeared where it should not. Some men could barely talk to their wives, but stared in wild accusation at the high ceiling, which had to stand in for the world and its cruelty.
Misery acquaints a man with strange bedfellows
One let out small cries every few breaths, like a wounded gull.
Be not afeard: the isle is full of noises, sounds and sweet airs, that give delight and hurt not...
...but burrow into the soul, like storm petrels tunnelling the turf above cliffs where waves burst their cold hearts. I tried to control the noises of my island, playing music on enclosing head-phones: all classical. I didn’t want to be stimulated, just held together.
The hard winter began. The snow was persistent, the cold relentless. On New Year’s Eve I was admitted as an emergency, dehydrated and with my blood in a mess from inadequate nutrition. If I became too ill to keep to the timetable, the treatment would be less effective. This might also be expressed as I was more likely to die. On 2 January my friend Tan died; there would be a post-mortem, but his body just seemed to have given in to multiple assaults.
One January morning at 9 am, it was the thirtieth radiotherapy appointment, the last. A few days later I was back as an emergence admission, ten kilos lighter, my ribs like a poor man’s fence, skin grey, eyelids like snail skin.
Over a year has gone since I felt the first symptoms. Slowly I have come back to the world. It seems the constellation of lights in my chest were just sarcoid reactions by the lymph glands to the throat cancer. I have the all-clear. I am still sleeping in the spare room, in a single bed, an island I can defend. I can start to wade back to the mainland of humanity, talk about my voyage. I’ll remain, not an island, but a peninsula. Somedays, that neck of land will be wide and high. Other days, the tide laps high. But I’m alive to watch it, waving, not drowning.
I saw Dennis Potter interviewed at Hay-on-Wye in 1994 when he was dying of untreatable liver and pancreatic cancers. He described the plum tree that was in blossom below his study window. His senses heightened by knowing it was the last spring he would see, he not just saw, but felt in his heart, that it was ‘the whitest, frothiest, blossomest blossom that there ever could be.’
As Ariel says, ‘Merrily, merrily shall I live now, Under the blossom that hangs on the bough.’
I’ll share it with those pigeons and squirrels, for a few more seasons.
latest, nonfiction, title is Forgotten Footprints: Lost Stories in the Discovery of Antarctica
previous vintage gems: White Food
next vintage gems: Eclipse