Untold Stories (79 page)

Medical fees apart, the price one paid for board and lodging at the London Clinic was not much different than that for staying at the Connaught. Unsurprisingly, though, the food did not compare and meals were dull, tasteless and old-fashioned. Paying for them out of my own pocket perhaps made me more critical than the average patient, who was likely to be putting it down to insurance, and unlikely to be here for the food anyway, and eventually I wrote to one of the board of trustees, complaining in somewhat exaggerated terms:

The nurses assured me that their food was even worse, but the irony of crusading for better conditions for some of the richest patients in the world was not lost on me, and eventually I took to having most of my food brought in, a practice I'd thought confined to the inmates of Turkish prisons.

When, later on, I spent time in UCH and the Middlesex, both NHS hospitals, I was reassured to find the food, though of course free, was of approximately the same standard as in the private sector. There were fewer frills but it tasted (or didn't) much the same as most institutional food tends to do. But there, at least, I wasn't paying through the nose for it.

The final session of my chemotherapy ought to have been at Christmas 1997, making one wonder if this would have involved any festive accompaniments (the holly and the IV) but it was put off until the beginning of January, and this marked the end of my treatment. Now all I had to do was wait and come in every three months to be examined, thus becoming in the course of the next four years a denizen of that quartier clinique that lies east of Marylebone and north of Oxford Street. Sometimes it was Harley Street, but on two occasions, both quite dramatic, I was taken into UCH and the Middlesex. More often than not, though, my visits were on my bike, as it's only fifteen minutes from home, and most of them were without event. There were, though, as there had been already, various low points.

In the course of chemotherapy a considerable volume of liquid is passed intravenously through the body, only part of it folinic acid, the rest saline. The passage of this out of my system seemed, in my case, quite slow (I tried to imagine it staying and doing some good) but this retardation had to be catered for. Never feeling particularly incommoded by the treatment, I would often go home to Yorkshire the following day, but on one occasion en route I was taken short and pissed my pants. It was the first time I had done this since I was a small child, and though the relief was so blessed it was almost celestial, I found the episode unexpectedly depressing. It was on King Lane in Leeds, and I have never passed the spot since without remembering it, one of the grid references in that
private topography of memory, embarrassment and romance that is laid over the map of Leeds.

Incontinence featured at another low point, the first of a series of scans that punctuated my treatment. At the time I was filming the second series of
Talking Heads
at Twickenham, and had to come away from the filming of one of the monologues when it was not going well. The sense of stillness, which to my mind is essential to the effectiveness of this form, had begun to give way to a busyness which betrayed an anxiety about the bleakness of the set-up. I wasn't directing the piece myself, but had already insisted on retakes, without managing to make it any less
mouvementé
and I had the feeling when I came away that the director and the studio were glad to see the back of me.

There were retakes at the hospital, too. I had to drink a good deal of water, or radio-sensitive squash, so that my bladder and bowel would show up properly on the screen. The retakes here were themselves a cause for anxiety (what had they spotted that they needed to see again?), and as I lay on the table, being passed in and out of the scanner, I became more and more desperate to piss. In the event, I managed not to, and in that sense there's no point to the story, but the wretchedness I felt, which must be part of the ordinary commerce of such a place, remains vivid. As it was, I was sure that the film they had taken (and retaken) did not bode well. In this, happily, I was wrong. The film I had left at Twickenham was probably better than I had imagined, too, though there was no retaking that.

Another low point concerned the rogue trader and banker of Baring's Bank, Nick Leeson, not a character with whom I had much sympathy, or thought to have any connection. Shortly after he was gaoled in Singapore he developed cancer of the colon, the onset of the disease causing much comment in the press and, I would have thought, an undercurrent of satisfaction. Certainly, there was much speculation in the papers about colonic cancer in general, and on Leeson's chances of survival in particular, journalists gleefully quoting the odds.

I tried to sidestep most of this, knowing it would depress, but one item
caught my eye: an interview with Professor Gordon McVie, then the Director General of the Cancer Research Campaign. It had been well advertised in the press that, after establishing itself in the bowel, the cancer's next port of call was often the liver.

‘And what', enquired one fearless newshound, ‘are Leeson's chances if the cancer has reached the liver?'

‘Zero,' said Professor McVie or (which may have been a very different thing) that was what he was reported as saying.

Now I knew from my original operation that the cancer had reached my liver, if only just. So, unlike the pronouncements of my surgeon, which at least gave me a fighting chance, this pronouncement offered no hope at all. It's to be hoped Professor McVie was indeed inaccurately reported, because even if what he said were true, it scarcely helped to say so, and there must have been thousands of patients like myself for whom it seemed to sound a death knell. Leeson is not an appealing figure and altogether too cocky for my taste, but cancer made us kin. He was not the only one. Around this time Ian Dury succumbed too, and I even felt some kinship with the far more unlikely figure of King Hussein of Jordan, whose last months with cancer were served up and lengthily dwelled on by the press.

My own liver was obviously a source of concern to the doctors, and in the first three years following the operation was repeatedly sounded and scanned, so far, anyway, revealing nothing, as they say, sinister.

‘And,' the scanner would say, ‘I've had a good look round, besides.'

Regardless of age, looks or gender, radiologists never know how close they come to being kissed.

Cancer licenses hypochondria. Watchful for the disease's recurrence, one feels there is no ache that can be safely neglected or symptom ignored. In early detection lies the best hope of cure: and having, as I saw it, neglected this precept in the past, I was anxious not to make the same mistake again. So, a sore knee or an hitherto unnoticed mole would send me to the doctor's, never knowing in what guise any new assault might occur. I was lucky in having an understanding GP, and the regular check
ups that an operation for cancer requires, particularly in the early post-operational stages, helped to keep me on an even keel, and in some respects ensure that my general health was better than it had been before.

It was discovered, for instance, that I was on the edge of diabetes which I would not otherwise have known, so that precautions could be taken accordingly; high blood pressure similarly. It's true that I had reached the age when such perils and prudences are the common thing but I owed it to cancer to remind me.

The regular check-ups which are part of the treatment of cancer helped allay any incidental anxieties. Did you get cancer in the elbow, I wondered, as mine was quite painful. Was the thumb a site? One of the blessings of the seriousness of the disease was that nobody seemed to mind one asking these fool questions. Every three months I had a blood test and saw either the surgeon or the oncologist, a routine I kept up throughout the five years and, though in the later stages this was probably more frequently than I needed to, suited me, and I was paying.

Still, I never made these appointments without foreboding and there were often anxious moments when the blood tests were not clear, and I was sent for an ultrasound or a scan. I learned to measure out my existence in these three-monthly spans. Life became a series of small paroles, and I never came away without a sense of reprieve, wheeling my bike back through Regent's Park often a time of idyllic happiness. For all these check-ups, though, when in due course illness did strike, it was sudden and unexpected.

In April 1998, nine months after my first operation, I was taken into hospital with a high temperature and pain in my right side. It was in the area of the appendix but, in the light of the cancer, the doctors at University College Hospital were at first reluctant to settle for that diagnosis, presumably thinking that the most likely explanation was a recurrence.

That seemed the likeliest explanation to me, too, but the truth was I felt so ill I hardly cared, every jolt of the ambulance taking me to hospital, agony. Eventually, I was transferred to the Middlesex, where appendicitis was finally diagnosed; the appendix itself not to be found having, presum
ably, disintegrated, and in its place an abscess which was lengthily and tediously drained. It meant that, as on several previous occasions in my life,
*
I was in hospital on my birthday.

Two years later I had a similar episode, which again was thought to be the cancer recurring but turned out to be the residue of the previous infection. Both episodes included sudden
rigors
during which I shivered so violently that I felt I'd been attached to an electronic machine; my teeth chattered and in the stiflingly hot room I was bitterly cold. It's not an unusual symptom, though alarming to experience and spectacular to watch and, as often in such circumstances, there was part of me, moaning and shaking as I was, that registered how seriously ill I must seem. Stripped of my bedclothes to fetch my temperature down, it seemed to me like the onset of death, but was, in fact, not grave at all. This, too, was around my birthday.

I hesitate to dignify such self-scrutiny as a writer's instinct as it seems to me often closer to self-dramatisation. But there is no doubt that knowing that one day (provided there is a one day) you may write about what is happening to you (or just write it down) is a solace not on offer to patients unblessed by a similar instinct. For a writer, nothing is ever quite as bad as it is for other people because, however dreadful, it may be of use. Living is something I've managed largely to avoid so, naked and shivering on the bed though I might be, for all that I could reflect that something at least was happening.

The most painful experience had, as I say, nothing to do with the cancer, the operation for which had left me only a little sore and with a scar so lengthy it was something of a trademark.

‘Ah ha!' said a consultant at UCH, as he kneaded my belly a year or so later, ‘I see you were operated on at St Mark's.'

This was shortly before a tube had to be introduced to drain the abscess on the appendix. I had assumed that this would be done under Valium, a drug I find so delightful I'm happy to submit to any investigative
procedures that have to accompany it. Laid out on a trolley in the basement of the Middlesex, I kept expecting the needle on the back of the hand and the near-oblivion and telescoping of time that generally come with it.

It was only when I saw the professor in charge running his hand speculatively over my abdomen, deciding where to insert the tube, that I realised this was to be done cold. It was kindly, if a sudden blow to the belly can be called kind, and it had to be weighty enough to force the tube through the stomach wall. But it did not end with that, as thereafter he followed the progress of the tube on a screen, while he guided it round my guts to try to reach the root of the infection. It was like being host to an angry hornet that was crawling around one's insides, stinging as it went. The martyrdom of St Erasmus, whose intestines were wound round a wheel, must have begun in much the same way.

I was probably crying out because a nurse who was passing stopped and held my hand. Perhaps no more than a gesture of fellow-feeling, it seemed to me at the time like the kindest thing anyone had ever done for me: he was an angel and I loved him. Then the tube must have got to the root of the abscess and the accumulated pus began to flow out in gratifying quantities, as the professor rejoiced. I did not care. All I cared about was that the pain had stopped. The nurse wiped my face and went on his way.

The two sessions I had in UCH and the Middlesex gave me a chance to compare them with the treatment I'd had in private hospitals. Some comparisons could be direct. I have had scans, for instance, in all three, and while there is little to choose between the performance of the scan itself, even in the attendant circumstances the NHS came out of it quite well. There was no greater degree of privacy in the private or the public sector; the waiting area was just as crowded at the Princess Grace as at the Middlesex; the
class
of people was different and sometimes their nationality, but in both one had no choice but to traipse around in a hospital gown in full view of one's fellows, so if what you think you're paying for is seclusion, certainly in the treatment room, it's money wasted.

On the ward, I'm not sure that money spent on privacy is not wasted, too. However rotten I was feeling, I never felt so low on a public ward as
when in expensive isolation. It's partly that on a public ward one comes to know the nurses and their routines; one sees the changeover from the night to the day shift, the daily formality of the ward round and the comings and goings of consultants of varying age and exaltedness. Something is always going on and with the same cast. Because what is above all comforting and professionally reassuring is that the same faces recur day after day. It seems to me incontestable that outside the specialist units of the private hospitals, where there is a permanent staff, the general ward nursing in the NHS is better than in the private sector, and it is better principally because there is more continuity.