Cancer 10
Posted on February 26, 2023 1 Comment
My sister died yesterday. It was cancer. She was 63 years old. It is good that our parents are not around to see both children with cancer.
It can be a strange relationship, that between siblings. I would not dream to judge other people’s relationships. All are similar, all different, but ours was one of both closeness and distance. There is a natural bond between two people who emerged into the world from the same womb, a bond built throughout childhood at the same time as being battered by the experiences of the same two people who spend most of their childhood not getting on very well (I still have the scar to prove it. See below). We generally got on better in adulthood, partly because we were adults, and mainly because we lived in different houses. We sometimes went a long time without seeing each other, but when we met it was as though no time had passed. Many times I have been exasperated by her, by something she did or something she didn’t do. No doubt I exasperated her too, but there was never a real fall out. Perhaps there is no reason to have a fall out when you are both close and distant anyway.
She was 3 years 6 months older than me. She said she liked being an only child and was annoyed when I turned up. Perhaps what she said was true, that our father always wanted a boy and was glad when I turned up. I never saw that. I thought he treated us equally, though I think I spent a lot more time playing with him than she did. I put that down to boys prefer playing with boys. After all, she didn’t like football, cricket, digging holes or building treehouses in the garden. She had an old chicken shed as a Wendy house for what I remember as a short time, then it became mine. I was to move it seven times to various parts of the garden. My finest memory of it being a Wendy House was getting my sister to open the door and I threw a bunch of nettles at her bare legs. She was stung quite well/badly (depending on your point of view). I was a good little brother. Some time previously (probably years) she had locked me in a rabbit hutch.
We had a big garden, getting on for an acre, which had a quarry, a field, and lots of trees, along with the vegetable garden, lawn, etc. I know we were privileged in that respect compared with other children (though there wasn’t much money around), and I have always looked back on my childhood in a positive manner. We were fed and sheltered, we had an annual holiday, and we were looked after. I was happy, I dug holes and climbed trees, made dams and rode my bike, all the things that boys did before the internet and computers were so sadly invented. My life was busy, generally positive, and provides great memories. The worst thing was having hand me downs from my sister, girly clothes, girly bikes (until I got my own racing bike at 11).
My sister had the same opportunities, the same space, but as an adult looked back in a generally negative way about her childhood. I have never understood why. Perhaps she wanted to be a boy.
She did have responsibility for looking after me on many occasions. She took me to school, which was a good long walk each way including one busy (for a village) road. In the holidays when both parents were at work she was meant to look after me. My strongest memory is that she would never let me in the house, keeping the doors locked and forcing me and my friends to play utside all day. What a shame. It was sometimes a game to try and break in. My scar arose from me trying to open the front door and my sister trying to close it. Unfortunately I was pushing on the glass (she should have told me not to. She was responsible for me. I was a child. How was I to know? ahem….), which broke and a piece took a big chunk out of my wrist. I stared at it, this great gouge, and suddenly the blood started splurting out. I didn’t wait for a response from my sister, but ran about 500 metres to my friend’s house, where his Mum sorted me out. I don’t remember, but surely my sister must have been nice to me for at least a little while after that. I still bear that scar.
We did share a lot of things. We occasionally went on bike rides together (I would go round in circles waiting for her to struggle up hills). We occasionally played together in the garden. She twisted her knee badly when we were playing in the field behind the house and ended up in plaster for weeks. We certainly spent a lot of time together on the back seats of the various cars we went in on holiday to Scotland and the Lake District (We all have selective memories. Who wants remember a week on a beach in Blackpool?). We sometimes even spoke to each other civilly and played games.
On the whole I thought our relationship was normal, presumably because I didn’t really see that many relationships between brothers and sisters. Those of my (male) friends who had sisters tended to ignore them when we were together.
Yesterday I was in a state of shock. My insides were turned inside out, my emotions in turmoil, and my thoughts confused. Today is better. The shock has worn off. We were expecting her to die. Now she has died. My recollections are mixed. Good memories, bad memories, indifferent elements. Why would I want to change anything? She was my sister, and that’s normal, I assume.
Cancer 9
Posted on February 23, 2023 Leave a Comment
0727. Today the treatment has a beginning. This afternoon is the pre-op. I will be meeting again with the surgeon and with the nurse, and then have an appointment with the anaesthetist, who may want to test my fitness. Hopefully I am fit enough. The wait is notoriously long. I am going in early to order that, and then write my book in the medical school, where fortunately I can park all day as I work in the medical school.
1057. After spending 20 minutes in the queue for the pharmacy, with the sign indicating a 1 hr 10 min wait for picking up, I was told that my drugs were not in stock. There is a benefit to this. My pre-paid certificate ran out a few days ago, and I don’t become age eligible for free prescriptions until Monday (presents to the usual address please!), so at least I saved a tenner or what ever they cost, though it does mean I will have to drive back to Derby which will probably cost more than a tenner. And that is a good example of Tory economics!
1105. If I am having to hang around all day getting border then you, my dear reader, can also go through something similar reading this. I am now sitting in the cafe of the Medical School in the hospital. I am fortunate in having this sanctuary away from all those sick people! My intention is to spend the next couple of hours reading my book before I have to go for the pre-op appointment. Blog writing is a great avoidance strategy. I am on the boring part of the book, rewriting and editing. It seems to take forever with no visible gain. At least when writing the first draft you can watch the word count gradually go up, 10,000 words, 20,000 words, and feel you are achieving something. At the editing stage it also involves realising how bad the writing is. OK, get on with it.
1248. I managed to finish off another chapter (and by finish I do not mean finish, but completed the latest, penultimate, stage). A couple of things. I am now in the ‘restaurant’, where the main meals are pie and chips or curry. I had curry as being the lesser of two evils (if you know me you will know that I don’t mean that. Give me pie any day. I am just trying to be good). I don’t know why hospitals aren’t compelled to just sell healthy food, given that diet is a key indicator of health. Many of the staff turn up with their own food, boxes of salad, sandwiches and the like. I have also noticed that, despite the rule that they should be worn, fewer people are wearing masks. I haven’t yet been asked about wearing one. In the past I just say ‘I am exempt’. While I want to say ‘I am exempt because I am following the science that indicates masks have no effect on the transmission of viruses’, I should say, ‘I am exempt because I have heart failure, cancer, and lungs battered by previous experience of pneumonia and pleurisy.’ Back to the book. This is exciting isn’t it?
1836. I am back home. It is over. The pre-op lasted over two and a half hours, but it was mostly positive. Good rapport with the nurse. My heart is not bad, my lungs are fine. My blood pressure is a little high but I knew that. My weight is, ahem, and my BMI is more than 20. They even managed to take some blood, which has been difficult since I have had heart failure. The 30 day mortality risk after the operation is 1.48%. The main anaesthetic drug will be diamorphine, injected into my back. I will have overnight pulse oximetry to check my blood oxygen levels, but it showed 97% today, which is good. I need to go back to the hospital tomorrow with the results of the oximetry test, and then again next week for my prescription. The day before my operation I have to fast and take some high carb drinks. I then need to take tablets to induce the emptying of my bowels before I arrive at the hospital at 7am on the big day. Now I am going to spend the evening doing nothing of importance.
Cancer 11
Posted on February 23, 2023 Leave a Comment
I generally have an optimistic starry-eyed view of the world, where my cancer will be cured, but today has been one of those days where it has been difficult to keep staring at the stars. Last night I spent too long on or near the toilet , with my abdominal cramps worse than normal, and blood oozing and spurting – I hope you are not eating. There should be some good toilet humour in this, but I am not in the mood. Let me know if you think of any good jokes. It is not particularly painful, but it is worrying that it is getting worse, ie that the malignant tumour is increasing in size and narrowing my colon, so making it difficult to get things past it.
I telephoned the cancer nurses to let them know what was happening. They have put me on a low fibre diet (where at least I can eat white bread, meat, fish and eggs) to help ensure the safe passage of looser stools.
My second worry over the last few days has been that my operation may be postponed because of the junior doctors’ strike. I hope it won’t be. I asked the nurse if there was any information. She checked with her manager and we should know sometime towards the end of next week, which is a week too long for me.
The stress of the day meant that we completely forgot that my niece was taking me out for my birthday afternoon tea today, She phoned me 15 minutes after the due time, and we got there half an hour late, extremely apologetic. This never happens. We are early people. Tell us to be somewhere at 1100 and we will be there at 1030 and think we are just in time. Stress has profound effects on behaviour.
Whenever I worry I inevitably think things will go wrong, that my cancer has spread so that it cannot be easily controlled, that it is in my lymphs, in my liver, in my kidneys. I feel it everywhere. OK, I know this is my neuroticism but neuroticism is real so my feelings are real (even when I know they may not be – see, even here I can only say may not be rather than are not).
These are the times when I reflect on my life and wonder whether it has been of some value, I mean subjective value. We can’t all be Einstein, Gorbachev or Churchill. Do I think it has been in some sense worthwhile? I start to think in existential terms, with the ideas of being and becoming and absurdity to the forefront. In the end I know that objectively no life has value. A few atoms bonded together in a weak, floppy body, ever-changing for a few rotations of a minor star around a minor planet until it dissolves into the earth. None of it matters. Yet of course it does; it matters to ourselves in some absurd manner. It matters that we have achieved things, that people like or respect us, that we have in some minor way contributed to the world. These things give life some meaning. As Sartre would have it, a sense of becoming rather than just being. Albert Camus would conclude that while life is absurd, the meaning we put on it is important, and so we should not commit suicide (see The Myth of Sisyphus for a fuller explanation) . Thanks Albert, I was not thinking of committing suicide just yet, no matter that parts of my body might want to.
Sorry that I have been negative again. The key thing is that I just want this operation over and done with. Inside I am under stress, but my self is aware that the chances are that Western medical science can destroy my cancer and make me reasonably well again (apart from my heart failure, my pinned big toe, my outsized belly, my flat feet, my alopecia and my perennially broken shoulder).
Cancer 13
Posted on February 23, 2023 1 Comment
Notions of god have never played an important part in my life. Having a life challenging experience such as the one I am currently going through has made no difference whatsoever to my views. As I have said in an earlier post; you don’t exist, you exist, you don’t exist. That’s it.
I have my narrative of the rejection of Christianity, with its two critical elements, crying so much at the age of 3 that I had to be taken out of church, and walking to school down the croft (a field on the way to school, now covered with houses, some of which I helped build in a previous career) at the age of 7 and suddenly realising, once and for all that there is no god, that it is just a made up story.
My reasoning may have become a little more sophisticated since then, but I have never doubted my atheism. I have never been to another church service apart from weddings, funerals and the like since that day when I was 3. I don’t like churches. I find them unpleasant. They smell with a lingering sense of the obscenity of faith, despair and hopelessness. After all, what hope of life is there for a person who simply looks forward to paradise after death? Live now as there is no tomorrow.
Many philosophers have made their name through discussion of the possible existence and nature of god. Descartes, in his Meditations, argued for a system of doubt as a means of understanding the world. He progressively doubted (nearly) everything, arguing thathe could not be sure of the existence of an external world as his senses might be deceiving him. In the end he doubted everything except the existence of god, and through this rebuilt the world as he assumed that a kind and loving god would not deceive him about the world, so therefore it really existed. Descartes’ method of doubt is sensible, until he found he could not doubt god, and then it falls to pieces. For the system to work he had to doubt everything, including god, but if he doubted god he was left with nothing. He would then have to build up the world through evidence. He would probably learn to trust his senses and realise that the world existed, other people existed, but he would find that there is no reason to not doubt god’s existence, so he would have to conclude that god does not exist – which did not fit his world view.
If you really want a god then you could try Spinoza’s god. Spinoza argued that the universe consists of only one substance, an infinite substance, that he called both god and nature. These terms are interchangeable, so god is nature and nature is god. The problem with this is why both with god? There is one substance, nature, so why give it another name, god? Pretty pointless really.
It was the Enlightenment that saw the separation of god and philosophy, with the latter based on reason and the former on faith. Kant argued that while we cannot prove the existence of god with empirical knowledge we cannot prove his non-existence. Fair enough, but then why bother with the concept of god if it stands outside our ways of thinking? Nietsche did not actually say god is dead, but he rejected belief in god as unrealistic, weak and untenable. God had never lived so how could he die? For Nietsche, god is irrelevant. For Freud, god is a projection of the mind, a kind of wish fulfilment. I like this idea, that of god as being an extension of the self, basically a weak form of mental illness where people refuse to take personal responsibility for their actions, ‘It wasn’t me it was the extension of my self that is god.’
In our modern world we are told to have respect for the various religions. I am unable to do so, basically because religions are silly and childish. I can respect the person but not their religion. Religions are the cause of so much of the harm in the world. I work in science. I do not see how someone who genuinely believes there is some sort of bearded fairy in the sky who created us all out of magical clay can be a real scientist. That is back to Descartes’ failure to doubt the existence of god. We are trained to be skeptical, to disbelieve, to argue against matters of faith and present evidence for the structure of the world and our understanding of the way it works. We have a fair understanding of many aspects of the universe, though there is still a lot to learn, and we have become much better at engineering the world to make it a better place to live. We have made plenty of mistakes, but if we are to advance our knowledge and make life better (whatever that is) we are going to make mistakes. Some bridges fall down, but most enable us to cross from one point to another in safety.
With regard to my cancer I prefer to put myself in the hands of trained and competent scientific medical practitioners who have a good understanding of the nature of cancer and how it can be treated than the imaginary bearded blunder that many people think is responsible for the world. If my treatment goes badly wrong then I die, which I will do anyway in the next few decades. If, as is much more likely based on the science, it works, then I get to live for a while longer. When I do die, whether it is sooner or later, I will cease to exist. As Bertrand Russell said regarding death, ‘I should scorn to shiver with terror at the thought of annihilation.’
Cancer 8
Posted on February 22, 2023 2 Comments
Sometimes it is overwhelming. It is difficult to describe in words. It can reach a point where I feel I cannot cope, I cannot cope with my cancer, my sister’s cancer (she is in the final stage of life) and my heart failure, let alone the everyday stressors of life; yet I have to cope, There really is no alternative. Breaking down is not an option. Fortunately these feelings do not usually last long. Within hours I generally restore that unmoving lip.
Human resilience is incredible. Both the psychology profession and society general tend to focus on the negative: so many people have mental health problems, how we all need counselling or psychotherapy when something horrid or stressful happens, how we can’t cope with death and serious illness, how watching something on the TV can be traumatic (!). The reality is that most of us cope very well. I have spoken in a previous blog about social support, but I think we as individuals are – usually – incredibly strong and able to deal with most of what is thrown at us in life.
I realise that many people have genuine problems, and that some are unable to cope and do need professional help, but I am focussing on that large majority of us who usually deal with things pretty well.
In society we seem to have a problem with negative feelings and emotions. We want to be happy at all times. If we are a little sad we call it depression, label it as a mental health problem, and swallow pills or talk to psychologists and counsellors. Instead, much of the time, we should just realise that life is not just about happiness, it is about the whole range of emotions. We all experience death. We all experience illness. We all experience very stressful times in life. It may sound old-fashioned but I often want to say get a grip. You can cope. These things are normal. If someone dies we are sad, often very sad, but we eventually get over it and start living normally again. We grow to remember the dead person with fondness (or not!), and get on with life. We reflect back, remember, get sad, have a few tears, but these are moments. They should not take over our lives.
One area of my research is post-traumatic stress disorder (PTSD). I became interested when I was working with World War Two veterans. I found that there were some who had very serious problems relating to their war experience, and could suitably be classified as having PTSD. They experienced traumatic events, and they had difficulty dealing with those events. Memories would emerge at various points in life and cause serious problems that sometimes needed professional help. The problem now is that the word trauma is overused. Everything negative is traumatic. My dog died, how traumatic. I saw something upsetting on TV. How traumatic. I had an argument with my wife. How traumatic.
None of these things are traumatic. They can be genuinely upsetting but they do not constitute a mental health problem.
We have a large and growing language about the negative aspects of life. We should spend more time talking about the positive aspects of life. Some psychologists do discuss the positive aspects of life, but they are relatively rare. Most of us, and I am guilty of this, focus on the negative, while trying to make things a little better. It is laudable, particularly when someone has a serious problem that really does need the help of a psychologist, but it is often the case that people need to recognise that there are bad bits in life and deal with them.
It is often about the way we appraise our situation. Shit happens. Right, how are we going to deal with this? Deal with it and get over it. Having moments of feeling unable to cope does not mean I have a mental health problem.
Dr Nigel Hunt 