Space for Alternatives

I am delighted to have reached the end of my current chemotherapy course, and somehow to have reached this milestone feeling better than I did when it started. It is not difficult to bid farewell to sixty nights of pills, all the nausea and fatigue and changes of appetite, and the other side effects like the itchy rash. Still, all that poison seems to have done its job, so was always welcome in my life.

 

We have deferred celebrating this milestone for the time being. Next week I have a regular MRI and the following week my oncologist will pronounce on its findings and his suggested next steps. I understand that a break from chemo is almost mandated at this point whatever my condition, to allow some time for recovery of platelet and white blood cell counts and a few other metrics. So even if we might possibly be leaving the door slightly ajar for the cancer, it and any other ailment would encounter a stronger immune system to impede its progress.

 

Still, reaching the milestone with such unexpectedly good health has filled me with awe and wonder and prompted a few tears. I find myself noticing small seasonal events and contemplating how I never thought I would have that good fortune. The change of the clocks and the evening daylight hours, some occasional warm sun, the colours of early flowers and blossom, the transitions through the end of lent and in Holy week, and even the start of a new baseball season have all made me pause and give thanks.

 

I see the main oncologist, a man we greatly respect, every eight weeks, although that might become more occasional in the next phase. Before each visit I make a list of questions to ask him, and I have noticed that over recent months that list has been very short. I have had my head down and been focusing on enduring the treatment and not really had space for much else. The path forward has been clear and obvious and the risks ever-present and known. It has been like the middle execution phases of some work projects, where distractions are unhelpful, and all energy should be focused on getting things done and handling any setbacks.

 

But this time it is different. I find myself waking up with my head full of questions. I haven’t started to write them down yet, but soon I will, and the poor man will surely face a barrage when he sees me, so long as the meeting agenda is not overwhelmed by fresh bad news. Most of the questions seem to fall into two categories. What can I do to make the cancer less likely to return, and what are the primary warning signs to look out for?

 

The first of these big questions is really one we could all ask ourselves all of them time. The answers are quite likely the same as they would have been had I my chance run into a leading neuro-oncologist before the brain tumour had developed at all.

 

Beyond the obvious and well-known answers such as not smoking, avoiding addictions, controlling stress and sleep as well as possible, avoiding ultra-high processed foods and too much salt and sugar, and fitting in some exercise, I am curious as to whether any answers will be forthcoming. As far as I can tell, the primary answer might be to have better luck, or at least have less susceptible genes. That would be quite frustrating, but also perhaps somewhat reassuring, because at least I could conclude that I did nothing daft to bring the cancer on. Fifty years ago, the prevailing wisdom would have suspected that the root causes of my cancer must have included a large dose of sinfulness. Part of me wonders if, twenty years from now, folk might look back at today and be astonished to recall that we currently consider the main root cause of many cancers, including mine, as plain bad luck.

 

The second category of questions, the ones about warning signs, should be easier to answer, and perhaps I know a few of the answers already. I am anxious because for sure I was lucky last time to spot the small change in my peripheral vision and to take some action about it. The sooner we can identify a problem, the more likely we are to be able to fix it.

 

My wife was probably having similar thoughts about lifestyle and behaviour when she recently encouraged me to visit an acupuncturist. She has started seeing a practitioner to help her with muscle and joint issues and is encouraged by her progress. I am an advocate of acupuncture, albeit a cautious one, after the treatment helped me fifteen years ago when I had very sore shoulders. Acupuncture helped me, but the real cure was to retire from work and to stop lugging heavy computer cases around with me all the time.

 

I had my first session earlier this week, and I remain curious. I am fascinated by the idea that sticking needles into an arm might offer relief to a kidney, but such wonders seem now to be generally accepted. The stretch in credibility was simpler for an aching shoulder than it is for brain tumours, but perhaps this Japanese gentleman will have something useful to offer. His answers to my questions are sure to be different to those of the oncologist, but perhaps they are also valid. The first visit failed to deliver any magic wands (how could it have?), but I came away convinced that he was not a scam artist and that if he tried a treatment, it would be because he thought it might work rather than as a ruse to take money from our insurance company.

 

Such diversions are probably another sign of a progression to a new phase in my cancer journey. Six months ago, buried deep in chemotherapy, I would not have been open to complementary approaches, but now I find that I am, at least a little bit. I reached a space where there is room for such alternative thoughts. That in itself is a cause for celebration. 

The Magnificence of Ann Wroe

 More than twenty-five years after first subscribing, I still find The Economist a splendid read. For anybody using English language, it must be the most informative, intelligent, balanced and even entertaining publication available. Americans may gripe a little at the Anglified use of their mother tongue, but probably no more than my complaints about how the New York Times daily Connections game frequently employs idioms or practices unfamiliar to anybody from outside the USA.

 

When I was recently asked to compile my own Desert Island Discs, simply as an exercise, I chose The Economist as the reading material I would most like to be granted on a desert island. But I didn’t choose the whole magazine, but only a compilation of their back pages. That is because that page is reserved for a weekly obituary, which has been written for the last twenty years by Ann Wroe. I am frequently moved to tears by her reflections on a recently deceased individual, by a combination of thought-provoking insight into her chosen subject and the sheer beauty of her writing.

 

When I first subscribed, the only way to enjoy The Economist was through its print edition, either at a news stand or through the post. That is still my preferred mode of access, and I am still amazed at how fresh news from Wednesday can be elegantly transcribed, printed and then delivered to my mailbox each Saturday. It takes the Inland Revenue and others many months to accomplish much simpler tasks. Notwithstanding my preference, I am grateful nowadays on occasion for the opportunity to read my favourite magazine from my laptop. And technology offers even more than that these days, including a series of webcasts offered to subscribers. Last week I registered for one of those for the first time. It took a special subject to tempt me into giving up n hour of my time for medium I don’t usually use. That special subject was an interview with my literary heroine, Ann Wroe.

 

I was not disappointed. Sometimes characters we admire turn out not to be quite as saintly as we imagined when we get a chance to see them in a new way. Ms Wroe was just as charming and as elegant to listen to during an unscripted chat as she was in print. She came across as curious, humble, and funny as well as informed, poetic, and even musical.

 

It was fascinating to learn about her weekly process to produce her obituaries. Over the weekend she reads many published obituaries and comes up with a few candidates for her piece and eventually with a preference. There is an editorial meeting at 11am each Monday morning which results in a decision. No doubt after twenty years of experience and a rather regal reputation at the magazine, editors rarely challenge her own instincts. Once she has a subject, she spends the rest of Monday reading and listening any material she can find about them, especially anything resembling memoir. By the end of Monday, she aims to have decided upon a style, opening, closing, and general outline for her obituary, leaving her Tuesday to write the piece in time for a publication deadline on Tuesday evening. Wow!

 

I did not have the chutzpah to submit my own written question, but many did, and the interviewer cleverly interlaced his chat with some of these. Inevitably, one question referred to Ms Wroe’s own obituary. Who would she like to compile it, and what would her wishes be for what should be included?

 

Ms Wroe’s answer intrigued me, partly because cancer has led me to random thoughts about my own obituary from time to time. She did not have strong opinions about an obituarist, and even seemed rather disengaged about its contents. She said many times that she valued experience over record and would be happy to let others reach their conclusions about herself, without too much remote curation from her. What she did say was that she hoped any obituary would be funny and would capture her own sense of humour and quirkiness. This felt entirely consistent with how she writes the obituaries of her subjects, full of wit and quirky anecdotes.

 

I spend less time nowadays pondering my own obituary, because I think I am less concerned about influencing how people might remember me than about how I can perhaps help them to enjoy fulfilling lives after I am gone. But the interview did lead me to wonder which quirks and anecdotes might shed a revealing light on me.

 

Two anecdotes come to mind, coincidentally both certainly from the year 1968, when I was seven turning eight and our family moved from Folkestone to Portsmouth. The first event must have been around April, when I accompanied by mum to an interview as part of an application to a particular school on Hayling Island, where would be living for a short time. The teacher addressed most questions to mum and had just asked if I had started any French yet. Then he suddenly turned to me and asked how much seven times eight was. Quick as a flash, I replied that it was cinquante six, to the general astonishment of everyone in the room. I recall the incident in uncanny detail; I was not trying to show off (for a change), but only thought that he was trying to verify my French credentials rather than some trivial arithmetic.

 

The second anecdote probably occurred around October, a few weeks into my career in the first year of another school, Portsmouth Grammar junior. One morning, class was interrupted by some sirens, and we were all ushered into the gym for some time while various teachers mumbled in worried tones. We took to gossip and managed to establish that a boy I had not encountered from another class, named Moon (Korean?), had suddenly fallen very sick. It transpired that he had turned a shade of blue and that the ambulance had arrived too late to enable medics to resuscitate the poor kid. The teachers were in shock and probably did not feel comfortable restarting classes and there was a general air of paralysis in the packed gym. Then quietly, from the back of the room, came the voice of young Bobby. Wow, said he, that only happens once in a blue moon. He was, of course, royally admonished for this extraordinary display of juvenile wit. I still wonder if that was the best original joke I ever concocted.

 

One possible way my disease progresses might involve something like dementia, and indeed I do sometimes struggle with names these days. Who were the coaches of Chelsea between Conte and Pochettino? I have no idea but think back to 1968 and I can recall much more than those incidents. There was the trip when the car broke down outside Eastbourne, mum’s racist reaction to the black power salute in Mexico City, the beginning and the end of horse riding, golf with two clubs on the nine-hole course and accompanying dad on the full course, and my only perfect childlike summer on Hayling Island, including my first ever crush on a girl next door names Caroline Torrance.

 

Ann Wroe will, of course, never compose an obituary of me, but, if she did, those two anecdotes could lead the opening paragraph, and a third one might follow from the next year, when I brought the house down at a school revue with an improvised slapstick routine involving lots of shaving cream. Put the three together and you might have all you need to know about quirky me, from the desire for a stage, the edgy wit bordering inappropriateness, the prodigal sums, and the later propensity to compose and perform tribute songs at cabarets and parties.

 

She might allude in passing to how I was probably most proud about the long list of people who declared me to be their best-ever boss. She would surely include a lot of less flattering references too, but Saint Ann would struggle to make much poetry about any of that. 1968, she could work with.