Dreams can come true

 Our move to Portugal has often been described as fulfilment of a long-held dream. In some respects that is a fair description, but we learned quickly that the move would be much more complex and there was no certainty that it would end well. Luckily, it has turned out quite well so far, but of course a seizure or other setback is always potentially around the next corner, so all dreams have to be considered somewhat provisional.

 

Dream-like thoughts go right back to when I bought the villa in Portugal with my ex-wife nearly twenty years ago. Certain repeating experiences felt like fulfilled dreams from the start, which helps explain how Portugal has always had an over-exalted place in my heart. I have always associated the arrivals area in Faro airport with a particular smell, and that odour still puts me in a good mood, without even needing to enter any airport building to experience. The villa itself evokes positive feelings, especially after the recent upgrades. There has always been a tradition of standing on the roof terrace with a glass of something bubbly to observe the lovely view, especially around sunset. Then, over time, our stable of favourite restaurants has steadily grown, each one somehow with its own place in my heart and dreams.

 

Of course reality always challenges the naivety of our dreams. We can think of our lives as living out our dreams, and that is probably a healthy attitude to take, but real life causes us to adjust again and again. Stuck in my dreams, I constantly underestimated the degree of difficult adjustment imposed on my wife daily, an adjustment that can never be fully completed.

 

Then again, our time here in Portugal so far has turned out very well. There have been ambushes to evade everywhere, and every likelihood of major setbacks, with health or otherwise.

 

Thins have gone so well that at times it really does seem like we are living out our dreams. Only considering the month of June, examples are manifold.

 

We started the month with one more singing holiday, this one with the familiar surrounding of the Italian Adriatic coast. Every time I do a singing course nowadays I have some fear, with the travel to add to the everyday health risks. Although it was tough week musically, it turned out very well overall, with my wife able to hop on a train for a couple of days in Florence as a great bonus.

 

The week after travelling also worked out very well. The local choir that had performed the Mozart Requiem in April offered up an encore show. It was a bit of a strange project, and at one point I feared that our a capella Ave Verum might be among the most embarrassing of my life, but, as tends to happen, improvements in late rehearsals and performance helped a lot. I remember Ave Verum Mozart performed in Church as maybe my first “You can take me now, Lord” moment soon after diagnosis. Each time I have a feeling like that it feels almost dreamlike. The new church community that we are testing out offers potential promise of many such moments.

 

The week of the concert offered up another huge bonus, coinciding with a visit of our daughter from the Netherlands together with her boyfriend, introducing him to us for the first time. We hope there will be many subsequent opportunities to meet him, as the visit went very well indeed. What more joyful dream-like experience can there be for a (step-Dad) than a meeting like that?

 

As the month continued, a legion of visitors, mainly cousins of my wife, spent some days with us. We had twelve sleeping at the villa and four more at a neighbour’s place. All six of the kids turned out to be great company, and the whole week seemed to be filled with recurring dreams coming true. How splendid it was to observe six kids frolicking in our pool? What about the adults sitting on the terrace chatting and reminiscing late into the night? Visits with our large party to beaches and familiar restaurants? Maybe best of all, we were able to revive a treasured tradition, that of sharing a toast of something bubbly while enjoying the sunset from our rooftop.

 

After the visitors all departed, we have been able to resume more of our habitual routine. As the weather has become warmer, we try to take our morning walks by the seaside earlier in the morning, before the heat becomes too oppressive. These walks, often with a coffee at the end, are one more dream reignited. I am so lucky to be able to continue this tradition, so far at least.

 

So June has been a bit of a dream month for us, much as the previous two Junes turned out. We can also remind ourselves that it does not require a large cast and complicated props to experience a dream coming true. What can beat a good morning cuddle? Not a perfect morning coffee, but it can come close, as can twenty minutes sitting outside in the warm morning sun.

 

June has turned out to be the true zenith of each of the past four years. Each time, things went somewhat downhill later in the summer and into the autumn, starting in 2022 with its strange summer vision symptoms culminating in the cancer diagnosis. Perhaps this summer and autumn will turn out similarly, or maybe we can avoid some of those seasonal setbacks this year.

 

One key, as always, is to try to lead a full life with a positive attitude. Recurring dreams, with their associated joy and tears, have been very therapeutic so far.     

Cancer in other people

  

My remarkable run of good health has continued And I feel almost as well now as I did before cancer struck. It becomes even easier to focus on feeling gratitude, while remaining aware that setbacks will surely arise eventually.

 

I lived sixty years with barely any practical understanding of cancer, because almost nobody I associated with fell victim to it. I vaguely recall one rather distant friend dying of a cancer in his forties, but I struggle to recall any other examples.

 

There is good news and bad news from a life untouched by cancer. It must be good news to avoid a common source of fear and anxiety, but the other side of the coin is that many of us are not ready to face up to cancer (in ourselves, loved ones or acquaintances) and are likely to be thrown off balance when the time comes.

 

My run of good fortune of having low exposure to cancer in others has come to an abrupt end in 2025, Scarcely a month has passed without unwelcome news of somebody we know, in some cases quite closely. It is probably primarily to do with age. Many cancers do most of their damage to people who are already sixty or over, including me. Nowadays we do have to consider sixty or even seventy a young age to die, but we should remember that some are afflicted much earlier. The toughest moments in my entire journey have occurred in the radiation therapist’s waiting room, upon realising that I was sharing the space with a sick child. Those poor children, and their parents and siblings, deprived of so much.

 

The run of bad health observed in others in 2025 has led to some new thoughts. Cancer comes in many forms and can strike at any time and any age in many different ways. It invariably triggers an emotional tsunami, for the victim, their loved ones and potential carers and for everyone else who is touched in any way. I suppose we have learned many things from our experience so far, and perhaps what we have learned might be useful to others.

 

Perhaps the most significant lesson and certainly not a thing I considered before diagnosis, is to understand that this is not just about you. If you are victim with good prospects or poor prospects, a life partner, sibling or offspring, or any friend or relative, cancer strikes in the gut where we are all vulnerable. We have to be as ready as we can be, and try to form part of a team that supports each other.

 

The life partner can be the most neglected. This is the most important relationship and one that can be a salvation or a curse. Whatever the diagnosis, both partners are victims whose lives are changing forever, but on different trajectories. Good medical professionals recognise that both partners should be treated as patients who need care, albeit different care.

 

Next, we can all take comfort if we realise thtat,that for most of us, cancer is much less physically painful than we think it will be. Our mental image from film and TV is probably of somebody bedridden and often in pain. There is some pain, but usually that is quite fleeting and easily borne. It is the emotional anguish that is the tougher challenge, and worthy of lots of discussion, even when it brings on tears.

 

Another observation is the value of trusting a medical team. That is the best way to avoid anger and other emotions that boomerang to your own detriment. Sure, doctors make mistakes and there is a lot of guessing involved in most cancer treatment, but most patients will only suffer if they do not trust their team. We have been especially fortunate, and my wife exceptionally smart, in this regard.

 

Part of trusting a medical team is avoiding putting them under unwarranted pressure. In most cases, doctors will try to avoid offering over-detailed and overly-time-specific prognoses. That will usually turn out to everyone’s benefit.

 

Anyone with a cancer diagnosis and a partner or team of supporters will be well served by hammering out a communications strategy. Increasingly, this is central to regular business situations as well as medical ones, but it certainly helps in the medical field. We chose to be open, a strategy we have maintained throughout and which I believe has served us well. We try to recognise that most people have issues with openness. Most are able to cope well with our openness and even come to appreciate it, but a lot of people, especially younger people, find it hard to talk about cancer in somebody they know well. We have generally been able to respect this reticence and hold back from sharing when the outcome might discomfort people with different communications preferences.

 

There have been many lessons from our own cancer experience. The cancer of others has reinforced some of these lessons and created opportunities to learn more. That can help me, it can help my partner and the rest of my close team, and perhaps it can help other sufferers as well.       

Anniversaries

 Anniversaries

 

Last weekend, at Easter, offered me by chance a trio of very different anniversaries. It is strange how these coincidences come along from time to time. When they do, they give us a chance to reflect and learn.

 

The first anniversary that I noticed was fifty years of Lenten fasting. I first gave up alcohol for lent as soon I had started drinking alcohol at all, let us assume when I was rising fifteen. At school there was talk among some of the religious teachers about the virtue and benefits of fasting.

 

The dangers of alcohol had been impressed on me by my mum long before this. Alcoholism really did seem to run through my family. My suspicion is that this dependence made my family more normal rather than more exceptional, and this may still be true across parts of the world. I don’t think I ever saw my Dad’s sister sober, and Dad himself had a history of alcohol abuse before allowing himself to be “saved” by Mum.

 

Whatever brought on the pledge, I decided one day at school that I could happily do without alcohol between ash Wednesday and easter Saturday, and duly proved it without serious difficulty. And my guess is that this Easter marked the end of my fiftieth consecutive such fast. The logic was always the same. If I could live without alcohol for six or seven weeks each year with no cheating, then I could be sure that I had no alcohol problem. It still works beautifully.

 

Despite my pledge, alcohol and its dependence continued to play a central role among people close to me, including some of those I held most closely. At one point I embraced Al Anon, a sister organisation to AA, and that choice did me a lot of good for a few years. Addiction is a horrible affliction, for the addict and those close to them, and I am grateful to mum and the teachers and proud of myself to have kept up such an effective antidote for so long. Nowadays my wife joins my fast. The first glass of wine at Easter is one of the joys of every year too.

 

The second anniversary that came to mind recalls an event of two and a half years ago, just one twentieth of the Lenten fasting period. All the anniversaries refer to times around the third or fourth weeks of April or October. For some reason those weeks seem to have assumed unusual significance in my life. I can think of others long after fifty years ago but long before two and a half years ago. My first marriage was during the fourth week of October, thirty six and a half years ago. And the Portuguese villa, now at last our home, was purchased in the fourth week of October too, nineteen and a half years ago.

 

Two and a half years ago was when a CT scan first revealed a mass in my brain, a mass later described as lesion, then tumour, and later on confirmed as the sort of tumour that usually resulted in death within eighteen months, a Glioblastoma. I had noticed a slight change in my vision during that summer and managed to find enough common sense to tell an ophthalmologist about it. I cannot be sure, but I suspect I would no longer be alive if I hadn’t made that move, because the tumour would have been present and doing damage for too long before meaningful treatment.

 

I Carry around a lot of medical quotes in my head. The first neurosurgeon, among other unhelpful proclamations, declared that in cases like mine sometimes people lasted years while others lasted only months. Our research also came up with a 6-18 month median survival window and a five year survival rate of less than 10%. I make assumptions based on some of these statistics and on what has transpired, which by happy chance is the passage of half of the five year period without really serious illness or near miss. Does the clock start again, or accelerate? Is 6-18 months still valid as a median survival window or is that now too long? Time will tell, and I try to avoid becoming fixated by such ideas.

 

The third April 2025 anniversary marked six months since our arrival in Portugal. It has been a remarkable time. We had deliberated over many years about whether and when to decamp to Portugal, and, despite both of us claiming to be good planners, the project went far from smoothly. Last summer involved some health setbacks so during the critical months I was not much help for my wife, and she had to execute many practical things while fragile emotionally and harbouring doubts and anxieties about the whole venture. Yet somehow we made it without calamity, my health reached a good plateau and has remained resilient, and, little by little, we move forward.

 

We remain aware of our ABC model, and that provides the context for everything we do in Portugal. We strive to enjoy every healthy day to its fullest, and to do that together. Then we both know there will be a transition to a period, short or long, where I will need progressively more care and support, and when my wife will have to put some of her own plans on hold. After that she will have to find a way to build a different life, a way that works for her. No matter how much anticipation and planning has been possible, that will surely be a shock and a challenge that persists for months and years.

 

Still, we have successfully reached our first six-month anniversary in Portugal, and can enjoy each day together while trying to be ready for what must follow. When we arrived here, six months seemed a long time ahead, yet we made it and used the time well. Now we are into the second interval of six months, and, who knows, maybe there can even be a few more to look forward to. Throughout my illness we have continually found ourselves changing our time horizon for planning, and our moods have also swung with the seasons and events.

 

This constant adjustment of our time horizon is something we are well used to by now, but it does catch some people out. If somebody is thinking of visiting us, they might make their plans without considering our strange situation, only to panic when factoring in what my cancer may or may not do before their visit. Should they leave it until the last minute to book, just in case? Should they come at all? What questions should they ask? Of course our preference would be for them to plan as normal, but not everybody finds it easy to talk about serious illness.

 

In any case, six months in Portugal feels like a milestone to celebrate as well as the start of another six month period, whatever time horizons we may end up using during that interval. Six hundred, thirty and six months form a neat triad of anniversaries for now, and each contributes to our mood in a positive way.   

Shrinking Tumours

 The last few weeks have taken a circuitous route to added uncertainty. I had my second MRI in Portugal in mid-March and met the oncologist a week or so later. We could hardly believe our good fortune when we were told that the tumours had not just limited their growth, they had actually shrunk by about 20%. I didn’t think such shrinkage was even possible at this stage. We have ruled out further operations and the more experimental treatments, and radiation has reached its toxicity limit. But the absence of worsening symptoms suggests that something is working. Although shrinking tumours do seem too good to be true, perhaps the  current treatments, maybe with one more new chemo,  can limit tumour growth for some more months, as I approach my third summer with cancer. 

 

This has been an emotional few weeks for other reasons as well. My wife spent the last week of March and the first week of April back in New York, sorting out the closure of her job while spending time with family and friends. We both found this separation tough to handle and we are pleased that it is over and that we are reunited in Portugal. My sister was kind enough to visit me here during most of the time while my wife was away, and the timetable also allowed for another friend of my sister to visit too. We were further blessed by a week of lovely weather, ushering in a new season after an unusually cold and wet March in the Algarve. We are now eagerly awaiting a glut of other visitors during the next few months. With each month that passes, the villa and our new surroundings feel more and more like home.

 

For all the excellent health news and the welcome company of my sister, emotions have run high. The first and last days of separation involved many tears on both sides of the Atlantic, as we were both reminded of the reality of our situations and what must lie ahead. The period of separation brought our respective fears to the fore. Perhaps in both our cases the greatest fear might be loneliness.

 

I was only alone for a couple of days at each end of our separation, but they were long, tearful days. I had to cope with being semi-marooned at home, being unable to drive safely and with no simple, safe walks available. Our neighbours kindly visited a couple of times, but the days, and the evenings and nights, dragged on anyway.

 

Amid all the tears came many thoughts and questions. Although collapse and seizure are always possibilities in my condition, I did not really have those type of fears at the top of my mind. But how would I cope if the separation was extended, perhaps due to flight delays? If I was living alone and with health vulnerabilities for an extended period, how would I cope? Would I be able to settle into a tolerable routine? And how could I cope with the loneliness?  

 

I wonder if my wife was considering the same or similar questions, but from her own future situation. For all of my good health and positive indications, the cancer is still highly likely to disable me progressively and then to kill me. But what about my wife? The caring months as I decline will probably be tough, but the real difficulties for her may only kick in once it is all over. No matter how long things last, no matter how surrounded she will be by supportive family and friends, I guess that loneliness will be her toughest challenge and will be difficult to shake off. As usual, we are preparing for different futures, helping each other as much as we are able.

 

Once we were joyfully reunited, this past week still had another challenge for us, when we had an e-meeting with our New York oncologist. Whether he was dealing with different photos, different technology or different skill sets, he did not subscribe to the idea of tumour shrinkage, but instead saw some progression which might indicate different treatments. He will now connect with the local oncologist and make recommendations.

 

As usual it took us a day or two to process the new information. But we could both understand that the general tenor of the news was more positive than negative, and that in itself is quite remarkable after two and a half years of living with glioblastomas. Whatever lies ahead, fortune has been kind to us.

 

There have been many lessons to learn from these unusual weeks. Regarding the shrinking tumours, perhaps we can reflect that when something seems too good to be true, it often is. If available, multiple medical opinions can help everybody. I am delighted that we have managed to avoid slipping into anger and blame over the seemingly inconsistent medical interpretations.

 

The wider lessons might be about separation and loneliness. In a loving couple, especially one with at least one vulnerable member, loneliness is a frequent reality and constant fear, more of a concern than pain or even death. A loving partnership finds ways to cope, but fear of loneliness can come to haunt both of the couple. There will come a time when the survivor feels utterly alone. No matter how prepared the couple are, that will help.

 

For people not living in a loving couple, these fears are likely to be worse. Many people we know are ageing alone. Living alone suits some people well, but coupling does offer enormous benefits for many of us. As I continue to observe people separating in their 50’s, I do hope those people don’t come to regret their decisions

Staying active with some limits

 You do receive quite a lot of advice as a cancer patient. Mostly this comes from people trying to be positive and sympathetic, and is very welcome. Sometimes the advice veers into unreality, notably with the story that so many people have about their granny who lived to ninety after being told they had only months to live, and who by the way carried on smoking two packets a day until they finally died.

 

Most of these conversations are about morale and support rather than anything practical. But there are recurring themes, and one of those is about staying active and continuing as much regular activity as possible. We usually receive this message not as advice but as admiration. Staying positive, though also realistic, has been a mantra which many have noticed and praised. And there is similar common ground about staying active. In general we agree with the attitude and try to follow it. But there are limits, because activity does entail risk.

 

At the beginning of this month we took our first trip out of Portugal since we arrived in October, attending a music holiday in Granada, Andalucia. As has often been the case historically, I sang as a member of the group while my wife came along as a non-singing participant. We have enjoyed these weeks roughly once per year since my first one in Rome in 2009, and we love them very much.

 

Musically, the week turned out very well. My voice has almost returned to its historical level, most of the time. The group was relatively strong and the direction and repertoire were excellent, and efficiently handled to make good use of everyone’s time.

 

The week demonstrated the value of staying busy and following established holidays, and I am grateful to the leadership and fellow choristers for letting me take part. But the week also reinforced the fact that most activity outside of normal parameters does carry some risk, for both me and for my wife.

 

Firstly, we had some trouble with our car on the journey, when it started to struggle to climb hills. We were happy to make it to Granada at all, and very relieved to learn the next day that the car was mechanically sound but merely lacked clean oil and other necessary liquids. The extra maintenance need for preparing journeys should probably have been made clearer to us when we bought the vehicle, but I guess that is predominantly our responsibility.

 

As usual in our new roles, the one who had to manage this mini-crisis was my wife. Instead of enjoying the magnificent city in peace, she spent many hours walking around looking for places and finding mechanics and negotiating, all quite stressful, even without the worry of the initial journey and fear of further issues on the drive home.

 

There was some inconvenience for me as well. Afet arriving in Granada, we ended up taking quite a lot of time waliking around, first for parking, then locating our Airbnb, and finally locating the meeting point for the opening group dinner. In former days I would have led all of this with ease, but now I found myself becoming tired and a little unsteady on the cobbles and eventually with unpleasant back pain. Luckily this discomfort only really persisted for the first night, but perhaps next time we will not be so lucky and hospitals might have to become involved. We were surely lucky in Granada, with its slippery streets and cobbles and late winter conditions and venues with awkward steps too.

 

The experience called to mind our trip to Europe last June. That was also a great pleasure in terms of music and family, but, it is now clear, did entail risk. I managed to pick up Covid on the way home and had quite an uncomfortable week. That precipitated a couple of difficult months with an operation, radiation and many side effects. I don’t believe that the Europe trip or its aftermath actually caused or worsened any of these problems, but I can’t rule that out. 

 

It certainly feels true that bad things, and good things too, tend to arrive in bunches, and probably that is not solely due to coincidence. When we are vulnerable, more can go wrong, and probably more will.

 

It happens that another singing holiday is available in early June, this time in Italy at a venue we know well. Unlike Granada, once at the venue in Italy there is little reason to leave the hotel area. It is hilly and may involve some steps, but that all feels manageable. But I must remain cognisant of the risks, including those related to travelling by air, and take careful note of my state of health and vulnerability as the time for travel draws nearer.

 

Despite the need for some extra caution, we are generally managing to stay active, engaged and positive, and my wife is making new contacts and trying out new projects regularly, which makes me feel very happy. With dancing of many varieties and volunteering at a food bank to add to singing and church, her agenda is filling up nicely. As well as singing, there are also many activities we can still share together without taking inordinate risks. We walk on most days the weather suits, often quite long distances on the boardwalk, though I do get tired a bit more quickly than I used too. Then we have restaurant date nights once or twice per week, an activity offering many pleasures. We are optimistic that there will be visitors to entertain too.

 

I am more cautious than before, but that part of my routine does not often frustrate me. I am a little bit obsessed with the risk of trips and falls, having got this far with an unblemished record. I remember from the old folks home in New York how accidents often started a progression of declining health. A lot of those accidents occurred in the bathroom, so I take extra care when showering. I remind myself frequently that I do not need to subject myself to much extra inconvenience, and am lucky to have remained so capable for as long as I have. We believe that we also have extra help ready when we will need it.

 

The balance between staying active and positive on the one hand and avoiding reckless risks on the other is one that will continue to evolve. We face such trade-offs throughout our lives and there is always much to learn. We have short- and long-term goals to consider, both as a couple and individually. As usual, we have managed most of the challenges quite well so far, and in general we feel ready. But of course we are never really ready, and adaptation will remain high on the agenda.    

Second Fiddle

 Partnerships are important in all our lives. Many of our activities we complete as a pair. For most of us, most significant are our marriages or other life partnerships, but other partnerships can be important too, whether at work or with a hobby or vocation or simply as buddies.

 

In any long-term partnership, roles tend to emerge over time and these roles often become critical to the success and the longevity of the partnership itself. We all have roles that we gravitate towards, roles that suit our personality and skills and come most naturally to us. The roles tend to become more established over time, so that each partner can find it easier to be comfortable with the other to the benefit of each of the couple and of the pair.

 

Both of my marriages have shaped my life, and I consider both as successful partnerships even if one did not survive the test of time. In both cases, roles emerged that made everybody concerned stronger and more resilient. During my first marriage we had a dominant hobby of playing championship level bridge together. Developing roles, unconsciously, within a competitive context went to along way to refining our personalities. The same thing has happened in my second marriage, though we might argue that there is a bit more balance and maturity in our lives.

 

In a life partnership there are many areas where partnership roles can emerge and become established. Hobbies and activities can be part of this, but more important than those are usually in bringing up children and in managing finances. In both these fields, roles emerge and persist, though they are also the areas where serious disconnects within a partnership can develop. 

I have always made many mistakes, but I do feel that the roles I have gravitated towards in the major partnerships in my life have generally worked out well for all parties. I can extend that thought beyond partnerships, to include tight-knit teams of more than two people. Those teams could refer to an extended family, a work team or even a choir, but in all cases I found it relatively simple to establish roles for general benefit that utilised my strengths.

 

But now, with cancer and its likely outcome, I have been forced to embrace new roles in responding to my new situation. In simple terms, in many aspects of life, but most notably with my wife, I am learning how to play second fiddle. There are areas where I would habitually take the lead but where I am no longer reliably competent. There are other areas where I retain the capacity to take my traditional roles, but where that division no longer matches the needs of the partnership.

 

I can attest that learning to play new roles in an established partnership is difficult, when the situation involves responding to dramatic or sudden change. If the context is relatively slow-moving, as it usually is, we can muck along and use our experience together as a useful set of guardrails to help us. But sudden changes to context will challenge even effective partnerships, even with abundant goodwill on all sides.

 

We each spend an unhealthy amount of time making assumptions about our partner. What do they want? What do they need? Why are they taking on their familiar role in a particular situation when it is obvious that something new is required? Why are they forcing me into a new solution when the old one has worked so well for so long?

 

These are all symptoms of the partners trying to adapt to a change of context that is unfamiliar. My wife and I have come at the issue with love and goodwill and relevant experience, but we have struggled mightily. We had somewhat similar experiences when navigating other changes, notably as empty-nesters, but the current challenges seem to be tougher. We should not be too tough on ourselves – a terminal diagnosis, a major change of work situation and a choice to move between continents are all large changes, sure to challenge established partnership routines. On balance, we have probably handled the situation as well as any partnership could, but the mistakes have been frequent and will no doubt continue. As and when my health deteriorates and some pain and lots of frustration re-enter the equation, the challenges will probably only intensify.

 

Just because I am the one with cancer does not make it tougher for me, indeed I suspect the opposite is true. I am having to learn to play second fiddle in many aspects of our partnership, and that does entail frustration when my capacity is compromised and where I can’t be as helpful or as independent as I would wish. But I recognise that I have no choice in most matters, and adapting to the new roles feels quite natural in our situation. For my wife, she has been forced to step up, and has generally responded magnificently. Perhaps I am also now enjoying one more benefit of my early retirement all those years ago – a rather sedentary life does seem to suit me, and the soporific aspects of my second fiddle part do seem to suit me well.

 

So, compared with other couples in our situation, perhaps we are quite lucky. We have been given plenty of time to establish our new roles and to adapt to them. No doubt much more adaptation will become necessary in the future but, as usual, we feel quite well prepared. Except that, every time we have felt prepared so far, reality has come to bite us. It will do so again. We will do our best, and I am optimistic that our curve is quite a positive one, with our new roles becoming progressively more comfortable and our teamwork intact. 

Ordinary Love

  

I have never been a big consumer of movies. That is probably one of the many legacies from my mum, who would reach to change channel anytime BBC or ITV would deign to broadcast a film in the 1960’s or 1970’s, announcing how she hated films for being too long.

 

I have a very clear criterion for a film I am likely to appreciate, that it is about plausible people in realistic scenarios. Sadly, that rather mild stipulation rules out almost anything that comes out of Hollywood these days, so I tend to steer clear of that material.

 

The exception arrives around this time of year, when Oscar nominees are announced and then awards given out. Last year I made a point of watching nearly all the nominees for best film and I ended up enjoying most of them. We have a good TV package here in Portugal so I am looking forward to repeating the positive experience over the next couple of months.

 

This year we stumbled into an early start, thanks to a bunch of content provided by my sister after her visit at New Year. That led us to watch a 2019 movie starring Lesley Manville and Liam Neeson called Ordinary Love. The experience proved very gratifying.

 

The context of the movie could almost have been created specifically for my wife and me. The title suggests real people in a real scenario, and the movie delivered what it said on the tin. The real scenario was that one of a long-term couple contracted cancer. Inevitably in our predicament, we do find ourselves attracted to stories about cancer. Sometimes these stories make us tearful, but they also have potential to teach us lessons and help us respond to the challenges we face.

 

What I loved the most about the movie was the way it focused on the couple and how they navigated their new situation. There were no huge plot twists or surprise revelations. The cancer and the resulting treatment were not over-dramatised, but felt completely typical of the experience of millions of couples around the world at any time, including my wife and me. The couple stumbles along, cancer is discovered, treatment results, the future path is left open. The only thing slightly unusual in the plot is that the couple had already lost their only child, perhaps to another illness or something like a car crash. That extra dramatic dimension was an important element in understanding the couple, but the film-makers did not let it distract from the main theme.

 

That theme was how the couple responded to the cancer diagnosis of one of them. Smartly, the focus was more on their emotional responses and less on the medical details of their particular case. Hence the beautifully conceived title of Ordinary Love. This is a story of an ordinary situation, exploring the responses of characters facing that situation, unique and life-shaping for them but, sadly, all too common around the world.

 

The medical details and experiences were not entirely absent from the drama. After all, this is a story about cancer. I found many parallels with our own experiences in these aspects of the movie. We have had times when we have questioned the medical service we have received, especially near the start when my wife campaigned to transfer our care to a facility she trusted more (a wise move, as it turned out). There are many scenes where Neeson and Manville are sitting together in soulless waiting rooms, making wild insinuations about what was really going on, and drawing unreasonable conclusions about the possible paths of progress of Manville’s cancer. We have had many similar thoughts.

 

The most interesting part of these aspects of the movie, to me at least, was trying to understand the thoughts and reactions of the couple, including their common and separate motivations. Like all such couples and like us, they are enduring parallel journeys to what may be separate destinations. Through these journeys they try their hardest to act as a team and to support each other, but individual factors intrude from time to time. Like us (I think), they show a lot of love and each displays impressive courage. But their unity does come under pressure at times, despite their best efforts. Sometimes a well-meaning intention to help actually becomes a problem. These scenes are wonderfully conceived and executed.

 

There is not a lot of interaction with other patients, as indeed is the case with my own situation and probably most others. But a bond gradually builds with one fellow patient and with his husband. Their diagnosis is more terminal and indicates a shorter survival time. The drama is, once again, understated and intensely believable.

 

Many things about cancer can make me tearful, and it came as no surprise when the film tugged at my emotions. This occurred whenever there was a poignant private scene between the two lead actors. I would project our own situation onto theirs and notice all the pitfalls and challenges, as well as a few rewards. Each would fall into the trap of assuming the thoughts of their partner and then acting on those thoughts. They believed they were acting in the interests of the couple and carrying out what their partner wanted, but this method is far from foolproof. As well as misunderstanding, it can lead to resentments and frustrations.

 

We make this particular mistake all the time, sometimes persistently and with lasting damage. For me, observing this was the most powerful takeaway from the movie, because I know I can improve and the film gave me some extra incentive and tools to do so.

 

So I am very happy that I saw Ordinary Love and could celebrate its excellence with empathy. Perhaps its most powerful message comes from its title. We all tend to classify our own experiences and predicaments as special and unusual but, in most cases, reality is much more humdrum. Everyone’s situation is indeed unique, but most elements are shared with countless others around the world. Cancer has changed our lives and many of our perspectives. But cancer is, until now, also an ordinary occurance in life. We are special, but add up everything special and the result is all too ordinary. And the emotion that can cut through the ordinariness with most effect is love. Flawed, flailing, imperfect love is the greatest weapon that we can deploy in tough situations. Those of us surrounded by love have the best chance of coming through challenges in reasonable emotional health. I am so grateful to my wife, and to many others, for powerful loving support during cancer, and Ordinary Love served a useful purpose too. 

Another Year to Celebrate

 

We are continuing our good start here in Portugal. We have now spent three months residing here, and my health has remained consistently strong through that time, with no new symptoms or recurrence of previous symptoms to report. My medication and treatment list has been consistent since we arrived here and seems to be working for now.

 

This good health is a blessing in so many ways. Looking back on the period just before our move, I can’t imagine how we coped and how we have somehow emerged on our feet.

 

I started this piece with something of a plan to document the progress of my cancer during 2024 and how we responded. 2024 did feel like a year of decisions. But how many of these decisions really were milestones involving genuine choices?

 

Throughout my illness, and probably for most others facing similar situations, there have been apparent choices, but I now suspect that mostly these are not real choices. Partly we may instead be using our thoughts and the opportunities for consultations to help us face up to new realities. Partly the illusion of choice may be to support a feeling of agency, convincing ourselves that we are active partners.

 

Upon reflection, it feels more accurate to characterise these milestones as events or developments rather than choices. Mostly, we listen to our medical advisors and accept what is usually an obvious path, even if this advice is often presented to us as a choice.

 

There have been many developments but arguably few true choices. The initial diagnosis took time to come into focus and remains incomplete. The major operation and initial radiation and chemotherapy all involved choice but felt more like mere acceptance of a clear reality. There seemed only one logical way to respond to the infection of October 2023.

 

There was more apparent choice during the summer of 2024 once the first chemotherapy lost some of its effectiveness and MRI’s started to show more tumour growth. But again, as things developed, were we making choices, or simply allowing medicine to take its logical course?

 

Looking at the medical history in this way, I can really identify only two major points of decision. The first true choice was in November 2022, when my wife campaigned aggressively for Memorial Sloan Kettering in New York to replace our initial providers. It feels like we ended up in the best possible place with the best possible care.

 

I believe the second true choice occured much more recently, in fact during our last week in New York during our final consultation at MSK. I had endured a difficult few weeks of symptoms and side effects, and at this meeting we learned that the most recent MRI revealed substantial swelling and probably an acceleration of tumour growth. We were warned not to be surprised if episodes and symptoms cropped up more regularly from now on.

 

A little to my surprise, we were then offered a genuine choice. We had previously accepted that the windows for operations, clinical trials and experimental treatments had probably closed for us by then. Useful treatments remained available but effectiveness would reduce, perhaps quickly. Now we were informed that Dr Brennan would be willing and available to operate one more time later in the week.

 

The implications and possible outcomes of accepting the operation were made clear to us. Risks would be high, recovery slow and beneficial outcomes far from certain. Steroids, chemo, and immunotherapy still had some useful road for us to travel. But the operation had considerable upside as well.

 

We made our decision within a few minutes, and a lot of the decision was driven by non-medical factors. That coming Saturday we were booked on our one-way flights to Faro. Taking on the operation would have delayed that for months, and probably forever. We declined the intervention. Dr Mellinghoff steered us through the moment with aplomb and wonderful sensitivity. The die was cast, and here we are in the Algarve.

 

Reflecting more, the decision to come here looms larger and larger, in some ways overshadowing everything else in what was already an eventful year. And the main outcome from these reflections is how ill-prepared we both were.

 

We have had chats for many years about my wife taking retirement and us coming to live here, but until cancer came along there were valid reasons to defer any decision. Then came cancer, and a year ago we came up with the ABC concept, where A was healthy time together, B was a period of caring and C was widowhood. We still find this to be a helpful model.

 

In January of 2023 my wife declared that she was ready to stop work and come here at some point in 2024. June solidified the intent, and we went ahead with it in October.

 

But how prepared were we? On our parallel journeys to different destinations, what were the pros and cons for each of us? Did we need contingency plans? If we chose to stay in New York, what would that mean for each of us? How could we make our ultimate choice work best for each of us? Did we really understand the issues from the perspective of our life partner? Our recent beachside walks suggest to me that the answer to many of these questions was a resounding no. This was one of most consequential decisions of each of our lives, yet we stumbled into it.

 

I could quote many examples of how we were misleading ourselves and each other. One powerful one from my side was finally accepting that Portugal is not nirvana. Previously, I suspect a part of me felt that nobody in their right mind and given the option would ever choose to live anywhere but Portugal. Well, it does have its advantages, but it has challenges too, in A, B and C. I undersold my wife with my sloppy thinking. She was similarly influenced by her own blind spots.

 

We can deepen these discussions further as things develop. It does feel now that the decision was final, for my lifetime at least. We will hold each other close, celebrate each day and be thankful for the time we have. There is always ample opportunity for gratitude. Walking by the beach and working to understand each other better invites gratitude in abundance.

 

We have already enjoyed family visits here and are getting to know good, rewarding people. We hope we can look forward to more of the same. Perhaps stumbling into such a huge decision will continue to play out well for us. But I have to accept that the process involved was highly flawed. So be it.