Diary of a Man With a Neck

06-06-2025 (Uploaded previously to Wordpress)

The following is a record of my experiences in 2024 when I took part in a trial treatment program for cancer of the head and neck. It is not meant to be a tale of how I “battled ” my illness. Nor is it intended to be inspirational or even especially admirable. My hope is that it might be funny and even a little bit informative. I have tweaked some parts after the event, in the service of clarity, but most of this was written while I was experiencing what I was writing about. If my use of tenses may sometimes seem erratic it’s because I was sometimes writing stuff with the benefit of days/weeks of hindsight . (Pete)

El Salvador 1970

The year 1970 is where it begins.

Right now, in June 2024, I am about to start treatment for HPV-positive cancer of the left tonsil, even though in my case the tonsil in question is (in principle at least) non-existent. But in 1970, year of the football World Cup in Mexico, I was ten. My parents were advised by our doctor, in line with medical thinking of the time, that I should have my tonsils removed in Alexandra Hospital in Coatbridge, Lanarkshire, Scotland. Tonsilectomy was a common milestone of childhood at that time, to be spoken of in tones alternately braggadacious and spine-chilling, a process involving rituals associated with searing pain tempered by the promise of unlimited consumption of ice cream in a hospital ward afterwards. I mention the Mexico World Cup because while in hospital I remember being uncommonly absorbed by a piece of what would now be called “merch”. In this case, football-related “merch”.This took the form of an impressively comprehensive World Cup-themed sticker kit called a “World Cup Datakit” which came in a clear A3 plastic folder packed with loads of little booklets, charts, cards and foldey-outey things.

It was sponsored by the magazine publisher IPC, who produces comics like Smash and Pow that I loved at the time, but hardly anyone has ever heard of now. It came replete with “Top secret”team dossiers, descriptions of all the stadia, Group Stage breakdowns, the various national team kit options, the whole works. Someone, I can’t remember who, had very kindly brought this into the hospital for me as a gift, presumably to take my mind off the ordeal I was about to go through. And by god it worked. I wasn’t usually much interested in football, but the baroque complexity of this kit, all the palaver of what stickers to stick where, and the sheer trainspottingness of it all absolutely absorbed me. For the World Cup Final match there was a special fold-out wall chart which came with 2 identical sets of stickers - ‘Actions Stamps’ - one red set and one blue set . These represented all of the individually notable things that can happen to each team in a football match – goals, passes, corners, goal-kicks etc. More sinisterly I noted that there was a little smaller strip with four red stickers and four blue ones, each of which featured an image of a referees pointing finger superimposed over a caricature of a footballer’s face grimacing in an objectionably dim manner. These were “sending-off” stickers.

Presumably it was calculated as unlikely that a World Cup final would ever descend to such brutality that more than four players would be sent off from each side. The plan was this. You were supposed to watch the match on TV. You would then react to what you were seeing by choosing the appropriate sticker – minute by minute, mark you- and sticking it on a big cardboard grid which represented a minute-by-minute breakdown of the World Cup Final in two halves, plus extra time if necessary. When it was all over you had…well you had a wall chart with a “minute by minute breakdown of football’s event of the year!!” or something like that. I remember nothing about the final, which took place after I got home from hospital. However while reading about the group stages shortly after my admission, I recall registering that it was the first time I’d ever heard of El Salvador. The memory of this remains intact. Rather like the little shard of tonsil they, for some reason, left behind, and which is the reason why I’m here.

Where I am

I am in a room (actually, literally Room 101) in a quite anonymous, though perfectly OK, corporate accommodation facility, ostensibly a hotel without a reception or bar, on a kind of industrial estate near Århus University Hospital in Denmark. More specifically the sub-department of the hospital which bears the title The Danish Centre for Particle Therapy. I am one of a group of selected head-and-neck cancer patients participating in a five and a half week long trial, during which I am to be treated using a combination of proton therapy (33 rounds) and chemo. The aim seems to be twofold. As I understand it, proton therapy is slightly different from normal radiation, or “photon” radiation, as I’ve heard it called. According to the charmingly unambiguous short animated film I was asked to watch on the website, photon radiation therapy works like this. The radiation consists of photons which blast into the cancer cells, causing carnage like they’re supposed to. But tragically this doesn’t sate their bloodlust. Like sub-atomic berserkers, they continue onwards, ripping into everything else in their path, including healthy tissue, before passing out of the other side of your body, and presumably waking up in a cell at the International Court of Human Rights in Strasbourg. Protons however are more focused. On the whole, they hit their target and….that’s it. The consequence of this is that they seem to cause fewer of the side effects which can make radiation therapy for tonsil cancer a literal pain in the neck. What the trial aims to find out is that (a) Are the advantages of protons significant? And (b) Are they significant enough to justify spending gazillions of Danish kroner on treating more Head and Neck Cancer patients this way instead of using photon therapy?

Summary of how I got here

I live in Copenhagen, Denmark. I am a Scottish musician, composer and theatre maker, 63 years old, my wife Nina is Danish, and I have lived here for 28 years.

Summary of how I found out I was ill

• One day I poked my index finger down my throat, just behind my tongue. I think I may have had a mild mouth ulcer at the time, and I was doing the strange, morbid prodding thing you often do when you find something in your mouth that’s acutely painful. Then I noticed a weird lump where my left tonsil should be. Not painful, just…strange. By this time I had already been operated on for prostate cancer about 18 months previously …..another story….I am, to paraphrase a legendary Monty Python sketch “Pete Two-Cancers Livingstone”. In any case I was more than usually aware that cancer isn’t something that necessarily only happens to other, older and more decrepit people than myself. I read a bit about cancer of the throat. It wasn’t very pleasant. The most common kind of tonsil cancer is caused by the HPV virus, the genital wart virus, the one most girls are vaccinated against (in Denmark at least) when they reach puberty, as it can cause cervical cancer. Something like 85% of people who are, or have been sexually active have been infected by it, which is pretty whopping. HPV is sexually transmitted, is not prevented by using a condom, and can be also be passed on by oral and digital contact. The incidence of HPV cancer in the mouth and throat has been increasing among men of the boomer generation. This is not because we are the first generation to indulge in oral sex, but apparently because we are the first to be any good at it. I made that last bit up.

• General Practice Doctor: “You have little remnants of tonsil in your pharynx. These were left over from your childhood operation. The thing you see there doesn’t look like any HPV cancer I’ve ever seen. But I’ll send you to an Ear Nose and Throat (ENT) specialist. Just to be on the safe side”

5 …count ‘em …5(!)…WEEKS LATER

• ENT Doctor:“ Almost certainly not cancer, although I can see that you now have swollen lymph nodes on that side. I’ll take biopsies, and send them to ENT at Rigshospital (The main hospital in Copenhagen) but quite honestly it’s just to be on the safe side”

2 WEEKS LATER

• ENT Hospital Consultant: “ You have tonsil cancer. “

• Me: “What the fuck?”

• ENT Hospital Consultant: “Squamous. HPV positive. Metastasised to lymph node. But not anywhere else. Good prognosis (80-90% cure rate). Nothing to do with your prostate cancer, by the way.”

• Me: “Does that make me lucky for not having prostate cancer which has spread, or unlucky for getting cancer two independent times?”

• ENT Hospital Consultant #2: “We can send you to Århus in 4 weeks”

4 WEEKS LATER

First chemo and First proton therapy

Chemo -

I have never been a notably reticent person at the best of times. However today I find myself in a particular conversational overdrive, due to a drug called Prednisolon which has been prescribed for me, as part of a whole suite of medications . These drugs form a kind of branching network of interacting problems and solutions whose aim is to deal with the side-effects caused by the main culprit – the chemotherapy drug Cisplatin. Even the name sounds like a Dungeons and Dragons figure.

The medication scheme is a kind of pharmacological “Whack-a-Mole” - the old fairground game in which little “moles” repeatedly and randomly pop up from a board with holes in it, the aim being to thump them with a mallet to keep as many down as possible and thereby gain points and win a toy. In the case of chemo, the aim is to bash each side effect as it appears. It works like this: the chemo helps the proton therapy to kill the cancer… whack!… but also makes you nauseous…pop! ….so you take anti-nausea medicine….whack!… The anti-nausea medicine makes you constipated…pop! and so you have to take laxative and colon-stimulating drugs to make sure you don’t just stop shitting altogether…whack! You get the idea, I’m sure. Incidentally, speaking of constipation etc. presumably because of a grammatical quirk of the Danish language, my wife Nina always refers to defecation not as “shitting” but as “The Shitting”, which makes it sound like an historical phenomenon categorizable with “The Reformation” or “The Highland Clearances”. One of the side effects of medicines which impact (as it were) on The Shitting can be headaches, so you are allowed to take loads of painkillers if you need them. Meanwhile, in the course of chemo, they have to pump you full of water which makes you overhydrated. So you take diuretics to make you pee. But not too much. Any questions?

Meanwhile, one of the anti-nausea medicines is also the aforementioned Prednisolon which quite-frankly feels like a mild speed hit. This is the reason why I now find myself jabbering, quipping and info-dumping like an over-familiar bar-room bore to the infinitely patient and sweet chemo nurse. In addition, the whole set-up of chemo is such that you are made to feel very comfortable, almost pampered. Sitting in an absurdly pleasant ergonomically designed chair, you are serviced with snacks, drinks, coffee and pleasant chat, while at the same time stuff is happening to your body which is definitely less than wholesome. It’s like being poisoned by a treacherous lover in a 1940’s noir movie. I hadn’t realized this, but the whole procedure of a chemo session takes ages, about four hours in my case. You are intravenously connected up to a drip bag on a stand. The first hour or so they pump saline solution intravenously into your body, loads of it. Then at some point, the nurse tears down the clear plastic, empty saline bag and ceremonially replaces it with a bright scarlet, semi-opaque bag which looks like it could be from a child’s magic set. This is Cisplatin the Mighty himself, clad in red, to avoid light-damage to the mixture and presumably to avoid confusing it with anything less villainous. Administering this only takes about 30 minutes. The rest of the time entails yet more bags of saline, after which you’re done.

Afterwards I discovered that my body had taken on 2 kilos of water from one day to the next, like a teddy bear which had fallen into the bath. This all, as it were, gets pissed off in a day or two. I was sent off with a list of grim side effects and warning signs to heed; breathing difficulties, swallowing problems, etc. The reality was that I was lucky enough to not feel much at all. There was a slight, rather bitter aftertaste behind foods and drinks. There was something of an underlying weariness and heaviness, like a hangover that was crippling this morning, but is starting to clear. But it seemed like I’d been lucky. I was even a bit hungry.

Proton therapy

When I first saw the machinery I was expected to hop into, I was reminded of the 1970’s science fiction puppet series Joe 90 …if you know, you know. This facility is genuinely futuristic and awe-inspiring. In the basement of the building lies a massive proton accelerator, which is spoken of in hushed tones by the staff. This is situated in a room behind a sinister door bearing a large radiation symbol. On the wall next to this door is a wall-size photograph of the inside of the forbidden room, so you can see what it’s like. This is the nerve-centre. The source of all healing. But you can’t see it for real. You just have to take their word for its existence. It’s like visiting the replicas of cave paintings at Lascaux, while knowing that the real thing lies underground a few metres away. The awe-inspiring machinery which delivers the protons fills all of three storeys directly above where you lie, although you can only see the part of it which pokes into the treatment room. One hopes the architects and builders showed due diligence, vis a vis the load-bearing properties of the ceiling.

A week ago I was observed, measured and tweaked in order to facilitate the creation of a close-fitting customized whole-face and upper body mask made of plastic netting. A sheet of this netting is warmed, then stretched over your face, as if placing the top layer on a pie before putting it in the oven.. It’s a weird sensation, but not entirely unpleasant. This mask is your personal mask, stored and used every time you come for therapy. One fun side effect of this is that, after each proton treatment, the plastic netting of the mask leaves a temporary criss-cross imprint on the skin of your face. As a man who was young in the punky, gothy 80’s, I was rather wistfully reminded of the aftermath of hastily removed fishnet tights. In my case it looks like I have shape-shifted into one of the illuminati.

For the actual event, you are strapped on to a gurney and wheeled in under the machinery. The mask is then placed on your upper body and fastened to the sides of the gurney by press-studs, thus rendering your head and neck immobile during the treatment. Then the staff leave the room so the zapping can begin. I was asked to choose suitable music from my Spotify profile to be played during the 20 minutes or so the treatment takes. Unwisely I choose a rather anaemic, jazzy bossa nova which took only a minute or so to irritate me intensely. Over the next few days and weeks I will be wheeled around in this machine to the sounds of Glasgow epic-mongers The Blue Nile, Massive Attack, and on one rather moving occasion, Scottish bagpiper Fred Morrison’s stirring rendition of the slow air Hector the Hero.

Half Way – 3 weeks

The iconic Scottish comedian Chic Murray was famously a dab hand at the comic non-sequitur. Apparently once, in response to a workaday inquiry of “How are you doing?”, he replied “Fine…apart from the odd touch of diarrhea”. If I was to describe my sense of well-being at the half way stage of this treatment I might say (and have done shamelessly) “Fine…apart from the odd touch of cancer”. It seems I have a fortunate ability to deal with chemo without wishing to throw up all the time. This is no small mercy, when I hear about the hell that some people have gone through with nausea. However the more I talk to other people in treatment, especially the old lags with 4-5 weeks experience of this, a clearer picture seems to emerge of how this whole thing can feel. Pretty much nobody escapes untouched by at least one or two side effects, either of the chemo or of the protons.

Battery Acid and Tom Waits

In my case I developed a crippling heartburn which felt like I’d swallowed battery acid. This was swiftly dealt with by some miraculous medicine called Pantoprazol. One dose of this caused my symptom to abate, and led me, alarmingly, instantly and I hope temporarily, to completely reassess my opinion of bloodsucking pharma companies. At that moment, I unreservedly loved Big Brother.

The other thing was the hawking up and spitting of industrial quantities of phlegm. There were times when I felt that the neighbours to my little room 101 must have wondered what in hell this hacking, growling and spitting Tom Waits was building, ingesting and subsequently regurgitating in there.

As I said, no one escapes unscathed. But equally no one seems to suffer the whole menu of gruesome side effects listed at the start of the treatment. Also, it’s rather like the old metaphor of boiling a frog. Things happen so gradually that there is never a specific day when everything goes awry and you think “OK, this is officially shitty.” It just kind of creeps up on you.

You start to feel less like eating, yet are oddly enough still hungry, if that makes any sense. Smaller portions suffice, and you eat like a sedate elderly lady at high tea, meticulously nibbling and chewing. By this time the protons have started to do their work and parts of your mouth and throat have become tender and sore. This makes you acutely and uniquely aware of the actual mechanics of eating and swallowing, in a way I hadn’t expected. In my case I am fortunate that my tumor is only on the left side of my throat, and so the treatment leaves the right side relatively unscathed. Nevertheless my tongue has definitely taken a hit on one side, which means that it can’t always do its usual efficient job of mechanically manipulating food around my mouth, clearing up debris and generally keeping house without hurting. I have found out that you can’t shovel too much food in at one time. I also discover that with a deft tilt of the jib I can let as much of a mouthful as possible tip over to the right, and then swallow without too much grimacing. I imagined myself looking like a pelican ingesting a fish, or a labrador downing a chunk of hot dog, Odd things suddenly become unpleasant– raw onions on a falafel sandwich, jagged burgers which demand too wide a gape, little flecks of chili powder on a salad. For me, yawning is also a bit weird. It’s not so much that it’s painful to open wide, although it can be. Its more like if you picture the involuntary muscular flexing that takes place in your throat when you yawn, even if you don’t fully open you mouth because you’re at a classical concert. Imagine that smarting a bit.

Elvis

The question of energy and tiredness is frequently broached by the staff in preparation for the treatment period, so I suppose it’s important to know about it and be aware of how it might feel. Pretty much everybody ends up being a bit decked by the combination of protons and chemo. The extent to which you experience this seems to vary. I was discussing this with the two other guys in my group of chemo patients, whom I now like to refer to collectively as “The Chemical Brothers”. Some of the old lags spoke of a deep weariness, which is not the same as sleepiness. More a kind of “I’d love to but I really can’t” vibe. This can be pretty debilitating for some, it seems, and I can see how it could shade off into a kind of semi-depressive state. I found that for me the tiredness was tempered by the effects of the aforementioned Prednisolon. On the two- to three- day periods of a week in which chemo was kicking in, this resulted in a kind of see-sawing mood. Rather like Elvis Presley’s in his decline, the medicine meant that I was able to sustain a couple of hours at, say a restaurant or a gig, wise-cracking and enjoying the evening, before plummeting like a stone in a well and longing for the numbness of napping or deep sleep.

BBC Radiophonic Workshop

Another strange thing is what can happen in your ears. I had been told about temporary and sometimes (more worryingly) long-lasting tinnitus as a side effect. And yes the strange little malign sine-wave “peeeeeep”s appear from time to time, although they mercifully disappear again quite quickly . However there are occasions when I get a little snippet of the BBC Radiophonic Workshop sound bank – short reverse-envelope “zzzzzzip” sounds and little metallic crunchy artifacts, often when I have just woken up and my sensory world is a bit woozy anyway, or again when I yawn. I also sometimes have what I might describe as a flattening out of the directionality of my experience of sound. Standing in the chemists shop, I found it slightly harder than usual to place where things were happening sound-wise, and so perfectly normal sounds, like the drone of a ventilator or the dragging of a chair on the floor almost acquired an air of the uncanny.

The choice of music for my proton sessions continues to assume more importance than it should. There are some things that clearly work and some that don’t. To my surprise I find that anything “meditative” or relaxing doesn’t work for me – Morton Feldman, Philip Glass….uh-uh, too soporific. On the other hand I feel that being wheeled under to the shouty opening of Muddy Waters testosterone-fest “Mannish Boy” hits the right mixture of absurdity and panache. da Da-da-duh Duh…ev’ry thangs gonna be awraat! Yes, that’ll do.

Margaret Thatcher

After 5 weeks of this , I am sent home, intact, but not without scars. However I am assured that I am lucky enough to have escaped the most severe side effects. This makes me feel weirdly proud of having what is presumably a robust enough constitution to deal with this stuff. I have always resisted the narrative of a plucky patient “battling cancer” with a faraway look in the eyes. It would seem to me that any credit should be given to the medical professionals and not the patient. In the case of the former, what they do is far from an engagement in battle. It’s more like a kind of scorched earthed policy whose aim is to limit any future damage. If being cured of cancer is a fight, then cancer has almost always managed to get the first blow in and is consequently at an advantage. Chemo and proton therapy is then an overblown response to this which does ten times more damage to you than that first blow, as it were in an attempt to preempt future strikes and teach cancer a lesson. Any hubris I may have experienced was also tempered by grim assurances that the worst period in all of this was going to be the two weeks or so immediately following cessation of therapy. Apparently, the nastier effects of the protons don’t really kick in until after the sessions are over. This means that I could look forward to open burn wounds on my neck coupled with equivalent internal damage on the mucous membranes of my throat. All in all, I should prepare to spend some time looking and feeling like Gary Oldman’s character in Hannibal. In practice, so far, this has led to me attempting to cover my neck in public, so as not to gross people out. My wife Nina bought me a fetching purple silk scarf to this end, which I tie in a merry knot around my neck, and tuck into my shirt collar. “You’ll look a bit like a flamboyant actor type” she’d said “But you can pull that off”. In reality I look like someone who is in the early, tentative stages of developing a cosplay version of Margaret Thatcher, but isn’t really giving it the commitment it deserves. The hearing in my left ear has also taken somewhat of a hit, hopefully temporarily. This has the effect of making my own speaking voice seem oddly abrasive to me, resonating in my head in a way which makes me want to pop my ear by flexing my jaw, which sometimes works and sometimes doesn’t.

Young Upstart

In the event, what follows isn’t as bad as I might have feared. The wound on my neck looks like exactly what it is, a radiation burn. I cover this with a dressing, the changing of which leads to some squeamish eye-averting from those closest to me. The inside of my throat is tender, but not excruciatingly so unless I’m sloppy with what foods and drinks I ask it to deal with. For some reason, brushing my teeth seems to trigger a gag reflex, not so much because of the toothbrush, but because the foamy toothpaste and saliva mix runs to the back of my throat. I found that the only solution to this was to rest my lower jaw on the edge of the bathroom sink while brushing, and let all of the foam in my mouth dribble out over my bottom lip into the sink. While doing this on one occasion I unfortunately caught sight of myself in the bathroom mirror, looking remarkably like a pursuant zombie.

Bit by bit, all of this starts to feel like it’s healing and I can dispense with bandages and such. I still tend to lie down and slob out much more often than usual, but no more than say, a teenager, or at any rate myself as a teenager. As regards neckerchiefs, I scrapped the Margaret Thatcher one after a couple of weeks and purchased another, opting for a look along the lines of camp 70’s British comedian Dick Emery. I finally found yet another one, a polka-dotted salmon-hued affair which lent me the air of a sadly ageing drug dealer, mentally stuck in his heyday in the 70’s, and whose time on the streets was soon to be brutally ended at the hands of a young upstart.

Confusion will be my epitaph

One slightly disconcerting episode occurs around 3 weeks into my post-therapy period. I am repairing our daughters bicycle in our backyard, which involves lots of bending over, crouching down and tinkering with the wheel. I have of course eschewed the much more logical and ergonomically obvious option of flipping the bike upside down and popping it onto the picnic table right beside me and working at eye-height. I stand up and trundle the bike out of our backyard and round to our local cycle repair shop. There they have a free air pump standing on the street which I can use to inflate the tyre. At the risk of sounding smug, if not twee, Copenhagen is full of little repair shops like this, all with free air. Fifty yards along the street I am aware of a strange, swimmy feeling of absence, a sense of observing the world like a movie. It strikes me that this is what being stoned used to feel like in my youthful days of (albeit occasional, but definitely inhalatory) marijuana use. On arriving home, I carry out all the normal actions appropriate to the situation; I park the bike, put my tools back in our lock-up in the basement of our apartment building, let myself in to our apartment, settle down and answer a couple of emails. I should mention that I am completely alone at this time, all other family members being gone for the week. It’s only now that I still feel weird, weird enough to need to lie down. I start to search the internet for “warning signs of a stroke” and begin grimacing in front of a mirror to see if I can smile, frown stand on one leg and recite the spoken-interlude part of “The Bear Necessities” from The Jungle Book – I may have misremembered some of this. I also decide to ask myself what day of the week it is. I have seen many hospital dramas. To my horror I find that not only can I suddenly not remember what day it is, I also can’t remember the names of our cats, what date in the month it is and several other things that, well…I can’t remember. Putting this down to general messed-upness and having had a rough time lately, I lie down again, though not before calling Nina. When I describe the situation to her she is immediately horrified and insists that I call the hospital immediately, which I do. They are also concerned and send an ambulance. I, however am still able to carry out all basic tasks, lock up the apartment and meet the ambulance on the street, hopping into the back to meet the slightly bewildered paramedics. They immediately start taking measurements in the back of the ambulance to determine how long I have to live. The younger of the two paramedics is interested in theatre, my field of employment and knowledge: There ensues a Pythonesque scenario in which I am lying on a gurney being tended to both solicitously and concernedly by one paramedic while the other is asking me if I’ve heard of a show he performed in a couple of years ago, before he started to do this for a living, and no he still does the occasional piece when he can and hasn’t given up the dream.

A long harrowing and worrying night ensues. I spend hours in admissions and then in a hospital bed, after which I am prodded, tested, scanned and questioned to ascertain my cognitive and perceptive abilities The upshot after 18 hours or so is that this has had nothing to do with my cancer, I have not had a stroke, and I’m not going senile. It may however have had to do with drinking a few beers with friends the previous evening, bending over a bike and then standing up too quickly. As I emerge blinking onto the streets, having been signed out off the Neurosurgical Unit of Bispejerg Hospital , my main concern is that the entry on my journal gives my diagnosis on admission simply, and rather mortifyingly, as “confusion”. So this is where I am in my life. I would like here to paraphrase the words of the song “Confusion” by progressive rock icons King Crimson from their canonic release “In the Court of the Crimson King – an Observation by King Crimson”

”Confusion ….could have been my epitaph.”

Psychic Musculature –mostly shite

Two months after my treatment ended, my health settles into a kind of semi-benign stasis. On the one hand the severity of my side-effect symptoms appears to be diminishing. I’m not as tired as I was, and I am able to start a freelance job which requires me to rehearse and perform as a singer, actor, and musician in a theatre production. I’m grateful to be able to deal with this without having to lie down at 2-hourly intervals. However, there is a feeling of reaching a kind of plateau of normality. I am curious to see the extent to which, if ever, I will feel entirely the same as I did before all of this kicked off. Do I have to adjust to a new normal – physically of course, but also psychologically? Should I expect any alterations to my general way of being in the world? I confess to never having been entirely without skepticism when I read or hear pious accounts of the life-changing, priority-reassessing and value-reshuffling effects of being treated for a serious illness. Quite frankly, the amount of love I feel for the people whom I love has neither increased or (thankfully) decreased since I became ill. Neither have I had any great revelation of deeper meaning to my life, other than being reminded of what the difference is between the experiences of health and illness. I also confess to a mistrust of any talk of an increased sense of “spirituality” that I sometimes hear about people experiencing post illness and recovery. Any explanation I’ve ever heard of what that word means has always sounded to me like someone vigorously washing a hog. Without wishing to appear overly cynical, I suspect that this kind of discourse can sometimes be an attempt to salvage something intangibly positive out of a situation which mostly smells of shite. I can therefore see why one might be drawn towards it. On the other hand I can now concede that being pushed towards an awareness of ones own mortality – coupled with a degree of illness and physical discomfort - may have some weird and unexpected effects on ones unconscious mind. In my case it feels like that the experience I have gone through has conferred on my body and mind an ability to perform, on occasion, what I want to describe as an “action”, a kind of psychic, almost physiological muscle-flexing. This “action” feels completely novel to me, but I can feel that the potential to carry it out has always lain dormant inside me, and indeed is part of how I, and I presume all other humans, are put together. It’s as if, quite sensibly, we contain an algorithm in our unconscious which lies in wait, and is specifically for dealing with suffering and death. The tentative flexing of this previously unused psychic muscle seems to set off some emotional events which I find unfamiliar in an almost alarming way. For example, I have always been more prone than most people to tearfulness in response to the usual stuff – beautiful or powerful music, artistic experiences and real-life situations whose intrinsic emotional content move me in some way. I have always put this down to being (a) a general wuss and (b) a stereotypical person of Celtic origin, prone to sentimentality and a sucker for melancholia. But now, more often than usual, I find myself in situations in which I feel emotionally stirred, but can’t fully explain what is moving me to tears. Not only that, but the mechanism of this feeling, the way it kicks in, seems to follow a trajectory which is unfamiliar to me. It’s a feeling which has the quality of a loss of innocence, a kind of existential sadness, a melancholy which is connected to a fleeting heightened awareness of the immanent (and indeed imminent) cessation of ones own time on earth. I suppose in a more banal sense it’s what you feel if you’ve had what people like to call “a brush with death”. The closest I recall having been to this feeling in the times before I got ill, was how unexpectedly and powerfully emotional I get when confronted with any kind of art which somehow evokes a sense of the absurdity, fleetingness and essential pointlessness of existence – such as the theatre of Samuel Beckett, the music of Erik Satie or all of DADAism. It’s difficult to pin down, but it’s sure as hell not the same kind of tears I get at, for example, the ending of ET.

As I said, I can’t help feeling that there is something primal about this feeling, that we have evolved with a psychic musculature to deal with this stuff, which somehow kicks in when required.

Out of The Woods

My two-month assessment comes around. This is the point at which a small group of clinicians, referred to as a “conference”, meet to decide if any of this has shown any signs of having worked, or if I’m, as my parents generation used to say, “for the chop”. The conference consists of two doctors – an Ear Nose and Throat oncologist and a surgeon – and a nurse. The doctors take turns to perform what seems like identical examinations on me; they examine my nose and throat with a fibre optic camera, and use an ultrasound device to check my lymph nodes. The reason for doing this twice seems to be to get an immediate second opinion. This is presumably to avoid one of the doctors telling my I still have cancer just because he’s maybe had like, a shitty day.

The conference’s opinion is that my cancer is in complete remission, in other words there is no local evidence of its existence at the moment. I am sickness-free. Suppressing an urge to punch the air, I am told to return in a months time for a PET scan to make sure that there has been no metastases to some far-off , or indeed close-by, part of my body. I’m left to ponder their careful choice of the word “remission”, albeit “complete” and the absence of any mention of “cure”. It strikes me that a cure can only be determined as it were in retrospect. In five years time – five years seems to be the convenient period used in research to measure these things and draw conclusions– then if there is no further action by the cancer cells they can more safely say that I may have been cured. But until then I can’t regard myself as being 100% out of the woods. Still…. Ya beauty. A blood test has also revealed that there is no evidence of HPV in my bloodstream.