Category Archives: Health

I’ve Started…

Over the years, I’ve appeared on a few TV quizzes, including victory in an episode of 15-to-1 that is thankfully lost to the mists of time—thankfully because of the terrible goatee I sported back then. One show that I would still love to appear on is the venerable Mastermind, BBC’s extra-dramatic test of general knowledge. Just the contestant seated in a black leather chair under the spotlight, as questions are fired at them.

One nice little touch in Mastermind has become the show’s catchphrase: should the final buzzer interrupt a question, the host will still let the contestant answer, with the phrase “I’ve started, so I’ll finish.” Thus there’s no frustrating sense of being cut off, and the contestant’s fate remains in their hands, not those of the inexorable progress of time.

This twist on the quiz format fits my psychology well. I’m a completist, and I get irritated when I can’t wrap my affairs up neatly. (Not to the point of being obsessive-compulsive, though you will occasionally find me straightening the salt and pepper shakers during dinner.) The main impact of this is that if I start reading, or watching, or participating in something, I don’t like to step away until it’s finished.

Given that TV shows and book series can turn bad during their runs, this isn’t the happiest of traits to have. Spending my time and money on entertainment that makes me feel resentful instead of happy isn’t logical behaviour, but the fallacy of sunk costs has a powerful grip. If I give up, aren’t I just admitting that I’ve wasted the effort and attention I’ve already committed? Having come so far, I may as well see things through, right?

Like most personal flaws, once you’re aware of it, you can take steps to rectify it. I’ve gotten better over the years at walking away from activities that I’m not enjoying any more. Not that I’m perfect though. If I’m quitting a TV show, I’ll still watch to the end of the current series. I might abandon a book series if I’m not enjoying it (Robert Jordan’s Wheel of Time was the first I did this with), but I’ll still finish an individual book, no matter how much the experience drags.

My recent diagnosis was a reminder that I need to get better at this. Though the initial impact has faded away, replaced by a return to something resembling normality, the reminder that the time we have available to us is finite still lingers. Wasting time on activities that I’m only persisting with out of a misplaced need to have a tidy ending isn’t a worse idea than it was a few months ago, it’s just that I’m more aware of how bad an idea it is.

This shouldn’t require some grand audit of how I spend my time, either. Just a metaphorical tap on my shoulder any time that I find myself bored or annoyed at a time when I ought to be engaged with whatever I’m doing. Do I really need or want to be doing this? And if not, what could I be doing instead? (This includes nothing—allowing myself time to recharge and decompress is better than spending my time busy when I’m achieving nothing more than winding myself up.)

So, unlike that metaphorical contestant on Mastermind, I don’t always have to finish. I can just walk away if I want to. Though in one particular instance, I might decide to finish properly. You see, the main reason I’ve never been on Mastermind is that my brother works for the BBC—an organisation that’s a bit touchy about potential impropriety. But it seems that an external company has now taken over the show, so that bar to my participation is no longer an issue. Next time they’re looking for contestants, I might just see if I’m a good fit for that black leather chair.


Cancer Update

Missed a week, didn’t I? That was careless of me. Still, it hasn’t been a fortnight filled with incident, so you’re not missing too much. I’m just about finished my fourth week on (and hence first pack of) Alecensa, and the major side effect has been a reduction in my average heart rate of around 10bpm. You’ve probably heard enough about my digestive issues already, so on that side let’s just say that everything is under control with only minimal interference on my part.

I’ve also been putting on a bit of weight, though whether that’s down to my lowered metabolism or the fact that I’m back at a workplace which is keen to provide as many meals and snacks as possible is hard to say. Maybe both. In any case, a visit to the doctor in midweek suggests that the cancer has paused its advance, though more detailed results won’t be forthcoming until early April. Until then, let’s hope for smooth sailing (and an absence of coughing).

New Year, New Movies

As promised, something a little lighter. The turn of the year brings with it Oscar season and a swathe of awards-bait movies. Somewhat unusually, this year I’ve managed to see a few of them. This has proved to be good timing. Movies gunning for golden statuettes can tend to be desperately self indulgent, but I actually enjoyed most of the movies that I watched over the Christmas period.

Below are brief reviews of four of those movies (one of them is not an awards-bait movie, but I did see it over the holidays). I also saw The Irishman, Scorsese’s mob epic, on Netflix, which was probably the best way to watch it, as it’s an interminably long retread of ground that Scorsese has already crossed and re-crossed, mostly in the company of the same actors. I’m not a big Scorsese fan but when all a movie has going for it is familiarity and technical achievement, it’s going to be a lesser work.

For upcoming movies, I still want to catch Greta Gerwig’s Little Women and I’m looking forward to Armando Ianucci’s The Personal History of David Copperfield. However, while I wait for those, on with the reviews, in more or less chronological order:


Knives Out, Rian Johnson

Having become the focus of Internet fan ire a year earlier for his work on Star Wars: The Last Jedi, Rian Johnson’s return with a wonderful modern version of the classic Agatha Christie detective story is a warming success. Garnished with a truly wonderful cast, led by Anna de Armas and Daniel Craig, it does what Johnson likes doing best: takes apart a well-known genre, figures out what makes it tick, then puts it back together in a form just skewed enough to require the audience to pay close attention.

Paying attention pays off in this case, as Knives Out plays fair throughout, providing all the information that the audience needs to figure out what’s going on. Casually mentioned facts reappear later in the story, and no one is entirely to be trusted. Even better, the film lays out early on exactly what happened, turning instead into an exploration of how and why it happened. It’s a subtle distinction, but it brings the characters and their motivations to the fore, much to the evident joy of the cast.

Often when the people involved in a movie have clearly had a good time making it, the movie itself is a bit of a mess. That’s not the case here. Johnson’s script is tight and purposeful, and his cast are clearly having a ball playing a bevy of horrible, entitled people. Chris Evans, Michael Shannon, and Jamie Lee Curtis are all worthy of note, but Craig’s louche detective Benoit Blanc is a constant joy. All the happier news then that Johnson is planning further movies starring him. Bring them on.


Star Wars: Rise of the Skywalker, J.J. Abrams

It’s been a tough few years for Star Wars fans at the movies. For all the money they’ve made, the Star Wars films have stuttered for Disney, with production on movies outside the main story having been halted. Which leaves only the final movie in the trilogy of trilogies for now. Following on from The Force Awakens, which was predictable but buoyed up by its appealing young cast, and The Last Jedi, which did interesting things with the Star Wars universe but clunked in several areas, we have Rise of the Skywalker, which lands with the dullest, heaviest of thuds.

The problem lies mostly with the writer/director. J.J. Abrams has a talent for tapping into fan nostalgia and grabbing audience interest with mysterious stories, but if Rise of the Skywalker proves anything, it’s that he has no idea how to plot a movie. He got away with it in The Force Awakens, which could devote itself to setting up mysteries for later films and which in any case borrowed its plot from earlier films in the franchise, but here he’s required to provide payoff for at least two and as much as eight earlier films, and he really doesn’t.

What he does instead is deliver a film stuffed from one end to the other with incident, action, and brand new and unexplained twists and turns. In this constantly weaving spaghetti junction of plot lines, the appealing traits of the core cast are lost and no time at all is taken to build suspense or allow the impact of seemingly galaxy-shaking events to sink in. Despite watching Star Wars since I was old enough to follow a story, my sense of wonder only twitched once, a positive reaction far outweighed by my eye rolling at overt fan service and sighing at yet another pointless hint that never gets followed up on. This should have been so much more.


JoJo Rabbit, Taika Waititi

Imagine the trickiest assignment you could give a scriptwriter. A comedy set in the waning days of World War II, told from the perspective of a ten-year-old Nazi fanboy, with Hitler as his imaginary friend? Oh, and it has to deal sincerely with anti-semitism, tragedy, and despair, all without being offensive or trite. That’ll probably be close to as tough as it gets. It’s entirely to Taiki Waititi’s credit that he took on the assignment in the first place and a sign of just how good a writer and director he is that the resulting film is something close to a triumph.

I’ve seen and heard a few reviewers complain that as a satire it’s toothless as a result of its silliness, which somewhat misses the fact that JoJo Rabbit isn’t a satire. It’s a coming-of-age story, told amid the most insane of circumstances, as the titular JoJo is required to confront the Nazi “truths” that have been drummed into him from his earliest days, embodied by Waititi’s Hitler, an imaginary friend who is by turns supportive, manic, and hateful.

The complexities of the supporting characters are deliberately hinted at rather than delved into: JoJo simply isn’t equipped to understand their despair, devotion, and rebellion. The exception is Thomasin McKenzie’s Elsa, a jewish girl he finds hiding in his house. Older and more insightful than JoJo, she has a drive for survival that he doesn’t understand, and it’s through her that he finds a path to growing up and developing empathy. By turns hilarious and deeply heartfelt, JoJo Rabbit was my favourite movie of the winter.


1917, Sam Mendes

Most of the attention paid to Sam Mendes’ World War I epic 1917 prior to its release centred around its unusual editing. The entire two hours is presented as taking place in more or less real time, with a single time jump in the middle. Any edits are carefully concealed, with the result that the camera almost never leaves its protagonists as they struggle through no-man’s land and across the western front during a lull in the fighting.

Does this structural flourish actually serve the movie? Arguably, it increases the sense of immersion, as the audience has little opportunity to breathe or look away across the two hours of the film. By the end of the movie, they’re likely to be just as exhausted as the survivors are. However, film editing is an almost universally recognised language, and at times the refusal of the editor to cut away or switch to a closeup can be jarring and remind the audience of the artifice of what they’re watching.

What’s left then is a solid, well-told story of desperation and heroism amid the horrors of the World War I trenches. Mendes doesn’t shy away from showing how awful the experience was, though the film is rarely gratuitous in its use of corpses and death. The cast, while not as impressive as that of Knives Out, does provide some highlights for viewers, but it’s the core duo of Dean-Charles Chapman and George MacKay that impress the most. The weight of having an entire film production focused on you for far longer than normal can’t be underestimated, and succeeding as well as it does marks 1917 as an impressive feat.


Cancer Update: Towards the end of my second week on alectinib/Alcensa, things are settling down a bit. The most notable side effect has been a lowering of my heart rate, which may have knock-on effects in time but otherwise isn’t bothering me too much for now. My weight has also gone up a bit, but the cause of that is harder to identify. Constipation and returning to a sedentary job with ample access to snacks could both be contributing. So it’s probably a good thing that I started running again today.

Well, I say running. It was more of a 5k run/walk/stagger. However, the breathing wasn’t a problem. Instead, the out-of-practice legs were. So, as before, good news worth taking and I’ll run with that. Once I recover, that is.

The New Boss…

I was torn as to what to write for this week’s post. More cancer-inspired philosophical ramblings? A review of some of the movies I’ve watched over the holiday period as a bit of a break from all of that?

Then some idiot went and called an election as I was driving up north to visit my family. So I’ll talk about that instead.


The current Irish government is led by Fine Gael and supported by their long-time rivals/alter egos, Fianna Fáil. Not that they’re in coalition. That would imply that Fianna Fáil are the lesser partner in such a coalition, and that would never do. No, Fianna Fáil is just graciously lending Fine Gael their votes in order to keep the country ticking over, until the appropriate time comes for them to stick the knife in and take over.

That time may well be now, by general agreement, as the latest polls as of Sunday January 19, 2020, suggest that we will indeed see the traditional Irish flip from FG to FF at the top of governmental stationery. The Irish electorate being nothing if not conservative in their choice of Taoisigh.

This fits pretty nicely with the ambitions of Fine Gael and Fianna Fáil, both of which are deeply conservative parties. Which I mean in the traditional sense of conservative, not the balls-to-the-wall insane sense currently in power in the English-speaking nations that lie to the east and west of Ireland.* No, FG and FF are conservative in the sense that they both hew to the foundational conservative tautology: The people in charge are the people who ought to be in charge because they’re the people in charge.

After all, FF and FG have been swapping leadership of the country back and forth among themselves since the foundation of the state, which means that the path Ireland has followed has weaved through the narrow gap between FG’s market-focused conservatism and FF’s broader sense of “anything for a quick vote.” This game of catch they’ve played with the leadership of the country has kept Ireland fairly stable over the decades, but it’s been creaking for the last few years as the pressure for change has increased.

Ireland’s single transferable vote system means that smaller parties get their day in the sun too, which means that neither FF nor FG have been able to form a government on their own in a long time. When they’ve been able to, both parties have formed majority governments with minor coalition partners. Discounting Sinn Fein, whom neither FG nor FF currently countenance going into government with (we’ll see how long that lasts when the results come in), the main runners among the smaller parties are Labour, the Greens, Solidarity-PBP, and the Social Democrats. (There’s also Aontú, the Judaean People’s Front of Sinn Fein, but that’s as much as I care to say about them.)

Notably, all of these smaller parties are of the left, or at least to the left of the two main centre-right parties. Sinn Fein also claim to be of the left, but that’s a claim that’s rarely tested or borne out in their actions. Admittedly, as someone born in the 1970s in Northern Ireland, I’m deeply suspicious of Sinn Fein, but they seem far closer to Fianna Fáil than they do any other Irish party, not least in their willingness to do anything for a vote. Well, almost anything.

The lack of a strong left-wing party has left Ireland to follow a conservative, centre-right path through the decades. This has resulted in internal stability but vulnerability to outside shocks. The financial crisis of 2008, for example, which devastated Fianna Fáil and threw them out of government for the longest period in their history. Or the current climate crisis, which neither of the main two parties seem to have any notion of how to deal with.

Where change has come in Ireland, it has come from public sentiment, activists, and responses to crises repressed for years and finally coming to a head. In recent years, the child sex abuse crisis cracked the hold the Catholic Church held on Ireland since its founding, and in its wake other scandals came to light and public campaigns changed the face of the nation that Ireland believes itself to be: referendums on abortion and same-sex marriage passed with large majorities and amid scenes of unabashed positivity.

This willingness to change is coming from below, not above, in Ireland, and it’s far more in tune with a world where twentieth-century dogmas are crumbling in the face of massive financial inequality and a world gasping under the weight of exploitation. Conservative as they are, the two leading parties are ill-equipped to deal with such a world.

FG have retreated back into soundbites and condescension as they attempt to explain why, in the past nine years, they’ve failed to materially move Ireland on from where they found it. FF, meanwhile, show little sign of having changed from the party they were when they drove the country into bankruptcy in 2008. It’s enough for them to merely be FF. After all, their turn will come around again.

The sad thing is, they may be right. That poll mentioned above indicates that the main reaction to FG’s unpopularity and inertia may be for voters to simply to turn back to the other devil they know. The game of catch may just continue for another round, and the people in charge may just continue to be in charge because they’re the people in charge.

Except … for how long?

As events in recent years have shown, continuance isn’t the same thing as success. Suppress awkward truths or difficult challenges in favour of ensuring that the current regime gets a smoother ride just buries landmines for the future. The climate and the increasing problem of people who struggle to just live day to day aren’t going to go away. The question is, if FF/FG have power, do they have any answers?

* The U.K.’s Conservative Party and the U.S.’s Republican Party have both veered in the direction of authoritarian nationalism over conservatism in recent years. The former in pursuit of an impossible freedom from Europe and the latter driven by a deep-rooted paranoia about a future that doesn’t look the same as the past. Cheered on by a media driven more by the need for attention and profits than the desire to inform, it makes for uncomfortable viewing. We’re not there in Ireland yet, but we shouldn’t kid ourselves that the early warning signs aren’t present.


Cancer Update: Not much to report this week. I’m a little less than a week into the course of alectinib pills, and so far the side effects have been minimal to non-existent. So much so that I’m almost positive about going back to work tomorrow. (Capitalism waits for no man, and those pills need paying for.) Even my cough seems much diminished the last few days, though it’s probably too early to credit the pills for that. And most importantly, the constipation is holding off. Though courtesy of a present from a friend (see the image above) I should at least be able to spot it if and when it does arrive.

Middle-Aged Mutant Ninja* Writer

(Not actually a ninja. Though I do have a sword. And a bow and arrow. And I like dressing in black. So maybe there is a little bit of ninja in there.)

A lot of the experience of cancer is waiting. Waiting for a scan and then the results of the scan. Waiting for the next treatment, and then for that treatment to take effect. Waiting to see if the cancer has progressed, stalled, or retreated. Waiting across the span of weeks and months.

It might all be a bit annoying if I wasn’t used to being patient. Possibly more patient than I ought to be sometimes, but that’s a topic for another post.

When I was first diagnosed with lung cancer, some of the tumour samples were sent off for a trio of extra tests. These tests were looking for a specific mutation, ALK, that might open up other treatment options. Normally the chance of finding this mutation is pretty small, but I was already an edge case as a relatively youthful non-smoker, and the doctors figured my odds of having it were higher than normal. So they crossed their fingers and sent the samples off.

And then we waited.

Waited long enough that I had to make a decision on whether or not to start the standard chemotherapy course or wait for the test results. Deciding that punching the cancer in the face right away was the better option, I decided to go ahead, and the results of that you can read about in a preceding post.

The second course of chemo was due for yesterday, but it didn’t go ahead. Why not? Because the long-awaited test results came through, and they came through positive. Or mostly so—two out of three tests returned positive, and the third was ambivalent. My tumour was one of the rare ones with the ALK mutation, and that meant that a drug called Alectinib was now the preferred treatment option.

Why preferred? Well, beyond prospects for better results, Alectinib is delivered in pill form. Instead of going to the hospital every three weeks to have cytotoxic drugs dripped into my bloodstream, I get to go to the pharmacy and collect a box of pills, which I’ll take twice a day, with breakfast and dinner. Side effects too should be much milder, though everything to do with this kind of treatment is described in terms of percentages and I’ll have to wait and see what my percentile dice roll turns up.

As for treatment prospects, I’m still doing the reading and not getting too ahead of myself, but Alectinib does seem to offer a much better outlook than chemotherapy. The numbers for lung cancer are … not good, as a rule. The numbers for Alectinib specifically look better, with the caveat that this is a very new treatment. So new that they talk about two-year outcomes instead of five-year outcomes.

But I’m not getting too far ahead of myself on that score. This is probably the best news that I’ve had since my initial diagnosis, and if nothing else it means that I can live a much less restricted life than I was worried I might have to. One pill, twice a day, with fewer side effects than chemo? That’s something to be glad about.

Of course, this means that I’ll also be back to work before too long, and living something resembling a normal life. There’ll still be things to write about here, and I’m hardly going to be forgetting that I have cancer. There will be plenty of tests and results to wait for. I’m also giving serious thought to deleting my Facebook account, as I’ve already made the decision not to link any more posts from here to there.

For now though, I’ll take the win. More to see and more to do as the year comes in, but for now I’m in good form and hope you are too. Thanks for reading.

Cancer Capitalism

Another new year. A new decade, in fact. (The “starting on a 1” thing doesn’t count for decades. We’re in the ‘20s now.) And what have we learned?

<Takes a quick look around at the current state of the world.>

Not a damn lot, apparently. Going to have to do something about that.

It looks like it’s going to be an interesting year and decade. For most of the world, this is because there are people in positions of power trying to kill them in pursuit of endless profit growth. In my case, that too, but also because there are parts of my body doing their best to kill me in pursuit of endless growth.

Fun metaphor, isn’t it? Oddly, I don’t ascribe malice to either. In the case of cancer, anthropomorphising my tumour isn’t a step I’m willing to take just yet. It’s just a bunch of cells with faulty instructions, following those instructions to the letter and completely ignorant of the fact that their ultimate success leads to their ultimate destruction. If I’m not around any more, no more growth for them.

Malignant, yes. Malicious, no.

Corporate bosses wedded to the desire for continual growth are more culpable but still trapped by the same faulty instructions. As someone who had a job for years reading business magazines, the constant desire for growth always struck me as odd. If a company failed to increase its growth rate year on year, or worse yet failed to grow, the market would “punish” it by hammering its share price.

Why? Because shareholders demand a return on their investment, and merely remaining profitable year on year offered no great returns. Companies had to grow like crazy (hi Amazon!), promise future crazy growth (hi Amazon!), or dominate their market to such an extent that they grabbed all the profit therein (hi Amazon, Apple, Google, etc.!). Growth, growth, growth. Didn’t matter how it happened, as long as it was legal-ish, and as regulations on markets have tumbled and frayed around the world, the definition of legal-ish has gotten wider and wider.

The people at the helms of these growth machines are only doing what they’ve been taught to do. Maximise profit and growth and minimise loss, whether in the form of taxes, salaries, or competition. The results we see all around. People struggling to make ends meet on jobs that once would have supported most or all of a family. Social safety nets so threadbare that more and more people fall through and end up on the streets. Ecologically damaging industrial machines that keep churning because the alternative is to drop a few share points. More and more of the world’s “wealth” concentrated in the hands of fewer and fewer people. And for wealth, read “power,” because that’s how the world has been arranged since mankind got over its self-consciousness and started living in groups.

Malignant? Yes. Malicious? Not in most cases, I think. But vicious? Definitely. Vicious to anyone caught in the teeth of the growth machine.

Capitalism as cancer then? But what about all the good it brings? Well, capitalism, unlike cancer, does have some benefits. It’s a remarkably efficient engine for generating wealth and enhancing productivity. But leave it unregulated and it might as well be cancerous. Growth for the sake of more growth, without regard to the well-being of the host body. When your concerns are wholly focused on the quarterly shareholder report, you’re not paying attention to the long term.

If there’s a solution, it’s that nasty word: regulation. Regulation in deed, as well as word. And that’s going to be hard. The first country to clamp down on unrestricted corporate growth is going to see an exodus of the big boys. (Ireland is particularly vulnerable in this regard, having made itself a cosy home for them in the past few decades.) Large-scale action, in the form of nations implementing new regulations together, might halt the growth of capitalism and the erosion of the society it’s built on, but the alliances of nation states that might make such things feasible are looking shaky these days. (Someone, somewhere, is very much enjoying Brexit and the Trumpocracy and all the international mistrust that’s spreading as a result.)

But, you know, it’s a new year. And only two days in, we ought to remain at least a little optimistic about how things are going to turn out. Hopeful that we’re in the midst of late-stage capitalism, not end-stage capitalism. Hopeful that some global medical team more knowledgable than me has the correct therapy to halt the ever-spreading gospel of growth. Because most of us have enough on our plates to deal with, without worrying that the whole system is going to collapse within our lifetimes.


Cancer Update: Since I know a few people are keeping an eye on this blog for reasons other than my anti-capitalist pessimism, a little personal update. The first chemotherapy session was two weeks ago, and things have gone pretty well so far. Side effects were minimal and gone within a week. I didn’t even need to use any of my anti-nausea medication (though the vile-tasting laxative drink did prove immediately useful). Next dose of chemotherapy is in a week, and if things turn out the same then I might be back at work before too long. As for any results from the treatment, it’s way too early for those, but maybe (just maybe) my cough seems a little less harsh. Even if that’s purely psychosomatic, I’ll take it. And, as before, I’m still fully active and enjoyed the Christmas and New Year period, so no complaints on that front either.

Most of all, I want to thank everyone who’s reached out on hearing about my diagnosis. It has been one of the nicest parts of this whole experience. Which is not saying a lot, I know, so just know that each and every one of you are deeply appreciated.

Chemo, then and now

I don’t think I have any photos of myself getting chemotherapy from the first time around. That was nearly a quarter of a century ago, in the pre-digital age, so any photos there are would be the old-fashioned type, buried in a folder somewhere. In any case, it didn’t feel like the sort of thing one would take photos of. It was too desperate, too morbid, too confusing—too close to the bone.

Now though? Well, we take photos of anything, don’t we?

In the photo above, I’m having my first session of chemotherapy in St. James’ Hospital, getting a combination of pemetrexed and carboplatin pumped into my veins. Pumped very carefully, of course. These are toxic chemicals, and if the needle isn’t positioned right, well … 25 years ago it was explained to me that it would be like a chemical burn under your skin. They didn’t go into the gruesome detail this time around, but the nurse was appropriately careful.

You might note that I’m smiling in the photo above. Does that seem odd? Wrong? I don’t know, but it is honest. As much of a shock as the lung cancer diagnosis was, I feel like I’ve adjusted well. This is what needs to be done for now, and compared to a lot of other people, I’m lucky. I had one of my best friends keeping me company through the first session and plenty of others asking after me. Plus—and this is no small thing—I’ve been through this (or a variation of this) before. I’m prepared.

(Or at least I think I am. Time will tell.)

Back in the 1990s, the experience was similar, though maybe a little less efficient. Chemotherapy for Hodgkins’ Lymphoma likewise involved a combination of drugs, the names of which have long since escaped me. Though I was, at the time, put on the less harsh regime of the two available, it wasn’t a fun experience. Beyond having a line inserted into the veins of my hand (more painful than the elbow, but I have decent veins, so it wasn’t a chore for most nurses), the several hours that I spent in the ward watching drugs drip into my feed usually saw the side effects kick off, in the form of nausea and lethargy.

Whether the combination of drugs have been refined, or it’s just early days and I’ve yet to be worn down, that’s not the case this time around. The initial session lasted just a couple of hours, and two days later I’ve yet to be hit with anything particularly bad as regards side effects. Inevitably, the bit that has dropped in has been my least favourite: constipation. Still, that’s not so bad—my prescription included a couple of hefty boxes of laxatives, and I’m not going to wait around to use them. Fecal impaction is one of the least fun experiences I’ve had over the course of my life.

It’s probably too early to be making much of a comparison between then and now. I need a few more runs around the chemo carousel to get a better idea of how things are different. Or I need to do more reading to get a better idea of how things have advanced in the last quarter century of anti-cancer efforts.

What I can say is that this treatment does feel more refined. Last time out, I was taking in cytotoxic drugs two weeks out of three and swallowing enough pills every morning to make me rattle. This time, it’s one week out of three, and the drug intake has been pared down to cover the treatment days and any side effects that might crop up. My body should have enough time to recover between sessions. Hopefully the cancer won’t.

The reassurance, then: I feel fine, right now. Walking and driving around, living the same life as before. Waiting for the hammer to fall, just a little, but not so much as to stop me living my life. It’s Christmas, after all. I’ve got people to see. The role of a cool uncle to play (current plans include introducing my nieces and nephews to Dungeons & Dragons). Chemo’s not going to get in the way of me doing that.

Two Bad Words

When I was 19, I had cancer.

(Content warning for discussions of illness and mortality. If you want to avoid that, skip to the last four paragraphs for the summary.)

That’s not 100 percent accurate. When I was 19 I was diagnosed with cancer, but the cancer itself—Hodgkin’s Lymphoma—had been hanging around since I was 18, perhaps 17. Over the course of a year and a half, it had kept me from sleeping with constant itching, set off regular sweating, and carved a couple of stone off my weight. When a couple of lymph nodes swelled up and I was sent off to a hospital for diagnosis and treatment, it was a relief.

Chemotherapy consumed my life for eight months. As a teenager who hadn’t taken time out between school and college, it served as my gap year. I’d advise travel instead. Lethargy and nausea pinned me to the couch most of the time, and constipation was a very unpleasant occasional visitor. The brightest spot in all of this was getting to spend more time with my youngest brother, fourteen years younger than me, who was just starting primary school.

It was worth it in the end. After eight months I got the all clear and went back to college, doing my best to resume my life with barely an acknowledgement of what I’d been through. For the next two decades and more, I stayed healthy and gradually became something close to a functional adult.

Then, this January, I noted a wheeze in my breath.

Given how this article started, you can probably see what’s coming. I didn’t. For all that cancer had never left my mind, it wasn’t the first thing I thought of. Back at 19, I had symptoms aplenty. Now, I had none. I was healthy and fit. In fact, just a few months before, I’d run a half marathon in a little over an hour and a half. The wheeze was probably the remnants of a cough. It would go away.

It didn’t.

After a few months, I went to see a doctor. They did the usual checks, listening to my breathing and my heart, asking if I had ever been prone to asthma or had any allergies. Neither those checks nor blood tests showed up anything, but I got an inhaler and tried it out. It didn’t make any difference, and running and cycling were now chores instead of enjoyable exercise.

I went back to the doctor again. My mum had gone through heart problems the year before, and I knew that heart and lung problems often went together. So I was sent to a cardiac consultant. Tests were done, including breathing tests, but once again nothing was found. I began to seriously wonder what was going on.

I went on a holiday to South America. You can read about it in previous entries in this blog. It was a special experience but I noticed that the wheeze seemed to ease while I was there. Could there be something at home causing it? I checked with the doctor when I got back. I’d had a leak problem in my apartment for a while, and I suspected that there might be mould present. But there wasn’t a good way to check for that, so I focused on resolving the leak and hoped that would deal with the wheeze.

Then I started to cough up blood.

Back to the doctor I went. I was referred to a respiratory consultant but first I was sent to St. James’ Hospital for a chest x-ray. The reaction was quick—my GP got in touch to tell me that the hospital would be arranging more tests. A couple of weeks later, I was brought in for a meeting with a consultant (by mistake, I was sent to the Lung Cancer Surveillance Clinic first, though I wouldn’t put it past the universe to just have a warped sense of humour) and told that part of my lung was blocked and had collapsed. I was scheduled for a CT scan and bronchoscopy not long after.

It was that day that I first became sure, if not absolutely certain, of what was going on. My wheeze had turned into a persistent cough, and the doctor performing the bronchoscopy told me (and my parents) that the CT scan had found a mass blocking one of the passages in my lung. The bronchoscopy saw a sample taken from it and an enlarged lymph node between the lungs, and I was told that the next step would be a PET scan.

Things moved slowly as the PET scan was scheduled. I did a little reading. If the CT scan and bronchoscopy look for the shape and substance of things, the PET scan looks for something different. It examines the body for fast-growing cells. Cells like cancer, wherever they might have spread. If I was being sent for one of these scans, the doctors probably had a strong suspicion that cancer was involved.

(As an aside, the PET scan was one of the more interesting medical experiences of my life. It involves being injected with radioactive fluid, which was delivered in a lead-lined case and injected using a lead-sheathed syringe. Before the scan, I was left alone in a room for an hour, and afterwards I was told to stay away from pregnant women and small children, so radioactive was I for a few hours. Sadly, no superpowers ensued.)

Finally, the day came. I was brought into another meeting in St. James, and I brought my parents. I’d tried to prepare them, explaining my suspicions the weekend before, but it still wasn’t easy. The doctor was clearly uncomfortable, and there was a nurse hovering behind us, perhaps ready to pick up the pieces.

Exactly what he said, I can only remember in snatches. Two-word bursts. Lung cancer. Not curable. I was more focused on my parents. My mum’s pained silence. My dad’s breathing coming in shorter, louder gasps. We were told the situation. Not curable but treatable. There would be more chemotherapy, and perhaps radiotherapy, after some further tests. No surgery though. It had already spread enough that cutting it out of the body would only inflict pain without benefit.

That was several weeks ago. The tests have been coming back slowly since then. I’m not a candidate for more advanced immunotherapy treatment, but I might yet be eligible for a pill-based form of treatment that would be preferable to the standard chemotherapy. Even then, there will be scans and tests aplenty to come. With cancer, especially one that is treatable, not curable, it’s all about seeing what treatment works best. Holds the cancer in check or even pushes it back.

That’s what my life is going to be now. Treat, test, repeat. Exactly what my prospects are, it’s hard to say. As a non-smoker in my 40s, I’m already an outlier among lung cancer patients, so the usual statistics don’t apply. For myself though, my assumption is that this is what is going to take me out eventually. Treatments don’t hold forever. There are two alternatives to this fate: some other death intervenes, or cancer treatments advance to the point where they can do something more than just treat. To where “not curable” is no longer the status quo.

Am I being morbid or hopeful? I’m not entirely sure. I’ve already had another two bad words: Stage Four. But that’s mostly a way for doctors to gauge their progress and effectiveness. What matters now is direction. Whether the cancer goes forward or backwards. I won’t know that until we’re already deep into treatment. Regardless, what I want is time. Time to read, to write, to travel. Time to spend with my family, especially my nieces and nephews. If nothing else, I want the treatment to give me that.

It starts tomorrow. My first chemotherapy session and six weeks absence from work. What do I do with that time? I have ideas, and some of them will show up here. I won’t be posting about this on social media, so this blog will become the home of whatever thoughts I do have. Though they won’t be restricted to cancer alone. Or at least not biological cancer—there are plenty of metaphorical cancers in the world. And I have thoughts to share on those.

If you’ve read this far, thank you. If you know me personally, I apologise. I’ve had to tell more than a few people about this, and it’s never been fun. If you stick around, you’ll have my gratitude. Already, I’ve been overwhelmed by the offers of assistance and expressions of love from friends and family. That, at least, is one thing I don’t see changing any time soon.