This is part of the full text of the medical memoir "Cancer Patient" written by Hugh Cook. The full text has been published online on a free-to-read-online basis. This autobiographical non-fiction account deals with the author's initial health problems, diagnosis, and treatment with chemotherapy and radiation therapy.
The complete text of "Cancer Patient" is here on this web site but is also available for purchase from amazon.com as a proper printed paperback book. The full text may also be purchased as a download (a PDF file) from lulu.com for US $5. Go to lulu.com/hughcook
For a chapter-by-chapter breakdown of what's in the book (in its online version, in the PDF version and in the paperback version), see:-
Table of Contents
CANCER PATIENT is a medical memoir which deals with the author's autobiographical experiences which involve, amongst other things, chemotherapy, radiation therapy, a brain biopsy, a lumbar puncture (and then some more lumbar punctures), treatment with Ara-C, treatment with vincristine, treatment with methotrexate, treatment with radiation from a linear accelerator, and a vitrectomy (an operation to remove the jelly from an eye). This is a non-fiction account but it does contain a couple of fictional stories, clearly identified as such, and it also includes some poetry.
Life as a cancer patient enfolds slowly with no quick rush to drama. The author goes to a bookshop and a coffee shop. The author has dinner out. The author has problems with the dexamethasone which he is taking to reduce the swelling in his brain, and realizes that he, the patient, failed to take in all that his doctors were saying to him.
Wednesday 12th January 2005.
Ironing the fragile blister of my identity
Into the bland maroon of eternity.
Day, and my father chauffeurs us (me, wife and baby) to the Children's Bookshop in Ponsonby. Cornucopia hasn't quite got the sequence of events right:
"No, Cornucopia! First you buy the books, then you eat them!"
My father suggests coffee, and I have to say this feels like pushing the envelope a little too far. But I go along with the idea and we have the Ponsonby outside coffee experience, and it's good. Then my father suggests walking around the shops, and I really do have to beg off. A nice, simple, straightforward morning, but I'm at my limit.
Afternoon activity: rest in preparation for dinner (at my brother's place) in the evening.
* * *
Thursday 13th January 2005.
Restless night, late breakfast. Today I'm not taking my oral steroid, dexamethasone, after breakfast. I've decided to shift it to after lunch, see if that helps. Yesterday I had an acidic stomach through the day, for which, rightly or wrongly, I blame the magic brain-shrinking dex.
And yesterday evening, just before it was time to go to the car to be chauffeured to my brother's place for dinner, my gorge rose and I abruptly found myself racing to the bathroom to spew up into the toilet, the sink, the toilet and then the sink again -- it was that kind of unplanned, unexpected, improvised spur-of-the-moment event. Bad dex!
I think the only person who noticed was my wife, who, in my hour of need, is being the low-key always there for me "I must support him" wife who, to be honest, I don't deserve.
We arrive at the house. There are some steps leading down to it and, not so long ago, my father was having to support me as I lurched unsteadily down the steps.
"Will you need help getting down the steps tonight?" he says.
"No," I say, with confidence.
Still sick, but no longer a cripple.
"It's wonderful what those steroids have done for you," he says, meaning the dex.
"Yes," I say.
And it is wonderful.
"But you do realize, of course, that it's just a palliative," he says.
"Yes," I say. "I think I'm properly oriented to reality."
I think everyone is properly oriented, which is one of the really good things about this situation. Everyone is in the picture. And I'm not fooling myself because I have all these little cues to orient me to reality. Stamina deficit. Vomiting. (Just the once, but it does send a signal.) Right eye messed up, a blur of partial information.
Anyway. Dinner at the house where my brother Charles lives with his wife Jenny and their daughter, the house beautifully lit by the late afternoon sun. Jenny's parents, Ken and Julie, are there, and Julie has done a wonderful job of cooking dinner, shepherd's pie. ("Do you have any traditional food in Japan?")
And I am socially buoyant in a way that I cannot remember having been for months, years maybe, and the food sits in my belly happily, and it is just marvelous, though by the time I am being driven home, full of pie and wine and chocolate, I am feeling a little bit like the caterpillar which severely overdid the eating thing, and, the next day, was very happy to settle for just one green leaf.
So now it's Thursday, my green leaf day, and the phone rings for me and it turns out to be Sarah from neurosurgery at Auckland Hospital. They would like me to come in Sunday for brain surgery ("Are you on any blood thinners?") with a possible three to four day stay, depending on what they find.
Monday my wife flies back to Japan with our baby daughter, and, ideally, I should be at the airport. But I do know that the next step is to sample the brain to look at exactly what the nature of the enemy is, and speed is of the essence.
"You do realize, of course, that it's just a palliative."
I need to go beyond a palliative. I need to go for a cure.
Auckland Hospital will courier me details of exactly where to go, and I need to show up with "pajamas, toiletries" -- that, it seems, is all I need to bring.
I am sanguine about the brain operation. Having an eye cut open under local anesthetic gets to me emotionally, but the brain, for some reason, doesn't have the same emotional significance for me as my eyes.
... and then a tooth breaks in half as I'm eating spaghetti (of all things!) ("Come in at 5 p.m.," says the hard-working Chinese dentist's receptionist), and then the baby, which has been parked in the pushchair while we eat lunch, vomits all over the place, and, just for a moment, I'm dizzy, overwhelmed, totally overloaded.
The pushchair? The stroller.
At the dentist's, I get a standard form to fill in, on which I am to specify any medical conditions that I'm suffering from, so I do so specify. The dentist (an ethnically Chinese New Zealander, a very nice guy who is surrounded by a reassuring aura of total professional competence) tells me that I can expect my teeth to "go downhill" during chemotherapy. Come back after chemotherapy and he'll deal with any minor cavities I have and put in a cap (a crown) to provide a permanent solution for the broken tooth, a job which he estimates will take three weeks and will cost about a thousand dollars.
He patches the broken tooth with a temporary filling, and confidently predicts that the temporary filling will last through the months of my chemotherapy. If it should happen to fail, however, he will make a special effort to fit me into his schedule and fix it promptly.
[Later in the year, when I spoke with a radiation oncologist and mentioned dentistry, I was advised not to have dentistry done while having radiotherapy, because I would be immunologically compromised, and so any infection in a tooth would be more of a problem than usual. Consequently, I delayed getting a permanent fix for my tooth until after I had finished both chemotherapy and radiation therapy. I'm pleased to be able to say that I came through chemotherapy with zero extra cavities. And the temporary filling? That did the job perfectly.]
* * *
Friday 14th January 2005.
Adage: "Patients only take in thirty percent of what they are told."
I would have said that this adage did not apply to me, but today sister Catherine, a former oncology nurse, has been lecturing me on not taking my dex. The dexamethasone, after all, is necessary to reduce the swelling in my brain, to keep away the symptoms of paralysis.
What Catherine told me (and I have no memory of this) is that Dr. Hamid told me (at my initial appointment at the oncology department) that I should let a doctor know if I was experiencing nausea.
She got on the phone and got someone at the hospital to fax a prescription through to our local pharmacy. I had no idea that it was possible to have a prescription simply faxed through like that.
Catherine on the phone:
"So, no, he's not ... the steroids have been fantastic in other respects ... you are drinking fine, aren't you, Hugh?"
"Yes, I am."
Obedient to medical instructions, I am drinking considerable quantities of water. Apparently this is necessary while you are taking dexamethasone.
The prescription that Catherine arranges by phone is for an antacid called Losec (omeprazole). Taking Losec once daily will reduce stomach acidity, the bad side effect of the dexamethasone. However, the Losec will take a day or two to become effective, so for the next couple of days I'm also going to take Gaviscon, an over-the-counter antacid. I'm also going to be taking an anti-nausea medication called Domperidone half an hour before each meal until medically advised to do otherwise.
I asked Catherine:
"So what happens to patients who don't have a sister to keep them on the right track?"
And she said, "They get confused."
The text on this page is part of the cancer memoir "Cancer Patient" which has been posted online. All the chapters of this book are on this website and can be read for free online. However, the text is copyright - all rights reserved. For permission to use this text or any portion of it contact Hugh Cook.
This personal memoir of the writer's encounter with cancer (non-Hodgkin's lymphoma of the large B-cell type) attempts to cleave to the truth. However, the text may contain information that is wrong, outdated, incomplete or otherwise misleading.
This memoir has been written in a time of illness by a cancer patient who, though he feels sharp enough, must admit to sometimes misinterpreting things, forgetting things, or, on occasion, quite simply not hearing things.
This memoir is designed to communicate the writer's personal experience and is not intended as a source of medical information. Got a medical question? Ask your doctor.