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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:-

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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.

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Chapter Thirty-Three

Summary

The author writes about the writing of the cancer story "Metastasis", a horror story. A horror fantasy story. On the medical front, the author suffers from internal bleeding. Serious or trivial? He is tired of being the cancer patient, the constant object of observation, and decides to ignore the bleeding.


        Another story that I wrote in the early weeks after my diagnosis is the cancer fantasy story "Metastasis". What follows, below, in this chapter, is, an account of how some personal experience fed into the writing of the "Metastasis" story. The following chapter contains the full text of the actual cancer fiction story itself.


* * *


        Saturday 12 March 2005.
        Since my life is now focused on dealing with cancer (and, all going well, recovering from it) it's natural that my latest short story is a cancer story, a piece of fantasy fiction with horror elements. A rather unpleasant piece of work in some ways, but we're not in dandelion territory here.
        Anyway, this is my account of how I was inspired to write this rather ugly cancer horror fiction story called METASTASIS. It demonstrates the synergy between memory (past experience, digested over time) and life now (the press of ongoing events.)
        This account of the writing of the METASTASIS cancer story is not typical. It's not an account of a standard writing pattern. Different stories get written in different ways, some with more ease than others.
        A technical note to begin with: as most people know, "metastasis" is a word used to denote the spread of a cancer from one part of the body to another. My parents' crumbling copy of CHAMBERS TWENTIETH CENTURY DICTIONARY, the dictionary which I grew up with, gives the etymology as being from the Greek word "metastasis," meaning "change of place." A "stasis," it seems, is a "a standing".
        Avoiding any specific connection with cancer, the dictionary supplies a general meaning for metastasis, glossing it as "removal from one place to another: transition: transformation: metamorphic change in rocks: metabolism."
        However, after a lifetime spent working with words (if forty-eight years can be called a lifetime) I have to say that in my experience the word metastasis has never cropped up except in reference to cancer (sometimes literal cancer and sometimes metaphorical cancer.)
        And in fact the cancer association is one highlighted by a different dictionary, COLLINS ENGLISH DICTIONARY (third edition, 1991) which starts with a definition reading "the spreading of a disease, esp. cancer cells, from one part of the body to another." If you are a cancer patient, of course, then metastasis is a bad news development.
        The start point for the METASTASIS story, then, is the word itself, freighted with ominous meaning, suggesting doom: the collapse of defenses, the inner sanctuary being overrun. Flood. Inundation. Overwhelming invasion.
        Next, feed in my own situation, which is that I find myself seriously ill at the age of forty-eight, with the prognosis uncertain. Here in New Zealand, I'm dividing my time between my parents' house, where I'm living as an invalid, and Auckland Hospital, to which I am periodically admitted for chemotherapy treatment involving spending days at a time with an intravenous drip in my arm.
        The situation is a combination of the unsettling and the boring. The unsettling part is that the ultimate outcome is unknown. All going well, I will make a good recovery in 2005, and, by early 2006 at the latest, will once again be living and working in Japan, the country where I have spent the last seven years of my life.
        However, although my doctors have made it very clear that they are working for a cure, a cure is not guaranteed. It's a lottery. This disease, my genes, my idiosyncratic reaction to my chemotherapy regime: there are a lot of unknowns here.
        I'm basing my life very firmly on the assumption that I'm going to live long and prosper. If I don't, the alternative outcome will take care of itself. If I exit history then I exit history, and there's no helping it.
        Uncertainty, right now, on this Saturday morning, concerns my nose bleeds, of which I've had a couple recently, spontaneously and unexplained, and the possibly related mystery bruise on my right elbow, which is smudged dark red.
        My sister Catherine, a trained nurse, has been urging me to press the panic button, phone the hospital, go in now, get it checked out. We don't know what is happening. Maybe it's trivial or maybe this bleeding is signaling some appalling response to my treatment regime, with (to speculate recklessly) sudden and massive internal bleeding a possibility.
        However.
        I have an appointment for ten in the morning, Monday, at which time I'm scheduled to physically show up at the hospital to be checked out to see how I'm going, and, as far as I'm concerned, the question of how serious this mystery bleeding might be can wait until then.
        I guess I'm feeling just a little bit rebellious, tired of playing the role of panda: the blobby object which has lost control of its own destiny and has been reduced to the status of the observed thing.
        Tired, too, of needles.
        If you'd asked me a few months ago, I would have said, "Oh, needles, they don't bother me." But the number of times I've heard "Just a sharp scratch now" or "Just a little prick" (or, from a Canadian nurse, "Just a little shove") has been adding up, and, though I'm not yet at the phobic stage, I'm not nearly as relaxed about needles as I used to be, each new needle edging me one step closer to my "one needle too many" point.
        And I'm tired, too, of hospital monotony, of the boredom of lying in bed which is the counterweight of the situational drama, the hours of nothing happening (can't sleep, not inspired to write, library book fails to hold my interest) smoothing away the angst and leaving me with a kind of "sitting waiting at a bus stop forever" feeling.
        Inert.
        And empty.
        And, into this emptiness, there came the horror figure of the fiction character Metastasis, the decayed entity of translucent green jelly sheathed in a plastic shroud. Arriving fully formed, out of nowhere, self-creating, horror spontaneously generating itself.
        Storywise, this incident would work better if I wrote that the figure of Metastasis ambushed his way into my consciousness, fully formed, while I was lying alone in my hospital bed with my life-or-death intravenous drug running, feeding a poisonous chemotherapy agent into my system. Kill or cure!
        However, in fact, the piece of fiction called METASTASIS is a story I wrote one night a couple of days before one of my stays in hospital, and I was actually sitting at the living room table when the figure of Metastasis walked into my imagination, gross, graphic, visual, fully formed.
        Darkness within shadow.
        The entity known as Metastasis was provoked into existence, obviously, by my own situation, which is one of fairly arbitrary uncertainty. I have for some reason (but for what reason I do not know) fallen ill with a fairly uncommon disease which represents a significant threat to my continued existence. And, although my plans are optimistic (make a full recovery and continue) I don't yet know how this will work out for me.
        The character Metastasis, having been born of my own situation, is an incarnation of motiveless malignancy, arriving from nowhere and arriving without explanation.
        Like my medical condition.
        In a sense, the character of Metastasis is a creation of my present circumstances. In another sense, however, Metastasis has been something like twenty years in the shaping, his genesis going back to an incident that occurred in the South Island of New Zealand, in the city of Christchurch in (perhaps, to guess very approximately) about 1984, back when my age was closer to twenty-eight than forty-eight.
        At the time in question, I was in the military, and was doing a course for army medical assistants (people who get training in first aid, basic hospital work, and the elements of field hygiene and the like.) The course, which was for people who had already done earlier training, and who had acquired some years of experience, was run at an army base called Burnham, within easy driving distance of Christchurch.
        Anatomy was part of the course, and one day one of the instructors brought along a big bag of animal organs, glistening wet with dead animal juices. Unfortunately, memory expires at this point, and I can't remember what, if anything, we were required to do with the organs. I just remember the look of absolute disgust on the face of one of the female students of the course as these chunks of disemboweled animal came slithering out of the bag. (Big pieces. The pieces were not from a little animal, like a rabbit. They were from something pretty big. Maybe a cow.)
        (At a guess, maybe we were required to identify the organs and to say how they plugged together. Two legs or four, the basic anatomy of the gut is pretty much the same.)
        Another part of the course also involved anatomy. It was to observe an autopsy. And so, on a certain morning, we were driven into Christchurch, and to the morgue. If memory serves, we got given a very sensible "don't stress" lecture beforehand; if I recall correctly, the general drift was that this is not some kind of rite of passage, and if you can't handle it then don't worry.
        The scene, in short, was set for something educational to happen, the course being run by civilized people who were good at what they did. The approach to the autopsy, like the approach to the whole course, was, in a word, immaculately professional.
        So we were driven into Christchurch.
        Then: problem!
        There had been some kind of mixup, and the friendly civilian pathologist who had agreed that we could all come along to watch him cut up a dead body was not there. Instead, his disapproving colleague was. We were not welcome - no show today.
        I remember our instructors being very mature about this. The morgue is the pathologist's domain, not ours, and it's his judgment call, which he has to be free to make as he sees fit. Any, anyway, there will be another day.
        Meantime, for the moment, our instructors improvised ("In adversity, opportunity," is, I think, a standard military slogan) and, somehow, we ended up touring some kind of one-room museum-type display. At a guess (and, so many years later, this is only a guess) this place (quite a big room, as I remember) was probably part of a university medical school or something like that.
        The display cases were full of body parts which had been removed during autopsies and had been preserved in various ways. And we're not talking about healthy body parts. We're talking about diseased organs. Gross, bloated, pancaked, distended. burnt brown and black, shriveled or expanded, contorted into the unguessable. The contents of the body's envelope looking like maimed remnants of flesh garbage partially destroyed by incineration.
        Being then in the peak of health and physical fitness, I had only a remote observer's connection with the exhibits, which failed, after a few minutes, to really hold my interest. Still, I gazed, absorbed, remembered.
        It never remotely occurred to me that I would one day write about those disfigured human organs, those murky monstrosities. However, twenty years later, on the occasion on which the character Metastasis created himself, there those organs were, visible in Metastasis's visionary body.
        What I did think I would write about (though I never did) was the autopsy that I saw on the occasion of our second visit to the morgue. This time, the military-friendly pathologist was on hand, and, in a relaxed and informative manner, dissected a baby for us.
        There was an initial shock in being confronted not by the expected adult corpse but with something much smaller and infinitely more vulnerable, a victim, I take it (though this is a guess) of SIDS, Sudden Infant Death Syndrome (sometimes referred to as cot death), this being the unexplained death of a baby - a possibility that, incidentally, my wife worried about during the first few months of our daughter's life.
        After the initial shock, however, I found myself fascinated. In particular, I was struck by the contrast between the messed up deformities of the diseased organs that I had seen previously in the museum-type display cases and the marvelously clear, precise, textbook-logical appearance of the baby's flawless innards.
        However, I never wrote about that.
        If my own daughter (now well past the danger stage, I believe) had died of SIDS then maybe that baby autopsy memory would have ambushed me into an agonized creativity. But that would have been in a different universe, one far less tolerable than this one.
        In this universe, what came to me, fully formed, the product of twenty years of occasional remembering, was the sheathed organ collection calling itself Metastasis, sliding out of the cracks at the edges of nowhere, unsummoned, and with no excuse for his arrival. An arbitrary entity in an arbitrary world. The world which, for the moment, I am living in.
        It is a horror story, the theme is not pleasant, and the content may offend.
        Here in this universe, it is just coming up to 10:00 on a perfect day, sunny, blue sky, the temperature 22 degrees Celsius, and the humidity at 60 percent. And I've just moved outside to take a seat in the sun for what will be a carefully rationed ten minutes.
        The sun.
        It ages the skin and it causes cancer, but ten minutes a day is good for building up vitamins, and being irradiated makes me feel good.
        So I'm here in New Zealand, blobbed out in a chair in the sun. My life on hold. Meantime, my wife is in Japan. Today, she will be taking baby Cornucopia to the local daycare center for some kind of introductory meeting.
        She'll be tired, as she just got off the plane yesterday.
        So much for my life.
        Now, in closing, today's fragment of Kiwi English, heard on the radio, A female announcer was giving out a web site address on air, the web site beginning with the usual "www", but what she actually said was "dub dub dub." I have no idea whether this is (a) her personal habit or (b) her spontaneous one-off improvisation or (c) a standard feature of today's New Zealand English.

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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.

Disclaimer

        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.

Cancer Patient Copyright © 2005 Hugh Cook.

Hugh Cook

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