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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:-

Table of Contents

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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 Forty-Five

Summary

The author's sixth and final chemotherapy cycle begins. Why does the man in the bed opposite have black eyes and other bruising? (Hint: it's not contagious.) While the author cruises through his final chemotherapy cycle, other patients are busy being seriously sick. The author contemplates the origins of modern chemotherapy in the world of chemical warfare and decides, essentially, that chemotherapy is an imperfect treatment in an imperfect world, but it's the best we've got at this stage of human civilization.

        Monday 16 May 2005.
        In hospital for my sixth chemotherapy cycle. The last of six. This is the last time I will ever have to do this. (All going well.)
        This afternoon, a doctor was talking to a patient in the bed opposite me. The patient was developing bruising, including black eyes. So what kind of cancer causes black eyes? I wondered, and listened closely.
        As the conversation continued, it became apparent that the black eyes and other bruising was not the result of cancer. Rather, the patient had been beaten up by a guy who had, amongst other things, thrown him into a wall.
        When I was admitted to hospital today, I ended up, coincidentally, in the same bed in the same ward where I started my chemotherapy months ago, back in February.
        I was admitted at 10:00, had a cannula put in a vein in the back of my right hand at 10:10, had lunch shortly after twelve noon and then, at 14:00, a drip was hooked up to the cannula and fluid loading began.
        As usual, the line from the bag of intravenous fluid descends into a boxy blue computerized pump attached to a drip stand, and the softly purring pump physically pumps the fluid into the cannula stuck in the back of my right hand. Green LCD numerals show both the rate at which fluid is being administered and the amount remaining.
        I started with a single pump at 14:00 today Monday, but later a double pump was provided, because at 02:00 on Tuesday a second IV infusion was scheduled to start flowing, one containing sodium bicarbonate to increase the alkalinity of my system.
        As usual, the other people in the ward seemed to be sicker than I was. The guy who had been thrown into a wall was ill enough to warrant a visit from a specialist who described his job as "pain control". And one of the other guys on the ward was on oxygen, and, judging by the sounds of his breathing, merely staying alive had become effortful for him.
        Lying in bed today -- wearing, as usual, short trousers, a T-shirt and a heavy-duty cotton sweatshirt -- I was conscious of having been fairly lucky. For me, the chemotherapy experience has worked out pretty well.
        Of course, there's still the radiotherapy to come, and in terms of health outcomes my analysis is that being zapped by the radiation is a bit of a gamble. But at this stage I am really solidly convinced that I am going to survive. And, all going well, I'll come through the radiation without too much damage to my eyes, tear glands, pituitary gland and thinking box.
        What strikes me about my current chemotherapy cycle, the sixth cycle, is the routine nature of it, the repetition of the repetitive. It's this sense of familiarity which underwrites a poem I wrote about having blood taken:-


Drawing Blood

White sheets, white walls,
White neon lights,
The whole
Staging the drama
Of grayness,
The opera
Of silence.
Supine
Is a lifestyle.
The bedsheets
Are rafting through forever.
In the nullity of punctuation marks,
A routine needle,
A sharpness, closely observed,
Sliding home.
In the lithe tubing,
A red
Thicker than hysteria,
Phlegmatic.
One of the day's unevents.
Later,
The puddled question mark
Of the bodged gorbage
Which purports to be lunch.

        Not "garbage" but "gorbage": this particular lunch quite simply wasn't in my dictionary. No matter. I'd come equipped with my own rations: apples, pears, mandarins, cashew nuts, mixed nuts, rice crackers and chocolate biscuits.
        Your own rations, your own cup of tea made in the kitchen using your own high-quality tea bag, a copy of a 2004 issue of Vanity Fair with a stack of library books to follow: this short-term incarceration can be perfectly tolerable once you're properly adjusted.
        Monday, 16:35: nurse to patient in the bed to my left:
        "I'll just give you some more pethedine."
        I'm cruising through my routine but he's struggling through his drama.
        My own assessment of chemotherapy: it worked for me. In all, six cycles for a total of thirty-two days in hospital. A little nausea and vomiting during the first cycle, plus, again in the first cycle, a bit of fever and a mystery rash. Overall, a smooth ride. And, most of the time, I've felt as calm as mashed potato.
        Okay, it's tediously monotonous lying for days in a hospital bed, and being physically hooked up to a drip stand for twenty-four hours a day is an irksome form of imprisonment, even though it is possible to unplug the drip stand (which will run for a time on its own battery power) and push it around (carefully, because it's not particularly stable).
        But, all things considered, having chemotherapy has not been too bad, for me. Other people have had a rougher time -- I've seen a range of patients over the passing months, different people with different variations of cancer, with different problem mixes, different treatment protocols and different health dramas. Not all have experienced outcomes as smooth as mine.
        However, my opinion, based on what I've seen during my hospital admissions from February through May inclusive, is that the average cancer patient tolerates his or her treatment reasonably well, and that, although some people may get a rough ride from chemotherapy, an outsider's image of chemotherapy is likely to be unduly negative.
        One of the things that moves me to offer this opinion is a totally negative book on chemotherapy that I skimmed through recently in the Devonport Public Library. The book, written in the 1990s, is a denunciation of chemotherapy, going so far as to suggest that the cure kills more people than the disease.
        One fact that the book used to attack chemotherapy is that modern chemotherapy has its roots in chemical warfare. This is true but irrelevant. Let's look at "true" and then at "irrelevant".
        Back in the Second World War, both the British and the Germans stockpiled chemical weapons so that they would have the option of retaliating in kind if chemical weapons were used against them.
        At one point, the Germans bombed a large British ammunition dump in Italy. The dump contained mustard gas, a chemical warfare agent that causes burns and blistering, and the release of this British mustard gas contaminated a large number of British troops.
        The result was fresh research into the interactions between mustard gas and the human body, research which led, in due course, to the development of chemotherapy agents which were, in effect, evolved chemical warfare compounds.
        It is true, then, that modern chemotherapy has its roots in chemical warfare, but, from the patient's perspective, this strikes me as being self-evidently irrelevant. It falls into the "So what?" category. But the denunciatory book I was reading pretty much equated chemotherapy with chemical warfare.
        This kind of anti-chemo book probably influences at least some people. In fact, during one of my admissions there was a woman on my ward who said that her "holistic books" advised that chemotherapy should be avoided for all cancers. Except lymphoma.
        Fortunately, this woman had lymphoma, otherwise her "holistic books" might conceivably have persuaded her to refuse treatment.
        Admittedly, the basic principle of chemotherapy is pretty crude: dumping potentially lethal poison into the body in the hope that the cancer dies before the body does. Come back in two hundred and fifty years and we'll have something better. Or, at least, something more nuanced, more targeted.
        But this is now, and, when you're stuck in the world of now, with no time machine convenient, you have to live with the technologies of this particular day and age. And the bottom line on chemotherapy, as far as I can see, is this: for a lot of people, it works.

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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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