The Lit­tle Lump on my Neck

Port Douglas & Mossman Gazette - - GROOVE - by Rainer Breit

THE lit­tle lump on my neck, to the left and slightly above my Adam’s Ap­ple, had been wor­ry­ing me for a while. A visit to the GP didn’t ring any alarm bells, even though my white blood cell count was slightly odd.

Ev­ery now and then the lump would itch like there were lit­tle legs crawl­ing around un­der the sur­face, and scratch­ing wouldn’t sooth it. As there was no pain, I took the itch­ing to be just part of a heal­ing process.

But it wouldn’t go away, and six months later it felt like it was start­ing to de­velop an ir­reg­u­lar shape, mak­ing it un­likely to be a blocked or swollen lymph gland as had been sug­gested by my GP. When I’d lost a few ki­los, it was time to check into hospi­tal for a biopsy. ’I bet its can­cer!’ my friend said jok­ingly. The phone rings that evening. It’s the doc­tor who has done the biopsy. My life flashes be­fore me! (How of­ten has that hap­pened since? Like a lit­tle blood in the urine; hav­ing some tests; anx­iously await­ing the re­sults. The doc­tors say­ing it’s prob­a­bly noth­ing to worry about. But you al­ways ex­pect the worst.) The news isn’t good. I have a nod­ule on my lymph gland. ’Is it can­cer?’ I de­mand. ’Yes’ he says, and keeps ex­plain­ing, but I hear noth­ing.

A glimpse of my­self in the mir­ror re­veals the same star­tled ashen face, and dead black eyes on stalks, that I had seen years ago when I failed sec­ond year uni. He is still talk­ing and I ask him to re­peat it. ’I have cut out all the ab­nor­mal tis­sue and you should be right for while’

(The big ’ C’ I shud­der. Jeeze, why me? Why me?)

’Is it ter­mi­nal then?’ I ask ap­pre­hen­sively (but I’d rather not know).

’There is no cure at present. I have made an ap­point­ment for you to see Doc­tor H to­mor­row. He is widely re­garded as the best on­col­o­gist in Aus­tralia. He will be bet­ter able to fill you in on the prog­noses and treat­ments’. That’s it? That’s all there is? Head-shak­ing numb­ness. Dis­be­lief. I feel like a courtier in the French Rev­o­lu­tion. From per­fectly com­fort­able one day, to a death sen­tence by guil­lo­tine the very next.

Doc­tor H is tall, dis­tin­guished look­ing and bru­tally dis­pas­sion­ate - a bit like Mal­colm Fraser in his early po­lit­i­cal life. His priv­i­leged Collins Street lin­eage has thrown his dic­tion so far back, that it al­most pre­vents him get­ting his words out in any de­ci­pher­able form. This is not the guy I would choose to con­fer the death sen­tence upon me.

’You have his­ti­o­cytic dif­fuse Non-Hodgkins Lym­phoma. It is quite ag­gres­sive but it re­sponds to ra­dio­ther­apy. There is no cure, but you may not have a re­lapse for a cou­ple of years. Treat­ments take their toll, so I sug­gest we do noth­ing right now and wait for a re­cur­rence. Then we will zap it with ray treat­ment’. End of story.

On­col­o­gists, or doc­tors of any sort in these times have ap­palling bed­side man­ner. Poorly trained in the art of break­ing bad news, they be­lieve that the less we pa­tients know, the less we have to worry about. There may even be an ar­ro­gance that de­crees us to be too stupid or too un­de­serv­ing of the truth. But I want to know the facts, tak­ing the lack of in­for­ma­tion as a sign that things are prob­a­bly worse than stated.

Next day is a blur. Why me? What’s gone wrong? Have I taken on too many projects? Maybe I need to re­lax more. I look laid back, but I am burn­ing up inside. Mum had breast can­cer - it might be ge­netic.

The di­ag­no­sis has a dev­as­tat­ing ef­fect on me. When­ever some­one gets shot on tele­vi­sion, I turn it off in dis­gust. Wil­ful murder seems so trite com­pared with the un­fair death I am fac­ing. I start sidestep­ping ants and stop swat­ting flies. They also have a right to live. Noth­ing de­serves pre­ma­ture death. If I’m go­ing to be dead soon, what’s the point of learn­ing or do­ing any­thing? It’s all go­ing to noth­ing. Time hori­zons be­come short - feel­ing for lumps ev­ery few hours. I am grate­ful for each ex­tra un­event­ful day.

There are com­pen­sa­tions of sorts, like the prospect of never hav­ing to go to the den­tist again, and I won­der how many vis­its to the bar­ber I have left in me. Hav­ing al­ways hated go­ing, I now mea­sure the rest of my life in hair­cuts. My first is met with re­lief, my sec­ond with pride and my third and fourth with a cer­tain smug­ness.

It’s hard to take any­thing other than death se­ri­ously. I be­come in­tol­er­ant of fools, and make my­self scarce in dis­agree­able com­pany. There is des­per­a­tion and de­spair; com­ing home late; go­ing straight to bed with­out play­ing with the kids. Para­noia. Con­stantly feel­ing for lumps any­where there are lymph glands.

Some months later my wife takes me gen­tly to one side and sug­gests I pull my­self to­gether. Maybe the prog­no­sis is in­cor­rect? Get a sec­ond opin­ion. There’s noth­ing to lose. She has read an ar­ti­cle say­ing how a Dr R has been fol­low­ing re­cent developments in Cal­i­for­nia, treat­ing leukaemia and lym­phoma with an ag­gres­sive cock­tail of lethal drugs. (At the time chemo­ther­apy is still new to Aus­tralia, and has not been widely used as a pri­mary can­cer treat­ment, be­ing more a fol­low-up strat­egy for rad­i­cal surgery and ra­dio­ther­apy.)

Dr R de­cides I’m a suit­able case for treat- ment. He warns that it will bring me close to death many times - the closer the bet­ter for it to work prop­erly.

But first they have to de­ter­mine how far the dis­ease has pro­gressed.

Blue dye is in­jected into the lymph glands and CAT scans show no ab­nor­mal­i­ties in lymph, liver and spleen. A lum­bar punc­ture de­tects no pres­ence of ma­lig­nant cells in the brain. But the big­gest doozy of them all is the bone mar­row biopsy to see if the can­cer has spread to the mar­row. The doc­tor proudly as­sures me that this pro­ce­dure is the most painful in his whole reper­toire.

Dan­gling non­cha­lantly yet men­ac­ingly from his fine sur­geon’s fin­gers is a huge hol­low horse nee­dle. The mother of all nee­dles!

’When the corer goes through the bone there is no way of anaes­thetis­ing it,’ he says, rec­om­mend­ing a big dose of Val­ium first. ’Will that stop the pain?’ I ask. ’No, but you prob­a­bly won’t re­mem­ber it as well when it’s over’.

’Well I guess if it’s only pain and I’m go­ing to feel it any­way, I’ll want to re­mem­ber it’ I re­ply, re­ject­ing the Val­ium and ly­ing face down naked on the bench, brac­ing my­self for the on­slaught.

At first the cut through flesh isn’t too bad. But then there is real down­ward pres­sure on my hip. The hot knife slic­ing eas­ily through but­ter is now a corkscrew bust­ing to budge a stub­born wine-cork.

’Jeeeeeez!!’ The pain is elec­tro­dy­namic as the bore siz­zles through bone, like a sil­ver fork on your worst den­tal fill­ing. You can feel the elec­tric­ity crack­ling up the nee­dle. My whole mus­cle struc­ture seizes up. If they could carry me out by the toes I wouldn’t slump an inch.

When the doc has fi­nally had his way with me, I roll over and hear a splash like a spilt spit­toon. A deep pool of anx­ious sweat had welled up in the small of my back in just thirty sec­onds of pro­ce­dure.

There is cause for some mi­nor cel­e­bra­tion when the re­sults show that I am in the early stages of the dis­ease. A cel­e­bra­tion fit for a For­mula One rac­ing driver whose clair­voy­ant has just told him that rather than fa­tally crash­ing in lap three as pre­vi­ously thought, he would now crash in lap twenty-five.

So I was off to a five-month course of chemo­ther­apy as an out­pa­tient at the Royal Mel­bourne Hospi­tal. A toxic cock­tail of five drugs in­jected in se­ries through an in­tra­venous drip. Too much of any one would kill me.

The first ses­sion was rel­a­tively easy. I didn’t even feel bil­ious and it looked for a time like this would be a walk in the park. Next time there was some dis­com­fort, but it was man­age­able. An­other three weeks later, when the tap into the vein was opened for the green laser-like Vin­cristine, a pun­gent syn­thetic com­bi­na­tion of pineap­ple, nail pol­ish and burn­ing plas­tic jolted the ol­fac­to­ries into trig­ger­ing a pro­jec­tile vomit. Things got pro­gres­sively worse and my hair fell out. The week af­ter ther­apy was re­cov­ery, fol­lowed by a good week, but the third week was one of dreaded an­tic­i­pa­tion. In those days ter­mi­nal pa­tients of­ten elected not to have chemo­ther­apy at all, be­cause qual­ity time was so brief com­pared with the hor­ror.

Fi­nally the hospi­tal staff con­grat­u­lated me and for­mally pro­nounced me in re­mis­sion.

There were still no guar­an­tees, but there was hope. And hope cre­ates en­deav­our, which cre­ates life.

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