The Little Lump on my Neck
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.