Tuesday, 16 October 2012

Not enough words.

‘Eh up, this must be bad,’ I said, as my clinical nurse specialist, head oncologist (that’s the Curly Professor, longtime blog readers) and his new registrar walked into the consultation room all together, like my very own three horsemen of a soon-to-be-revealed apocalypse. You see, after you’ve been at this cancer stuff for a while, you know the consultation-room drill: one registrar = good news; registrar + nurse = something to explain, but nothing to worry about; whole team together = DANGER.

And, if we delve into more complicated arithmetic, the sum of: whole team + clipboards + pasted-on smiles + prior waiting-room encounter with tilty-headed nurse (- prior waiting-room encounter with cheery, winking nurse) + a call the day before to hastily arrange said appointment (- a call the day before to say the scans looked fine) = pure, frantic, disastrous, spontaneous combustion. Which is exactly the kind of reaction that would have taken place, had the Curly Professor not met my cynical greeting with an intriguing: ‘Well, yes, it’s bad. But also, it’s good.’

And therein lies another thing you learn once you’re a seasoned pro of The Bullshit (a Bullshitter?): there just aren’t enough words to describe it all. ‘Bad’, for example, could mean anything from ‘you have cancer, but we can get rid of it’ to ‘I’m afraid we’ve run out of options’. Thus ‘good’ could be the ‘we’ve got rid of it’ or the ‘not to worry; there’s something else we could try’. And then, of course, of all the Not Enough Words, those available are either pitifully inadequate (chemotherapy isn’t quite the spa treatment it sounds) or worryingly onomatapeic – like the Gamma Knife I may soon be having. Back in the consultation room, then…

‘Lisa, there are a number of new tumours in your brain.’ 
He doesn’t beat around the bush, ol’ CP; one of the myriad reasons I love him so. ‘But they’re very small, so I can sort them,’ he said almost cockily, miming the shape of a Malteser, and interrupting the formation of an enormous ‘FUCK’ in the mouths of both me and my husband.
‘Honestly. They won’t be a problem. Perfectly treatable.’ (This is genuinely how he speaks. Unconventional, perhaps, but it’s a method that instils so much confidence in you that, were he to have a LinkedIn profile, I’d happily endorse him for the role of God.)
‘They can each be zapped in a matter of 20 minutes.’
P and I stared back as though he’d just proclaimed, ‘Now watch, as I make this clinical nurse disappear!’

‘Hang on, hang on,’ I said, needing to take this back to the beginning, recalling the location of my first brain tumour, in the meningeal layer protecting my now-frazzled noggin. ‘Are they in the brain, or on it?’
‘You said there were a few. What’s a few?’
‘And where exactly?’
‘Three are in the cerebellum, the other’s in the parietal lobe.’
‘Do you know where those parts are?’
‘Well, I saw that thing the other night on…’ I stopped myself before admitting to having watched Channel 4’s calamitous Drugs Live. ‘No, not really.’
‘I’ll write this all down for you,’ offered the registrar.
‘The cerebellum deals with balance; the parietal lobe with language,’ CP continued.
‘Have you had any problems with your balance?’
‘Well, I dunno really. I s’pose I’m always losing my balance. Even before the cancer.’
‘Right, well just be on the lookout for anything new.’
‘Okay. And the meningeal tumour?’
‘Exactly as it was. Still insignificant.’
There we go again. Insignificant. ‘Insignificant’ is the clinical term for the thing that shrank my prognosis from ‘three to four years’ to ‘more likely just months’; the thing that – thank goodness – has since been shrunk to the size of a Toffee Penny, and yet nonetheless frightens the very crap out of me every time I have even the slightest inkling of a headache; and the thing, funnily enough, that I was convinced had begun to grow again over these last few weeks. I’d steeled myself for it. I’d repeatedly run through the conversation in my head. I knew how this appointment was going to go. I’d even practised P in the likely list of treatment options available to us.

‘So how did the others…?’ I looked at P. His stunned, startled eyes were still stuck on the plurality of the ‘brain tumours’ revelation. ‘How did they even GET there?’ I imagined some kind of evil night-time sidekick of the tooth fairy, who, having been usurped by the Curly Professor’s conjuring of a once-sizeable meningeal tumour into the final remnant of a Quality Street tin, cruelly sought revenge by stuffing further confectionery into the gaps in my brain where ‘not falling over’, ‘walking in heels’ and ‘speaking French’ ought to be.
‘I’d expect through your neck,’ he mused, ‘Or via the disease in your skull. But that’s not important. What’s important is that they can be dealt with.’
P and I answered at the same time: he with ‘When?’; me with ‘And what about the other scans?’
‘Well,’ he said, casually folding his arms as he rested his back against the wall of the treatment bed on which he sat. ‘There’s good news and bad news on each of those fronts...’

At this point, I remember being more concerned by the lack of adjectives at CP’s disposal than the nature of the news. All these hopelessly clear-cut opposites to describe such an inexact science; it’s a wonder doctors can adequately explain what’s going on to their patients, let alone we poor buggers try to understand it. Surely the single accurate term in the entire sodding cancer field is that of ‘shadows’ on scans. The whole damn thing’s a ruddy great shadow, fercryingoutloud. There’s neither good news nor bad news. Neither black nor white. No perfectly all clear, nor put-a-date-on-it terminal. That’s what makes the whole thing so ruddy difficult to get a handle on; never mind explain to anyone else.

In which case, the best I can do is tell you that the ‘good news’ lies in the treatability of my brain tumours; the ‘bad news’ being that the correct treatment – the aforementioned Gamma Knife (sounds worse than it is) – is only available privately at the Cromwell hospital, and thus hangs on my local PCT signing off on funding. Which they of course will: I mean, come on – have you ever messed with an angry Midlander with limited time and a leopard-print walking stick? Besides, CP’s so convinced that he’ll get me a positive answer that he’s insisted (okay, recommended) that I squeeze in a holiday in order to stop me fretting about it. (Yes, P and I utterly worship him. And yes, we’re off to Malta this weekend.)

As for the good/bad where my bones are concerned, then (cue boring bit), there’s neither an enormously worrying difference in recent like-for-like scans nor a spike in my tumour markers (read: good). But (ah, where would we be without a ‘but’, eh?) the increased pain in my hips suggests that The Bullshit might be preparing to rev its engines again: hence the need for a ‘quick blast’ of chemo to sawht it aaht, pub-fight-style (read: bad). ‘Quick blast’ being the Curly Professor’s words, of course. ‘Two three-week sessions of the shit stuff over a life-pausingly monotonous six weeks,’ being mine. But hey, one man’s gold is another man’s getting smacked in the face with a water balloon full of cat piss, innit? And, as I dare say a fair few of you know yourselves, that’s just typical of the kind of terrain The Bullshit forces you to negotiate.

The contradictions get my goat as much as the definitions. Like being entirely convinced that there was a recurrence of the existing tumour in my brain, yet so heart-stoppingly shocked to hear that the problems were in fact brand new. Feeling so pissed off that my lovely, fun-filled treatment break is almost over, yet still ready for the next stage of the scrap. And then the absolute devastation of having one (nope, four) more motherchuffing, futnucking tumours to contend with – yet completely, self-assuredly, almost smugly confident that my curly-haired hero will save the day with his Bullshit-busting – if somewhat inadequately named – treatment plan.

It’s a bit of an odd gripe, I know. You might think that a bunch of contradictions, a load of opposites and a difficulty to find the right word might seem like daft things to worry about in circumstances like this. And you’d be right. They are daft. It’s just that, with so much new information to take in – right at the moment at which I hadn’t expected to hear any – it’s disconcertingly difficult to figure out how I honestly feel about all the good, the bad and the… y’know, the other stuff.