great expectations

There’s an envelope with a Birmingham postmark on the mat.  I can just make out through the address window, where the letter inside has been folded, the word ‘latipsoh’.  Quicker than Hercule Poirot can say “little grey cells” I deduce from the two clues – postmark and ‘hospital’ backwards – that this is the letter I’ve been hoping for from the Birmingham voice clinic.  Unless it is some cruel prank from a backwards letter writer whom I may have offended in a previous life.

Sure enough, they have offered me an appointment in August.  This is sooner than I expected, just 3 months from when I last saw Mr ENT.  My expectations of this encounter are high – but it has its risks.  Suppose it doesn’t work?

I mention to people who ask, that I just want a chance to talk to someone about the voice.  If they can do something, then great – if not at least I’ll know and I can stop banging on about it.  I say this in a relaxed, laid back way, which suggests I’m comfortable with either outcome.  The truth however, is quite the opposite.

If they tell me that there is nothing that can be done and this is as good as it gets, then I am going to be disappointed.  For the past three years I have let myself believe that – with a bit of luck – I can go back to the way things were, before the lung resection.  That I can just walk up to the microphone and carry on from where I left off – as if the intervening time was no more than the usual 20 minute break between sets.  But the experience of trying to get back on the bike should have spelt out clearly in capital letters that THINGS ARE NEVER GOING TO BE THE SAME AGAIN. Doh!

I met up with an old friend a few weeks ago and she asked how I spend my time now that I’m retired; what do I do each day?  I recited a litany of things  – some creative, others mundane – that I engage with.   Or rather, could engage with if I got my act together.  It occurs to me much later, that what really takes up my time is simply surviving.  That is the 9.00 to 5.00 job, the rest is just frippery.  Not a career move I’d have come up with by choice, but one that I now have to do to the best of my ability.  No one wants to become an ex-cancer survivor.

Anyone who’s been through this awful disease will tell you that surviving is hard work. More often than not, we look fine on the outside, a picture of health – no hint of what lies beneath the surface – a chaos of sutured organs held together by the medical equivalent of duct tape and zip ties.  Some of us will appear to breeze through this on autopilot, others will struggle, burdened down with discomfort and fear, like a latter-day Pilgrim¹.

And now I sound like Miss Haversham²; the naïve sense of optimism and good fortune that has got me thus far, replaced by brooding melancholy and bitterness with all my clocks stuck at 4.45pm³.  Although to be fair, I have not let myself go in the hair and clothes department to the same extent as Miss H did.  OK – so perhaps my jeans are now M&S ‘relaxed fit’ rather than Levi red tabs – but I am not sitting around in a 30-year-old tatty white wedding dress, wearing only one shoe watching the wedding cake gradually disintegrate; (plot spoiler alert – apologies if you’ve not read Great Expectations).

Annie has, on her iPhone, a recording I made over 20 years ago with my friend Alan.  I’m singing and Alan’s playing a Steinway grand piano.  Though I say myself – it does sound pretty good.  She wants to play it at the clinic in Birmingham, and say something like ‘make him sound like that again’.  This though, is an expectation just a little too great.

I know Annie is concerned that I am dwelling more on what I can’t do, rather than what I can do; she’s right of course and so I take advantage of the sunshine/lack of rain to help her in the garden.  She points out that the peonies we’ve just planted need some water.  I’m puzzled; we’ve not planted peonies.  She tries again; “You know – primroses”.  Another blank.  I catch her mumbling – she’s working her way through a song, like someone who can only read by saying the words out loud.  “Petunias!”  Ah petunias.  They do indeed need watering.

This happens every time that she forgets the name of this brightly coloured annual, much favoured for summer bedding displays and hanging baskets.  I ask how she arrived at the correct name.  “That old song – you know”.  I do now.  Like an old decrepit jukebox, the synapses in my brain eventually make the connection, pick out a recording by Tommy Cooper from 1961 and plonk it down on the turntable.  The crucial line is “Mother’s just planted Petunias”.  And now it’s in my head and I can’t get rid of it.  Which is why, with a breathtaking lack of good taste, we find ourselves sitting in the garden shed on Father’s Day singing “Don’t jump off the roof Dad.”  I wonder if they know it in Birmingham.

¹ for example, The Pilgrim’s Progress by John Bunyan, 1678
² Great Expectations by Charles Dickens, 1860-61
³ this is the moment I went under the lung surgeon’s knife (25th July 2010)
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a bloody nuisance

I hate warfarin.  I know… what’s warfarin ever done to me to provoke such a reaction?  Hate is such an extreme emotion.  Some psychologists would have us believe that Hate is the same as Love.  And there are plenty of tales where the hero/heroine hates the heroine/hero to begin with, only to fall in love later.

OK – so I’m unlikely to fall in love with warfarin at some future date as I gaze at the packet of pills across the counter at my local pharmacy.  Perhaps hate is too strong.  But I dislike it utterly and completely.  It is a bloody nuisance.  And I use that adjective, not as an expletive, but in its proper vascular sense.

I’m at the GP’s surgery for a blood test.  My INR¹ has increased somewhat from its regular therapeutic value so I’m now having blood tests every 2 weeks instead of monthly.  The nurse cannot find a vein in either arm.  She stabs me first in the left; “sharp scratch” – yeah right.  The needle is stuck.  She withdraws it.  Nothing; not a squirt.  She tries the right.  Same thing.  She tries my left hand; there are lots of nerves in the hand and she manages to find one, along with the vein.  I try not to wince but she notices.  She then explains that they’ll soon have a new machine to take INR samples from a fingertip much like the test for diabetes.

That’s the ‘nuisance’ part.  The ‘bloody’ part is more insidious.

I’ve not been able to get out much on my bike (at all, if truth be known) over the winter.  So I built a bike out of bits from fleabay and other Internet auction sites, to attach to a turbo trainer so that I could pedal away in the comfort of my own home.  I made it into a racing bike rather than a ‘sit-up and beg’ by using drop handlebars.  This was done in a vain attempt to recapture my lost youth.  In fact I went a bit further back in time, and ended up using shallow drops in the style of the original Victorian/Edwardian ‘scorchers’, because I’m not as supple as I used to be.

a scorcher

a scorcher

This style of handlebar is very fashionable right now with young urban cyclists.

me and the lads, Preston Park, circa 1906

me and the lads, circa 1906

The saddle is higher than the bars which means a good deal of my upper body weight rests on my hands.  After a few test rides, my body begins to accept this radical change in posture and I no longer ache around my neck and shoulders.  But I notice bruising on my hands and arms.  In fact after one such ride a bruise forms on my left arm from my wrist to very near my elbow.  My forearm is purple and yellow.   I was wearing a wristwatch at the time and I assume the watch, or rather the strap, to be significant – perhaps trapping any blood flow and forcing it to the surface?   If warfarin can do this to the skin, what on earth can it do deep inside?

I know the answer to this one.  Two years ago, in my early days with warfarin, I had internal bleeding to the extent that I was forced to undergo the most embarrassing and painful examination known to man (any man, that is)².  The consensus was that it was caused either by warfarin or cancer of the bladder.  So I had a cystoscopy to rule out cancer.  Thankfully.

The surgery rings around teatime with my latest results.  This is unusual; it’s normally the day after the blood test.  My INR is 5.00.  This means my blood now takes roughly 5 times longer to clot than that of someone who’s not taking the stuff.  Good for preventing strokes, but not so good if I have to shave.  So I have to miss two doses (i.e. the next two days) and then reduce the dose and have further blood tests every week until my INR drops back down.

A few weeks ago I couldn’t remember if I’d taken a dose or not.  I usually take it around the same time each day – 5.00pm.  But on this occasion I just couldn’t remember.  Later that night I assumed I hadn’t, so I took one just in case.  This is not a good idea.  Better to miss a dose than take too much.  Annie reminds me that this is not the first time I’ve done this.  So now I have to keep a book and write down each time I take a pill and the dose.  Which is what is known, in medical terms, as a bloody nuisance.

¹ INR; international normalised ratio.  The rate at which blood clots when on warfarin compared with the rate for a non-warfarin person.  The higher the number, the longer it takes to clot – which is a bad thing.
² See a man’s gotta do what a man’s gotta do October 12th 2011
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I went to the doctor and the doctor said …

…. yeah but no but yeah but no but …….

What he actually said was; “I’ve think we’re at the limit of what we can do here.  I have no problem referring you to Birmingham.  I’d be interested to see what they can do.”

So – Mr ENT is going to refer me to another ENT department – one that specializes in treating professional singers.  He is surprisingly (to me) supportive of my wish for a singing voice again – or even the chance to discuss the possibilities of further treatment (or not).  My speaking voice has improved dramatically over the past few weeks – perhaps all that Australian sunshine made a difference.  My singing voice is lagging behind though – there is some improvement but it’s slight compared with speaking.

Mr ENT has a new camera but it has a few teething problems.  I was supposed to be at this clinic before going to Australia (seems a long time ago now…) but they cancelled owing to ‘equipment malfunction’.  There’s now a technician sitting outside the consulting room door – he comes in, makes a few adjustments and leaves.  We start – and stop again.  Enter technician, twiddle, twiddle, and we’re good to go again.

The old camera was pushed up my nose – not altogether unpleasant once the numbing effect of the banana-flavoured sedative had taken effect – but this one goes straight in the front door.  I feel it probing the back of my throat (no sedative this time).  This new camera (or rather, camera system – there’s a new monitor as well) allows recording and playback of the images and after having a good poke around, Mr ENT invites me to watch the screen.  My left vocal cord looks white and fat – and moribund – like a contented maggot asleep on a sunbed.  (I know that might sound gross, but that’s what it looks like.)  As I utter a stream of ‘Es’ the right cord wriggles over to join it.  They meet and slam shut, pretty effectively, all things considered.  The ‘posterior chink’¹ still refuses to close, but this is something that Birmingham might be able to sort out.

I had expected a battle over the referral because I thought there might be a little professional pride at stake (there was none) and because it might seem a trivial request in the grand scheme of things.  Back in 2011 when I was first trying to juggle the conflicting priorities of the cardiology unit and the ENT unit, a cardiologist had commented that restoring my voice was a “lifestyle thing”.  Meaning that it was not life-threatening and therefore not important.  It did not command the respect, resources and time that sorting out the heart did.  This may be true – but only to a point.  Having no voice is misery.  Full stop.  Full glottal stop.

But Mr ENT understands totally and so – we wait and see.  It will probably take months, but that’s OK.  It’s not cancer.

Which by happenstance is what this morning’s post from Oxford suggests.  It’s my copy of a letter to my GP.  It doesn’t matter what people actually say – the message always carries more weight when it’s set down in back and white.  Whatever the news.

…..Since his last review here six months ago he has been very well and reports no constitutional symptoms of note.  His appetite is good and he reports no weight loss and his main issue is that his exercise tolerance has been limited by his cardiac issues and his pneumonitis post-radiotherapy.
He had an up-to-date scan on 17th April 2013 which was compared with his October imaging.  This shows no evidence of any recurrence of his disease.  This is most pleasing.  I have informed Mr Spratley of the results and that we would like to see him back in six month’s time with an up-to-date CT of thorax, abdomen and pelvis for review…..  

I love ‘This is most pleasing’ – as if Jane Austen had written to my GP: ‘Dear Dr D’Arcy, we find the absence of disease most pleasing.’

I feel like I’ve gone back in time to 2008 (or possibly 1808).  I was fully recovered from the bowel resection, the liver resection, chemotherapy and the removal of the awful ileostomy bag.  We took our bikes to Spain and France that summer and assumed that we would ride off into the sunset.  And when I wasn’t riding my bike, I was singing in a band.  

Of course at that stage I was not deficient in the breathing department to the tune of one lung.  And my heart was far from dickey.  (Oh no – sounds like a song title coming up…).  We didn’t know, couldn’t know, that the sunset would turn out to be a cliff.

But – in spite of the ‘limited exercise tolerance’ I feel better than I have done in ages; both physically and mentally.  It seems like progress.  Which is weird when you think about it – that going back in time is progress?

¹ See Posterior Chink, April 23rd 2012
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If the nurse comes in … part 3

I’m getting stressed – every single car park, and there are five at the Churchill in Oxford, is full.  Not just full, cars are queuing, backed up round the ring road.  We do a circuit but it’s hopeless.  I’ve never seen it like this before.  In the end I join others and park on the grass verge.  If I get a ticket or a wheel clamp, then so be it.  Today my mind is on other things.

It’s usually a long wait.  We pass the time either in companionable sniggering or silence, lost in our own thoughts.  Today my mind has gone walkabout and taken me to ‘aging’.  I feel I’ve aged – what? – about 7 years since I first got sucked into CancerWorld.  Which is uncanny given it’s been 7-odd years ….

What I mean is that in my head I am still 58.  And fit and healthy.  While there are advantages to this state of mind – positive thinking and all that – there is a downside.  I have a tendency to make plans that my body has no intention of going along with.  In fact it would probably run a mile at the very thought of some schemes that I dream up.  If it could run a mile, that is.  I’m planning a trip to the Pyrenees in September.  With bike.  Three flights of stairs is about my limit right now – so just what makes me think I can get up a mountain, I have no idea.  Although I did climb a 200 step tower (or 222 steps as a 9-year old pointed out as he raced past) in the Australian Bush – at 35°C – with only 3 stops to catch my breath.

We’ve just laid a new wooden floor in our sitting room.  I say we.   I give the orders and helpfully point out where they’re going wrong, while Annie and a builder friend do the easy bit.  But prior to this I decided it would be a good idea to bury TV cables, the phone cable and sundry other cables, under the old floor before laying the new one, in the interests of neatness.   It took me all day to do something that should really have taken no more than a couple of hours at best.   I could hardly walk the next day – all the squatting and levering away at 40-year old nails, stuck in 40-year old joists having reduced my quads to jelly.

I can’t decide if this is simply old age creeping up (Doctor: “You’re not as young as you used to be”), or if it’s the effect of cancer treatment.  Given that in my head at least, I’m living 7 years in the past, I like to think that it’s simply the cancer treatment.  I’m not ready for the alternative.  Besides – old age is no place for sissies¹.

I lean across to Annie and say, “ I’m feeling a bit past it”.  “Past it? – You’ve never even been level with it.”  She laughs and repeats herself just to make sure I hear.

People who know my wife will testify that her sense of humour is straightforward and uncomplicated.  While she enjoys the sophisticated wordplay of people like Eddie Izzard and Bill Bailey, her favourite joke – the one guaranteed to have her rolling on the floor, tears streaming, her children a picture of silent distain and embarrassment as if to say “are we really related to this woman?” – is ….

…. in fact the unfunniest, most miserable person in the world could tell this joke and she’d be in convulsions – like in From Russia with Love when Rosa Klebb is interrogating James Bond;

Rosa Klebb “Now Mr Bond, I will ask you one more time – what’s brown and sticky?” 

James Bond “I tell you I don’t know”  

Rosa Klebb “ A stick.  Ha ha ha ha ha ha ha”      

James Bond “Damn you…”

At this point the audience gasp in horror at James Bond’s inability to deliver the punch-line, as they realise his future as a straight man is clearly over.  But Annie is rolling in the aisles, holding her sides…..

…… where was I?

Of all the jokes in all the world – including those in Christmas Crackers yet to be pulled – my wife regards the ‘brown stick’ joke as the apotheosis of comedy.  This is the daddy – nothing can surpass it.  Perhaps her vocation – teaching Maths – is partly to blame.  Most teachers I know are a bit odd.

She caused a scene recently in the Art Gallery of Western Australia in Perth when an exhibit caught her eye.  Grabbing my arm, pulling me towards it, all the while pointing, pointing – stabbing the air in excitement as if she couldn’t quite believe such a thing possible.  Her favourite joke – for years nothing more than a mental construct – has suddenly taken material form.

what's brown and sticky?

what’s brown and sticky?

The only other thing I can imagine having a similar effect is James Taylor calling her on stage while he sings just for her.  I get a glimpse of my wife as a teenager.  And realise that, perhaps, this is what art galleries are for.

She’s not unsympathetic to my sense of years passing – but she does come down on the side of the doctor; “You’re not as young as you used to be.”  I tell her that I feel better than I have done in ages – it’s just the sudden exhaustion and tiredness that comes over me when I do anything physical that I find frustrating – and confusing.  And I explain about the Pyrenees – what was I thinking?  She smiles;  “We can always look at them from the bottom.”

She then brings me back to the here and now with a bump; “you could be dead. Mr S (lung surgeon) could have left you to die.  When he was deciding to operate or not – I saw it cross his mind.”  She delivers this brutal recollection in a matter of fact way, as if we’d been talking about pruning the roses.  “I can say this now – I couldn’t then.”

And she’s right of course – I’d forgotten.  We’d sat in the surgeon’s office on a hot stuffy day while he made up his mind; he explained that because of the location of the tumour it was probably too difficult to remove and I had to argue that I was willing to take the risk.  He even phoned a friend for a second opinion.

She rests her hand on my arm; “even if you have lie on the sofa for half a day, it’s still better than the alternative”.  I ponder on this until my name is called.

Which it is – and much sooner than expected.  No checking my weight first.  Odd.  It’s a young doctor and there’s no nurse.  As we walk down the corridor to the consulting room I’m thinking this must be good, but I can’t catch Annie’s eye.  He gets to the point straightaway; “there’s no sign of the disease on your scan”.  The hot spot in my abdomen appears to be shrinking.  Still no clear idea what it is, but it’s going the right way.  We have a very brief chat about my general health and then I’m on my way, with an appointment for another scan in October.  That must be the shortest consultation ever.  On the way out Annie grabs my arm, “I’m clicking my heels..” ²

As we walk to the car, the ring road is still backed up.  No ticket or clamp, just a dirty look from someone queuing to get into a car park.  Annie doesn’t care; “another 6 months of freedom, yay”.  It’s almost 3 years to the day since we discovered the tumour in my lung.  And I’m still alive.  Yay.

¹Attributed to Bette Davis, but quoted by many others.
² See if the nurse comes in we’re doomed, part 2, October 19th 2012.
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and it’s goodnight from Oz

People keep asking us “what single thing do you like most”.  Our answers are the same; “waking up to a blue sky”.  I don’t think we could ever tire of that.

We take lots of photos; lots and lots.  Here’s an arty one that Annie took of some kangaroos.

arty kangaroos

arty kangaroos

And here’s one I took from the top of a research tower out in the bush.  The country is flat for hundreds of miles.

the bush from 200 feet

the bush from 200 feet (quite a lot of bushes, actually)

Mary and Glyn have three children and six grandchildren so Annie has met her six great-nieces and great-nephews for the first time (ranging in age from 1 to 11years).  Being a ‘great’ auntie makes her sound old; but one conversation confirms just how ancient we really are.  Her 11-year-old great-niece is impressed by Annie’s array of Apple technologies (iPad, iPhone, MacBook); Annie mentions that she also has an iPod Nano at home.  The girl asks what an iPad Nano is; her 9-year-old brother explains (with a serious look on his face); “it’s what they had in the olden days before iPod touch.”

I’ve felt really well here; just one nocturnal visit from the Gods of Arrhythmia and not a single crackle from my left lung.  My voice is strong.  The eruptions on my forehead have all gone – my skin is as smooth as a really smooth thing and I’ve not needed the heavy-duty ointment that my GP prescribed.  Ladies may be interested to know that the skin on Annie’s elbows is also smooth – prior to coming here you could have filed your way out of a prison cell with them.  She attributes this to the climate – specifically the lack of central heating.

We’re both dreading going back to the cold.  Although, as Einstein might have said, had he turned his hand to thinking about climate rather than time, temperature is relative.  We’re bemused by slogans we see in the Perth shops; ‘say yay to scarf weather’, ‘say yay to coat weather’.  It seems as soon as the temperature drops below 20°C people put on their hats and gloves and coats.  It’s hard to get my head round the fact that it’s Autumn here – soon to be Winter.  It’s still in the 30s during the day, although it cools in the evening.

It’s not just the cold that makes us apprehensive; it’s the return to CancerWorld.  We tend to treat holidays like commando raids – get in, do what we have to do and get out again with the minimum of casualties.  So we fit them in between major hospital appointments and hope that nothing goes wrong while we’re away.

I’m due a scan as soon as we get back to check on the progress (or not) of this ‘hot spot’ in my abdomen.  We’ve both managed to park it for a few weeks, but now we have to think about it again.  That’s just the way it is with cancer; you can chug along for a while as happy as Larry (or perhaps Thomas the Tank Engine, as I’m in a railway mood) and then every so often, you bump into the Fat Controller and head off to the engine shed for a spell of whatever happens in engine sheds.

Travel in general, and flying in particular, can do strange things to the human body.  The cabin in an aircraft is pressurized to around 8000 feet – about the same height above sea level as the Grand Canyon (which caused us so much trouble last year¹).  It’s a compromise – if the cabin pressure at 40,000 feet was the same as that at sea-level, then the plane would have to be much stronger (and therefore heavier) and would probably never get off the ground.

At 8000 feet gases in the body expand by around 20%.  Especially those in the digestive system.  So travel clearly not only broadens the mind – it also broadens the waistline.  It also affects gases in our blood stream and organs.  Last year, on our return from America, Annie’s left leg became so swollen that she ended up with a visit to the local hospital.  Which is why we purchased a pair of those rather unflattering flight stockings prior to this trip.

At around 3.00pm on Sunday 7th April we’re paddling once more in the Indian Ocean, three weeks to the day – to the hour – since we first did this.  In a few hours time we’ll leave for home.  Annie asks if we should go into hiding now or on the way to the airport.  It makes me wonder what would happen if we just stayed.  I could sit in the sun, looking at the ocean as I am just now; I guess my pension would still be paid every month (although I would forgo the winter heating allowance); BUT…..  (and it’s a very big but)….  I’d have to pay my own medical bills.  And cancer doesn’t come cheap.  Thank goodness for the NHS.  (I assume we still have an NHS?)

I’m reminded of the novel, So much for that by Lionel Shriver.  Set in America, it tells the story of a man who dreams of retiring to an island in the sun.  It’s his big passion, the one thing that keeps him going in a job he hates.  But his wife has cancer.  And it’s not too long before their health insurance is unable to cover any more treatment and they are forced to dip into their ‘island in the sun’ savings. Each chapter starts with a diminishing bank statement.  I won’t spoil the plot, other than to say it’s a good read and spells out the difficult choices that those with cancer – or rather – their carers often have to make.  (I think you’ll like the ending though).

We’ve really liked Australia (or the small part of it that we’ve seen).  Perhaps more so than we expected to.  Here’s Perth from King’s Park just after dusk.  It’s a popular place – people get married up here, party or simply take a picnic and watch the sun go down on their city.

Perth skyline from KIng's Park

Perth skyline from King’s Park

We’ve loved walking on deserted beaches and sitting in the bars and cafes (particularly in Fremantle) just chilling and watching the world go by.  In spite of various warnings, we’ve not come across anything that wants to eat us.  Perhaps the biggest surprise of this trip is that until now, I’ve never really known envy.

It’s not the big flash houses with their roof-top swimming pools looking out on to the ocean, or the guy in the bar singing and playing guitar in a way that I can only dream about, that is the cause of this.  It’s not Annie’s niece with her pool and out-door dining room.   Nor my brother-in-law with his Kawasaki motorcycle and Mazda MX5 sports car (OK – perhaps a bit).

What gives my tan a greenish tint is a man about my age, dressed in lycra.  I see him everyday whizzing along the ocean road in the sun on his shiny carbon road bike.  Everyday.  In the sun.  By the ocean.  Now that really does make me jealous.

1 See When Mother Earth met Father Sun, June 18th 2012
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the wizard of Oz

Friday 15th March, 3.00pm.  I’m cold.  The house is freezing, the weather’s miserable and I hear on the news that the odds on a white Easter have shortened.

Sunday 17th March, 3.00pm.  I’m warm.  I’m standing in the Indian Ocean, waves lapping round my feet.  We’ve travelled in a matter of hours, a journey that would have taken our forebears weeks or months to achieve.  This surely is Magic.  If that sounds too fanciful it is, at the very least, amazing.

us in the sun

us in the Indian Ocean

It’s about 7 on Sunday morning by the time we finally clear customs and immigration and find Annie’s sister, Mary and husband Glyn, waiting for us.  It’s an emotional reunion for the two sisters.  Outside, as we make our way to the car, it’s already warm.  The sky is blue and I’m momentarily dazzled by the unfamiliar golden orb in the sky.  The drive from the airport to their house takes us past the ocean.  Alongside the road is a paved area and it’s packed with walkers, runners and cyclists.  The M25 has nothing on this.  The more impatient roadies, with their stream-lined helmets and carbon framed bikes, clog the road.  There seems to be hundreds of them.  Is it a race?  Can’t see any numbers so just assume this is confirmation of the image we have of the Australian life style – sports mad – and living by the sea.

The houses alongside the ocean are extraordinary – enormous glass and steel structures making the most of the view.  Every single one could feature in an episode of Grand Designs.   This is what happens when Chinese industry meets Australian ore.

An hour later, we’re sitting on M&G’s front porch, shorts and tee shirts, (I did wonder if I might ever wear such things again) drinking coffee and watching an exotic bird feeding from an exotic flower.  CancerWorld seems a million miles away.

Later that day we drive a few miles up the coast to a picnic area for a barbecue.  It’s a bit like an Antipodean version of Alice in Wonderland.  A herd? (party?) (flock?) of Kangaroos play on the grass; the birds are all the wrong colour and their songs are nothing like those at home.  For us Brits brought up on books and television programmes about Australia, there is though, a familiarity about the unfamiliar.  Until we see it in the flesh.  I think about the early visitors to this place and wonder what they made of it.

There’s a special enclosure a short distance from the picnic site and the light is starting to fade as we wander along an elevated, fenced off, walkway.  Then we see it – asleep high in a tree, a Koala bear.

We’ve been in the country for less than 12 hours and we’ve had the full Australia package – a paddle in the ocean, a bbq, kangaroos and koalas.  I tell Glyn we can go home now, we’ve done it all.  “You haven’t heard the banjo frog”¹I assume this to be a wind up – frogs playing the banjo?  Or an aussie variation of the anti-banjo jokes so beloved by British musicians; e.g., definition of a banjo with perfect pitch – when you can toss it in a skip without touching the sides.  That sort of thing.  But no; as we walk back to the car I hear a  strange metallic ‘bonk’ – like the plucking of a string.  It’s not the theme from Deliverance – but it would not be out of place on Britain’s got talent.  I decide it might pay to be somewhat respectful towards this creature; it has, apparently, poisonous glands in its thighs.  Unlike their human counterparts who only inflict pain with sound.  (With apologies to banjo players everywhere).

It’s day three and I’m sitting on M&G’s front porch as I write this.  About a mile away, through a gap in the trees, I can see the Indian Ocean.  The house is a modest bungalow, surrounded by modest bungalows.  Immediately in front is a park – a playground for children, surrounded by well-manicured grass, planted with what look like well-manicured trees.  People jog or walk their dogs while others ride their bikes.  It’s clean and neat; the people are clean and neat.   There are three predominant colours in this landscape; the blue of the sky, the green of the grass and trees and the pinkish-red of the paths and roadways.  I keep thinking I’ve seen it all before and it eventually dawns on me that this could be the film set from The Truman Show.  Or how a developer – or a child – might picture their ideal town.

Like all communities there must be a darkside.  We hear what have become universal stories about young people and drugs and the latest local fear, a white van that is snatching dogs for illicit fighting.  I give Milo, M&G’s chocolate labrador, a reassuring look when I hear this.  Right now, it’s hard to imagine anything bad happening here.  It’s as if someone has lifted a corner of the artificial lawns that seem to front the new housing developments and swept it all out of sight.

I’m under the spell of this place.  The wizard has done his stuff.  If things had been different I could have been quite happy here.  What’s not to like?  I know there are downsides – it’s too hot (and getting hotter) in summer, it’s a long way from friends and family (and John Lewis says Annie) and there are things in the sea that want to eat us.  But the lifestyle appeals; we pass a hoarding advertising a new housing development; ‘surf at 7, work at 8, that’s what life’s all about’.  Annie’s youngest, Dan, currently working in Melbourne, wants to stay.  I can see why.

I can’t help thinking that the Judiciary, back in the 18th and 19th centuries got the whole transportation thing wrong.  Instead of sending the bad guys off to to Australia, they should have said “we sentence you to stay here in the cold and the rain – the rest of us are off to live in the sun”.

¹ Western Banjo Frog; Limnodynastes dorsalis
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I went to the doctor

I went to the doctor and the doctor said son, you look older than me and I’m seventy-one.¹

I read somewhere that you should not go your GP with a list of symptoms.  One or two maybe, but not a shopping list.  Hmm; if I have to pick a just a couple…

I start with the recent cardiology clinic; that won’t count as a symptom.  He takes it all very seriously – he hasn’t yet had a letter from the hospital – when he does we’ll talk again.  I also mention the idea of a pacemaker to control the arrhythmia.  He explains patiently and clearly why this won’t work in my case.  What might work is an implantable cardioverter defibrillator (ICD).  This gives an electric shock to restore a fast rate back to normal.  It’s about the size of a matchbox and fitted under the collarbone.  But only for ‘high-risk’ patients.  I know nothing about ICDs so envisage a long Google session coming up.  If this does prove to be an option, I have plenty of space to fit one.

He knows I don’t like being stuck on bisoprolol, warfarin and flecanaide, but that’s just the way it is for now.  I tell him we’re going to Australia in a few weeks (to see Annie’s sister and catch up with her youngest son, Dan), so he makes sure I have enough medication for the duration.  Tick; another thing off the list.

He’s looking at my forehead; now I can mention a symptom.  Although this is somewhat redundant as he’s beaten me to it.  So I offer a diagnosis instead: “I assume it’s hormones”.  Earlier that morning I’d been staring in the bathroom mirror at an eruption about to take place just above my left eyebrow; my own pocket-sized Vesuvius.  The last time I had stood before a bathroom mirror looking at spots was about 50 years ago.  Is this teen-age angst all over again?  I resist the temptation to give it a hand.

It’s not just my forehead; my nose is also host to an outbreak.  It’s very red – and starting to look a bit like the sort of nose a person with a drink problem might have; if you’re old enough, think W.C. Fields.

“No – it’s probably the warfarin.  We may have to take you off it, if it gets too bad”.  I explain that I’ve tried using E45 cream, but to no avail.  He prescribes a heavy-duty alternative.

I check my list; apart from the physiognomic volcanic activity, I’m looking and feeling remarkably well.  So we leave it at that for now.  I consider myself lucky to have such a good GP.

…. I went to the doctor and the doctor said, kid it was something that you ate or drank, It’s something that you did …

Luck.  I have this thing about luck.  Not superstition, but the chance happenings that can sometimes make or break our lives.  I also believe that we can make our own luck to some extent; recognising an opportunity when it comes along.

I put the fallout from lung surgery down to bad luck.  That I needed lung surgery at all was nothing to do with luck, however.  That was simply a consequence of bowel cancer cells getting into my blood stream.  Once cancer cells break through the bowel wall, their progress towards other organs is inevitable.  First stop liver, next stop lungs.  This is not some random trip – cancer cells do not get out the travel brochures and have a think about where they might like to spend the summer.  The secondary sites of specific cancers appear to be already programmed in.  Further surgery or chemotherapy or radiotherapy can stop them in their tracks or slow them down.  But it doesn’t change the nature of the beast – it’s just what they do – like some malevolent homing pigeon, they have to follow their instincts.

But once they reach their destination organ, then luck does come into play.  If my left lung was, say, the United Kingdom, then they could fetch up in the car-park at John O’Groats or the teashop at Land’s End; that is, in some distant, quiet, unspoilt part of my respiratory system.  But no – they settle for the cardiovascular equivalent of Spaghetti Junction – just off the M6 and about as far inland as you can get.  A high-rise mess of nerves, veins and arteries.

And as anyone who has driven around the M6 will know – once you start digging, chaos and disruption on a major scale are inevitable.  Which is why I find myself under the care of an ENT consultant.

And now for the good luck part.  A few months ago – I can’t remember what prompted it – I found myself staring at a blank Google page.  My fingers are poised over the keyboard and I’m wondering where to go next.  I type in ‘ENT’ and end up with a glossary of various departments up and down the country.  There’s a hospital in Birmingham that specialises in the treatment of singers with vocal palsy.  I get quite excited about this – but at the same time, can’t help thinking – why am I only just finding out about this now?  Why didn’t someone tell me earlier?

Perhaps that’s a bit unfair, although ever since the lung surgery in June 2010, I’ve been banging on about getting a singing voice back to anyone who would listen.  I saw an old friend a few weeks ago who’s recovering from serious injury after being knocked off his bike.  He needs specialist treatment and is having to research a lot of it himself; “I don’t know how we managed before the internet”.  We didn’t I guess; we just took what was on offer and got on with it.

I mention the Birmingham clinic, as an aside, to the speech therapist at a routine appointment in January.  I almost didn’t bother, the events over Christmas having overshadowed anything I might be feeling about myself – but something brought it to mind as we were finishing the appointment.  The speech therapist knew all about it – apparently they can reach parts of the voice box that most other ENT clinics can’t.  Before I can say anything, she offers to ask Mr ENT if he would refer me to the consultant concerned.

I’m apprehensive about this; will Mr ENT refer me?  It’s not a slight on his expertise – far from it – but the techniques and procedures available are simply not within his compass.  Will they agree to see me?  The clinic information mentions treatment for ‘professional singers’.  Do I qualify?  A bucket passed round in a pub after a gig is not the same as a salaried position, even if it does contain £175 in coin of the realm.  And if they do agree to see me – will they be able to do anything?

Watch this space.  It’s all a matter of luck.

… I went to the doctor and the doctor said, shucks that’s just about all, you owe me 300 bucks,                                                                                                                                              And you can call me in the morning – that is if you’re not dead…

Chorus; oh, oh, oh, I went to the doctor ….


¹ From a song by Loudon Wainwright III
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