World Cancer Day: 'I told my wife, I love you so much I got sympathy cancer'
On World Cancer Day, writer John Keogh recounts how he was diagnosed with the disease at 46 - just months into his wife's treatment for breast cancer
At 15 minutes past midnight, Laura Malay carries the red dragon into the room and unleashes it on the woman lying in the bed. There will be little mercy.
Laura is a specialist oncology nurse, a pleasant motherly redhead who claims to have Irish roots, like every other American I've ever met. Though Laura's case is stronger than most, and she has a photo album to prove it - memories of a family trip to Ireland, including pictures of the ancestral headstone in a graveyard in Kerry.
The red dragon that Laura carries is a bag of doxorubicin. It's a chemotherapy drug that gets its nickname from its colour, and from its notoriously harsh effects on the body. Other nicknames include "the red devil" and, slightly more worrying, "the red death".
The room is a hospital room on the 10th floor of New Hanover Regional Medical Center in Wilmington, North Carolina, not far from where I used to live before moving back to Ireland last February. It's October now and I'm back for a visit, though it's anything but a holiday.
The 10th floor is the cancer floor, and the woman lying in the bed is my wife. It wasn't supposed to be like this.
We had plans.
In February of 2015 I moved back to Thurles, Co Tipperary after five years in America. My wife, Tracy, is American, and for a while after we married it made more sense to live there. But I had health issues, and we always knew that one day we'd have to come back. Without health insurance, long-term treatment in the US was out of the question.
Tracy stayed behind to tie up the loose ends of our old life - giving her notice at work, getting rid of the house, selling the car, giving away most of what we'd owned.
After that there was just one thing to do before she left to come join me - she needed to have surgery to remove a thyroid tumour. We were obviously concerned but all indications suggested it was really nothing to worry about. And it wasn't. The tumour was benign, and Tracy was good to go. Except…
Except she'd had a CAT scan prior to surgery, and something else had shown up - a mass in her right breast. Her doctor said it was probably nothing, but a mammogram was ordered.
The biopsy took place on a Friday, and it was a very long weekend while we waited for the results on Monday. But despite the anxiety, we were fairly confident that everything would be fine. Many times over that long weekend, Tracy said, "I really think this is going to be nothing."
Then the doctor called on Monday - and it was something. Exactly one week before she was due to finally move to Ireland, Tracy was diagnosed with triple negative breast cancer, a particularly aggressive form of the disease. Chemo and a double mastectomy was the only option. She is only 45 - a year younger than me.
Unspeakably devastating news, made all the worse by the fact that Tracy would now have to remain in the US for treatment. She was stuck there and I was stuck here, unable to go back, at least not for any length of time.
But my health was stable enough for a short visit to be there when treatment began.
And that's where Laura comes in. I stay with Tracy until she's through her first treatment, and despite the fact that she's unwell, we make the most of the short time we have together. We go to the beach, we go to the movies, we go to dinner. Making memories we hope will last until we see each other again. Whenever that might be.
I return to Ireland at the end of October, and I promise to be back for Christmas. But I'm only home a few days when I start to feel under the weather. Constantly exhausted, breathless when climbing the stairs. And out of nowhere, chest pains.
Within an hour I'm in A&E at Tallaght Hospital, where I learn that the reason for my symptoms is severe anaemia. Urgent blood transfusions are called for.
After several invasive and undignified procedures (never believe them when they say that three colonoscopies in a week is "not that bad"), a CAT scan reveals a mass in my colon. The doctors are hopeful it's nothing suspicious, but a biopsy is ordered.
Like Tracy's, my biopsy is on a Friday, and it's a long weekend while we wait for results. But again, despite the fear, we can't help but think, "This is really going to be nothing." If only because both of us having cancer at the same time would be utterly ludicrous.
Then the doctor comes around - and despite our finest logic, it's something. It's cancer. Plasmablastic lymphoma, a rare and aggressive form of non-Hodgkin's. And I learn within a few days that it's already at stage 4. As Christopher Hitchens said about his own terminal cancer, "The thing about stage 4 is, there's no stage 5."
My reaction to this news is strange, though. Where Tracy's diagnosis had left me devastated, feeling like my own heart had been ripped out and our life torn to pieces, this just leaves me numb. Cold. Distant from the thing, as if it can't possibly be happening. That it's unreal, that somehow someone is playing a great big cosmic joke.
My wife and I have cancer? At the same time? At the one time in our lives when we can't be together to help each other through it? That's surely a joke. And joking about it is often the only thing that gets us through, a dark game of one-upmanship, our dread played out as a contest.
"My cancer is worse than yours." "I don't think so. Mine is a billion times rarer." "Chemo is sending me into early menopause." "Yeah, well my beard fell out." "Poor thing. Try being a woman with no hair." "My doctor told me I only have a 50/50 chance." "So did mine. Join the club." "I'm stage 4, I beat you by one. I win!" "Whatever." "Don't be mad. I love you so much I got sympathy cancer." "Please…"
Of course that can only work for so long. Then the breakdowns come. The tears, the anger, the panic, the utter despair. The long lonely nights apart when the terror of it all crashes down on our heads - the overwhelming fear that our lives have been irreparably shattered and we'll never be able to put them back together.
As I write I'm still in Tallaght Hospital, going on three months now. The same dragon that was set loose on my wife now hangs over my head on a drip pole, bleeding into my arm, doing its great and terrible thing. Mine is unleashed every 21 days by a wonderful specialist haematology nurse named Roisin Gill. Not a redhead, but 100pc pure Irish. No photo album needed.
Tracy, meanwhile, continues her treatment at home in the US. The new plan is that she will move here in April when she finishes, though in truth it can be hard to be hopeful about that. It's not easy to hope, to plan, and to dream when your dreams have already been crushed in the cruellest of ways. And when the harsh reality is that we don't know if we have a future at all, let alone a future together.
Yet we do hope. A desperate hope, perhaps, a hope that frequently sounds like a cry for just one more chance, despite the odds. But hope all the same. It just wasn't supposed to be like this.