Sunday 18 August 2019

Author Emily Hourican on her first Christmas after life-changing diagnosis: 'Life is fragile, just as we're told'

This time last year, I had just started treatment for cancer and was about to endure a pretty miserable Christmas. One year on, I can't believe how well and happy I am, writes Emily Hourican

Emily Hourican at home last week with her daugher Bee, Right Emily undergoing treatment for cancer in St Luke’s Hospital, Dublin, this time last year
Emily Hourican at home last week with her daugher Bee, Right Emily undergoing treatment for cancer in St Luke’s Hospital, Dublin, this time last year
Emily Hourican at home last week with her daugher Bee. Photo: David Conachy
Emily undergoing treatment for cancer in St Luke’s Hospital, Dublin, this time last year

Emily Hourican

Happy Christmas. That's not a polite wish. It's a statement of fact. It is a happy Christmas. Whatever happens - no matter how disappointed the kids are with their Santa presents, no matter if the turkey is dry as a bone and the pudding burnt. No matter if it rains all day or rough winds blow, it is a happy Christmas. Because it isn't last Christmas.

This time last year was difficult. I had just started treatment for cancer, of the tongue base, a cancer caused by the HPV virus. By December 18 I had completed the first three of 35 sessions of radiotherapy, and the first two of six weekly drug infusions. By the time I woke up on Christmas morning, I had begun reacting to the drug, by producing huge spots all over my face. My face was sore and itchy, and I was desperately self-conscious. Worse than the spots though, I was in a state of terror, one that had gripped me from the moment I heard the diagnosis, on November 16, after what I thought would be an entirely routine examination of a small lump at the base of my tongue.

From the minute I heard the words 'tumour' and 'cancer', I was terrified. Terrified of what could happen to me, terrified of what was required to get rid of the cancer. Most of all, terrified of the impact this would have on the lives of my children, my husband and family.

That word - 'cancer' - is the start of a very strange journey. Everyone who walks that line has a different experience, but some things, I think, we carry in common. The fear. The dread. The loneliness. No matter how much those around you love you, no matter how much they are prepared to do for you, there are places you must go alone. It is, in the end, your arm the needle goes into. Your veins the drugs drip through. Your body that is subject to the knife, to the radiotherapy rays. Your self that will bear the scars, mental and physical, from that journey.

Emily undergoing treatment for cancer in St Luke’s Hospital, Dublin, this time last year
Emily undergoing treatment for cancer in St Luke’s Hospital, Dublin, this time last year

And then there is the feeling of letting everyone down. That's the one I've seen grown men crying over; the one we all get snared by. No one wants to be an invalid, no one wants to drag their family into a world of hospitals and talk of 'outcomes'. No one wants to be the portal through which the most painful realisations - of death, disease, the sheer fragility of all that's good - reach their children for the first time.

By Christmas morning last year, I had lived through five weeks of those thoughts. Those weeks, hard as they were, were a sort of phoney war, because hanging over them was the knowledge of all the weeks I had not yet lived through, where treatment got into full swing. It is, my doctors told me frankly from the start, a very tough treatment. They were right. Pretty much everything they predicted came to pass: a feeding tube up my nose, significant weight loss, third-degree burns on my neck, morphine for the pain, complete physical exhaustion, whole heaps of other things that may have been dwarfed by the enormity of the Top Traumas, but were nonetheless nasty, sore, depressing and numerous.

Christmas, last year, felt, not like an oasis from the contemplation of misery, but an interruption, because all I wanted was to carry on, and get the treatment over with. For the children's sakes, we did our best. Santa, predictably, was more generous than usual. Uncles, aunts and their grandmother were almost more generous again. We had a swim on Christmas morning (well, I didn't. I watched. I was afraid of getting a cold), and a glass of Champagne with friends. We had dinner - 14 adults, eight kids - as we always do, with plenty of chat and laughter, and through it all, I was conscious that I was mostly just going through the motions. My attention was elsewhere - focused on what lay before me, distracted by the profound misery I was trying to hide from those around me (I doubt I fooled anyone). I didn't dare, then, project forward to this Christmas, because far too much lay between the two days. I had, by then, set sail on a dark and lonely journey and the lights of home were fading behind me.

If someone, some kindly ghost of Christmas-Yet-To-Come, had shown me a picture of this day, I don't know if I could have taken it in. It would have been too bright to believe. Because the friend, a medical professional with huge experience of my kind of cancer, who told me I wouldn't even remember the bad times by now, was right, although I didn't believe her... It is only when I sit down to write this, that I really recall what happened, and how tough it was.

In week two of her Cancer Diaries, Emily Hourican is fitted for the mask she will wear for her daily radiotherapy sessions. She is still determined to believe herself a ‘person who is, in the scheme of things, lucky’
In week two of her Cancer Diaries, Emily Hourican is fitted for the mask she will wear for her daily radiotherapy sessions. She is still determined to believe herself a ‘person who is, in the scheme of things, lucky’

And for that reason, this feels like the best Christmas ever. Because I have been given the best presents ever: Health. Happiness. Another chance. This year, I will enjoy every bit of the big day. Every moment will be wonderful, because there will not be the dread, the tension, the desperate, pathetic attempts at cheerfulness, of last year. I won't feel my oldest son looking anxiously at me when he doesn't know I notice, to see if I am OK. My middle son ignoring me because he doesn't know how to begin to process the blow I have dealt him. My mother won't be watching to make sure I have eaten enough. My siblings won't be forcing themselves to chat brightly through their own worry and upset. My husband won't be stoically stepping into every breach, trying to pretend that everything is normal; everything is OK. My five-year-old daughter won't be asking 'is your mouth sore mummy?' with a kindness that breaks my heart. Instead, I hope, they will be doing what they do best - going about their day in their own ways, largely ignoring me except when they want something, or want to talk to me about My Little Pony, or Trump, or Dickens. I wonder will we even say the word 'cancer'? Perhaps once, a kind of final toast or salutation.

It hasn't been an easy year. After the initial excitement of finishing treatment and the joy of realising that I felt a little stronger every day, came the depressing acceptance of the damage done. My skin was awful, my taste buds annihilated, muscles wasted, energy uncertain, a strange buzzing feeling down my left side caused by nerve damage; various pains and burns and rashes that flared up and down for months. Step by step I trudged through the recovery period and discovered with delight that literally every week I was stronger, more energetic than the one before.

Then I had my three-month post-treatment PET scan, the one that tells you if the cancer has gone or not, if the treatment, in all its pain and indignity, worked. And it did. The cancer had gone. I was entirely free of it. That was a high point. At first I was jubilant - 'it's over, I survived, I did it!' Then came the hypochondria; rampant, ridiculous, insistent. Months of it. Every lump was cancer, obviously, but I also managed to squeeze in clear signs of MS, lymphoma, underactive thyroid and lots more that I don't remember.

Yes, I could see the funny side of this, the absurdity, but that didn't stop me. Each time I voiced a new concern, my doctors would patiently hear me out, check me out, and set my mind at rest. Off I would go, delighted all over again for a week or two, and then the creeping worry would start up again.

Writer: Emily Hourican
Writer: Emily Hourican

It passed, eventually, along with everything else. There is no healer but time for these things. And through it all, no matter the daily discomforts or mental anxieties, I have been profoundly happy since February 9, the day I finished my last dose of radiotherapy. Happy in the way we can be when life shows us the abyss, forces us to dip a toe or two into it, then pulls us out. The happiness of relief, of contrast, of a long look at what-might-have-been.

I am not - alas - a better person for my ordeal. Such is the cancer narrative, that often people want you to be different, more enlightened, more attuned to what's important. Well, I'm not. Yes, I have confronted the possibility of my own death, or of a significantly altered existence, and despite this, I am still me. Cancer was a life-changing experience, but I don't know how much it has changed my life. I still work a bit too hard and get stressed over small things. I am still capable of being cross and materialistic, of getting bogged down in the mundane. I do no more good works now than I ever did, I don't contemplate the deepest meaning of life on a daily or even weekly basis. My kids will say I am still often demanding and impatient. My husband will say I am frequently ungrateful and critical. And they are correct. And yet, beneath it all, like an underground river, is a strong flow of joy. Of gratitude and relief and taking pleasure in small moments. I may not be a better person, but I think I am a happier one. Sometimes I stop what I'm doing and think to myself 'how happy I am right now in this second', knowing that I may well be giving out to someone within minutes, about football boots in the hall or kicking the ball in the house, but highly conscious of that moment's joy. I think that is new for me. It's not that I was unhappy before - far from it - but the clarity of contrast has shown me exactly how much I have to be happy about.

Sometimes I ask myself if I have learned anything from this? Again, 'learning' stuff is one of the things we are supposed to do through cancer. I have, of course. I have learned that I am more resilient than I thought; that I am capable of being pretty well crushed by an ordeal but, that given even the faintest glimmer of light, of hope, that I will more than meet that glimmer halfway. I have learned that medical care in this country is excellent, and held together by people - consultants, doctors, nurses, technicians - who go above and beyond the call of their duty almost as a matter of course. I learned again what I already knew - the profound goodness of other people. From the remarkable response of my husband and family, to the unflagging kindness of friends and neighbours.

Some were people I hardly knew, themselves busy with work, parents, children, life.

SAFE HARBOUR: Emily Hourican with her husband David Crann. Photo: Malachy Crann
SAFE HARBOUR: Emily Hourican with her husband David Crann. Photo: Malachy Crann

All were wonderful.

The friend who forced me to go to Swan Lake with a feeding tube still up my nose, and in so doing gave me back a tiny bit of confidence in myself, because confidence is one of the things cancer knocks out of you, for a while, anyway. Ella, the masseuse who gently coaxed my body out of its stiff, sad hunch; Dr Katherine Mulrooney who saved my skin and gave me back the glow of vitality. The people who wrote to me, who I have never met and probably never will, but who cheered me through some very dark hours.

I wish cancer hadn't happened - I think the toll on my family was too high, I think the sneaky psychological effect on my children will be too great, and I think that I will always have a physical weakness from the radiotherapy - and yet I'm not sorry. It was an 'interesting' experience, in the fullest Chinese-proverb sense of the word. It showed me a depth of humanity and decency in people that I will never forget; it gave me empathy I didn't previously have for others who are sick.

Emily Hourican with two of her children, Bee (5) and David (9). Photo: Gerry Mooney
Emily Hourican with two of her children, Bee (5) and David (9). Photo: Gerry Mooney

And maybe, just maybe, it has given me something to keep - a quiet sense of joy in small moments, a realisation that life really is fragile, just as we're told, and that it is worth making the most of.

Happy Christmas.

The Privileged by Emily Hourican, published by Hachette, was shortlisted for the Bord Gais Energy Irish Book Awards 2016 and is available now from all good book shops.

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