Emily Hourican's Cancer Diary: 'On my birthday I will get a second dose of drugs and my first radiotherapy session'
In week three of her Cancer Diaries, Emily Hourican is convinced that the cancer has gone, defeated by wheatgrass and turmeric. This, she discovers, is 'the final struggles of a horse before it accepts the harness'; by Wednesday, she is hooked up to her first dose of drugs
So by Sunday last, the cancer had gone, leaving no trace. No pain, no discomfort, no sensation of a lump in my throat, no faint earache, not even the vague dull twinge I had become used to. Nothing at all.
The symptoms had been gradually dwindling over the course of a week or 10 days, and then, at last, there was nothing left. This is the point at which, if I had still been waiting to see a consultant, I would have cancelled my appointment, thinking: 'Great, that's that resolved, whatever it was. I'll probably never know, but now that it's gone, who cares? And hey, I saved €180!'
My problem was that I was already in The System. So, how to get out? "The cancer's gone," I announced to my family. "The wheatgrass and turmeric worked. It's gone. Now all I have to do is persuade the doctors to scan me again so I can prove it to them." I spent the day discussing with them how best to get my medical team to take this miracle seriously. "I'm not going to let them treat me for something that isn't there," I said firmly. "Not when the treatment is so toxic. After all, my body is clearly dealing with this. It needs to be left alone now to get on with that job."
That evening, I met a friend, a medical man, who has a great deal of expertise in this area. He was giving me some advice on radiation side effects and how best to manage them. "It's ok," I said, "the tumour's gone. I can't feel anything any more. I'm going to ask for a reassessment tomorrow first thing."
"It hasn't gone," he said kindly. "Cancer doesn't do that. By all means, ask for a reassessment, but it hasn't gone."
Sure enough, I woke up on Monday morning and the earache was back, the sore throat was back, now with a sort of tight feeling in my oesophagus that made me feel as if I was choking. The tumour, in all its malignant power, was still there, still active and, like the One Ring in Lord Of The Rings which grew heavier as Frodo approached Mordor, this thing seemed able to sense the nearness of danger and dig itself further in.
That delirium of mine - the idea of the miracle cure - was, I suppose, the last desperate wriggle as the net tightened. The final struggles of a horse before it accepts the harness. Because that very day I got the call to say that I would be starting my drug treatment in two days' time.
The random clinical trial I signed up to has awarded me cetuximab rather than chemotherapy. A newer drug, more targeted, perhaps less toxic, although with plenty of unpleasant side effects of its own, including acne (very likely), extreme tiredness (very likely), increased risk of mouth ulcers and inflammation of the mouth (also very likely), followed by the less likely - nausea, headache - down to the more-remote-but-still-possible - wheezing, sweating, conjunctivitis, fever, and so on.
More warnings, more explanations, more information that churns about in my head, throwing up horrible words and images: 'mucositis', 'jaw stiffening', 'impaired bone healing'. At this stage, I am pretty good at shutting them out. 'Tongue lacerations,' I think la di dah di da di da; 'chronic fatigue,' oh whatever... And yet, they do their work somewhere, those words and images, because by Tuesday night, the evening before my first dose, I am increasingly frantic and then miserable. Childishly, I cannot get over the fact that this is actually going ahead, that no call has come. A line from Auden's The Shield Of Achilles kept playing around in my head: "they were small/ And could not hope for help and no help came."
No help came.
The feeling lasted until I entered the day ward of St Luke's Hospital on Wednesday morning. And then it went. "I am here now," I thought, "this is all there is. There is no mistake, no call to come, no cavalry. Just me, and whatever inner resources I have accumulated over the years." It's not the worst feeling.
And so I did not flinch when the nurse said cheerily: "We'll all be running from your veins by the end of this," as she gently put the line into a reluctant vein, that will allow the drugs to drip into my bloodstream. I had visions of teams of medics digging at my arms and legs in a couple of weeks, trying to find a vein stout enough to take the needle. I nearly laughed.
Then they hook me up. I get steroids and then antihistamines before the main event. This is already more drugs than I have put into my body in a year. The antihistamines make me feel woozy, but I don't dare drop off. The last time I went under in a hospital, I woke to be told I had cancer. So I struggle to stay awake, too scared to let go. Instead, I wonder, what is the essential Me? Is it the Me that is indelibly connected to this body? So that what happens to it, happens to Me? Or is it something somehow separate? Autonomous? Something that retains its own stamp, no matter what happens to the thing attached to it? Something that can lay low when times get really tough, the way certain amphibians do, digging themselves into the mud throughout food and water shortages, going into a kind of sleeping death, only to emerge in glory when the rains come? If the former, this is going to be tough in ways I can't yet fathom. If the latter, we're ok. At this stage, I truly have no idea. It will be interesting to find out.
And actually, the day ward is a very pleasant place, and of course the drug infusion is a complete anti-climax. For two hours it drips steadily into me, unobtrusive, painless. I thought I would be disturbed by the toxicity, after a lifetime of working hard to put only the healthiest things into my body - organic food, supergrains, shampoo and face creams made from all-natural ingredients - instead, I wish the drug well on its way: "go find the cancer cells and kill them," I will it. I feel like Russell Crowe in Gladiator, roaring out to the massed Roman armies: "At my signal, unleash hell!"
Next week, on my birthday, I will get a second dose of drugs and my first radiotherapy session. Happy birthday, me!
But I have realised what of course I already knew. What we all know. That words are dangerous too. That descriptions of what will happen are far worse than the happenings themselves. When I am told about all the things that will be done to me, I feel mauled, abused even. In practice, I am minded, babied through it all by nurses with gentle voices and gentle hands. The time is punctuated - as I have learned everything in hospital is - by cups of tea and biscuits. A chat with the doctor, many chats with nurses, chats with my fellow patients.
We swap war stories, these women and I, but in a low-key kind of way. "How many weeks in are you?' I ask. "Three." "And how is it?" "Fine, I'm a bit tired, that's the worst of it." There is a gentle heroism to the responses. A discreet bravery hidden beneath comfortable tracksuits and baggy tops. We ply each other with all the usual clichés: "One foot in front of the other." "Step by step." "A day at a time." "You do what you can do." There is no drama, just determination. We are a community of the quiet and focussed.
The day goes by easily. When done, I am collected by my mother and brought home, fed and sent to bed. I cannot get used to being the one who is minded rather than the one who does the minding. This is entirely new for me - a lifetime of being eldest sister; sensible help and support to my more highly-strung friends; mother of one, then two, then three. I am the one who minds, who helps, who cheers up and talks down. Now, all roles are reversed and it feels like vertigo. I feel I have let my family down. My husband down. My kids. This, I think, wasn't the deal.
But I go obediently and sleep for a few hours. I wake up and watch TV. I feel serene and pretty stoned. The next day I have what feels like a hangover: faint headache, wooziness, nothing nasty. And I am, at last, begun. I am on the road, and one step closer to the end. "That was easy," I think. "No bother."
After the phoney war of last week, this is undoubtedly a false dawn. Or perhaps a fool's paradise. But that's fine. It will do for now.