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'I did not know who I would be on the other side, but I knew I'd get there'

Five years after a cancer diagnosis and the gruelling treatement that followed 'exploded' her world, Emily Hourican looks back on her journey with the disease, and reflects on how it shaped the resilient person that she is today »

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Emily Hourican says five years on is a good time to take stock. Photo: Kip Carroll

Emily Hourican says five years on is a good time to take stock. Photo: Kip Carroll

Emily Hourican. Photo: Kip Carroll

Emily Hourican. Photo: Kip Carroll

The photo Emily took towards the end of her cancer battle; her daughter never wants to see it again

The photo Emily took towards the end of her cancer battle; her daughter never wants to see it again

Emily wrote a diary in the Sunday Independent as she underwent treatment

Emily wrote a diary in the Sunday Independent as she underwent treatment

Emily's diary while she was undergoing treatment

Emily's diary while she was undergoing treatment

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Emily Hourican says five years on is a good time to take stock. Photo: Kip Carroll

About a month ago, my nine-year-old daughter was going through my phone looking for photos of herself, when she came across a selfie of me from February 2016 that made her pause. "I don't remember you like this," she said. And then she started to cry a bit, and asked me why I kept the photo. She had a point - it is pretty horrible.

It's a photo of me propped up in a hospital bed with a feeding tube up my nose held in place by a large piece of pink plaster. My face is very thin and discoloured, and I'm wearing a pink protective collar around my neck, which was badly burned. I look frightened and dazed, as if wondering exactly how I had pitched up in this parallel universe where my life was a daily round of radiotherapy treatment, doctors, blood tests, drug drips; full of talk of outcomes, side effects, pain relief and other unpleasant, unfamiliar things.

"I never want to see that photo again," my daughter said.

I tried to tell her that I like the photo - it makes me feel bizarrely happy to look at it. Because that was then. It's not now. That photo is proof of distance travelled. Of survival, resilience; how far I have come. In the world of Fitbits and exercise stats, that photo is the start line from which I can measure my progress. And now, five years on from that cancer diagnosis and treatment, is a good time to take stock. Five years is a big deal in cancer terms. It is a kind of ledge, a place of some security on which to rest.

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Emily Hourican. Photo: Kip Carroll

Emily Hourican. Photo: Kip Carroll

Emily Hourican. Photo: Kip Carroll

Even so, every bit of that is written with my fingers crossed. Five years is a milestone but it's not a guarantee. Cancer does strange things, and there are, of course, other cancers. I have known people too superstitious, or too traumatised, to celebrate their five-year milestone, and I understand that. However, for me, now is time to appraise - who I am now, who I was then.

My cancer diagnosis came to me out of the blue. An annoying lump at the back of my throat that I first noticed when I was running or exercising, in the summer of 2015. Within a month or so, I began to notice it all the time. Not sore, but irritating. I had to 'talk around' it so my voice began to sound slightly hoarse and constricted. Soon, there was a very swollen thyroid gland and then a swollen lymph node to be seen.

I went to my GP, who referred me to an endocrinologist for thyroid checks. She did a blood test. Everything, apparently, was fine. I was sent for an ultrasound. Everything there was apparently fine too. No one could see or explain the lump. "It's psychosomatic," one medical professional told me kindly. "There's isn't actually a lump, just the sensation of a lump. It's common enough in women in their 40s," - I was 43 - "you need to de-stress."

So, biddable as I am, I valiantly set about de-stressing, even though I didn't feel particularly stressed about anything except the lump. I meditated every day, took walks as well as going for runs, tried to work a little less. The lump got bigger and now there was a second lymph node visibly swollen in my neck. At this stage, you probably think I'm some kind of hopeless ostrich. But the truth is, even though the lump bothered and annoyed me, I never, not for a minute, thought it was cancer. Even when I put my symptoms into Google, and Google each time came back with a possible diagnosis of cancer, I ignored it. Obviously it's not that, I thought.

If it hadn't been for my eldest brother - whose wife told me one day, "You know he can't sleep because he's so worried about you?" - I might have let the whole thing drift on, talking around the lump, working around the discomfort, living around the worry. Because of him, I went back to my GP for a third time, and this time she sent me to an ENT consultant, the wonderful and much-missed Aongus Curran.

He booked me in for a proper investigation and biopsy under general anaesthetic for two days later. That he managed to do that, and send me home without panicking me in any way, is, for me, testimony to the remarkable, kind man he was.

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The photo Emily took towards the end of her cancer battle; her daughter never wants to see it again

The photo Emily took towards the end of her cancer battle; her daughter never wants to see it again

The photo Emily took towards the end of her cancer battle; her daughter never wants to see it again

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I pitched up for my Monday morning procedure in great humour. "This will all be sorted out by lunchtime," I thought to myself. I had plans for the afternoon - I had to pick the children up from school; they were then aged four, eight and 11 - for the next day, the next week. So many plans. I think I thought that being busy was a talisman - nothing bad could happen, because I didn't have time for them. There was no vacancy in my calendar into which the universe could insert new and terrible events. As if the universe, and indeed bad things are, like telemarketers, waiting for an appointment, a free hour.

Coming-to after that anaesthetic is one of the things that stands out most in my mind from that time. A lot of what happened later is a blur - so many hospital appointments, so much new and hideous information - but that moment when I was woken, in the hospital recovery room, and told: "You have a tumour, and it's malignant" is vivid in my mind, even though I can't recall the face of the person who told me or anything about my surroundings.

I remember saying, "You mean I have cancer?" and the answer to that - "yes" - and the way that answer exploded my life, burst through all the things I had to do, the plans I'd made, but also splintered the person I thought I was - a healthy, lucky, somehow inviolable person. The person we all think we are, the person who believes 'that can't happen to me', because they have not yet learned that such things can happen to anyone.

I remember being asked: "Is there someone we can call?" and giving my husband's number. I remember being handed a phone and telling him, "I have cancer, please come". I remember telling my children - each according to their age, with as much or as little information as we felt they needed - and my family. I remember how hard we all clutched at every scrap of what seems to be 'good' news.

The specifics were that I had cancer of the tongue base, with two affected lymph nodes. It was graded at stage three, but the really relevant information was that it was HPV-related. This, everyone told me, was a good thing.

HPV is a virus with over 100 different forms. Some of these cause cancer - most commonly cervical cancer, but also mouth cancer. All secondary school children are now offered a vaccine against HPV in this country, in common with countries across the world (I would strongly counsel anyone who has doubts about this vaccine to explore fully via the most credible sources they can find, such as the WHO).

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Emily's diary while she was undergoing treatment

Emily's diary while she was undergoing treatment

Emily's diary while she was undergoing treatment

Discovering 'good' news amidst so much bad, was a relief, even though for me, 'good' would have meant something quite different: 'There's been a terrible mistake, of course you don't have cancer...'

That 'yes' to my question started me off on a long road - of scans and tests and X-rays, meetings with the new consultants who would have charge of my treatment. There was a day spent being fitted for the mask I would have to wear for all my radiotherapy sessions - this was one of the all-time low-points. The mask was terrifying; tight, constricting, claustrophobic and, when bolted in placed, extremely painful - there were long hours in St James's, St Vincent's; a host of moving parts to be fitted together into the coherent next step: a treatment plan. This was to be seven weeks of daily radiotherapy, along with weekly doses of immunotherapy, and Day One was December 23, 2015 - my 44th birthday.

Those seven weeks involved plenty of misery, exhaustion, pain, depression, sleepless nights, fear and self-pity. And astonishing amounts of kindness - from the medical professionals and the world at large; friends, neighbours, strangers, nurses, doctors, hospital porters. It was intense and frightening and debilitating and weirdly fascinating. And then, five years ago this week, it was over.

I remember the day I took the photo my daughter hates so much. I had been admitted to St Luke's as an in-patient a couple of days before. I was coming to the end of my treatment, but I had reached a very low ebb - eating had been pretty much impossible for several weeks by then and I had lost a lot of weight, hence the feeding tube.

I had third-degree burns to my neck and was woozy from the morphine I was on, and very disconnected from anything beyond the round of hospital visits, even my children. They were too noisy, too vital, too solipsistic for me to cope with. I had drifted beyond them, to a kind of twilight place where I mostly dozed, woke for whatever treatment was required, then dozed again. But taking that photo, I knew the end was in sight. That I would make it. I didn't know who I would be on the other side, but I knew I'd get there.

Of course 'the end' wasn't really the end. There was a lot of aftermath to get through: months of recovery, months of uncertainty - there's a loss of confidence that comes with serious illness that is very physical; the first time I went into town, alone, after my treatment, I remember being terrified of all the people rushing around, busy, determined, oblivious - anxiety around my health that meant I self-diagnosed with everything from a broken arm to MS.

However, also the realisation that I had come through, that I had been tested and I had shown resilience. I had learned (been forced to learn) how to stay in the moment and not spiral - something that has come in pretty useful over the last year. And I had demonstrated to myself that I could cope with far more than I would have expected (there isn't actually anything particularly great about that - after all, what choice did I have?)

Five years on, I have no idea how different, or not, I am to the person I would have been without that cancer diagnosis. I know that I feel incredibly lucky - to be alive, to be healthy, to have been cared for so well. I feel a degree of empathy with others who are seriously ill that I am grateful for, and an understanding of hospitals and healthcare that is interesting. Mostly, I feel that the days are precious and I need to value them. There are people I met along that path who are no longer with us, and I don't forget them.

I have some hangovers still. There's a particular advertising jingle that sets me off every time I hear it because it transports me back to sitting outside the radiotherapy suite, waiting to go in and be bolted to the trolley for another agonising session. The smell of St Luke's catches in my throat each time I go there for a check-up, and I have to remind myself that it's OK; that I'm OK.

I still have my radiotherapy mask. It has a Francis Bacon quality - a kind of agonised expression, head tilted back at a painful angle, face set in a grimace. I don't know what to do with it. It's big and cumbersome and ugly and I have no place or purpose for it, and yet I still have it. It sits in a corner of a box room, behind the Hoover, and every once in a while I need to move it in order to get something else, and I think, "I should really throw that out". But I can't.

It isn't the last reminder of that time - I have a few scars on my neck, some hearing loss, a tiny tattoo on my chest, a black dot that was put there to aid the correct lining up for my daily dose of radiotherapy.

These will always be with me, aide memoires, if I need them, to jog me back to that time. But the mask is something else - it's something I can get rid of. Something I can dispose of any time I like. Something that was once vital and is now useless. As such, it's more symbolic of that time of my life than any of the non-negotiable side effects. It exists now, only because I let it. That power is mine.

 

Photography by  Kip Carroll


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