Illnesses are like journeys. They go up hills and down dales. Decisions have to be made at forks in the road. After a long drive, we get tired; we try to rest and hope to reawaken with energy restored.
Most journeys include interactions with less than competent drivers, or maybe it just seems that way, as a particular mood colours our perception. And most journeys end where we would like them to, but not all.
At the beginning of the trip, some illness journeys simply cannot be mapped.
Perhaps more than any other illness, journeys through cancer are often challenging and uncertain. Readers will be familiar with my abhorrence of the use of war terminology in cancer care – it leaves those who are not of a warrior disposition feeling weak and dispirited.
This is where the concept of patient stories is so important. If you can, view your cancer journey as an uncertain, changing narrative. It definitely helps. And there are many cancer narratives out there, waiting to guide you. I have just finished reading one of the best I’ve ever come across.
Film director and writer Stephen Bradley’s Shooting and Cutting: A Survivor’s Guide to Film-Making and Other Diseases (Mercier Press) describes his journey following a stage 4 cancer diagnosis. They don’t come much worse than stage 4 – it means the cancer has spread to other organs or parts of the body. It is also called advanced or metastatic cancer. In Stephen’s case, he has advanced bowel cancer with a large secondary growth in his liver. It’s the equivalent of being stuck tightly behind the eight ball in a game of pool.
At this point I should explain that I was a good friend of Stephen’s sister Fiona. Sadly, Fiona died aged 41 from metastatic breast cancer. She was the year ahead of me in college and was the person I went to for periodic steers about the challenges that lay ahead. As well as caring for her patients in a deprived part of Dublin, she was a ground-breaking researcher into domestic violence.
For Stephen, Fiona’s journey was a guide to the uncertainty of what lay ahead. And for their family, the experience of Fiona’s illness made it a challenge to see a positive outcome for Stephen.
Crass medical intervention
A crass medical intervention doesn’t help. His wife, Deirdre O’Kane, and he are in his hospital room as Stephen recovers from his first colonoscopy. The door suddenly bursts open and “before we have time to to respond, (the doctor) lays the graphic images out on the bed. I look down to see ugly, black shiny tissue . . . they are pictures of my bowel cancer.”
It’s a major bump in the road.
“All the blood drains from my head. I realise there and then that I am probably going to die,” Stephen writes.
But the road surface eventually improves and there is a welcome change in his thought process as he waits for surgery to remove the diseased part of his liver: “every person, place and event that I encounter (with all of my five senses) is more interesting and affecting than before”.
The book is full of gentle guidance: “I am aware of how much this past year has made me revert to a childish state, dependent on the decisions and support of others . . . I have embraced my vulnerability willingly. I conclude that it’s part of the healing process, this temporary retreat from adult egotism.”
Stephen’s journey is an eventful one. Portacaths and stoma bags become part of life. Initial treatment success is tempered by periodic setbacks. The cancer reappears in his lungs, but is successfully excised. He is well now, but is “unlikely to escape further complications in the grand scheme of things”.
This book is a superb cancer memoir. It is also an excellent guide to the cancer journey one in three of us will face at some point in our lives.
Read: ‘I’m still in shock over the whole thing’