Monday, 22 October 2018

Ancient apples

The Nuttery

The Nuttery is a mysterious ancient woodland above Clare, beyond the Swan. It's a wonderful place to walk the dogs. Once, in days when rectors had vast houses, servants and land to support them, it was private ground providing walnuts and hazelnuts, and fish from its pond for the rectory. Now it is overgrown common woodland, part of the network of public walks here. For Edwin, it is a gentle stroll up through the fields, but for me a breathless climb and I am glad to pause in the silence. It is cold out of the sun, and glades with log seats beckon. Strange figures carved in dead tree trunks lurk in the undergrowth. 

A huge old apple tree, hidden from bygone days, hangs with glistening fruit beyond reach, but I pick a glowing red ember from among the recent windfalls, one fit to tempt Snow White. It is the sweetest, most succulent apple I ever tasted, veined with thin red streaks I’ve never seen before in any variety. It is cold from the overnight air, sweet and soft as candyfloss, quite unlike brands that boast "hard, crisp and crunchy". Even the skin was soft and could be eaten without wedging in the teeth. Perhaps it is one of those long-lost varieties that supermarkets reject. Back at the Swan, ripe walnuts have fallen on the car, remnants perhaps of that ancient wood.

Beneath the tranquility lie thoughts of what is to come. I have received a copy of the medical summary. There is little that was not discussed, but confirmation of a G3 pT2 TCC, i.e. an aggresive Grade 3 transitional cell carcinoma that has spread into the muscular wall of the bladder, grotesque and unnatural as terrible carvings in the deadwood. A large pelvic lymph node may indicate wider dissemination. Today is the Specialist Multi Disciplinary Team, or SMDT, meeting at Addenbrookes to determine management, and my fate. I await their call.

Sunday, 21 October 2018

What are the downsides of being a man?

Catlin Moran, a well-known feminist writer, has devoted her life to women's causes. In The Times Magazine today, she argues for equality in popular terms for yearning and sexuality, listing a whole thesaurus for men's arousal, and comparing it with the only word she could muster for women's desires: moist. She describes "moist" as the worst word in the lexicon, although I have always considered "damp" or "wet" to be worse words - I'd rather be moist than damp or wet. She concludes by calling for new terms for female arousal, to redress the balance in the name of equality.

Now she asks on her Twitter feed, "What are the downsides of being a man?" I feel compelled to answer, but can think of no great problems I suffered in youth from my gender, so perhaps the question was rhetorical, or ironic. If I suffered at all, the problems were from my class – an old-fashioned word, but one meaning a working class background with basic education, low in expectation or encouragement. Most in my school left at 16 to work in factories, with no thought of university or even career jobs. A good apprenticeship was an aspiration. The sixth form was a runt class, and the few of us who left for higher education knew that Oxbridge was closed to comprehensive school boys with Midlands accents. I was fortunate indeed to be selected into St Thomas' Hospital.

St Thomas' medical school was filled with the public-school sons of consultants (but was considered less exclusive than Barts, which was rumoured to only select the sons of Barts consultants). There was a quota of women, but only to fill the legal minimum, and they from Roedean, Cheltenham Ladies College, and their ilk. I was the first and only working class entrant, possibly selected to fill another political quota. The teaching was world class, but I felt an outcast.

That early prejudice is well past. Now I feel the prejudice of the young against the old. TV programmes show active, virile people, chasing adventure, or idly flirting. Even the adverts aimed at we oldies – for funeral plans, care homes, stair lifts, or equity release – have actors in their 50's who look a fit generation away from me. In shops, people are annoyed with geriatrics who fumble for their money or can't work the card readers, and assistants look at me pityingly, thinking I should be in a care home, and turn to talk past me to someone more interesting even as they scan my items.

Only now am I aware of even mild prejudice against males. I am still working, but only in a consultant role, and most of the people I work amongst are young women, and the bosses are all women, and there is no danger that they are ever going to proposition me. There is, though, a sense that the selection process is unconsciously biased, and women will be given preferential treatment – but that is more likely to be my own opinion than fact. Also, as a man, I am aware that I tend to push my opinions with a strident voice, so make myself hold back, a repressed role that is forced upon me. There is an awareness that to be a white male, and especially an oldie white male, is to be placed behind the line of women, minorities, the disadvantaged, the LGBT community and people of colour.

I hope I have these terms right - they seem to change every few years, and all the other downsides of being a man will be as empty air compared to the wrath of these groups if I mislabel them. For that is the greatest downside of all: the virulence of complaint if we men step beyond the narrow lines they prescribe for us.

Saturday, 20 October 2018

A lesson in cosmology

In cosmology, it is usual to talk of three types of universe. They are hard to envisage, because they are all three-dimensional and change with time, so it is is generally easier to hold a two-dimensional picture in one's mind, and leave the third and time dimensions to the mathematicians. The three are: ones that are flat, like a sheet of paper; ones with positive curvature, like a globe; and these with negative curvature, often likened to a saddle shape, curving in two opposite directions. Time is then "pictured" by thinking of the shapes as elastic, then being pulled equally in all directions so that if we draw little galaxies on them they will begin to move apart.

Visualizing the mysterious open Universe
What force pulls them apart? I said it was hard to imagine – indeed the force that started it all is itself described as "unimaginable" in all its attributes; vanishing smallness, infinite temperature, infinite density, and a time so small it is thought that no other time can ever be shorter. Cosmologists sum it up as the Big-Bang, though only the Universe itself could have heard it. Now imagine all that going on in three-dimensions, and the mind's eye fails. It really is easier to think of it as a great saucer carried by elephants. And how many people even handle saddles these days?

Not dead yet
We have walked the graveyard,
touched the tombstones
felt the putrid air of death
wept at the nameless wreath.
Today, we have rejoined life,
drank the sweet red wine,
eaten of the forbidden fruit
breathed the spring like autumn air,
it is our world
and we are still here.
by Annie Elliott

We may as well describe the open universe as the contrary curves of a woman's waist, usually hidden from view, everywhere quite mysterious, yet smooth and continuous. Ann is my Universe. Just don't describe the galaxies as wrinkles on the surface of time, moving apart as the curves expand, or you'll get into serious trouble!

Friday, 19 October 2018

The analysis of emotions

I am a scientist first, and a poor poet and writer second, though many reviewers rejecting my papers might say I'm a poor scientist first. Be that as it may, I do try to analyse my emotions.

The main one is rage. Rage at having life torn from me, and feeling weak and tired. Rage at thinking of the time I will loose from all the nasty treatments yet to come. I have always bottled up emotions, as trained to do. My background was the "stiff upper lip". Don't show your feelings. Put on a brave face. Face the world with head high, chin out, back straight, stomach in, chest out, shoulders back, look the person straight in the eye, give a firm handshake, and remember "you're British". Now I find myself swearing, raging against fate and the world, angry with my stupid body that's slowly falling apart. But thus far, it is bottled in, and I rage silently, in the darkness of my own mind.

A second one is resentment and envy. I see young people, and envy them their healthy skin, their strong limbs, their tireless energy. I yearn to be young again - and fully understand writers – such as Shaw with Back to Methusala – who imagine an elixir of eternal youth. I remember in youth I could run and climb, swim a mile, and had breath for two lengths underwater. Now I get tired walking the dog.

Pity or depression have not come, and Ann – bravely strong and wanting to keep busy to block her mind – only cried briefly on first hearing the news.  But today came a memory of the forlorn look and despair on my father's face when my mother died, and I was suddenly overwhelmed with a thought of Ann, and the grief and despair to come.  For the first time I wept today. I know her so well, I feel already her suffering and the pain she has yet to bear, and I wept for her future sorrow. But the tears were silent, and came when I was alone.

I do not write poetry now. Ann and Edwin's poetry far eclipses mine. Edwin's are introspective, exploring his own rages and frustrations. Ann's sum up the universal humanity we share in suffering or joy. She writes everyday. Here, a couple of new ones:
We are a couple,
two people sharing
a caring
simple life
which others join a while
then disappear from sight,
while we, the two who strive
to live and to survive
must face our world together
through the bleak and  cruel weather
side by precious side.

Tummy turning 
like a wheel 
hit by a whirlwind, 
rushing, screeching 
twisting over and over, 
just waiting, 
tick tick tock, 
then the clock 
is silent.

Thursday, 18 October 2018

Post Graduation

Yesterday was Edwin's post-graduation ceremony. The omen's were strange. Walking past the Corn Exchange, we passed a foundation stone inscribed, "John Death laid this stone." In his gown and robes, we went with Edwin for a coffee before the ceremony. A woman on her own, but dressed in the blue and gold robes of Edwin's university, followed us into the arcade, then caught up with me. "Is this the way to the Corn Exchange?" she asked to my surprise, for she must have been studying in Cambridge for at least three years, and had walked past it to follow us.

Ann mentioned that her bag was very heavy, because she was carrying water and a folding walking stick in case I needed them. I commented that she'd have to fit a folding wheelchair in when the time came, but she wasn't amused.

At dinner in The Ivy afterwards, I kept looking at a strange optical illusion: a reflection of the back of a man with a black hat. He was like a ghost figure that people walked in front of, behind, and through. I got up to find the cause of the reflection; it was of a picture on the far wall. Then in an alcove I stared at a couple carrying gender equality to a new level. They were identically dressed in black suits, and homburgs that they didn't remove all evening, like a pair of Jehovah's witnesses matching a front view of the ghost image.
The ratio of women to men entering medicine is close to 60:40, and is probably similar veterinary medicine. The biochemistry ratio seems higher, and in the Arts, Law and Social Sciences Faculty it runs at up to 4:1 on some courses. It does begin to seem like the feminist battle has been won, and now they're just mopping up minor pockets of resistance. 

News item in The Times: Feminists object to the name "Gentleman's Relish".

Story in The Telegraph: After more than sixty years Kleenex is phasing out the Mansize tissues name, deciding instead to call the disposable handkerchiefs "Extra Large" tissues following complaints by active feminists.

Next to fall will be ladies fingers; we should just call it okra. At this rate, all differences will be eliminated, and we will wear identiclothes. There will be no more gentlemen's outfitters, or ladies fashions, just clothes shops; and women's magazines and those glossies promoting male bodybuilding must merge on the alter of true equality.

Wednesday, 17 October 2018

On advertising

I am thrilled with my new Apple i-phone. I don't like to say it too loudly, because Edwin has been pushing me to get one for years and I don't want him to think he is right too soon. It is fast, clean, and I love the facial recognition feature to unlock it. True, its keyboard lacks the row of numbers above the alphabet, but this is a minor inconvenience. Interestingly, 67% of views for this blog are from Apple devices (with 52% the i-phone); 20% are Android; only 10% are viewed from Windows.
But the main virtue of the i-phone is it doesn't support intrusive advertising.

Google will not like this post, but - I hate advertising. I don't like it on TV, though it would be hypocritical to say I only watch BBC. I don't like it when I do searches, but accept it as the price of good content and for ease of searching. My favourite site is Wikipedia; I would gladly pay a yearly rental for that site, and I send them money each year when they put their appeal out. But where advertising really cheesed me off was on my Galaxy phone.

Even before it exploded in my pocket, I was fed up with it to the point where I wanted to throw it at the dealers who sold it me. It was not a free phone. I paid good money for it, through the rental contract with EE, and a large fee every month to rent their system for calls and data. I therefore expect a clean service; but instead, I kept getting adverts thrown in my face. Full page adverts! Covering the screen after I picked it up and started to text or dial! Adverts that insisted I wait a few seconds, with a countdown before I can clear them! Adverts about irrelevant rubbish that I can't even read because I am so mad with them!! I do not expect to pay for the privilege of getting adverts!!!

Ann says I should write about my "feelings", and not keep making jokes and pretending all is well. It is not easy. I have never delved far into the dark pit of emotions. She keeps feeling shudders of shock as the news hits her in waves; I seem to have put it from my mind, and don't like to dwell on it. I suppose if anything, my emotions are of anger and apprehension - I resent having a black curtain hung before me through which I must pass. I enjoy life, and had hoped for a few more good years - there are so many things I still wish to do.
The apprehension arises from the thought of the cystectomy. I spent 6 months as surgical houseman on a GU unit. As a houseman, we didn't do much important stuff - just assisting the surgeon by holding retractors while the nurses wiped his brow. But I did see the severity of the ops, and the attempts to fashion a piece of bowel into a false bladder draing to a bag on the abdominal wall. I witnessed the failures too, where the bowel became infected, or did not graft, and needed another urgent procedure. Also, the cases of the poor men (were they always men?) with aggresive cancers, too late to halt, racing through their bodies to claim the ultimate victory.

I don't suppose my feelings will help anyone else much, but the Macmillan cancer site offers brillient support, and is Ann's first port of call when she has questions. So if anyone reading this wants to bring me their feelings, at least I'll be happy to share them, and maybe they will resonate with my own feelings and help me better to express them.

Tuesday, 16 October 2018

Clearing up the mess

I am always surprised at how difficult women find it to load a dishwasher. Each time my wife tries to do it, I find myself having to reload the thing. The problem is, I believe they have no spatial awareness. Dishes are pressed against each other and come out half unwashed; cups are piled higgledy piggley, and won't fit together properly in neat rows; glasses are not proped up and topple over, so come out full of dirty water; forks are placed in tine downwards, so they stop the bottom rotator doing its job; and huge items are placed vertically to stop the top rotator from turning.
Worse still, they don't get the concept of initial rinsing to remove loose pieces, which end up coating the glasses so they have an unwanted coating of crud. I don't know what prevents them from learning, but Ann is sensible and says, "well you do it then!"   Ben says his partner is exactly the same; he has to do it every time, as she refuses to touch it anymore.

Today was crunch time with my urologist, Mr Sengupta. He is a good, serious, surgeon with a firm handshake, who speaks with clarity and looks me in the eye. The news was not good, but he had a box of tissues ready which he passed to Ann. It is stage 3, having passed through the bladder wall, with evidence of possible metastasis to a pelvic gland. I have had lighted candles, prayer meetings, and even a mass said for me! If this were a scientific experiment, I would have to say it has failed to reach statistical significance. However, it has demonstrated what a large group of  people care, and that surely gives strength and hope, even if no physical cure.

The Addenbrooke's team will meet on Monday to decide my fate: some combination of radical cystectomy, chemo and radio therapy, or possibly some experimental treatment, which they are always keen to try out at there. I will be happy to accept their advice to clear up this mess.

Ann is a rock. The last time she was passed tissues was 25 years ago, in the same hospital, when we were given news that the scan for her pregnancy showed an empty sac. But she rose above that to produce an Edwin, weighing in at 13 pounds, and with an Apgar of 10 even after the Caesarian Section. Mr Sengupta asked if she would like to take the box, but she was strong enough to control her distress.

Yesterday, Mike phoned. I have always been proud of a good head of hair. My children used to take it as a sign for a healthy genetic inheritance, but some of them are already getting a bit thin on top. When told I might need chemo, Mike said I'll end up looking like him. I had a haircut yesterday too; I could have saved the money.