Conspiracy theory

I do like a good conspiracy theory. I have a new one. It is about the USA Miami bomb maker. Cesar Sayoc appears to have been a loser of low intellect who attacked his granny, was thrown out of their house by his parents, and was living in a white van plastered with Trump posters. Yet somehow, he assembled the components for more than a dozen pipe bombs without attracting attention, discovered the names and addresses of leading critics of Trump, and mailed them to their targets without arousing any suspicion.

Surely this guy must have had vital support at every phase by someone as yet unknown. But not one of the bombs exploded, and the suspect left a fingerprint that drew the FBI to him within a day. Of note was Trump's initial comment on the situation, asserting that the media was in part to blame for the attempted attacks, and that their false news had turned the opinion polls against the republicans before the forthcoming mid-term elections.

A good conspiracy theory needs good suspects, and there is certainly no shortage of these. Let's see - who would want to damage Trump's presidency?

1. All the Democrats
2. The FBI
3. Half the electorate
4. Feminists
5. Every LGBTI person who every attended a pride parade
6. Many Republicans
7. All the ex-presidents he has slimed 
8. Ex-candidate Hilary Clinton
9. The whole of the liberal press
10. All the people he has sacked during his presidency
11. Trump himself

I am not American, and it is impolite for an Englishman to criticize the leader of another state (usually we're too busy criticizing our own government). But Trump does give the impression that the consequences of his words are not always considered with great depth. It is just possible that he might have thought verbal attacks on his critics were insufficiently effective. I can imagine him thinking, "Heck, I keep telling everyone what creeps these guys are, but they keep on telling their lies about me. It's time for real action!" He might then order that they be silenced by direct action? Possibly it was only the clandestine intervention of someone with any common sense in this plot that ensured the bombs were harmless, thus saving many lives. But perhaps the team he sent were as incompetent as he is, and that too was another cock-up? This conspiracy theory can run and run.

Dealing with severe invasive bladder cancer

After yesterday's euphoria on being told that radical bladder surgery is probably no more effective than radiotherapy, today I am beginning to take in the significance of all that lies ahead. Yesterday, I felt back to normal and full of energy; I thought my tiredness and general lethargy might have been psychological from the stress of knowing I have cancer. But today they are returning, and must in large part be the result of a vicious malignancy fighting within me, making me anaemic and run down.

Operation

Softly,
operate softly,
gently move
towards aged limbs,
move instruments
with tenderness,
reach soul
with loving touch
bring him back,
that we can hold him near
he is our world,
please hold him dear.

by Annie Elliott

Addenbrookes is a major treatment centre, and gave us a video to take home to help understand the road ahead. It is very lengthy, like the journey itself, but very thorough, so Ann and I are wading through the more relevant sections, such as the tests that are done, the choices to be made, and the pitfalls of each modality. At the moment I am skipping over the many sections on cystectomy in all its lurid variations, and concentrating on chemo and radiotherapy. They are enough to cope with at present.

A few famous people have bladder cancer, but mostly it is a disease of the poor and the unknown. The video gives pros and cons fairly, but the patients are survivors who seem to have had minimum problems and came through smiling. I am a cynic, always examining the other side of each lemma. Wearing my sceptical hat, I know those with fatal outcomes were not interviewed. I wonder – where are the patients who vomited violently and couldn't stomach chemo? Where are they who suffered irreversible radiation burns to the bladder? Yes - this is the worst side of pessimism. Partly it's my normal way of looking at the world, but perhaps too it reflects my deeper fear of what is to come and what can go wrong.

My blog posts are very subjective, and certainly no one should read them who wants an upbeat or optimistic view of bladder cancer. For anyone wanting facts, go to the official sites and read the positives, which are very real. Ann has certainly found some good sites online for advice. Fight bladder cancer and Macmillan Bladder Cancer Support pages are excellent, and I still have fondness for my original ones at Addenbrookes Urology Unit and The NHS Bladder Cancer Site.

The Doom Lifts

Doom Day. It is dark and raining. The road to Cambridge is closed by a “police incident” so we take the back roads – normally deserted, but now following a long slow caravan of diverted traffic. We sit in silence. Edwin sings some modern song in a low voice. Ann sits quietly without speaking. We wait in Addenbrookes' coffee lounge until the appointment at nine. The talk wanders over what might be said, what the future might bring. I am resigned to having a radical cystectomy, and life with a bag clinging to my side like an unwelcome leech. I say I do not want to die, so will probably opt to follow the consultant's advice, taking the discomfort and pain to come.

The waiting room is divided in two by a trellis, with a sign by the opening clearly saying, "Clinic 12 on this side". A large woman keeps trying to go through, insisting to her husband he should be that side, while he refuses to follow her and the receptionist keeps insisting, "your clinic is this side." She must be deaf as well as blind; but perhaps, like us, she is distracted by the severity of her husband's disease.

Mr Turner, the principal urology team surgeon,  is a solemn man whose eye never wavers from me. He explains with great  detail the situation, and outlines the possible road map ahead, and I appreciate his directness. Then his message begins to get home. The cystectomy is not the first choice; indeed, he emphasizes that the odds are equally balanced between radical cystectomy and radiotherapy, giving me the choice. Either will follow a bout of chemotherapy, which will be done by the oncologists at Bury. My chances either way will be about 50:50, which are considerably better odds than a diagnosis of terminal cancer, and would be very good odds  in a horse race, well worth a punt.

Coming out, I feel I have been granted a reprieve. The rain has stopped and the clouds are lifting. On the pavement, we overhear a conversation by a man with a wide grin, "They say I don't have cancer!" and his friends and rels cheer and laugh with him. Edwin says, "Mum, if you hold him, do you think we can break his arm?" Ann replies, "No. I'll break it on my own!"

By the time we're home, the sun is shining and the skies are blue. I had lived in dread of radical life-changing major operations. These other treatments I can face as they come, and the side effects should not last for ever. Now we can begin to live again and enjoy cracking the wild walnuts I collected from the tree in Clare.

Clare walnuts

D-Day minus one

Yet more harbingers of doom as I count down to my surgical fate. Lying in the centre of the road was a dead cat. The Times today carries a pull-out supplement on Modern Cancer Therapies. And  suddenly we have to quit our unit in Clare Antiques Warehouse.

Contemplating what is to go

For many years we have had the unit: just a small modest affair, but it took us to auctions and car boot sales, and was hugely enjoyable. I was amazed to discover a world of Uranium glassware, ancient oak English furniture, or Victorian paintings and Silhouettes. My own favourite subject was the books, researching their dates and authors often unknown (to me) who had produced them, then pricing them. We had some beauties, including one lot of some 300 books from the estate of one elderly spinster, Jane Hunt. She had built the collection over her lifetime, and often visited the literary places described, keeping letters or postcards, or Times reviews or obituaries about the authors, or penciled marginalia, till I was able to build up a full and fascinating biography of her life. Many of her books I read myself, and would never have met them but for her. One collection I bought at auction was a full hardback set of first edition Terry Pratchetts, several of them signed. I kept those, and read some I hadn't seen before. But with all this looming we decided to quit the trade.

First thing this morning, we had a phone call saying someone wanted to take over our unit, so our stuff would be moved into another less favourable space. Then, within a few hours, we were told someone else decided they wanted a unit too, and we would have to get out by the end of next week, as the owner is slowly converting the place into accommodation, so many fewer units are now available. The one bright hope is that, knowing I face doom-day, the wonderful person who manages the place has promised to help move some stock into empty places, and find someone else to shift all the bookcases and books. I wonder if the Macmillan Trust would like to take everything?
Even Ann's new poem carries the melancholy of the days.

Ending

I know I must give you up
yield you to the mother earth
where once you sprang
with such enthused breath
to sing your sweet and merry song.
My heart sinks stone-like
in an everlasting pool
at the sombre, cruel hand
that points to losing you.

by Annie Elliott

D-Day minus two

Doom Day minus two. In Hundon, it is half-term, so MA and her family are away at the seaside, enjoying the last of the late summer. Ann has volunteered to look after her many animals, including the dogs. They are strong and lively, too much so to manage alone, so we walk them in pairs. 

Once things go wrong, they seem to keep going wrong. If I believed in omens, another one was thrown at me today. It took the shape of a paper I submitted to a physics journal about six weeks ago. I hadn't heard from them, so went on the site again today to check its progress. The paper had completely disappeared - no trace of it, and no record of having received it or of its rejection. All I could do was resubmit and hope it makes some progress through the system.

I get very tired now. We go to town, looking for winter jerseys for Ann, but I have to wait for her over a coffee in Waterstones. Visiting a bookshop was always a joy, to browse new titles and choose something unexpected almost at random. Today the excitement is gone, as I drift among the sections. Even Terry Pratchett fails to appeal - usually certain to provide a relaxing read. This cloud is depressing me before I even have the op or the treatments. Not a good omen for what is yet to come.

Ann says I can get some Viagra once I've recovered. I say I'd be embarrased to ask for it in Clare, I'd have to go to somewhere I won't be known. Ann says I can go disguised as a Mexican, with a huge moustache covering my face, and call myself Poncho Villa, but I'd probably forget and say "I'm Aston Villa".

Dreams of death

This is a morbid post. I dreamt last night of space ships, taking us to a room on a distant world. Pipes began to ooze water, and thick Kawasaki-green sludge that filled the room, then the planet and all of space between. The others were struggling to return to Earth, and blaming me for taking them there, then left me to drown in slime, alone and immovable as they returned home.

Today the summons came to attend the urology clinic at Addenbrookes, so on Friday I face Mr William Turner, a specialist in Reconstructive Urology at the Aggressive Bladder Cancer Unit. Their site blurb informs us: "Muscle invasive bladder cancer — because of the high risk that the cancer will spread from the bladder to other organs, the treatment for muscle invasive bladder cancer is often more intensive. It may include chemotherapy, surgery to remove the bladder and other organs, and radiotherapy." Then, to make sure the message gets home, "The outlook for people with muscle-invasive bladder cancer is not good....a complete cure is not often possible. Around half of people diagnosed with muscle-invasive bladder cancer will die within five years."

I suppose, on the optimistic side, this means my odds of being here in five years are 50:50, which is better than zero, but at what cost? Having seen it close to from the surgeon's side of the OR table, I dread the idea of radical cystectomy. Now I do wish there were people I could talk to who've been through it, and learn about it from the patient's side of the table.

Once, to dream of space ships was to dream of adventure and excitement. But then I was young, and those dreams, like the patients, are long gone. Despite the care and love of a supportive family, I feel quite alone as I wallow in these dark thoughts.

Ancient apples

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. 

The Nuttery

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.