The long immunotherapy journey begins

I am strapped to the drip stand

The long road of immunotherapy has begun.  On Wednesday I was summoned to Addenbrookes for the blood tests. One can tell one is in a Cambridge teaching hospital. Along one long corridor were a sequence of Searle-like cartoons depicting the history of the University (and the city) starting with its founding in 1209, when scholars fled Oxford after some of their number were hanged by the local citizenry, and working through a number of eminant people who studied or taught there. Another corridor is lined with quotations from Shakespeare, but to bring the place back to earth one notice pinned up read: Thank you for practicing social distancing. Being Cambridge, someone had crossed the spelling through to correct the American 'c' with an English 's'.

I duly attending the bloodletting room, giving several pints of the precious stuff, then they said I was all done. It is a long walk from the oncology outpatients to the carpark, but I was nearly there when my phone rang. "You were meant to see the doctor as well," said the voice, so back I traipsed. It was for very little. A young registrar asked if I was still OK, and tried to reassure me that I might not get any side-effects. Driving home through Hundon, a funeral cortage had assembled at the bottom of our hill. The coffin was in place in the hearse, which was clearly ready to move off. At the church as I drove post were many more black-tied or skirted people waiting at the entrance, with more walking down the hill carrying food for the wake in the village hall. It is the first funeral I've spotted in Hundon, but Mary-Anne says they are quite common, the village being peopled by so many elderly souls. She's a great source of comfort as I start my treatment.

 Today, I had the first course of immuno. The list of potential side effects is long and chilling, for all are common and potentially serious. In these days of uncaring Covid, Ann is not allowed to accompany me, and being a weekend the hospital was eerily quiet with empty corridors and a silent, deserted outpatients. Only the treatment bays were busy, arrayed with comfortable upholstered chairs, probably accommodating up to sixteen people at a time. The cannula was inserted, the drip started, and I just had to wait patiently for two hours while it ran through. The senior nurse, Nithia, had been there for sixteen years and was very professional and competent. She ran through a list of problems I might encounter, accompanied by a box of tablets for potential sickness and another for diarrhoea. There is not an organ in the body that might escape the onslaught, and I did feel progressively sick as the poison dripped away into my system. Perhaps it is psychological, but I was glad to take one of her tablets.

Afterwards, I drove to Edwin and Andre's apartment to pick up Ann. Andre was out visiting friends in Ely, but was expected back shortly and when the doorbell rang, Edwin said that must be his Amazon friend and pushed the intercom to release the main entry door, calling through the speaker phone "come on up, love." The man came up with a delivery and it really was Amazon rather than Amazon man. He threw the parcel at Edwin and fled rapidly down the stairs. Andre came in a few minutes later, to berate Edwin for chatting up another man. I was glad to get home and relax, for the nausea continues and I feel very washed out.

Hospital visiting week

 This is hospital week. Yesterday was Papworth for surgical follow-up - and happily the new X-ray is clear. My lung has re-expanded, with no fluid or partial collapse, and the surgeon confirmed he had removed it all. Yippee!! I told the surgeon I currently feel much better even than before the op, and he said, "make the most of it. The time between surgery and immunotherapy is usually your best time." Oh thanks, a real gloom-monger. I had left Ann at the Scotsdales Garden Centre, and Edwin was there when I went to meet her with tea and cake and an invite to go on to their apartment for dinner, so that was a good day.

Today I go to West Suffolk for my regular cystoscopy. This is the most painful and uncomfortable examination of them all, as any man may imagine. It is not pleasant having a tube and camera pushed up one's intimate bits, and poked around all corners of the bladder while a huge colour image is flashed up on the large monitor for all to see and comment on. I'm just thankful that thus far they have been clear for three years, which is good for bladder cancer. With that and the successful metastatic melanoma removal, I live in hope of a few more good years. Tomorrow I go to Addenbrookes for the oncology check and blood tests before my immuno, then on Saturday does the actual treatment begin.

Nick at the Swan, Clare

I continue to paint, though now somewhat sporadically. I am working on a large full-length joint portrait of Ann and me on our wedding day. We had little money when we married, so had no professional photography, relying instead on the cameras of guests and relatives, so we don't have many. Also, these old photos are hard to work from as they are small and contain little detail. I have however completed a portrait of Nick, the landlord at the Swan in Clare. He is always very friendly and welcoming, with a distinctive face and it was a pleasure to paint him.

Celebrate while we may

 We have been invited out twice this week - a record indeed. On Friday, we went for a wine and nibbles evening at the home of one of the men in our Hundon men's old codgers group to say farewell to another member moving from Hundon to Linton in Cambridgeshire. It was the first time we had met all the wives, and the first time most of the wives had met each other, but the conversation flowed freely with the drink, and everyone amalgamated well, and some new friendships were made. In the end, they even suggested they ought to hold a rival meeting of wives each time we met.

I watched the Abu Dubai grand prix this afternoon. I do not usually watch motor sport, but as aficionados will know, this was special, with Hamilton and the Dutchman Verstappen entering the race neck and neck with equal points. One only had to finish before the other to take the world F1 championship. We were all rooting for Hamilton, hoping he'd take his eighth championship for England, but it was not to be. However, it did feel as though something was not right with this race; there was a crash near the end of the laps, and a safety car drove slowly round as the wreckage was cleared. No cars were meant to pass the safety car, leaving Hamilton over ten seconds ahead, and with three lapped cars between him and Verstappen. But unexpectedly, the race steward let the lapped cars pass ahead of the safety car, allowing the Honda to move up to just a few seconds behind the Mercedes. From there, it succeeded in moving ahead of Hamilon on their fresher tyres. It seemed to me, a mear novice, the most unjust decision in sporting history, so I'm glad they are appealing the decision.  

At the Baltic Amber

Today we went to the Baltic Amber for a fine meal curtosy of Richard and Chris, my brother and sister-in-law. We even had a good bottle of wine and post prandial cocktails thanks to their generous gift - so thank you both! It was a timely gift, for next week I have four separate hospital visits, moving from Papworth to West Suffolk, to Addenbrookes, and ending with my first immunotherapy treatment on Saturday. I hope to remain well on these treatments, but am aware that they can have bad side effects, and I may not feel up to much celebrating if the treatment goes unfavourably.

The return of the wanderers

The new Turkish restaurant in Haverhill

 Edwin and Andre have finally returned to the fold after their US trip. They should have been out of quarantine at the weekend, but because of delays in testing, it was not till Tuesday morning that they were given the all-clear. This meant Edwin missed his regular trip to UEA in Norwich, but at least he could run his sessions from home. They came round on Tuesday evening, the first time in over two weeks since we have seen them, and shared a first rate meal at the new Turkish restaurant on Haverhill High Street (highly recommended).

Bronte dog is getting old, and like her owner she is stiff getting up, and sometimes walks with a limp. She can no longer jump in the car, and even with the aid of a step to get in, I fear she will damage her hip or legs jumping out again, so I took Byron alone when I had to go to one of my hospital checkups. He had become more reluctant to get in the car recently, probably because he's squashed in next to Bronte who makes her dislike of him too obvious. But this time, alone, he couldn't wait to get in and was so happy there. After my hospital visit (alone because of Covid restrictions), we had a great walk on Hardwick Heath, just behind the hospital.

The consultant, a dermatologist who is nominally responsible for monitoring my melanoma, usually keeps trying different creams or tablets to ease the bad pruritus, and this time was no different. I think he is working his way through the ABC of dermatology, and gave me yet another diagnosis for it with a new cream to try. I have added it to the cabinet pharmacopeia of creams and lotions I have amassed. Even Edwin and Andre managed to smuggle through security a veritable caseload of tablets and lotions for me to try, each unique to America, and I must admit that between them they have given some ease.

Ann and I have been invited to take wine with the people who live down the road in Hundon at the Old Chapel, former home of the United Reformed Church which is its turn was once the Congregational Chapel. It was still in use when we came to Hundon, but its poor congregation led to its closure and conversion to a house. It is still surrounded by old gravestones and reputed to be haunted. Yesterday our friends Rae and Malcolm came for afternoon coffee. At least that was the intention, but we all went straight to the wine. They know Jim and Sue at the Chapel well from when the U3A was running (University of the Third Age); they used to do art together before Covid closures drew a line under everything. I hoped they would come too, but they will be seeing their grandson's play tonight, so Ann and I will go alone.

Christmas cake day

A frosty Hundon sunrise

To avoid waking Ann, I usually take my clothes into my office to dress. This morning I carried them in as usual, and brought in my dirty laundry from the day before, which I threw down the stairs ready to carry to the washing machine. I started to dress, then realised I'd thrown the clean clothes downstairs. But to compensate, I woke to a brilliant frosty morning to drink my morning tea as I prepared to go online for my first calls.

Our 'new' neighbours have been there for five years, and yesterday we finally had our long-promised coffee morning with them. The last proposed visit had been cancelled because their dog had to go to the vet; this morning, it still had a bare patch on its tail. It looks as though it has been attacked by a fox, or a very fierce cat. Their house is the old vicarage, and the last time I saw it was when I had to break in through the front door with the police because the vicar had had a stroke and lay collapsed on the floor. 

Edwin and Andre should have visited yesterday evening to tell us their tales of America, but unfortunately they had still not got their PCR test results back, and were confined in quarantine, now five days after they landed at Heathrow. They finally got the all-clear this morning, so may be coming this evening. 

Ann has baked all the Christmas cakes, and it is my job to marzipan and ice them. Her cakes are very popular, filled as they are with sweet, dried fruits and warming brandy, and so rich they easily last all year. She used to bake six, but the numbers have gradually reduced so I had only four to cover this year. Now they have their ribbons round and are ready to be decorated and handed out. It is Sam's birthday today, so we can give MA theirs when they come round and Edwin his tonight. We only do a small one for ourselves, but it still takes the full year to get through it.

Family visits and good cheer

Arwen and Matthew visit Hundon

It has been a busy time for visitors. On Thursday/Friday Matthew, Rosie and Arwen came down. We are reluctant to let the dogs loose with a baby or small child in the house, so we have to keep them locked away. This is hard on the dogs, but easier on the child who otherwise might get knocked over or worse - the dogs have a very loud bark and can be frightening. But we can't lock the dogs away for 48 hours, so Matthew and crew stayed at a hotel in Saffron Waldon. 

It was a bright, sunny though wintery day. with a penetrating, cold north wind. They had left Middlesbrough in a snowstorm, though we had no more than flurries. But with double jerseys, scarf and gloves I managed a walk with them all. Ann, meanwhile, had a long-standing luncheon engagement with Mary-Anne, who took her to Bury, so she was out all afternoon. In the evening, we went to the Swan in Clare for their Christmas dinner, and a high standard it was, Matthew and Rosie enjoying the full turkey treatment while Ann and I sampled the less meat-inspired dishes.

Then on Saturday/Sunday, Ben and Kaz came down from Telford. Edwin and Andre are back from New York, and going through their hopefully brief quarantine before they come over on Monday to regale us with their merry tales, and Mike and Ryan have requested to come down before Christmas, so with Lucy's visit last month we will have seen all our children/step-children bar Dan, who has exiled himself to the middle of the Yorkshire Moors. In his acting days, Ann and I tried to visit every play he appeared in, sometimes in the most remote corners of London. His Sweeny Todd was superb. I even remember seeing him in the brilliant London Road at its London performance in a major theatre, which resonated because of its local Suffolk connection. Going to the Levington marina in the days when we had a boat, we used to drive past the memorial sites to the poor Ipswich girls who had been murdered and buried in the ditches there. It must be ten years since Dan walked out of our lives, but he has never talked of what went wrong or given an explanation to any of us. As my old gran used to say, "There's nowt so queer as folk!"

Ben and Kaz have been amazing. We had a meal out last night at another Swan Inn, this time in Long Melford, then retired into our library for brandies and other drinks, for an evening of jokes, funny stories and great humour. Even after everyone went to bed, Ann and I were laughing together till well gone 1:00a.m. we were in such good spirits, releasing some of the tensions we have been through over the past weeks. Then this morning, the two took the ladders and various cutting and chopping implements out in the cold wind and drizzle to lop branches off the great maple tree where they overhung the car port, and birds used to take good aim at the cars decorating them with Damien Hirst-like artwork. Now, not content to rest and warm up, they have taken the dogs out for a good walk. They are doing so much for us in such a short time, it is hard to extol them enough. I hope they know how grateful Ann and I are.

 

Intimations of mortality

Finality

We will not speak of parting,
for I will be where you are
as you will ever be with me,
I will carry every day
with the haunting memory
of every thing you said and did
every dream we ever held
and every moment lived.

by Annie Elliott

Last night I awoke from a dream of death. I have not dreamt of death before. Even in my worst dreams, though shaken I survived. I suppose it is knowing the cancer has been growing in my lung for two years, peppering its malicious seeds to every part of my body where they may take root and grow. I dreamt I was in a busy building of many rooms, perhaps like a university, with dormitories and a refectory, filled with bustling young people. I tried to move with them, but sluggish and tired I lay down. Some stranger noticed me, and came across kindly to rest her hand on mine. It was warm and soft and comforting, but her words were, "you are not well, are you?" and I felt the life begin to leave me in the presence of that angel of death. 

I knew my age - it was the same age my grandfather had reached - and I thought it unfair. I hadn't even made four score years, and there were so many things I wanted still to do, and affairs to put in order. I awoke abruptly, thankful that I had not slipped away in the night, determined to fight to the end - not to avoid the inevitable outcome, but to continue my painting and writing and living as long as I can, for my life is good, I have Ann by my side, and I yet enjoy living.

My grandfather's grave in Burnley

If death should be the end

If death is the end, it is better to die
in the cradle without pain or strife;
yet on we live.
Through thought and writing,
by poetry and art,
in children and friends
we live on.
All we are and all we have been
is poured out through them.

When friends die and children die,
do we then die with them?
It is said that when someone dies,
whole worlds die with them.
We each contain a world of thoughts,
of habits learnt and feelings won,
of loves known and memories earned,
worlds awaiting death.

How little passes on;
some trick of speech,
some memory of a distant day's event,
some happy moment.
How little is the recollection now
of once dear grandparents;
yet all that exists of them may be
that tiny and fragmented memory.
Somehow you try to ingrain it
in children of your own.
But you forget, and they forget,
and though their insidious influence
creeps through your every act,
everything that was and made
that individual fades gradually away
into insignificance,
as surely as their name fades
on an old tomb stone until
one can barely read the scratched out lines.

John Herbert Marr