When a month or so later I was demobbed and went up to Oxford, something had happened. I had learned authority was not to be trusted. I was an Other Rank and I had better get used to it. Not a second lieutenant and so never a member of the Oxford Union or an actor in OUDS; I did not write for Isis or speak at the Labour Club. I led a thoroughly domestic life in my own college and began to fancy myself an outsider (which I wasn’t, though it saved me from making an effort). What I was not was a joiner. And so in due course not a CBE and not a knight. An Other Rank.
The greatest honour I have ever been given had nothing to do with the Honours List and thus evaded the strictures of my recusatory temperament and all my misgivings about authority. This was when in 1993 I was appointed a Trustee of the National Gallery. It was entirely unexpected and unlooked for; when I asked, ‘Why me?’ I was told that I represented the man in the street.
The position of Trustee carries with it one inestimable privilege, namely permission to go round the gallery out of opening hours. To be made free of the nation’s pictures and to be allowed to roam the gallery at will seems to me a distinction of more substance and worth than any of those doled out in the Honours List, particularly since, though a Trustee serves for five or seven years, the privilege of out-of-hours entry is given for life. Even though I was for all sorts of reasons an indifferent Trustee, nothing I have ever been given has pleased me more.
The last word on honours, though, ought to be a joke. The painter Francis Bacon accepted nothing. He was asked in his seventies why he had not taken a knighthood or the OM and his reply, though camp, as so often with Bacon concealed a good deal of common sense.
‘Oh, I couldn’t. So ageing!’
* I leave aside the objections to the actual nomenclature or that many decorations come in the name of an empire that has long since disappeared. It’s true this is antique and outmoded but, in my view, the more to be welcomed on that score. So too are pageantry and ceremonial, and after all, what is the Order of the Garter but an antique, and nobody so far as I know has suggested updating the name of that.
An Average Rock Bun
‘I remember when you were here last time,’ says the nurse as she checks my blood pressure. ‘It doesn’t seem like five years.’
‘It does to me,’ I say, ‘every minute of it.’ I am lying on a trolley in a cubicle in the endoscopy unit of the London Clinic. With my gut scoured clean and awaiting scrutiny and naked except for a hospital gown, I am beginning to look forward to the Valium. The nurse goes out, pulling the curtains closed. Condemned cells have no door, I reflect, just a tastefully patterned curtain and a locker for your valuables.
Actually the curtains have changed since I was last here. Then they were a cheerful flowered print, Laura Ashley perhaps; now, it’s a rather sombre design of African violets in blue and grey. Five years ago I glanced at the fabric as I was taken out, thinking that when I was wheeled back after the colonoscopy I would see this same pattern again but by then I would be in the clear and it would all be over and done with, though why it should have been the soft furnishings I fixed on I can’t think; tasteful unto death perhaps.
It’s a Friday afternoon and the unit is not busy. In the corridor, a few feet away, a doctor is telling some relieved woman that there is nothing amiss.
‘No polyps?’ she asks.
‘Not to speak of. Nothing out of the ordinary. You can go home and prune the roses.’
Oh, the lives that doctors wish upon us! But if she has no roses, or garden at all, she is still overjoyed as he ushers her out and the corridor falls quiet. Soon it will be my turn.
I have never got used to the sight of blood. On the paper, in the pan, the toothbrush or the handkerchief, however innocent the explanation, it never fails to startle and to mar the day. At different times I have shat blood, coughed blood, spat blood, and of course bled blood; it has happened all my life, but seldom with serious consequences or from significant cause.
Still, the sight of it has generally been shock enough for me to seek medical advice as one is told to do, though, suffering occasionally from piles, to do so on every occasion was hardly practical or fair on the doctor. But I have had regular sigmoidoscopies as a precaution, the doctor looking up my bum with a telescope (‘A touch of cold steel now’). Sometimes I felt that more people had seen the inside of my bum than had seen some productions at the National Theatre.
My first London GP, a saintly man who never made me feel a fool, as doctors sometimes have, was often required to reassure me in this area. I was once lying on the couch while he carried out a manual examination of my back passage.
‘No,’ he said patiently, ‘I find nothing that concerns me here. Though of course’ (and his finger was still up my bottom) ‘it’s always nice to see you.’
So, even though I was bleeding fairly regularly, it was without any particular feeling of alarm that I arranged to see the usual specialist and have one of my periodic sigmoidoscopies. This revealed the piles which would account for the bleeding, but that apart, the examination was reassuring; the specialist could see nothing alarming, though he did ask when I’d last had a colonoscopy.* He didn’t press the point and whether or not to have one seemed up to me. One reason why one goes to a doctor is to try and make another person responsible for one’s life. I wanted him to tell me what to do but he didn’t, and not being at all anxious and feeling reassured by the sigmoidoscopy, I don’t know what it was that made me, nevertheless, decide on a more extensive investigation. Luck, I think now, or providence, or maybe there was still a doubt and I was hankering after perfect peace of mind. But in that curtained cubicle in June 1997 I was probably thinking that, as on previous occasions, it was all a fuss over nothing and I was being a bit of a fool.
On this point, at least, I was soon proved wrong. Dr W., the head of the unit, breezily explains the procedure, how I will be given some IV Valium with more if I need it, and that if I choose I can watch the proceedings on a screen while he gives a commentary.
The tube with the camera attached begins its track up my bowel. ‘Very few people come out of here without a smile on their face,’ murmurs Dr
W. as he cruises past some unassuming piles. ‘Nothing to worry about there.’ The camera pushes on with its proctoscopic odyssey. Suddenly the tone of his commentary falters as he rounds a bend and is brought up short before something huge and craggy. Once it may have been benign; now it’s not benign at all. Even before Dr W. explains this, I notice how the two nurses, who are also watching the screen, instantly become more solicitous, one kneeling down and stroking my arm, whispering reassurance before I have entirely realised that reassurance is required.
The culprit is a polyp that has gone undetected, turned malignant and is now firmly attached to the wall of the bowel. It’s a situation, I know, in which I am expected to be an adult, and Dr W. invites me to look at the screen and confront the agent of my misery. But openness has its limits and my eyes are firmly shut as he gives me another burst of Valium and edges the camera past the evil monster, even looping the cable round it and giving it a tug to show how rooted it is. And he must be a gardening man because, almost to himself, he says something that chills the heart.
My own gardening skills are limited and the pleasure I get from the garden in Yorkshire has always been mitigated by my almost Manichaean attitude to plants, which I divide into good and evil, with the evil obviously weeds, thistles, dandelions, bindweed and a particularly stubborn resident of our garden, ground elder. I see ground elder as a nineteenth-century evangelist saw sin, something to be rooted out wherever it breaks the surface. The trouble, though, with ground elder is that it doesn’t always break the surface, spreading through the soil and strangling the roots of neighbouring plants, and weedkiller and meticulous sifting of the soil notwithstanding, never to be wholly eradicated.
So when, having tugged the polyp to no purpose, he mutters, ‘Ground elder’, I know that I am doomed. When I’m dressed he comes to see me off.
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‘I imagine you’re the sort of person who can cope,’ he says. I imagine that, too, though it remains to be seen.
‘It’s about the size of the average rock bun. It will wait a week but not a month.’
Still half cut from the Valium, I write a cheque for the £800 bill, noting at the desk that the receptionist finds it hard to look at me and that I, in my turn, feel shame that I have somehow failed.
When I came home that afternoon, for all the shock and the reeling anxiety and the collapse of any imaginable future, there was, nevertheless, a feeling, too, that this was what I had been waiting for all my life. Waiting for in my mother’s life and my father’s and always in my own.
This makes me sound more morbid than I am. It was just that of all the ways any of us might go, cancer has always seemed the likeliest because most often met with. And it was more likely than I then knew.
I had known that there was some family history of bowel cancer as my father’s brother had died of it, and I knew, too, that it was something my father feared. It was only later, after I’d been operated on, in fact, that I found that he had reason to fear it because his father had died of bowel cancer too. However, my father seldom talked of it and an aunt, one of whose regular topics of conversation was that ‘cancer was in the family’, he thought morbid and self-dramatising. His reticence was understandable, though in the light of what happened to me thirty years later, misplaced. And even in the sixties, when my uncle died, the familial nature of bowel cancer was not a great deal emphasised and the notion that some forms of cancer might run in families tended to be thought of as hypochondria.
However, this rock bun I was sequestering was not hypochondria and, distraught though I was, I noted that there was some small satisfaction in being able to ring my GP over what was not, as was so often the case, a triviality or an ailment I was imagining. This was real. ‘Steady,’ I wrote in my diary. It’s what Dad used to say to us children when we were coming down the steps of a tram or waiting to cross the road. ‘Steady!’
My GP recommended that I see John Northover, Senior Surgeon at St Mark’s Hospital and head of the colorectal unit of the Imperial Cancer Research Fund. Though he was an NHS surgeon and in private practice, living in Camden I was obviously outside his catchment area for the NHS, for which, in any case, there was a waiting list. Even his private list was oversubscribed, and it was only because a vacancy occurred at the last minute that I was able to be operated on within a week, and in the specialist colorectal unit of St Mark’s, Northwick Park.
There is no doubt in my mind that it was the skill of John Northover and the expedition of the operation that saved my life or, since I am still in remission, saved it so far, and certainly for five years. At the time, this seemed an unlikely prognosis. Although the cancer was found to be quite compact, and had not yet breached the wall of the bowel, unseen on the scan beforehand a small patch of cancer had begun on the liver, and traces were found in one of the nearby lymph glands.
The outlook did not seem cheerful and Mr Northover gave me, with chemotherapy, a fifty-fifty chance of recovery, odds which I think I knew at the time were probably overstated for my benefit. Still, the operation was uneventful and before and afterwards I remained uncharacteristically cheerful. As indeed did every doctor I came into contact with.
‘He’s very positive,’ I wrote in my diary. ‘Sometimes one wonders why anyone ever dies of this disease, everybody’s always so hopeful.’ Still, cheerful or not, I did not at that time, July 1997, expect to last more than a couple of years.
But we managed jokes.
‘All I ask,’ said Rupert, my partner, ‘is that you don’t follow [the Murdoch-Murdoch] Dennis Potter’s example and christen the cancer Rupert.’
Jokes or no jokes, in some ways the diagnosis of a life-threatening disease is easier for the patient to bear than his or her loved ones, who have to stand by and watch it happen. The positive thinking which the conventional wisdom requires of a cancer patient was easier for me (who had at least something to do, even if it was only to undergo surgery). Had I been cast as help or support I would have found it hard to disguise my anxiety. Rupert, on the other hand, seemed never other than cheerful and gave no hint of what he must have been going through, an impeccable performance in a role that is largely unsung, but which must be played out every day in thousands of households, suddenly stricken with mortal illness.
Various entries from my diary:
18 July 1997. I suppose that I assume this disease abides by the programme doctors impose on it: I have now had the operation and will to some extent recover; then I will have chemotherapy for six months and will in due course recover from that. I imagine that it will be then, and only then, that I will have to start worrying whether anything else is happening, the disease meanwhile having bided its time … or with luck, been eliminated. But why should it bide its time? What is it waiting for? And yet people survive.
There were unlooked-for bonuses:
24 July 1997. One of the blessings of my situation is that I no longer feel obliged to recycle and am absolved from trips down to the paper bin, laden with the week’s supply of newsprint; I don’t feel the need any more to post my few bottles, brown, green or clear, through the bristled mouths of the bottle bank. Excused duties, I suppose it would be called.
25 July 1997. However hard I try (and I probably don’t try very hard) I keep being caught off guard … by a photograph, for instance, taken a year ago (‘If I’d been investigated then,’ I think, ‘I wouldn’t be in this hole now’) … something in the house (‘When I bought that I wasn’t poorly’ … not that I feel poorly now). So, I suppose from henceforth it must always be BC and AC, before cancer and after. Mine was, indeed, the blood of a new testament.
30 July 1997. To look at me in the glass one might think nothing much had happened. I am slightly thinner, particularly in the face, but all there is to show besides is a thin red line two inches above my navel, going down to the borders of my pubic hair with a neat little bypass – or chicane – round the navel itself.
‘The scar will fade with time,’ the nurse tells me, an assurance that tactfully forgets that time is probably what I don’t have.
I am still surprised, though, at my own good spirits, not that I deserve much credit on that score. People talk of courage as if there were a choice, whereas one shows courage very often because there doesn’t seem to be much alternative.
Larkin’s ‘Courage is no good/ It means not scaring others’ is slightly beside the point.
But I don’t want my life, or what there remains of it, to be all about cancer, any more than I’ve ever wanted it to be about being gay.
In the few weeks that elapsed between the operation in early July and the beginning of chemotherapy in August, I made some enquiries about alternative therapy. These weren’t systematic or unduly conscientious; I had made up my mind to undertake the precautionary chemotherapy and, while I had no intention of signing up for the full range of holistic and dietary therapies that were on offer, I did feel, after talking to my GP, that homeopathy might help. The oncologist, while dubious about the alternative therapies, had no objection to homeopathy and, on the recommendation of the wife of a friend, who had had breast cancer, I made an appointment at a reputable complementary health clinic in Harley Street, simply in order to explain the situation and arrange some homeopathy.
The clinic was plainly busy, the only appointment available at seven in the morning. The doctor who interviewed me told me that he had himself been a conventional therapist, and so was well placed to assess such claims as were made for conventional cancer treatment and, in particular, chemotherapy. I explained, though, that I’d decided on a course of chemotherapy, and simply wanted it to run in conjunction with some homeopathy, expecting him, in the circumstances, to soft-pedal any understandable misgivings he himself might have about such treatment. Not a bit of it. He proceeded to pour scorn on chemotherapy, the benefits of which he said were unp
roven, and when I didn’t budge, rather sulkily conducted some finger-tip tests, which I took to be to do with the homeopathy, but done in such a perfunctory fashion I’m not sure he thought much of the point of this either. People kept coming in with whom he chatted, and throughout treated the whole business so casually and with such a disregard for my predicament, and presumed agony of mind, that it reminded me of the arrogant and unconcerned conventional doctors one used to come across thirty years ago.
21August 1997. Try and read some of the literature the alternative doctor gave me, but since one of its objectives is to discredit chemotherapy, which I’m currently undergoing, I put it aside.
Of course, there’s a lot of money at stake in both approaches, one can see that, and the two sides behave like commercial rivals, each trying to discredit the other, with the truth somewhere in the middle. Only the patient is in the middle too. It’s like the claims of two brands of soap powder, only you’re the fucking shirt.
I agreed to have a blood test to check the level of the various minerals etc. in my blood. A few days later a letter came back with the results. Again, the alternative therapist did not mince words. The results of the blood test, the letter said, ‘turned out to be a lot worse than I thought they would be. Don’t be alarmed, however, we can certainly put this right’ and an analysis of the various vitamins etc. followed. ‘Without sorting this out, your chances are much less than fifty-fifty.’ The remedy was six weekly visits to the Centre’s clinic, an hour out of London, for a course of intravenous vitamins. ‘I trust you can see the arguments,’ the letter ended.