The author's prognosis for a brain tumour was blunt: there was no cure. It is a fact she has been making sense of since. By Georgia Blain.
The unwelcome guest
Life changes fast. Life changes in the instant. Joan Didion wrote these words shortly after her husband sat down to dinner and, moments later, died of a sudden heart attack. She didn’t alter them, choosing to open her memoir The Year of Magical Thinking with those unedited sentences, teasing them out as she tried to make sense of grief in the wake of her husband’s death. It’s curious, her use of the word “the” before “instant” – denoting an absolute specificity, no matter how ordinary this moment may be.
My instant came early in November, and these were the first words I wrote shortly after returning home from hospital two weeks later:
It was a Thursday. I was in an ambulance, and Andrew was up the front with the driver. An older guy – bald, serious – was sitting at my feet.
He told me it was okay. I was on my way to the Royal Prince Alfred Hospital. They were going to examine me.
Apparently I’d had a total global seizure when I was mowing the lawn.
It was an instant as prosaic as lifting a fork to your mouth to eat dinner; it was also the instant in which my life was fundamentally and irrevocably altered. Andrew is my partner, though nothing else in this moment was familiar to me.
As I waited in emergency, I began to recall the moments before my fall, the time leading up to that dividing line, but I have never been able to get myself right up to the instant in which my illness first revealed itself. Initially I remembered the impossibly blue sky; next there was the furry texture of the silver leaves of a plant I was pruning; then I recalled greeting Andrew when he came back. Each are isolated visions in a dream full of saturated colours, the buzzing of cicadas, and the sweet smell of grass. I have no memory of just before the seizure.
Throughout that first evening in hospital, doctors and nurses came to examine me and question me. Besides the fact I had difficulty speaking, and I couldn’t recall the prime minister’s name (they all joked about that one), I didn’t think anything was seriously wrong.
I was surprised when they wanted to keep me in overnight. At some stage they scheduled a brain scan, but I don’t remember actually having one. Shortly after, the neurosurgery team came to my bedside.
They had detected a brain tumour. They were going to have to operate.
Six days later I had a craniotomy.
Although the operation was a success in that it removed all of the tumour, the surgeon was blunt in his prognosis. I had a stage 4 glioblastoma. It was sitting right on the language centre of my brain.
There is no cure, he told me. The best I could hope for was two to five years if I underwent chemotherapy and radiotherapy. Without treatment, it would be liable to grow back in about four months.
There was no indication that the tumour was there prior to my seizure, except for the fact that I had noticed a slight difficulty in finding the right words. At the time I put it down to turning 50, and the stress of putting my mother in a home. Later I’d wished I’d paid more attention to it, but I was never someone who was fearful of cancer. I didn’t worry about any illness or grave misfortune striking my family or me.
This was partially because I felt I had been dealt my fair share of bad luck when I was growing up – my brother’s mental illness and my father’s violence made for an unhappy childhood. I always assumed this had given me some kind of cloak of immunity, shielding me from being struck down by serious adversity for the rest of my life.
It was a silly notion. When you enter the land of cancer you also enter the land of statistics, from the likelihood of the operation further damaging my speech, to the calculated risk of radio and chemo, to the possibility of defying the odds of living more than two years. Bad luck in childhood has little if any bearing on the statistical probability of being diagnosed with a terminal illness at 50, barring some kind of demonstrable cause and effect.
So, how did I deal with this news? As I write this, I am aware of the fiction in the past tense. I am dealing with this news, and my response changes daily, even hourly.
In the fortnight I spent in hospital I initially clung to the hope that there had been some kind of mistake. As more and more information was gathered, from the initial scans, to the operation itself and then to the final pathology, it became clear there was no error.
I wept a lot. The seizure, the surgery and the after-effects of the anaesthetic, as well the Endone I was on, contributed to my tears. Nurses and social workers constantly asked if I needed to see a counsellor. One particularly kind nurse told me that of course I was going to weep. It was okay. I was dealing with a lot, she said, and I should just go easy on myself.
I also kept thinking it was all a dream. A clichéd response, I know, and one that surprised me with its force. At times, I really believed someone would wake me up to tell me I didn’t have cancer.
At other times I attempted to rationalise, to intellectualise, with a kind of illogical logic. No one knows when their time is up, I told myself. My odds have been considerably shortened against having a long life, but I could be hit by a car tomorrow. In fact, on the night I came home from hospital I almost choked on a fish bone, and the possibility of having gone through a craniotomy to be felled by a sliver of salmon bone was too much.
Sometimes I had hope. I still have hope. I cling to stories of people surviving against the odds. My GP told me that a lot could happen in medical science in the next couple of years. Your tumour is an unwelcome guest that you can’t get rid of, she said, but treatment may develop to such an extent that you can live with this guest. It’s happened with the HIV virus, she said.
At other times I am overwhelmed by sorrow. I feel like a transparent but impenetrable barrier separates me from the living world. I have crossed the mythological river and I am already dead, interacting with the living but never really being able to join them again. And I am envious, so envious, of the people on the other side.
When the surgeon came to deliver my diagnosis, he said it wasn’t good news, he couldn’t deny that. But think of it as an opportunity to reprioritise, he told me. You need to think about what matters to you. Most people never do that, he said.
Three weeks later, at my follow-up appointment, I thanked him. I had found some solace in his advice. I had realised how much I loved my life and how blessed I have been. I have love and friends. I have work that I enjoy. I have never suffered for lack of anything. And I am wary about sounding like a Pollyanna, because so often when you are in the midst of life, and even here on the periphery, you can be overwhelmed by the day-to-day anxieties.
I also realised how little I wanted to alter my life, even the mundane aspects of it. It is the ordinary that gives me an anchor when I despair: sweeping the floor; hanging out the washing; weeding the garden. Although
I never mow the lawn now.
A doctor friend of mine told me you never become immune to delivering news such as the news that was delivered to me. He also told me that he was consistently surprised by people’s strength in the face of their mortality.
In the months or years to come, I will probably have to hear worse news. I hope I will have the strength I need. But for now, I am trying to live alongside this unwelcome guest, a guest whose presence cannot be ignored, and must be accommodated in the best way I am able.
This is the first in a monthly column Georgia Blain will write for The Saturday Paper.
This article was first published in the print edition of The Saturday Paper on Jan 30, 2016 as "The unwelcome guest".
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