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Cartography of Cancer

It has taken a while to think about this, how to say what needs to be said.

In the manner of current NHS guidelines for clear and open communication to patients my parents have been receiving copies of all letters sent from specialists back to my Dad’s GP.

Right upper zone mass-stage T2b, N2, M0 if NSCLC
COPD

Very informative.

Scared what any of that might mean my Mum asked if I could ‘translate’ it back into something approaching English for her before she told my Dad about the letter. (I know, I know, it’s his cancer not hers but that doesn’t stop her trying to take control of everything).

I did what most people would do nowadays – I Googled it. I thought I was getting quite good at working out TNM classifications, the calm and clinical discussions of the latitude and longitude of illness. I could even show her the figures for 5 year suvival rates. They were not good but at least it gave hopes that he would be able to see another football season through.

PET scan results came through next. They showed the folly of trying to play the odds game. The lung tumour may have been stage 2 (still operable) but his spleen showed up hot. At stage 4 they have said there is no point in trying to take the lung, my Dad wouldn’t survive the operation.

Three to six months they said. Three to fekking six months for a man who, even a month ago, didn’t know – or didn’t say – he was ill.

He had his first session of chemotherapy on Monday, his second will be tomorrow.

This isn’t a cure, this is just an attempt to slow things down. I’m not certain how much can be done. Now that he is in the care of the real specialists at The Christie they are being kind to him but they are being honest. The jargon has stopped and they are speaking to him in English.

He is too weak for the more aggressive forms of chemo. He will have three sessions and on the fourth week they will take a view on whether or not there has been any response to the treatment. If there has been no benefit then they will not put him through any more medical poisoning and all that will be left will be palliative care.

If he responds to the treatment, and the side effects are bearable, then they will continue for up to eight more weeks. At best, if all goes well, they think they might be able to buy him another three to six months.

As a family we are coping in different ways, none of them seem to be particularly good but I guess that that is quite normal. My parents have been here before. Specifically they have even been at The Christie before as my sister died of cancer in the mid sixties. This time around they have been sent away with leaflets packed full of advice and phone numbers and how to get support for all aspects of the illness and the grief that is to come.

I think that first time round they got nothing and have struggled with the effects of the grief ever since. In the sixties it may have all been stiff upper lip and keep calm and carry on left over from the war. That was the environment I was born into and I’ve never really been comfortable with emotions. The stats and the charts and the TNM I can get my head around. The thought of my Dad just not being there and, more importantly, the thought that he may suffer in the process, is something that I have no answer to.

My job has always been to fix things. I can’t fix this.

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Father’s Day

I’m not much of one for family. They are just there – like the Pennines or the seasons, or, if you live in Manchester – like the rain. There are different kinds of rain but you know you’ll always have one kind or the other and often closer than you would like. It’s a given.

Only soon it might not be. I got back of holiday a couple of weeks ago to be told my Dad had a cough (cue analogy to weathering and erosion or some such). Later this week we find out if/how the cancer can be treated and how long they think he’s got. There you go. Simple as that, part of the coastline crumbles into the sea.

So today is Father’s Day. Do I go along and tell him off for 60+ years of smoking and then having the gall to get ill? There can’t be anyone that doesn’t know the risks. I even grew up telling him that this would most likely happen. Always there – Dad and smoking. He wasn’t the only one. I remember Uncles and friends of the family all smoking (we must have all reeked of it but everyone else’s parents smoked so who was to notice?). I remember the party one year when they all decided to give up together.

And they all did. Except for my Dad.

We all are all made by our environment.  Years of watching my Mum nag him helped me grow up to be someone who very specifically does not nag. I also do not tut. I also realised that there is next to no chance in changing a person. My Mum seemed to have wanted to stop Dad smoking ever since she met. At that was over 50 years ago you’d think she’d have got the hint before now. I’ve even known my Dad wind her up to an argument so he can go off and have a smoke in peace on holiday.

Current husband smokes. He smoked when I met him and I have never nagged him to stop. I haven’t even asked him to start smoking outside. He’s tried giving up a couple of times and I’ve been supportive but he always goes back to it. He might not smoke a lot, but he does smoke. (By coincidence my previous chap smoked cigars. I might not like it but I do seem to have ‘form’ with smokers.)

Last week I finally asked other half if he would consider the possibility of maybe giving up smoking for good. (You can see I was really forceful about it.) He’s still smoking. He tells me not to panic, not to upset myself as – after all – the final diagnosis has not been determined. His own Father died of a smoking related cancer. If nursing your own Dad doesn’t make you reconsider then I doubt if what your wife says will make much difference.

I’ve grown up expecting this, there’s nothing I can say or do that will stop it. And I’m so angry at my Dad but I cannot say “I told you so” because that does no one any good. I can’t tell him I’ll miss him, because we haven’t had the final word yet and we don’t know how long things will take. After years of waiting for it I’m trying to be the objective one but I still expect to fall apart when the time comes.

Father’s Day. The day we celebrate bad DIY (yes, that shelf did fall on my head), being shown up in public (dancing to Satisfaction by the Rolling Stones), putting your foot in it (“no, I only meant you were all in proportion”, “oh, so I’m fat all over, thanks Dad” – conversation on holiday some years ago) and having the sartorial elegance of socks and sandals with milk bottle white legs and baggy shorts when abroard. The day we also say “I love you” with a card, often sarcastic and either mentioning money or farting, because we are all too stupid to say it out loud.

This is my Mum and Dad and my brother at his wedding a few years ago. I can’t quite think what the scenery is going to look like when one of them is missing.

Our kid (‘ar kid’ if you are local), Mum and Dad