In which our hero doesn’t, and then maybe does, and then definitely does have cancer. Just so we’re clear.
“John, I think you’ve got blood cancer.”
“I just really think you should go to the GP. There’s that rash on your leg, and you keep having nosebleeds, and you’re always tired and-”
“Fuck off. You’re a hypochondriac. What’s worse, you’re being a hypochondriac at me. This is basically Munchausen’s Syndrome by proxy. Fuck off.”
The awkward thing about spending two months telling your girlfriend that she’s an idiot for Google-diagnosing you with leukaemia, of course, is when she turns out to be very nearly correct. Ought I to regret, to recant the conversation above and the dozens like it, or is it just inevitable that one nervy partner in a million will accurately call a cancer diagnosis eight weeks before a doctor appears on the scene? I’m more inclined to chalk it up to extremely long odds than insist she does an AMA on how she can smell aberrant cell division, but perhaps that’s just bias. After all, coming to terms with long odds has been very much the order of the day of late.
When I finally went to see my GP, thirteen days ago, I’d been quietly dying of cancer for about three or four months. I hadn’t noticed, because the progressive destruction of my bone marrow began more or less as I started a new job in magazine publishing, which often feels like that anyway. After two years of working from home, the second as an almost entirely idle freelancer, I was suddenly spending 45 solid hours a week in the office and catching a rush hour Tube for the first time since 2011, plus getting up at 5 whenever I could think of something fun to write. Of course I was exhausted. Of course I was getting nosebleeds, and headaches, and weird shadows in the corner of my left eye. Having a job is dreadful. (It’s not, of course. Having a job is just the ticket, except when you’re dying, when it becomes dreadful by virtue of being ‘a thing to do that isn’t lie in bed and whimper’.)
Sometime around the start of the nosebleeds, my long-suffering girlfriend Ella started mentioning leukaemia. The first time it came up, I eventually discovered that her period was a day late and her concern was not so much that I’d die of cancer but that she’d have to raise a fatherless child alone once I did so, which maybe gives you some context re: her capacity to worry about utter bollocks. It certainly wasn’t worrying me. I’ve always been prone to bruises, always at risk of nosebleeds when things are stressful – not sickly by any means, but a bit full of blood. My dad had haemochromatosis, one of the very few diseases for which bloodletting remains the most effective treatment (aren’t you thrilled that there are still some left?), and I’ve got a bundle of the same weird genetic markers – not enough for a diagnosis, but more than enough to keep my cheeks and handkerchiefs regularly topped up with vermilion.
This was the point at which I arguably started to ignore the evidence. I developed weird rashes on both my shins, purply masses that looked like rows and rows of ruptured blood vessels. The Internet called them petechiae and said they were a possible symptom of blood disorders. I decided they were because I had to wear trousers all the time (fucking job again) and there wasn’t any proper aircon in the office. Then I started getting such bad night sweats I had to sleep on a towel and change it at 3am before it could get the mattress wet. I dug out the fan I bought last summer and clocked it up to my usual boom and bust weight routine getting out of sync – normally I try to save being fat for winter, but this year it didn’t work out.
Then Ella and I went on holiday with her entire extended family, and I spent almost every day of it throwing up – sometimes so badly that I’d spontaneously develop more petechiae on my face during the twenty seconds or so I was actually retching. I grimaced at the offensively healthy-looking mountains, swore off booze and crawled into bed for the week, spending more time in my room than I really wanted to because I didn’t want anyone to notice how hard it was for me to manage the stairs. Ella’s grandparents, both pushing seventy, made it to South Base Camp a couple of years ago – they do not fuck about – and the last thing I wanted was to appear as pathetic as I felt.
By the end of the week I’d lost half a stone, passed on dozens of meals that would normally have had me weak at the knees and substantially bolstered my reputation as the lazy boyfriend who didn’t like hiking or joining in. But, thank Christ, it seemed I was going to leave the bug in Scotland, along with the weird yellowish water and the complete lack of WiFi. I got home intact, spent one day at work trying to make sense of an article about tax avoidance, and promptly started throwing up again.
I hadn’t seen my GP for three and a half years – in fact, I hadn’t spoken to a doctor since I discharged myself from a mental hospital in early 2012 (see many, many self-indulgent columns passim) – and I wasn’t keen to break the streak, but I really did need to get this article done and vomiting wasn’t going to do anything for my prose. So I choked down a Berocca, registered with the surgery up the road and secured a ‘new patient checkup’ for the following Wednesday evening, with a vague recommendation to pop to the out-of-hours clinic over the weekend if I still felt rough. I did, so I did, but they aren’t allowed to prescribe anything so I went home again.
By Monday, I was so desperate to work that I’d have cut my legs off and used them as paddles if only I had a canoe and a creek and all the other things this analogy is somehow lacking. Alas, a brand new office meant that my commute had shifted from the air-conned and reasonably salubrious Hammersmith and City line to the steaming green shit serpent that is the District, and after one rush hour trip spent standing in the last carriage I was barely conscious. My boss sent me home comfortably within five minutes of my arrival at work, and I crawled into bed with just enough wherewithal to call my new GP and beg for a telephone consultation the next day.
On Tuesday morning, the doc duly rang and, to my surprise, asked me to come in as soon as I could manage. I expected to be written up for some anti-emetics and sent home, perhaps with a salutary warning about being fat and stressed when it’s hot. I did not expect my GP to palpate my liver, write me a note to bypass the queue at A&E and call me a cab there herself. Neither did I expect to walk into A&E and be in a bed within fifteen minutes. I certainly didn’t expect to be seen by three doctors and then admitted to an urgent care ward. I hadn’t even taken a fucking book with me, and I generally take a book into the shower.
As I settled into my new bed and contemplated the plate of lamb bolognese, pasta shells and baked beans which my immediate predecessor had inexplicably chosen to order before (I hope) dying, a twitchy young registrar popped in and introduced himself. He was from the haemotology team, and he’d been scrambled because there was something amiss with my blood. They’d know more tomorrow.
“We’ll know more tomorrow,” as it turns out, is a deeply loaded phrase when used by a haemotologist, because what it actually means is “we’ll know more when I biopsy your bone marrow with this colossal syringe.” The technique is actually called a ‘punch biopsy’, and I just looked up the tool they used to do it, and now I wish I hadn’t. I had to be sedated eventually, but I’m told I carried on screaming under my breath. The registrar went away with his little tray of aspirated blood and chunks of bone marrow, and I decided I probably wouldn’t ever go to St John again, and that was that.
After a very long, very slow day spent staring blankly at Right Ho, Jeeves and slowly drawing up an armful of antibiotics, I decided to have a horrendous vomiting fit just in time for the haemotologist to come back and see me. It probably wasn’t the worst thing I could have done, because once a relative stranger has found you covered in blood, IV fluids and cottage pie on the floor of a hospital toilet there’s nowhere for the encounter to go but up. Even if, with the sort of nauseating neatness that you’d never write into a proper story, where it was going was here:
“John, I’m sorry to tell you that you have a cancer of the blood.”
NEXT TIME ON JOHN VS CANCER: The Move to Barts, Adventures in Blood Sugar and a Looming Diagnosis. Assuming, of course, that I stay alive long enough to write another column. You don’t get this sort of suspense on Comment is Free
I’m going to keep writing these blogs until I die or get better, probably, and although I don’t really want to sell them (there’s a time and a place for editors), I do want to include a regular plug for Anthony Nolan, the charity that will hopefully save my life with a stem cell transplant some time in the future. I’ve written a thing about them over on JustGiving, and put in a button below to make it as unavoidable as possible. You can give them your spit and maybe save a life sometime down the line, or give them some cash and support they work they’re doing right now. Either way, if you don’t at least have a cursory read then I’ll know, and I’ll lie in my hospital bed wishing you were a better person.
Donate to the Anthony Nolan charity through John’s fundraising page here.
This article originally appeared on John’s blog, JM Underwood. He tweets @JM_Underwood.