Can-can Cancer Dancer 5 — Chemo’s Ghost

Malign spirits

Sariputta, one of the Buddha’s two chief disciples, was once meditating in the open air on a full-moon night. A passing mischievous spirit, beguiled perhaps by the moon shining on Sariputta’s freshly shaven head, found such a tempting pate irresistible and gave it a hefty swipe with his club. However, Sariputta was so deeply absorbed in meditation he felt nothing.

His friend Mogallana, who had seen the assault, asked him if he was in pain. After thinking about it, Sariputta admitted to a trifling pain in the head, but nothing more.

You may not believe in mischievous spirits, but I’ve seen them. They assume many forms, most frequently manifesting as fourteen-year-old boys on bikes. A totally bald head was part of my immediate post-chemo legacy.

One afternoon, while sitting on a park-bench talking to an old friend, my naked head presented an easy and irresistible target for one such spirit as it passed swiftly by. Consequently, I received a hard slap on the back of my scalp, giving me a headache that was more than trifling. This malign spirit then took aim at another bald patch a hundred metres further on.  As we all know, a real boy would never behave so badly, which is how I knew it was a spirit.bike

A malign spirit prepares for action; don’t be fooled by the cute disguise.

 

My hair’s reluctance to grow was clearly a liability and my reviving beard was no protector, as beards are insufficient to frighten such wanton spirits, but even if they could, my new growth was barely visible. And, anyway, I had started shaving again — not that there was much to remove; it was more an exercise in reassurance. Other chemo side effects also lingered — addled brain, leaden legs, neuropathy in fingers and feet — but all much milder than during treatment.

“You’re going to Mercury, today”

Mercury

The CT scan I had been given to determine whether or not my intestinal gas had been dispersed revealed that it mostly had, but there might now be an issue with my large intestine. Although there was still doubt as to whether or not I could have the full treatment, there would be no further delays. At the very least I would receive what had been the normal treatment a few years previously.

I started ten days later. “You’re going to Mercury, today” the receptionist told me, smiling sweetly at me as I checked in, having her little joke with a new patient. All the machines are named after planets. All equally powerful, Mercury is the latest model.

Once more the preparation routine was explained to me by a radiographer. “Am I getting the full treatment?” I asked.

“You would not be here if you were not.”

“Good.”

Any doubt about treatment prompted mild, residual anxiety — it tripped me up every time — usually just a quick flash and then it was gone. It was like an alarm clock that awakened me then I would remember that I had forgotten and had fallen victim again to complacency.

“Could I have a later appointment time? I need to fit in an early morning swim.”

“I wouldn’t advise swimming. It could irritate the treatment area.”

A human water sprinkler?

My preparation completed, I reported back to reception, “Ready for lift-off.” The older of the two receptionists looked at me quizzically, the younger, pretty one, giggled.

Fifty minutes later, having put on a hospital gown, I was taken into the treatment room. My bladder was then checked to see if it was sufficiently full, which it was not. Twenty minutes later, having drunk two more cups of water, the necessary level was finally reached.

It took a few days to work out how much fluid I needed to be ready on time: three glasses of water first thing in the morning, followed by a very large fruit smoothie mixed with muesli, a mug of decaffeinated coffee [caffeine was not recommended], another glass of water before leaving for the hospital then two more cups as soon as I arrived. After evacuating my bowels and emptying my bladder I then had to drink another litre of water as my immediate preparation.

Good job I was not about to have acupuncture — I might be at risk of becoming a human water sprinkler. But probably not; most of this fluid seemed to store itself in my body until night time so that it could then slowly trickle into my bladder to keep me active half the night emptying it.

Anyone nicked it?

The door of the treatment room looked like it could resist a nuclear blast, it was so thick. Mercury itself was enormous and highly complex.

Varian

“Oh, it’s just a load of plastic,” Sangita, one of the two radiographers pronounced, dispelling my awe.

“It’ll circle you several times, with different parts moving in and out,” explained Yasmin, her companion, “but nothing will touch you.”

First they had to position me very precisely on the treatment table. To enable them to do this, I had been given three barely visible tattoos, during the dummy run ten days previously — one a few inches below my navel, the other two, on top of each side of my hips. Two lines of intersecting green light projected down from the ceiling, forming a cross on my exposed pelvis, so that they could get the tattoos in alignment with the light.

My head, legs and feet had to rest in moulds to ensure that I did not move. When they were satisfied, they raised the table to their head height — they were both rather petite — then darted out of the room, always with the same parting words, “Here we go!”, just before that huge door closed behind them. Shortly afterwards the machine swung into action, circling me to take a scan.

After several minutes the position of the table was slightly adjusted from inside the control room to get my prostate in exactly the right place. A little later there was the sound of things clicking into position followed by a sustained electronic buzz as the machine began to circle me again, this time delivering death and destruction to the cells it was targeting. Rotating through 360 degrees, starting and ending beneath me, it then revolved back in the opposite direction, completing the day’s treatment. I was to undergo this procedure 39 times — each revolution taking about forty seconds — a total of 52 minutes penetrated by the beam.

Mercury had cost the hospital one million pounds, excluding installation costs. “They came one day to check that it hadn’t been stolen,” Yasmin claimed.

“Where did they think we would sell it,” asked, Sangita, her potential partner in crime, “Ebay?” I don’t think they were being ironic!

Cyril and the Ladies

I don’t know Cyril’s particular protocol, but he is always prancing around trying to empty something, bowels or bladder; I had too much delicacy to ask. Probably much older than his youthful looks — “Black don’t crack,” says Muditasri — tall and heavily built, he cut a merry caper tip-toeing from Mercury, heading for the Ladies, opposite.

Obviously, he needed to empty something and the Gents was at the wrong end of the waiting area for a man in a hurry. His NHS gown swinging open at the back revealing his naked legs, he darts surreptitious glances this way and that then grins at me mischievously as he disappears inside.

Emerging from Mercury on another occasion, having already taken advantage of the Ladies just a few minutes before, this time it was engaged; even worse, the waiting room was full. “Get back in there!” bawled out a cockney voice.

“Do it in a bottle!” called out another amid the general mirth as Cyril headed for the Gents grinning all the way, utterly unabashed, gown swinging open, as usual, to reveal his black briefs. Cathy and the other ladies — with whom he was a great favourite — giggled with delight at the sight of his hind parts. Cyril was a man — no apology, no mistake.

Cathy, a bleached blonde, her face meticulously made up, was probably in her sixties, had an extremely girly voice, girly clothes and a thick cockney accent. After Cyril’s latest antics she left, as usual, for Venus.

I had seen no men go in there, just as I had not seen any women heading for Mercury — though, admittedly, I had seen them leaving Mars. “Is Venus just for women?” I asked Yasmin. She laughed.

“No. They treat men in there as well, but most of our work is with breast cancer.” The Mercury team concentrate on prostate, bladder and rectal cancer.

“Why is there no Pluto?”

“It was declassified; it’s no longer a planet.”

“Really? …And Uranus?”

“Hardly appropriate,” she said, grinning.

“Oh… I suppose not.”

A few days later, Cathy was chatting with a friend while Cyril sat aloof, as he often did, eyes closed, arms crossed, desperate to catch up on sleep.

[“Eight times!” he had told me, “eight times every night I get up.”

“I know what it’s like,” I had responded.]

“Come and join us, Cyril.” I could see his reluctance. Not the kind of man to enjoy conversation about babies and granddaughters, I suspect, but, graciously, he went over to sit with Cathy and her companion.

“Your inner geography is unstable”

I was on the table waiting for the beam to go around, but instead Sangita was back in the room. “We weren’t happy with our first scan,” she explained, “you were two millimetres out of position.” The machines are accurate to within half a millimetre. She and Yasmin adjusted me slightly. “Can you hang on for a few more minutes?”

“Sure,” I responded without thinking; not so easy — you must not move once you have been positioned. Sometimes, it seems an age before the beam finally hits you and for a man with restless legs which might commence a jig without notice, this was potentially problematic. Worse, I might fall asleep then awaken suddenly as my body jerks. Just to remain awake, I had to exert my will fully.

The following day, shortly after checking in for my fifth treatment, one of the senior radiographers came out to talk to me. I sensed a problem. “Your bone structure has changed.” That sounded serious.

“Is that common?” I asked, sensing my bogey lurking in the background, keeping it at a distance.

“It happens. Are you still having acupuncture?” she asked a little suspiciously.

“Yes, but I cleared it with the consultant.”

“What for?”

“Fatigue.” She was obviously unhappy.

“Okay. We’ll give you the treatment as normal today, but we’ll have to get another CT scan to get a more accurate treatment map. At the moment, they are struggling to target you precisely.”

The radiotherapy department is alive with radiographers — seemingly dozens of them. Back in the scanning room another complained, “Your inner geography is unstable.” (Like continental drift, perhaps? Different parts of my innards parting company?) “Your large intestine is always full.”

“Well, I was told to have a ‘good breakfast’ before treatment. …Should I cut back?” She paused to consider.

“Don’t change anything unless we tell you.”

Prurience

For over a month I had enjoyed a taste of the freedom to which I had been accustomed before chemo, but that was all about to change. The last weekend of this temporary release I went to see Debbie perform in Prurience. It was a piece of immersive theatre, with the actors dispersed among the audience, set up as a mock support group for porn addicts [the assumption being that everyone present was an addict].

 pru Our caring facilitator

(Behind him is the founder of Prurience, ex-porn star Amelia Atkins, as she appears, uncharacteristically fully clothed, in a promotional video.)

The rather camp ‘facilitator’ invited us all to participate and then proceeded to conduct the meeting in the ‘New Age’ style of many such groups. It was an extremely funny piece of satire which triggered my sense of humour uncontrollably.

Many people seemed unsure — should anyone be laughing at this rather sensitive issue? I had no choice, having a politically incorrect sense of humour. The more I stifled my laughter, the louder it would explode and, according to Gus, who had come with me, it persisted for about ten minutes, sparking several others including him.

But it’s uncomfortable if you are seemingly the only one laughing. It had happened to me once before, decades ago, at the premiere of Edward Bond’s play Lear, but, on that occasion, I had been alone and several people had scowled or tut-tutted at me for the disturbance. They were oblivious to Bond’s obvious irony and I delight in irony, as I do satire, both in theatre and in life, unfashionable though they have become.

Debbie had recognised my laugh at once. “It was great!” she said afterwards, “It helped warm up the audience.” I had not laughed so much for a long time.

Chemotherapy? Had it. Radiotherapy? Having it. Porn therapy? Don’t need it. Laughter therapy? Can’t get enough.

Four plus five equals hospice

The following morning, I caught an early morning train to Colwall to see Bhante[i] at Adhisthana[ii]. Had I not taken this opportunity, I would have had to wait perhaps several months before I would be able to do so. I was so pleased to see him again.

We talked about what he had been writing recently then I mentioned the memoir I am writing about my experience of the early days of Triratna.

“Well I hope you tell it as it was,” he said quite firmly. Naturally, I shall do my best. I would not wish to do otherwise.

A retreat had just started the evening before and, upon seeing me, an old friend approached and asked how I was getting on. “You know, I had prostate cancer,” he said. “What’s your Gleason score?” [The Gleason scale is a gradation of prostate cancers from mild to aggressive.]

I did not like talking about it; I never do — but I could hardly not answer.

“Four plus five,” I replied.

“Same as me… And I’m still here,” he said, smiling at me as living proof.

(Yes. And so am I… but it’s early days. And anyway, what does it matter if I am not ‘still here’ in a few years’ time? It will not be that much longer before I am gone, whatever happens.)

Once more a flash of anxiety had jolted me. My friend’s words were meant kindly — perhaps as reassurance or encouragement, but I neither seek nor want either.

“If you ever need to talk about prostate cancer, just give me a call.”

(Yes, of course… but I knew I would not. Why? Why do I dislike talking about it? Do I still feel too close to the edge for comfort? Edge of what… existence?  And what has comfort got to do with anything?)

“You know what they say about ‘four plus five’?” I didn’t. He told me. All I recall was the word ‘hospice’. And that was enough. I had remembered again and I was grateful for that.

The ghost

I cycled to the hospital every day during the first couple of weeks of radiotherapy. The last day I did so, Cyril noticed me heading into Mercury with my cycling gear.

“You didn’t cycle in, did you?”

“Sure.”

“How did you manage that?”

I paused pensively then replied with a smile, “I’ve got legs.” As I disappeared, the waiting room erupted with laughter.

“What are you laughing about?” Yasmin asked as I entered the treatment room.

Unfortunately, the following day, the fatigue in my legs, which had so plagued me during chemo, had returned with a vengeance and my few weeks of freedom were at an end. Once more I could no longer walk to Victoria Park.

Your enema is your best friend

enem

Having to use an enema every day could be hazardous (especially if you have a haemorrhoid; I spare you the details.) After three weeks, the effects were lingering well into the afternoon so that I dared not be too far from a loo.

“What are you eating?” Sangita, asked. I told her. “Cut back on the fruit,” she recommended before taking me through to Saturn — I was temporarily switching planets; Mercury had swung out of orbit.

“Nice to see a different part of the universe.”

“Oh, it’s just a slightly older model,” she replied. It was slower, noisier and less sleek.

Me playing dead all the while, this great, lumbering electromechanical beast cranked into place for the scan, groaning as it extended its arms before circling me, penetrating my innards with its eye, not liking what it saw.

The treatment table jerked forward then lowered as Sangita returned. “Your bowel’s too full,” she complained, a little sternly. Further evacuation was necessary. I scampered off to the loo, Cyril-style. The beast had a second look. It was just empty enough.

“What do you have for breakfast?” Sangita asked after the treatment.

“Mostly fruit.”

“Eat lots of stodge instead.” The following day, before my only trip to Jupiter, I did. “Perfect!”, Sangita cooed.

A farce of my own making?

One problem solved, three more to confront — that’s the way with cancer treatment. The fatigue in my legs seemed to be slowly getting worse and, coincidentally, my GP had called me to the surgery to discuss blood test results taken for my annual hypertension review.

“You’re mildly anaemic,” she told me, “we may need to put you on one or two supplements.” And of course, my blood pressure had gone up, probably as a result of chemo. “The anaemia could be a factor in your fatigue,” she added.

I phoned a radiotherapy nurse. “What’s your haemoglobin count?” she asked.

“118.”

“That won’t cause fatigue.”

“Could it be the radiotherapy?”

“Not fatigue like that. I’ve never encountered it. It’s probably lingering chemo.”

“But it eased off during the break between chemo and radio.” Now she seemed uncertain.”

“Ask to see one of the doctors when you come in next.”

I called a chemo nurse. “Chemo stays in your system for about six months,” she said.

“But why would it ease off and then return?”

“Well look, if it gets any worse over the weekend, go and get checked out at your local A&E.”

A few minutes later she called back, “I think you should go straight to A&E.”

“But why?”

“It might be something spinal. Best just check it out, for your own peace of mind and mine.” I now recognised her voice. She had sent me off to A&E unnecessarily before.

Dayanatha, a young doctor who lives in the community above mine, kindly came downstairs and examined me. “No. Nothing spinal.” Good. I could forget about A&E. But the chemo nurse could not.

“Did you go to A&E?” she asked later that evening.

Was this farce of my own making? I could not help wonder. It was so reminiscent of what had happened when I began chemo.

I simply wanted to understand what was going on, I had told myself. But actually, that was a tired old rationalisation I had used too many times in the past, masking my deeply ingrained unwillingness to face the uncertainty of existence. Too frequently, it seemed, I would do anything to distance myself from it, preferring to wallow in the cowardly comfort of complacency. But that was unworthy of my higher aspiration.

No magic solution

The fatigue worsened over the weekend. As I was not quite half way through radiotherapy, I could easily imagine that, like a friends’ sister, I might not be able to walk by the end of it.

Of all the side effects I had endured through cancer treatment, this was the most alarming. The fatigue I had experienced with each chemo cycle always began to recede after a few days, but this was worsening by the day.

When I reached the hospital on Monday, I felt very weak, mildly nauseous and a little dizzy. One of the nurses examined me then consulted with a doctor. I should not be experiencing this level of fatigue, I was told. Unfortunately, my consultant was at another hospital and so I had to wait another two days before I could see her.

“The haemoglobin level is not a problem,” she insisted. “Chemo hits the bone marrow extremely hard. It will slowly recover without the need of any supplements,” she continued. “As for the fatigue, your body has been hit with one very severe treatment and now you’re receiving another. That’s the problem.”

At last, someone at the hospital understood. This was exactly what Joanna had said to me when giving me acupuncture the day before.

“There’s no magic solution.”

“So, I just have to ride it.”

“Yes… And rest up!”

I did not relish the prospect of being unable to walk, but my enemy, now having been clearly identified, I knew how to fight it and I carefully chose my weapon. I hired a wheelchair later that evening from Wheelfweedom. [Profuse and most heartfelt apologies to the company for such an unforgiveable spelling mistake. I hope they won’t sue me.]

But I was still struggling and could not understand why, until I realised that I needed to speak frankly with my community. I would have to rely much more heavily on their help than before. I would need them all to do a lot for me, perhaps even help me up the stairs; I had already given up trying to climb them and was now going up backwards, pushing myself up each stair using my arms.

As I expected, they responded magnificently. A burden lifted from my mind and my characteristic buoyancy reasserted itself. I had suffered the worst dip in my spirits since my cancer saga had begun, but I must make more effort to ensure it did not happen a second time.

I had allowed my mind to dwell on the possibility of life without the use of my legs. Again, I had been distracted from the cancer and the deeper, threatening issue beneath it — my own impermanence. I had lost yet another battle in the raging war between Reality and my intractable self-clinging.

Beauty is where you find it

“What an uninspiring view,” a visiting friend had said months before as he looked out of the window of my room. Accustomed to gazing at the hills and sheep surrounding his isolated home, perhaps all he saw was a block of flats, terraced houses and the forbidding façade of an old school building enclosing the view.

But now, recalling his comment while lying on my back and looking through that same window, I could see nothing but infinite blue sky, white clouds drifting across.

I sat up and looked again. The outlook was far from beautiful, but I had gazed at it for countless hours and had found beauty within it, nonetheless — and beauty is always a source of inspiration to me; many times, it had touched me — especially when house-bound and I had nothing else to look at.

blog

I saw three trees; I’ve watched them morning, noon and evening — in twilight, in sunlight, in shadow, in shifting, shimmering shades. I’ve watched their bare branches spring to life, sporting the tenderest green, brightening into the brilliant hues of summer, softening to the muted tones presaging autumn, clusters of seeming-orange keys — of the tallest, grandest of the three — darkening its leaves further, to my eye. I’ve watched all three sway with the wind, whether in wild protest or gentle surrender; I’ve seen them battered by the rain.

Crows and magpies perched on chimneys, or squabbling along rooftops; pigeons seeking shelter in the foliage, gulls or swifts soaring high above, parakeets darting by; goldfinches and blackbirds searching for food; a lone heron lumbering through the air; a squirrel squatting on a rail, cheekily observing me; I’ve seen them all through that window and more besides. They have inspired me with the thrill of life.

I might not be able to walk, but I did have a wheelchair and friends to take me for a spin. Even better, I need not look where I was going and was free to let my eyes seek the hidden beauty that surrounded me when trundling along the avenue of trees leading to the park.

Where the planes completely overarch the road, I gazed upwards and felt dwarfed by their grandeur, astonished by their elegance; never before had the mottled beauty of their pealing bark seemed so vivid.

“With this, you don’t even know if you’ll be here next week”

I could no longer travel by bus for my treatment as I lacked the strength to walk the short distance to and from the bus stops and I was now dependent on hospital transport. Sometimes that would be a car, at others an ambulance — an excellent service where I met and got to know other patients and some of the drivers.

I was often struck by the sanguine attitude of terminally ill patients. Jean, for example, probably about my age and formerly an actress, was so bright and genuinely cheerful, despite her evident pain. She had had a large tumour removed recently from her thigh, making it very painful for her to walk.

“When you get something like this [metastatic lung cancer] it shifts your perspective on life.” She clearly meant for the better, as her ready smile demonstrated. The last time I saw her shrunken form, she wished me well then, “Maybe we’ll meet again,” she said, “but with this, you don’t even know if you’ll be here next week.” I’ll never forget those words, nor the sweetness of their accompanying smile.

Some, unfortunately, bore their burden bitterly, or succumbed to depression, but many, perhaps most, were optimistic; and there was an abundance of mutual well-wishing, as one often finds among those facing a common misfortune.

Although I would never wish it upon anyone, facing a life-threatening disease, like cancer, had a noticeable humanising impact on many of its victims, perhaps bringing the best out of them, highlighting their fortitude and other strengths they themselves might never have suspected they held in reserve.

It was also in an ambulance that I first met Pauline and her partner; he had terminal prostate cancer. Although now a follower of David Smith, she had once been a mitra at the LBC and was full of gratitude for what she had learned there. Despite concluding that our path was not hers, she could only speak positively about Triratna.

Dread-legs

Within an hour after each treatment, my legs felt as if most of the life had been blasted out of them. Taking the few steps to the toilet was exhausting — but at least I could do that.

The chemo had mostly affected my thigh muscles, but the radiotherapy had penetrated down to my calves, the sensation more severe, filling them with dread at the prospect of moving, feeling as if iron rods had been sown into them. By the following morning, they would revive a little, feeling more flexible, most of the visceral sensation having dissipated.

As throughout chemotherapy, I continued with twice weekly sessions of acupuncture. Joanna had worked on my legs to bring some energy back to them as she had done when I was undergoing chemo, but this time her initial treatments were not working; then she got it right — not with needles but with lots of moxa. My legs were far from normality, but they revived sufficiently for me to be confident that I would still be able to walk at the end of radiotherapy. In particular, Joanna had dispelled the physical sensation of ‘dread’ from my traumatised muscles, enabling me to make the few steps each day absolutely necessary to a sense of relative independence.

Prostrate Prostate and the Battle of the Bladder

But the radiation was affecting more than just my legs; my prostate gland was under daily onslaught so that passing and holding water were increasingly toilsome.

One day, my treatment was significantly delayed as Venus was on holiday and Mars had a hiccup. Like several others, I had already drunk the required amount of water and my bladder was expanding at a worrying rate. A growing queue of men sat tight, some with their legs perhaps uncharacteristically crossed, maybe wondering why the current patient was taking so long.

But it was not just men who had to hold their water; women receiving radiotherapy to the pelvis also underwent a similar preparation.

“You’re a little over-full,” one of my radiographers informed me, with typical English understatement, when my turn eventually came. “Could you pass some water without letting it all go?”

“I doubt it… Is it too full for treatment?”

“Only if you can’t hang on to it.”

“Then let’s do it.” They quickly positioned me then left. Immediately, I regretted my decision. I had just wanted to get the treatment over quickly, but I was struggling to hold on, worried that my bladder might suddenly expel its contents without my consent.

(What are they up to in there?) They seemed to be taking an age to make their final adjustments.

“Sorry, mate. We’ve had enough of this,” my bladder complained. “Me and the muscles are constantly being abused and overworked… We’re going on strike.”

“No, no; please don’t. Honestly, I won’t drink another drop today!”

“Should’ve thought about that before, guv.”

A sudden, slight movement of the table. (Hope at last.)

“But it’s only a matter of seconds, now… “

“No use, mate, we’re running out of power.”

Yet more delay. (For heaven’s sake, come on!)

“No use calling out to that lot; they can’t hear yer.”

A sudden thud.

“It’s about to start!”

“Oh yeah? …We’re about to stop.”

“No, no! Not now! The beam will hit my intestine if you quit now.”

“Not our problem, mate. Demarcation.”

“What?!”

“Not our job pushing your inflated, fat cat intestine out of the way.”

The long awaited and overdue buzz commenced as merciful Mercury spun into orbit.

“Okay lads… LET GO!”

“Christ!”

The radiographers got me off the table quickly when they came back. “You can pass water here, if you like,” one of them said a little apologetically, handing me a disposable urinal.

“No. Just let get me to the loo fast.” As quickly as my quaking legs could carry me, miraculously replenished with fresh energy, gown swinging open at the back Cyril-style, I darted into the Ladies opposite where I experienced the bliss of release.

“That was a close call,” I commented to Sangita, after changing out of my gown. “Don’t know how I managed to hang on.”

“Yes, it’s a problem as the treatment progresses… I sometimes think we ask too much of patients.” Hmm… “But you’ll get through it,” she said smiling encouragingly.

Once, previously, as she had been about to usher me into the changing room, she had exclaimed, “Whoops! Someone’s had an accident… Would you be okay changing in the treatment room?”

“Sure.”

Now I could better understand the significance of the occasional damp patch on the changing room chair… And Cyril’s merry dance. I have not yet had a spill, but at times it has been very close. And it’s not just water. When the nearest toilet is occupied and the enema insists on further, immediate evacuation, what is a man to do? Spin his wheels with Herculean strength to the next, even if it’s the Ladies.

Any names in this blog attributed to patients or hospital staff are fictitious.

[i] Bhante is an honorofic term used when addressing a Theravada Buddhist monk which literally means ‘Venerable Sir’. Within the Triratna community, although Sangharakshita, its founder, is no longer a monk, many of us still use this mode of address when we are with him or referring to him both as an expression of respect and affection.

[ii] Adhisthana is a retreat centre in Herefordshire.

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