Can-can Cancer Dancer 7 — Living Paradoxes


“Are you bored?” he asked. I was sitting quietly reflecting, after breakfast and was startled by the question.

“Why should I be bored?”

“Well, you know, all this time you’ve not been able to do very much.” True, but I was never bored. I cannot remember the last time I was significantly bored. Yes, sometimes I had been bored with a film I was watching or with a particular conversation, but generally bored? No. I don’t get bored. Chemotherapy, for example, is far from boring; it’s exciting — unpleasant, I grant you; sometimes wearing, but never boring. Although I had wearied of it a little towards the end — I confess — I had cast off my weariness quickly.

I would wish them upon no one, but the treatments I had received had opened up new experience to me in many ways, thereby enriching my life.

beethovenMost unforeseen, perhaps, was a much deeper appreciation of Beethoven’s late string quartets. Often, while undergoing chemo, I had very little energy for anything and I lay for hours listening to music. I was living a paradox, simultaneously experiencing the travails of an ailing body, like a swan grounded by a broken wing while yet being uplifted by the most sublime music, a vulture riding a thermal to the heavens and beyond.

I listened to the quartets countless times, their strains seeping into me, penetrating further and further. Perhaps not so surprising; they were Beethoven’s swansong. There seems to be a profound poignancy suffusing the slower movements, especially his ‘song of thanksgiving to the Divinity’ [upon recovery from serious illness]. Did I feel a spiritual kinship with the genius of the music, a solidarity with its source?


Cancer had first entered my life quite innocently as a basal cell carcinoma on my arm — a wart that had slowly increased in size then turned bad and bled constantly. It had been diagnosed in Nagpur, in India, and was surgically removed in Pune. It had deeply alarmed me at the time — so much so that I’m amused at myself in retrospect. Nonetheless, it was one more encounter that had helped to prepare me for what subsequently happened, further enabling me to see through the absurdity of my reaction, honing my capacity to respond equanimously to something truly life-threatening.

The carcinoma recurred and required further treatment shortly after it had been removed. Having had one, there is a fifty percent chance I will have more. Consequently, a few weeks after my final radiotherapy session I had to return to see my dermatologist for a routine check.

“It looks beautiful to me,” she said, referring to the long, smooth surgical scar on my arm, now no longer blemished by cancer cells. At last it had gone.

“Hospitals seem to be becoming my home from home,” I said.

“Well that’s not good, is it?”

I shook my head. “Could I be discharged, please?”

She agreed. “If anything recurs, let your GP know and we’ll see you within two weeks.”

The NHS is truly wonderful.

Lymphatic reaction

Excessive optimism frequently leads me into trouble. Ten days after being utterly dependent on a wheelchair, I sent it packing. And that was just three days after being stranded a few hundred metres from the LBC without the energy to walk back. Muditasri had had to return for my wheelchair. Even so, I was already back in the pool training, as I had enough energy to walk there and back.

“It got into my lymphatic system,” I was explaining to a fellow swimmer and could proceed no further as his reaction was instantaneous.

“Oh, I know what that means!” he said with an involuntary shudder, triggering a shiver in my mind, his eyes shrinking back with fear. The power of words is truly extraordinary. By now I was impervious to such reactions and the echoes they sound within my mind. He had asked how I was and I had told him. I had been urging him, ever since I had been diagnosed, to get a PSA test, as he was clearly at risk.

“You don’t want to end up like me,” I said firmly, smiling encouragement. That finally seemed to galvanise him.

“Well, maybe I will.” Later he thanked me for nagging him. His GP arranged an early hospital appointment after they got the results. I haven’t seen him since.

It’s always raining…

And of course, I was back on my bike. I should have read the signs. I was getting cocky. One day I cycled seven miles; the following day I swam nine hundred metres; on the third day I did the same, swimming harder — and walked over ten thousand steps, according to my fitness tracker. On the fourth day when I got out of bed I could hardly stand.

That was problematic. I had to get a train late that afternoon to Manchester to participate in the stone-setting ceremony for Dayanatha’s late father and I was determined to go.

I travelled to Euston station by the underground, helped by Prajnamanas. The following day, Sunday, was cold, windy and wet — Manchester! But that was not why it was tough. Although everyone else was standing in the packed chapel at the cemetery, I sat at one side throughout the service as standing taxes me even more than walking.

When the rabbi had finished, Dayanatha spoke movingly about his father then afterwards I stood with Prajnamanas by the door, leaning against the wall to take some of the weight off my feet, holding a box with stones for people to take and put on top of the gravestone. Amused to think it très cardinalesque, I had chosen a scarlet kippa, but it sat precariously upon my head and I was now anxious lest it might take flight with the gusting wind. I did not remove it as I was uncertain of the protocol and did not wish to risk offence.

“Thank you so much for coming,” Dayanatha’s elderly grandmother said to me as she came out. His mother expressed the same sentiments. Their warmth took the chill out of the wind and I was glad that I had come, despite having to stand for the ceremony at the graveside on tremulous limbs and despite my frantic attempts to secure my flighty kippa.

The following day I had an acupuncture appointment. “I think I might have overdone it a little,” I confessed as I shambled through the door. Joanna laughed then later admonished me. I must conserve my energy at least until the new year, she insisted.

I had never seriously considered that I would need to convalesce. I am not used to being ill and because the cancer itself had caused me no pain, it was difficult to believe that my body was diseased. I did not disbelieve that I had a tumour, but I had never seen or felt it. I had taken my diagnosis on trust and had therefore consented to treatment. Experientially, however, I was recovering from the therapies, not cancer, and it was difficult for me to grasp that that warranted convalescence. But, at last, I understood… I think.

But the enervation was not just physical. With the onset of chemo, I had stopped meditating because the mental fatigue was so extreme. I had hoped to pick up my daily practice when it was over, but my lethargy continued throughout radiotherapy, albeit less severely. For seven months I had not meditated and yet, oddly, my mental acuity was as sharp as ever and my emotional positivity sustained itself throughout. This would have been impossible without forty-five years of continuous Dharma practice (including daily meditation) behind me, but, even so, I did not wish to become complacent and was eager to re-establish my routine. In the weeks following my treatment I gradually succeeded.


Six weeks had passed since I had finished radiotherapy and I had returned to the hospital for yet another encounter with a phlebotomist.

Two days later came my final consultation. Thereafter I would only return for six-monthly reviews preceded by a blood test.

“How are you?” my consultant asked.

I’m always very well,” I replied, “it’s this wretched body that’s the problem.” Indeed; still, I really ought to resist this stale joke which I have used far too often… but it is so tempting; it usually provokes a chuckle — as it did on this occasion. “I really need a new one,” I continued, “Not that I intend to do anything about that, by the way,” I hastily added.

“I’m relieved to see you out of that wheelchair,” she said, trying to get serious, “I was very worried about that. Had you turned up in one this time I would have had to give you something that would have made you really sick.”

“You’ve already done that,” I quipped.

No more nonsense — to business.

“Your blood results were excellent. Your PSA is down to 0.003. That’s an extremely good result at this stage,” she said with typical enthusiasm when communicating something positive. A quick mental calculation: it had been roughly 15,000 times more than that when I began.

“Is that the hormone therapy?”

“No. Radiotherapy. The last time we tested it, it was 1.42 when you were still on chemo. It was forty-three before you started treatment.”

“Forty-six, according to my GP,” I insisted, not wanting to be cheated by one iota of the seriousness of my diagnosis — there’s status in this. Another quick calculation: 1.42 is approximately 473 times more than my current level — a further huge shift. “So, if I’m asked, for legal purposes, ‘Do you have cancer?’, what is the most truthful answer?”

“For insurance, ‘Yes’.”

“What’s my actual status?”

“You’re in remission.”

“What does that mean?

“There’s no evidence of cancer present anywhere in your body at the moment.”

So, I have been given a reprieve until my first review, six months hence. I must live my life in biannual cycles, never forgetting those last three words — at the moment — mindful that I may be living merely on borrowed time and that the cancer might already have returned even when her words were spoken. It can recur very quickly.

My life remains on the line, as it had been for the past year when I was first diagnosed, yet I forget so quickly and easily like a man on death row who cannot believe his executioner will ever call.

“Don’t you ever wake up scared in the middle of the night?” one of my friends had asked. Never. The thought of cancer does not disturb my dreams any more than my waking life. It used to scare me before afflicting me; now that it threatens my life, it no long does — how perverse — it’s simply the reality I face. I’m no more or less conscious of it than I am of the sun when it shines. It is only at relatively rare moments, usually in conversation, that I’m conscious of cancer — and then only fleetingly, mostly free from disquiet. Then begins the struggle to overcome my wilful ignorance, to seize the moment of awareness, daring to stand on the edge and look down, perhaps to soar above the abyss.

Possibly I lack imagination — how could I not be afraid of it? I cannot answer my own question. Probably I should be shot through with shivers of fear — it’s a terrible, painful disease — but I am not. What I fear most is dying with a mind deadened by morphine with its concomitant confusion. I am determined to greet the Grim Reaper with a bright mind and will take any steps necessary to ensure that I do.

“Are there any other lingering side effects from the radiotherapy?” my consultant continued. I could think of none, other than the fatigue, having forgotten, in the moment, my chronically dry left eye. But what about my bones?

“There’s a slight thinning; you don’t have osteoporosis, but osteopenia which can lead to it. It’s too early for the hormone therapy to have caused that.” She prescribed calcium and vitamin D. “You may be able to come off the hormone therapy after two years instead of three.” These were soothing words to one whose manly breast was under threat. “I’ll let you know when we have the results of the latest studies.” May the gods preserve my chest — a perfect plateau blighted by neither hill nor dale.

“I still have neuropathy in my hands and feet.”

“That may take between eighteen months and two years to clear. Chemo destroys the nerve endings; they take a while to grow back.” She paused before continuing. “You may not see me the next time you come,” she explained. “The nurses may be taking over the reviews of patients in remission — a change I’m trying to resist, but I may not be able to do so much longer.”

“Well, I hope I do see you,” I said with feeling, saddened by her disclosure, “I’m very grateful for everything you’ve done for me.” When you have a good rapport with a doctor you want that relationship to continue. Though we had had our differences over acupuncture, it had been evident from our first meeting that she took a genuine interest in her patients — certainly, she did so with me. I had felt immediately at ease with her bright, lively personality and had always found her warm, sympathetic, good-humoured — and candid when necessary.

Suddenly I was conscious that I had no gift for her. I had wanted to give her something at the end of radiotherapy — but what? The chocolates I had given to my radiographers and the receptionists would be hopelessly inadequate given how indebted I felt.

How do you adequately thank someone who may have saved your life? In context, that may sound overblown. Had she not simply done her job, for which she is well-paid? Perhaps. But there is a human dimension which can easily be overlooked and undervalued. We had a positive and effective relationship characterised by the trust that should arise naturally between doctors and patients, but which often does not. I imagine that mental attitudes on both sides of the clinical divide might have a bearing on the outcome of treatment.

Even if this thing finally kills me — even were it to do so relatively quickly — I’m sure that I shall continue to feel greatly indebted to her, grateful at least for the stay of execution she has given me from the ravages of cancer; grateful for prolonging my much-valued opportunity to give of my experience to those who esteem it. I had been fortunate, but I did not know how to express this upsurge of gratitude appropriately — until fortune intervened.

Sir Antony

Antony Gormley came to the LBC to be interviewed by Maitreyabandhu as part of his Poetry East programme. As usual, it was a wonderful evening. Who else other than Maitreyabandhu could have pulled it off? I sat next to his fellow poet and poetry mentor, Mimi Khalvati. “I don’t know how he does it,” she said. “His preparation is so thorough. There’s nothing else like this on the literary scene. What he does is unique.”

UnknownAntony Gormley is a sculptor, of course, not a poet; and he’s almost a Buddhist. Afterwards he signed books including the Phaidon book on his work. “Could you dedicate this to ‘Angela’?” I asked. He readily agreed.

During the interview, he had spoken very warmly about the north-east of England — it’s culture, landscape and people — even mentioning my home town.

“By the way, I was born in Middlesbrough just after the war,” I said, after he had signed the book. His face lit up. “My father was a fitter in the shipyards.”

I might have been an old and cherished friend given the warmth with which he put his arm around me. (What a shameless fraud I am, given my ambivalence to my birthplace.) He was evidently about to launch eagerly into some discourse about the north-east, which, sadly, I had to check, as there was a long queue of people behind me awaiting his signature. Nonetheless, I now had the perfect gift.

Two days later, I left the book at the hospital with a card and a letter of appreciation. Both the book and my words were warmly received.

Now that I was evidently looking well, several people told me how dreadful I had looked, especially towards the end of my treatment. One of my friends had even thought that I was not going to survive it, though I never felt as bad as others seemed to have perceived me.

It is easy for me to forget that the precarious state of my health affects not just me, but also my friends, one of whom told me he felt sad that he might lose me. I was very touched. Yet he might not — at least not from the cancer. I’m in such a paradoxical position. I might be completely cured — or dead from the cancer in a year or two. If I am cured I am unlikely ever to know, but I will certainly know, eventually, if I am not. Damocles sword will dangle above my head by an ever-fraying thread for my remaining days, but, should I look up, which most of us rarely do, would I see anything other than a harmless spider?

But there is a deeper paradox. Before cancer I was happy. During diagnosis and treatment, I was no less so and remain so, despite the greater uncertainty of my life and the discomforts and inconveniences cancer has brought. Indeed, I am probably happier than I have ever been. I was teaching regularly again, having just begun a six-week introductory course on Buddhism and meditation. Nothing makes me happier than communicating the Dharma.

Falling leaves and failing legs

Then came another test — my legs were getting weaker, even though I had neither been swimming nor cycling for weeks — and despite walking much less than during the early weeks of my recovery. It was a conundrum.

I had been to Birmingham to see my dentist, Jayabodhi, but the effort had cost me dear. Then for three days I had rested my legs, yet their strength seemed to be ebbing. What did they need — exercise or rest? I opted for the former and asked Gus to accompany me on a walk, lest I get stranded.

We reached the park, but I couldn’t go much further, so we paused by the bridge over the canal and I eased my weight against the parapet, luxuriating in the mildness of this late November day. The light was all but horizontal, catching the lingering yellow on the trees, alchemizing it into purest gold; the most poignant moment in autumn — and my most precious — the last few leaves clinging with but the slightest grip to their life-source, hanging on to face their fate — a gentle fall to earth, or a taunting flight heavenwards, that they might then be cast down like fallen angels; a choice not theirs to make.

“Here, look through these,” Gus said, handing me his tinted shades, and the subtlest gold was transmuted into brilliant copper; spectacular, but gaudy, counter-alchemical.

I needed advice and so I called a prostate cancer nurse. “It’s not just the radiotherapy that’s caused the fatigue,” she insisted. Chemo and hormone therapy were also culpable. The latter blocks the production of testosterone which is important in helping to maintain muscle mass.

“The fatigue could continue as long as you are on hormone therapy,” she warned. What a wonderful exercise in patience that might be! Fourteen more months, with possibly an additional twelve, on shivering shanks! “But it could also clear up within two months. There’s no predictable pattern,” she added reassuringly.

“So, what can I do?”

“Learn to manage it.” Is not that what I had been trying to do? “It’s a matter of trial and error.” But I had had many trials and had made as many errors. “If you do too much one day, you will simply have less energy the next. You can’t damage anything.” But it’s a double bind, if I do too much, I fatigue my legs and if I get insufficient weight-bearing exercise, such as walking, I will lose more muscle mass, which will compound the fatigue.

I rested for two more days until, at last, my insatiable appetite drove me to the park to savour again its autumnal beauty. Although the overnight gale had diminished, countless fallen leaves were yet restless on whatever beds they had found.


The trees that had moved me so much a few days earlier were now bare, their glory surrendered, like reluctant Richard’s crown, to an implacable force. By the time I returned to the LBC, I doubted my legs could keep me upright, they seemed so ready to give way.

And then the beast slunk heavily into my mind — Doubt. Will my energy return? Why had I been tricked by its revival then mocked by its wane? Will I permanently lose the use of my legs? Irrational, of course.

I reminded myself that my energy would recover by morning. But what if it did not? If this was just the beginning of a steady decline, what would I do? And would it really matter? I could still hear Mitsuko Uchida play Schubert, though perhaps not in concert as I hoped to do the following week. I would continue to write and would write more. I could still meet people and lead a fulfilling life — it would not stop me teaching.

The girl and the eagle

As these and similar thoughts drifted through my mind, my attention was drawn to a girl, of perhaps nine or ten, in school uniform. It was now dark and, during an idle moment, I watched her from our bathroom, two stories above the street, as she mimicked a pole dancer in the café opposite. She was dancing in a floor-length window — revealed and obscured by its broken condensation — empty tables and chairs extending behind her; her mother at one side, consumed by her food, oblivious to the dance. I was its sole spectator, touched by the girl’s innocence, amused by her precocious talent, struck by this supposedly enticing routine robbed of its sensuality.

It might have been the following morning; I was in a ruined abbey on the edge of a major city when a large eagle landed on the remnants of a wall a few metres away. A distinctive white collar highlighted its dark brown plumage, the latter mismatched with its scuffed, and decidedly lighter-toned, shoes, several sizes too big for its feet. I’m a great lover of nature, but, frankly, it looked ridiculous. Had the shoes been of the right size and coordinated with its feathers, possibly I would have thought less harshly of its appearance, but when it turned its diminutive anthropoid face to look at me, there was no chance.

Why had this regal creature been reduced to this absurdity, its penetrating eyes dead as buttons, it’s fearsome bill broken off, its offensive talons tamed… or had some hideous deformity displaced them? I stared back uncomprehendingly until I awakened.

It was the first dream I had remembered for a very long time. My sleep had been excessively fitful for months, so when I had at last sunk into the profoundest slumber this mockery on stolen wings had stolen in.

What goes down must come up

When I began cancer treatment I had been relieved of community chores — washing-up, cooking and cleaning — everything. My community was happy to do these things for me and I was very grateful. Nonetheless, I still wanted to contribute. Consequently, I continued to buy our fruit thrice weekly from a nearby market stall, as it was relatively easy for me to do this with a trolley bag. On returning, I would leave the bag downstairs for others to bring up; sometimes, however, I would do so myself — perhaps unwisely.

One day, I was half-way up the stairs dragging a large bag of bananas, pushing myself up backwards with my arms, when one of my community members caught me. He paused, regarding this laughable sight with both concern and amusement.

“Where there’s a will there’s a way”, he said drily, yet slightly accusingly (I thought), as if I was a recidivist apprehended in some nefarious activity yet again.

(“Honest, Guv, I’d never do this in public. No! Not even on the underground.” I know others find me eccentric, but I do retain some sense of dignity.) He kindly relieved me of my swag.

“I can actually climb the stairs,” I said, somewhat weakly, “I’m just trying to conserve my energy.” Was he convinced? More pertinently, was I?

I must do something about my legs. Joanna had recommended chi kung and so I took it up again together with a simple exercise for developing muscle mass. A week later my strength began to return, enabling me to hear Mitsuko play three sonatas by Schubert at the Festival Hall.

She strode briskly to the piano in her golden shoes then after a cursory bow, without pause, the opening chords resounded dramatically around the hall. It was a golden evening, not because of her meticulously coordinated attire or the light that bathed her, nor yet her natural grace — nor even the humility that ennobles the truly gifted. The final piece (D850), played with a sublime touch, utterly transported me. Perhaps my sensibilities, heightened by recent experience, were elevated still further by music born of the imagination of one who — though yet young — knew he was fatally ill.

I felt grateful that I was not a musician, especially not a highly accomplished one like her. Immersing myself day after day in such exalted music, as she does, might have deafened me to the song of impermanence now singing constantly in my ear.

Another man from the LBC had just died of prostate cancer — the second in three months. A few weeks earlier the cancer of an old friend, with the same diagnosis as mine, had recurred. I had been expecting to co-lead a study group commencing in the new year, but this had now been allocated to two other Order members lest I should die before completing the four-year course. But most significantly, December 25th was just three weeks away. Should I awaken on Christmas day, I would have lived longer than my father. I half expected not to do so.


I sometimes feel as if consciousness is seeking a divorce from the body (on grounds, perhaps, of physical cruelty). It’s a pleasing sensation, but probably it is simply a misperception of fatigue. My physical fatigue was obvious to anybody, but its mental counterpart still affected me, perhaps more than I cared to admit.

But maybe it is the other way around — that this body wants rid of its troublesome spirit, hence the mad spinning in my head, as if my whole body was in an ever more furious whirl like an Olympic athlete desperate to cast his hammer beyond silver.

And its slimy trick; the accompanying nausea — when it is that severe, you just want to die at once. My usual response was to pass out, leaving this body well behind — seemingly released into another universe — only to awaken in its vomit, as I had done on several occasions in India.

But there was a new carpet and it span at a pace well beyond my madly turning brain. It was a new carpet; I mustn’t. I stood up, staggered toward the door, reeled through another, fumbled along a darkened corridor, slid against its wall, stumbled down steps and hung my head over the bath — not in shame, but relief.

Had I remembered, I would have had my bucket by me, but I had dispensed with it, thinking it would be no longer needed after finishing radiotherapy (which I wrongly imagined had caused the dizziness) but it had continued and gradually intensified for weeks after. Then I recalled that this dreadful swirling had overwhelmed my brain two years previously, before cancer had slipped surreptitiously into my life.

I had completely forgotten about benign paroxysmal positional vertigo. Surely, I could be forgiven; the name itself trips your tongue, spins your head and forbids remembrance. Finally, I had recognised it, and again began the contorted exercises necessary to cure it.

“Your pulses are quite deficient,” Joanna had said and so the following week I asked her,

“Am I about to fall off my perch, do you think?”

“No, it’s just the effect of the [cancer] treatments you’ve had. Your body needs time to recover.” She paused before adding, “You do realise that this has aged you.”

Age had stared back at me from a mirror, months before, but she was the first to say it and I was grateful. The final vestiges of my prime were being drawn from my blood, eroded from my face and sapped from my limbs.

“I had noticed,” I said, but her words highlighted its reality. No matter how youthful I might feel inwardly, my body was visibly decaying; paradox and conflict. The spirit trapped inside this physical wreck was in rebellion.

The following day my legs were so weak I could hardly walk again. The culprit was not acupuncture, but a cold; for three days, at its height, I struggled up the thirty-seven stairs to my room then a further treatment restored more vitality — but not for long.

Still, I had now completed the six-week Dharma course and a few days later I travelled, unaided, to Adhisthana for the LBC winter retreat.


The following day, I met Bhante. We talked mostly about writing — his, mine and Henry Miller’s whom he had been re-reading. He had read my cancer pieces and had found them funny yet horrific. Though I had exploited my humour, I had not intended to horrify and was startled at the thought that he and others experienced my words in this way.

Why had he returned to Miller, whose writing he considered to be of mixed quality? He cited, as an example, Miller’s poignant account of a clergyman helping his father to deal with alcoholism. Discussing literature with him brought back countless memories of the times we had lived together, but then a loud knock on the door told me it was time to go.

“I hope we’ll meet again,” I said, grasping his hand as I was about to leave.

“Surely, we will,” he responded, smiling. Surely? How ‘surely’, I wondered, as conscious of his mortality as of mine.

I headed for the door, but then turned back. “Hopefully, not surely,” I said. He had not heard and so I repeated my words, increasing their volume. Now he understood and smiled, though I forget what he said.

Two days later, I awakened, conscious that it was Christmas day.


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


Can-can Cancer Dancer 6 — Susie and the Skunk

Let my fate be a warning

I had intended to visit Jayamitra who was dying at St. Joseph’s Hospice in East London, stricken by the same disease that was afflicting me, but my legs were so weak it would have cost a huge effort to get there. He died before they had regained their strength.

Unfortunately for him, like many men, he had not been diagnosed until well after his cancer had metastasised. So far, I had been lucky; though at a relatively advanced stage, mine was still potentially curable at the time of diagnosis. But it had probably been a close call.

“What’s going on with you guys?” an old friend had asked in reference to the number of Order members recently diagnosed with prostate cancer. “I’ve had my PSA levels tested every year since I was fifty.”

But, you see, “Most men die with prostate cancer, not of it,” is the common refrain, meant to reassure, which was voiced to me even by a GP. Doubtless it is true, but it can trivialise a very serious disease, perhaps obscuring the fact that prostate cancer kills more men than breast cancer kills women.

It would never have occurred to me to have requested an annual PSA test from my GP. Had I done so, as some of my friends had, I might have spared myself and my friends a lot of inconvenience. I might not now be facing the threat to my life that confronts me daily and I would have saved the NHS a huge amount of money. Let my fate be a warning to any man reading this.

Having pursued a healthy life-style and having enjoyed robust health all my life, perhaps unconsciously I had considered myself immune to any form of cancer. Moreover, I had believed that there had been no family history. Then, five years before my diagnosis, I learned that my paternal grandmother had succumbed to breast cancer, not to diabetes as I had previously understood. She was the only person on either side of my family known to have had cancer.

More recently I learned that a link has been established between breast and prostate cancer. So that any man who has a close female relative who had developed breast cancer might be more susceptible to prostate cancer. (I believe that this also works in reverse.)

But whatever the cause, it did not change the reality I had been made to face as, once more, I lay on Mercury’s altar, offering up my cancer cells to his devouring beam.

More water wars

Even before I had finally made it into the treatment room, I knew there would be further delay.

“Craig gone for the bladder scanner?”

“Yeah,” Sangita replied. Why had I bothered to ask? I had seen that wretched, wayward planet-hopper heading for Saturn just a few minutes earlier. It’s never there when a bladder is getting inflated ideas of its own importance.

The department had two scanners, but one had been unserviceable ever since I began my treatment leaving the other to be shared by the entire solar system. Often, I had lain on the table straining my ears for the slightest hint of rattling wheels, heralding its approach from some remote celestial body. Frequently I had been beguiled by phantom sounds of that longed-for clattering along the corridor that promised imminent relief, only to be disappointed, duped again by an auditory hallucination conjured by my wishful imagination.

“Are you sure you don’t want to empty?” Sangita asked, a little anxiously when Craig read the scan reading. Of course! But not until after the treatment.

“Let’s go. Just be quick.” They promised — and they were. They raced through the usual protocol asking me for my address and date of birth before double-checking my dosage.

“Two loops at one point two volts,” Craig said. Sangita confirmed. He had spoken softly as always, as if I was not supposed to hear, but, living with a medical engineer, I now knew that that meant megavolts. Jeepers! First, they poison you with chemo then they fry you. Not that the megavolts actually hit you, but it takes that much power to generate the radiation that does.

“Here… in case you need it.” A seemingly disembodied hand appeared and a soft grey object was thrust onto my chest by Sangita. I clutched it with both hands which had been clasped together high on my chest, corpse-style — as if interred within some sepulchral chamber — well out of the way of the beam’s path. I laughed when I recognised the urinal.


“Thanks… but I won’t.”


Then the bleeping warned of the closing door as I heard the scurry of her retreating steps overlaid by her familiar, brief valediction, “Nice and still… Here we go!” And the wall of lead closed upon me, sealing me within, like the boulder in front of Christ’s tomb, alone once more at the heart of Mercury’s orbit, bracing myself for the latest battle with that bloated water bag. All the whingeing and whining going on in my nether regions was so unfair. It really was not my fault that it was all but brimming. Mercury had been uncooperative so that again things were running late and my bladder was more than thirty minutes fuller than it should have been.

“Thank you for being so patient,” Craig said, a little guiltily, as soon as they returned.

“Oh, it’s not your fault,” I insisted, removing the tissue they had placed as usual (in the absence of fig leaves readily at hand) to cover my exposed genitals. “Here — you can keep it,” I said to Sangita, after hitching up my boxer shorts, as I returned the urinal to her. “Forgive me, but I’m heading straight for the Ladies.”

“Please feel free!” she responded, smiling encouragingly. It was reassuring to have official sanction. Drat! It was engaged; fortunately, the Gents was not. As nonchalantly as I could, I sauntered along, desperate to keep face, holding the back of my gown closed as I headed for my distant destination, close to Mars.

What Sangita nicked


The following morning, I had a little less in my bladder — not that it refrained from its inveterate grumbling.

As I returned to change out of my gown, in one of the two cubicles, the door of the other was wide open. A man, probably in his forties, was sitting there gowned and highly agitated. He could keep neither his arms nor his feet still, the latter tap-dancing the floor. I smiled encouragement into his anxious eyes, but he didn’t seem to register my presence. He was obviously uncomfortably full.

“You can come through now,” I heard the familiar voice of Sangita call out to him, as I closed the cubicle door behind me, mercifully glad that I had only nine more dates with Mercury. Many times had I waited with anticipation for the sound of Sangita’s voice uttering those same words to usher me in.

A few days later, as I was about to lie down ready for the beam, I noticed a swish bladder scanner nearby. “You’ve got a new one!”

“Yeah,” Sangita replied.

“So now you have two working machines again.”

“No… We nicked this one from the CT unit. It’ll have to go back.”

“Oh… pity.” I pondered a moment before putting a question that had troubled me for a while. “Has anyone ever passed water during treatment?”

“It happens — more often than you might think,” Rick responded.

“Not that I’m about to, by the way!” I said, reassuring myself as much as him, as he scanned my bladder.

“Well, if you’re able to hold less and less, start doing the pelvic floor exercises again,” he advised.

“Oh, I never did them; I could hold seven hundred mils before starting all this.”

“Really… You’re a bit over,” he said checking the reading. “If you can hold this much at this stage, you’ll be fine.” Good — but it was costing more and more effort, especially at night. If I woke up with what felt like a full bladder, passing water was strenuous and could take several minutes. It was as if my muscles were still asleep; some were waking up rather grumpily, convulsing as if I was about to vomit.


Several people who had undergone both chemo and radiotherapy had told me that the latter was much easier. I could understand that, but, in some respects, I had found it much more difficult. The fatigue in my legs had never been so severe under chemo and my strength had always recovered significantly as each cycle wore on. But with radiotherapy there was little respite. During the final weeks of my treatment I had a three-day break due to a bank holiday and by the end I felt the energy returning, which was heartening.

“You’d be surprised how quickly it will return when you’ve finished,” Rick had assured me when I mentioned it to him.

In the meantime, however, I had become markedly dependent on others and was wheelchair-bound if not house-bound. Getting up the two flights of stairs to my room from the front door had become increasingly taxing and occasionally I needed to be virtually carried up as I had strained the muscles on my upper arms. Pushing myself upstairs with my arms several times a day together with spinning my wheels a little over-enthusiastically had taken their toll.

“Have you used a wheelchair before?” one of the radiotherapy receptionists had asked me.


“But you seem remarkably adept.”  Perhaps I had been, but now I could barely propel myself forward!

At least I had sufficient energy to get down to the LBC, though not as frequently as I would have liked. A highlight had been the celebration of Bhante’s birthday, which included three very different, but equally beautiful talks celebrating him as fully as he deserves. It was an event worthy of the occasion led with great feeling by Subhadramati.

Several days later on Dharma night, I spoke about Amoghasiddhi but unfortunately, I had been feeling particularly fatigued. Perhaps I should have found a stand-in, but I had been reluctant to throw up the opportunity. 

Susie and me


Sometimes I had wondered about Susie and what might have passed through her mind, her memory haunting the recesses of mine. At the very beginning, the same parasite had been my agent and hers. I had worked with her at the Octagon Theatre in Bolton long before she received her BAFTA and Tony award nominations. I had lost track of her when I stopped working as an actor, but I heard of her occasionally from mutual friends.

She had worked to the very last, seemingly denying it — though all her friends knew — and she refused to talk about it or acknowledge it, they said. She was only thirty-four, same age as me — then. I was saddened when I heard — and shocked. Albert Finney had hosted her memorial programme at the National Theatre. She was the first person I knew who had died of cancer.

I have never denied my cancer, either to myself or others — even if that is what she did — although I find it difficult to believe that she would have denied it to herself and I could understand if she had refused to talk about it with others, perhaps defiantly so. I had known from the outset that my cancer could kill me, as it still could, but I did not care to dwell upon the details and only spoke about them reluctantly.

And yet, did not that convict me of a subtler form of the same crime? Had not her memory returned to accuse me? So often I was unwilling to get too close to the edge, not wanting to look into the abyss, even though when I had done so it had vitalised me, focussing my mind on the deeper issues I had wanted to confront. Occasionally I had been dragged there by circumstance — a chance comment, the glance of fear or repulsion in someone’s eyes — and was forced to stand and look down once more.

Initially, I had just wanted to get through the treatment then deal with the outcome when it was over — so I had convinced myself. But that was merely a rationalisation of the reluctance I was reluctant to acknowledge, an avoidance tactic to prevent me from uncovering what lay beneath the resistance. But there comes a time…


My treatment was virtually over. It was my final visit to Mercury, but first I had to see my consultant. “I’m sorry to have kept you waiting so long,” she said, “I had wanted to call you in earlier, but I was hijacked by another patient.”

I wheeled myself into the consulting room. “I’m a bit concerned to see you in that wheelchair,” she said; her words were heart-felt, not merely dutiful. We have developed a good rapport and I have come to really like and appreciate her.

“Oh, I can walk,” I assured her, “but not very far.” She then introduced me to her latest registrar and I wondered, are there any male prostate cancer specialists? I have yet to meet one. I must ask her next time.

After a few pleasantries, we then got down to serious matters. “There’s a fifty percent chance that the cancer will recur,” she began. “You see, once it gets into the lymphatic system, it is very difficult to cure,” she continued, looking me straight in the eye as I returned her gaze. “We’ll monitor you every six months,” she said, handing me a slip for my next blood test, six weeks hence, before our next consultation.

My blessed lymph nodes! I had always known that they were the most dangerous factor in my diagnosis: ‘T3b N1 M0 Gleason 4+5=9’. ‘N1’, referred to the lymph nodes ‘M0’ indicated that the cancer had not travelled beyond the pelvis, meaning that it was still curable. N1 was my potential assassin; M0 had been my saviour, for the moment. This is only just the right side of terminal illness; had M0 been M1, I would now be heading rapidly towards the bardo[i], driven hard by my 4+5 tumour — speeding, in fact, like a car hurtling recklessly along a motorway well beyond the speed limit, indifferent to whatever was caught in its way, bent on self-destruction.

How unpredictable is life! Several years ago, at Madhyamaloka, Bhante had been listening to the radio, as he often does. During one programme, he had heard it claimed that one in four of my generation could expect to live to be a hundred. He grinned, wagging his finger at me, “And you will be one of them,” he said firmly, as if he had no doubt. The thought horrified me, having witnessed the reality of old age, but the chances of that happening now must be very slim, whatever they may have been in the past. If I survive this disease, I will consider myself to have been truly blessed.

“I’d like you to help me make a financial decision,” I said to the consultant. “By having deferred my state pension, I have two options — I can accept either a rise or a lump sum, but, to take the increase only makes sense if I have a good chance of living another seven years.” She looked at me seriously. “If I’m likely to be dead in three years’ time, I would opt for the lump sum. …You can work out the question.”

“You mean, if I was to place a bet, which would I choose?”


“I’d put my money on the first; I think you have a very good chance of living another seven years,” she said, smiling.

She then arranged a DEXA scan for me, as I had been on hormone therapy for almost nine months and would continue for three years in total. As my mother had had osteoporosis, it was possible that this treatment would reduce my bone density, in which case, I would need to take a calcium supplement. I was already benefitting from hot flushes, courtesy of my twelve-weekly injections, but thankfully, the man boobs had not manifest. I am still able to hold my head high at the swimming pool.


It was late afternoon by the time I headed for Mercury. “I’ve got something for you,” said Rick.

“And I have something for you, too,” I replied, “I’ll give it to you when I come through.” He handed me a flier for a session on ‘health and well-being for men with prostate cancer, post treatment.’ “Thanks, but I don’t think I’ll come.” After changing into a gown, I passed once more beyond that impenetrable barrier which would soon close upon me for the last time.

“Here,” I said, handing over my gift together with a card and a flier, “this is for all of you.” He smiled warmly, then set me up for my final treatment. There was just enough water in my bladder to start straight away then, soon afterwards, Mercury orbited me and I was done.

Another dry run — not that I had ever seriously thought I might leak — despite having undergone thirty-nine sessions. I had only met one other patient prescribed that many; everyone else had been scheduled for twenty-nine, or much less. Even ambulance drivers were astonished that I had so many appointments.

When I came out of the cubicle having changed out of the gown, Rick was waiting for me extending his hand, obviously wanting more than just to shake mine; but we were men and I was almost old enough to be his grandfather. Although we bungled it, there could be no mistaking the mutual warmth as we wished each other well.

“Thanks for this,” he said, still grasping the flier advertising the LBC open day I had given him. He seemed interested and knew that I would probably be present the following Sunday, even though I would not be teaching.

I was sad to say goodbye; I had liked him from the start when he had spoken at the introductory radiotherapy seminar and we had often had brief chats since — as I had also with Yasmin. I was sorry not be able to say a few parting words both to her and Sangita — who had been with me for almost every treatment.

Although I was glad to have both chemotherapy and radiotherapy behind me, as I left Mercury, I felt a sudden, brief surge of insecurity and immediately understood why. While undergoing these radical treatments, there is a sense that the cancer is under control — that for the time being you are unlikely to deteriorate — and you are in regular contact with people who are looking after you; then the treatment is suddenly over. Having been seduced into a false sense of security, you are now forced to remember that you are on your own — as you always have been.

‘Oh build your ship of death, oh build it! / for you will need it. / For the voyage of oblivion awaits you.’[ii]

I had acted long ago upon Lawrence’s exhortation, but had kept to harbour. Even so, in the moment, I felt I had launched into stormy seas, a solitary sailor in a small boat, seeking the deep calm beyond.


I had the car to myself as I was driven back from the hospital by the African driver. The radio was on, as usual, and there was the hourly pause in the music for the latest news. I was barely conscious of the disembodied, dead-pan voice seemingly recounting the same old stories, until I heard, with a mixture of amusement and horrified dismay, that, “The ‘Poundland’ chain announced today that it is withdrawing one of its products, out of concerns that it may be offensive to people with mental health issues. As from today, packets of chocolate-coated peanuts, marketed as ‘Nutters’, will be removed from shelves…”


The driver doubled up in a fit of uncontrollable laughter. Fortunately, we were stationary, locked in a traffic jam. When he had recovered, I grinned at him. “I’m glad you find that funny,” I said.

He shook his head. “Man… Oh man!” he exclaimed, as he continued to chuckle, while I inwardly asked myself,

“Who are the real nutters?”


It was a black card on which the letters had been printed in large blue type: ‘Urgent’. Beneath, in smaller white characters, it said, ‘I have a medical condition that means I need to use a toilet quickly. Please can you help?’ I had never used it and could not imagine I ever would, but it had been inside my wallet ever since it was given to me at the radiotherapy seminar. “Just go into any pub, show it to them, and they’ll let you use the toilet,” Rick had said. Apparently, local government authorities were paying the celebrated alehouses of England for this service — it is cheaper than funding public toilets.

I had never taken note of the words on the reverse side of the card, but I did now: ‘Speak to our Specialist Nurses,’ it urged and so, since a question had surfaced since my consultation the previous day, I called the Prostate Cancer UK helpline. What was the significance of the word ‘recur’?

“It could recur within five years locally or remotely,” the nurse said, confirming what I had suspected. ‘Remotely,’ would mean secondary tumours and terminal illness. Then she had questions for me which I was happy to answer. I told her about my treatment, since she asked.

“Then you’re lucky,” she said, “You’re one of the first to receive this sequence. Although it is very early days, studies suggest that this may significantly reduce the likelihood of recurrence. If it does recur, there’s always docetaxel,” she continued, as if that might reassure me, “You’re a responder; not everybody is.” Good — but I doubt that I would be willing to endure a second round of chemo, should the worst happen.

After further questions, we discussed the fatigue in my legs. She was not surprised; she had encountered it several times before.

“Because the cancer got into your lymphatic system, that will have been heavily targeted by your treatment. That’s why they gave you thirty-nine sessions of teletherapy. The lymph glands release fluid to your muscles which helps you to walk, but yours have been pounded very hard to get rid of the cancer. Don’t expect the energy to come back quickly. It could take quite a while.”

A funeral

Later that day I went to Jayamitra’s funeral. I had thought twice about attending, as my legs were feeling particularly weak, and had decided not to go. But how could I not? He was my Dharma brother.

He had always seemed to have held me in good regard, occasionally sending me cards of appreciation from which it was evident that he felt an affinity with me. We had also lived together for a few months fourteen years previously and, poignantly, we had met twice at the hospital where we had both been treated for a common disease to which he had capitulated at last.

Seeing his body in the LBC shrine room was a strong reminder of the perilous situation I was in. Messengers of death seemed to be approaching me from several directions at once and, though I did not yet know it, another was fast approaching.

The old skunk

It was still only twenty-four hours since I had talked with my consultant, but so intense had been the interval between our consultation and the end of the funeral, that time seemed to have been suspended. Yet I had had precious few moments to reflect. All my mental energy had been engaged by the tumult that had erupted in my mind as I was cast into the confusion of riotous, conflicting mental states. And still no respite seemed in sight.

The turbulence I was experiencing was reminiscent of a two-month period during the early months of a nine-month solitary retreat, four years previously; but, on that occasion, of course, there had been nobody to whom I could talk to help me clarify what was happening. I had been thrown hard against my inner resources even to the point of feeling that I was in danger of losing my mind. I had had to fight extremely hard to come out on top.

This was the key experience which had enabled me, right from the start, to deal positively with cancer. It had been like a dress rehearsal before the real show. On that earlier occasion, I had been dealing with phantoms, but the spectre haunting me now had more substance and I knew that I must take a step further.

Trying to understand what I was actually feeling had become a conundrum — it seemed so complex. I needed to objectify the turmoil that this succession of events had precipitated. Fortunately, at its height, I had the perfect opportunity, just a few hours after the funeral. It was ‘community night’ — the one time each week when, after the usual shared meal and household chores, me and the men I live with, spend the remainder of the evening together.

They listened patiently and sympathetically as I recounted the ferment that was stirring within and when I finished they all seemed at a loss for words — not that I expected any — but they had done what was required; their willingness to listen had helped me to perceive the more obscure currents within my mind, highlighting the individual conflicts pummelling its equilibrium.

What was I feeling? It was still hard to tell, but something had loosened. The previous night all I had felt was a tight knot in my abdomen. Fear seemed the obvious culprit. I knew that fear was a protective mask worn by self-clinging — a facade to keep threats at bay. I had seen it before. “Stand back!” it seemed to say, “you are entering dangerous territory.” But it was a face, with no living feature, attached above a scarecrow’s fluttering rags, hiding a powerful force I had, perhaps, once glimpsed, but which dare not be seen by human eye. How easy it was to be taken in by its masquerade then rapidly retreat, like a rabbit startled by a rustle in the grass, diving deep into the darkness of its warren, terror-stricken.

No; it was not fear — at least not predominantly, if at all. It was something closer to the surface. Shock, perhaps? No, something else. I knew the sensation. It was painfully familiar then slowly it revealed itself. Companion to Despair, I finally recognised the stench of that old skunk, Loss. It seemed absurd; I had lost nothing, but here it was, fouling my mind, dogging me like a professional mourner at a funeral. “Thank you for coming… Now you may leave.”

And yet… I had a sense that my life was over — not that I was about to die, but that I was leaving my old life behind for good. Whatever might await me in the future was seemingly more unpredictable than ever — a sensation I felt all the more acutely when I heard that the cancer of an old friend, who had had the same diagnosis as me, had just recurred.

Perhaps, perhaps…

I had been in danger of losing perspective by reacting against uncertainty. But cancer is uncertainty; samsara is uncertainty. Why do I find it so difficult to welcome it? Does it not lead to unexpected adventure, to the new experience that revitalises me? Is it not ultimately my friend?

How contrary I am! I do not want reassurance, yet I had sought it. I do not wish for hope, yet I had pursued it. In the circumstances, I had not yet sufficiently seen the vanity of either, though I knew they were both empty and that neither could deliver anything other than yet another revolution of the wheel; thus, one impulse had been pitched hard against another. I had tried to resist the forces that led to comfort and to endure the discomfort of their absence. Hence this impasse, this terrible, tightening knot in my belly, which at last was unravelling to leave me in peace.

I was content. And so I should be — my hair was growing. “It suits you. You should keep it like that,” they kept saying. “You’re looking really well,” was the other refrain, nearly always accompanied with such big smiles. I had looked yellow; I had looked grey, they had said; but not anymore.

And don’t believe everything they tell you about these treatments. I had solemnly signed my consent in the presence of a beautiful young woman. Before she had permitted me to do so, she had warned that radiotherapy would make me impotent — not that it might, but that it would. I was rather pleased about that. Unfortunately, it failed. My erectile function has survived the severest nuking medical practice permits. And I now have another reason, should I have needed one, why I shall not be investing in a vacuum pump.

I may yet live to be a hundred. If there is a fifty per cent chance of my cancer recurring there must surely be an equal possibility it will not. At the very least, I had been given a stay of execution, so far as cancer is concerned — perhaps even a new lease of life. Hmm… perhaps.

The greatest blessing

But something new had emerged. When I had been diagnosed with hypertension on my sixty-seventh birthday I was shocked. This sort of thing did not, should not, happen to me; but it had. It was the first time that I had had to face a serious health issue. Then I saw that old skunk, tail up, head turned, taking aim, mischief in its eye, about to squirt. Vainly I ran for cover then I mourned.

I had something substantial to offer others, I believed. I had been blessed when young by a spiritual friend of great depth and substance. It had taken decades for his blessing to mature, but if my health failed, its potential benefit to others would be lost.

Eighteen months later, I knew I had a serious cancer; eleven months more and the treatment was over. It was then that I felt most keenly and urgently, not so much that I want to live (though, of course, I do) but that I had a duty to live as long as I could — even to a hundred years, or more (perish the thought). I must preserve and cherish the blessing I have received and pass it on to others. I have nothing else to live for; but that is quite something.

A young man recently came to see me. We had talked several months previously when by chance we encountered each other in Victoria Park, one beautiful spring day, while I was still in the midst of chemo. He had heard me speak about my experience of cancer at the LBC and he had his own tragic tale to tell.

Now it was autumn and he had come to tell me, among other things, that I had become an important figure in his life because of what he perceived as my ‘mature’ attitude in the face of cancer and death. He had never encountered that before, he told me, though he had looked for it. For him, I had become an exemplar. May I not fail him — or anybody else. May I truly become a beacon for others.


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

[i] According to Tibetan tradition, an intermediate state between the previous and the next life.

[ii] The Ship of Death, D H Lawrence.

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

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”


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.”


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.


“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.”


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?”


“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


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.


“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.


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.


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.”


“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!”


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?”


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.

Can-can Cancer Dancer 4 — Chemo’s Parting Kiss

My swansong?

“The third week of the cycle is your recovery week,” a chemo nurse had explained to me in the early days of my treatment when I was still a chemo-innocent. “We like to give you a short break so that your system can recover a little before you start the next round.” Pausing, she chuckled before continuing in a tone of mock cruelty, “and then we hit you hard again!”

I was determined to take full advantage of these weeks when I had a bit more energy and could lead a more normal life. Just before my sixth infusion, making the most of my few days of freedom, I attended a concert featuring a late Beethoven quartet and left with a lightness in my step which belied the fatigue still weighing heavily within my legs.

The following evening I went back to the Old Red Lion Theatre in Islington, where I had performed the previous year in a new play directed by Gus, with whom I live. When I arrived, I was warmly greeted by Clive, the artistic director who almost immediately told me that he would remember my performance in Further.Still. as long as he lived, which astonished me.

Should he still recall my performance fifty years hence, I swear that the stupa confining my ashes, unable to resist the unbridled vanity swelling within, will shatter into a thousand pieces, blasting to the heavens any lingering hope of stream entry[i] that might yet be harboured by my dusty remains.

I was deeply touched. Wondering how my performance might have left such a powerful impression upon him prompted me to reflect.

The blood that had foreshadowed my cancer diagnosis had been flushed out with my urine while I had been rehearsing. It had haunted my mind then, its significance lurking on the periphery of consciousness like a watchful thief waiting for the right moment to abscond with my health or, better still, my life.

I had not then been willing to face the seriousness of its intent and this must have influenced what was working out in rehearsal, eventually finding subtle expression in performance. There was an uncanny congruence in my immediate experience and that of the character I was playing, although I did not understand this at the time. Was it my swansong?

It’s about porn addiction

Enduring the chemo limbo, though I was often alone, I also had many visitors including several friends from beyond London and I was very pleased to see every one of them. All of those meetings meant a lot to me and I regard them as vital elements in the extraordinarily supportive conditions which have borne me up and helped to carry me beyond the concerns of my ailing body.

I was also visited by Debbie Korley and Vinta Morgan, my fellow cast members in Further.Still..

Image result for vinta morgan


I was truly moved that they had made the effort to come. Working together with Gus and two such seasoned actors had been a sheer pleasure to me after such a long break [forty-three years]. Better still, again I have friends whose work I can go and see; that always makes theatre so much more enjoyable.

Image result for debbie korley prurience

Debbie and I had had to work particularly closely together. As I never do things by halves, and because she is such a gifted and hard-working actress, we established a strong connection. She was currently rehearsing a play for the Blue Room at the Royal Festival Hall.

“I’ll go and see it,” I said.

“You won’t like it,” she warned.

“That won’t stop me.”

“It’s about porn addiction, Devamitra.”

“Pity… But that won’t put me off!”

Sometimes they do get the results wrong

Two days after my evening at the Red Lion, I was back at the hospital. I had looked forward to June 5th as if it were my birthday. It was my last morning on the chemo ward — the beginning of the end of chemotherapy. However, as soon as I had sat down on the treatment chair, I was told that it may not be possible to treat me.

This time the culprit was not the computer system, or its hackers, but my own body. A test, taken a few days before, indicated that my white blood cell count was far too low. A new test would have to be taken and unless there was a significant increase they would have to send me home.

Shortly afterwards, Teddy arrived. Overcome by embarrassment, as he recalled his previous visit, he was apologising to all the staff in sight.

“Don’t worry I’m in a good mood today, I promise yer. I won’t give yer any problems.”

I glanced at him then at the nurses. “I’ll make sure he doesn’t,” I said. Teddy laughed.

“Oh yeah. He won’t give yer no problems, either. He’s always very calm, he is.” Then he was put to the test. He too needed another blood test before they could proceed, but this time, he was as good as his word and made no complaint.

Astonishingly, my white cell count was now normal for the first time since I started chemo! Previously it had always been low, yet sufficient. The nurse seemed surprised by this latest result — and I certainly was.

And so, I received my final infusion and left the ward for the last time a very happy man, wishing well to the nurses and to Teddy. Sure, I had the final storm to ride, but that could not daunt me because I would not be going back for more.

But what could have so miraculously increased my white blood cells?  The first test had been taken on the Thursday, but two days later I had acupuncture and I remember Joanna saying that she had wanted to prioritise boosting my immune system. Was this the explanation?

“Probably,” she said when I saw her the following day, “but, you know, sometimes they do get the results wrong,” she continued rather modestly, her mild scepticism of Western medicine revealing itself momentarily from behind her wry smile.

Overpowering the rank refuse

The chemo ward was now behind me, but the chemo itself was not and I would still be under its influence for four more weeks.

In the meantime, it was wreaking its usual havoc, especially inside my overburdened legs and my rotting nails, the latter tinged with an odious smell from the discarded tissue trapped beneath them. No matter how thoroughly I tried to clean them their mildly faecal odour was as persistent as Lady Macbeth’s damned spot. I could not rid myself of it, but… why should I try? Is it not the mark of death — with which we are all born and which cannot be washed away — made manifest? Was it not of benefit to me, this faint, yet constant reminder not just of death, but of decay?

As the neuropathy afflicting my fingers intensified, attempting to pick up coins accidentally dropped to the floor became a major enterprise, invariably ending in failure, as my fingertips lacked grip. Best not to drop them in the first place, but this was not entirely a matter of unmindfulness; just getting hold of them properly inside my pocket required a skill that had deserted me and it could also be painful.

But worst of all, my restless legs were more hyperactive than ever — sometimes for hours without cease, especially at night. By 4am, if I was lucky, they would calm down and I could once more sink intermittently into delicious oblivion for an hour or two before it was time to rise.

Coping with insomnia is always difficult, but I am well-practised; surrender is the only answer. But there are also perks.

One Sunday morning, rising at five, abandoning any further attempt at sleep, I went out onto the terrace adjacent to my room to get some fresh air. The morning chill enlivened my senses as I took in the surrounding scene. From behind a tower block, the sun was slowly revealing his splendour to a cloudless sky. Along a neighbouring roof, a solitary crow sauntered with not quite his usual swagger and sway, still caught perhaps in corvine dreams of corvine beauty.  King of his television aerial, atop its highest point, a goldfinch released his ever-rising trill, proclaiming his faith to the Feathered Almighty on high — it was the Lord’s Day, after all. Rising from the stillness below, overpowering the rank refuse nearby, the sweetest jessamine suffused the air and wafted me higher still.


Despite my sleeplessness and my errant brain, I was able to write most days, sometimes for several hours. My capacity for immediate response, so necessary for fluid conversation, was significantly retarded by chemo brain; my communication sometimes disjointed and a little haphazard. But writing is much more reflective. You can take all the time and space you require — two commodities I had in excess. Better still, at times my mind was uncommonly lucid, my perception sharper than ever.

Writing became a great solace to me, but it was also fun. Laughing at my predicament and my foibles unburdens me — especially if others laugh along with me; but, if it could help others, that would give it a value far transcending the diversion it brought me.

I am no more scared of cancer than I am of life

Several friends who had spoken or written to me had mentioned their ‘cancer scares’, prompting me to reflect on what this idea might imply. I had an instinctive aversion to it and needed to understand why.

A few years ago, on a long solitary retreat, I strained an intercostal muscle just above my heart. I understood that perfectly well, but my unconscious fears quickly attached themselves to the idea that I had a heart problem. They haunted me with increasing intensity for several weeks until finally I broke free of them. That was a heart scare, I suppose; but it had nothing to do with my heart.

When my blood had fled with my urine, I understood that it might have serious health implications and sought immediate medical advice, but, even when I was told that the blood could have come from a tumour, I did not have a ‘cancer scare’— that would have obstructed or distorted my immediate experience.

Consequently, when I was finally diagnosed, cancer was not a ‘scare’ but the reality I faced. It did not scare me; I am no more scared of cancer than I am of life. It sobered me and concentrated my mind, enabling me to bring a Dharmic perspective to bear upon it at once. Had I allowed it to scare me, I may have wanted to push it away, making it more difficult to face and ultimately more painful.

Thinking in terms of ‘cancer scares’ is just one symptom of the widespread, disproportionate fear of cancer that afflicts our society. If you have a ‘cancer scare’ you are not dealing with cancer, but engaging with an abstraction to which your unconscious fears have become attached.

When my father was dying of an enlarged heart, his cardiologist insisted that, in terms of health, people should most fear heart disease, not cancer. Much can be done to treat cancer, very little for heart failure.

But the tragedy of human life is much greater than cancer, or any other health issue. Our fears need a broader and deeper base. I do not fear cancer, but I am wary of falling into unskilful mental states: I fear my own potential negative reaction to cancer. That is far more serious than the cancer itself.

The pump demonstration

Before I could start radiotherapy, I had to go to the hospital for a dummy run so that at my first session three weeks later, things could run to schedule. Shortly after arriving, I was greeted by Rick, the bright young radiographer from the seminar, who then took me into a consulting room and explained what was about to happen. But first, he asked if I had any feedback on the seminar as these events had only recently been introduced.

“Apart from your presentation, I learnt nothing new, frankly,” I said. “I doubt I would have relished a demonstration of the erectile pump, had that happened,” I continued, unable to hide my amusement at the idea, “but I also wondered how the women present might have found it.”

“Well, there was a demonstration at the next one,” he said. “James was very good, he just came in and got on with it straight away, no messing.” He paused, unable to completely stifle a grin, “Must admit, some of the women did look rather shocked when they left.”

Know your enema

And then down to business.

“Did you bring an enema?”

“Of course.”

“You’d be surprised how many don’t.”

“I wouldn’t! …But there’s no mention of it in the letter.”

“Yeah. We need to fix that. Now, first thing we have to do is get you to evacuate your bowels. So, go to the toilet, use the enema, squeeze it all in and, if nothing happens after fifteen minutes, have a go anyway.”


“Then empty your bladder, go back to the waiting room and drink five cups of water in the cups provided so we know you’ve drunk the right amount. Okay? Then we’ll call you through after twenty-five minutes and check your bladder.”

“We’ve come for radiotherapy”

I did as bidden then sat down in the waiting room opposite a woman of my own age who was obviously very anxious about her husband, whom she had accompanied. I could imagine they had been together all their adult lives, but now their shared life was threatened by cancer.

“We’ve come for radiotherapy,” she explained.

“Both of you?”, I asked, slightly puzzled.

“No. Just him. …We’re already on immunotherapy.”

“I see.” I paused, not quite sure what to say next. “Well, I hope it goes well.” She smiled at me rather sadly.

A little later, her husband returned and they left as wrapped up in one another as perhaps they have been all their lives. How would she cope without him, if he died? I doubted that she would have the resources to separate her own life from his. But I hope I am wrong.

“You a runner?”

Eventually I was called by one of the radiographers. “Devamitra?” I nodded, pleased she had got my name right. “We’re ready for you now.” But unfortunately, I was not ready for them as there was insufficient water in my bladder and so I had to return to the waiting room for a further twenty minutes.

This time, I found myself opposite a young woman who had obviously been observing me quite closely before she spoke. “You a runner?”, she asked, tentatively.

“No. Dodgy knees… Swimmer and cyclist.”

“I knew you did something.”


“Well you carry so much sports equipment with you.”

“Do I?”

“Trainers, fitness tracker… But the real give-away is the SIS water bottle.”


“And you’re very trim.” I was flattered.

“You’re a runner.”


“Here on your own?”

“Yeah. My husband is with the kids.”

“How many?”


She looked so fit, healthy and full of life, but, like me, she must have cancer. “I’ve just finished chemo,” I volunteered.

“Me too. When?”

“Last week.”

“Then you’re still in it.”


“How many rounds?”


“They gave me eight.”

“That’s a lot.”


We lapsed into silence and smiled at each other.

She was then called by one of the radiographers and I was left alone to reflect. I had been strongly affected by our brief meeting and the potential tragedy haunting someone so young — and her family.

A few minutes later I was called again. This time my bladder was sufficiently full to proceed with the CT scan which was necessary to set up my treatment.

“Why didn’t they offer you surgery?”

Several of my fellow Order members have recently been diagnosed with prostate cancer, one of whom came to see me just as I was emerging from chemo. He had finished chemo a few months previously and his hair had grown back already; his nails, too. Naturally we compared notes and there was much that we had in common, but we spent relatively little time talking about chemo and the cancer it was targeting.

I was struck by the mutual shift in perspective that this life-threatening disease had effected. There is almost a sense of relief about it. You don’t have to take life that seriously anymore because suddenly everything is perceived as so much more precarious. Almost paradoxically, at least in my case, you can relax in a much deeper way, which is really quite wonderful, though difficult to sustain.

Everyone I know who has had prostate cancer, unless it was at a very early stage, had undergone prostatectomy, but it had not been offered to me and I never bothered to enquire why. But that did not stop my friends from asking me.

“Why didn’t they offer you surgery?” asked one of my medical friends, incredulously.

I suppose it was a question I did not want to consider, but in any case, I did not feel I needed an answer. When my friends suggested I ask my consultant, I thought that perhaps I should; but then I would forget about it.

Eventually, just as I was emerging from chemo, someone wrote to me who perhaps had a good reason for asking other than concern for my wellbeing and so I decided to respond, but all I could do was surmise — although of course, on a certain level, I had understood all along.

“Oh — I didn’t realise that your tumour had spread beyond the prostate! Now I understand! Crossed fingers!!!” I appreciated the kindly, well-wishing sentiment; but crossed fingers? No. I don’t want crossed fingers. Milarepa forever warns against the terrible twins of hope and fear and I was determined not to fall prey to either.

The mirror’s reflection and the pesky commuters

Before chemo people would always say that I looked much younger than my actual years, but now as I look at my reflection in the mirror, after the full course of chemo, a man significantly older than his actual years stares back. It is not just the absence of hair and the diminished eyebrows, there is a parchment-like quality to the facial skin; his eyes seem more deeply sunken into their sockets; his ravaged face more in the grip of proliferating wrinkles, while the muscles surrounding his lips tauten slightly into the mouth, prophetic of the corpse to come. As I continued to gaze, Shakespeare’s famous lines came back to me.

In me thou see’st the glowing of such fire, / That on the ashes of his youth doth lie, / As the death-bed, whereon it must expire, / Consumed with that which it was nourish’d by.[ii]

The moment I got back on my bike I was shocked. I had not cycled since just before my prostate biopsy seven months earlier, but now I could hardly pedal. Cycling a mere mile-and-a-half circuit exhausted me; swimming was equally draining. Yet a week later, I was cycling with ease, gliding through the rushing air beneath avenues of trees, in and out of the early morning sun, relishing the shifting warmth and cool caressing my bare arms and legs. Who cares if others could easily overtake me? Just give me a few more weeks and I’ll show those pesky commuters.

Feeling energy thrill through my legs once more seemed a huge turning point. For more than four months, I had been legless — not from alcohol, but weighed down with chemo. I had dragged my reluctant limbs from place to place as if a hex had transformed them into marble stilts which might suddenly morph into a febrile tissue barely capable of keeping me upright, before shifting again into their ceaseless nocturnal frenzy. But now that my legs were slowly reviving and their restlessness diminishing, I felt particularly buoyant, even complacent; I was forgetting again. It was time for a reality check.

Another tumour?

My phone rang. It was a radiographer. There was an issue with my intestine, which was problematic for the radiotherapy. Consequently, my consultant had ordered a further scan and postponed my treatment. In the meantime, could I go to the hospital as soon as possible to collect a prescription? I was unable to go that afternoon, as I had an acupuncture appointment.

I did not quite understand the nature of the problem, even though it was explained to me — something to do with my small intestine being overfull. To me that suggested some kind of blockage. And immediately I was back on the edge — that uncomfortable place, so beneficial, yet so unappealing, where I must learn to stand fast.

“Have you found another tumour?” I asked the radiographer as soon as we sat down together the following morning. She laughed.

“Nothing so serious!”

“It was the first thing that popped into my mind.”

Such is the psychology of cancer, certainly as it affects me. Having one tumour, I am constantly alert to the possibility of more.

“No. The problem is that your intestine is very gaseous,” she continued. (Could it be those accursed broccoli sprouts… or perhaps all the soya?) “This means that we can’t get it sufficiently clear of your prostate to give you the full treatment.” (But I want the full treatment.) “If we did, the side effects would be very severe and, obviously, we don’t want that.” (Hmm, I suppose not.) “So, starting today, we want you to take a course of laxatives to try to dispel the gas.” (Good; let it be blasted to the end of the universe!)

“My acupuncturist has already done some work on my intestine,” I added, immediately regretting it.

“Where did she put the needles?” she asked, frowning. I told her. “You must not have any needles anywhere near the pelvis, when you are being treated,” she insisted.

“I’m sure my acupuncturist would not do that,” I replied. Even so, she would need to check with my consultant about the acupuncture. Next, I was told the results of my recent MRI scan, as I had asked for them when speaking to her over the phone the previous day.

“The swelling has completely disappeared from the lymph nodes,” she informed me, “and the prostate lesion has shrunk significantly.” I felt hugely relieved, (thus stepping back again from the edge, forgetting… How quickly it happens).

“So, the chemo has done its job.”

“Yes,” she smiled, “It’s a very good outcome.” How ironic, I had gone to the hospital braced for the worst, but would leave with mostly good news; better that way around than the other. Unfortunately, however, my consultant was insisting that there must be no acupuncture during radiotherapy, as “acupuncture changes the way the body functions.”

A ghost, a bad omen, a man on the brink?

I was then given a prescription for the laxatives which I took immediately to the hospital pharmacy then sat down to wait.

“Hello Devamitra.” I turned to see someone I knew from the LBC. “What are you here for?”

I explained. “And you?”

“I’ve just seen my consultant. My tumour’s been downgraded from T2 to T1.” He looked very relieved.

“Good news.”

“What’s yours?”

“T3b.” The expression on his face rapidly changed. His eyes seemed to retreat from me as if he was trying to get away. What lay behind them; fear, embarrassment, aversion, pity? What were they seeing; a ghost, a bad omen, a man on the brink? Having pushed me back on to the edge, he said goodbye.

Of course, I could have compensated with a little inner kudos getting all snottily, mentally uppity. (“T1! Call that a cancer?”) Instead, as I waited for my medication, I recalled my own reaction, months before, to Jayamitra who had passed the point of no return from stage three to stage four. So far, I had remained on the right side of stage four, but I try not to forget that others, despite treatment, had been at stage three only for some of their bad cells to migrate through their bones, or lymphatic system, and thrive elsewhere, with murderous intent, as stage four.

Eye of the needle

“But I’ve treated hundreds of people on radiotherapy; most find it really helps with fatigue. It’s never been an issue,” Jessica maintained when I told her the following day that the acupuncture had to stop. Clearly, I needed to speak directly with the consultant, but first I sought advice from two friends, both senior doctors. Although neither could speak authoritatively, they were not aware of any conflict with the treatments.

Several days later, just as I was about to be needled yet again, my consultant phoned. She relented about the acupuncture, but insisted that there must be no needles from my navel down to my mid-thighs, both front and back, during radiotherapy. It was to do with rounding up free radicals, apparently (a totalitarian purge, perhaps). This left me much happier, though no wiser.

She needed to see the result of my next scan before she could re-plan my treatment. Of particular concern were the the lymph nodes, which needed to be hit hard, but that would not be possible if the gas persisted. The intestine must be well clear of the beam. This was normally achieved by a sufficiently full bladder pushing it out of the way, but the gas was preventing that.

It would be at least three more weeks before I could be placed at the mercy of that powerful radio beam. In the meantime, Jessica set to work — to blow the gas away.

“Phlegm!” she said.

“In my intestine?” I asked doubtfully. She smiled inscrutably, her Chinese conditioning coming to the fore.

“Two kinds. Visible. Invisible.”

“This is invisible phlegm?” I asked, yet more sceptical.

“We can get rid of it.” As she rather charmingly put it, “When your stools can pass through the eye of a needle, you will know it has gone.” Six days later, after having consumed large quantities of organic vitamin C and ‘Oxytech’, the phlegm invisibly passed away.

Four weeks after my final infusion, I had celebrated my freedom from chemo with a talk on Vajrapani[iii] (principally about his wrathful form) to the LBC Dharma night class. And it really was a celebration; I could have danced all night in his aureole of flames. I relished every moment.

But how foolish of me to tempt fate so blatantly; Vajrapani cast his thunderbolt to rein in my intoxication. Though I had kissed goodbye to chemo, like a jealous lover, it would not let me go that easily and it gave me one last, nasty surprise — another lesion, this time much bigger, on that most delicate part of the male anatomy. It bled and it hurt. Huh! No more parting kisses for chemo.

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

[i] Stream entry is the point at which transcendental insight — seeing things as they really are — arises, according to Buddhist tradition. This is the first goal for all Buddhist practitioners.

[ii] Shakespeare, Sonnet 73

[iii] The archetypal Bodhisattva symbolic of spiritual power.


Can-can Cancer Dancer 3 — Chemo Sostenuto

You forget…

Several years ago an old friend, Punya, was diagnosed with terminal cancer. I believe he was given eighteen months to live, but before he died he wanted to return to England to say goodbye to all his friends, me included. When we met, I felt immediately that something had changed. He was animated by an urgency which I had never seen in him before; all that mattered to him now was the Dharma.

Eighteen months later he was still alive when I travelled to Boston to interview a Vietnamese Buddhist monk, for a book I had hoped to write. Punya met me at Logan Airport and drove me to his home. The moment we met I sensed that there had been another change, but I said nothing. I just watched him as he drove along. Finally, I broke the silence, “What happened?”

He laughed and said, “I could see it was on your mind.” He shrugged, sighed and simply said, “You adjust; become habituated. You forget.” Seven months later he was dead, but, before he died, he had remembered again.

I did not want to adjust and forget, but I sensed it happening. All the signs were there; I had forgotten the cancer and my mind had become preoccupied with trivia. Certainly, the ulcerated skin on the most delicate part of my male anatomy was unpleasant, but it was hardly life-threatening. The large hardened swelling just below my navel was indeed tender, but was localised and clearly a reaction to my latest hormone injection. Yes, the scarlet vein on my wrist was unsightly, but it was not even painful, so why the anxiety? (It had been damaged by a tiny amount of chemo leaking at the beginning of an infusion, I later learned from my consultant.) If I was to get anxious about anything, should it not be the cancer? Admittedly I checked the anxiety as soon as I was aware of it, never allowing it to take me over, but I did not know how to counter the underlying complacency of which I deemed it to be symptomatic.

Perhaps I expected too much of myself. The period and process of diagnosis had induced a state of heightened awareness that I had endeavoured to capitalise upon, but it was difficult to sustain over an extended period. It’s analogous to bereavement. The immediate pain of grief fades with time and is eventually forgotten. I knew I had lost the edge that had driven me dramatically forward. Constant reflection no longer seemed to bite in the same way, but then occasionally something would briefly jolt me back to reality, as happened on my fourth session on the chemo ward.

Why should you be treated ahead of others, perhaps at their expense?

When I arrived, I was taken straight to a treatment room as I had one of the first appointments. I was then told that there would be a delay as the computer system was down for the fourth successive day. However, the nurses wanted to get everything in place so that if the system revived they could move things along swiftly. It was 9.30 in the morning and a cannula was once more inserted into one of my veins where it remained for many hours as computers remained unresponsive.

By early afternoon the nurses were getting restless. They had had nothing to do all day and nobody knew whether any of us would be treated. Later patients were being sent home; among them were many unhappy people, some of whom had become angry with the staff.

I had no more reading material, having slowly worked my way once more through Shakespeare’s The Winter’s Tale. I had seen Declan Donellan’s production of the play a few nights before and had been irritated by his imposition of fashionable ideology upon the text. Perhaps these ruminations were precursory to what happened next.

I became anxious. Will I get my treatment? What will be the consequences if I don’t? A succession of similar thoughts rumbled through my mind as I slowly paced up and down the corridor until I caught myself and felt ashamed.

Samsara always goes wrong! This had been my mantra for decades, often saving my mental state in testing circumstances. Why had I forgotten it at the very time I most needed it? How foolish! I demanded of myself, “What’s so special about you? Why should you be treated ahead of others, perhaps at their expense? In the widest perspective, does it really matter whether you are treated at all?” …And then, remembering Shantideva[i], I reflected, “Let others go before me, ‘Let me be medicine for the sick’…”


Thank you for being so calm

I returned to the treatment room and sat on my chair as a deep tranquillity displaced the dark thoughts that had troubled me, leaving me perfectly happy to accept whatever the outcome might be. I wished the best for all — especially for the staff who were having to deal with a trying situation, not of their own making, sometimes without the sympathy and patience they deserved.

I chatted with the nurses. They were frustrated because they could not help their patients. Because ‘pharmacy’ could not access computer records, they would not release any medication in the absence of a handwritten prescription from the prescribing doctor. Those doctors who were present were all in clinic.

By mid-afternoon we knew that some of us would be treated, but we did not know whom. It was not until 5pm that I was told that I was one of the lucky few and that my medication was being prepared. I was the second-last patient out of a very small number to receive chemotherapy that day.

Just as I was about to leave the ward, the Filipino nurse who had treated me smiled and said, “Thank you for being so calm.” I finally left the hospital ten hours after I arrived, well past 7pm.

This incident had jolted my memory again; it had helped me to realign my emotional attitude, but it took something of great subtlety to reinvigorate my momentum.


The day before my third infusion, I had celebrated my sixty-ninth birthday for which Alex, one of my young community members, had given me a dvd of Pawel Pawlikowski’s film, Ida. Several weeks later we watched it together. It is one of the most beautiful films I have ever seen and I can think of no other that has affected me so positively apart from Tarkovsky’s Stalker. For weeks on end my mind had been preoccupied with old age (fatigue), sickness (chemo) and death. But Ida highlighted the vision of Siddhartha’s fourth sight of the homeless wanderer in a surprising and uplifting way.

The film is set in Poland perhaps twenty years after the end of the Second World War. Anna/Ida is a novice Catholic nun whose Jewish origins are suddenly revealed to her by her last surviving relative. Her new-found identity precipitates a sequence of events that have a profound impact upon her, but she meets each new challenge head on and rises above them all.


For me, Ida embodied the spirit of Going Forth and I could see many parallels in the experience of the eponymous heroine with my own, enabling me to readily identify with her. I was reminded quite dramatically of my own higher purpose, which perhaps I had been in danger of forgetting. It is so easy to become self-preoccupied when you are confronted day after day by a succession of minor ailments such as those thrown up by chemotherapy. Although I had vigorously resisted any tendency in that direction, I needed Ida, at the time that I watched it, to stiffen my resolve. But the film did more than that; it renewed, perhaps deepened, my own inspiration.

Radio school

Tragedy and comedy are the stuff of life and after the sublime tragedy of Ida I was next thrust into the comedy of a radiotherapy seminar, which certainly had its ridiculous moments. There were about twenty patients present, some with their partners. Everyone except me had undergone prostatectomy and they would only receive four weeks of radiotherapy — half my dose. I was the only chemo patient.

A urology nurse introduced the seminar which would explore four principal topics. First to speak was Rick, a young radiographer, who was later often on the team treating me. I took an immediate liking to him. He emphasised that we must all start training now as the bladder needed to be full at the time of treatment. “It’s no use coming if you can only hold 200 millilitres; that won’t be enough and we won’t be able to treat you.” The target was 350.

After Rick, the physio took over. The presence of women did not inhibit his slightly suggestive demonstration of how to identify our bladder muscles together with the exercises necessary to strengthen them. Discourses on the general importance of exercise and good diet, neither of which taught me anything I didn’t already know, followed.

I was beginning to yawn until at last we arrived at the entertainment.

Erectile dysfunction

Apparently, James was to have been present to explain and demonstrate a vital piece of equipment but, unfortunately, he had not been able to come. The urology nurse looked distinctly uncomfortable as she explained this to us. As his stand-in, she was caught between a rock and a hard place and my flagging interest was now suddenly aroused.

“Well… the important thing to remember is… use it or lose it, because… well, if you don’t there is the danger of permanent loss of function… and it may shrink. After all it really is only a muscle and, like any muscle, lack of exercise will result in wastage.”

I could easily imagine the alarm hidden behind the impenetrable faces of many of the men present, some of whom, I suspect, were suffering from involuntary lack of exercise of a possibly shrinking muscle.

We don’t actually have a pump here at the moment…

Nurse continued at a rapid pace perhaps in an attempt to get the ordeal over as swiftly as possible, “Fortunately, we can help you… I mean, there are things we can give you. James should have been here to demonstrate how to use the pump… but we don’t actually have a pump here at the moment so… well, if you do have any questions, do ask.” (Clearly, Nurse was not a position to demonstrate anything. I wonder how James would have gone about it.)

There was an uneasy silence until one brave soul spoke up.

“I have a question.” Nurse smiled encouragingly, if somewhat uncertainly. “I’ve tried the pump, but it didn’t work.” Nurse was looking increasingly unsure of herself and, obviously at a loss for words, glanced desperately in the direction of her male colleagues. The physio gallantly sprang up.

“What happened?” he demanded firmly, yet sympathetically.

“Well, I read the instructions and… had a go, but it was really uncomfortable.”

“Ah, yes. You see, it’s really important that you get a vacuum. It draws the blood into the, er… muscle. You just need to persist. Talk to me afterwards. Most men manage to get stimulated eventually. Any more questions?” No, just blank looks — except I had one for Nurse, which I was sure would be of no interest to anyone else and which I sincerely hoped would cause her no further embarrassment.

When the session had finished, I approached her and asked, “Apart from shrinkage and loss of function are there any other medical concerns about…  not exercising?”

“Oh no, you don’t have to,” and then with an inquisitive look, “but most men seem to want to.” I explained that I was a Buddhist and that for a period of twelve years, when I was much younger, I didn’t. And there had been no shrinkage, I might have added, but perhaps that might have pushed my credibility a little too far.

I approached the physio as I had an appointment with him.

“What’s the problem.”

“I need help in managing fatigue.”

“That’s unusual.”

“I thought it was very common.”

“Not really.” He quickly scrutinised me. “How do you exercise?”, he asked somewhat suspiciously, looking at me like a detective about to trap a criminal. I told the truth and he laughed. “I see the problem. Most people don’t even notice the fatigue because they don’t exercise very much, if at all.”

Dancing the night away

Chemotherapy seems to exacerbate existing weaknesses and conditions. Restless legs syndrome (RLS), involuntary movement of the legs — especially at night — was one of mine. The problem is that it can severely interrupt sleep. For me, RLS had previously tended to be mild and occasional; under chemo it became chronic and at times almost constant. Having mentioned this to Joanna, during one acupuncture session she concentrated specifically on treating it.

I was lying on the treatment table with needles in my legs and elsewhere when suddenly my legs began to go and they would not stop. Looking down at them, although they were clearly not up for the cancan they seemed to be attempting an Irish jig. I called out to Joanna who was in an adjacent room and she returned immediately and worked hard to calm them down.

“I’ve never seen anything like it,” she said, with a hint of suppressed amusement in her expression; me neither —  it was the worst it had ever been. “Ask the oncologist if there’s anything they can give you,” Joanna suggested.

Indian tonic

“You need quinine sulphate,” said the registrar the following day, “but you are on so many drugs at the moment, I’m reluctant to prescribe anymore. Try Indian tonic water.” Of course! I mentioned that my swimming coach used to recommend drinking it just before a training session to guard against cramps as it contains quinine.

“Oh, I used to love swimming,” she said wistfully. I noticed the fitness tracker on her wrist and asked her about it. “My husband bought it for me,” she explained.

“What do you do for fitness now?”

“Nothing”, she replied. “I know I ought to.”

“Like so many of my medical friends. …You would like to?”

“Oh yes, but it’s so difficult getting started.”

“Just go to the pool!”

You realise that you will become infertile?

A few weeks later, she began our consultation with a long preamble about radiotherapy, speaking rapidly’, like an actor racing through lines to himself minutes before the curtain rises, as she explained likely side effects and post treatment problems. This was necessary before I could sign the consent form.

“You realise that you will become infertile?”

“I’m almost 70,” I replied, wearily bracing myself for the erection question.

“Yes, but you see, I met with a man in his eighties a few months ago, omitted to tell him and, when he found out later, he was deeply upset.”

“You’re kidding!”

“Unfortunately, not.”

“How absurd,” I said, taking her smile as silent concord.

“…And you will also become impotent.” No surprise. Surreal, though, to hear these words in my seventieth year, enunciated in such a matter-of-fact way, by this beautiful young woman.

I gave my usual response then signed away my genital prowess for this life without a twinge of regret.

And I can’t be bothered with pumps. Such items may bring solace to a younger man, but at my age, the very idea is ridiculous and prompts inner laughter which occasionally breaks the sound barrier into irrepressible mirth.

Cezanne to the rescue

A mere moment of inspiration can sustain you through the most difficult times. Often, they come unbidden, but you may also seek them as I did shortly after signing that document seemingly so fatal to my manly pride. I had gone to the Courtauld Gallery where I spent most of my time in a room in which a large painting by Manet hangs amid several by Cezanne. I absorbed myself in the Cezannes — the same paintings I had first enjoyed and learned to love fifty years ago when I was a student; but now I saw them afresh.

I ignored the Manet until finally, stepping back to look at the whole wall, I could do so no longer. It is perhaps one of the best-known paintings in the collection, but its sensuous portrayal of a woman behind a bar at the Folies Bergere seemed so crude and out of place in Cezanne’s company that I found it painful to look at.

Only then did I begin to see why some regard Cezanne to have been the greatest painter of modern times. His paintings seemed bursting with a hidden life that sprang off the wall into my mind and expanded consciousness. Perhaps only my current precarious state of health could have induced such heightened perception and gift me yet another precious moment.

“Ask me ornitholigist!”

The cyberattack struck on the very day I consented to radiotherapy, just a few days before my fifth infusion. The hospital was one of the most severely affected in the country and so consequently, again, there was doubt about whether I would get my treatment on time. There were confusing messages in the media and I received seemingly contradictory information from the hospital itself.

I was told not to take the steroid necessary before an infusion as I could be given it intravenously, should things work out, which they did. I had phoned the chemo ward on the day of my appointment and recognised the voice and accent of the Spanish nurse. She phoned back forty minutes later to confirm that I was on the list of the few to be treated and that I could go in at any time. However, there would be a delay of up to four hours as new blood tests would have to be taken and analysed before we could be given our medication.

When I reached the treatment room, Teddy was already there complaining about the delay on test results which he could not comprehend. New tests were unnecessary in his case, anyway, he explained. “Ask me ornitholigist,” he demanded of the doctor who was trying to clear us all for treatment, “She’s seen me results and said they were okay.” But the ‘ornitholigist’ was not answering her phone. (Tweeting, perhaps?)

The doctor came over to me, “Have you taken your steroids?”

“No,” I replied. He frowned, but I explained why and later a Chinese nurse administered the usual rather high dose by the drip. However, I still had to take an additional half dose orally.

“You realise you won’t sleep tonight,” the nurse said. I laughed.

“I can’t even sleep with the normal dose!”

“It’s me nature.”

Meanwhile, Teddy was getting increasingly restless and unreasonable. “I can’t wait four hours for them results. I’ve got an appointment this afternoon.” Several nurses, the ward sister included, explained to him that it was beyond their control, but the more they reasoned with him the angrier he became, insisting at frequent intervals that they should check for his results. After two and a half hours he got them and I was perhaps the unwitting beneficiary of his badgering as my results came through at the same time. At last he calmed down as a nurse administered his medication.

Again, he was ashamed, offered copious apologies and then excused himself: “I can’t help it; it’s me nature.” And once more the comedian emerged.

The nurse gave him his supplementary medication for the coming weeks. “Do you need any anti-sickness pills,” she asked, offering him some.

“No, I don’t get sickness. Keep ‘em. Save the NHS fifty-five million quid.” She laughed, but a little later there was another problem. He was short, by two pills, of another medication that he really did need. At once he was anxious and very quickly he was demanding the missing pills. Despite being told several times that they would be provided before he left the hospital, he insisted repeatedly that they get them immediately, working himself into a terrible passion as he did so. Consequently, he ended up with twice the amount of medication he needed.

This jolted him out of his madness and once more he was overcome with remorse when he realised what he had done. Yet again he offered his excuse. “I’m sorry, I just can’t help it. I’ve always been like this. It’s me nature.”

“I disagree,” I said, from the opposite side of the room, “you can change, but you’ve got to want to do so.” Suddenly everyone’s eyes were on me. As he had just been released from his drip, he came over to me.

“How is that possible?”, he asked.

“It’s what I’ve been trying to do all my life,” I replied.

“Oh yeah, I remember… You’re a Muslim, aren’t you?”

“Buddhist,” I said as a smile escaped me; we then talked further as his mood softened.

“I greatly admire what you’ve done, but I made all the wrong choices in life.” His last few words succinctly summarising not just the tragedy of his own life, but of human existence itself. Very few see, feel or grope their way to the right choices; fewer still make them.

A few minutes later, after he had left, the nurses gathered together talking in subdued tones for the first time since Teddy’s outburst had displaced the natural hubbub of the room with a wary silence. By this time, I had been discharged and so I went over to them. “You do realise that you are much appreciated here, don’t you?”

They smiled at my words, but then the Chinese nurse, who had had to bear the brunt of Teddy’s anger, asked me “Why didn’t you speak earlier?” Initially, I was taken aback and cannot recall whether or not I eventually did say what I certainly thought later.

Although she understandably found Teddy extremely difficult, I felt that she had dealt with his anger admirably well, but more importantly I had been waiting for the right moment to speak. I had not wanted to risk stirring his anger further by acting in a way which, in the heat of the moment, he might have perceived as interference and which in turn could have driven him to fury.

A blessing in the guise of an illness

When I returned home, Gus was in the Kitchen. “I got my fifth chemo!”, I said, delighted at my good fortune, so grateful to have been treated. He laughed saying he could think of nobody else who would be so pleased about that. I could understand, yet I also wondered, why.

Is chemo not a blessing in the guise of an illness? At the very least, is it not a trial of human resources? How can you be sure of your ‘insight’ or tranquillity if life is relatively easy? Is it possible to be confident in your Dharma practice if you cannot withstand and rise above mere adversity? Finally, can you truly know yourself if you are never severely tested? I had been tried and tested and my weaknesses had been exposed. Should I not therefore be pleased to have been given this wonderful opportunity and to welcome it, as I try to do, with my customary enthusiasm and optimism?

Riding the fifth

The nurse had been right; I could not sleep that night. Dexamethasone had catapulted my mind into the stratosphere. I was in and out of bed for half the night until I could no longer be bothered to get back into it again. I did not feel a hint of tiredness until the following evening.

When my body and mind were finally reunited, I noticed something very strange. The horrible metallic taste that chemo leaves in your mouth had gone a stage further. I had completely lost my sense of taste and my appetite had disappeared with it. It was with great difficulty that I motivated myself to eat as it was such an unpleasant experience. Eating food that you cannot taste seemed a pointless exercise. Why would you eat if it gave you no pleasure? I had never realised just how much my sense of taste drove my appetite. My empty stomach was insufficient in itself to move me to eat. Fortunately, my loss was fleeting; after a couple of days my taste returned and I could eat happily once more.

However, a week later things were seemingly taking a bigger downturn. The strength in my legs was not returning as I had come to expect and other chemo side effects were much more pronounced and painful. Most alarming of all, I was beginning to weary of the whole process of chemotherapy. I had been immersed in it now for over three months. Was my spirit about to break, finally?

I confessed my weariness to a few friends who thought this trough in my spirits perfectly understandable. Perhaps it was, but I was still dissatisfied with myself and became convinced that there must be some unacknowledged factor at work. Mulling it over, I realised that I had had no acupuncture for almost two weeks, as both Joanna and Jessica were away. Luckily, I had an appointment with Jessica the following day and she restored the energy to my legs. Now I had no doubt just how much I owed to the dedication of my two most kind and generous acupuncturists.

The show must go on

Two weeks into my fifth cycle I was due to speak at the LBC’s Dharma night, but the week before I had been plagued by chronic sleeplessness, caused by RLS which, in turn, had been exacerbated by chemotherapy. I felt exhausted.

Just before I was due to speak, one of my friends looked at me concernedly and asked, “Are you sure you can do this?”

“Of course. I just need to get started, but it won’t be one of my best.”

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My topic was the chapter from the Vimalakirti Nirdesa[ii] in which Manjusri asks about Vimalakirti’s sickness. How ironical; I had not chosen it, but, perhaps inevitably, I spent a good deal of time talking about my own illness, placing it firmly in a Dharmic context.

The talk was appreciated perhaps more for effort than content. My theatre conditioning runs deep. I had been determined to give that talk even if I had had to do so lying on a couch like Vimalakirti. The idea that ‘the show must go on’, regardless of personal circumstances, was still deeply embedded in theatre culture when I was working.

Perhaps for this reason, I cannot recall ever having excused myself from giving a Dharma talk through ill health, though I have often stood in for others.

To my shame, however, I did once cancel a trip to India, decades ago, for health reasons which, in hindsight, were rather obviously psychosomatically induced. (Foolish, deluded man! I had fallen in love and did not wish to be separated from my new-found beloved.) Bhante [my teacher] berated my friends for being too soft with me. He was right; embarrassingly, my severe stomach cramps disappeared almost overnight and I felt deeply ashamed. I swore that I would never fall victim so easily to self-deception again.

The cosmic joke

As chemotherapy proceeded, I found myself increasingly prone to laughter — the soft, chuckling variety not the violent, belly-shaking kind — and I wondered why. Life seemed to be becoming more and more amusing. Why had I never noticed before that life itself is such a comedy? Why had it taken me so long to finally understand the huge cosmic joke in which we all participate?

I found myself laughing at small things: human foibles — both my own and those of others — and even those of animals. The squirrel at prayer while greedily munching its food could divert me as much as the gulls and geese battling for bits of bread cast into the lake in Victoria Park.

Perhaps inevitably, given my ill-health, the absurdity and vanity of worldly endeavour struck me with greater force. My laughter was never tinged with contempt, but was often accompanied by poignancy. How sad that things should be the way that they are and that so often we fail to see beyond them. There is no comedy without tragedy.

Probably because of the cancer, I feel the tragedy and comedy of my own life with increasing acuity; the one reminds me of the seriousness of the human predicament, the other lightens its burden; both are tinged with poignancy wherein lies their transcendent beauty and both can give rise to wisdom and compassion when keenly observed.

Chemotherapy does not always work

I was due for an MRI scan later on the same day that I met with the registrar for the routine consultation a few days before my final infusion. “Presumably the scan will show whether or not the chemo has shrunk my tumour.”

“Oh, it will have done something! Otherwise, why put yourself through all that?” Indeed. The scan would enable the radiotherapy to be precisely targeted.

There was nothing else to discuss and so, as we had several minutes to spare, I advised her how to establish a regular exercise routine, warning that I would be quizzing her as to whether or not she had succeeded when next we met.

“Good. That will give me an extra incentive to actually do something.”

“Perhaps involve your husband too,” I added.

“Yes!” she responded seemingly delighted at the idea.

When I finally left the hospital, I could not but help wonder what my latest scan would reveal, as, despite my young friend’s optimism, I was aware that chemotherapy does not always work. But it was pointless to speculate and I did not want such thoughts to distract me, so I put it out of my mind. I would find out in due course.

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

[i] Shantideva was great 8th-century Indian Buddhist poet, scholar and teacher.

[ii] A Mahayana Buddhist text which is very popular in China and Japan. Manjusri is an archetypal Bodhisattva symbolic of Transcendental Wisdom. Vimalakirti, in context, is a lay follower of the Buddha who is renowned for his wisdom.

Can-can Cancer Dancer 2 — Chemo Limbo

The whole process has been of significant spiritual benefit to me

“Tell me one thing you would not be prepared to do on stage,” the director said. I was one of the last to speak; everyone before me had mentioned something.


“I can’t think of anything,” I said. It was 1968 and I was an ambitious young actor. He paused and scrutinised me. Later, in rehearsals, he drove me into new terrain. And I loved it.

Reflecting back over my life I believe that my underlying attitude has remained the same. I have always tried to be open to new experience, but facing the challenges of a theatre director is not nearly so difficult as meeting those that life throws in your way and I am conscious of how many times I have fallen short. Nonetheless, it has been one of the guiding principles of my life and one to which I still hold. It keeps me alive and vital; it helps me not to settle down into habitual patterns; it enables me to keep Going Forth[i].

Chemotherapy was certainly going to be a new experience that I would not have chosen had I been ready to die, but if I wanted to live I could not afford to spurn it. If I truly wanted to benefit from it I must welcome it, just as I had welcomed the cancer.

I had no illusions; I knew that it would be a big challenge. It is difficult to imagine that anybody could enjoy its relentless rigour, but it is not my intention to give a blow by blow account of all the minor trials it threw in my face; that would make for tiresome writing and tedious reading. Nonetheless, in its unique way, I believe that the whole process has been of significant spiritual benefit to me. It is difficult to pinpoint anything in particular as it is more to do with the overall impact of what, for me, was a kind of bardo — a dream-like state between one phase of life and the next, as I hope to communicate.

First infusion


Just before I was about to start chemo I was booked for a photo-shoot in Birmingham and had been asked not to shave for the week before. It was not just welcome work; it was an opportunity to have evidence that I did once have long hair and that my beard could actually grow.

The following week I received my first dose of docetaxel, the chemotherapy drug I had been prescribed. However, when I had arrived at the hospital I was told that my medication had not yet been prepared and that there would be a delay. I was finally called into the ward four hours later. I later learned that such delays were not uncommon and that tensions between the nursing staff and ‘pharmacy’ were part of life on the ward.

A cannula was inserted into a vein on the back of my hand which was then hooked up to a saline drip to flush my vein before and after the docetaxel, the whole procedure taking just under two hours. I was monitored by a nurse very closely for the first few minutes in case there might be any adverse reaction to the drug; fortunately, there was none.


The ward, which was divided into five rooms, was at the top of the building and commanded an impressive view of the City. There were seven or eight chairs in each room and a quiet, but friendly atmosphere pervaded the whole place. Quiet in my room, that is, apart from Teddy, the life and soul of the chemo party.

“She lives in the flat above mine,” he explained, pointing to his already giggling wife, who sensed what was coming, “Yer know what she does?”, he continued with a big grin as he glanced round the room. “She comes down in the middle of the night, creeps into me bedroom and holds a mirror over me mouth to see wevver I’m still breavin!” He grinned ironically while nodding his head at his amused listeners before resuming with greater emphasis. “An’ then coz she can’t see anything,” he proceeded, as an expression of amused disbelief swept across his face, “She jabs me in the side of the ‘ed like this,” aiming two fingers at his temple, “to see if I’m still alive. Then whoa! I wake up in a panic, me heart thumpin’ away, wonderin’ what the devil’s goin’ on.” Even the nurses had to pause in their work to control their laughter at this natural comedian. But later, when there were no visitors in the room, Teddy’s mood swung in a different direction.

“The trouble with friends and relatives is they’re so gloomy.” Then in a doleful voice of excessive solicitude, “’Ow are yer, dear? Are y’ alright?’” He shrugged and glanced upwards as if to ask how do you respond to such inordinate concern? “If yer not careful it can drag yer down. But I’m not gloomy, I’m hopeful. Where there’s life, there’s hope… In any case, I don’t believe death is the end. I think we come back.”

“Me too,” I chipped in.

“Do yer?”

“Sure, I’m a Buddhist.

“Oh, you are, are yer? …Have yer ever thought what yer’d like to come back as… have yer?”, he continued, scrutinising me. “I have. I wanna come back as me.

“Don’t worry about it, mate,” I quipped, “you probably will.”



Because of the pharmaceutical delay, I left the hospital too late to attend the team meeting before the Monday night class at the LBC. I was due to give a talk that evening at the conclusion of a six-week Dharma course. As I did not know how many more such opportunities might come my way, I was particularly keen to speak; but more than that, I felt on fire — not with chemo, but with inspiration. I was in ‘the crucial situation’ — one in which I felt I had to grow or die, perhaps literally, but certainly metaphorically — and I wanted to take full advantage of that. By the time I began speaking, I was beginning to feel the effects of the chemo: fatigue in my legs and a slight headiness. Nonetheless, my words flowed freely and clearly.

Later that night, I suffered interminable hiccups and couldn’t sleep. Consequently, I spent much of the night searching on the internet for a cure. After several false starts I tried a remedy that involved sticking fingers in both my ears, while simultaneously holding my nostrils then breathing out before sipping water from a glass. Though it sounds absurd and probably looked even worse, because I was feeling desperate, I successfully managed this strange contortion and found an unlikely cure for my hiccups. Thank goodness nobody was watching me. I am already considered to be far more eccentric than I care for.

Forty-eight hours later the full force of the chemo began to plague and torment me. It was one of the worst nights I had under its influence: chronic toothache, sore gums, a mouth ulcer — and I forget what else — were just the backdrop to recurrent gastric reflux, which by 4am was so severe I called the chemo helpline.

When asked by the nurse if I had chest pain, naturally I said yes, which put an end to our conversation. “Call an emergency ambulance immediately”, she said. I insisted that it had nothing to do with my heart, but she kept repeating, “Call an ambulance now!” I reluctantly gave way and woke up Vidyadaka to ask him to let in the ambulance crew. My call was made a priority so that by the time Vidyadaka reached the front door, the paramedics were waiting — a short, plump rather jolly woman and her taller, leaner, male side-kick.

I was greeted like a long-lost friend as Vidyadaka showed them into my room and they set to work and took charge of me with a will, sticking a variety of medical implements in my ear, in my mouth, on my finger and on my chest.

Shortly afterwards, my phone rang. “DID YOU CALL THAT AMBULANCE?” demanded the anxious-sounding chemo nurse.

My blood sugar was very low. “Here, swallow this.” I sucked a sweet sticky substance from a tube as eagerly as an insatiable infant at its mother’s breast and immediately I felt better. The side-kick was impressed as I had emptied the tube — a rare occurrence, apparently. “Good, that’s me sorted”, I thought. But no; further tests were necessary in the ambulance. Damn it.

As we were about to leave the community, a figure emerged from the bathroom. “Oooh another one!” chortled the paramedic as she fixed a startled male face with her eyes. (She’d obviously never been inside a men’s community before and seemed genuinely thrilled.)

To my dismay, after several minutes in the ambulance, my new-found friends were dissatisfied with their tests and decided to speed me off to hospital before I had had a chance to let Vidyadaka know.

“Have you had a heart-attack before?”, asked the junior doctor examining me.

“Have I just had one now?”, I asked, incredulously. She didn’t reply but studied my notes more closely before seemingly confirming my own diagnosis of severe gastric reflux by advising me to double the dose of my normal medication. With that I was discharged — and it was still only 7am.

It was a fine, crisp winter morning and as there were no buses in sight, I decided to walk back to the LBC. My legs were weak from the chemo, but I felt there was probably enough power in them to get me back. Walking very slowly it took me half an hour — twice as long as usual.

If this was the price of life, was I really prepared to pay it?

I had plenty to reflect upon in the dazzling lateral light. Could I face another four months of this hell? Several people had warned me that chemo had a cumulative effect, implying that each cycle got tougher. (This was not my actual experience, by the way. As my treatment progressed the side effects tended to settle down, although there was always something new.) If this was the price of life, was I really prepared to pay it? Would it not be better just to let nature take its course and let the tumour kill me?

When I finally reached the community, I kept my thoughts to myself. It was the only time I doubted that I could endure the impact of chemotherapy. My body seemed to be in total rebellion against it. (Mara testing my will? Perhaps that was all.) I had had an extreme induction into the trials of chemo, but gradually all thoughts of discontinuing vanished.

Some of my friends seemed taken aback — even horrified — to hear that after having disappeared in an ambulance to A&E, I had returned on foot, but I have always considered taxis an extravagance. Having been raised in Middlesbrough just after the Second World War when food, money and fuel were scarce, the importance of frugality had been drummed into me and I have never lost the habit. Besides, enduring minor hardships makes you hardier — a necessary thing if you are serious about practising the Dharma.

Chemo brain

As best I could, I tried to maintain my normal routine — morning meditation, swimming, meeting people, writing, walking around the park and classes in the evening — but this became increasingly difficult. The first casualty was meditation; I did not have the energy anymore.

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It is difficult to describe the mental lethargy known as chemo brain; at its worst, I experienced it as a total mental exhaustion — almost as if I no longer existed, having been finally reduced to the operator of a complicated and ungovernable piece of machinery inside which I was trapped. Fortunately, this extreme did not usually last more than a couple of days, about three days after the latest infusion. At its mildest it was a kind of light-headed, forgetful state of disconnectedness.

The second casualty was my usual level of physical activity. I managed 800 metres in the pool most days, but that is far short of the 1800 to which I am accustomed. Eventually I had to stop swimming as the chemo exacerbated my recurrent chlorine intolerance.


Worst of all was walking. Docetaxel is infamous for inducing severe fatigue in the legs so that sometimes I could not walk more than a few hundred metres in a day. One day I found myself stranded half way between Victoria Park and the LBC (approximately 500 metres). My legs would not move and I was forced to rest repeatedly so that I could progress by short stages. It took me so long that I was seriously concerned that I might not make it back.

A few days later, having walked just a few hundred metres for my first appointment, I told my acupuncturist that I might have to get a taxi back.

“Don’t be absurd; of course you will walk back”, is not what Joanna said, but it’s what the sparkle in her eye accompanying her actual words communicated. And I did walk back — with a spring in my step, but with a warning that it would only be a temporary fix. Still, so far as I was concerned she had performed a miracle. My twice weekly sessions with her, or occasionally her colleague Jessica, were a blessing which greatly helped to relieve the more severe chemo side effects and buoy up my energy.

Being hampered by my legs shifted my perspective on life yet again. I could only walk very slowly and it took several attempts during the first few weeks to get the pace right. But it was not just me that slowed down; the world slowed down with me. I saw things as an enfeebled old man; familiar things took on a different hue; once more I was seeing the world afresh.


One morning I gave a slight tug at my hair and a handful came out. It was still clinging to my scalp by its rotting roots, but only just. I tried a second and a third time and more came off. It was clear that if I continued my head would be painlessly stripped bare within hours and so I called in my barber, Luke, who clipped it all off in a few minutes. (With unwarranted zest, I thought.)

“You look so much better, Devamitra! It really suits you.”

“Huh,” I snorted, unappreciatively — all the more so as I later discovered that he seemed to have triggered a reprise which spread rapidly around the LBC.

Two and a half years of continuous growth was then gathered and dumped in our bathroom bin, where it sat on top of the other detritus like an abandoned wig. And I walked away, a born-again skinhead; my elf-like ears, shorn of their cover, making me look more mischievous than ever.

If only my nails had come off so painlessly. First to go was my right thumbnail after I had caught it on a piece of cardboard. But it only partially lifted off which made it much worse causing me further discomfort. Looking at the rest of my nails it was clear that they were all going to come off eventually. It was the natural consequence of the neuropathy affecting my fingers and toes; my fingertips were very tender which made it so difficult to fasten buttons or press the keys of digital locks.

Watching my nails slowly rot was a kind of contemplation of decay and regeneration, a metaphor for death and rebirth. It put me in mind of the traditional Buddhist meditation on the ten stages of the decomposition of a corpse, except that, here was that same process affecting a live body: me and mine; I was a process of living decay.

To persevere through so many minor trials, while simultaneously retaining a positive outlook, requires a lot of support that many people lack, but I was very fortunate. My community members gave me all the help I needed without reserve — not just free haircuts. I was relieved of all chores and if there was anything I needed it was promptly provided. I was even chided for doing things for myself that others were only too happy to do for me.

I have never received such continuous kindness in my life — not just from my community, but from many associated with the LBC. Whatever rigours I might have faced they certainly helped me to maintain my generally buoyant mood and I am very grateful for all the cards, messages, flowers and small gifts I received.

Second infusion

When I arrived at the hospital with Muditasri for my second infusion, a young Spanish nurse, took charge of me and cannulated me. Shortly afterwards, Teddy arrived in a very sorry state. He’d been up all night with diarrhoea. As he is rather stout and elderly, the nurse helped him on to his chair and then had the unenviable task of telling him that his medication would be delayed by an hour. It was more than the poor man could bear and he exploded.

She did her best to calm him down, but he had got himself into a foul mood. I quietly watched the whole scene. Finally, she freed herself from him and came over to check my drip. I whispered, “Well done; such kindness, such patience! …I have the greatest admiration for your profession.” She squeezed my arm in silent appreciation.

I was sorry that she had been subjected to this unnecessary outburst, but so was Teddy, once he had had time to reflect, and he apologised profusely. Throughout the whole of my treatment I never saw any of the nurses lose their patience with any of their patients.

Muditasri and I left the hospital at lunchtime, which left me with plenty of time to reflect on what I might say to the Dharma night class at the LBC that evening. The talk I gave proved to be perhaps the most popular I have given since my return to London.

Ollie Brock and Maitreyabandhu had come with me to the hospital for my first round of chemo. Muditasri accompanied me not only for the second but also for the third. Thereafter I preferred to go alone as there really was no objective need for anyone to be with me. This is no reflection on my friends, or on their kindness and concern (which is deeply appreciated), but somehow, I was able to relax more in the anonymity of the ward.

Perhaps this is why the idea of dying alone in a remote place has such a strong appeal for me. Should I ever feel death calling (I mean within a matter of days or hours, not months or weeks) then I suspect solitude would enable me to relax more into it and, assuming I was not bed-ridden or incapacitated in some other way, I would probably seek it.

Solitude has been such an important aspect of my life — like an old friend from childhood. I have done many solitary retreats of never less than one month’s duration, the longest being nine months. Perhaps the circumstances of my early life had predisposed me towards seclusion. I was raised without siblings and my school career protracted itself through eight different schools. As a result, I lost my new friends almost as soon as I had made them which, in time, rendered me an inadvertent outsider and left me extensively alone.

Full dose

Although I had not been told, the second dose of docetaxel was considerably higher than the first — a jump from 108 to 148mg. The initial lower dose was precautionary, just in case there were any adverse reactions, but thereafter I received the full dose which was calculated according to my body weight. This sharp increase caught me unawares and it was then that I found it difficult to walk as my fatigue level took a quantum leap. Suddenly my body felt very old and I shuffled along streets and corridors like a nonagenarian, as if I had been given a preview of old age. This extreme phase only lasted for three or four days during each cycle, but it was seriously debilitating and a great test of my patience. I could go nowhere; I was housebound.

I spent hours on end lying down alone in my room, drifting in an out of a doze, occasionally reflecting. Even when I was brighter I often lacked the concentration to read or to write due to chemo brain and frequently eased my mind by listening to music. The Romantics, principally Beethoven, Liszt and especially Schubert, matched my mood of the moment.

One of the great ironies of chemotherapy is that although it is a treatment, I experienced it more as a chronic illness. Thus far, the disease afflicting me, serious though it was, had barely troubled me. It had caused me no direct pain or discomfort, although in due time without treatment it would do so before finally killing me. Yet the treatment itself reduced me to an invalid.

All my life I have been an embodiment of health and vigour, but now I was reduced to this so quickly, so easily. I was beginning to appreciate what Siddhartha had seen when he encountered old age, sickness and death. True, I am still alive, but death has felt very close.

One morning I woke up feeling uncharacteristically grouchy as my mind wandered in and out of petty grievances. They were so petty I am embarrassed to recount them. This dragged on for over an hour until I caught myself. What was going on? Such thoughts had become alien to me; why had they returned unbidden? There must be some deeper significance, as indeed there was. For three weeks, I had not had the strength to walk to Victoria Park and I missed it badly; missed the contact with nature. I had to get there somehow for the sake of my mental and spiritual health and I determined to do so.

I had been warned by a chemotherapy nurse that I must not try and push through the fatigue in the way an athlete might when training or competing, because this was of a different order. I decided, therefore, to walk to the park in short stages, no matter how long it took, resting whenever my legs felt as if they were about to seize up.


When I finally reached the park, my spirits soared as a surge of energy carried me forward, amongst the Sunday crowd, into the warmth of the sun, down the avenue of trees, beneath their shade, across to the pagoda, along the wooden bridge to gaze into the lake and laugh at the quarrelling coots.

The consultant and her registrar

Every three weeks, I met with the consultant, or her registrar, to be cleared for the next infusion, which would follow shortly afterwards.

“To my embarrassment, we have not met before,” the consultant said as she greeted me with a warm smile a few days before my second round, “but I know a lot about you.”

“Then you have the advantage over me,” I responded jovially.

“Let me introduce you to my new registrar,” she continued. It was only then that I, noticed the silently attentive devi sitting beside her. Obviously of subcontinental extraction, though in most respects she seemed thoroughly English, she had the natural charm common to many Indian women. I sensed that most of my future consultations would be with her and I knew at once that we would get on well.

Amongst other things, I was expected to consult them about supplements. The general advice was not to take any. However, Joanna, my acupuncturist, had been encouraging me to take several.  Chemo was my priority and I was unwilling to compromise that in any way, but I was happy to run her suggestions past the consultant.

“A few whacky questions for you,” I said.

“Fire away.”

“Frankincense oil rubbed into the roof of the mouth.”

She laughed. “Why?”

“Supposed to destroy cancer cells.”

“There’s no scientific evidence,” she insisted. (Joanna asserts that there is plenty. I know nothing, but I’m game for anything — even broccoli sprouts.) “It won’t harm you, but it won’t do any good. I can’t imagine what it would taste like.” (And she clearly had no desire to find out.) “It won’t get into the blood stream, you know.”

“Tincture of wild lettuce?” She looked puzzled. “To calm restless legs”, I explained, feeling myself on firmer ground. A shrug was her answer.

“Magnesium oil for the same purpose.”

“Well, yes. I have heard that does work”

We then moved on to the routine business as she asked had I had any nausea, vomiting, breathlessness, neuropathy and I forget what else.

When we met again, three weeks later, although I was only halfway through the chemo it was now necessary to start organising the radiotherapy. She explained that the intention was to give me the maximum dose of 39 sessions spread over almost eight weeks. Finally, she said encouragingly, “You are dealing excellently well with the chemo.”

But however well I might be coping with it, something was wrong — not with my body, but with my mind. I knew and recognised the problem, but did not know how to fix it.

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

[i] Traditionally associated with the Siddhartha leaving home for the life of a homeless wanderer. In spirit, ‘going forth’ constitutes a willingness to change or an openness to new experience akin to the spirit of adventure.