Trying On a New Persona

Helen Trinca, editor of the Australian’s weekend magazine, made the most encouraging response to learning I was being treated for prostate cancer.

“That can be your new persona!” she exclaimed.

As a professional performer I knew exactly what she meant. From now on, whenever I wrote and published something it would have cachet as possibly my last words. Not that this would necessarily guarantee reverence. For example, when a journalist friend recently announced his retirement, our former prime minister Paul Keating asked him: “Why don’t you get that old fart Devine to retire too?” This implication that I still had the ability to get under the skin of somebody who claims to be able to read and listen to music at the same time added appeal to my new persona.

The other most encouraging comment on my circumstances came from a loved one after observing me exercising my personal magnetism with some attractive nurses during a stay in hospital: “Ah, the Maurice Chevalier of the prostate ward.” Even if you’re past it, there’s no reason not to “Thank heaven for little girls / They grow up in the most amusing way.” It was this particular loved one, incidentally, who packed all my pills and potions into a used (naturally) Dom Perignon box.

This may all seem frivolous or smack of whistling in the dark, but it is neither. Procedures for treating prostate cancer are well established and have a good rate of success. The booklet I was given says the average time my form of treatment holds the cancer at bay is two and a half years, which isn’t nothing, and that “some men continue symptom-free lifestyles for many years”. At present I am symptom-free and consider myself a suitable candidate to become one of the some.

In any case, when you reach a certain age, say from seventy-five on, it’s hard to share Scarlett O’Hara’s conviction that “tomorrow is another day”. Maybe it’s not. You become accustomed to not fretting about it. The reassurance by several doctors who have given me their attention that I am more likely to die “with” my cancer than “from” it is therefore only a modest and possibly short-term comfort.

P.J. O’Rourke, the noted American essayist and author, recently delivered a fine Irish deathbed oration in his syndicated column. He has been diagnosed with a form of cancer that has, like mine, often been treated successfully but he is twenty-six years younger than I and therefore inspired to a higher level of eloquence.

Describing himself as “a practical Republican”, he argues first for the usefulness of death. Without it, evolution would not be able to sustain momentum. This pragmatic way of looking at death had not occurred to me but O’Rourke, whose fame is to some extent built on his flights of fancy logic, asserts that “if death weren’t around to finalise the Darwinian process, we’d all still be amoebas”.

However, O’Rourke also believes in God, as I do, and in prayer being too sacred to be used for whingeing. He concludes: “The next time I glimpse death … well, I’m not going to go over and introduce myself. But I’ll remind myself to try, at least, to thank God for death.” Being one of the superstitious Irish, I’m not inclined to jog God’s arm with such detailed forward planning. Maybe I’ll take the circuitous route and thank him for practical Republican Catholics.

In the meantime, I am busy concentrating on enjoying the things I enjoy—family, friends, reading, going to the movies, shaking my fist and snarling at Harbhajan Singh on television, and the amenities of my exceptionally comfortable house. This is not a case of my squeezing all I can out of my remaining days but of cherishing the remains of each day by fitting in as much pleasant activity as possible between the tedious routines of prolonged medical treatment. Man cannot live by doctors’ appointments and filling prescriptions alone.

As I write, I am nearing the end of a month of radiation treatment. My appointment is for 2.30 p.m. each weekday. This precludes going out to even moderately long lunches, an almost lifelong predilection.

As well, I am required to present myself to have my cancer radiated—and this will be my only venture into unsavoury clinical detail—with a full bladder and exigently empty bowels. Apparently this is necessary for the accurate aiming of their death ray by my treatment technicians. Achieving this delicate and unnatural balance exactly on schedule for 2.30 p.m. requires intense application and dominates a large part of my morning. I arrive for treatment in a sensitive state and must not be made to laugh between 2.30 and 2.45, which takes supportive self-control by my radiators, who are a genial bunch.

The fact is you enter a parallel universe when you become a patient for an extended period. You pass through its portals when, lying compulsorily motionless on hard platforms, under the scrutiny of machines, possibly designed by Daleks, you get your first sight of your innards on a screen, the picture, perhaps fortunately, coming to you in rather insipid black-and-white.

My first reaction was to wonder if all that pulsating was good for me. I concluded that it was by drawing a comparison with my watch. Presented to me years ago by an impulsively generous employer, it has a movement rather than a battery and depends on me to keep at least my left arm in frequent action. If I have a really sedentary day it stops.

My inner organs proved rather unattractive in appearance and it was a sound design decision by God not to put them on our outsides. They were also unexpectedly delicate and frail. I experienced a brief feeling of wonder that they had been able to do so much for so long. But truth to tell, it is hard to sustain much interest in innards even when they are on display. My prostate was minute and devoid of personality.

Hospital is the next stage of entry to the parallel universe. Needing collateral surgery, and requiring a gradual reduction and then restoration of anti-clotting medication in my bloodstream, I spent three weeks in Royal North Shore, a large public hospital in Sydney. In terms of accommodation, décor and cuisine, RNS would probably rate as late post-Crimean. It was there that I realised how exceptionally well-found my house was. But the hospital takes intensive care of nearly 50,000 patients a year on a budget of about $300 million. Its governors have wisely spent their money on equipment, including state-of-the-art Daleks, and staff, including sophisticated administrators to co-ordinate a myriad interlocking tasks and, in effect, herd 50,000 cats who are not feeling at their best. RNS is chronically short of nurses, who earn between $55,000 and $75,000 a year for shift work that involves muscle-wrenching physical toil, a high level of technical qualification, emotional stress and much involvement with human messiness.

Men as well as women now take up the profession and I don’t believe I encountered a loser among the several dozen who did me favours. A beautiful, dark-haired woman of forty-four, who had been qualified for less than two years, stays in memory as representative of the best.

She had wanted to be a nurse from the age of six, when she set her grandparents’ sitting room on fire with a kerosene lamp while pretending to be Florence Nightingale. A few years later she unilaterally removed the stitches from her little brother’s wounded leg, apparently without damage. Early marriage, children and helping her husband in his fruit and vegetable business diverted her from her dream. But with the children grown and the business flourishing she plucked up courage to enrol in a nursing course, unsure that she would be able, at such an advanced age, to cope with learning a new set of complex skills.

Her husband has been supportive but finds her passion for nursing incomprehensible. He refuses to listen to her accounts of the messier events of her day. But she loves being a nurse. When the hospital comes into sight on her way from the railway station she lengthens her stride to get there faster.

The worst thing about a prolonged stay in hospital as a patient is the erosion of personal autonomy. Hospitals are essentially repair shops in which your broken and eroded parts take precedence over your whole. The backless, short-sleeved hospital gowns are designed to give instant access to these parts. The torturous beds exist less for sleeping than for raising, lowering and tilting you for repairs and wheeling you down endless corridors to the Daleks. When you are attached to drips, feeding or withdrawing God knows what into or out of your bloodstream, the sense of close captivity is acute. You know you are losing it when you cease even to grunt grumpily over the routine of blood samples invariably taken in the early hours of the morning, between ten and twenty minutes after you have finally fallen asleep.

You’ve lost it when morning rounds by the specialist doctors become the focus of your day, rather than the condition of your self-funded super, the inability of Australian bowlers to achieve reverse swing in India, whether Kevin Rudd and Barack Obama are up to it and what Winston Churchill will do next, if you happen to be reading William Manchester’s superb biography of him. Your specialists know what has been happening to your innards and what, possibly, will happen next. The amount of information directly conveyed to you varies from individual to individual. Instructions snapped briskly to junior doctors are not always, or even often, comprehensible. Specialists also write in ward logbooks out of your sight. The day they have planned for you on their morning round is sometimes revealed to you only episodically.

Many of the best and most experienced specialists deal with “cases” rather than patients. I have this on the authority of the wife of one of them. They handle many cases at the same time and a large proportion of their cases require maximum exercise of intellect, knowledge and skill. You realise that this is a good thing for you but it causes a wilting of the natural desire for self-determination.

I had some good advice on this from a strikingly entrepreneurial male nurse who may one day own Royal North Shore. “The doctors are providing you with a service for a fee,” he said. “It is up to you to decide what you want to buy.”

Following this precept, I achieved occasional wisps of self-determination. But it is hard to be confrontational with somebody whom you accept, axiomatically, as knowing what he or she is talking about much better than you do. You also want to avoid distracting your servicer from the full exercise of intellect, knowledge and skill, arduously acquired, on your behalf.

Leaving hospital is an exhilarating emancipation. For me, my magnificent king-size bed symbolised freedom. I could rarely pass it without pausing for an exultant bounce. But even as an outpatient, enveloped in pill-taking, blood-sampling, appointment-keeping with fetishistic punctuality—you have no idea how crafty some people are at slipping in ahead of you if you are late for radiation—it is a struggle to maintain self-determination. It is necessary to avoid becoming clingy with your GP, especially if you have achieved long-standing rapport with him. It is essential to store the fact of your unwellness in the back of your mind and to dismiss thoughts of death almost entirely. Death is less assertive as a non-immediate threat than you might think.

My radiation appointments and other medical consultancies have somewhat restricted my social circling but have increased my admiration for my fellow humans. Apart from association with good doctors and members of allied professions, I have mingled extensively with patients. The calm and courage of all of them, some travelling a much harder road than mine, stir heart and mind. Most talk freely about what ails them but few dwell on it. They remain firmly connected to the fruitful real universe.

A guy occupying the bed opposite me in one of RNS’s post-Crimean six-bed wards was gravely ill and didn’t sleep much. When I awoke and looked across at him he always had earphones on. He listened to talking books a lot but, at this time of day, usually to the news. We would grin and wave to each other and he would give me a lucid and thorough news summary, updated during the day if anything important happened. We’d discuss those parts of the news that annoyed us most and side with each other when visitors perversely disagreed with us.

A bushie in our ward, awaiting amputation of his foot, got up each morning and hobbled around making his own bed. The nurses would remake it when he was away, visiting the Daleks, for example, but I think they understood how important it was for him to do it himself.

The general conviviality of the radiation centre waiting room is, as they say, a tonic. Those of us who have got to know each other a bit now pass up “Comment ça va?” as a greeting and ask, “How’s your bladder?” An attractive couple around my age were in a particularly merry mood the other day. They were going out that night to celebrate their fifty-second wedding anniversary, with a son who had flown in from Canada for the occasion. They also have a daughter who qualified as a doctor at the age of twenty-two and is teaching herself to knit. She came to the waiting room a couple of times and knitted. It is clear she is never going to make it. But somebody who chisels out a medical degree at twenty-two is unlikely to be unaware of the therapeutic power of comic knitting.

With such exemplars I find myself increasingly able to resist the gravitational pull of the parallel universe. Though not secretive, I mostly, for example, resist unnecessary discussion of my prostate. At a party the other day my host offered to introduce me to somebody who had survived a similar bout with cancer several years previously. “Can’t,” I said, politely but firmly. “I have to go for a pee.”

So thanks, but no thanks, Helen. I think I’ll struggle on with the persona I’ve got.