Cancer: My Part in its Downfall by Colm Toibin

I bought Colm Toibin's book A Guest at the Feast because I wanted to read his essay about his cancer diagnosis and treatment. Cancer: My Part in its Downfall is quite magnificent - funny, bleak and ultimately hopeful. For me it expresses beautifully something I have found incredibly difficult to describe. He puts into words the overwhelming, relentless nothingness involved with chemotherapy and how you are less than a bystander in your own treatment.

Then I would take some pills and open the curtains and get back into bed, only half listening to the radio. Then I would turn off the radio and lie in bed for a few hours without thinking. Then I would decide to get up. The rest of the day would be spent on the sofa. It was not merely that the chemo left me brain-dead so that as time went on I could not even read; the effect of the drug darkened the mind or filled it with something hard and severe and relentless. It was like pain or a sort of anguish, but those words don't really cover it. Everything that normally kept the day going, and the mind, was reduced to almost zero. I couldn't think. All I could do sometimes was concentrate on getting through the next five minutes because contemplating any longer stretch of time under the pressure of chemo and the steroids (and perhaps some other drug) was too hard. At about six o'clock in the evening I would feel OK for a while, but by nine or so a real lassitude had set in again. When I decided to go to bed I would find the decision made no difference. Two hours later I would still be lying on the sofa. I spent the time staring straight ahead. No watching films; no TV; no radio; no books; no magazines or journals. No memories; no thoughts; no plans for the future. Nothing.

I am really pleased now that I kept a record of my treatment because I can't really remember the detail of it. It is all blurred around the edges. I could not concentrate enough to read and it made me so sad. I was relentlessly tired and that fatigue continued well after treatment had finished. It took me a year post chemo to feel like myself again. The fatigue was bizarre - I would fall asleep sitting at the dinner table (I made myself join my family for dinner for some sense of normality - if I could bear the smell of it) yet I'd be wide awake in the middle of the night high on steroids.

Colm also describes perfectly the disruption to your senses of taste and smell and what it does to you.

In the first week after chemo I lost any desire to eat or drink, and I lost all sense of taste. Instead, my sense of smell became acute. For the next few months, on the street, I could smell everyone's perfume or after shave or deodorant. It grew to be confusing and surprising. In the house, when I was upstairs, I could smell any food in the kitchen even when there was nothing cooking. I could smell the soot in the chimney.

I was the same. It was similar to morning sickness in pregnancy. I could smell the flowers in the garden and the soil.

Colm could not taste. I could taste things but they tasted dreadful, metallic and disgusting.

Not being able to taste brings with it dreams of tasting. On days when I was at my worst and could be cheered up by nothing, I imagined a large grilled lobster and then I thought about a boiled lobster. And then I dreamed of a steak cut into strips and marinated and then put into the pan to fry. The strange thing about this is that in the normal course of events, I wouldn't know marinade from Toilet Duck. But now, in this time of chemo, it was much on my mind. Food had no taste, none at all, but it had texture and it had colour. Sometimes, I was sure I wanted something - a duck breast, for example, or a piece of fruit, or some yogurt - only to find when it was in front of me that I didn't want it at all. I liked really thin, cheap, white sliced bread. I found that I had an interest in making a sandwich with plenty of butter and two grilled rashers. I can't think why I could eat this when I could eat nothing else. I could also eat a sandwich of tinned salmon. A few times I made a big fry up and added a small tin of baked beans. I ate it all down, even though it could have been sawdust or deadly poison. A few times I gorged on a banana sandwich. I could not drink water. Since I had no taste, my mouth treated it as a foreign object. No other drink was better.

I liked white bread by itself and scrambled eggs and not much else. I had lots of trouble with water. It made me gag. Finally I discovered sport replacement drinks that were salty and sweet. I spent a lot of my time fixated on food. I half watched Jamie Oliver and Nigella Lawson and collected recipes to make when I could taste again. As a result I over did it when treatment finished! I cannot put into words how joyful it is to taste food again when you haven't been able to.

Another bit I loved is his description of being a bystander to what is happening to you.

People often talk about their "battle" or "fight" against cancer. It was really hard to know what that meant. I was sure that the nurses and doctors were involved in some battles, as were the cleaners and the kitchen staff, but I just lay there not thinking much. All I wanted to do was fall asleep and not wake up until it was over.

I had a good laugh at Colm being nonplussed by blood clots. I felt the same when my leg swelled up and my oncologist was concerned that I had one.

As I lay there, however, I could not take the blood clots seriously. I knew they were potentially dangerous, but that knowledge still didn't make me worry. In bed, I identified the difference between cancer and blood clots. In a tennis match, blood clots would be all smashes, aces, double faults and disputes with the umpire. Cancer would be steadier and stealthier, keeping calm on match points, returning the ball accurately - low, cross-court strokes - rather than hitting big winners. In literature, blood clots were Christopher Marlowe, violent, restless, brilliant, while cancer would be Shakespeare, coming in many guises, dependable, sly, fully memorable. In painting, the blood clots would be Jackson Pollock, the cancer Barnett Newman. In Tory politics, Boris Johnson would be a blood clot; William Whitelaw, if anyone remembers him, the cancer...In Europe, Macron is a blood clot, Merkel the cancer. In other words, instead of battling cancer I was becoming foolishly respectful of it. Like Shakespeare, Newman, Whitelaw...and Merkel, it would not respond well to being underestimated.

I love Boris Johnson being described as a blood clot. I am looking forward to reading the rest of the essays in A Guest at the Feast. Colm Toibin is a wonderful writer. If you would like to listen to a fabulous Kim Hill interview with him try this: https://www.rnz.co.nz/national/programmes/saturday/audio/2018868687/colm-toibin-writing-on-changes-in-life-church-and-state

I have a pile of books to get through over the summer break (including Brooklyn by Colm Toibin). Reading is one of the great joys of being on holiday. You can probably tell I have lots of energy and lots to say. Expect some book reviews as I have been reading prolifically since the ability to concentrate returned. Anyway, must go, I have books to read and work outs to complete. I hope your 2023 is filled with lots of great stories.