CEREBRODONDREGLIOMA
1 APRIL
‘It’s called a cerebrodondreglioma.’
‘I’m sorry, it’s called a what?’
‘A cerebrodondreglioma.’
‘A serrybobondeglioma?’
‘No. A cerebrodondreglioma.’
‘A serrydobonblogleglioma?’
‘No. Repeat after me, Mr James . . . a cerebrodondreglioma.’
‘A serrobebrodendoglioma?’
‘CEREBRODONDREGLIOMA.’
‘Serrebolbo . . . serrodogbonelio . . . serbolobonob . . . serrybellynoblio – oh, for crying out loud, I’ll just call it a brain tumour, how’s that?’
‘If you’d prefer.’
My neurosurgeon, Mr Chakraborty, sits back in his plush leather seat and looks down his vastly expensive spectacles at me.
‘So, that’s what caused the blackout?’ I say to him. ‘And the whole thing about the potato?’
He gives me a solemn nod. ‘Blackouts of that nature and confusion in the speech centre are both symptoms of a tumour in the position yours occupies in your brain, Mr James, yes.’
I let out a long, deep breath. ‘And you can’t just get in there and whip it out?’ I ask, already knowing the answer from the grave expression on his face.
‘I’m afraid not. As you can no doubt see from your scans, the tumour is placed in a very difficult location, deep between the temporal and frontal lobes, and is therefore impossible to access with surgery. If we were to try, the odds are zero that you would survive.’
I look down at the various bits of paper and the MRI scans that Mr Chakraborty provided me with at the start of this happy discussion. They all look completely incomprehensible. I’m just going to have to take his word for it.
‘So there’s nothing you can do,’ I remark, trying to keep the wobble out of my voice.
‘I’m afraid not, Mr James. I’m very sorry, but this is an extremely rare tumour, one that’s unfortunately inoperable.’
‘But it’s not . . . you know . . . the “C ” word?’
‘No. The tumour is benign.’
‘I thought “benign” meant it wasn’t bad?’
Chakraborty attempts a smile. He’s not particularly good at it. ‘In most cases it does, Mr James. As I say, unfortunately the position of your tumour means that we cannot remove it. Therefore, it will continue to grow. Very, very slowly . . . but growth is inevitable. It’s already large enough to be affecting some of your brain and motor functions, and even a very small increase in its size will have a major effect on your brain’s ability to function.’
‘Meaning?’
Chakraborty’s voice lowers an octave. ‘Meaning that, at some stage, the tumour will cease to allow brain function on any meaningful level to continue.’
I open my mouth to respond to this, but my brain – still functioning for the moment, just about – sensing that there is no way to improve the contents of this conversation, decides that discretion is the better part of valour and freezes my vocal cords shut.
‘As I say, it’s a very rare and difficult type of tumour,’ Chakraborty continues. ‘In fact, it’s a variant I’ve only read about in journals until now. I’ve never seen a case of Stryzelczyk’s Syndrome before in my career.’
‘I’m sorry, what?’
‘Stryzelczyk’s Syndrome. It’s named after the Polish neurosurgeon who first wrote a paper on it about twenty years ago. He was a sufferer himself. I met him in Brussels at a conference shortly before his death. He was a physical and intellectual powerhouse before it. Such a tragedy to our profession.’
‘Strizelik’s Syndrome.’
‘Stryzelczyk’s Syndrome.’
‘Strikelikik’s Syndrome.’
‘STRYZELCZYK’S Syndrome.’
‘Stryclickyzik’s Syndrome.’
Chakraborty looks down his glasses at me. ‘Close enough, Mr James.’
I put my head in my hands. ‘What about radiation?’ I ask. I’ve seen enough movies, TV shows and features on Sky News to know that radiation therapy is the treatment of choice for this kind of thing.
. . . I’m fairly sure it’s also what created Spider-Man, but I choose not to say this for what should be blindingly obvious reasons.
‘Radiation therapy is something that could be explored,’ Chakraborty hazards, ‘but as I said, this type of tumour is extremely hard to treat given its location. It would probably prove to be ineffective.’
He says this like we’re discussing a new toenail fungus cream that’s just come out and had mixed reviews on Amazon.
It also sounds like he’s paying lip service to try and make me feel better about the whole thing.
He’s failing.
‘And chemotherapy?’ I enquire. ‘What about that?’
Chakraborty’s frown tells me all I need to know about that option. ‘There’s no evidence to suggest that chemotherapy has any effect on the kind of tumour you have. I fear it would not improve the situation even if it were an option, and may even worsen your health considerably – the side effects can be extensive. The blood–brain barrier prevents effective treatment at the depth we’re talking about. As I say, it’s a very difficult—’
‘—tumour to reach. Yeah, I get it.’ I pick up the glass of water that Mr Chakraborty’s assistant provided me with at the start of this life-changing conversation. I manage to just about get it to my lips without spilling too much of it.
The next thing I say is the worst thing to come out of my mouth since that time when I was four and I tried to eat three slugs in quick succession off the patio table. I can’t remember how bad they tasted going in because the taste of them coming back out was so horrific.
‘How long have I got?’ I ask the unflappable Mr Chakraborty.
He pauses for a second.
I wonder how many times he’s had to answer this question. More than once, I’ll wager. It can’t be easy for him. I’d like to feel sympathy for the difficult position he finds himself in – however, I am far too full of my own fears and confusion for any of that business. All Chakraborty is to me is a complete bastard who’s probably about to tell me I have three months to live.
‘It’s difficult to determine exact time frames, Mr James. The tumour’s growth is very hard to predict. It only requires a small increase in mass to become immediately life-threatening, but it may not grow at all for some time.’
‘But if I had to push you for a timescale?’ I shouldn’t be asking such a pessimistic question, but I am – if nothing else – the kind of person who doesn’t like to stick his head in the sand.
Chakraborty looks discomfited at being pressed this way. ‘There really is no way of knowing, Mr James. It could be six months away’ – he pauses, swallows and continues – ‘or six minutes.’
Jesus Christ. Jesus Christ on a rusty bike.
‘But you say that the tumour might not grow at all?’ I ask, clutching at what are probably some very thin and unattractive straws.
Chakraborty squirms. ‘It is a possibility. But I’d say a very small possibility. Stryzelczyk’s research concluded that the chances of surviving a cerebrodondreglioma in such a position and of such a size were—’
I hold up a hand. ‘Please don’t tell me the odds.’ I may not like to bury my head in the sand, but it doesn’t mean I want to leave the beach entirely.
I take another gulp of water, this time draining the glass. My mouth remains resolutely dry. I then sit back in the uncomfortable office chair and look into the middle distance. ‘I’m going to drop dead . . . and I’m going to drop dead from something completely unpronounceable.’ I rub a shaking hand over my face. ‘How the hell am I going to explain this to my friends and family?’
‘We do have counsellors who can help you with that,’ Chakraborty says in a soothing voice.
I shake my head. ‘No, I don’t mean that. I mean how the hell am I going to explain it to them when I can’t even say it myself? I won’t get halfway through breaking the news without covering them in a thin film of spittle.’
Chakraborty smiles in the self-satisfied way of someone who hasn’t just learned they have an inoperable, life-threatening tumour in their cranium. ‘I’d be happy to write everything up for you in an email, Mr James. That may help them to understand.’
Oh, lovely.
What an extraordinarily twenty-first-century way that would be to break the news of my impending death: a forwarded email. Perhaps we should go the whole hog and he can summarise it all in a tweet, or maybe a nicely composed photo for Instagram, featuring me sobbing in the corner. Is there a Snapchat filter for ‘I’ve just been given a death sentence, please come to my funeral’?
Chakraborty stands up and walks around the desk. ‘We will of course provide you with as much care and support as we are able to, Mr James. My assistant will be able to give you all the details of the next steps we can take.’
Aaaah . . .
Chakraborty obviously feels that his work here is done and that he’d very much like it if I and my tumour could vacate his office as swiftly as possible so he can get back to planning his next golfing holiday.
I, too, rise from my seat on unsteady legs. I then do something so unbearably British that I instantly hate myself. I hold out my hand.
‘Thank you, Mr Chakraborty,’ I tell him as he shakes it.
Yes. That’s right.
I’ve just politely said thank you to the man who’s told me I could die any second.
And look how I’m continuing to warmly shake his hand like we’ve just concluded a satisfying and profitable business deal, not a terminal diagnosis.
Before I came into his office today I was happy, healthy and about to embark on a new lifestyle of loafing about with a wad of cash in my back pocket – but now, thanks to this man, I have been transformed into a walking corpse who might as well not have that wad of cash because I’ll be dead before I get the chance to spend it.
I let go and turn to the door. As I do, I am gripped by a sudden wave of overwhelming fear and cannot move. I feel my breath shorten as I watch Chakraborty open his office door to let me out.
Don’t go out of the door, you idiot. Stay here. Everything will be all right if you just STAY HERE.
It’s completely irrational, but for that briefest of moments, it also feels like the solution to my problems. If I don’t walk back out into the world, then I’ll be okay. If I just stay here in this cool, calm office, then I will live forever.
I can help Chakraborty plan his golfing holiday.
I can make myself a nice bed out of the couch over there in the corner.
First thing in the morning, I can greet him with a cup of tea. I will become Chakraborty’s helpful mascot, ready and willing to offer support and sympathy for all those other poor buggers who have inoperable brain tumours.
Reality then reasserts itself.
I have an inoperable brain tumour that will keep getting bigger until it switches my lights off.
‘Mr James? Are you okay?’ Chakraborty asks from by the open door.
I take a large gulp of air. ‘Yes, yes, I’m fine, thank you,’ I lie heroically.
With some effort, I manage to get my legs moving and push myself towards the open doorway.
‘Please sit down with Claire for a few moments. She will take you through the procedure from now on.’ Chakraborty indicates to where his assistant is sat behind her small reception desk. She looks up at me with the practised smile of someone who knows how to handle the recently pre-deceased. ‘I’m sure we’ll see each other soon, Mr James,’ Chakraborty concludes.
He doesn’t wish me well, or hope that I have a good day. That would just be bloody silly, wouldn’t it?
I thank him again for his time and make my way over to where Claire has prepared a whole series of leaflets for me with titles like ‘Dealing with Terminal Illness’, ‘Coping Mechanisms’ and ‘So You’ve Recently Been Shafted by the Universe. Try Not to Let It Get You Down’.
One particularly edifying pamphlet is from something called the Heavenly Outlook Evangelical Church, which promises succour to those in need thanks to God’s holy love. I don’t think I’m a big enough succour to fall for that one at the moment.
I spend the next five minutes trying my hardest to pay attention to what Claire is telling me – without much success. All I want to do is leave this expensive office and drive home as fast as my overpriced sports car will take me.
‘So, we’ll schedule your next appointment with Mr Chakraborty in four weeks, okay, Nathan?’ Claire says to me, tapping away at her computer.
‘Yeah. Fine,’ I reply, wondering why we’re even bothering. What’s he going to do? Invent some new piece of amazing technology in the next twenty-eight days that can cure me of my tumour in one fell swoop?
With worthless follow-up appointment made and useless pamphlets grasped in one dry hand, I depart the hospital with the foot-dragging weariness of one who has just received extremely bad news.
Outside, the sun has the sheer bloody audacity to have come out from behind the thick April clouds and is bathing the hospital car park in a warm spring glow that I would have absolutely loved about an hour ago, but now loathe with a passion. If ever I needed proof that the universe simply does not care about the travails of Nathan Michael James, it’s this simple change in the weather.
Screw you, Nathan! Mr Sun seems to say. You might be one tiny growth spurt away from an early grave, but I still have to keep this world going, don’t I? Those plants aren’t going to photosynthesise themselves! They’ll all be here after you’re long gone, by the way!
Tears form at the corners of my eyes as I drag my feet back to where my car is parked. I wipe them away as I climb into the driver’s seat and stare out of the windscreen at the VW camper van parked in front of me.
I’ve never been in a VW camper van before . . . and now there’s every chance I’ll never get the opportunity to do so.
I’m thirty-three years old and have only just started living. Until today I had a long and happy life stretching out before me, but now I may never get the chance to do fun things like go for a drive in a VW camper van.
I spend the next few minutes sat there in the car park staring out of the windscreen at the camper van until a skinny bloke with wild, straggly hair climbs into it and drives the thing away, the engine backfiring as it goes. This snaps me out of my horrified reverie.
I get the Porsche started and manage to drive out of the car park and on to the road without much fuss.
. . . which immediately leads me to my next problem.
What the hell do I do now?
What are you supposed to do when you’ve just been told that you have the sword of Damocles dangling over you and that your life is now quite literally hanging in the balance?
People from other cultures may have ways of dealing with such a trauma that I am not aware of. Some may take themselves off to the nearest church to pray, some may surround themselves with loved ones, some may climb the nearest mountain looking for insight. I am British, however, so I do the only thing I possibly can at a moment such as this.
I go home and put the kettle on.
The tea should probably be tasteless, but it isn’t, because it’s bloody tea, and tea makes everything better. At least for a few moments. The tumour can make me think pussies are potatoes all it likes as long as it doesn’t take away my appreciation for a good cup of tea any time soon.
I sit at my kitchen table and look out past my open-plan lounge-diner and on to my exquisitely manicured back garden, which lies beyond the set of extremely expensive bifold patio doors I had installed a month ago.
Well, they were a waste of money, I think as I take another gratifying sip.
The garden – which is looking particularly marvellous right now, as the gardener came in last week – is bathed in that same irritating spring sunshine. I watch as a couple of tiny birds flit from the bird feeder to the garden fence with the precision and grace of two creatures utterly at home in the air. What a marvel of evolution they are – to be so perfectly designed as to make the process of moving between fence and bird feeder so completely effortless.
I sit up with a start. What the hell am I thinking? When did I start channelling David Attenborough? I’ve never given two shits about the birds in my garden before – beyond filling up the bird feeder occasionally because Michaela Strachan told me to do it on Springwatch, and nobody wants to let Michaela Strachan down, do they?
Here I am now, though, gazing out at the beauty and grace of two little brown, feathery idiots getting their fill of sunflower seed like it’s the Second Coming.
Is this what I’m destined to be like now I know that my life could end at any minute? Will I spend all of my time reflecting on the world around me in purple prose, while I sip English breakfast tea at my overpriced oak kitchen table?
Will every sunset be a revelation? Every raindrop a prism through which I see the glory of the universe laid bare?
Will I try to marvel at the beauty around me as much as I possibly can before the cold spectre of Death comes to claim me as his own?
Bloody hell.
I need a proper fucking drink.
I tell you who doesn’t care about my tumour – Kyleee the checkout girl in Tesco Express. Kyleee only cares for two things: the amount of letter ‘E’s at the end of her name and getting rid of customers as quickly as possible so she can bunk off for a smoke around the back of the shop.
I could stand here and tell Kyleee about my diagnosis. We have swapped small talk about the weather before, so the ice is already broken. There’s not really that much of a leap from discussing how much it’s going to drizzle today to talking about the painful inevitability of death.
I fear, however, that any woman brave enough to spell her name with no fewer than three ‘E’s at the end probably has no fear of the undiscovered country. Add the fact that she chain-smokes at a level unseen since the boardrooms of the 1960s and I’m pretty sure she wouldn’t have much sympathy for my predicament. This is a person scared of nothing.
‘Twenty-eight quid,’ she says in a bored monotone as she sticks the bottle of Jack Daniel’s in a carrier bag for me.
I pull out my credit card and hover it over the pay terminal, waiting for it to let me purchase my booze through the miracle of the contactless transaction.
A dark thought springs into my head as I do this.
How many more times will I get to pay for something with my contactless credit card before I die? A thousand? A hundred? Ten?
Will I drop dead while using my contactless credit card? Will it be Kyleee who witnesses my demise through her several layers of Tesco-brand make-up? Will she ring for an ambulance in the same dull monotone she employs when interacting with her customers?
‘You gonna pay or what?’ Kyleee says in a flat voice. ‘You’ve gorra wave it a bit closer.’
I shake myself out of my reverie, realising that I’m standing over the contactless payment machine in silence while the queue builds up behind me and Kyleee becomes ever more impatient for her next cigarette.
I pay for the Jack Daniel’s, pick the bag up from the counter and turn to leave. Then, a horrible compulsion seizes hold of me and I turn back to face Kyleee.
‘Are you happy?’ I ask her, for reasons that are quite beyond me.
‘You what?’ she replies, brow creasing and nostrils flaring.
‘Are you happy, Kyleee? Are you fulfilled?’
It’s very important to me to know if Kyleee is happy with her life or not.
I’m not sure whether this is a step up from worrying about how many more times I’m going to use my contactless payment card, or a step down.
‘What do you mean “fulfilled ”?’ she asks, brow creasing further. Then her eyes go wide. ‘Is that dirty? You wanna fill me with summink?!’
‘No! No! I just mean . . . I just wanted to know . . . Do you like your life?’
Now she looks angry. ‘You a perv, mate?’
‘No! I just genuinely want to know if you’re a happy person.’
‘She doesn’t look fucking happy to me,’ the bloke behind me in the queue points out. ‘Are you going to be long? I’m starving, and this lasagne takes thirty-five minutes at gas mark six.’
I shake my head. What in God’s name am I doing?
I look between Kyleee and lasagne man with the helpless feeling that I’m coming apart at the seams.
‘I’m going to die,’ I tell them both in a small voice.
Lasagne man rolls his eyes. ‘You’re not the only one, mate. I had a couple of Hobnobs at half eleven and haven’t had anything since, so get a move on, will you?’
Kyleee’s expression has changed, though. ‘You’re going to die?’ she asks, nonplussed.
‘Yes,’ I reply. ‘I have something wrong with my head, you see.’
Kyleee looks forlorn. ‘My mum died last month.’
All the wind is inexplicably sucked out of me. With one very brief conversation I’ve managed to transform Kyleee from a two-dimensional stereotype into a living, breathing human being with feelings. I’m not sure I’m comfortable with the change.
The look of loss on her face is heartbreaking.
Maybe that’s why she’s out the back smoking like a trooper half the time. Maybe that’s why she speaks in that dull monotone. Maybe before her mother’s death, Kyleee was just plain old Kylie and only changed her name as a rebellious stand against the cruelty of existence.
. . . or maybe I’m reading too much into absolutely everything at the moment and really need to go home and get fucking plastered.
‘I’m sorry for your loss,’ I tell her.
‘Thanks,’ she replies. ‘And I hope you don’t die.’
‘Me, too, Kyleee,’ I reply. ‘Goodbye,’ I say to both Kyleee and lasagne man, before scuttling out of the Tesco Express with my bottle of Jack Daniel’s clutched in one rather shaky hand.
Back at the house, the mug that earlier contained English breakfast tea is filled with neat Jack Daniel’s, and by the time I reach the bottom of it, the cold spectre of Death could be body-popping naked on my coffee table and I wouldn’t care.
I haven’t been this drunk for years.
Given that I live in a modern detached house – bought and paid for by singing anthropomorphic consumables – I can crank up the volume on my lounge stereo to its fullest extent and dance around the open-plan floor space to Kings of Leon all I bloody well like.
I then put on some Five Finger Death Punch. I have no idea who Five Finger Death Punch are, but Spotify tells me that they are an extremely angry heavy metal band – and boy does some extremely angry heavy metal sound good to me.
All I want to do right now is block out the world – let the whisky and the thrash metal consume me completely.
In this moment, I don’t want to think about brain tumours or checkout girls or VW camper vans or MRI scans or anything else.
I just need to escape. If only for a short while . . .
By half past seven I’m resolutely fucked, and the only thing that’ll be escaping any time soon is my lunch.
Five Finger Death Punch has ended its assault on my cochleas, and the medium-sized bottle of Jack Daniel’s is empty. It’s a bloody good job I didn’t get the biggest one. I might be needing my stomach pumped otherwise.
The rest of the evening is spent in a drunken, exhausted stupor on the couch. I try to watch Location, Location, Location, but give up when I start laughing at Phil’s jokes a little too hard. Phil’s jokes are not meant to be laughed at. They are meant to be groaned at expansively, with much rolling of the eyes.
When I find myself wondering how many episodes of Location, Location, Location I’ll get to watch before I die, I figure it’s probably a good idea to take myself off to bed.
As my head hits the pillow, I start to go over the day’s events once more, this time through the drunken haze of Tennessee sour mash whisky. I keep returning to three things: Kyleee’s look of lonely sadness when telling me of her mother’s death, the surreal image of Sienna holding a potato between her legs and the name of the thing that’s likely to kill me.
‘Serrahbrellodoglioma,’ I attempt out loud to the emptiness of my bedroom.
‘Serebrolodreglomia.’ A bit closer, maybe?
‘Cerebrolodondreglioma.’ Getting there . . .
‘Cerebrodondreglioma.’
There. That’s it. That’s what’s going to kill me.
‘Cerebrodondreglioma,’ I repeat.
Didn’t someone once say that if you can say the name of the thing that scares you, you will gain power over it?
‘Cerebrodondreglioma.’
They lied.