Margaret Innes

New Worlds: Reading, Writing and the Imagination


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7 On waking up in No Man’s Land.

The day after my first chemotherapy infusion, a Saturday, I was still high on the steroids I had to take to prevent nausea and it buttressed me from the chemotherapy drugs’ full effects. Sunday morning, the high was gone and I woke to be face to face with the unvarnished effects of their search and destroy mission against the existence of any cancer cells I might have in my body. Like all other chemotherapy patients, my body and me were the collateral damage in the fight and in a tussle between chemo and my cancerous doppelganger, it was no holds barred.

For the next two days my head seemed filled with a thick yellow miasma, impenetrable and unbreathable like the bushfire smoke that had blanketed Canberra and the southern regions after the black summer bushfires. It felt that every life force had stopped in the wake of a catastrophe. It hollowed me out, leaving behind an emotional fragility where I was teetering very finely on the edge of slipping into a very dark place indeed. I couldn’t concentrate enough to read and felt too ill to do anything much, even listen to music. I retreated into my head, repeating well known excerpts from loved pieces of writing or running scenes from my favourite movies through my mind to keep me balanced.

Then on Tuesday morning I woke up in a bath of sweat. It was the last of the drugs exiting my body. I remember thinking in a very practical way, I’ll need to change the sheets and then realising for the first time in a number of days I had a clear mind. I had woken up in no man’s land where my recovery from the last four and a half days might really begin. I started by sleeping on and off for 18 of the next 24 hours. After that, it was navigating the side effects.

Before I had left to go home after the infusion, a hospital pharmacist came to give me 50 anti-nausea tablets and as well, five injection ampoules together with a 24-hour emergency number for the community nurses should the nausea be uncontrollable. I did not need to use any of these things but it did give me the insight into just what chemo can do to someone physically. The aftereffects I was experiencing were in many ways mild: nose bleeds, a searching and lasting fatigue, muscular ache eased by Panadol, limited concentration. All things able to be dealt with until, as the nurse had told me I would, I began to lose my hair.

I remember I looked in the mirror and thought my hair was thinning. Extra strands began building up in the hairbrush during that first week on to be combed into the bin. Fine shining threads of hair littered the bathroom floor and were visible on the hall runners. Towards the end of the second week, my hair was coming out in handfuls in the shower. Me and my partner took to standing in the back garden where I picked the hairs out of my turban and he brushed away whole clumps to be scattered around the garden. ‘Oh, my, oh, my,’ we both said and to our credit, we both laughed. Even now after my second infusion, we can still come across those clumps of fine grey hair in the garden, covered with frost and dew and shining in the cold, late autumn sun like finely spun filigree. And for the very first time, my partner, who had first started losing his hair before he was thirty, had more hair than I did.

I went back to the mirror and started studying what I could now see now I had only the thinnest brush of a few pale hairs to cover my scalp. I said to myself, this is me. That’s the shape of my head, what my ears look like, the set of my features. For four sessions lasting into late June, chemo has stripped me to the essential features where nothing is concealed. I’m stuck in that fight between my cancerous doppelganger and the drugs and for the next two months I have to learn to navigate no man’s land.


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6 Chemotherapy or The Hunger Games

The question I asked myself most before my first chemotherapy session was what would I read for the three hours I would be sitting in the chair? I stashed a small collection of books into my bag and with my partner, headed down to Building 19 at the Canberra Hospital, their cancer centre, and then to the fourth floor where they do what they call the infusions. There was, as always, an education session to start, meticulous and detailed and another collection of papers to add to my portable filing cabinet. I asked, will my hair fall out? The nurse said yes regretfully. I accepted this as inevitable and then it was into the large room where everyone else is also being infused. Later there would be a young Asian woman ushered into a chair not far from me. She had the most beautiful long shining black hair whereas mine is only fine and grey. We are both doomed to lose it.

Since I have always mostly associated the word infuse with aromatic ingredients in cooking, it made me a little sad to think of it in this context. But it’s accurate. After putting the cannula into my arm, the nurses arrived in full protective gear, including gloves and eyeglasses, double checked the drugs and began the process, the slow infusion of docetaxel and cyclophosphamide into my bloodstream to counter whatever possible cancer cell might be there. Which is why I have likened this whole process to Suzanne Collins’ novel The Hunger Games. The drugs are poison: they take your hair, your energy, your cancer cells, your white blood cells without discrimination. In other words they make your body fight against itself for the survival of either the cancer or you.

To prevent nausea, one of the hospital’s pharmacist had given me steroids to take the day before, during and after chemo, with the unexpected warning they might give me nightmares. They did no such thing, they gave me a three-day high instead where I thought there was nothing I couldn’t do. Probably a good attitude to take into a chemotherapy session and one that went well with the book I chose to read, a book from a vibrant local publisher, Recent Works Press, a wildly imaginative, innovative collection of prose poems about loss called Errant Night by Jerzy Beaumont. Very simply put, to deal with grief he travels the stars and the universe, returns to where I was in Canberra Hospital to come face to face with the loss of someone loved before going out into the universe again. I speak of this book because, even given where I was, there was something close to exhilarating about reading of imaginary journeys to the far reaches of the universe and all its way stations to deal with grief while sitting in a chair having docetaxel flowing into my veins in the very location that is at the heart of the book. It was in its way a comfort, that wherever I am, my mind can go anywhere. I, all of us, always have that freedom to imagine, to find ways to feel and grieve, to read and to think.

There were other true heroes beside the nurses and the patients in the chemotherapy suite that day. There are the volunteer women who wheel trolleys around with tea, coffee, juices, biscuits (Arnott’s assortment for the nostalgic), cake, sandwiches and who stop to chat and laugh. The hospital also serves lunch, hospital food but it’s there for you. And when it’s all over and the cannula is thankfully taken out of your vein to be replaced by a round white dressing and you get a little shakily to your feet to go home, the nurse comes to wish you the best. I have to come back the next day for a pegfilgrastim injection to boost my white blood cell count. This is the process, a serious gladiator fight within the confines of your skin, within your system. It will keep happening until the doctors think they have done enough to save you from yourself. What I have to do now as a patient is navigate the battleground they have created inside my body to achieve that end. 


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5 Oncologists can be persuasive.

When I saw my surgeon for my follow up appointment after surgery, he was obviously pleased with how the operation had gone. The incisions were healing well, the margins around the tumour were all very clear. He smiled at me. ‘You won’t need chemo,’ he said. The moral of this story is, don’t take your oncological advice from your surgeon. However skilled they are, this is not their area of expertise. The oncologists I saw had a very different opinion.

I took that false confidence into my first meeting with the radiation oncologist. Radiation I knew to expect; three weeks of it instead of four because the margins were clear. We began, as usual, with education and detail. The registrar took all my facts again, I received another thick sheaf of paper to add to what I had begun to call my portable filing cabinet, a thankfully discreet bag from Bosom Buddies. Then the oncologist herself appeared, a young woman with long fair hair.

Everyone brings a demeanour with them when they walk into a room; they’re at ease, they’re ill at ease, they’re nervous, they’re self-possessed. Her first glance at me was serious. She took a seat and began to explain to me they had received the pathology results for the tumour. It had not reached my lymph nodes but had been active, its growth pattern one that would have seen it move out into the rest of my body. They had removed it but what else might be left behind that they couldn’t see or test for?  ‘It’s fifty-fifty whether you need chemotherapy or not. You’ll need to speak to the medical oncologist,’ she said. Her words were measured but her demeanour suggested she saw this as troubling.

I went home thinking again of the front cover of Marisa Acocella Marchetto’s Cancer Vixen and its drawing of a woman spectacularly taking a fall.

The medical oncologist was the same one I had consulted last time. I remembered her as a no-nonsense woman who was a stylish dresser. This being the time of Covid, we had a zoom session. Between her and her registrar, they laid out the situation. The tumour was unusual, an unexpected combination of pathologies. They could not tell if there were still microscopic cancer cells present. There might be, there might not be, there was no test to tell. If there were, they could reappear some years down the track as what is called metastasised distant breast cancer. ‘If they do, we don’t have a cure for that,’ said the oncologist. It would four sessions on the second tier of chemotherapy drugs. Horrible but by no means the worst possibility.

They spoke of it as being my decision, laid out the facts and the possibilities objectively but I could read the room; they saw the possibilities as troubling. I was reminded of both the sonologist and the radiologist I spoke of in my first blog. Without tests, they knew accurately what they were looking at pretty much as soon as they saw it. That kind of knowledge can only be gained by experience. To my certain knowledge, my medical oncologist is a very experienced doctor.

It is an odd thing, a precautionary gamble. Distant breast cancer might still happen even with chemo, it might not happen even if I do not have chemo. The percentages of those chances are low but they are possible. I write thinking of a line of William Blake’s poetry, ‘What is the price of experience?’ He goes on to write, ‘It is bought with the price/ Of all that a man hath.’  I couldn’t help but think that all the years of experience the medical professionals I consulted had collected between them meant they knew almost intuitively what they were looking at. I brought my own judgement to the decision. I said I would go ahead with chemotherapy, as another step along the way.