Читать книгу Ippi Ever After - Martin Jr. McMahon - Страница 4

The weeks passed. Work was going through changes. The demise of the Celtic tiger was beginning to bite home. Sometimes I loved my work, sometimes I didn’t. All jobs looked less secure than they had not long before. That, coupled with new ownership meant changes. It was a time of caution. The head count was sure to be reduced. I can’t remember being too worried. With change comes opportunity. Get up on time, get to work on time, stay off the trouble radar and maybe I’d get a step ahead, that’s what I believed. Sooner or later, at least in the private sector, your face just doesn’t fit anymore. You can fight it or you can adapt. I’d been there a long time and it was so close to home that the advantages outweighed the disadvantages by a long way. I was determined to stick it out and show that I was more worthy than the guy next to me.

At home Mary wanted to have another baby. She’d been talking about it for a couple of months. I was getting used to the idea but I wanted us to do some couples counselling first. I didn’t see our problems as insurmountable, with effort and honesty I thought we could put the screaming behind us.

I’d taken an afternoon off to get the mole removed, but I didn’t milk it. The following morning I was back on the plant floor at 6.45am. The same the next day and the day after. In a lot of ways the early shift was harder than the swing shift. More guys to organise and more machines to nurse through the day.

It was Friday and I was finished for the week. April had slipped quietly into May and with longer, warmer days the kids were eager to be out in the back garden. I was the only one in the house when the phone rang in the hallway.

“Hello”

“Martin?” the voice on the other end asked. I didn’t recognise the voice.

“Yes, how can I help you?”

The voice on the other end quickly explained that he was the dermatologist I had seen three weeks earlier.

“There’s no easy way to say this, the biopsy showed cancer”.

“Are you sure?” I asked, hoping desperately that there was some element of doubt, that further tests would be needed, that maybe just maybe I’d dodge the bullet.

“I’ve had it tested twice” he replied “there is no doubt. Its four point two millimetres. That’s bad news. I just received the second results and I had to tell you”.

It hit me on the tip of my nose before it mashed its way through to my brain. I was speechless. Thoughts raced simultaneously through my mind. In a mili-second one thought eclipsed all others,

‘How do I tell Mary?’ Some part of me already knew that she wouldn’t face this. Mary didn’t like problems of any kind, the smallest thing could quickly snowball into a dramatic disaster. I expect lumps and bumps, Mary expects one continuous smooth path

He talked on for a few minutes. His voice rolled over me like waves on a pebble. After a few minutes I think he realised that I wasn’t taking it all in.

“You have to have surgery to remove as much of the surrounding area as possible” a pause “Martin?”

“Yes?”

“Have you any questions?”

“Are you sure?”

“Yes Martin, I know it’s difficult, but I am sure”.

I know I asked more questions but I didn’t want nor need answers. I just needed to hear another human voice as I figured out what to do next. By the time the call finished, I’d realised that there was no easy way to tell Mary. There was no point in holding anything back. I hung the phone up and sat on the floor in the hall.

I was numb, stunned but not yet frightened, well, at least not as much as I should have been.

In the initial days after I was diagnosed, the GP told me not to look at the internet. Of course I did. Google, google, google. Malignant melanoma is a wicked cancer. If it’s not caught early, it kills eighty five percent of those with it in five years or less. Early is one millimetre or less thick, anything above two is trouble. The charts don’t go beyond four millimetres. I clocked in at four point two.

On the following Monday I spoke to my GP. He had a surgeon in mind.

“He’s the best” he told me.

The following week was a blur. The world spun all around me but I stood still. We were due to go on holidays to Spain in four weeks. I really wanted to go. I wanted to keep everything normal. I told the bosses in work what was going on. From the get go they were supportive beyond anything I could have expected. I was optimistic; I can beat this I told myself again and again. My immediate boss was a good guy. Over the years we had developed a good working relationship. When we weren’t talking about work we talked about our kids. His wife was a nurse, his kid’s teenagers. Very subtly he tried to temper my expectations. In hindsight, I think he knew that I was facing a longer, harder battle than the six weeks post surgery recovery I was talking about.

My eldest girl wanted to do a sky walk. In essence it was an obstacle course fifty feet up. I was all for her taking on adrenaline pursuits and I suspected that it would be a while before I’d be up to it again. Mary didn’t like to be outside her comfort zone and I wanted Leah to be a bit more daring. I’d been taking her on the best carnival rides since she was two. We headed off to the sky walk.

In front of us were two teenage boys. A steward fitted harnesses over their heads and led them to the first obstacle. Both guys chickened out and were taken down steps where they were unharnessed.

“I don’t think I want to now” Leah whispered to me.

I didn’t want to either but I wasn’t going to let that stop us.

“You can do it” I assured her.

We set off over, under and across the obstacles. I don’t know which one of us was more nervous but we didn’t chicken out. Beads of sweat rolled off my brow, disappearing into the space below before splashing unnoticed on the floor. When we finished we both felt exhilarated. She wanted to go again, once was enough for me.

On Monday I met the surgeon. He was professional to the nth degree. Sharply dressed, confident and honest. I immediately liked him. He explained what he was going to do. Much of the flesh of my left buttock was to be further excised. At the same time a radioactive indicator was to be injected into the area and then he could see which lymph nodes the blood was flowing through. Once identified, a biopsy of the nodes would tell if the melanoma had spread.

Lymph nodes are the body’s sewerage system. Impurities in the blood are filtered out in the lymph system; hence, you can have swelling in your neck glands with a strep throat for example. If the melanoma had spread, it was likely that it would show up in the lymph nodes first.

Beaumont is a teaching hospital. Ranks of upcoming doctors spend set periods learning by example from the best professionals the country has. It’s big and it’s imposing. Thousands of people pass through the doors every day. Visitors, staff and patients mill around the ground floor from early morning to late night. It is a place of routine hustle and bustle. On the day I was admitted, I was a bit overwhelmed. I felt out of place. I was not sick in the same sense as most that I saw. I didn’t feel ill, didn’t look ill and didn’t want to be there.

The room had enough space for six beds but there were only five. To the uninitiated that might not mean much, but it is the difference between semi-private and public to the bean counters. In each five or six bedded room is a small room in the corner. In there, is a toilet and wash hand basin. In the more modern rooms there is a shower cubicle, in the one I was in, there was not.

I was given a name band, a line in my arm and one of those stupid gowns that fastens at the back.

“Don’t go anywhere” the nurse told me “you’re on the list for later on and you have to go to nuclear medicine first”.

I’d never heard of nuclear medicine.

“The team will be around soon”.

I sat on the armchair beside the bed. I listened to music on an mp3 and waited.

The team came and went. Fresh faced interns gathered around the bed listening to the surgeon as he explained what was to come. I had no problem lying down on the bed and baring my ass. The surgeon traced his finger along the line of the incision he was going to make. He talked about using a flap of skin that could be closed over to seal the wound he was going to make. The interns hung on his every word, some took notes, the clever ones listened.

After a time a porter arrived with a wheel chair.

“Pop in there” he told me.

I put slippers on and sat in the chair. I’d never owned a pair of slippers before; I’d never seen the need. I’d bought them along with Pjs a few days earlier.

He wheeled me to the lifts and we descended into the basement. I was greeted by a small swarthy man in a white coat. He brought me through a door emblazoned with hazard signs and the words ‘Nuclear Medicine’. He was the chatty type which suited me fine. In the time it took him to get me ready I already knew he was from Malta, loved Ireland and was up to date on malignant melanoma. Moments later another man in a lab coat carried in a small steel box. The outside of the box was covered in yellow and black hazard signs. The Maltese man opened the lock on the box and took out a metal syringe. He injected the contents into my left buttock. A few minutes later a different porter arrived and took me back up to the ward. The nurse hung a sign on my bed. It cautioned that pregnant women and young children shouldn’t come near me. I was radioactive.

I wasn’t allowed to fraternise, I had to stay at the bed and wait. I watched people come and go to the bedsides of the four other men in the room. Two were elderly, taken from nursing homes to Beaumont for minor surgeries. The other two were younger. One, a man who drank his liver into failure, the other a guy who had picked up an infection abroad from which he was recovering. I listened to music and waited.

A tall bloke dressed in green with white clogs arrived with a porter. They had negotiated their way through the corridors and into the room with a trolley.

“Can you make it up there yourself” the gentle green giant asked.

I climbed onto the trolley using one hand to keep the stupid gown closed at the back. We chatted on the way down to theatre. The weather, football anything but hospital, cancer and surgery.

He parked the trolley in a room where everyone was dressed in green. A nurse came to my side with a thick file. She double checked the details on my wristband with the details on the file. Another nurse, older, matronly, arrived just as she finished.

“They’re flying along” she said comfortingly to me “won’t be long now”. She patted my blanket covered foot gently.

I thank god, or whoever or whatever runs the show upstairs for people like her. She knew not to engage me other than with a reassuring pat and a business as usual approach. It was what I needed. I lay back, closed my eyes and relaxed. I was almost asleep when she came back to take me to the anaesthetist.

The anaesthetist’s room was small. Just big enough for the trolley and a person to walk around it. One wall was covered with transparent plastic boxes, each labelled and filled with an assortment of tubes, syringes and other equipment. The anaesthetist explained what she was doing. She attached a syringe to the line in my arm. The liquid felt cold in the veins of my arm. That was the last thing I remembered before darkness closed in on all sides and consciousness was swept away.

I awoke back in the room with the green people. The matronly nurse was by my side.

“How’s the pain” she asked “on a scale of one to ten”.

“Six” I answered quickly.

Moments later pain relief flooded my system. The world closed in again and I dozed off. I was half awake as a porter brought me back upstairs and got me into bed. Early the next morning the team arrived. The surgeon pulled back the bandages and examined his handy work. I could tell he was more than pleased. If he was happy I was happy. A perfect question mark scar stretched from ass cleavage almost to hip. On the front near the hip bone a much smaller scar, the spot where the biopsy was taken. It was a perfect question mark dot and all.

I spent three or four days in hospital. The medical staff, nurses and doctors, worked long hard hours. The sheer volume of patients each was responsible for was staggering. Nurses in particular were always on the go. The one place where Beaumont failed miserably was cleanliness. One toilet between five men with varying capabilities is bad enough, but when you find it covered in excrement in the middle of the night it’s unnerving. I don’t blame the ill men, I don’t blame the overworked nursing staff, I blame an administration that doesn’t have the foresight to have toilets cleaned more regularly or at the very least, to leave some means where the patients can clean the toilets for themselves.

When I was discharged, I was more than glad to go. The general consensus between patients is that hospital is risky, infections a real possibility. Beaumont is so big, with so much through traffic, it has to be practically impossible to prevent outbreaks such as the winter vomiting bug or worse. I was out and it was over.

But it wasn’t, not even close.

I still wanted to go on holidays. The kids were looking forward to it. The imperative I felt to keep everything ticking over as normal outweighed anything else. It was with that frame of mind that I spoke to the surgeon a week later.

“The biopsy came back positive” he didn’t mince his words, that was ok with me.

“Surgery?”

“Lymph nodes in your left groin have to come out” he continued to explain what was going to happen.

My head nodded but my mind was a million miles away. I hadn’t dodged the bullet. Ok, look for the positive, what is it? Mind blank for a moment……. There it is, it might only have spread to the main or sentinel node. I fixed my thoughts on that one place, sloppy luck I told myself, lose a fiver to find a tenner, I’d get through it.

“I have a holiday booked next week” I told him “can I go?”

The surgeon knew I had kids, I hadn’t crumbled with the news he had just given me. He mulled it over for a moment or two.

“Yes, but take care of that wound”.

Despite my best efforts, that holiday was a nervous time. I tried to focus on giving the kids a good time. I had arranged to come back a day earlier than Mary and the kids. It was too much of a risk to fly home on the same day I was scheduled to go into Beaumont. I arrived at Malaga airport in plenty of time. I checked my luggage and walked to the boarding gate area. It was only then that a delay was announced. For the next twelve hours I was stuck in Malaga. A tyre had burst on the incoming flight. A replacement tyre had to be flown in. All that day I kept in touch with Mary by phone. I can honestly say it was the last day she ever pretended that she cared about what happened to me.

It was in the early hours when I got home. I didn’t sleep much and early the next day Mary and the kids arrived home. I saw them only for a couple of hours before my dad collected me and I set off for Beaumont. I don’t like goodbyes at the hospital door, it’s too fraught. I had given the kids a hug and told them I would see them soon. I had tried to with Mary, but she held her hands up to stop me. It hurt, but I was accustomed to her little hurts, ‘it’s just her way of coping’ I told myself. I had other things on my mind. Again with the shitty toilets.

The surgery was over. This was a much bigger operation. Its impact much harder than the previous one. ‘Get up, get on your feet’ I told myself and I did. My left leg hurt badly. Below the belt line, I was bandaged on my ass and now crotch. It all felt weird, jumbo weird. I’d expected some nerve damage, but the reality felt oh so strange. When I touched just above my left knee, I felt a tingling sensation in my hip. The area between hip and knee was numb most of the time, but occasionally there was a flood of pinprick sensations. I didn’t dwell on it and it has remained more or less the same ever since. To me it was a small price to pay. In the initial days, I wasn’t freely mobile. I needed the support of a crutch.

Oncology came to see me. I was still under the care of surgery. The oncologist arranged an appointment for me to see him two weeks hence. He talked about options. There were damn few. It was do nothing and wait or have a somewhat experimental treatment called interferon. The evidence for interferon is weak. Some study somewhere showed that it had a marginal, and I mean marginal, two maybe five percent chance of being beneficial to the patient. There is no substantial evidence that interferon makes any real difference to the grim statistics. That said, I wanted it. I knew it was expensive with tough side effects, but it might make a difference. Might was enough for me. The other fact I gleaned from googling was the timetable. To have any chance of making a difference, interferon has to be administered within sixty days of surgery. Some oncologists will differ on the details but the core truth remains, advanced melanoma is a greedy, destructive son of a bitch. Surgery and interferon don’t git rid of it, the best they can do is hold it at bay but eventually it wins, always.

By the fifth day post op, I was eager to be home. I missed the kids a lot. I consider myself very fortunate to have been able to spend so much time with my kids. Working shift has advantages, particularly before children are old enough for school. Over the years I got to spend good quality time with first Leah and then Judy. Even when I worked night shift I got the best of time with the kids. I will always remember Leah’s little head peeping through her bedroom curtains at just after seven every morning. She was watching for me, when she saw me her face lit up and she would scuttle down the stairs. We’d have breakfast together and she would chatter. I was always amazed and grateful that this little person was so eager to share her thoughts and feelings with me. I was and am very conscious that I don’t own my kids, they are individuals in their own right, the best I can do is watch out for them. Guide and protect them, but I don’t own them. Lots of dads only see their kids briefly if at all on a day to day basis, not so for me. I was with my children at least as much as was Mary. My time with them was more important to me than time spent doing anything else. I was privileged to share so much with them.

The other thing that happened on the fifth day post op was pain. It started slowly in my testicles, left side. It built gradually over half an hour. It felt like the pain a man gets following a good kick in the nuts. I had a definite sensation of the pain moving slowly upwards. All in all it lasted for about two hours. I told the nurse on the ward and she in turn told the on call doctor. By the time he got to see me the pain had passed. It did worry me and I definitely thought blood clot, but I felt reassured that the pain ceased.

The following morning one of the surgical team came to see me during rounds. I was asked if I wanted to go home. I nodded vigorously.

“Ok then” the doctor agreed.

I rang Mary and my dad. It was still early maybe eight thirty am. The August bank holiday was looming and the weather was good. It would be ten or so before I could leave. I needed a prescription for painkillers and an appointment for out patients. Dad arranged to collect me around ten thirty.

I got dressed as much as I could. I was going to have to wear pj bottoms because anything like jeans would be unbearably painful. I dressed, packed and was ready to go when the doctor arrived with what I needed. The bed was already stripped, cleaned and ready for the next patient. I said goodbye to the nurses and made my way to the ground floor entrance. Dad was waiting for me in the car outside.

I was relieved to be home. I was also exhausted. When dad left I went upstairs to my own beautiful bed. Mary carried the bag I had used in hospital up with me. As I lay in the bed she unpacked the bag and threw the nightgown across the foot of the bed.

“Ouch” I said half joking.

“Yeah, well it’s a learning curve for us both”.

It was the way she said it, it was so cold, so hostile that I thought she was joking. I laughed.

“God your quick” I said.

She looked at me straight in the face. There was no mirth, no good humour. It really wasn’t something funny. She said nothing else before she left the bedroom. I didn’t sleep, I couldn’t. Mary had turned on the radio in the kitchen and put the volume up loud enough to be heard all over the house. Then the banging started. By banging, I mean banging, for example, if Mary washed dishes they invariably ended up crashing together and or driven against the aluminium draining board so hard that everything close by rattled. If she vacuumed a room, the head of the hover was slammed into the skirting board again and again. Bang, bang, bang. I’d long ago given up asking why. All in my head she screamed at me until I believed it, but I also knew that she didn’t want me in bed.

Not long after, I got up out of bed. My ass ached, my groin throbbed and now my back felt like I’d overstretched it. That dull pain like the distant beating of a far away base drum. I put on the nightgown and winced. ‘Cowboy up’ I told myself, ‘feet on the floor’. When I find myself in difficult situations, I try and get through by breaking the overall task into smaller bite size pieces. I don’t focus on the overall outcome, just the next step. The next step was down the stairs. It was infinitely trickier than it had been going up. I put most of my weight on the banister and slid forward a step, then waited for my feet to catch up. Once back on the level it was easier, less of a task. I sat in the kitchen at the table. Mary had her back to me at the sink. We did talk, but the coldness was still there. I assumed it was the green eyed monster. Jealousy was a constant with Mary. I’d been away almost a week. I’d talked to other women all be it nurses and doctors in the course of their duty, Mary didn’t like that. One night years back I woke up in the dark, freezing. My pillow was gone and the duvet was doubled over Mary leaving me bare assed.

“What’s going on” I mumbled.

“I had a dream that you cheated” she said matter of fact.

“For god’s sake” I got out of bed, picked my pillow up off the floor and pulled the duvet back over the bed. I went back to sleep, that’s how common place her jealously was to me.

We’d discussed it, time and again, but it never went away.

“I couldn’t do it” I told her once “I couldn’t spend days imagining that you were cheating on me, I’d be demented. I have to trust that you won’t for my own sanity”

So sitting at the kitchen table, I waited for a thaw, a thaw that was never to come.