This is the first in a series of postings related to my cancer treatment. The aim is to talk about the personal experience of illness in a broadly analytical way.
I am starting with blood: what it is made of, and how that affects our very being.
Blood and its qualities have long served as powerful metaphors for the human condition. And people spend a lot of time putting things into the bloodstream to alter their mental state. In the case of medical treatments, the alterations are less voluntary.
In the case of chemotherapy, you are also taking something away from the blood’s basic composition, rather than adding to it. Chemo works by killing off cells that divide and grow rapidly. This targets cancer but also catches other, more useful, cells like hair and the bone marrow, which produces red and white blood cells. So the patient feels worse during the long treatment, not better.
What is it like to receive a dose of chemo? It is like being in a pool, and someone throws you a boulder. The boulder drags you down into the water, until you shake free and float back up to the surface. In the body, the chemicals feel heavy, like an unmoved meal. They are heavy – body weight goes up by several kilos immediately after a dose, before coming down again a day or two later.
Medicine worries a good deal about the effect of chemo on the body; specifically about the blood cell count, because a deficiency in red cells causes anaemia, and in white cells leaves you vulnerable to infection. Medicine doesn’t worry so much about the effect on the mind. (The mind, that is, as a complex process of thought and feeling, rather than a disembodied, Cartesian object.) But even when there is no physical emergency, the lack of white cells has an impact. Without those cells, you literally have no ‘fight’; no defence against a threat to existence. And this state exists at the level of feelings, not just as a physical fact.
At the lowest point in the chemo dose’s three-week cycle, it feels humanly hard to go on living. Not because you are depressed, but because you lack the basic bodily ingredients, which we otherwise take for granted, that make living possible. And in a long course of treatment this happens not just once but over and over again, leading to an accumulated feeling of precariousness. It is this specific effect, I believe, that makes chemotherapy the dreadful experience that everyone acknowledges it to be.
Future postings will look at the business of being a ‘patient’; attitudes to risk and mortality; and the impact of serious illness on our relations with others.
Any feedback on these themes, or any others that you think I should consider, is very welcome.


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