According to the eponymous tradition of Scottish philosophy, common sense refers to an ability to perceive the properties or qualities of objects using separate sensory modalities. The classic example used to demonstrate the principle is the fact of the cubeness of a cube being both a visual and a tactile experience – we can both see and feel that it is a cube. The common sense is that which makes it thus possible for vision to confirm touch and vice versa. It is the basis of learning directly to perceive higher orders of abstraction than raw sensory experience, and of using these to navigate about complex environments.
For the last few months I have had an uneasy feeling about what is going on in my chest. The only information I had to make sense of this was the sure knowledge of metastasis in my lymph system. I imagined rogue prostate cells sloshing around as I remained active during the day and coming to rest at night, gathering somewhere near something important inside when I sleep and making me feel like shit in the morning. Now I have a much clearer picture of what is going on.
Six years ago, when I first had to tell friends, family and loved ones that I had been diagnosed with an incurable cancer, I learned very quickly that such news is not easy to receive. Sometimes I found myself giving comfort to friends who had simply broken down before me. Soon, I found it difficult to repeat over and again the same story and to risk again soaking up the grief of others. I was too self absorbed, too crippled by resentment and rage, too determined to rant about the great injustice that had befallen me. This was one motivation behind my decision at the start of 2013, to come out publicly on the Facebook about it all and to create an online persona, which became an incredible source of strength and inspiration for me, and which has morphed now into this blog. To this extent, my life as a cancer patient is already public; I feel perforce a degree of responsibility to document every turn it takes, to speak the truth of my condition.
Once again though the truth is not easy to speak, and may not be easy to hear.
For several months my visits to the hospital have become more and more difficult to justify, given my attitude to the treatments on offer. Nevertheless I have been scanned and had my blood tested so that knowledge of my condition exists for others. I have had conversations with wonderful, caring people at the Edinburgh Cancer Centre and at Maggie’s. I have also been preparing for this moment. From the beginning there has never been anything else for me but postponing the inevitable, which has been a highly successful strategy. It is my agency that keeps me going, the decision at every moment not to succumb, to remember now that I am alive and that this is all there is, there is no past, no trail of regrets, failures and missed opportunities, no future to be feared, no prospect of bodily collapse into pain, indignity and despair. Only the slow inhalation and exhalation of air.
It is best to be plain.
The disease has now invaded my bones. There are five or six hotspots in my rib cage and spine where rogue prostate cells flourish. I saw these presented on a screen when my oncologist ran through the CT scan in all dimensions and showed me an image of my skeleton lighting up like a Christmas tree, at the exact same places I have experienced what seemed to be mild bruising, which I put down to the ordinary bumps and strains of an active life. For the next few days I compared this double experience of the internal structures of my body represented on a screen, with the feeling I have daily of my own body. I know now exactly where the cancer lies. My oncologist also pointed out the continuing enlargement of a couple of lymph nodes in my groin, which are now eminently targetable by clever radiography, to which I have consented. He was pleased at last I think to be able to offer me something I would accept.
Although I am well aware that radiotherapy is highly damaging, I am also convinced that collateral damage is indeed minimised with very precise targeting by highly skilled radiographers using clever machinery, and in my case any side effects or permanent damage will be the least of my worries.
The good news is though that the bad news is nowhere near as bad as it could have been. There is no sign of the disease in any vital organ; liver, kidneys, lungs, bladder, stomach and gut are all clear, no blood chemistry suggesting anything but continuing good health. Most importantly though, I know what the disease feels like. The vague twinges and feelings of unease, the strange nauseas and dull aches all become explicable and are clarified because I was able to compare feelings of my insides with visual images of my insides – to perceive directly the anomalous tissue growth, to be able to bring it to mind in a safe place, in the moment, knowing that what I feel is what it is, that I am alive still, and breathing, relatively pain free, active and optimistic that I have not yet reached the summit of my last Munro.
It was common sense in another sense to know, to let go of the delusions of not giving the disease any solidity, to celebrate both the with and the without of living with(out) and to focus on the living. Now more realistically, and also as an affirmation to myself that I have overcome much during these last years, put to rest many delusions and tamed many demons. No longer am I living with fear. This is a condition, despite the circumstances from which it arises, to which I would most certainly recommend everybody aspire.
I have reached the point where I have absolutely no investment in any imagined future political condition where things are different from the way they are now, where the world is not run by a cabal of oligarchs and demagogues with the ethics spoilt infants, cynically exploiting the concept of democracy to maintain their power, where drug companies do not control healthcare, arms dealers and bankers do not deploy warfare as a means of destroying capital and thus maintaining the need further to extract value by pushing down the price of labour, where plastics were not both invading the biosphere at a molecular level and forming massive islands of floating rubbish in the oceans, where rainforests were not being bulldozed for genetically modified oil and starch production, where biodiversity were not a thing of the past, where the future of human life did not look likely to destroy the very possibility of life itself, here on this planet, the only home we know. Given that things are not different from the way they are, it is not very difficult for me to imagine my particular condition as but a symptom of this more general planetary decline.
Having said all that, I know what is right, what my reality feels like, how to conduct myself, what is good and what is not good, and I do not need now anybody to tell me these things. It is all a consequence of having honestly chased down my demons and put to rest my delusions, of a conscious effort to behave mindfully and with love for all life in my heart. It is strange to read these words, to realise that such an attitude has to be fought for, that it does not arise naturally within the ambient conditions of humanity, that we are riven by artificial divisions, resentments and indifference, from which it seems impossible to escape. There must always be hope though, for agency will always overcome blind, obedient, unreflective habit, shake out all complacency and reveal the truth.
To put into words what is necessary is not simple; deliberately not to behave as before is not easy, consciously not to take for granted what seemed always to be the case is never straightforward, actively to work together to overturn destructive powers is always challenging. This is nevertheless the gist of it.
It has taken cancer to kick me up the arse hard enough to realise these things; it seems impertinent to suggest that others might also benefit from a similar journey, that living with(out) cancer might be a strategy others could follow. This is nevertheless the only advice I have to offer anybody who wants things to be different; be prepared always to be living with(out) cancer, for not only is every individual increasingly likely to be diagnosed with a particular form of the disease, sustainable life on planet Earth seems to be in terminal decline. It is then only common sense to acknowledge this honestly without fear or recrimination, and always to concentrate instead, at every moment, on being alive.