The first cycle

what does not kill me makes me stronger

Munro with cancer #175

14:30 – Meall Chuaich (M214), 3120ft, 951m

Chemotherapy is a bit of a rollercoaster.

Before I was properly introduced to the precautions necessary to avoid infection and to the supplementary medication chemotherapy demands, at the start of the first cycle I was absolutely terrified. The fear gradually declined though after the poison was administered and the more nuanced reality of being poisoned kicked in. When I began to experience what the stuff was actually doing to my body, the fear was replaced by a slow progression towards feeling worse than I have ever felt before, where my only mental condition was trusting that this would pass, that like everything else it was temporary.

The seventh day of the cycle was the worst of the worst, after which something quite remarkable happened; I began to feel better.

At the end of the second week of the cycle I was able to walk reasonable distances and no longer felt any residue of the poison. Even although my nights were still disturbed, the nightmares declined and I felt as if I was at last getting enough rest, enabling my body to heal. Sometime about then, I was walking along the beach with my wife, feeling much better than I had for a long time, and remarked rather speculatively, that I thought I could probably get up a Munro, an easy one, if I put my mind to it. She agreed, tentatively. So I sent a message to Martyn. And it was decided. From this moment I focused in on the next Munro, one of the easiest, thinking through what would be necessary, concentrating on how my body was healing, preparing myself for the trip.

About half way through the last week of the cycle I was chatting with my wife one morning, reflecting that despite the hell of the first week, I was feeling pretty good, better than I had expected, better even than I had felt before the start of the cycle. My hair was not even falling out I added, whereupon I grabbed a clump to demonstrate that it was still securely anchored in its follicles and pulled it out as if from a moulting old teddy bear. For a couple of days, I fell into a bit of a dip; my sleep was again troubled and I suffered one or two minor panic attacks. To cheer me up I’m sure, my lovely wife decided to call me Patch.

There is no clearer sign that a person has cancer than a patchy balding scalp or one shaved clean in anticipation. A shiny pate these days is often displayed with pride as cause for celebration, since chemotherapy is regarded as a cure, and so anybody demonstrably undergoing treatment is surely one of the lucky ones. I have had to explain to at least two others who expressed such a view that my chemotherapy is palliative rather than curative, that according to the science it will only postpone rather than curtail. For a day or so I was once again consumed by the grief and the rage of terminal diagnosis, but found peace again with the humour of artificial baldness, the prospect of a fresh Munro and the glimmer of something new. Maybe too this chemotherapy I am being given will do more than expected, maybe my substantial stubbornness, my mental fortitude and sheer bloodymindedness will combine and interact to work wonders. Perhaps Degarelix plus Docetaxel plus all these steroids plus mindfulness will do much more than pharmaceuticals alone. Perhaps being aware of the processes, perceiving directly what is happening in my body, visualising this, will make the crucial difference, tipping over the miraculous biochemistry of being alive from palliation to cure.

I have no doubt that achieving any goal is mental, that when I get a sense that I am going to do something, put my mind to it, make all necessary preparations and have my wits about me, this is inevitably what I will do. The weather forecast was excellent for the last Sunday before the next cycle, open skies with sporadic high clouds, wind still, morning frost and cold clear air, not to mention an extra hour of daylight with the return of Summer Time. My wife encouraged me to carry a very light pack; Martyn offered to shoulder all the heavy stuff.

He picked me up before nine, and despite speed restrictions on the A9 we were walking away from lay-by 94 at 10:30. It took us an hour along the flat walk-in to a locked bothy with some fascinating, albeit rather alarming furnishings and fitments, clearly on display for all passing hillwalkers to observe through large unshuttered windows. We sat outside in the sun for elevenses. On the other side of a little burn, a male grouse gurgled expressively, surveying us with his vibrant red eye, while Coll looked back, wondering why the bird was not flying away.

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The ascent follows a rough, sometimes squelchy walker’s path all the way to the summit. Throughout the walk thus far, we had plenty to talk about, what with Brexit and all, but while climbing we decided to try not to speak about these things, for it takes up far too much oxygen. This was an exercise in mindful hillwalking; short, slow steps each always poised precisely, to be placed on a specific, strong and stable, foot-sized piece of ground. My intention, particularly over the initial steepest sections, was never to go beyond my limit, never to work up anything of a sweat, always to maintain a sensible heart rate so I would preserve resources for the round summit ridge, which I expected would be exposed to cold, faster moving air.

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We stopped again for lunch not far shy of the final summit lump, under a protruding rock facing towards Ben Alder, the High Laggans and Creag Mheagaidh, with the Aonachs peeping out from behind, all garnished with clean fresh snow above about three and a bit thousand feet. On the way up and as we sat, many others passed us, firstly on the way up and now on the way back down. There was an obvious difference in pace between us and all these (much younger) folks on the mountain; I observed that I had probably become now what I once aspired to be, one of a pair or small group of casually climbing old chaps, nonchalantly chewing the fat, apparently unbothered by haste on the way to a summit. Of course, I added, I was not suggesting that either of us was old.

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We reached the summit at two thirty, from which we were blessed with three-sixty vistas of snow capped plateaux and denuded brown hills. The air was still and very clear, affording incredible views in all directions. To the west, the aforementioned plateaux of Alder, Laggan, Aonach and Meaghaid, with Ben Nevis now just visible. In the far distance, north of west, peeping over the high plains of Monadhliath, we could see Knoydart, Cluanie, Affric, Mullardoch, Strathfarrar and even Ben Wyvis. To the south west, the Drumochter Hills, Schiehallion, Glen Lyon, Ben Lawyers and the Trossachs. The the south and east, Ben Vrackie, Ben a Ghlo, the Atholl wilderness, Carn nan Righ and the Glen Shee massifs. To the north of east, Lochnagar and the enormous Cairngorm plateau. And due north the broad greening expanse of Strathspey. All bathed in bright sunshine and dappled with random cloud shadow. We tarried, enjoying the peace and eating another lunch. Even Coll sat doggo in the sunshine, aware we were going nowhere for a while.

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On the way down, we stopped several times briefly to adjust clothing, admire the views, snack and rest. The return journey was uneventful, we even managed to avoid Brexit – at least until we got back in the car, which we reached before five thirty. We were back home in Fife just after seven, where courtesy of my lovely wife, a delicious supper was waiting – hearty soup, mackerel with kale and potatoes, followed by cake.

So I managed to bag another Munro? Even in the midst of chemotherapy?

Nobody really knows what a body can do. The medical staff who told me about what to expect emphasised that everybody reacts differently, that some people are completely floored while others carry on with their lives. Seemingly, I got a bit of both on the first cycle. It remains to be seen what the next will bring. Martyn warned that I might feel rather stiff the next day, not having been up a hill since mid November, but miraculously I feel no particular fatigue, stiffness or aches and pains – possibly an effect of the steroids. Even the tightness in my chest (which I have put down to a side effect of steroids) abated during the ascent – presumably all that fresh air and mindful hillwalking.

It truly is amazing what a body can do. Only two weeks ago I was wracked by the hellish effects of chemo; yet here and now, I have summoned up the fortitude to get to the top of a wee mountain, achieving another minor compleation with this the last Munro to the east of the A9 corridor, and surprising even myself.

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The following morning I get my blood tested and have to ingest an extra dose of steroids to support the first infusion on the second cycle. Also it is time to remove the hair falling out problem by visiting the barber for a short crew cut. What a body does can be also mundane and ordinary; what it naturally does is look after itself, knowing at some pre-intellectual level that what does not kill it, makes it stronger. Intuitively, we know exactly what we can do, but so often this is overwritten by opinion, knowledge and advice that undervalues intuition and natural intelligence, persuading us that what we can and cannot do is constrained by forces beyond our control, too powerful in the face of any individual agency.

The trick is to perceive it in advance, to grasp this as necessity, to plan methodically, prepare mentally and expedite mindfully. The present is not a point on some convenient mythical continuum between past and future, where human agency acts there and then to make things happen. Rather this presence, this life, is an event with tendrils reaching back and forth into the experience of time, opening up possibilities and showing the way of necessity to anybody with the will to embrace it and the wherewithal to know what to do, of acting in keeping with forces that determine events rather than stand immobile in their way, reckless to the infinite impermanence of things.

I regret very much sometimes that it has taken a diagnosis of terminal cancer, nearly seven years trying to avoid reacting against the edifice of medical science, and more recently the pain of cord compression and the horrors of chemotherapy, to reach such conclusions as these. For had I known then what I know now, been able to learn more benevolent and naturalistic wisdom than is offered by the establishment at all levels, before I had to unlearn it all, so that I could rediscover my mother’s genius and faithfully adapt her wisdom to this modern context, I suspect my life might not have been so dominated by this disease. But then again, if I had, I would probably never have learned these things. So really I have nothing to regret at all.

The first cycle is complete. Ready now for another five.

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Thanks as always to Martyn and Coll, and to Shona for making us all food.

Author: Duncan Spence

Mountaineer, retired bicycle messenger, philosopher, wordsmith, Dutch translator.

3 thoughts on “The first cycle”

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