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Episode 1: Here we go.. Justin Case is borne! Yes borne!!

So, on my Cancer Avenue; where to start?

I guess let’s start in the middle. What to say when someone says that single word to you as a sentence? For me, one of those totally uninitiated to death-inducing situations, I just sat there doing my best goldfish impression. Words and questions were rapidly forming behind my eyes but none were making it to my mouth. What do you really want to ask that you really want truthful answers to? Do you really want to know any form of upcoming treatment or what your prognosis is? Up front, I can tell you it instantly fucks with your five-year plan. Do you want to be armed when well-wishers and ghoulish nosey bastards ask how you are? No, I didn’t; and that was for selfish reasons, I didn’t want to know myself, let alone be able to tell others. I wasn’t ready for it. Few people are willing or ready to give an answer to the very important question. “Am I going to die?” So, I didn’t ask it.

Ignorance is not bliss. It’s more of a hiding place for those who aren’t ready to face their own truth. Hiding is what I was doing. Hiding from that one ugly C word! There it was, spoken as a sentence; and it was hovering there in plain sight, right there in front of me. Like a speech bubble right there, CANCER, hovering in front of my face, invading my ears, written large across every square inch of my skin, stinking and pervading through every pore and living in every molecule of me. It was evicting me from my lovely selfish warm hidey-hole. After that one ugly “CANCER” sentence, I really don’t remember hearing anything else, and now five years later I can’t remember a single word of what was said in the doctor’s surgery. A big silent envelope formed around me like a cone of silence. I realise now that I was in shock. I remember looking at my doctor talking to me, but it was like looking at a silent film; lots of words, but for me, no subtitles. I remember thinking, what a brilliant doctor this is. She had stepped up to the mark that my regular doctor had literally fled. My regular doctor was conveniently away, and the locum delivered the bad news.

Now I say bad news, but I really heard a little beyond the headline. The body copy I didn’t see as it flew around my self-imposed cone of silence. I was oblivious to the seriousness of what was happening inside me and the subsequent steps to get it out of me and get me to my five years cancer-free. You could have said you were flying me to Mars and I would have believed that more possible than making it to five years cancer-free. Yet, now, today, here I am on my own red planet; a little red dirt island off Brisbane in Queensland. I am as puzzled about how I got here as I would be if I stepped outside and saw a Martian sun rising over Earth.

Let’s go back to the corner of the street and then walk slowly up Cancer Avenue. What happened in the following two months in the hospital was like being cast adrift in a warm ocean, wearing a life jacket and bobbing around. Occasionally a promising life-saving vessel would pop by tending to my needs, feeding me, cleaning me up, redressing wounds. But forever it seemed, once fed and bled, those vessels would all then just turn around and sail off into the distance, abandoning me.

This is very distressing and scary at first. I felt like I was constantly being abandoned by my rescuers and left surrounded by sharks, forever expecting at any moment to be savaged. Slowly, you give up the expectation of rescue and just accept that you are like the Great Barrier Reef; tourists visit often, but no one takes you home. Most tourists come to have a look at you. Some come and stand on your coral. They pollute the very waters you live in and even spill effluent on you. Others come and cut chunks off, not caring if this kills you or cures your ills. They just want a piece of you. Then, just when you have accepted your fate, a minion pushing a wheelchair steals your life jacket and pushes you ashore.

That’s a neat little synopsis explaining my cancer operation and post-operative hospital journey when, in all reality, it was a lot more complex.

Yes, Justin Case is/was cancer and became an alter ego of me. N0. 1 Cancer Avenue if you like is where he lived. He had been growing quietly in my left groin for two years. I had ignored him all that time. Any personification that I originally allocated to him was as a minor ache and me making him out as a self-diagnosed hernia. The doctor gave me bad news, and I adopted an external, surface-deep devil may care attitude. On the inside I told myself, “I don’t give a fuck if I have cancer. I am invincible”. To the doctor, full of bravado, “It won’t change me one bit” is what I said out loud and big and proud. Behind my bravado, every other bit of me was terrified. The major part of me that faced my inner reality, thought shit, half my relatives died of the big C; some of them far younger than my then age of 56.

The outer me met the news with obnoxiousness. A second-visit doctor told me the tests had shown a basaloid squamous carcinoma; a BSC of the lymphatic system. Four probable cancerous lumps sitting and maybe attached to the artery that supplies blood to my left leg. He said that I would have to have more tests to locate what he now called my BSC. I told him just how absolutely delighted and, in fact, honoured I was when he gave me the diagnosis of basaloid squamous carcinoma. He was dumbfounded; so I explained that at the end of school I couldn’t go to university. My mom needed me at work and to earn money to bring into the house. Therefore, I missed out on getting a BSC. Now I had my own BSC. I said that I was going to Vista Print online straight away and ordering new business cards showing my BSC.

The doctor smiled weakly and that should have given me some idea of the hard times ahead on my trip down Cancer Avenue. All the same tests again plus a delightful endoscopy and colonoscopy were required. Those of you who have never had a colonoscopy, please do yourself a great favour and visit YouTube and listen to Billy Connolly’s experience. Some people will tell you it’s not that bad of an ordeal. Let me just say, that for something that doesn’t hurt at all, it stays in your memory a very, very long time after the imprint of the toilet seat disappears from your arse. You will purge so much from your body that you will be eventually shitting out your mother’s breast milk.

My secondary tests revealed nothing more than the preliminary tests had done, so even more tests were done. My wonderful doctor said she was sending me to the vets for the full treatment; The CAT scan, PET scan and Lab Tests. After all that was done, they quickly booked me in for surgery. Let me lay it bare. I hate hospital. Some people will say a hospital is a hotel with poor meals where they try to make sick people better. Some people lie, and not the horizontal in bed lying. In the hospital you will be uncomfortable; you will most likely experience pain and quickly lose any last shred of dignity.

Hospital is just like a prison but with better-looking, nicer guards. Just about everyone working inside the doors of a hospital does a remarkable job. But there are always going to be more sick people than doctors and nurses. Find more money and build more hospitals and there will be enough patients to fill them before some supercilious politician cuts the ribbon to open the new wards.

My surgeon was amazing. His job was to cut into a body that had shown him remarkably little in the way of secrets or precise locations. He had to locate and take out all probable and any possible cancerous lumps with a scalpel. With that scalpel, he also had to avoid my femoral artery that was entangled in and maybe even attached to the aforementioned cancerous lumps. While deep inside my groin and on the fly, he had to make a choice that would affect the rest of my life markedly. If the cancerous, malignant lymph nodes were in fact connected to the femoral artery, he had to decide just how many micro millimetres to cut off the artery without cutting into the artery itself. Also, he had to decide just how many of the dozens of lymph nodes were infected by cancer and take them all without leaving my leg with little to no lymphatic system. That’s why they get the big dollars. And frankly speaking, every dollar that I have earned was earned a thousand times more easily than any dollar earned by any successful surgeon.

I know you are getting impatient, and want to know when Justin Case was born. Well, here we are in the birthing lounge of my sick and sad mind. A minor complication after the cancer operation saw me forget to breathe. In fact, I forgot to breathe for quite a while. Maybe 10 minutes, maybe 20 minutes, could be half an hour of not breathing by the time they had resuscitated me. The nurses had found me on their rounds at midnight. I was an ugly shade of bluish-grey. I maintain that this was just the colour of Birmingham City Football Club’s away kit and I was really okay.

The crucial bit was not the colour, but the lack of breathing. It was midnight Saturday on the nursing rounds; about 36 hours after me awakening from the surgery. If my surgery had been on a Wednesday instead of a Thursday, I would have been home in my bed and I can tell you that there would not have been any midnight nursing rounds to save me at home. I would have shuffled off this mortal coil and been no more. I can also tell you that there have been many a time in the days, months and now years to come, that I have wished that it had been a Wednesday operation.

I had a “do not resuscitate request” in place which was ignored by a couple of student nurses, and eventually it took them and a couple of doctors 30 minutes to get me breathing and make me stable. Then they placed me in a medically induced coma so they could get a read on what damage had occurred and what issues the lack of oxygen might have caused. I was in a coma for four days. Although I don’t remember having any near-death experiences, I had an out-of-this-world experience as I came around.

My first thought when I gained a slight foothold on my new reality was that I was on board a UFO and being kidnapped by aliens. I had tubes up my nose, a tube draining yucky stuff from my groin and needles in my arms. To top this off, there was what I was later told was a cleaner wearing full personal protective equipment to not catch anything or spread any germs. To me, he was a spaceman walking around my alien prison cell complete with his own personal breathing apparatus and holding a death ray gun. The death ray gun was actually a Dyson stick vacuum cleaner. I am told I went straight from comatose to sitting upright instantly, where I immediately started screaming and pulling out the tubes and lines from various parts of my body.

Within a few seconds, another alien appeared and was upon me, trying to stop me from pulling out feeding tubes, drip lines and the wound drain from my thigh. I did the only reasonable thing a man being restrained by aliens would do. I punched the nearest alien as hard as I could. Fortunately for all concerned, when a man who has been in a coma for four days punches you, it is like a three-year-old hitting you with a lemon meringue pie. Despite my aliens claiming I was in the hospital’s ICU department, it still took them the best part of a minute to convince me and even then I had to have it confirmed over the phone by my wife.

Why I believed an alien race that was advanced enough to build a spaceship, fly it across the universe and kidnap me wouldn’t be able to synthesise my wife’s voice on the phone, I don’t know. After a few minutes, I calmed down and I was very sorry for my actions. The alien I had punched was the wonderful surgeon who had worked for three hours diligently extracting cancerous lumps from my groin; all the while just micro-millimetres from the end of his scalpel’s blade was my pulsing femoral artery. I was very, very sorry I had punched him, however softly.

But I was even sorrier for the cleaner. Firstly, a nearly dead, comatose patient had sat bolt upright and started screaming like a zombie while he had his back to him hoovering. When the cleaner had turned around, he realised it wasn’t his Dyson making the screaming noise; it was the zombie in the bed who was now spitting blood at him from extracted feeding tubes. But there was even worse to come for him. When you have been in a coma for four days and fed via a feeding tube with quite a volume of liquid nutrition; if you wake quickly, that liquid nutrition will exit your body quickly. It did so anally. The cleaner was not at all happy.

when a coma happens to you, it is a very selfish event. It’s not something you can do anything about. But you are totally unaware of the hell that you are putting your family and closest friends through. The hospital awoke my wife and two sons in the middle of the night and told them I was in a coma. They explained with medical professional language that they had found me not breathing, and that I had been resuscitated.

Within 24 hours, my family went from delighted that I had come through a cancer operation fairly well to wondering if they had to come to the hospital and turn off my life support. The Intensive Care Unit is a very scary place to visit someone you love. Tubes, beeping machines, bandages and lines will obscure them. The bank of machines would put a 1970s hi-fi unit to shame. My youngest son was physically sick before he even got to the hospital. I couldn’t imagine how he felt till I thought about how I would feel if I had to walk into ICU and see him hooked up as I was. This realisation only came to me over two years later and it made me physically sick. My wife and sons are the centre of my universe. If I could stop any single part of the whole thing, having them see me like that would be the part.

After recovery in ICU, they returned me to the general ward, and I asked my doctor friend Dave what he would do if he had just been through what I had. The operation confirmed that my operated cancer was a secondary cancer. Dave, told me that as it was the secondary cancer, his best guess was that at some stage my primary cancer would eventually turn up. He added that as I had died for a while anyway, and that if he was me, he would seriously start thinking about doing a bucket list. Then, almost as a second thought, he muttered the sentence that changed my thought process and my life in so many ways. He said, “Yes, if I was you I’d definitely do my bucket list; you know, just in case.” And that is the moment Justin Case was borne.

After recovery in ICU, they returned me to the general ward, and I asked my doctor friend Dave what he would do if he had just been through what I had. The operation confirmed that my operated cancer was a secondary cancer. Dave, told me that as it was the secondary cancer, his best guess was that at some stage my primary cancer would eventually turn up. He added that as I had died for a while anyway, and that if he was me, he would seriously start thinking about doing a bucket list. Then, almost as a second thought, he muttered the sentence that changed my thought process and my life in so many ways. He said, “Yes, if I was you I’d definitely do my bucket list; you know, just in case.”

And that is the moment Justin Case was borne.

Comments (3)

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