England lost to Argentina in the semi-final last night. Two minutes after the final whistle, a nurse came in to tell me I was being put on a 12 hour drip for phosphate and potassium. No explanation. Nobody knew why. Just another thing happening to me without context, in a week that has been full of things happening without context.
Within two or three hours the pain in my arm was severe enough that I asked for the drip to be removed. I refused to have it put back in until someone reviewed the prescription — I was frightened it was wrong, ordered by a junior doctor who'd seen me briefly earlier and knew nothing about my case. I lay awake with a 6 out of 10 pain in my arm, drafting questions for this morning's meeting with the ward sister, which I'd already planned to request before any of this happened.
That's the backdrop. That's what 2am looked like on Wednesday 16th July, two weeks to the day since I was admitted.
Around 7:30am a young on-call oncologist came round. I'd met him briefly before — he'd reviewed the drip situation, confirmed the medication was the right call and that the pain was a known reaction, and left. Something must have intrigued him, because fifteen minutes later he came back.
He'd been on call for twenty-four hours, covering for a sick colleague. He came back anyway. In what followed he gave me more useful, clear, joined-up information about my own case than I've had in a fortnight of ward rounds.
I don't know his name. I should have asked. If you ever read this — thank you. You have no idea how much those fifteen minutes meant.
Two pieces of news. One difficult, one extraordinary.
The difficult one first.
His honest view is that if he were my oncologist, he would never give me immunotherapy again. My reaction has been too severe — colitis, liver inflammation peaking at 2,500, electrolyte problems, two weeks in hospital. He couldn't guarantee the next round wouldn't be worse. Considering immunotherapy was meant to be the plan for the next two years, that's quite a statement.
I want to acknowledge that properly rather than immediately softening it. It's significant. The treatment that gave me the best chance — the Konami code, as I called it — may be off the table because my body has responded to it too aggressively. That's hard news at any time of day, let alone after no sleep at 7:30am.
He did say alternatives exist — a careful discussion about single dose and risk, chemotherapy which is more predictable, targeted radiotherapy, potentially new drugs or trials. Those conversations are for Dr Ranatunge and the MDT. This was one doctor's honest opinion, not a final decision. But it deserves weight, and I'm not going to pretend otherwise.
And then the extraordinary part.
While he was reviewing everything — properly, all of it, in one sitting — he pulled up the CT scan results from two days ago.
The original abdominal lump that started all of this: down from 3.5cm to 1.5cm.
The adrenal gland cancer: halved in size.
The spleen: no sign of cancer — though he noted this could be an imperfect image rather than a definitive result, so we hold that one carefully.
The brain: based on what the body is showing, he said you'd expect the same results there too.
He called it amazing progress.
And then he said something that I keep coming back to. His view was that if you had a choice — these side effects, with these cancer outcomes — you'd take it. One hundred percent.
I've been lying here for two weeks. Painful drips at midnight. A liver that won't cooperate. Fighting for every hour outside these walls. Struggling mentally in a way I haven't before. Missing my anniversary, nearly missing Florence's birthday, watching Albert's football from the sidelines rather than the touchline. And underneath all of that, quietly, the treatment has been doing something remarkable.
I don't quite know how to hold both of those things simultaneously. The same aggressiveness that's been causing chaos in my liver and bowel has been dismantling the cancer at the same time — pointed in different directions, same force. That's not a positive story or a negative story. It's just the story.
The other things, briefly:
He's pretty certain the colitis isn't colitis at all — more likely a side effect of the MMF medication, which means the bowel may actually have settled rather than continuing to flare. That's good news if confirmed.
The liver specialist referral is right. Biopsy results still pending. Just a case of waiting now.
And the isolation I've been placed in twice during this admission — without explanation, and which the liver specialist on Monday said shouldn't be happening — he's formally documented that it should end. Two weeks in. Better late than never.
This morning
I have a meeting with the ward sister. I have a document — three sections, covering who is actually in charge of my care, what is happening medically and why, and what the last two weeks have felt like as a human being.
The irony isn't lost on me. The best, clearest, most useful update I've had since this admission began came at 7:30am from a doctor who'd been on call for twenty-four hours and came back because something intrigued him. Not from a ward round. Not from a consultant visit. From someone who chose to look properly when he didn't have to.
That's the battle I'm up against day to day with the standard procedures. I'm still winning the important one though. The cancer numbers say so.
Long way to go still. But probably the most information I've had in a long time.
