Chronicle It is possible to live with cancer

Henning-Mankell_7972

Now in September it is eight months since I was diagnosed with cancer. On a rainy evening when the warm summer is over, I decide it’s time to take a closer look at how things stand. Where am I now, with regard to my cancer and my treatment? How have I coped with what has happened? How do I feel? Both in my body and in my emotional awareness – in what some might call my soul.

I have written before about my treatment, about my reactions and, not least, about my great admiration for all the staff I have met at the Sahlgrenska Hospital. Nothing has happened to change my opinions. If I had to be stricken with cancer, I’m pleased it happened in Sweden.

The Swedish health service is constantly being criticised. Unfortunately the criticism is often justified. But it is important to express publicly the opposite point of view when it is appropriate. I give top marks to all the staff I have come into contact with. The standard of their instruments, technical equipment and laboratories must, of course, also be very high.

But how do things stand now as far as I am concerned? Fundamentally speaking, one never shares one’s illness with anyone else: it is inside me that the tumour has shrunk, or is continuing to grow.

During the warm summer we have enjoyed, I have often sat out on the terrace overlooking the sea, when I haven’t been hunched over my desk, working on the book that is due to be published in a year’s time. I have watched the sea constantly changing, and asked myself how I have changed after that catastrophic diagnosis eight months ago. Have I changed at all, in fact? Or am I still the same person now as I was then? What happens to people’s identity when they are stricken by a serious illness?

The answer to that question which seems most natural to me today is that everything in my life is now played out in front of the backcloth formed by my cancer. Everything I undertake – or refrain from undertaking – is weighed up against the cancer that is hidden away all the time in my body.

Some years ago the writer Per-Olof Enquist made the wise comment: “One day we shall die. But all the other days we shall be alive.” If I add to that a quotation I read in a repair workshop when my car was in for an oil change, the picture becomes even more clear. It said: “Don’t take life too seriously. You won’t come out of it alive no matter what.”

I’m not quite in tune with that last quotation, of course. Life is a serious matter. You can never take a step back and start it all over again. There are no bonuses in the shape of a couple of extra throws of the dice. Life is a continuous process, it never stands still nor moves backwards. But of course, the quotation did make an important point. A lot of people live lives that are totally incomprehensible to me. They seem set to go on living for ever. But I’m not criticising anybody. Everybody makes their own choices.

Those two quotations are words I repeat almost every day, silently, to myself. My life is mine and can only be lived by me. I don’t know how long I shall survive, having been smitten with this disease. It is incurable. I shall never be able to shake it off. The question is simply how long can the chemotherapy I am undergoing oppose those cancerous cells and keep them subdued. Nobody knows, neither I nor my doctors. The only thing we can be sure about is that my prognosis is incomparably better than it would have been 15 or 20 years ago. Advances made in the treatment of cancer have been prodigious. Today I can carry on living for very many years, whereas not long ago the very diagnosis would have indicated a short survival time.

But chemotherapy is both a saviour and a vandal at the same time. The cytotoxins strike hard at both infected cells and healthy ones. Much of my summer has been spent trying to deal with the fact that the medics discovered that my kidneys were being badly affected by the cytotoxins. For more than a month I didn’t know if the problems in my kidneys would prove to be chronic and hence impossible to put right, which would have been disastrous.

However, after repeated X-rays and blood tests the doctors established that the kidneys had recovered sufficiently for my chemotherapy to continue. That was a day of momentous relief. But there are no guarantees. Nobody knows whether the problems might return. Or if other side-effects might suddenly crop up.

Nevertheless I never have the feeling that I am living on what one might call “borrowed time”. There is no such thing. I have no doubt that my time is mine and mine alone. I don’t know how long it will last. I try not to think about it, since there is no point, and try to live as if everything is normal.

But at the same time I am aware that the biggest danger in my life and that of other cancer sufferers is to submit to illusions. I shall never be completely healthy again. But I could live long enough to die of something else.

It might sound as if I am regarding everything in a state of complete calm. I suppose that is true in a way. But at the same time there are days full of darkness. When the voice I use to talk to myself is draped with mourning crepe. Days that are hard-going, depressing. Days when the only thing to do is to grit one’s teeth and force oneself to think different thoughts. It usually works. There are few days when apprehension gains the upper hand. I am usually stronger than the dark forces that are trying to drag me down into a spiritual abyss.

It is possible to live with cancer. It is possible to fight against it. Nothing is ever too late. In its own way, everything is still possible. My stance this damp September evening is to do ultimately with what cancer has not taken away from me. It has not robbed me of my joy at being alive, or my curiosity about what tomorrow has in store.

Henning Mankell

Translated from the Swedish by Laurie Thompson

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