Alright, so the surgeon had been largely unsuccessful in his attempt to remove the cancerous lymph node from my neck. There being nothing more he could do for me with his scalpel, he pointed me in the direction of an oncologist just down the road.
On Friday, 23 September 2022, K took me to meet Doctor D. The Oncology Centre is part of the Hermanus Medical Village, a small private hospital on the corner of De Goede and Church Streets. First, we saw the social worker, who gave us some general information about what they did to treat cancer patients. Then she talked about how the town was being overrun by semigrants from the rest of the country, where services and infrastructure were collapsing. We went back to Reception, and while we waited an old man and his wife emerged from a room and tottered towards the exit. As he passed close by, I was struck by how ill he looked. Jesus, I thought to myself, this guy has got to be terminal! Pain, resentment and anger were written on his ashen features and I detected hatred in the glare he gave me on his way out.
Doctor D appeared and welcomed us into his office. Around 50, dressed smart casual, he was tall and slim built but with a slight pot belly. He gave me a cursory once-over, palpated the growth and explored the rest of my neck, my armpits and my groin. Looking for more tumours, I assumed. Apart from a slight swelling in the node above the left clavicle he found nothing. To treat the cancer in my neck he recommended five weeks of radiotherapy. Before that, though, he wanted a CT scan done to ascertain whether there was any other malignancy lurking beneath the surface. His receptionist would schedule an appointment with Radiology.
The serious business out of the way, K asked him about the framed print on the wall behind him. He seemed quite happy to talk about it and said the artist was the Scottish painter Jack Vetriano and the piece was called The Singing Butler. He agreed that, apart from its sentimental appeal, there was something intriguing about it. He also acknowledged that it could be criticised as kitsch, like the work of Tretchikov. That didn’t bother him at all. When K said it reminded her of the tango scene in an Al Pacino movie, he enthused about Scent of a Woman, which he recalled in some detail.
K was working on Monday 3 October, so Nina took me in for the scan at 9.45. The appointment with Doctor D was for 1.45. After another slow trip in and out of the white doughnut, I went with N to the light industrial area where she stocked up on packaging and food items for her mobile takeaway business. We parked on the seafront near Fick’s Pool and ate K’s sandwiches for lunch and then made our way back to Oncology.
Before Doctor D could discuss the results of the scan, I asked him about fasting as a way to slow the growth of cancer cells. N had been reading up on it and we wondered what he thought. Only slightly impatient, he said he would give us a quick Physiology lesson. From his explanation I gathered that, being much faster growing than healthy cells, cancer cells consumed more nutrients. The idea behind fasting was that these cells would be deprived of food and their growth would be slowed down. However, in reality, only the healthy cells would be starved and the malignant one would continue to grow at their expense. Something like that. Anyway, the bottom line was that fasting was no way to tackle cancer.
He fiddled with his laptop, turned it to face us, and attempted to interpret what was on the screen. Of course, being three-quarters blind, I couldn’t see much, but N was able to follow what he was pointing at with his ballpoint pen. Apparently, the lymph node in my neck and to a lesser extent, the one above the clavicle, showed up as dense white blobs. He scrolled to another image and said that the scan had also picked up a suspicious speck in one of my lungs.
N took a picture with her phone in order to show K. Doctor D said that this might or might not be cancerous, and there were two ways to find out the truth. One was to surgically remove the growth and have it analysed; the other was for me to undergo a PET scan. He was not in favour of surgery, as it was an unnecessarily invasive procedure, while the scan, although expensive, was able to detect any malignancy without me having to do more than lie on my back. As the cost would be covered by Medical Aid, it was agreed that an appointment would be made for me to have the scan at the Cape PET-CT Centre, which was in the Panorama Medical Clinic in Cape Town.
I asked him what would happen if the result was positive. Chemo therapy, came the reply. Six three-week cycles. Eighteen weeks. Call it five months. And side-effects? Hair loss, nausea and vomiting, to a greater or lesser degree.
That evening I experienced another tachycardia episode with my heart pounding away at about 200 beats per minute and leaving me so dizzy I had to lie down until it subsided. In the morning I phoned Doctor D and told him I had had a panic attack and described the symptoms. He said he had not intended to alarm me and prescribed some Ativan pills I could pop under my tongue should there be a recurrence.
A week later, having heard nothing further concerning the PET scan, I phoned the rooms. The receptionist, Marissa, said she had submitted the necessary documentation on the 4th and they would contact me direct. Well, another week went by and still no word, so I phoned the PET Centre. They said nothing had come through from Hermanus Oncology. Christ Almighty! I informed Marissa and shortly afterwards received a call from Doctor D himself. Irate and apologetic, he blamed the PET-CT Centre for the administrative bungle. I thought of saying something suitably facetious and sarcastic but desisted.
That was on the Wednesday. On Friday PET-CT phoned to make an appointment for 11 AM, next Wednesday, 26 October.
It was a warm day with a cloudless blue sky and next to no wind. Having become country bumpkins, we were a little apprehensive about finding the place, and K did not know how to use Google Maps. We got onto the R300 and passed through flat, mostly residential areas of scruffy appearance until we made it onto the N1 heading for town. When we realised we had gone too far, K took a left off-ramp and pulled up at a small shopping centre. While she hurried off in search of directions, I sat looking at the blank side aspect of a single storey building. A man was sitting on a beer crate in the shade with his back against the wall. He was talking on his phone and I idly wondered what language he was speaking. It did not sound like Xhosa or Zulu, and then I realised it was French. He must be from the DRC or further north, I conjectured. Maybe he was arranging the arrival of illegal migrants, or he could even have been plotting a coup somewhere up there in West Africa.
K returned with the news that we were not far from our destination. The Panorama Medical Clinic, we soon discovered, was situated in a leafy suburban setting and we pulled into a parking bay just a few minutes before eleven o’clock. At the PET-CT Centre k filled in a form for me and we were led to a large room with comfortable chairs and a TV on one wall. There were three other people present, possibly waiting their turn to be scanned.
A radiographer told me I was to relax for half an hour or so and then the radioactive tracer would be administered over 45 minutes. After that, another 45 minutes for it to be absorbed, and then I would undergo the actual scan, which would take about half an hour.
K said she would take a walk and then have her sandwiches in the car and maybe do some reading. I could not see it, but gathered there was the usual mindless sports coverage on the box, probably cricket highlight, or some other shit. I stared into space and let my mind wander until a nurse entered the room and called my name.
She took me to a narrow room with a bed that was also narrow and got me to lie down on it after inserting a canula in my arm and checking blood sugar levels. Once I was hooked up to the bag of radioactive tracer hanging from a drip stand, she told me to lie back and chill. She would call in every five minutes or so to make sure all was well.
Over the years, I have taken an autodidact’s amateurish interest in many subjects without making a serious study of any one of them. My superficial knowledge of anthropology and anatomy now enabled me to admire this young woman as a fine example of a particular body type. She had a friendly, self-confident manner and an open face with regular features. Her attractiveness was enhanced by the warmth and humour I detected in her eyes. She was short of stature with large breasts, broad hips, a well-rounded abdomen and prodigious posterior and thighs.
As an ectomorph, I am tall and lean with little muscle mass and, to my regret, my buttocks are not well padded and pronounced. By contrast, this nurse was clearly and endoporph with a large amount of fat deposited on her gluteal muscles. So much so, that I wondered if she might suffer from the steatopygia associated with Sara Baartman. It pleased me to note that she seemed unselfconscious, and I looked upon her rump as a thing of beauty, and certainly not a deformity.
Back in the waiting room, I did my best to ignore the TV and decided to occupy my mind by thinking about the procedure I was undergoing. I started with the PET-CT scan itself. Positron Emission Tomography combined with Computed Tomography to give a 3D picture of internal structures. And the role of the radioactive tracer. Fludeoxyglucose F18, abbreviated to FDG because of pronunciation difficulty I presume, is a glucose analog that accumulates in tissue with high glucose demand, like tumours. Thus, the scan is able to visualize cancerous tissue that shows up as a bright blob.
I was thinking about the gluttonous cancer cells in my neck that were chomping sugar at a furious rate in order to establish themselves in my lymph node an then go on to colonise the rest of my body with the express intention of killing me, when a radiographer arrived and told me to follow her. It was doughnut time again.
I removed my shoes and some of my clothes, and got into a dark green smock that came down to my knees. She led me into the white interior of the space station and told me to lie supine on the gurney positioned before the mouth of the plastic doughnut. For my comfort, a wedge was placed under my knees, I put my hands behind my head, elbows jutting at 45 degrees, and she rolled me into the tunnel and out again, just so I knew what to expect. Then I heard the heavy hatch slide shut behind her and the procedure finally got underway.
The gurney moved forward and stopped with just my head penetrating the orifice. There was a slight jolt and I was being thrust into the duct ever so slowly. Deeper and deeper for about a metre and a half before coming to a halt. Obviously, it was a confined space, but it was well-lit and I did not feel claustrophobic. Another jolt and I was being withdrawn at the same slow, stealthy pace. I paused at the mouth for a few moments, and then went back in, repeating the manoeuvre. This process lasted for about half an hour until, instead of stopping at the opening, I was withdrawn completely. The experience over, I dressed and went in search of K.
The next day they emailed the results.
At 5pm, Doctor D phoned to say he had good news for me. The scan showed that the cancer had not spread to my lung. This meant that chemo and radiation treatment to my neck could now proceed as soon as possible.
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