The air is unfamiliar: iodised, with feral undertones. The sheets are tightly-tucked and stiff. No sleep-drenched body curling into mine, no side-table piled with part-read books. I’m surrounded by the rumbling snores of strangers. Nightlights provide pale illumination and through the part drawn curtain a full moon hangs suspended in the dark. These are not my nightclothes.
Hospital. The word presents itself and disquiet flutters through.
I’m not ill, am I?
Consciousness begins to fade, slipping from my grip.
The lights are eye-dazzle bright. Sadie is here, her smile big, eyes anxious, her skin starlight pale. ‘You’re awake,’ she says, as if this is an astonishing feat. ‘How d’you feel?’
I test out her question through my body. No pain. A little stiff on my right side. A kittenish weakness so I know without trying that getting up would be an impossible task. A mistiness to my thoughts. ‘I feel OK. What happened?’
She speaks rapidly and I seem to follow with a time lag, understanding arriving two or three moments later.
We were with friends. Ah yes. Had stayed up late after dinner: drinking, arguing, playing music. Ghostlike images emerge. But then …
‘You had a fit.’ She jerks her arms to demonstrate. ‘First you talked nonsense and then you couldn’t speak, but your eyes were still open.’
What did I see and hear? What thoughts passed along synapses? Memories have been erased.
I’m fine now. Discharged. Back to normal.
Possibly a small stroke, they said. I should visit my local hospital and get some scans done.
Life carries on busily and the episode is reduced to anecdote, an oddity to retell, with no continuing consequence. Until …
The ringing phone cuts into my office morning. Results of the scan have been examined by a consultant neurologist, his brain examining images of mine.
‘It’s bad news, I’m afraid. You have a brain tumour. About the size of a walnut. Located in the left temporal lobe, the centre for language. It could well be malignant.’
The call cleaves time into before and after. My sense of wellness pitches into fragility and my hand rises to my left temple as if I might soothe the badness away. I ring Sadie and only as I repeat the words out loud do they begin to feel real.
‘Oh God, Martin,’ she says. ‘Oh God.’ Neither of us believe in God.
We talk. On and on. Trying to negotiate this unfamiliar world. The chances of a malignant brain tumour are less than one in ten thousand. Toss a coin thirteen times; each time it lands heads. It sounds so improbable.
For forty years I’ve enjoyed robust health. Only occasional coughs and colds. No aching joints. No breakages or serious malfunctions. I’m accustomed to my own durability. Nothing about how I feel has changed, other than the unsettling thoughts spinning through my head. I am dangerously ill; I feel fine.
I undergo more scans. We inhale eau-de-hospital as we meet face to face with the consultant. Sun blazes through the window, glancing off his screen which displays images of a pale, white mass with a cratered surface. Surgery is my best option.
‘And the other options?’
It turns out, surgery is the only option.
‘And how long do I have?’
Life expectancy is less than two years. ‘I’m so sorry,’ he says.
The self switches off at some point. Our one certainty: we all die. My self resides in the organic structures of my brain; there is no ghost that outlives the machine: I have always believed these things. Tentatively, I test out other possibilities. Could there be a God? A mystical upload of thoughts and memories to a mega-computer in the sky? The concept seems inherently implausible, as alien to my brain as the walnut, as unlikely as my unlucky run of thirteen coin tosses. I lack the enthusiasm to hedge my bets and convert.
I feel well. I am not unhappy. I am going to die young.
I check in for brain-surgery. The chances of death or profound brain-damage are one in a hundred. Toss a coin and only if it’s heads pick out a card at random from the pack. Pick the ace of spades.
I have an irrational urge to test it out and see for myself.
Sadie and I are egg-shell cautious on parting. It could be the last time. We don’t say it. Details are hyper-vivid: the texture of her skin, her favourite fragrance, the creases of anxiety between her eyes as she tries too hard to smile. Repeatedly, we assert our love, as if it might be in question. The manner of a last farewell will make no difference to me; it might matter to her. As she continues in a world that I no longer observe.
A world that I do not observe is nonexistent. From my point of view.
The anaesthetist chatters as a background distraction, so my final words might turn out to be a comment on England’s chances in the World Cup.
One in a million. Hardly original or profound.
I feel the slide; I am flying to the moon.
I wake in a finger–click, the intervening hours lost to chemical processes which no one fully understands.
Gingerly, I test out fingers and toes. As far as I can tell, these still answer to my brain’s command.
I test out thoughts.
My name: Martin. My wife: Sadie. The day of the week: Monday. I have to assume that I am getting the answers right.
I am in King’s College Hospital, Denmark Hill and I have just undergone brain surgery.
I can still think, am still myself.
Surgery is declared a success. The walnut is gone. Chemo will keep returning cells in check.
The poison pills leave a metallic aftertaste, but do not make me nauseous in the way I feared. I’m one of the lucky ones.
We acquire a new vocabulary. Carcinoma in situ. Cerebral oedema. Craniotomy. Glioma. Intracranial. Oncologist. Metastasis. Parietal. Stereotaxis.
Friends are newly uncomfortable, their words falter. You’re taking it remarkably well! They say this with an edge of reproach, as if it might be more appropriate to endure my remaining time in misery.
I am told to be strong, to fight it. They churn out Google tales of people beating the odds; these stories are wielded like a sword, challenging the secular god of statistics.
I am sent books on natural therapies, on organic and macrobiotic this and that. No harm in trying. Except … Excluding alcohol, caffeine, sugar; chewing virtuously raw foods: it sounds so joyless, seems too little. Cancer is a moon disease, opines Sadie’s younger sister. Caitlin is into astrology and other mystological crap and Sadie cuts her off before she can fully expound. Later, the two of us laugh, gently. My astrological disease: if only it was as fanciful.
Scans occur at three-month intervals.
The first one is very good. I feel well. My thoughts are clear, mostly. We are over the moon.
The second one is good. I feel well. I have on-off difficulties with words. What goes, comes back. I am optimistic.
The third one is not good. I feel well. Words are increasingly a problem.
I am going to die. We all die. I will die sooner than I’d hoped.
Language requires conscious effort.
I speak rapidly, hurling myself at the problem, building momentum; Sadie nods and assures me I am making sense. I cannot recall any of what I’ve just said.
I reflect on what I want to say. I can sense the shape of it. ‘Mustard,’ I pronounce with great certainty. ‘Lunar.’ Sadie frowns at me. ‘Mustard lunar,’ I repeat.
With time and patience and much digging around, different words are found. Blasted tumour. It becomes a running joke between us, my mustard moon.
The self is in constant flux. The boy, teenager, young man that I was, these are gone. Consciousness crests the instant before being extinguished, reduced to temporary and unreliable memory. I lose myself in sleep each night. Happily. Willingly. I am accustomed to experiencing my own mortality.
These ways of thinking about death do not help, not particularly.
I am losing things. Muscular control. Mobility. Language. There are blackout gaps in time. I think back to the process of acquiring words, a process that starts slow and then accelerates, vocabulary multiplying up.
I am unlearning the words that I’ve come by over a lifetime. I lose the complex ones first, like a robot or a computer whose higher level functions are being unplugged. What was the title of that film? The name of the computer they did that to?
There are holes in my brain which are shaped to particular words.
I undergo a second operation. Toss a coin, pick out a card from the pack. There is more chemo. Life expectancy declines; doctors can offer no more than palliative care. The brain in which I reside is killing me.
At some moment of some day, I will cease: I have always known this to be the case; I do not quite believe it to be true. I continue to be remarkably upbeat. Everyone tells me so.
Words drain from my mind, like water through sand. Sadie and I play games. I tell her what I can. It’s round and white, I say. Round and white have less than a coin-toss chance of being correct. She asks me questions and all I have to do is answer yes or no. Slowly she homes in on the item I am asking for. This works best for objects. It is less successful for intangibles. Like love and sorrow.
I am a mustard seed in the middle of the sphere of the moon, which itself is a mustard seed within the next sphere. And so on and on. I forget which religion teaches that. I try to focus on my own insignificance; I remain important to me.
The seeping away of words builds to a trickle, then a flow. Language eludes me. I cannot plug the dyke.
On good days and at a good time of day and with much help words are found. They are eclipsed and then appear again, a game of hide and seek in which the concealment improves with each round and the uncovering becomes much harder.
I know what things are; I cannot name them. I feel feelings, cannot give them voice. I am reducing down to senses. Sensations. Memories flash through my mind with no accompanying narrative.
I know the woman who visits my hospital bed. Know I love her. That I want to spend my life with her. That I hoped my life with her would be much longer.
I can feel the form of her name, of what she is to me. The words hover out of reach and I cannot grasp them. They lurk on the dark side. ‘You,’ I say. ‘You.’
Her eyes fill with moon-drops.
Sarah Evans has had over a hundred stories published in anthologies, magazines and online. Prizes have been awarded by, amongst others: Words and Women, Winston Fletcher, Stratford Literary Festival, Glass Woman and Rubery. Other publishing outlets include: the Bridport Prize, Unthank Books, Riptide, Shooter and Best New Writing. She has also had work performed in London, Hong Kong and New York.