I lie there, bolted down to the table in my closely-fitting plastic face-mask, thinking sweet thoughts against the background musak of an old Beatles tape, whilst wondrous machinery behind the scenes accelerates electrons to some unimaginable speed and hurls them at a target just above my head.
I am told that the X-rays thus generated and carefully aimed will 'sterilise' the area left behind by the surgeons after their removal of all that they could see of the cancer which had been creeping through my neck from its origin at the top of the oesophagus. The 'nasty' cells, reproducing more rapidly and chaotically, will be selectively killed off, whilst the rest of the healthy 'me' is, relatively, spared and comes to no harm.
Judging by the speed at which my attendants flee the room, and judging by the thickness of the surrounding concrete walls in this bunker two stories underground, nobody else is particularly keen to try out this latter theory... What, I wonder, are my chances now of developing some other cancer elsewhere? Somebody must have done the sums. Surely...?
The last of the radiologists out of the room hits a button on the wall: they swing a pair of gates shut behind them, closing an interlock: the warning bells sound in the distance, heralding the start of therapy: red lights flash on: and then... nothing happens, for precisely 24 seconds. It would be rather like a John Cage musical composition if it weren't for the Beatles in the background. Perhaps it would be more impressive if the radiation was accompanied by some sort of sensation: any sensation - a sizzling sound, a distant smell of garlic or even ozone, some odd wibbly-wobbly visual disturbance such as suggests a dream sequence in a television play. But no: not even any sense of heat or tingling of the nerve endings. Just the "...All you need is love, yeah..." and the tastefully 'calming' surroundings of plastic tiling and Monet prints.
My guardians during this procedure, having laid me out to a precision of a millimetre or so on the table, barely have time for any repartee at all before undoing my clamps and ushering in the next patient. It is a continuous 'production line' of a surprisingly fit looking cross-section of humanity. We patients are of a variety of ages; none of us appear overtly ill, and we each exchange civilities on arrival and departure. It is a curious little society, anonymous, yet bound by this common bond of dicing with death in a variety of forms. The radiologists put us at our ease, explain the rudiments of what is happening, and let us know how to minimise any possible side-effects. It is all supremely efficient. But somehow, it all seems surreal. It is as if we each have our part in a mediaeval play. Here am I, the sick physician, a curiosity amongst the 'ordinary' line of sick patients. But I am no different to them: I am treated no differently, and I have to assume that my illness behaves no differently.
Prick me and I bleed: "...Haemoglobin 12.5 grams: nearly back to normal. Jolly good..."
By the fourth week I became entirely used to the routine of commuting up to town. Surprisingly, I didn't suffer much in the way of side effects at all. Some days I just felt tired and retired to bed in the afternoon - what wonderful luxury, not having to do anything! And there was slight reddening of the skin around the neck, but really nothing to bother about at all. I even asked the consultant radiologist if it was actually working: I think she was a little insulted with the thought of me casting aspersions at her wondrous technology... So compared to the horror stories I have been regaled with for the last 28 years from patients undergoing even short courses of radiotherapy, I appeared to be floating through. I started to think that radiotherapy was really not all it was cooked up to be. A back of an envelope calculation showed I could get much the same effect (well, er, roughly 1/200th of the effect...) sitting between a pair of colour television sets.
But the last week was not nice. Just as I almost recovered some sense of normality in the middle of each morning, all the strength would get knocked out of me again. It's just as much the demoralising effect as the physical effects, though the continual nausea is the worst part, and has the greatest adverse effect upon morale. There was also marked interference with sleep patterns, mainly through a series of extraordinarily vivid dreams.
After my original extensive surgery, and nearly three weeks in hospital, when I emerged, I didn't feel ill at all. A bit uncomfortable certainly, but never ill. I'm just not used to feeling ill I suppose, never having been ill in the past. But I'm now forced to agree with those who warned me about radiotherapy. I thought I would be immune, as I appeared to be to everything until this cancer caught up with me; but once again, I'm no different from other mere mortals.
Still: four days after the last dose and I could feel myself slowly getting back to normality. There's less nausea each day, slightly more energy and less tiredness, and my appetite gradually improved from absolute zero to occasional sudden urges to eat once more. Sleep was still chaotic, with no longer than around three hours at a time, so I still flagged from time to time during the day, but this too seemed to improve as the days went past. It will certainly be nice to get back to the eight hours of uninterrupted sleep I was getting when I first came home from hospital.
I suppose, with the stomach having been 'pulled up' into the neck, and therefore in the direct line of fire of the X-ray beam, both from fore and aft, its very radio-sensitive lining suffered even more than the skin of my neck which is now a sort of mottled burnt-crumpet colour. It certainly feels like a rather solid lump in there, and it certainly isn't sending out signals of hunger. So eating has become a chore rather than a pleasure. Not a nice situation, though it improves slowly day by day.
A total of 45 'Grays' worth of radiation it says in the notes.
This Louis Harold Gray, F.R.S. was an interesting fellow. He lived from 1905 - 1965 and was a scholar of Trinity College Cambridge, going on to a fellowship and member of the research team at the Cavendish Laboratory under the eyes of such luminaries as Sir JJ Thompson, Sir Ernest Rutherford, Wilson of the cloud chamber and Cockcroft and Walton of the high voltage generator found in every TV set to this day - an extraordinary collection of people.
Gray went on to become president of the British Institute of Radiology, chairman of the British Units Committee, and was elected a Fellow of the Royal Society in 1961. The Gray Laboratory of the Cancer Research Trust carries on his name.
Unfortunately I can claim no family relationship: but I feel I know him well...
Dr Alan G. Gray