The Christmas nurses

Georgione. Adoration of the Shepherds

Here’s a handy tip for the festive season. If you fall ill at Christmas –  and I’m talking about collapsed on the floor, in pain, with blood everywhere, the works – then try not to do as I did a few years ago: stay in a remote cottage without mobile coverage and far from the nearest road.

Despite spasms of pain, I felt strangely calm. There was absolutely nothing I could do to make a difference. Everything was out of my hands. It was up to others now, especially my wife speeding to the coast where there was a mobile signal to call triple-zero. At last I saw her car returning across the paddock toward the house; behind it, a bulky ambulance bobbed up and down across the rough ground.

The ambulance crew took charge of the scene like angels in bright, reflective clothing. My wound was dressed. Question after question was gently but persistently asked. How wonderful it felt to be lifted up, carried into the ambulance and driven away! How good that first injection felt to take away the pain! How pleased I felt with my presence of mind, hugging a plastic bag with book, phone, and charger safely inside!

It took almost an hour to reach the nearest hospital, spread out on the hillside over a seaside town. The ambulance doors opened, unfolding a view of paperbark trees, rooftops, and a harbour far below with fishing boats bobbing at anchor. The view disappeared as I was swiftly wheeled into the emergency department. My curious calmness had not gone away. How interesting it was to be taken away on an adventure with my new friends in their hi-vis uniforms – what would happen next?

I lay alone in a room for a few minutes before two young women walked in wearing t-shirts with Happy Birthday Jesus! in sparkly letters on the front. More questions. Blood pressure check. A blood sample taken. Cannula inserted onto the back of my hand (interesting, I thought, examining the device.)

A bearded man entered, in a white coat and a stethoscope around his neck, those universal symbols. After a murmured conversation with the nurses, he came forward.

‘Hi, I’m Brendan. Sorry about the fucking Christians,’ he said, gesturing towards the nurses’ t-shirts. ‘There’s a lot of it about this time of year . . ’

One of the nurses stuck her tongue out at him then grinned. They obviously knew each other well.

‘We’ll keep you under observation for a few days,’ said the doctor after examining me. ‘If you’re lucky, it’ll heal by itself. If not, the surgeon will take a look and probably want to operate. You’ll need to recuperate after that, so you’ll miss Santa calling, I’m afraid.’

‘But look on the bright side,’ said one of the nurses. ‘You’ll be here for our carol service on Sunday.’

Now it was the doctor’s turn to roll his eyes.

I was with Brendan. Christmas in Australian meant nothing to me, after a childhood in northern Europe. As a nine-year-old in Wales, it had been easy to imagine Good King Wencelas and his page trudging through the snow on the hill right behind our house. So how could it be Christmas in mid-summer? Reindeer and snowflake decorations hung listlessly from lamp-posts in town, looking cheap and tawdry in the bright sunlight. If we were staying near the coast, there would be swimming in the afternoon, then dinner cooked on a barbecue. But Christmas? It just didn’t feel right. The magic wasn’t there.

A real Christmas, I knew well, took place in dark and bitterly cold weather. My bedroom window was crazed with frost patterns when I woke to find a pillow case full of presents at the foot of my bed. A coal fire burned high as we gathered around the table to eat a turkey lunch. Afterwards, there might be time for a walk before darkness fell by four-o-clock in the afternoon. In the evening, we sat around the fire, watching television, passing around a Terry’s Chocolate Orange in its golden wrapper. When we tired of chocolate, there was a box of dates (never eaten at any other time), the lid bearing an old-fashioned illustration of two camels strolling nonchanantly past a pyramid.

On Christmas Eve, I had gone out carol singing with the choir from the local church. Wrapped in coats and balaclavas and sheepskin gloves, we walked through the snow to every house in the village. We took turns to carry a wooden pole with a candle glowing inside a lantern. At some houses, we were ushered inside (‘Don’t worry about your shoes’) to the bright fireside where mugs of hot chocolate and mince pies were passed around and we sang another verse of ‘Silent Night, Holy Night’.

I had a secret disdain for Christmas in Australia, therefore, and no interest in staying in hospital to endure the carol service. But as Doctor Brendan had warned me, the surgeon decided I needed an operation the very next day. When the following Sunday came around, then, I found myself being pushed in a wheelchair into the hospital forecourt.

The place was crowded. It looked like half the town was there. The Hospital Carol Service was obviously a big deal in the social calendar. Over by the car park, a pair of barbecues was being fired up, sending a smoky hint of sausages into the air. A fisherman in waders had just arrived, a bucket of prawns in each hand. I spotted members of the Rural Fire Service, too, directing traffic and showing people where to go. Filling the forecourt were local families and holidaymakers from nearby campsites, some in saris or turbans, with their children at the front so they could see. Some were dressed in costumes they had unwrapped as presents that morning. The whole scene was like a Qantas ad. Then there were hospital staff, patients like myself, and in the centre, a choir of nurses. There must have been a dozen of them, all wearing sparkly Happy birthday Jesus! t-shirts. Elaborate, home-made tiaras rose from their heads, with lights flashing on and off. It was an extraordinary sight. I spotted Brendan nearby and raised my eyebrows, but he just grinned back.

An electric keyboard played the opening notes of ‘Once in Royal David’s City.’ The crowd began to sing, raggedly at first, then picking up confidence with every verse. The familiar canon of carols followed, all those tender songs I had once known by heart as I made my way through the snow in faraway Wales, carrying a lantern on a pole from house to house. You couldn’t have imagined a more different scene. My eyes were drawn more and more, though, to the children at the front of the crowd, with here and there an eight-year-old Wonder Woman, cowboy, or Princess Leia. All were staring at the Christmas nurses, moved to silence by their glittering lights and costumes and the strength and harmony of their singing.

Wasn’t this the magical excitement I had once felt and now lost for so many years? When you are a child, so much is new and for the first time, and full of a wonder that cannot be repeated. Maybe Christmas for them in Australia was the same as it had been for me at home, after all. The heartfelt letter to Santa Claus. Counting down the days. A special trip into town to see the department store window display. Standing quietly in front of the nativity scene, seeing the stable, the kind-faced cow watching on, and the noble orient kings appearing on their camels to kneel before a new-born baby whose name was love.

But I had walked away from Bethlehem a long time ago. Around the age of fifteen, like many people, I become entranced by the beauty and logic of Darwin’s writings. I was baffled at the need for religion, for a child-like explanation of the entire universe, mysteriously imparted to some mammals on the third planet from the sun. It was sad to realise I would never know those Christmas feelings again. I was exiled from that safe and cosy world of cardboard certainties, but it was a willing exile. There was a price to pay, though, I now understood. The beauty of Christmas, childhood, and the past can be treasured as memories, as a part of who you are, but you can never go back. You betray your existence by clinging to the past.

I was grateful to the Christmas nurses for the care they’d given me, but had no time for the comforting fairy stories they advertised. Thanks to them and to the doctors, I would be on my legs again in a few days. I would leave the hospital and, a few weeks later, be back at work. I would be an agent not a patient. I would walk alone and be strong.

Image: Georgiono, Adoration of the Shepherds. National Gallery, Washington.

A bit of mischief

Six months ago I was diagnosed with cancer. This is the story of what happened next . . .

The boom gate rises.  I drive into the car park. It’s inside a converted factory. The roof is high, made of corrugated iron with wide skylights, so the place is flooded with a creamy glow, as in an artist’s studio. Birds fly freely inside the airy space. I like it here for some reason. It’s quiet, like being in a tall cathedral made of tin. I sit here undisturbed in the car to think about what the specialist told me half an hour ago.

‘It looks like there’s a bit of mischief . . .’

He must have said this to patients scores of times or more. But I’m not one for euphemisms. He may as well have spoken plainly, and said ‘You have cancer’.


 In movies, a diagnosis is often unexpected and dramatic. The reality takes longer, giving you plenty of time to get used to the idea, plenty of time to dread the result of the latest test. First the GP says after a routine blood sample, ‘That number looks a bit high. Probably nothing to it, but let’s repeat next week.’ And after the repeated test, a referral to a specialist, ‘just in case’.

It’s a nuisance to take a morning off work. This should be an ordinary day. I have enough to do.

‘The number from the test isn’t so important,’ the specialist explains. ‘It’s more how the numbers change over time. It’s the trajectory we look at. Yours have been rising steadily. There may be nothing to worry about, but let’s investigate to be on the safe side.’

The word ‘trajectory’ sticks in my mind. Every time I hear it, I find myself flinching. The number goes up again. I’m not even sure what it means. Some measurement that indicates – that may indicate – presence of a cancerous tumour.

I’m sent for an ultrasound. There’s a screen with an image on it, but I avert my eyes. I don’t want to see that dark flickering shape, like a demon-seed growing inside me.

I’m sent for a biopsy. It’s a day procedure: a tube inserted up my backside with a camera and needles for taking samples at its head: a one-eyed, multi-fanged, metal snake. I’m relieved to have a full anaesthetic. A few days later I get the phone call.

‘It looks like there’s a bit of mischief . . .’

Like most of us, I’ve known people who’ve had cancer. Some died (friends’ parents; that woman at work years ago whose name I’ve forgotten). Others had treatment and recovered; memories of them pale in headscarves fading as the years go by. As well as sympathy, there’s an atavistic relief too, as though a part of your brain is thinking, ‘well it’s happening to them, so it’s not happening to me’. It’s like driving past a crashed car – ambulance lights flashing red and blue, figures huddled over a body on the ground – then accelerating away, turning up the radio to put a distance between the scene of horror and yourself.

I find I have an urge to run away and hide from this threat, as from a hooded assassin. Remote places where I could never be found come to mind. I remember a fisherman’s bach on a New Zealand fjord, inaccessible by road. If only it would leave me alone. I promise to be no trouble. But cancer is no black-clad figure out on a hillside, watching me through the telescopic sight of a rifle. It is my own body, the cells crashing and grinding against each other like faulty cogs in a machine.

The specialist has the reassuring authority that surgeons and airline pilots always carry. He describes the usual treatment options, ending with radical surgery: opening me up and removing the mischief entirely. It’s a complex, intricate operation with a risk of complications but he recommends it. This is my kind of talk. I agree.

There are other investigations over the coming weeks. I don’t mind; the more information the surgeon has beforehand, the better.

The CAT scan. No worries. I’ve had several in the past.

The MRI scan. This makes frightening, loud clanking noises. It’s like lying inside the engine of a 747 as it prepares for takeoff. I hate the thought of a sick child having to endure this. I’m offered noise-cancelling headphones and a catalogue of music. After noting the poor selection, I choose some country and western. Hello Patsy Cline.

The nuclear scan. The results of this show whether the cancer has spread to my bones. This is a particular challenge for my sang-froid. (The answer is no.)

In hospital for surgery at last, I am turned within minutes into a patient. I undress and put on an open-backed gown. An identity tag is attached to my wrist. People repeatedly ask my name and date of birth. Lying silently on a trolley, I wait to be wheeled to the theatre. The process is disempowering but I embrace it. I want to walk through the fire, the sooner to emerge on the other side.

Some people find surrendering control difficult. They resist taking a sleeping tablet or even a Panadol for a headache. I’m the opposite. It’s almost worrying how I can surrender myself at times. It’s a relief. I love sleeping, and slide easily, even eagerly, into unconsciousness. I resist delving into the psychology of this tendency, of being ‘half in love with easeful Death’ as Keats put it.

On the operating table, I begin the countdown for the anaesthetist. Ten, nine, eight, seven … six hours later I wake in a chemically-assisted calm. I note the oxygen line at my nostrils. I take in the cannula embedded in each of my hands. The four lines coming in (saline drip, morphine, anticoagulant, and anti-nausea medication, I later learn). The two lines coming out: one from my bladder, and the other a rubber drain tube which hangs disconcertingly out of my stomach. I notice with relief too, that the incision is neatly vertical, leaving a symmetrical line from belly button to groin.

Moving to either side triggers pain, so it’s easier to lie still and drift back to sleep. On and on I float. This must be the netherworld that opium-smokers like de Quincy sought, I realise. And very nice too. My time out of time, space out of space, is interrupted periodically by a nurse taking my vital signs.

‘That’s good,’ she says, noting my blood pressure. ‘You’re doing well,’ she adds, writing my heart rate down. I feel pleased to be praised. I am a good patient.

By the second day, constant somnolence begins to feel suffocating. With the help of two nurses (London, Dublin), I’m supported to the shower, afterwards sitting in a chair for an hour before the bed draws me back.

‘Breathe right in, then slowly exhale,’ says Dublin.

I do as she says, to feel a searing pain as the rubber drain tube is pulled out through my stomach.

A few days later I can bear to eat solid food. It’s possible to get up from the bed without help, forcing myself to rise and shuffle around my room, or sit and read in a chair. After waiting an hour for the nurse to help me to the shower, I decide to do it alone. The patient begins to be an agent again.

The surgeon inspects his handiwork, making confident, hopeful prognostications. We discuss the subject like two hardened professionals. The following day I go home.

I make progress with all those books I’ve been intending to read. I get through boxed sets of two entire TV series, developing a crush on Lucy Liu as Dr Watson.

After ten minutes walking, though, I find I’m exhausted. A few days later I can manage 30 minutes. After a week I have my catheter removed. It’s pleasing to have my body entirely under my control at last. I make halting attempts at helping around the house. Two weeks after discharge, I start work from home a few hours a day – this grows rapidly as I get fired up. And today I start back full-time at the office.

The memory of this time will fade, I know. And yet the sharp horror of encountering my own mortality remains: a skull glimpsed in the mirror where I expected to see my face. So much of our lives revolves around familiar – comfortably familiar – routines. On Monday night I put the bins out. On Saturday morning, a trip to the market. How many years have I done this? I imagine a vast warehouse stacked high with all the shopping I have ever done. All those tins of Italian tomatoes. The hundreds of kilos of coffee. The paper towels and pyramids of Frank’s rye bread, as high as houses. How many shopping bags filled in my life before I die? The number is incalculable but finite.

Somewhere in arithmetic that number exists, but I do not want to know it.

Now, more than ever, I know this cannot last. There is no escape, only postponement of the inevitable end, whatever mischief is ultimately responsible. I take nothing for granted. I cherish the hour. There is no such thing as ‘an ordinary day’.

Image: Cancer cells (Wellcome Institute)