Thief

I did not hear him as he entered;
He made no sound, no cough, no knock,
As he slyly slipped his copied key and sprang my lock,
Siphoning off my dreams from the shelves where they lay,
Gathering long dust, awaiting the right day,
Tipping out my plans from the drawers
Where they were neatly filed,
Waiting for the leisure for review:
All scattered now in random piles,
Pillaged, trodden down, landing where he threw.
Stealthily he sapped my energy supply,
And silently he stole my life,
Leaving his indelible fingerprints
Where he wandered, touching, touching, touching.

This is the first reference in her poetry to her growing realisation that her dreams and plans for the future had been slipping away so slowly that she hadn't noticed, and now were unlikely to come to fruition at all, rather than (as with Itinerary) only postponed. On 2 April, she wrote to JA

It was lovely to chat to you today, as always. Here is the piece I wrote in a lucid moment last week, a few days after hearing the news, one week into chemotherapy treatment. It sort of just wrote itself, straight off.

She was to return to her unfulfilled, and unfulfillable, dreams in her next piece, Destination.

On 8 April, she wrote to KC

I have a lot of problems with memory so can't remember exactly when it was we last spoke. I only recall that I had a long conversation with you while we were driving back home from Barts. Unfortunately there are so many such visits these days that I can't distinguish which one it was, last week, or the week before, or the week before that ....

I think I did tell you that I had had a couple of scans which revealed the cancer has spread - a recurrent tumour on my chest, rock-hard like a stone under the skin near my armpit, plus bone mets to the spine - one vertebra so far - and the skull, a "node" in the lung, and "multiple sites" in the liver. I underwent the second chemotherapy treatment on Wednesday. Fortunately the consultant decided not to add in the second ingredient which I was fearing very considerably, because of the duration and extent of the side-effects which I experienced from the single chemical. So they have just repeated the same dose - maximum possible of the single substance - and will consider the results after a further CT scan to be conducted next week. With this chemotherapy it is necessary to take steroids in advance, as it is based on yew, in order to avoid immune response, especially someone like me who is asthmatic. The steroids boost you full of energy and interfere with sleep for the days you take them. Mind you, my sleep is not normal anyway, and has not been since initial diagnosis. My hair started to fall out last weekend and the doctors tell me that with this chemotherapy it is likely to go very significantly and I may eventually lose it all. Last year when I had chemotherapy I managed to keep most of my hair using the "cold cap" scalp-cooling machine and it was a great psychological support. I am finding the loss of my head hair a very hard prospect to contemplate.

So much more normal was I feeling last week - Week 3 - that the whole situation began to feel unreal and surreal. I have this intellectual knowledge, but can't acknowledge it internally. My mind just keeps going back to the moment on Monday morning 13th March when the consultant said "the cancer's spread: do you want it straight?" In the knowledge that a bad reaction will surely set in sooner rather than later, I have been trying to deal with practical things so that I can have head space for thinking, reacting, and writing. I have redrafted my will (just got to go through the difficulty of typing it out and probably having to sew it together in the old style as it goes onto more than one page) and last Thursday I went to see the rabbi of my local Reform synagogue, which I have now applied to join formally. This means also joining the Burial Society, so that is another practical burden which I can put to the back of my mind. I know that many perhaps most in my situation would not want to think of such things, but for me I need to get these practical things sorted then I won't have them buzzing round the back of my head. In Week 3, last week, I spent 3 days at Barts again: one full day was to get blood out of me, eventually achieved by a Venezuelan anaesthetist working as a phlebotomy assistant while awaiting registration in the UK. On the Friday it was to see the consultant at his request. I think he just wants to keep a fairly close eye on me. As I had previously requested, he showed us the images from the bone and CT scans from 3 weeks ago which revealed my situation. They were horrifying. "Multiple sites" in the liver, seems to mean about 8 or 9 tumours, of quite significant size, each about 2 cms, the largest about 3.5 cm. Even more shocking - very shocking indeed - was the bone scan printout, which reduced me to tears. I saw as expected the affected vertebra. However, I had supposed from the narrative report, that there was spread to the skull, that there would be one area somewhere in my cranium but the one-dimensional frontal image showed the complete arc of my skull affected, meaning that the cancer is diffused throughout my head. I had an appointment with the clin.psych. afterwards and spent the whole hour's session sobbing. Having begun to feel a little more myself, I had been saying over the past few days that the situation felt surreal - here I am feeling not as strong as I used to be but a bit like my old self again: how can it be that I am actually dying? But confronted by those images it is now all too real. All too real. Back home Roger and I clung together, distraught. He says he too now no longer has the feeling that it is all unreal: he has seen the enemy.

I have to go back to Barts again next Thursday for a repeat CT scan. That will be a very heavy day: an early appearance at the outpatient chemo ward for a nurse/doctor/anaesthetist to find a vein for a cannula, both for a full blood count test and for the purpose of the contrast agent for the scan. Then I have an appointment with the clin.psych. - and later that day, in the evening if I have the strength I have booked to go to the communal Passover service meal at the synagogue. I should like to go to that if I possibly can as I think it may well be my last. Of course, if the blood count result that day comes back too low, neutropaenic, they will admit me forthwith for intravenous antibiotics for about 5 days I guess. Last time was OK and I was very considerably debilitated when they shot the stuff into me that first time so I am hoping I can get away with it again this time, but they telll me there is a 1 in 5 chance of it happening each treatment. The next PLANNED visit to Barts will be on April 24th, when I shall see the consultant to hear the results of next Thursday's scan.

On the Thursday of last week, 9 days ago now, my son took me for a drive out to Epping Forest - my first outing not to a hospital in a couple of months. Roger and I have booked to go away to the Borders of Scotland in 2 weeks, from 19th April for 4 nights. We had hoped to do this during Week 3, but I was so ill for a fortnight last chemo cycle that we could not contemplate arranging anything. I started to pick up and began to feel more like myself again from Day 15 so we are risking it this time round. (As it happens there has been really bad weather in Scotland recently so perhaps it was just as well.) Still awaiting the response from Professor S. at the Marsden. I spoke to his secretary last Monday and she said he had been away for a week but that the letter had now "gone off" - although when I enquired yesterday it had still not arrived at Barts. I asked Dr.M's secretary to get him to call me when he receives it as I don't want to have to wait another fortnight to learn what the Marsden has to say about me, whatever it is - I don't want it hanging over my head in Scotland. (Not holding my breath, but you can't help hoping.)

Sorry if this seems all jumbled, like I say my thinking doesn't go in very straight lines these days. I am attaching my most recent significant piece of writing [Thief]. As you will see from the date, I started it quite soon after getting the cataclysmic news, and finished it off within the week

Hope things go alright with you and yours. I would dearly love to see you again some time when we can possibly get together.

Sandra