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The Boy in the Mirror

by Tom Preston

You’re lying on your back, arms raised above your head, your whole body perfectly still, air held uncomfortably in your lungs.

Breathe normally.

You feel the dye rush through your veins and your mouth tastes like metal. Here comes the hot flush. He said it might feel like you’ve passed water.

Breathe in and hold your breath.

Your eyes are drawn to a little red line under the glass. A sign reads, ‘Do not stare directly at the laser.’ You look away.

Breathe normally.

The whirring slows and comes to a stop.

Breathe normally.

Breathe normally.

Back in the waiting room, the scene is all dressing gowns and slippers. Zippy anoraks and woolly cardigans. Sad eyes.

They give you a queue-jump. A little red ticket. ‘What service!’ your dad says, half-joking. You manage a weak smile; the faster they see you, the worse your chances are.

Results will take up to three weeks.

They call you at home three hours later.

Can you come in today? We need to talk about your CT scan. Any time is fine. Any time you want.

The consultant’s office is all scribbles and charts. Academia. His eyes are warm, peering over his glasses. He talks about numbers and percentages. Your mother and father don’t move at all as he speaks. Not even slightly.

Breathe in and hold your breath.

The nurse stands behind him, arms folded, her face a picture of comfort and reassurance. Her eyes twinkle with sadness; she knows how bad it is.

Your consultant says, ‘The next step is called a PET scan. It’s a kind of nuclear medicine that produces a 3D image of the inside of your body. It can detect and pinpoint hypermetabolic activity. I’ve booked you in for first thing tomorrow. It should tell us exactly what’s going on.’

Hold your breath.

It’s a cold, blue morning and you’re standing in a car park on your own next to a huge grey mobile building. A careful man in a white uniform gestures for you to climb the stairs. Inside, they sit you down and the mood is faux-joviality. Trivial words.

This scene is all computers and clinical waste disposal bins.

‘We need to put this into your arm.’

The dye flows through the cannula into your veins but this time it doesn’t feel weird. The man tells you the nuclear dye means you are now temporarily radioactive. He leaves the room.

Over the intercom his voice crackles. ‘You need to wait here for a few minutes before your scan. They’ll call you in. Just shout for us if you need any help. When the scan is finished you’ll need to wait a few minutes for the radiation to diminish. After that, you can go. For today, avoid pregnant women and animals. Just as a precaution.’

Eight-thirty the next evening. You’re standing at the bar in a cheap pub buying a round of drinks for you and your friends. You interrupt yourself as you order with a brief coughing fit. It sounds terrible. The barmaid looks at you oddly.

‘You ought to get that checked out!’

You smile, ‘I know.’

It’s at this point you touch your throat and notice the hard little lump on the side of your neck. Something rushes through you, not quite panic, something else – something closer to the feeling of falling.

On the Ear, Nose and Throat ward the mood is boredom and tension. The scene is all flimsy hospital gowns, anxious checking of watches and ruffling of newspapers. The waiting room is just you and three older men, maybe in their fifties or sixties. In the corner a TV silently cycles through the early morning news.

The surgeon comes in to explain your operation. It’s relatively simple and should take little more than an hour. First they’re going to make an incision along your neck just under your chin. Then they’re going to carefully cut out the malignant lymph node and the sample will be sent for analysis.

There is a slight risk at this point in the operation that one of the delicate nerves in your neck may be severed. This could result in an asymmetrical smile or difficulty eating after surgery. Such damage would be permanent.

At the end of the procedure the surgeon is going to drill into your pelvic bone, take a sample of marrow, and see if the disease is present there. Both stages of the operation will be performed under general anaesthetic.

You’re taken to a holding room and asked to lie on a raised bed.

This scene is all children’s cartoons and comforting pastel paintings.

The anaesthetist puts a needle into the back of your left hand. He asks you to count down from ten. Your eyes blur and the world swims around you.

You awake in a room, it could be the same but you can’t be sure.

The scene is unclear.

Your mind soars and you laugh. Though you don’t quite understand why, something is very funny.

You float into a lift and feel infinitely comfortable as you descend, and you sleep.

The next time you wake you feel happy but fuzzy. Lifted but heavy. You’re in a bed on the ward and you can hear the soothing sound of your parents’ voices from behind the curtain. They’re talking to the consultant about something. About you. You drift in and out of their hushed exchange.

PET scan showed advanced spread of disease.

12cm tumour in the chest cavity pushing against the trachea, causing cough.

Tumours also present in neck, lungs, kidneys, spleen, bowel and bones.

Assumed diagnosis is high-grade diffuse large B-cell lymphoma, stage four.

Optimistic prognosis would be somewhere around 40%.

‘Cancer is a word, not a sentence.’

You’re back in the consultant’s office the day after surgery. You’re here to discuss your options. The bone marrow sample confirmed the initial diagnosis, he says. There’s a poster on the wall featuring a smiling young man with very short hair. ‘Jonathan had acute myeloid leukaemia – after two years of chemotherapy, he is now in remission. Cancer is a word, not a sentence.’

Your consultant tells you there’s a new medical trial being run at the City Hospital. It’s an intensive regime of chemotherapy that packs a year’s worth of treatment into four months. You’d need to live in the hospital as an in-patient during this time. He’s spoken to the haematology ward there already. You can move in tomorrow.

He tells you this is your best chance.

The City Hospital is around seventy miles north of home.

You are faced with a choice: either stay home with your family and friends and receive outpatient treatment at the local hospital, or move away from them all and live in isolation on the ward at the City Hospital until hopefully you get better.

There’s no time to think about this decision.

Your consultant’s words echo in your head: ‘This is your best chance.’

You call your friends and tell them the news. You arrange to meet them in the pub for one last drink.

The pub is all wipe-clean upholstery and waterproof menus. At the bar you’re served by the same barmaid who commented on your cough last week.

‘How’s that nasty cough?’ she asks.

‘Not great,’ you reply, but you smile.

As you turn your head her eyes flick to the large white surgical patch on your neck. She looks away quickly and goes to get your change.

Back at the table the mood is all stubborn optimism and good humour.

Your friends seem brittle but brave all at once. One friend holds your hand under the table as they ask questions about chemotherapy.

You don’t have many answers.

The next morning you visit a fertility clinic before you leave for the hospital. The chemotherapy will most likely make you infertile so the NHS is going to store a sample in a sperm bank so you can still have children in the future.

The scene in the waiting room is all anxious couples and vases of flowers and home-keeping magazines.

A nurse asks you some questions and takes some blood. She gives you a plastic pot and leads you to a room with a small sink, a clinical reclining bed with a tissue-paper cover sheet, and a black cabinet containing NHS-approved pornography. The pornography is laminated.

Back at home and you’re packing a bag for hospital. Books. DVDs. Photographs of people you love. Pyjamas.

Your mum walks into your room and looks at you sadly.

‘You’ll probably get through loads of books!’

Downstairs you stand with your parents and sister in the kitchen. You realise how much you love them. Nobody knows what to say. Your dad draws you all together into a hug. The scene is all wet eyes and sniffing back tears.

‘I’m so sorry,’ he says, his voice cracking just a little, the three of you held tight in his gorilla grip.

‘You’ll be okay.’

‘You’ll be okay.’

The haematology in-patient ward is all bright lights, beeping machines, business-like nurses, and a complete absence of patients. Each room is private. The communal area is deserted. This is where you sit with your family while they sterilise your room.

A nurse brings everyone teas and coffees. After a few hours, your sister suggests a walk. You walk with her quietly round the hospital corridors. It smells of cleaning products and old furniture.

Eventually your room is ready. Everyone says their goodbyes and you’re on your own. It’s late, and you’re tired. The soft lighting and fresh sheets make the room seem like some bizarre hotel. You catch a glimpse of yourself in your bathroom mirror; you look pale and shaken.

A nurse comes in and puts a cannula into the back of your left hand then hooks you up to a fluid drip. He leaves and you go to undress but you can’t take your shirt off because of the tube from your hand to the drip. You settle for pyjama bottoms and curl up into bed.

The ward is peaceful but for the gentle patter of shoes and the far-off beeping of a machine in a room somewhere else.

You sleep.

by Tom Preston, from The Boy in the Mirror (£7.99, £2.99 Kindle)

Click here to listen to an audio version of this chapter.

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