… begins “Dear Nicholas,” which is maybe as it should, but is also quite wrong; nobody calls me that. The last person to do so as a normal thing, my brother Glenn, died a couple of years ago. It is a signifier of the database form of address and alerted me to the formal tone of what was to come. Do I mean “formal”?

The contents of the first letter were mostly plain statements of facts: a list of symptoms and who had referred me to whom, test results, and a brief note on what the writer of the letter had found.

Nothing surprising. Factual, and the obvious word, clinical. Colourless, in contrast to my Technicolor emotions.

What was surprising were the omissions. The monster is not named; timescales for tests are shakey; the Big Timescales of prognosis are not mentioned. This is clinical, and those in charge for now of my health are also in charge of what can be expressed. The formal language if anything highlights what is not being said.

Henry Marsh has insights into this formality. He suggests that “faced by piles of paperwork and test results (now largely online) it is difficult to keep in mind that each result has an anxious patient attached to it” and that “much of what goes on in hospitals – the regimentation, the uniforms, the notices everywhere – is about emphasising the gap between staff and patients, and helping the staff overcome their natural empathy.”

“Patients want certainty but doctors can only deal in uncertainty.” This is something I shall have to hold on to.

***

Or not: a watershed crossed in late November and (to muddle my imagery) the dam bursts with info.

But even in the information flood there is uncertainty, and I look at all these guides like a first year undergraduate looks at a course handbook: so much to take in; how much of this is relevant?

***

So the latest letter is clearer, and today (11.12.23) is the day this word becomes flesh (why yes, this is all coloured in by the purples, reds and greens of Advent) with a F2F meeting. There is the scribble of results that is no more enlightening than the old-fashioned, mythic doctors’ bad handwriting, and then the veil is parted:

Unfortunately.

The job not got, the offer withdrawn, the bad news word. The heart races, sinks, I don’t know: rereading the text in the rush that follows I am struck by the name Gleason which takes me to the bull that tramples through Puck of Pooks Hill – thence my mind hears the yammering at my elbow of all those crazy, violent, vivid dreams that keep my sleep broken. Now Stop! Max said. And the wild things are stopped as by a lion-tamer’s whip and chair, stopped by another word:

However.

Watersheds and floods; dark towers and brave rescues; lion taming and þursen and the wild rumpus. Good, picaresque nonsense, jumbled fairytales to give shape, colour and texture to the bare outlines of grey corridors and professional friendliness and the heart-crunching worry of boring my friends.

Which is maybe what I’m doing here. Not a wild rumpus, not even an Ariadne thread, just a confusing set of encounters with images given a high fantasy gilding.

Time to stop and get ready for my consultation? Just one more thing, another letter:

A letter from the Blood Donor Service, in response to my having to withdraw from donation. It talks of ambassadors like you encouraging others to give blood…I hope you’ll continue spreading the word.

Give blood: https://www.blood.co.uk

And chaps: get your prostates checked https://prostatecanceruk.org/risk-checker?gad_source=1&gbraid=0AAAAAC_DJ7RCCrftQ3BTC63oIqJ-4wrw3&gclid=EAIaIQobChMI3qXct4iHgwMVrIpQBh1wXAqDEAAYAiAAEgJ2BvD_BwE&gclsrc=aw.ds