Diary 136
Life in Japan
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by Hugh Cook

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Cancer patient diary - blog lymphoma patient: author Hugh Cook, previously teaching English in Japan, receives cancer treatment in New Zealand - true story personal experience 2005 - non-Hodgkin's lymphoma central nervous system (brain and spinal cord) - between hospital admissions for treatment, Hugh stays with his parents in Devonport, near Auckland, New Zealand. Treatment began in December 2004 and by March 2005 had included a brain biopsy and three chemotherapy sessions, each five or more days long.


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Section 136 Entry 0001. Date: 2005 March 25 Friday.
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Since my life is now focused on dealing with cancer (and, all going well, recovering from it) it's natural that my latest short story is a cancer story, a piece of fantasy fiction with horror elements. A rather unpleasant piece of work in some ways, but we're not in dandelion territory here.

Anyway, this is my account of how I was inspired to write this rather ugly cancer horror fiction story called METASTASIS. It demonstrates the synergy between memory (past experience, digested over time) and life now (the press of ongoing events.)

This account of the writing of the METASTASIS cancer story is not typical. It's not an account of a standard writing pattern. Different stories get written in different ways, some with more ease than others.

A technical note to begin with: as most people know, "metastasis" is a word used to denote the spread of a cancer from one part of the body to another. My parents' crumbling copy of CHAMBERS TWENTIETH CENTURY DICTIONARY, the dictionary which I grew up with, gives the etymology as being from the Greek word "metastasis," meaning "change of place." A "stasis," it seems, is a "a standing."

Avoiding any specific connection with cancer, the dictionary supplies a general meaning for metastasis, glossing it as "removal from one place to another: transition: transformation: metamorphic change in rocks: metabolism."

However, after a lifetime spent working with words (if forty-eight years can be called a lifetime) I have to say that in my experience the word metastasis has never cropped up except in reference to cancer (sometimes literal cancer and sometimes metaphorical cancer.)

And in fact the cancer association is one highlighted by a different dictionary, COLLINS ENGLISH DICTIONARY (third edition, 1991) which starts with a definition reading "the spreading of a disease, esp. cancer cells, from one part of the body to another." If you are a cancer patient, of course, then metastasis is a bad news development.

The start point for the METASTASIS story, then, is the word itself, freighted with ominous meaning, suggesting doom: the collapse of defenses, the inner sanctuary being overrun. Flood. Inundation. Overwhelming invasion.

Next, feed in my own situation, which is that I find myself seriously ill at the age of forty-eight, with the prognosis uncertain. Here in New Zealand, I'm dividing my time between my parents' house, where I'm living as an invalid, and Auckland Hospital, to which I am periodically admitted for chemotherapy treatment involving spending days at a time with an intravenous drip in my arm.

The situation is a combination of the unsettling and the boring. The unsettling part is that the ultimate outcome is unknown. All going well, I will make a good recovery in 2005, and, by early 2006 at the latest, will once again be living and working in Japan, the country where I have spent the last seven years of my life.

However, although my doctors have made it very clear that they are working for a cure, a cure is not guaranteed. It's a lottery. This disease, my genes, my idiosyncratic reaction to my chemotherapy regime: there are a lot of unknowns here.

I'm basing my life very firmly on the assumption that I'm going to live long and prosper. If I don't, the alternative outcome will take care of itself. (My will is up to date, and, as far as I'm concerned, if I'm going to exit history this year then there's nothing else required.)

At this time of stress and illness, into my life there came the horror figure of the fiction character Metastasis, the decayed entity of translucent green jelly sheathed in a plastic shroud. Arriving fully formed, out of nowhere, self-creating, horror spontaneously generating itself.

Storywise, this incident would work better if I wrote that the figure of Metastasis ambushed his way into my consciousness, fully formed, while I was lying alone in my hospital bed with my life-or-death intravenous drug running, feeding a poisonous chemotherapy agent into my system. Kill or cure!

However, in fact, the piece of fiction called METASTASIS is a story I wrote one night a couple of days before one of my stays in hospital, and I was actually sitting at the living room table when the figure of Metastasis walked into my imagination, gross, graphic, visual, fully formed.

Darkness within shadow.

The entity known as Metastasis was provoked into existence, obviously, by my own situation, which is one of fairly arbitrary uncertainty. I have for some reason (but for what reason I do not know) fallen ill with a fairly uncommon disease which represents a significant threat to my continued existence. And, although my plans are optimistic (make a full recovery and continue) I don't yet know how this will work out for me.

The character Metastasis, having been born of my own situation, is an incarnation of motiveless malignancy, arriving from nowhere and arriving without explanation.

Like my medical condition.

In a sense, the character of Metastasis is a creation of my present circumstances. In another sense, however, Metastasis has been something like twenty years in the shaping, his genesis going back to an incident that occurred in the South Island of New Zealand, in the city of Christchurch in (perhaps, to guess very approximately) about 1984, back when my age was closer to twenty-eight than forty-eight.

At the time in question, I was in the military, and was doing a course for army medical assistants (people who get training in first aid, basic hospital work, and the elements of field hygiene and the like.) The course, which was for people who had already done earlier training, and who had acquired some years of experience, was run at an army base called Burnham, within easy driving distance of Christchurch.

Anatomy was part of the course, and one day one of the instructors brought along a big bag of animal organs, glistening wet with dead animal juices. Unfortunately, memory expires at this point, and I can't remember what, if anything, we were required to do with the organs. I just remember the look of absolute disgust on the face of one of the female students of the course as these chunks of disemboweled animal came slithering out of the bag. (Big pieces. The pieces were not from a little animal, like a rabbit. They were from something pretty big. Maybe a cow.)

(At a guess, maybe we were required to identify the organs and to say how they plugged together. Two legs or four, the basic anatomy of the gut is pretty much the same.)

Another part of the course also involved anatomy. It was to observe an autopsy. And so, on a certain morning, we were driven into Christchurch, and to the morgue. If memory serves, we got given a very sensible "don't stress" lecture beforehand; if I recall correctly, the general drift was that this is not some kind of rite of passage, and if you can't handle it then don't worry.

The scene, in short, was set for something educational to happen, the course being run by civilized people who were good at what they did. The approach to the autopsy, like the approach to the whole course, was, in a word, immaculately professional.

So we were driven into Christchurch.

Then: problem!

There had been some kind of mixup, and the friendly civilian pathologist who had agreed that we could all come along to watch him cut up a dead body was not there. Instead, his disapproving colleague was. We were not welcome - no show today.

I remember our instructors being very mature about this. The morgue is the pathologist's domain, not ours, and it's his judgment call, which he has to be free to make as he sees fit. Any, anyway, there will be another day.

Meantime, for the moment, our instructors improvised ("In adversity, opportunity," is, I think, a standard military slogan) and, somehow, we ended up touring some kind of one-room museum-type display. At a guess (and, so many years later, this is only a guess) this place (quite a big room, as I remember) was probably part of a university medical school or something like that.

The display cases were full of body parts which had been removed during autopsies and had been preserved in various ways. And we're not talking about healthy body parts. We're talking about diseased organs. Gross, bloated, pancaked, distended. burnt brown and black, shriveled or expanded, contorted into the unguessable. The contents of the body's envelope looking like maimed remnants of flesh garbage partially destroyed by incineration.

Being then in the peak of health and physical fitness, I had only a remote observer's connection with the exhibits, which failed, after a few minutes, to really hold my interest. Still, I gazed, absorbed, remembered.

It never remotely occurred to me that I would one day write about those disfigured human organs, those murky monstrosities. However, twenty years later, on the occasion on which the character Metastasis created himself, there those organs were, visible in Metastasis's visionary body.

What I did think I would write about (though I never did) was the autopsy that I saw on the occasion of our second visit to the morgue. This time, the military-friendly pathologist was on hand, and, in a relaxed and informative manner, dissected a baby for us.

There was an initial shock in being confronted not by the expected adult corpse but with something much smaller and infinitely more vulnerable, a victim, I take it (though this is a guess) of SIDS, Sudden Infant Death Syndrome (sometimes referred to as cot death), this being the unexplained death of a baby - a possibility that, incidentally, my wife worried about during the first few months of our daughter's life.

After the initial shock, however, I found myself fascinated. In particular, I was struck by the contrast between the messed up deformities of the diseased organs that I had seen previously in the museum-type display cases and the marvelously clear, precise, textbook-logical appearance of the baby's flawless innards.

However, I never wrote about that.

If my own daughter (now well past the danger stage, I believe) had died of SIDS then maybe that baby autopsy memory would have ambushed me into an agonized creativity. But that would have been in a different universe, one far less tolerable than this one.

In this universe, what came to me, fully formed, the product of twenty years of occasional remembering, was the sheathed organ collection calling itself Metastasis, sliding out of the cracks at the edges of nowhere, unsummoned, and with no excuse for his arrival. An arbitrary entity in an arbitrary world. The world which, for the moment, I am living in.

It is a horror story, the theme is not pleasant, and the content may offend.

Read full text fantasy horror cancer story

METASTASIS


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