Thursday, 02 April, 2015: the Diagnosis

After a pain-free, uninterrupted sleep, I’m quite chipper as I head back to Chelsea and Westminster in the morning. This should all be sorted out today, leaving me free to enjoy Easter and paint the eggs which Maddy will hunt for in her grandparents’ garden. I feel a little light-headed walking the final hundred yards or so from the bus. But once in A and E, I’m again quickly assessed and within another half-an-hour I’m with a new urology specialist. He’s young, sandy-haired, Scottish, and we quickly strike up a rapport. He, too, is confident it’s kidney stones, though he’s a puzzled why my kidney isn’t tender when he presses it. When I praise the service I’m getting, he expresses concern about the pernicious potential effects on the NHS of a Tory success in the upcoming elections, particularly their enthusiasm for TTIP (The Transatlantic Trade and Investment Partnership)[1] agreement currently being negotiated (in secret) by the UK government and others. He fears that, if adopted, it may open the way for predator private health companies to hive off even more of the ‘profitable’ parts of the NHS; and allow foreign ones to sue the UK government (and therefore us) if they feel their ability to make profits is compromised by legislation such as the minimum wage. Utterly iniquitous!

While he takes blood samples, we hear an appalling coughing fit from down the corridor and, with a knowing shrug, my doctor gets on to the cost of tobacco abuse to the NHS, telling me that the financial burden on the NHS now far outweighs the tax revenue it brings in. As an ex-smoker, I listen somewhat guiltily, but I acknowledge that it seems plain crazy that tobacco’s still allowed to be sold when everyone knows the harm it does. We discuss the formidable power of the tobacco lobbies and I get on to the subject of lobbies in general. He is appalled to hear that Southampton University has just cancelled a major international conference on Israel and International Law, as a result of the pressure of Zionist lobbies and their poodle MPs. They’ve cited health and safety concerns – as if a gang of Zionist trouble-makers, or the EDL thugs (judge someone by their friends!) to whom they sometimes franchise out their trouble-making,[2] can’t easily be dealt with by the police.

‘We’re all Charlie Hebdos,’ I comment scathingly, ‘if we want to insult Islam. But not if we want to have a rational academic debate about Israel.’[3]

I make an instant decision. Once this problem is sorted out, I’m going to stop being an academic anti-Zionist and become an activist one – at least as regards the abhorrent forms it so often takes in contemporary Israeli  political life and as manifested in the pressure on Southampton University. If we surrender the rights of free inquiry and speech to this lot, next they’ll be burning books.

Fear not, gentle reader, you aren’t going to have to put up with a sustained anti-Zionist rant disguised as a blog. However, Israel and Zionism are much on my mind at the moment, not least because of my current research project – and I’m sure this preoccupation will be reflected from time to time. Besides I’m supposed to be going to Palestine / Israel this coming Tuesday for a much-anticipated research trip as part of my Leverhulme Fellowship. I’m not clear yet whether this problem will allow me to go. I’ll have to ask as soon as the tests are complete.

–           –           –           –           –           –           –           –           –           –

I’m soon up on the next floor for my CT scan. I’ve never seen one of these machines before and I feel like a character in 2001: a Space Odyssey as I’m first injected with dye to make the kidney show up better, then lined up and fed into a circular tube with spinning entrails, like a Dyson fan. All the time I hear commands to breathe in and out delivered in a HAL-like metallic voice, complete with American accent, coming from somewhere deep inside it.

Afterwards, I’m accompanied back to A and E. Although my Scottish doctor said the results would be through in twenty minutes, the wait is much longer. The day before Easter, I guess, and staff already signing off. I take the opportunity to review the evolution of symptoms prior to yesterday’s attack. On Saturday 14 March, two and a half weeks ago, I went with Anna and Maddy to a birthday party for one of her nursery friends. It was quite a production, in a large community hall, with masses of people, entertainments and events. As the party wore on, I realised I wasn’t feeling quite right and told Anna I thought I should leave. As I had to be up very early the following day to attend a conference on Israel / Palestine at Birkbeck (which seems to have escaped the attention of the Zionist lobbies), I decided to head back to mine and have an early night. I felt very tired when I got back but, knowing I’d be missing my regular Sunday Pilates because of the conference, I forced myself to do some exercises, including lunges and squats, which my teacher has suggested I need to do more of. I felt pretty whacked after about half an hour, so decided to head off for a bath and bed.

I fell asleep at once, at about ten-thirty. At half-one, I woke up suddenly in the worst agony I’ve ever experienced, as if someone was squeezing my right testicle in a rapidly-tightening red-hot vice. It was so bad that I was only just able to get to the loo before vomiting, which provided some relief from the pain. I stayed there for about an hour, sweating profusely, trying to breathe deeply, while the pain slowly died down. My first thought, ironically, was ‘this must be cancer.’ I could think of nothing else which could possibly cause such torture. But if it was, this attack suggested it was manifesting very late in the day. Not a comforting thought. Unwilling to phone Anna, who would have had to get Maddy dressed to come over, I managed to get back to bed once the pain had died down a bit. I lay there uneasily and had a second, equally nightmarish attack about an hour later. Looking back, I don’t understand why I didn’t call an ambulance straight away. I think I was in a state of shock and panic and confusion, unable to make the right decisions in the middle of the night. Later, I woke up aware of a strange emission. I didn’t turn the light on to look but it felt just like sperm. How on earth? I wondered, before falling back into a doze.

After what seemed like an age, but with no further attacks, it got to seven in the morning and I phoned Anna. She told me to call 111 at once (why didn’t I think of that in the night!) The man who answered seemed pretty concerned at my description of the symptoms and within about five minutes a doctor called me back. He told me not to eat or drink anything and to go straight to the NHS drop-in centre at Clapham Junction station (thank God for living so close!) As I hobbled down, I realised that the injunction not to eat or drink might be related to the need for an operation and therefore this was clearly some sort of emergency. I tried to steel myself. Losing a testicle. Not something anyone would relish. But why?

I was assessed by a very sympathetic Philippino nurse who diagnosed testicular torsion, a twisting of the tubules, veins etc. serving the testicle which can cut off the blood supply and thereby quickly kill it. I had to get to A and E straight away, he insisted, the chances of saving it already being slim because I’d waited so long before doing anything. Needless to say, I was at Chelsea and Westminster in record time – happily it was still earlyish Sunday morning and there was little traffic. Once there, I was assessed quickly and within half an hour was with a pleasant young female urology specialist, originally from Manchester. After an examination, she ‘confirmed’ the diagnosis from the drop-in centre and said I’d have to be operated on as soon as a slot became available. The nurse began to fit me up on a drip and put a tag on my wrist and said the surgeon would be down to see me shortly. Once alone again, I started to panic. The chances are very small, but people do die under general anaesthetic and here I was, possibly with no chance to see Anna and Maddy before the operation. My voice breaking, I gave Anna some instructions as to where to find my will etc and told her I’d update her as soon as I’d seen the surgeon.

She was very young, personable and reassuring. ‘We’re really protective of testicles here,’ she smiled as she asked me to repeat my story and examined me again.

So there I am, having my balls felt by a third different person in barely an hour, and a less erotic experience I can’t imagine. After a good amount of poking and prodding, some of it very uncomfortable, she stood up.

‘I don’t think it’s a torsion. You’re presenting many of the symptoms but I’m not satisfied. Your nervous reactions down there are good. Besides, testicular torsion is extremely rare in people of your age.’

‘So what is it, then?’

She scratched her green stretch cap. ‘Look, I can’t rule torsion out completely, but it’s been so long since you had the initial attack that there’s a max 5% chance of saving it now, probably considerably less. You have to operate within six or seven hours and we’re past that now. I think it might be an infection. That could explain your emission. Pus, not sperm. The acute pain could come from the pus being forced out of the tiny tubes round the testicle and into the urethra.’ She paused. ‘If it is a torsion, then the testicle will shrink over the next few days and we’ll remove it. Are you thinking of having more children?’

I shrugged non-commitally. I don’t want to influence her decision.

‘Men are lucky that way, aren’t they?’

I nod, a little shame-faced beneath her penetrating look. But not if they have to feel this sort of pain in the bollocks, I want to protest.

‘If it isn’t torsion, we might take off a healthy testicle unnecessarily. What do you want me to do?’

I shrug. Obviously I want to save the Crown Jewels if possible. ‘You’re the expert. I’m happy to follow your advice.’

She smiles. ‘Ok, I’ll sort some strong antibiotics for you. If you have any more attacks, you come straight back here. And keep a look-out for signs of shrinkage thse next few days.’

By the end of the course of antibiotics on Sunday two weeks later, I was feeling much better. No shrinkage. And no more pain. Monday and Tuesday, I was full of energy and in a great mood. I’d got much the hardest chapter of my book on Palestine / Israel finished at last and sent off to various friends and colleagues who’d agreed to read and comment on it over Easter. I went into college, meeting administrative colleagues and my Head of Department, as I made preliminary arrangements to empty my office before August 31st. And I had the trip to the Transport Museum to look forward to the following day – and seeing lots more of Maddy than usual for the next week or so now nursery was on its break.

–           –           –           –           –           –           –           –           –           –

What, I wonder, as I continue to wait for the CT scan results, is the relationship between the testicle and kidney pain? My sandy-haired doctor friend speculated this morning that the former might be referred pain from the kidney stones. On the other hand, I reminded him, an ultra-sound I underwent later in the week of 15 March had apparently vindicated the surgeon, confirming the presence of infection in the mass of tubules and blood-vessels which anchor the testicle. Possibly the infection was passed down from the kidney, he responds. I spend some time updating Anna, who’s out with Maddy at Bertie and Boo’s Café in Balham where they’ve teamed up with Maddy’s best friend Lucille and her mother, Gillian. I assure her again there’s no need for her to come to the hospital. I’ll be out as soon as the scans arrive and I’ll be given some medicine for the kidney stones.

I pass some more time reading an Israeli writer I’ve just discovered, Oz Shelach. Picnic Grounds is a series of beautiful miniatures in English, sometimes less than a page long, rarely longer than two. He’s the first Israeli writer, albeit now an exile in New York, that I’ve encountered in these last nearly twenty months of research who frankly acknowledges the true horrors of what was done to the Palestinian Arabs to secure the establishment of ‘the Jewish State’ in 1948 – and the systematic attempted erasure of evidence of their presence afterwards.[4] Quite a revelation this far into my project! It seems like a very good omen. I’d like to send a copy to everyone who pressured Southampton University into abandoning the conference.

At around One o’ Clock, I catch a glimpse of my Scottish doctor scurrying past the half-drawn curtains of my cubicle. He’s gone before I can call out for an update. But it’s not long before he’s back.

‘We need to get you somewhere else,’ he announces, with a tired expression.

I follow him from the cubicle to a consulting room. He closes the door and motions me to a seat before parking himself uneasily on the table.

‘I’m sorry it’s taken so long but several different people had to see the scans.’

I stare. Why?

‘There’s no easy way to tell you this. They show a 6.4 cm tumour on your kidney. None of us expected anything of the sort.’

It feels completely unreal, as if I’m watching myself in a film. 6.4 cm? ‘What does it mean?’

He pats me on the shoulder again. ‘You’ll have to have it out. Lots of people lead perfectly normal lives on one kidney. It’s a fairly simple operation.’

I nod. I feel quite calm. But I’m flummoxed. How could something so large and poisonous have grown silently inside without me noticing?

‘But first we’re going to have to do some more CT scans.’

‘Why?’

‘To check it hasn’t spread to other soft tissue.’

Oh Jesus, I think to myself. Still everything’s out of my hands now, I remind myself with a deep breath, there’s simply no point in panicking.

‘I’ll take you back where you were. The surgeon team will be down to see you shortly. I’ve booked you another CT slot for this afternoon.’

He offers an arm, but I don’t want to feel like an invalid yet.

‘Would you like me to ring your partner?’ he asks kindly. ‘Sometimes it’s easier if they hear it from a doctor.’

I shake my head. Better from me, I think.

As soon as I’m back in my former cubicle, I phone. In the background, I can hear Maddy and Lucille laughing away, then Gillian’s New Zealand accent, calming them down. At a momentary loss for words, I repeat the doctor’s formula.

‘Listen, sweetheart, there’s no easy way to tell you this but it isn’t kidney stones. They’ve found a tumour. A big one. I have to wait for more scans.’

Anna starts sobbing and that sets me off. I can hear the concern in Gillian’s voice as Anna asks her to look after the kids while she goes outside. We struggle to collect ourselves.

‘I’ll come straight over in a taxi. I’ll ask mum to come and collect Maddy after lunch. Gillian will look after them until then. I love you. Let’s try to be as positive as we can.’

It’s a stroke of luck that Maddy’s grandparents live just a short walk away from Pizza Express in Balham.

London’s fast emptying for Easter and Anna texts regularly to say the taxi’s stuck in traffic. In the meantime I’m visited by a three-person surgeon’s team. The main man introduces himself as Mr Khoubehi and explains he’s going to do the operation. We fix a time for me to come and see him the Monday after Easter to plan ‘the schedule of works’ in the light of what this afternoon’s CT scans reveal. Once he’s left, the other surgeon, a pleasant-faced woman called Pippa, sits on the bed beside me and asks if I have questions. Strangely, I can’t think of any. So she asks me about myself, if I have family and so on. Overcome for a moment, I cover my face. I just about croak out an explanation and she asks how old Maddy is. I can’t get the word out, so I hold up three fingers. She puts a reassuring arm round me.

‘She’ll really help you through this.’

Once she’s left, the third visitor gives me a thick, forbidding-looking booklet entitled ‘Understanding Kidney Cancer.’ There’s a card inside with the contact details of a Macmillan nurse.

‘We’re not going to be able to get the results of this afternoon’s CT scans through today because it’s Easter. I’m really sorry, you’ll have to call next Wednesday once the inter-disciplinary team has met. Then we’ll be able to tell you if there’s been any spread.’

I’m not sure how to react. On the one hand, for the first time in my life, I find myself in agreement with David Cameron, who promises a 24/7, 7-day-a-week NHS service if he’s re-elected (but remember his promises in 2010 to be the greenest government ever, to get rid of the deficit, and to reduce immigration to a few thousand by this year?) On the other, at least I’ll be able to enjoy Easter without the burden of knowing the tumour has spread. Suddenly I have lots of questions.

‘It depends whether they can do key-hole surgery or have to do open. Assuming key-hole, it’ll take about a month for you to get back on your feet, then 3-4 months before you’re fully operational. That’s if it’s just the kidney,’ she emphasizes with a firm but kindly smile.

Anna’s still stuck in traffic by the time I’m called up for the next set of scans. Two lots of high-energy x-rays in one day doesn’t seem like a good idea, but needs must. I go through the same routine, obeying the American-voiced order to ‘breathe in and hold your breath…now breathe normally again,’ as the machine travels up and down my torso.

‘You’ve had two lots of dye today,’ the radiologist reminds me as I get up. ‘It will work your kidneys hard, I’m afraid, so prepare for that.’

I must remember to ask about pain-killers, I remind myself.

I’m barely back in my cubicle when Anna arrives. There’s lots of hugs and mutual reassurance. I feel bad for her, after all that effort to get here, that there’s nothing else to do now but get dressed and leave the hospital. But it’s so nice to see her and have company. I shudder with a sudden inkling of what it must be like to be single and face this sort of ordeal, especially if you have no wider family.

It’s now mid-afternoon and I’m starving. We repair to Carluccio’s across the road. While I eat ravenously, we talk over the diagnosis and the implications of the various outcomes that can be inferred from what I’ve been told. Obviously the crucial next step is to find out if the tumour has spread. If it has, I suspect the way forward’s going to be much more complicated than the kidney removal option. Still, that’s for another day.

I was supposed to be looking after Maddy tonight. But Anna’s mother has kindly stepped in and offered to host a sleep-over at her place so Anna can be with me. I feel bad causing all this disruption. Caroline works very hard and her own health isn’t so good. This is going to increase the pressure on her. Anna and I head to my place. She goes out for a Vietnamese and, despite everything, we thoroughly enjoy a rare evening together, just the two of us. After I’ve sent some preliminary emails to college, the Leverhulme Trust, friends and family, we watch the leaders’ debate on television.

It’s far better than I’d anticipated – even quite gripping at times. Nicola Sturgeon and Nigel Farage are the clear winners as far as I’m concerned – at least as TV performers. If UKIP was a film, it would have to be an Ealing comedy. Farage is a character out of the black-and-white 1950s, a cross between a Ted and a Spiv. I can see him campaigning happily alongside Hattie Jacques and Sid James. He and Nicola Sturgeon are so easy in their own skins, unlike the staring, lizard-eyed Cameron, who looks tired and unconvinced by himself; and awkward Ed, who robotically turns to the camera to engage ‘the people at home’ at the exact same interval after every question. Let’s hope people concentrate on the substance of what his says, and not his style. In alliance with the SNP, I think Labour might just live up to some of its promises. As a hitherto ‘undecided,’ I’m beginning to shift back towards the party from which Blair’s madnesses drove me away over a decade ago.

And so to bed with Anna, for lots of healing cuddles.

[1] See http://www.independent.co.uk/voices/comment/what-is-ttip-and-six-reasons-why-the-answer-should-scare-you-9779688.html

[2] Besides silencing principled academic discussion of Israel, UK Zionist lobbies have, of course, long objected to any discussion of Palestine which doesn’t toe their ideological line. See, for example, http://www.standard.co.uk/news/michael-gove-bars-schools-from-palestinian-literary-festival-6449578.html; and http://electronicintifada.net/blogs/asa-winstanley/jewish-defence-league-uk-extremists-sentenced-assault-palestine-activists

[3] That pro-Zionist voices were included in the conference is proved by this very interesting letter protesting at the cancellation of the conference by a prominent British Zionist academic slated to appear. See http://www.thejc.com/comment-and-debate/columnists/133640/an-own-goal-southampton

[4] Of course, some Israeli historians have (belatedly) begun to document a process long described in Palestinian historiography, though some also claim that the multiple atrocities and systematic ethnic cleansing of 1948 were a price well worth paying for the establishment of a ‘Jewish State.’ See, for example, Benny Morris, The Birth of the Palestinian Refugee Problem 1947-49 (Cambridge: Cambridge U.P., 1988, revised edition, 1994). If you follow this up, don’t skip his footnotes, which are particularly revealing of the dark side of the process.

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