Low life

Marketa stands on one side of me, Catriona on the other. Marketa is Czech and my carer. Catriona is my new wife. I’m lying on my back in dove grey flannel pyjamas. At seven I’d woken to the most excruciating pain. Where the pain is located exactly I’m not sure. It is among my various lung and upper skeletal tumours, I’m guessing. Shoulders. Shoulder blades. Ribs.Lungs certainly. Once an hour I am permitted to press the morphine button at the end of the cable for pain relief. It goes beep – a jolly noise! After the second go, however, I have no pain relief and I’m counting the minutes to the next one. But shortly after I’ve pressed the button for the second time, nurse Marketa arrives to wash me and change my incontinence pad and pyjamas.

Monday morning. In comes Frank. Frank is a carer in his late fifties. He comes daily to wash me. Still half asleep, I sit upright in my mechanical cradle forking in Greek yoghurt, strawberries and granola and looking out of the window. Up here on the cliff, it’s another clear, blue, busy day ahead for our feathery nest builders, egg rearers and chick scoffers. Although he was a bit brutal with his caring to begin with, Funky Frank has become gentler over time In his spare time Frank plays bass, he says. Of all the styles he likes funk best, he says. His style is a busy, intricate one. He’ll show you his air guitar version. Funky Frank is his nickname in the local pub music circle. I’ve been washed in turn by all the local carers now.

It took five firemen or pompiers to lift me out of bed, carry me down three narrow flights of stairs and down a rocky path, then to shove me into the back of their van. When I cried out in pain the sweating firemen joked that I was a muezzin calling the faithful to prayer. Henceforward they humorously addressed me as sheikh. It had to be pompiers because my legs don’t work. The educated guess is that a tumour is pressing against my spine, gradually paralysing me from the toes up. The old legs feel amputated: just colourless slabs of cold meat. ‘Can I perhaps have a glass of water?

I was discharged from hospital into local taxi driver Gilles’s brand-new metallic blue Skoda, of which he is intensely proud. I’d been in for more than a week. My pain level had been assessed and the daily morphine dose adjusted, and a new and different species of analgesic prescribed; also lignocaine patches, to be stuck on my breasts each morning. Humming, as he does when in a cheerful mood, Gilles collected me from the ward in a wheelchair and transferred me on to the back seat of his pride and joy. ‘So how are you?’ he said. I told him I thought I was more or less finished. Gilles wasn’t having any of that kind of defeatist talk. At rest, his slanting French eyebrows oppose one another like one acute and one grave accent.

The morning after we were wedded, I went to hospital in Marseille. The oncologist wanted to assess the pain level and find the right daily morphine dose. I went down in the back of a taxi and from the taxi to the cancer ward in a wheelchair. A nurse with a form checked me into the single-occupancy room, asking me my name, address, date of birth, occupation, etc. Then: ‘Are you married?’ ‘Yes. We married only yesterday as a matter of fact.’ The dear soul could not have been happier for us, though she was probably mystified as to who on earth would want to marry a mummy with the bandages off.

It’s been all go. After breakfast Treena brought a basin of warm water, a bar of soap and a face flannel into the bedroom. Not wanting to cede control of my personal hygiene, on top of all the other recent great and small losses of personal autonomy, even down to cutting up my own food, I have until now resisted her offer to wash me.  She pulled my T-shirt over my head. I lifted my arms and she gently soaped my armpits, an act which seemed more intimate somehow than making love. Now, with my arms aloft, seemed as good a time as any to broach the subject. ‘How about,’ I suggested conversationally, ‘if I just swallowed, say, 20 or 30 of the red, short-acting morphine capsules. Wouldn’t I gently drift off to sleep? And wouldn’t that be a nice and easy way for me to go?

‘They say they can’t do it tomorrow. The papers haven’t come.’ Catriona, just back from the village, was shouting up the stairs. ‘Oh?’ I said. ‘Who can’t do what? What papers?’ ‘You know. Our marriage papers. For the ceremony.’ ‘Papers? Marriage? Ours? Ceremony?’ ‘Well, not exactly marriage. Of course not. It’s a civil partnership. For tax purposes.’ ‘With a ceremony?’ ‘A signing. Just our signatures, to be witnessed by the mayor and another. That’s all.’ ‘Ah. And who’ve we got?’ ‘I was thinking the foreign correspondent and Mel [his wife].’ ‘We’d better take a bottle.’ ‘Champagne.’ ‘To celebrate our marriage.’ ‘Our civil partnership.’ ‘For tax purposes.’ ‘Yes.

I can see why rock stars and other impetuous celebrity types accidentally top themselves with drug cocktails. When you are spaced out on medicaments it’s easy to forget what you have or haven’t taken. A month ago I was prescribed a dose of corticosteroids to see off a chest infection: 60mg a day for four days. Apparently, it’s a big dose. Nurse Catriona says it’s the largest she’s seen. (She was a practice nurse for donkey’s years.) For some folk corticosteroids have a similar effect on the mind as coke. Which means, in my case, I become chatty, overconfident and overassertive, occasionally tipping over into aggressiveness and paranoia.

Since Christmas I’ve been sending off these columns with the anxious thought that perhaps I’m overdoing the dying bit and the truth is that I have a long way to go. Suppose I’m still here on Lammas Day, for example? I worry that some people might feel short changed. Moreover I worry that some might be already tiring of a columnist banging on interminably about his terminal cancer. A month or two of cancer shtick before falling decently silent – ideal. Six months? Well, OK. But a year? Thanks to global capitalism, choosing a night pot is like deciding on a make of saloon car For this reason I am pleased to report the passing of another milestone on my private Menin road. The bone and lung pain have lately increased to the point where I need to lie still.

On the last day of my grandsons’ week-long visit, Saturday, I was struck by bone pain of an unsurmised ferocity. I reeled around the cave swearing with incredulity. Shoulders, shoulder blade, ribs, the right arm more or less useless. The day before I had looked in the mirror and found a mass on my neck I hadn’t noticed before, hard to the touch yet tender. Yes, by all means bring it down to Marseille, said the oncologist via email, and I’ll have a look at it. And while I’m at it, I’ll prescribe a stronger morphine dose. How about Monday afternoon? Up till then I was on 40 milligrams of slow, long-acting morphine twice a day plus a reserve of fast-acting morphine for emergencies.

Two nights running I was incontinent of urine and woke up with warmly weighted pyjama bottoms. Former nurse Catriona didn’t bat an eye. When she first came to France she was a carer for three geriatric English expats, a lady and two gentlemen, and both gentlemen wore nappies in bed. Less than an hour after I’d confessed, she had run down to the chemist and returned with a ten pack of culottes/broekjes/cuecas/pants for medium urinary leakage. Though elaborated with decorative frills around the elasticated leg holes, the pads were not of the same thickness and high quality that her two gentlemen wore. She was apologetic about it. But if my incontinence was due to all these new tablets I was on – including antibiotics and corticosteroids – the inconvenience would be only temporary.

I was silently mourning the death of Brigadier General Charles FitzClarence at First Ypres when a young male nurse entered the crowded waiting room and called out my name. I must look fairly decrepit because he offered an arm for me to lean on as he walked me up the aisle and into the CT scanner anteroom. Kind, I thought. He was a dark, solid-looking chap in his early twenties. His uniform was all white: white jacket, white T-shirt, white trousers, white Crocs. He directed me to a chair beside a medical trolley and suggested I remove my jacket and fleece. Next, a female nurse with an unmistakable air of seniority loped up and asked me if I had an objection to having the cannula and contrasting agent fixed into my arm by her student – in other words, Mr White. None whatsoever, I said.

Feeling lucky always, I assumed that chemotherapy would be the piece of cake that some had predicted for me. They said they knew people who were treated with chemotherapy for years and years and meanwhile managed to live a relatively normal life. But by only the fourth cycle of my second round of it, I realised that this wasn’t going to happen in my case. I felt so rotten that it seemed to me that death would have been easier to bear and was probably preferable. Of course I told myself to get a grip, to put on my metaphorical tin hat and sit it out. No doubt the feeling of being poisoned by novichok or similar would pass eventually. I also reminded myself that chemotherapy was in fact part of my medical treatment, a cure, and that I had a lot to be thankful for. I was warm.

I woke up in the wake-up room (salle de réveil). The clock on the wall said half past ten. I’d been out for a couple of hours. What lifted me to the surface was the sound of the wake-up team persuading someone to wake up who was absolutely refusing to do so. The entreaties increased in volume and urgency. Then I heard a male voice say, in English: ‘Wake up please, Mr Clarke.’ I nodded my sleepy head to show him that I was already there. The voice then asked me in French whether I was in pain and I answered in French that I was not. After that I listened with interest to the tug of war between the wake-up team advocating wakefulness and the patient refusing it. The anaesthetist, I noticed, had added a delightful sedative to her narcotic mix, perhaps as a friendly treat.

Standing at the door was a hospital porter. He was resting an elbow on the back of a heavily padded wheelchair. A strapping lad, wholly masculine, a credit to us all. He regarded me levelly with a sort of Byronic boredom. I was fetching in a paper shower cap, paper gown, knee-length stockingettes and paper socks inside claret slippers decorated with the West Ham football club logo of crossed riveting hammers. The slippers – a Christmas present – arrested his survey. ‘West Ham,’ he said. ‘We sold you Payet.’ ‘You did,’ I said. ‘Fat and moody, but what a player.’ At La Timone hospital in Marseille everybody supports Olympique de Marseille or OM. You sometimes see hospital administrators in the replica shirts.

I remember my first day at South Benfleet County Primary School with rare clarity. My mother left me at the school gate and I hadn’t been in the playground five minutes when a supervising woman trotted up to me, suspended me in the air by my arm, and slapped my leg, hard. Apparently I ought to have stood still at the first blast of her whistle and lined up at the second. But no one had told me the drill. While everyone else stood stock-still, I had remained in motion. Her anger and unhesitating violence surprised, then shocked me. You might argue that I learned everything I needed to know about the world within five minutes of the start of my education. If you’re a publisher reading this, yes I could probably squeeze a book out of it.

Throughout the flat, post-Christmas limbo I lay languishing after another dollop of chemotherapy and read my Christmas present, Thomas Mann’s The Magic Mountain, in the later Everyman translation by John E. Woods. Set alongside H.T. Lowe-Porter’s sturdier pre-war translation, the difference was more marginal than I’d been led to believe by John E. Woods’s online trumpeters, and in many cases the old workhorse H.T. Lowe-Porter’s choice of words was more graceful and economical. Or so it appeared to this particular unwashed, unshaven reader with food stains on his pyjamas, drugged up to the gills on morphine, antibiotics and Domestos, or whatever it is the nurse dripped into the tube opening in my neck.

Then dear old Dolly drove down from Essex to pay her respects. It was a brave effort because she hasn’t been anywhere for years and only once before to France, in the 1970s to pick grapes. She arrived at midday and immediately piled into the wine. The day was pleasantly warm enough to sit outside on the terrace. I started her off on a Louis Latour Domaine de Valmoissine pinot noir and asked her what she thought of it. ‘It’s a nightingale by still water, Jel,’ she said, knocking it back in one. Dolly is exactly the sort of person advertisers are targeting when they add a click button peremptorily ordering you to ‘Shop now!’.

Sometimes, when the weather is fine, Treena calls up the stairs: ‘Why don’t you sit out on the terrace and get a bit of sun?’ Our little terrace faces nearly due south over the village pantiles and a succession of forested ridges as far as the littoral mountain range. It’s a sheltered, sunny spot with a great view. First-time visitors gasp and reel and whip out their phones when they go out through the kitchen door and clap eyes on it. At this time of the year, the burnished yellow of the plane trees adds variety and interest. But before I came here to France I lived on the south Devon coast and I’m an acute and severe critic of views. One might say that, lacking a winding river or a glittering seascape, it’s a bit monotonous. I give it an eight out of ten.

The sunny, growing month of November is the British expat’s Provençal dividend. Every morning the meridional sunshine comes in through the left-hand bedroom window, lighting my face as I sit up in bed with the breakfast tray and the daily paper. By 11 o’clock it has moved across to the right-hand window, warming the blanket and the dry soles of my bare feet. On the bedside table is the heavy brass base of a first world war French 75 artillery shell. Even on a November morning the brass heats up until it is hot to the touch. I use the shell base as a handy pot in which I keep my daily foils of morphine and paracetamol. The empty foils I let fall into my bedside bin, a 1944 US 105mm brass artillery shell case, bought at a local car-boot sale.