I make a mental note: Extreme fatigue. For the last four years, since an apologetic registrar told me I had a cancer called extranodal MALT lymphoma, I’ve been studying my body as a marine biologist would a microorganism in the lab. And each time I record something new, or different, the same little gape of fear opens in my pelvis.
The cancer was classed as low-grade at first, so low they said there would be ‘no clinical advantage’ to treating me. At the time Leo and I were three years into trying to get pregnant, and had just started an IVF cycle. My cancer team were happy for us to carry on with the fertility treatment; they’d review in a year if we still hadn’t conceived.
I trusted them when they said there was no reason to treat me yet. That it could be years before chemo became necessary, that quarterly chest X-rays would pick up any changes in plenty of time – but the fear was still like a stun-bolt to the brain. I felt cognitively disjointed, untethered.
Thoughts and desires I’d believed long dormant started to ambush me. I lay awake at night, full of wild imaginings and regrets about my university days; my twenties.
And of course about him.
I started having vivid, photo-real dreams about us meeting, the feel of his skin, the smell of his hair. And so, when the thought came to mind – I want to call – I didn’t immediately dismiss it.
It kept coming back. I need him to know I’m ill. I need to see him.
A few days after the diagnosis, I caved and made the phone call.
The first two meetings were in a hotel, miles from London, the third, a greasy spoon near Oxford Circus. I quivered in a smog of need and the fertility hormones I was injecting myself with every day. Each time, I told myself this was OK; that nobody could get hurt. It was, simply, the continuation of a conversation that had been going on for nineteen years. But of course it wasn’t OK. There was no solution that didn’t involve the destruction of a family.
In the end, I agreed to break off contact yet again.
Six weeks later, I held a positive pregnancy test in my hand. I showed it to Leo and neither of us knew what to say. The next day I did another test, and then another, and another, until it occurred to me that the tests weren’t wrong. It’s hard enough to contemplate the circle of life when you have been trying for years to get pregnant without success, but when you’re looking through the prism of cancer, it’s near-impossible.
That was four years ago. The beginning of Ruby.
The disease remained static through my pregnancy and the war of early motherhood. My chest X-rays kept coming back clear, and everything else was normal. Leo and I were so busy trying to keep a small child alive, we frequently forgot I had blood cancer.
But it couldn’t last forever. Last year, when Ruby was two and a half, I started losing weight and having stomach pains. After a gastric bleed they scanned me, and a few days later I was shown a picture of a malignant ulcer lurking in my stomach.
‘It’s progressed, I’m afraid,’ Dr Moru, my haematologist, told me, his usual smile absent. Apparently I now had an aggressive kind of non-Hodgkin lymphoma and was to begin treatment without any delay.
‘We’ve been trying for a second child,’ I began, but he held up a hand.
‘You can think about that when you’re not staring death in the face.’
He’s not normally a stern man.
Now, several months later, treatment finally completed and remission prayed for, it’s the fatigue that frightens me most. The deep pull of it, the still darkness below.
Perhaps I’m not a survivor.
Leo locks up the shed and we walk slowly to the back door. The grass is sodden underfoot, even though it hasn’t rained for days. Daybreak must be close.
Once in our kitchen we close the door against the perfume of our night garden, and Leo throws his emergency cigarettes in the bin.