Cell Out

First, Sylvie.

An hour ago my cat Sylvie was yowling in discomfort and confusion, but now she looks positively regal. She crosses her paws—one shaved to accommodate the IV through which the vet will inject a lethal overdose of anesthetic—and stares serenely into the middle distance.

Meanwhile, I’m a blubbering wreck. I’m sobbing my way through an entire box of tissues. I totally lose it. “What’s your date of birth?” asks a nurse who’s filling out forms.

I freeze. What do they want to know that for? Has my wife—cursed with a cancered cat and a cancered husband—secretly arranged a two-for-one deal?

Now, Me.

This is a story about dignity. I used to think I knew exactly how I’d respond in moments like these. I’d be like Cary Grant in His Girl Friday: Pithy, sophisticated, dryly witty and unflappably handsome. But, in fact, every time I’ve faced real-life drama I’ve been more like Ben Stiller at the end of There’s Something About Mary: running down the road screaming, flapping my arms, blubbing like a baby. Which is what I’m doing now.

Regal Sylvie is disgusted—even as the drugs take her down, she refuses to make eye contact. I think, “When I go, I’m going out like Sylvie.” But the truth is you don’t get to decide. Death isn’t like that. Most of us die lying in our own shit and crying for our mommies.

“Anyhoo, it’s malignant,” says the doctor to the cancer patient in the cartoon on the wall of the cancer doctor’s office. The horribly informal word strips away the patient’s last shred of dignity.

Ordinarily that’s funny, unless you’ve just been told—for the second time in less than three years—that you have cancer. Then it’s fucking hilarious.

This particular cancer doctor has festooned his walls with framed magazine covers that roar AMERICA’S TOP 100 DOCTORS. In England such a display would be considered frightfully immodest. In Philly it’d be considered a tad gauche. But in look-at-me-everybody New York it kinda looks cool. Dignity is a moveable feast.

Three years ago I was diagnosed with Hodgkins lymphoma. I did chemo and suffered an allergic reaction that nearly killed me. I wrote a story for PW about it. Shortly afterward a neighbor in my Mount Airy apartment block accosted me in the laundry room.

“I was really amazed you could write a story like that,” she said. “I mean, you English—you’re so aloof … ”

I went into remission—and then spent ages with various straight-outta-Alien super-long-necked, hi-tech mini- plumbing-robots probing my drugged-to-fuck innards trying to find the cause of an entirely new set of nasty symptoms (including, but not limited to, puking, shitting through a needle and stomach pain).

In June 2008 I was diagnosed with celiac disease—a wheat allergy gig. I cut flour and cake and croissants and (sob) the crusty baguettes from La Colombe on Manayunk High Street from my diet and spent hours interrogating waiters and shop staff about their food preparation procedures.

I became one of those insufferable, sniffy, subhuman asswipes who pisses everybody off by asking the deli counter guy to please change his gloves. I’m now a member of that species of prissy, nit- picking, ingredients-reading, self-obsessed bastards who always got on my nerves. I’m a cousin to the loathsome vegan, the tedious vegetarian and the religious nut job.

In short, I’m a full-blown fussy eater.

On this new diet the vomiting and the shitting through the needle ceased, but the stomach pain just grew. More sexy, sinuous, stainless steel snakebots were sent slithering down my throat and up my anus; snipping chunks out of my slimy guts.

Then on Thurs., Jan. 29, 2009, I got a phone call from my gastroenterologist. He told me I’ve got a cancer called enteropathy-associated T-cell lymphoma— which only afflicts a small percentage of the small percentage of people who develop celiac disease. And as cancers go, it’s a bastard.

Anyhoo. I put the phone down and let out a huge, self-pitying “Why me?” The answer, of course, is the same as the answer to Travis’ shit-awful 1999 international breakthrough hit, “Why Does It Always Rain on Me?” Because you’re a fucking dick. Now shut the fuck up and grow a pair.

Who Goes First?

I used to have a small penis jutting out from just above my belly button. Right now there’s a cute little vagina. The tiny cock drained the blood and puss out of the infected 6-inch wound the surgeon made when he hacked open my upper abdomen and cut out about a yard of cancered intestine.

Now, with the plastic cock removed, I have to pack the wound three times a day with a gauze string, the tail of which dangles from the gash, looking for all the world like a weirdly misplaced tampon.

On Sat., Feb. 7, I enter the emergency room shivering savagely and positively glowing with a temperature of 106.

I’m called into triage the minute I complete registration. This visibly pisses some people off. One chap makes a show of standing about 4 feet away, arms folded, staring hard as he mutters “motherfucker.” He eventually walks off in disgust.

My wife has chosen a seat in the waiting room four chairs away from the pissed-off guy. I join her. Pissed-off guy leans back, stretches out his arms, cocks his finger and points at me, nudging and whispering to his friend. His friend sits hunched over, hood covering his face. He looks fucked-up.

This is my third visit to the ER in two weeks. Last time was chaos. Every seat full, ambulances turned away. People shouting. Groans of pain and frustration. This time the security guards are visibly twitchy.

“Where you from?” asks a white security guard, running my painkiller and book-packed backpack through the metal detector.

“England,” I say.

“So do you have blacks in England?” he asks.

Two and a half hours later a woman in scrubs attempts to calm things down. She explains that patients are being seen on a strictly observed needs-first basis.

A man a few seats away leaps to his feet.

“Bullshit!” he yells. “Some people go straight into treatment,” he says. “Others wait for hours.”

The woman in scrubs avoids eye contact, rapidly restates her case and gets the hell out.

A couple of weeks later, on the hospital’s website, I stumble across an article about a recent report that states: “Sick or injured African-American patients wait about an hour longer than patients of other races before being transferred to an inpatient hospital bed following emergency room visits.” What a surprise.

Back in the ER my brain has turned to mush after explaining my symptoms (it feels like weasels are gnawing my entrails) and my medications and my allergies and my ridiculously complicated recent medical history to what feels like the 30th fucking white-coated wazzock in a row. Don’t you bastards read each other’s notes? Isn’t this on a computer somewhere? I’m tempted to just make stuff up.

The first two times I go to the ER they send me home, clutching prescriptions. On Feb. 7, the day of the fever, they keep me in the hospital. Last time this happened I didn’t go home for weeks, and when I did it was as depressed, hollow-eyed, bearded, emaciated and swollen-bollocked human wreckage.

This is all starting to feel horribly familiar.

Mistakes are made

It’s Tuesday morning, Feb. 10, and I have been X-rayed, CT scanned and blood tested to hell and back. There’s a happy little sunbeam at the end of my bed. A baby doctor. A child with a white coat and a stethoscope. She says that the CT scan shows that the cancer is dead. And it also shows some air.

“What do you mean by air?”

“Air. The stuff you breathe,” she says, waving her hand.

“So dead tumor and air. What does this mean?”

“I don’t know.”

“Does it mean I can go home?”

“This morning, yes.”

“Wow,” says my roommate. “That’s fantastic.”

He’s a Christian. I really hope he hasn’t been praying for me. I would hate to have to be grateful to a nonexistent God.

I am giddy with joy. It’s a miracle! And suddenly there’s a whole gang of doctors at the bottom of the bed. My little ray of sunshine is at the back of the pack and she’s avoiding my eye. I get the horrible feeling I’m about to disappear down the rabbit hole.

The CT scan shows that the tumor has grown, says one of the doctors. You will not be discharged today.

Wait, what? The tumor has grown? I was just told it was dying.

Yes, well, it’s grown so big it’s necrotic. It’s dying at the edges.

Oh, whoopee. Thanks a bunch, Jesus. My little ray of sunshine—the kid who told me less than an hour ago that everything was tickety boo—shuffles her feet, her face ashen. Poor bugger.

But wait, there’s more.

At 11 a.m., my oncologist arrives and says that the CT scan reveals the threat of an “abdominal catastrophe,” namely a perforated bowel that could at any moment rip apart flooding my thorax with poisoned shit. Holy fuck.

The following morning I’m wheeled into a surgical ward and then into surgery where I have an interesting conversation with a 12-year-old anesthetist about the horse tranquilizer (and top disco drug) Ketamine and especially its relation to the new British dance craze, wonKy (a sort of mutated dub-step).

Then he sticks me with the super-K and a ton of other lovely drugs and my stunningly skillful surgeon slices me open and spends five hours—five hours!—cutting out malignant chunks of my cancered-to-fuck shit-tubes and then stitching the healthy bits back together.

I love anesthetic. It’s like suicide with a round-trip ticket.

“Fuck Cancer” and Other Homilies

By Thurs., Feb. 19, I’m getting crabby. Still feeble as a newborn lamb, a doctor leans in close and shouts: “HOW IS YOUR BREATHING, MR. WELLS?”

“My hearing is fine,”

“NO, YOUR BREATHING!”

“I am neither senile or deaf,” I say.

“Oh. I thought you were asleep,” she says.

Hospitals hate sleep. After a night in which you’ve been rudely ripped out of your every Temazepam-addled drug dream by some fucker’s IV alarm going off, or some utter bastard wanting to prick your thumb or take your blood pressure or stab you violently in the thigh with a syringe the size of a space rocket—every morning at 7 on the dot, in trot the junior surgeons who turn on the retina-raping top light and start shouting.

I’m going a little stir crazy. My wife and a nurse discuss my case across my still-breathing body.

“For fuck’s sake, I am actually still fucking here!” I roar.

A friend brings in a homemade needlepoint.

“Wait, does that say what I think it says?” gasps a nurse.

It says “FUCK CANCER,” a slogan popularized on T-shirts and baseball hats by Hodgkins lymphoma survivor Steve Saltman, a dude who knows that subtlety is found in the dictionary between shit and syphilis.

The “FUCK CANCER” phemon has its critics, but you know what? Fuck them, too, especially when so much of the rest of the cancer-culture crap is mumbo-jumbaloid spiritual sewage, like the book Chicken Soup for the Cancer Survivor’s Soul. It seems every touchy-feely Christian fruitcake and magic crystal-clutching New Age ning-nang-nonger who’s ever survived cancer has written a book about it. It almost makes you sorry for the poor little cancers, having to share body space with such total flaming idiots.

The oncologist gets the biopsy report. There’s still a ton of cancer left inside. So we’ll probably have to do chemo. And maybe even a bone marrow transplant.

The good news is I’m healing well. I’ve even had a small rabbit-sized bowel movements and a coupla lady farts. They’re sending me home.

I wash. I get dressed. I’m just about to put my shoes on. And suddenly I’m pinned to the bed with brutal shivering. Oh, for fuck’s sake. This is very like what happened last time: me shivering like a shaved parrot on an ice floe; me telling my wife and assorted doctors and nurses to fuck off and let me sleep. Them rushing me down to Intensive Care where they carve holes in my flesh and pump in fluids to try and boost my flatlining blood pressure.

Smelling death in the air with a nose as sensitive as that of any hyena, a chaplain turns up. For months now I’ve been telling the hospital I’m an atheist, specifically to keep these vampires at bay. And for months now—for some bizarre reason—the hospital computer has insisted I’m Orthodox Jewish.

“Can I help?” says the chaplain.

“He’s an atheist,” says my wife.

“Oh, really? I’m a Buddhist,” says the chaplain.

“His blood pressure is dropping,” says my wife.

“Oh, really? I had low blood pressure. I found breathing helped. Tell him to breathe.”

The waiting rooms are well supplied with God propaganda full of lies like: “Prayer sometimes produces miraculous cures.”

How to strip a human of their dignity: Wait until they’re at their very lowest ebb and then suggest that they beg a psychotic sky-god for mercy.

Diarrhea of a Madman

Around 11 a.m. the next day they finally stabilize me.

The superpoo starts at noon. Having not had a proper crap for a week, I now turn into a one-man shit volcano, pumping out great boiling geysers of liquid dung every 20 minutes. After having crapped the bed a couple of times, I try to use the commode. This is a total disaster. Wired up to a half-dozen drips, I get shit all down my legs just hobbling over to sit on the damn thing. It takes me a full 20 minutes to wipe my unbelievably shitty arse. By which time of course the chocolate Krakatoa is ready for its next eruption.

Eventually I work out a routine. At the first stirring of a bowel movement I politely request any visitors to get the fuck out.

Then I maneuver the at-hand rubberized bedpan under my aching arse. Then I call for the nurse, who sorts me out with some damp towels and a dab of moisturizer. I have a deal with the nurses: They pretend I haven’t just shat the bed like a giant emaciated idiot baby, and I pretend they don’t have to wipe my arse for a living.

“You have beautiful eyes,” says one nurse, having just wiped my bottom for the eighth time that afternoon. She also says I’m the least sick person in the surgical ICU. There’s a 16-year-old kid down the corridor—my wife tells me—with a probably near fatal gunshot wound to the face. His family—some Christian, some Muslim—have filled the waiting room with their grief.

Turns out my special combination of the shakes, the shits, the ripped out and repackaged guts, the exotic cancer, the mystery infection (they never find out what it is) and the celiac disease don’t mean dick around here. One nurse tells me that when the Pentagon scrambled emergency MASH units together in Iraq during the insurgency, they recruited straight out of Philadelphia’s hospitals. These people are hardcore.

Planning An Exit

My definition of dignity is undergoing a severe readjustment. I have a dead male relative of the late Victorian vintage who, toward the end of his life, could no longer bathe himself. So he closed his eyes and held his arms out and sang whatever song came into his head—“Rock of Ages” or “Yes, We Have No Bananas”—the volume noticeably increasing every time the nurse with the soap got anywhere near his nadgers.

We are a culture that has been running screaming from our own spurting sphincters for generations, as summed up by that ridiculous euphemism “bathroom tissue.” Shit and death are to us what sex was to the Victorians. And talking of death:

“One in five patients who have this procedure don’t leave the hospital,” says a doctor, talking about a type of bone marrow transplant.

I stare at her, horrified. I have been here nearly two weeks now. I am depressed to hell and back and desperate to go home.

“They never leave the hospital?” I gasp, horrified, imagining secret, hidden, underground wards where patients stay for decades, never escaping the bedpans, the catheters, the drips and the fucking awful food. “You keep them here forever?”

“No, she means they die,” says my wife.

I have already planned my own funeral. I will sit up in the coffin, sporting a huge embalmed grin, my right hand waving with animatronic enthusiasm as my left hand furiously pumps an embalmed and cosmetically enlarged erection.

And as the conveyor belt drags me into the crematorium flames, Glen Miller’s “In the Mood” will blare out of hidden speakers (as actually happened at the funeral of Peter Sellers).

On hearing this plan my wife calls me a melodramatic twat.

“You’re out of here tomorrow,” says a nurse. “Or maybe today if someone gets shot. But hey, Saturday night in Philadelphia, what are the odds?”

I have a bedpan to my right, a vomiting bowl to the left; I am securely wrapped in three blankets. The IV drug button is within easy reach. There’s a tube up my cock so I don’t even have to move to piss. It doesn’t get any better than this.

Plus I’m having awesome half-awake hallucinations. Like the one where I’m an Orthodox Jewish rabbi and I carry out a full-scale Passion of the Christ-style Stations of the Cross reenactment on the borders of Catholic areas, just to piss people off.

They move me. In this new ward I have my very own gunshot-to-the face victim in the bed next door and a great view of what appears to be an utterly dysfunctional extended family alternately hugging, punching, slapping, abusing, mocking, throwing babies at and consoling each other in the visitors’ waiting room across the courtyard.

The dude in the bed next to me speaks through a shattered jaw, a fog of drugs and what must be incredible pain. He tells me he dreams he’s on the dance floor of New York’s era-defining ’70s disco Studio 54, strutting his funky stuff to Philly soul classics. The cops never found the bullet. He reckons he must have spit it out, “like Mighty Mouse.” The guy has so many friends and so much family, every visiting session turns into a party.

By the time this paper hits the streets I’m sure to be getting more treatment—my dignity intact (if totally redefined), my aloofness totally shattered. I’ve spent much of the time in between seeing specialists. One of them said: “Cancer is just cells that have forgotten how to die.”

How cute. According to some scientists, humans might be mere decades away from achieving some form of immortality. Meantime, we’ve given so many diseases a damn good kicking that cancer’s become the biggest bomb in death’s utility belt.

Which is maybe just as well. Can you imagine the damage we’d do to this planet if we became the species that forgot how to die? Go cancer. Kill humans. Yay. Just not me or anybody I (or you) know, at least not yet.

Okay, you fucked-up little mutant?

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