My Year with Bluestone: Friday House Day (5). Stone, water, cancer

That's the first day since I began this project that I didn't blog on a weekday. Oh well. I broke my own rule. But you know what? That's ok.  I'm on the point of completing an essay on another project altogether — what happens to glass objects when they are re-formed by intense fire — and writing time seems immensely precious. I do have a deadline for that essay (oh: it's today!) and I am also keen to get started on the next one, which is about the way Middle English texts register changing facial expressions.

But still, here's my Friday (yesterday) post about the bluestone in my garden, and it's a reflection on work and health. The gardeners were very excited about the bluestone slabs they used here, because there are so few lines and whorls in them.

You can also see the grey of the clouds and one big plop of rain that just landed: it's a still, grey and oppressive morning here. Sometimes we get out and wash the bluestone: it's a little dusty and grimy today as it hasn't rained for a while and there has been lots of summer traffic in the garden.

The builders were also excited about the fall of water over the ledge. They said it's surprisingly hard to get a good fall. It doesn't look all that regular to me now, and it's trickling rather than pouring on the right side. It's quite possible there has been some movement in the ground or the stone.



I love the sound of the water; I love to feed the goldfish; and I love to see the different things that fall in the water at different times of the year: blossom, elm seeds, gingko leaves from the neighbours' tree, little springs of the lemon-scented gum. The first big dig in this garden took place around June 2006. Six months later I was just about finished my radiotherapy treatment for breast cancer. It was a hot summer, but it was always very restful to come and sit in this garden and by this water. I always think it's where I got better.

Six Years Down

It is six years, almost to the day, since I went under the knife. I have just had my annual mammogram, ultrasound and review with my wonderful surgeon. I wrote about Suzanne a lot in the first months (here, here and here, especially) : she was a revelation to me, about how a brilliant technician could also be a calm, intelligent leader in the workplace. From my various encounters this morning, it's clear her staff adore her as much as I do.

What's the upshot, then, six years down the track?

• No sign of recurrence
• No swelling in arm (lymphoedema)
• No desire for reconstructive surgery (Suzanne asks each year, but I'm not at all ashamed of my scar and the deep indentation along one side of one breast)
• Some residual pain (from radiotherapy: it will be lifelong, but I'm now under instruction not to  use the really heavy weights at the gym)
• Bone density normal
• Menopause ...
• No medications (nothing; currently not taking anything of any kind; no vitamins; nothing)
• Weight under control (obesity is an indicator for breast cancer)
• Reduced alcohol consumption (alcohol is a BIG indicator for breast cancer)
• Some residual feeling that powers of concentration aren't what they were, but a gradual realisation that this might be picking up now I am no longer taking tamoxifen
• Reminder of sense that I am glad I did not have to go through chemotherapy or mastectomy (both of which have very long recovery times and difficult after-effects)

So all in all, I reckon that's about as good as it gets. I am very conscious that compared to many women I have got off relatively lightly, and also received (and been able to pay for) consistently superlative and compassionate health care. 

Last night I was talking with a friend who'd had a much rarer, more difficult blood cancer. We agreed that everytime you go in for these tests you kind of hold your breath for the day before. I guess eventually it gets easier. For me the five year mark last year was really important as it meant the end of the daily tablets and the monthly injections. This one seems to mark the beginning of a new phase, as every year out I am absorbed back into the general population with only an average risk of breast cancer.

So good am I feeling about this, and so much am I enjoying blogging again, I am even going to change my profile text in the next day or so.

Cheers!!

Five Years Down

Five years ago, when this blog was only a few months old, it underwent a dramatic transformation from a blog about applying for grants, to become a blog about breast cancer and its affects on body and mind. Those first cancer posts, here, here, here and here, seem now to me exercises in controlled drama. And then, indeed, the main issue was how to get through the next day's treatment.

This morning I had my fifth annual mammogram and ultrasound, and consultation with the wonderful Suzanne. All is clear. This is a huge milestone in the life of a breast cancer patient. If you can get through this period without recurrence, your chances of such are now dramatically reduced, not that much higher than a woman your age with similar weight, family history, etc. etc.

There is still some treatment to go. I don't see the oncologist, who is charge of my medications, till next month, but by the end of the year I will have stopped having my monthly injections, and will probably go off the tamoxifen, and possibly not have to shift to anything else.

So how do I feel? What I have learned? How am I?

I'm fitter than I have ever been, through a program of walking and going to the gym. But I also weigh more than I ever have in the past. I can't help feeling, too, that my brain doesn't work as well as it used to. I've heard women talk of a mental cloud that sits over them during menopause and/or tamoxifen treatment. I certainly know my concentration span is not what it used to be. I am sincerely hoping this cloud might lift in a couple of months when I stop treatment (and it would be nice to see a few kilos magically disappear, though I think that's unlikely). But I haven't experienced the mood swings that many report. A little depression, on occasion, but nothing too bad. And I was able to finish my book on the Order of the Garter, for better or worse, and keep on churning out essays and articles, enough to satisfy the bean counters.

In the first year or two, I thought I was learning things like how to slow down, how to meditate and live in the moment. Well, I think I've always been quite good at the latter, but that 'moment' over the last few years has too often been tinged with sadness and distress at things in the workplace. But I have finally learned to pace myself a bit better, I think. I remember, twenty years ago, with a horrible cough and bronchitis and asthma, I kept teaching a three-hour class till I could hardly breathe at all. This time, with a similar mix of symptoms, I cancelled a weekend conference, and have just cancelled a talk in the department on Wednesday. Since I can hardly put two sentences together without sounding like Violetta, this seems sensible.

But the main thing, I guess, is learning to take the pressure off myself, a little. Even expecting oneself to stay fit and calm, to exercise properly, to mediate, to learn one's cancer lesson -- these can all seem like further imperatives in a life that is already nothing if not dutiful.

Even without having to finish and deliver two papers, there is still an alarming "to do" list on my desk. I was moaning about the bureaucracy of the university to my surgeon and the nurse who was taking notes this morning, and they were horrified to learn I did not have a PA or a secretary. Heh heh.

Anyway, this is such a momentous day, I may even alter my Blogger profile, just as soon as I have stepped outside into the sun.

Christmas, St Agnes and Hypatia

About four years ago, I blogged about making Christmas puddings with my father, because I was too sick to stand and cut and grate and chop and mix and beat and stir. Two years ago, I blogged about feeling much better, and being able to do it on my own. This year, I'm a little late in making them, but am hoping a liberal extra dose of St Agnes's finest will make up for this in flavour.

Each year we stir and make a wish. And while a wish is supposed to be secret, I'm writing to invite my readers to make a virtual pudding wish. The puddings are currently boiling and simmering away. It's too late to stir them, so it won't hurt if you add your wish in the comments box.  I'm hoping you might think about adding a word for my friend Hypatia, who is having breast surgery on Tuesday, rather sooner, and more radically, than either she or her oncologist had hoped for. She is such a fierce thinker, is Hypatia, and so keen to get back to work and be with her students and colleagues, but she has a few trials to undergo first. So I hope you might, in even just one word, wish her courage or health or strength or concentration or peace or calm: whatever you would wish for yourself should this ever come to you. And even if you don't want to log on or write anything, please spare her a thought or a wish or a prayer or a blessing.

I realised a moment ago the tremendous irony, serendipity or unconscious convergence in my mention of the not-particularly-special brandy, St Agnes's, that I used in the puddings, since many of the legends of St Agnes describe how this third-century Roman martyr had her breasts torn off with pincers before her eventual beheading. She is now the patron saint, among other things, of breast cancer patients.

I can't find a text on line, and don't have a copy at home, either, but I do recall the thrill of reading Lampedusa's account of the little St Agnes cakes —  white icing and red cherries? —  in The Leopard, too.

Well, it's just getting weird, now, so to bring you back up into my world, here and now, here's a clip of the fabulous Ben Winkelman trio. Ben here is playing keyboards, but we had the CD of him on piano and this track filling the house as we breakfasted and as I tied up my puddings. Ben gave Joel half a dozen lessons before he headed off to New York to make his fortune, so we think of him as ours, of course.

Check!

Annual mammogram is clear: check!
Annual ultrasound is clear: check!
Annual physical exam is clear: check!
Annual interview with the goddess: brief, but clear! Check!

It's not that I was really worried: apart from a cold, I'm fit as a fiddle. But so I was when I first discovered the tell-tale dimple in the bathroom of the Chase Park Plaza Hotel in St Louis during a meeting of the NCS congress committee, almost exactly four years ago. So the possibility of a nasty surprise is always in the back of my mind. But as the years and treatment go on, it seems less and less likely I'm up for any kind of recurrence. I've just ridden home from this very reassuring set of appointments. I've also just ridden home again from the clinic wher I found, just where I parked my bike the first time, the hand-made copper earring Paul brought me from Lebanon, which must have slipped out of my ear when I was putting my helmet back on. All these things, on top of a gym session which included a lot of running this morning, have left me feeling extremely fit and healthy and pleased with myself today.

Searching back for that post about my surgeon, I also found this one about elementary meditation; a practice I have let go, rather. I feel I am moving too fast at the moment (the books I'm writing; the committees I'm attending; the plans I'm making) for such a slow activity. But of course, that's probably a sign I should think again about doing something slowly.

A quick word from Hypatia

Many thanks to all who've contributed suggestions to Hypatia's reading and listening list. She has emailed to say how grateful she is to everyone — "moved and cheered", she says. And she'll keep checking back, so if you think of anything else, please add it in.

She also says she is very happy for you to picture her as Rachel Weisz, though I must admit this film passed me by completely:

Advertising spam

I'm getting a bit of junk coming through my comments box lately. Something to do, perhaps, with the mention of cancer sending out a kind of alert to all the many websites selling pain relief or alternative cures....  I'm not ready to change my policy on comments, yet, but if you see traces of comments that have deleted by the blog administrator, it's because they are of the generic "I like this post and thought I'd leave a comment but don't know what to say" variety, usually featuring a link to a website that says if you take a special vitamin supplement you won't get cancer. Nothing more sinister than that; but nothing conducive to the friendly interchange of ideas and thoughts amongst human beings, either.

It ain't over till it's over

So you have the surgery; and the radiotherapy (and if you're lucky, like me, you avoid the chemotherapy). And then you start the five years' hormone therapy. Apart from the obvious trauma and shock to the system of instant onset of menopause (that lace fan I bought in Venice in September is getting a good work-out this summer), and an abiding suspicion that you don't think or concentrate as well as you used to, you're going ok. But then, after a visit to doctor and gynaecologist, you remember that long list of possible side-effects of tamoxifen.

I'm sitting up in bed at home, recovering from a general anaesthetic, yesterday, for a hysteroscopy to remove uterine polyps that grow under the influence of tamoxifen. So far, everything looks benign: just one more pathology report to go. At once stage Deborah, my lovely gynaecologist, was talking about endometrial cancer and a hysterectomy and chemotherapy and the whole works, but it seems I have got off lightly. Though with two more years of tamoxifen to go; and the way it seems to stay in the system, chances seem high I may have to go through this process again over the next few years.

It seems a little harder to blog about this than having breast cancer, and I wasn't sure I would. But I'm too groggy to do any work today, and am not really feeling strong enough to get out of bed. It involves rather more intimate body parts, too, I suppose: my "lady bits", as I think Ampersand Duck or Pavlov's Cat refer to them. I can remember being a bit appalled when still at school by a girlfriend who referred coyly to her mother's hospitalisation for "women's troubles." Though that's exactly what it is.

And also, my goodness, are heads of programs supposed to be blogging about their intimate bodies? Will having this administrative responsibility change the way I blog?

Yet again, I found myself fascinated by my surgeon and the entirely female team who attended me yesterday, with the exception of the orderly who wheeled me into surgery. Where Suzanne, the breast surgeon, is goddess-like in her attentiveness and authority, Deborah is equally direct and focussed, but a bit closer to the other side of the austerity—warmth spectrum. I was very sorry when she came round to visit me when I was back in the ward, to tell me that everything was looking fine, because I couldn't hold an intelligent conversation with her. For two or so hours, I would start to weep and feel I was about to black out, every time I opened my eyes. I can remember, similarly, waking up from breast surgery and sobbing. It's an acute form of the depressive affect of the general anaesthetic, but it's an object lesson in forms of chemical or hormonal depression that last longer: you know precisely what's causing it; and yet you can't stop feeling terrible.

I'm feeling much better today, though my lungs seem very heavy, and my legs and arms feel weak, so I still haven't got out of bed. I'll get up later, for the joyous resumption of our Friday night ritual with our mirror family (two academic parents; one girlchild Joel's age), back home after their sabbatical in Oxford.

I'm supposed to start Italian class again tomorrow morning: I'm going to load up one of the CDs and do some revision while I doze...

How to Become a Saint. Australian Medievalism #456

Some circles in Australia have become awfully excited about the prospect of our first saint, and it seems the final condition has now been met, with the declaration of Mary McKillop's second miracle (it takes two, apparently). The first was a cure from leukemia in 1961; now a woman in the Hunter Valley's prayers to Mother Mary have been certified as curing her cancer in the mid 90s. The report says, "The approved miracle ... had to be scientifically and theologically assessed before it was decreed by the Vatican." An announcement of her sanctity is expected from the Vatican next year.

I would have liked to hear a little more about this assessment process. Was it a joint committee? Did the same conditions have to be met by each body of experts? Apparently the woman in question does not yet wish to be identified. So her testimony has been taken over by the professionals, institutionalised and certified, and lifted out of the possibility of personal witness.

I guess this is similar to the medieval process, where miracles similarly had to be declared or authenticated by the church. I don't know enough to know if doctors were involved then as well. But I'm pretty sure that witnesses didn't often have, or want, the option of anonymity.

Mary's intercession apparently also played an important role in the recent successful separation of conjoined twins Trishna and Krishna in Melbourne, the survival of burns and car crash toddler Sophie Delezio, and the awakening from his seven-month coma of David Keohane, the Irish backpacker who was assaulted in Sydney. So that's good to know...

She was also known as an educator, establishing her first school in Penola, South Australia. I've been there twice: most recently on a road trip with some medievalists (some Catholic, some not). The Mary McKillop centre did seem, indeed, as if it was in suspension, just waiting for some news... My companions and I walked carefully through the question of religion: it can be a sensitive issue for medievalists.

But here's a funny section from the report in The Age:

Former Pentridge Prison chaplain Father Peter Norden said he was ''very pleased and happy to celebrate the fact that recognition is given for Mary, that it's a woman chosen for sainthood." ... "Even though many would view nuns as creatures of the past, we see the earnest goodness in the way in which she lived and dealt with adversity and met challenges,'' he said.

Well, Mother Mary died in 1909, so yes, she was indeed a "creature" of the past, though I suspect Father Norden really means something more like "medieval", or "not-modern" here. Do others find a bit of a back-hander here, though? He's pleased that it's a woman who's been chosen, but nuns — creatures — belong in the past? A little unconscious condescension here, I can't help but feel.

Update: Helen's sent me this photo, taken a few kilometres away up near St Vincent's in Brunswick St. So she's really a local Fitzroy saint as well...

Another all-clear

The research assistant on the clinical trial, the nurse and the surgeon all said to me this morning, "it's going quickly, isn't it?" Yes, it's the third anniversary of my surgery for early stage breast cancer, and this morning I sailed through the annual mammogram, ultrasound and examination with Suzanne with flying colours. It was good to see the very reassuring initials NAD (nothing abnormal detected) going onto my files and x-ray reports.

But is it going quickly? Not really. Not when you examine every day closely as it goes by, as I do these days. This doesn't mean I always make the best use of a day: I rarely feel that. But I certainly do notice them as they pass.

One of the lovely things for me about this practice is the sense of these teams of women working so well together (surgeons, nurses, radiologists, receptionists, researchers). I did see Mitchell, my oncologist, striding into the waiting room to meet a woman wearing a long scarf — I think they adminster the chemotherapy in this clinic, too — but everyone who attended me today was a woman. It's peaceful there. No televisions, no piped music, just magazines, comfortable couches and white towelling robes to wear while you wait. Women come and go, and although there's always a level of anxiety on our faces, it's calm. We are being attended by kindly, efficient and skilled women who know exactly what they are doing, how best to manage our visit and our health. For a place that is closely associated with a deadly disease, it's remarkably serene.

Anniversaries, revolution and mortality

You know, I didn't really notice the date when I began this blog three years ago, but I do remember Jeffrey noticing I had chosen Bastille Day on which to begin. I was reminded of this just now when Richard Stubbs was speaking on the radio with someone from Alliance Française about learning another language, and the big debate in Australia now about whether we should learn European or Asian languages. Given that so few students learn a language at all, I would have thought we had little to be picky about here, but that's another story. Anyway, how proud am I that I could understand all of Kathleen's comment on my post about Italian classes (and a good deal of the grammar, too), and also the email my sister, who is enviably fluent in a number of European languages, sent me in Italian. I do think the reading is going to be easier for me than the speaking, but then since I'm doing this in part to enhance my reading of Petrarch, Dante and Boccaccio, that's probably ok.

Richard was also inviting talkback on the various revolutions you've enacted in your life. I didn't stay to listen because I've just made a very scary phonecall about a piano, and because I wanted to come in here to post. But if I think back to where I was three years ago, it's timely, perhaps, to think whether cancer revolutionised me.

Yes. And no.

In some ways, I think the biggest change for me over that time has been my progressive disenchantment from my workplace. Not that I've done anything about this, so I can't call it a revolution. I still work just as hard for it, and in its interests, as I used to, but falling out of love with my university has made a substantial change to the way I see myself and my working future. Not a revolution, then, so much as a re-adjustment.

The pointy end of my dealings with cancer has passed, of course, and on paper, my prognosis just gets better and better. Even so — and maybe it's just a sign of middle age, now — for the last few weeks, I have been regularly waking in the middle of the night and pondering mortality in a way I never used to before. And even sometimes during the day, too. Partly this is book-writing anxiety, but I find I have to work hard, some days, to remind myself it's not too late to learn a new language, to finish current projects and start new ones, and to have faith in the future. Though the poor planet, if it were sentient, would surely be waking at night with worry, too.

D'ailleurs, Joyeux anniversaire, mon cher blog.

Hard Times for Breast Cancer Survivors

I know there's a lot of dispute about the term "survivor" for anyone who's had cancer and is still alive. But when you read about two women, roughly your own age, who've died of breast cancer in the last week, it can be a bit tough; and you do feel like a survivor, with all the resultant complexities. Not guilt, exactly, but certainly a shiver that barely separates you and your own excellent prognosis from them and their much harder stories.

And when they are famous, there's a lot to read about them: pictures of them, their children, and reminders of their public achievements.

I think a lot of Australian women thrilled at Kerryn McCann's marathon victories, especially those with children who saw an elite athlete just powering on through with her inspirational running. She died last week at 41.

And yesterday, Dorothy Porter, a wonderful poet, also succumbed to breast cancer at the age of 54. I loved her work, and heard her read and speak a couple of times. Link to a beautiful photograph that I think is copyright-protected.

The only time I spent any different kind of time in her company was on the oak lawns in the Botanical Gardens in Melbourne, where she had invited a small group of people to celebrate the life of Gwen Harwood, who had died, also of breast cancer, a few months before. We each read our favourite poem. I read "Dialogue", an early poem addressed to a stillborn child.

If an angel came with one wish
I might say, deliver that child
who died before birth, into life.
Let me see what she might have become.
He would bring her into a room
fair skinned —— the bones of her hands
would press on my shoulderblades
in our long embrace

[She asks what brought the ghost to her; and the child replies...]

— It is none of these, but a rhythm
the bones of my fingers —— dactylic
rhetoric smashed from your memory.
Forget me again

I had never heard Gwen read this in public until I was interviewing her at the Melbourne Writers' Festival in 1992, when I was writing my book on her (you can download a full-text pdf from the e-print repository). She had agreed to do it over lunch, but all the same, had to pause, half-way through, and collect herself.

Ahhh. These women. This disease. These deaths.

Day After Breast Cancer Day

Well, I wasn't really worried, but I'm very glad, all the same, to report that there is no sign of anything alarming on mammogram or ultrasound, and that Suzanne has given me the all-clear. It's quite a business. The mammogram is somewhat more painful on the site of the scarring, and the ultrasound (sonogram) sensor presses in quite hard and insistently on and around the area of my surgery, so it's hard not to be reminded of the initial scan, just over two years ago, when the technician went over and over the same area without saying a word. I remember when I left the room, he had frozen the screen on this big black cloud in the middle. Even if it wasn't my tumour, I still had that image in mind till I saw my doctor the next day. But I was pretty sure it was cancer, anyway, from the discovery of the very first dimple.

But that was a different hospital. The breast unit where I have all my treatment is run by a series of ministering angels. Every single person who works there is wonderful. The first thing the radiologist said when she came in to do the scan was to say that the x-rays were clear. And once she had had a good look, she told me then, too, that the ultrasounds were clear too.

So by the time I saw Suzanne, I was calm, with my mind at ease. As usual, we talked first about what it meant to be in the world before we talked about my health. Or at least, we began with my saying how hard it was to be in the university sector at the moment. But we ended by agreeing that if you love the work you do, and have your health, it's important, and good, to focus on that work, not the extraneous things if you can help it. This reminds me to keep working away at the things I love best about my job, while I can still do it.

For the first time she raised the possibility of some reconstructive surgery, but my case is so marginal it's hard to imagine it being worth it. I honestly forget about my slight lopsidedness once I'm dressed. And if other people notice or mind, too bad!

Anyway, I'm calling that two years down, with three years to go of my current treatment regime. Hooray!!

And in fact, when I got to work, our Middle English reading group had planned a special lunchtime meeting, for timetabling reasons, and because we are reading Havelok, we had a Danish feast. We had a number of different cheeses, some fantastic fresh dark rye bread Andrew had driven miles to buy, homemade coleslaw, some liver paté, with chopped up bacon to sprinkle over the top, lots of smoked salmon, three (count them: three) different kinds of herrings (I've never eaten them, but started with some in a wonderful mustard sauce, and am now converted), and some crispbread. Plus strong coffee, rum balls and what we call Danish pastries. I asked Annemarie, our Danish admin. assistant, to come in and authenticate and taste our food. She was somewhat dismissive of our pastries, I'm afraid, but approved of the bread and herrings and cheese and salami.

I took some photos, but had the phone switched to take only tiny photos. Here they are, anway:

Breast Cancer Day

October 27 is Breast Cancer Day. It's also the eve of my second annual check-up. This time tomorrow I'll have had a mammogram, ultrasound, and meeting with my wonderful surgeon. In contrast to last year, when I was a little spooked about this (and didn't fully blog about it till several months later), I'm feeling perfectly confident. I'm doing pretty much every thing I'm supposed to do, and hardly ever doing the things I'm not supposed to do, and feel fit as a fiddle (apart from walking into a plate glass window on Saturday, and still feeling a bit wobbly).

Even so, I still have the sense of the day, today, as potentially the last day before the world could turn upside down again. If they find anything tomorrow, I'll be up for biopsy and surgery again, which would almost certainly be more aggressive than the first time. What would this do to the piles of things on my desk, waiting to be read, and the documents on my computer, waiting to be written? What effect would it have on my dear family and friends? And you can see, from that very first response, the extent to which I no longer see myself primarily as a cancer patient, as I did for the first year or so: I've come back to the world of imperatives and tasks. This is both a good thing and a bad thing, but either way, that's the way it is now.

I'll take a moment, even so, in a minute, to step outside and sit in the garden for twenty minutes, to feed the fish, and sit with Mima, and marvel at the smell of rain. We've had two showers this morning.

Breast Cancer October commercial pinkness still raises my hackles a bit, but not today, actually. Today I'm thinking of women who are at the pointy end of diagnosis and treatment, and hoping they'll feel as calm about the future as I do now, when they are two years down the track.

Update: Maybe I'm not as sanguine as I thought. I was in the supermarket earlier this evening, standing at the deli counter next to a woman who looked and sounded like a lovely woman who used to work in the Arts Faculty, and then in the Research Office, who died of breast cancer a year or so ago and who was, I heard, also a talented artist. Same big eyes, same lovely open face. A real haunting; or better, a memory. Rest in peace, Cassandra.

How this face-blindness thing works

Ok, so this is what happens.

I'm in the changing room on campus, about to head out to my weekly tennis game with Alison, Denise and Clara. I hear two women come in, and identify them from their voices as Denise and Alison. Two women come around the corner and I greet Denise cheerily and smile politely at the unknown woman. 'Oh!' I think, 'Denise has brought someone new to play with'. And then of course I realise it is Alison.

There are some reasons for this misrecognition, however. Before her chemotherapy, Alison used to have gorgeous long, shiny, straight dark red hair. After her hair fell out, she wore a wig that looked exactly like her hair, but for tennis she wore a little cap over her slowly re-growing hair. So I knew it had grown out curly, though no longer shiny dark red in colour. But she had, as she explained, 'come out' as a cancer patient, and was now wearing her curls clipped and coloured a beautiful pearly blonde, and so I did not recognise her, even though (a) I was expecting to see her; (b) I had heard her voice; and (c) I knew she had short curly hair. To cover my embarassment, I found myself explaining the concept of face-blindness. It was only a second or two of misrecognition, but it was obvious that I was greeting one woman as a friend and the other as a stranger. Awkward, especially as the attention should have been on Alison's new look, not my mild cognitive impairment.

Alison also told me one of her students complimented her on her hair, and said, 'Did you have that done for cancer?' Alison hadn't been particularly public about her illness, but thinking she was going to have to face lots of these queries, said, 'yes'. But then it became clear that the student thought Alison had cut or coloured her hair in support of cancer research.

And so we all go on, half-understanding each other, half-recognising each other, and only half thinking about other people.

The Hour of Our Death

When I "went public" with my cancer diagnosis in October 2006 on this blog; and when I wrote two "op-ed" pieces on cancer and blogging and the consumerism of the pink ribbon campaigns ("Shop for the Cure" -- urrghh) for the Sunday Age, I was unprepared for the correspondence that ensued.

My blog was only a few months old and was only just starting to expand beyond its intended readership, when I suddenly had to start thinking of myself as a sick person, when I became a somewhat different person from the woman who had begun the blog. Moreover, I don't think I fully understood the nature of blogging; or rather, the engagement with readers that would follow.

So in addition to comments on the blog, I received many letters, emails and phone messages, because of course I have never been a pseudonymous blogger, and am easy to find. Most people who made contact were very sympathetic. Some were less so, especially after my criticisms of the schmaltzy, sentimental marketing of unhealthy or infantilising products to women in the name of "breast cancer awareness".

Most were simply heartfelt messages, from people who were similarly struggling with cancer, or who had nursed partners who had died, or were living in fear of the disease with mothers or sisters who had been ill. I am by nature, I think, a person who finds it very easy to empathise with others, and so I found these stories very moving. But I also found that being ill had shaken me up completely, so that I had very little emotional strength, many days, to hold myself together.

Going back to work last year, re-appearing in public, was immensely difficult. There was only one day when I got as far as the car-park, sat there for ten minutes then drove home again, but there were many other days when I felt the same way.

So while I might have wanted to help others, I felt pretty much unable to do so.

One of the things about sickness is that one develops a very sensitive antenna to one's disease. You see it everywhere. And when that disease is a very common and highly publicised one, like breast cancer, the problem is magnified. So the death of people like Jane McGrath and Belinda Emmett strikes hard. And you know pretty clearly that other people with cancer will be feeling the same shudder, asking the same question of how much time we'll have left, and what will be the nature, and the hour of our death. And yes, even people like me, in (relatively) excellent health.

But today I heard of the death, earlier this month, of Graham, from another faculty at Melbourne. He had written to me after one of the pieces I wrote in The Age, and we exchanged a few emails. Graham was suddenly diagnosed with a brain tumour; and seemed to be doing ok, until he collapsed with another inoperable one. He wrote to me in April:

After a couple of days they moved me down to a general ward, as the risk of another seizure diminished, but I'll probably not be allowed to drive for the rest of my life. I'm currently having daily radiation therapy to my brain to try and slow these down a bit, but it looks like I have only months to go. This is upsetting, obviously, but I'm ok - I'm cherishing every day with my family, as much as they'll let me, you know how it is! ;-) I'm still enjoying a bit of work, you know, replanning the entire university's strategy, solving all the world's environmental problems, that sort of thing! ;-)

I'm going to fight this hard - I believe in benefits of faith, and have it by the truckload. Sometimes I get weak, and falter, but most of the time I'm strong. You know, its about being there for the kids, being strong for the kids, so they remember me that way. I don't want to falter too much in front of them - they need to learn something from this about life, but sometimes its inevitable to break down and look weak.

I never met this man, but his death reminds me that in addition to the high profile deaths around us, there are hundreds of people like Graham who face death with quiet dignity and courage, still teaching, even in their dying. I couldn't do anything for Graham. I could have made an effort and gone to visit him, but I didn't. There was an instant ease and camaraderie about our correspondence, an instant recognition, if you like, but there were also huge limits to what I felt I could do, by way of reaching out. Tonight, though, I'm holding his spirit here for a moment.

Mind, Matter, Nature: Paper, Scissors, Rock

On my walk this morning, I came to the spot where I regularly pause, and make a modest obeisance to the goddess, and breathe deeply and in the morning sun visualise any cancer cells being rinsed from my body and passing down the creek. As I approached the spot, I saw there was a little clump of brown mushrooms glistening in the sun.

Oh good! I first thought. Here's a sign that something is working: a kind of energy field I have tapped into, or produced (honestly, I'm not normally one who goes in for this kind of thing, but the radio was full of Jane McGrath and breast cancer and death, so I reckon I'm excused).

But then I thought. Oh no! This clump of mushrooms is almost exactly the same shape as the image of breast cancer cells I had also posted about. Was this an omen of a less positive kind?

But then I thought. Oh good! This means my meditations are working; as the cells have been expelled from my body.

What an elaborate mental game of paper, scissors, rock to play with oneself, reading and re-reading signs from nature in this way.

I also had a dream about Glenn McGrath last night: we were saving some dolphins, or discovering some new ones after another had died. Vague, shifting memory I can't fully recall now. Perhaps also coloured by anxiety about my child, now heading in to the ninth day of a horrible flu.

There's obviously something here about the power of celebrity death to cathect emotion. But I don't have time to process it further: just entering the chaos of the last week before going to England for three and a half weeks.

Our Sisters, Our Selves. R.I.P. Jane McGrath

Can't help but be moved by the death of Jane McGrath this week, after complications from surgery for secondary cancers. If it's easy, sometimes, to mock the WAGs of international football and cricketing stars, here was a woman who faced breast cancer and its ghastly aftermath with courage and grace.

When I was given my passport to the country of illness, it was inevitable to look around me and acknowledge my travelling companions. Over the months of waiting in doctor's rooms, I read more than enough trashy mags, but always poured over stories about Kylie, Belinda, Jane. Of course all these accounts are heavily mediated, but the McGrath story always moved me, because the two of them just seemed so matter-of-fact about it all. And it was fascinating to get a glimpse of the non-cricketing side of Glenn McGrath. Sports gossip says he has a tremendous temper, but there was no sign of it in their dignified accounts of their struggle. Jane McGrath was only 42 when she died, but she and her husband established a foundation which raises money, very practically, for specialist breast care nurses, especially in regional areas.

I shuddered when I first heard the news this afternoon, and when we were watching the tv news tonight, I had to hold in a little sob. She leaves behind a loving husband and two young children. Requiescat in pace.

It must be cancer season

Every day, it seems, there are more and more news reports about cancer and cancer treatments. Within the last week, Melbourne researchers have reported finding that a "positive attitude", while it might make the rigours of cancer treatment more bearable, has no impact on the spread of the disease.

Also, news of a possible screening test for ovarian cancer (women taking Tamoxifen have a higher risk of developing this cancer, which is hard to detect in its early stages).

There's been a reported drop in the number of breast cancer cases, coinciding with a drop in hormone therapy use for menopausal symptoms.

And today, news from a team of Canadian researchers at the American Society of Clinical Oncology conference linking vitamin D deficiencies to the more rapid spread of breast cancer.

That's four articles in four days, practically, all on breast cancer, and three out of four from Australian researchers. What an extraordinary amount of research into this disease — or perhaps it's just the disease that is regarded as newsworthy.

It's a bit hard to know how to respond to these developments. I'm grateful, of course, that such research has made my own outlook so good. For the record, I'm now in the twentieth month of a five year treatment plan. In five months I'll have my second annual mammogram and ultrasound, but I see my oncologist every three months and the general consensus is that I'm doing very well. I've cut down on my consumption of alcohol and processed meats; and generally improved my diet. I'm exercising regularly; and meditating occasionally; and trying to keep my stress levels down (though in the current climate at my university, about which I think I have been extraordinarily discreet on this blog, that is exceptionally difficult).

Many of these developments are coming too late for me, of course, though I've always liked the idea of getting a little vitamin D from the sun. Australians find it hard to balance the need for vitamin D against the need to guard against skin cancer, which is rife here.

My own prognosis is so good I'm not really at all on the lookout for alternative treatments or needing to hunt down the latest research. But I can imagine how people with more advanced cancers must greet this kind of research; and how people with much rarer conditions must despair at the uneven distribution of research funds.

At the very least, though, I now have a cancer antenna. People sometimes make a special point of telling me about their friends and relations who have cancer, though I'm still not always strong enough to doanything about this. But there is also a lovely solidarity amongst people I know with cancer. I feel closer, I think, than I would otherwise have done, to three friends in particular: Peter, Trish and Alison. And actually, special congratulations to Alison, who's just finished radiotherapy and chemotherapy, and who joined our Tuesday tennis group at work and played throughout her radiotherapy treatment. And to Trish (Crawford), too, a much-loved figure in early modern and women's history who was presented with a festschrift on just one of the fields in which she works at the Perth conference last week. Trish is an inspirational figure to many historians and feminist scholars, and was one of the first people to comment on an academic paper I gave (on Christine de Pisan, in 1985, I think). She's an inspiration to me now, for facing the difficulties of advanced breast cancer with courage and dignity and as clear an intellect as an academic scholar, or anyone, really, could wish.

Three Excruciatingly Personal Blog Entries, No.2

The trouble with the grand plan I have now announced twice (viz. writing three posts that push the limits of the personal) is twofold.

First, I find that those limits are mutable. After a few days, Excruciatingly Personal Blog Post No.1 came to seem far too personal, with the potential to involve other people’s emotions and senses of privacy. And so I deleted it. It was an interesting exercise, all the same. Meredith made a beautiful comment, to the effect that poems usually take much longer than blog entries to grow and develop, and by implication, to develop a sense of the readerly exchanges they might invite, and the emotional effects they might set off.

Second, the genre of the blog doesn't naturally lend itself to plans. I've been caught out many times planning a blog entry - even taking the photos for it - and then because I don't write it that day, feeling the moment has passed.

But in this case I do feel that my blog has been working towards this second of three posts, for some time now, and I think I'm ready. So here goes:

The Menopause Post

I have never been a purely cerebral thinker or writer. I'm always deeply conscious of my surroundings: light, temperature, sound, bodily disposition. I've never been good at working in cafes, for example. I notice everything around me; and I think it's both a strength and a weakness in the kind of work I do. But ever since I announced my cancer diagnosis and made the decision to keep on blogging, I have been even more conscious of the fact that I am writing, here, and other places as well, both as a body, and as a mortal being. So in fact, this will probably turn out to be a post about menopause and ageing, not just the former.

It's more than a year since I began the hormone therapy that will last five years in all. I'm being treated as part of a global clinical trial that is testing the side-effects and recurrence rates of cancer under drugs that are normally prescribed according to one's menopausal status, being used in a range of conditions. It will amuse many readers of this blog to know that it is called the "TEXT" trial. So while Tamoxifen is routinely given to pre-menopausal women, I'm being made post-menopausal by an additional regime of ovarian ablation: this takes the form of a monthly injection to suppress ovarian function and the production of estrogen. Tamoxifen works to "lock up" any breast cancer cells that might remain after surgery and radiotherapy, and to stop them feeding on estrogen: the Triptorelin injections suppress the production of estrogen. There are a number of different kinds of breast cancer: mine was of the slow-growing, estrogen-feeding kind.

So, while menopause usually involves the gradual diminution of estrogen, its onset in my case was very sudden. Menopausal symptoms result from changes in estrogen levels as the body adapts to this changing hormonal environment... But I should put a disclaimer in here. Of course, I'm no medical expert. This is just what I have picked up.

The breast cancer booklet available from the National (i.e. Australian) Breast Cancer Centre lists these as the side effects of anti-estrogen drugs like Tamoxifen: menopausal symptoms, blood clots, stroke, cancer of the uterus and changes in vision. And the good news? lowered risk of osteoporosis, lowered cholesterol levels.

Menopausal symptoms are also spelled out: hot flushes, sleep disturbance, vaginal dryness and/or discharge, decrease in libido, no menstrual periods or irregular ones.

This is a shortlist; the leaflet with the Tamoxifen lists many more, though they affect only a tiny proportion of women.

Here's another list I found:

Other symptoms that can occur include anxiety, poor memory, poor concentration, insomnia, fatigue, palpitations, decreased libido, muscle pains, crawling skin and urinary problems.

And to really cheer you up, here's a list of 34 symptoms!

Of all these potential symptoms, the only one that's caused me any significant discomfort, to the point of thinking about any kind of medical or psychological intervention, are the hot flushes. It's like functioning with a broken thermostat. It's a little easier now but for most of last year, I would wake many times in the night, alternately freezing cold (even cold to the touch) and then burning hot. Imagine the most embarrassing deep blush you can; and imagine it spreading over your whole body. Twenty or thirty times a day. Every day. Then imagine being so cold, half an hour later, that you could see the sense of a nose-warmer, just to add to the dignity of proceedings. The flushes are often accompanied by a rush of perspiration, running down the back of your legs, say, when you have just introduced someone at a conference, or yourself at a "research lunch" hosted by the vice-chancellor.

My oncologist says if it gets bad enough, it can be treated with a low-dose anti-depressant, but whenever we have this discussion, we usually say something like "well, let's see how it goes, and we can review in three months".

I've written elsewhere about heightened levels of anxiety, especially when I went back to work last year. Of course it's impossible to say whether anxiety — which I've learned is sometimes regarded as a form of depression — is a direct result of hormonal changes, or compounded by other things like a cancer diagnosis and treatment, or major changes to the work environment, such as we've experienced at Melbourne over the last two years, or the general condition of trying to juggle several writing and research projects with teaching and administrative tasks. (Truly, most of you academic readers in the US: You Have No Idea how many such tasks senior academic staff are expected to take on in Australia.)

Other symptoms come and go a bit, while there seems to be a bit of dispute in the medical profession about what is a symptom or not. Heart palpitations? maybe. Changes to the constitution of one's tears? possibly. Weight gain? disputed.

And then we are quickly in different territory. Because of course it's not just menopause we're dealing with here: it's also the after-effects of serious illness; and it's ageing, too.

About six months ago I looked in the mirror and thought I must have absent-mindedly let my pen draw a vertical line down the side of my mouth. But it was a long crease in my skin, a new wrinkle, or a fold. I'd heard of people's hair going white overnight as a result of shock. This seemed to me to be of the same order. And very shocking it was, too.

Now I've read enough feminist theory to have a sense of the social and cultural climate in which women experience menopause and ageing, but I'll admit I was still unconsciously thinking of both these things as a kind of end, or even as a kind of failure, or flaw. I see myself looking at women younger or older than I am, and see myself making judgements about them. And I've lived enough of my life in the light of The Gaze to anticipate its withdrawal as a loss. But on balance, I thought I would mind much more than I do about starting to look older. OK, seeing that line on the side of my mouth was a bit of a shock, but it certainly hasn't provoked any lasting trauma.

But what I can really see now is that one's mortality is a much bigger deal than one’s ageing, or one’s hormonal status: that really is an end.

I never anticipated what it would really feel like to turn 50, as I will do next month. I think I have quite a strong capacity to empathise, but I could never identify with academic folk who talked about retirement, or with characters in fiction who were concerned about their life's work coming to an end. I can, now. I don’t mean to sound too dramatic: of course I have lots of good and productive years ahead. But I can see, now, that just as the ovaries only have so many eggs, I might have only so many books and essays left to write, that there might be a finite number of years ahead. Unexpectedly, thinking about my own mortality makes me, if anything, less anxious about writing and finishing project after project. It seems to take some of the pressure off, somehow.

And so, really, there's nothing very special about this set of menopausal side-effects, or really, effects. I am just about the perfect age to go through this, and I'm sure this makes it much less traumatic than for younger women, especially those who were planning to have children, or more children. My friends and I now regularly talk about our symptoms; and they all seem to be perfectly calm and cheerful about it, even about the anxiety and moodiness that beset us. There’s no doubt that naming and sharing the process is of immense comfort.

Menopause, then, turns out to be like so many of things we go through: childbirth, marriage, love, death, puberty. The experiences might be universal, or at least common, but the "going through" is not. It still feels, each time, for everyone, like an individual rite of passage. It’s made for blogging.