A day out (From “What’s Bibi Doing”); notes to my grandson and the rest when they come

It is a five-minute walk up the street to the station. To push the bowel out of the way of the beam and reduce complications the radiotherapists want my bladder nice and full. I have been drinking that morning as instructed. By the time I tread softly down the stairs on to the station platform and dare to look up at the board to find out how long I had to wait for the train my bladder is beginning its protest, wailing for detumescence.

I always had a sensitive bladder but radiotherapy sessions seems to have made it worse. My trouser waist is elasticated, the bladder will not brook a firm belt. I knew I should have put on a pad just in case, but I resisted doing so as a test of endurance- a stubborn streak that I may come to regret in wet patches. To quell the discomfort I walked stiff-legged up and down the platform envying, resenting, the apparent equanimity and poise of my fellow passengers. I recognise some of the regulars, the schoolchildren, the decorators with paint-spattered dungarees, executives in their trouser suits.

I board the 0712 Southern Service to London Victoria. The ache waxes with the rocking of the train when I sit down. If only the nephrons could feel my pain but they are only doing their job and I would be the first to complain if they took offence and went on strike.

Off at Belmont station I get and try to hurry up the hill but every step I take seems to fan the flames in my bladder and I cannot afford to amble as I may not get to the hospital in time. When I reach a parked car I don’t even dare risk turning round to check on the traffic behind me when I step off the kerb for fear that any distraction would release the desperate hold I have on my levator ani and the rest of the pelvic crew. Instead, I raise an arm by way of warning and apology. As I cross the road at a junction a driver hoots at me because I am not walking fast enough. Kill me then and do me a favour man, I can’t go any faster, my legs are weak and my bladder is like a grenade. Opposite the row of houses that backs on to the Marsden stand thick woods. Dive in there and be done with some of this urine? But a sense of propriety restrains me. How would I like it if someone pissed on my front door?

So up the hill I endure, turn left off Down’s Road, over the zebra crossing, the hospital main block, angular, functional, built in a style unlikely to become fashionable again except to those most nostalgic for the days of Stingray and Thunderbirds (look them up). But when your bladder is stuck full of burning arrows the hospital and the promise of release becomes an object of unsurmountable beauty. If only it would come close to me. I try not to think of our consummation, walking through its automatic doors, the warmth, the aroma of it, the tinkling into its ivory urinal, try not to think of the final swerve left past the porters’ desk, try not to unzip my jacket from the bottom up yet, for any hint of relief may lead to surrender.

Make it, made it, through the door, allow myself to hurry, barged past the cleaner’s yellow trolley blocking the way, into the men’s toilet on the right, dance on the spot for control as I unzip, now how much to let out to keep enough for the radiotherapy session. Like the IMF with its forecasts for the economy, I am almost always wrong. If I let too little out, inflation soon returns, too much out and deflation when the radiotherapists take me off the table, walk of shame for another drink, wasting everybody’s time you stupid man. Could even be that little child with the tubes in its nose and everywhere else that you are holding up. Is it not the base of your delicate middle member that will suffer if you don’t get this right?

For now all that is academic. Up goes one zip, down comes the other, relief is orgiastic. With difficulty I manage the excruciating micturition interruptus. How much is left in the vesical tank I don’t know. Now, it is 0830. In the main outpatients department I turn a plastic cup of water in my hand. To quaff or to sip is the dilemma. How fast will renals work? On a good day it takes ten minutes from one void to the next, but depends on how hydrated you were, on what you drank the day before. I pinch the skin on the back of my hand to test for turgor. No clue. I quaff and have another cup of water and trudge up the slope to the modern, glass-tinted radiotherapy department. To reduce the sore sloshing in my bladder I make my way gingerly down two flights of stairs. By the time I get to the department the bladder feels full again. Should have let more out. I look at the clock in the reception. Are they on schedule? I check in. Receptionist is inscrutable, hands back my appointment card. Is it good that she does not say anything? It is better than weeping for you, or frowning. I am beginning to fret again. 0845. They are late. How much more can I take? The leather bucket seats look inviting but I dare not sit and I shuffle back and forth. The other patients sidle into their cubicles. A sandy haired man sitting out the Juniper suite looks distant and sad. He is not glancing anxiously up at the clock on the wall or trying to see round the corner, so either it is not prostate cancer or he has an asbestos bladder.

Beep beep beep goes one machine in the near distance. They’ve started. Another machine responds. My stomach knots. Should I let another bit or urine out or wait? I recognise a radiotherapist. She nods. I nod back. I nod at another patient. We don’t say much but we are in the same boat on an unwanted voyage for which we were not prepared. They call me. Phew. If I’d gone I might have been too urine light and wasted their time. I tear off my clothes and into the gown, open at the back. I am in boots for the walk back through the autumn mud and leaves, but bending over to take them off fans the bladder flames. Someone knocks on the door, calls my name. I follow. How are you today, good I say, as in bursting good. Do you want a towel underneath? No. They shouldn’t have asked because the hint of relief may undermine my resolve. I say I will manage. I know from the pain that my bladder is full, an impression confirmed by the satisfied air of the radiotherapists as they set me up on the couch and in one slick movement whip off gown and replace it with a towel. They check the markers on my skin, wriggle me on the couch, I end up slightly more on to a left sacral prominence, probably because I twisted my spine once when I fell on the stairs. Dry bare feet on the stairs can kill, so watch that.

Figures are whispered, 1.9 then something that sounds like 787, a satisfied grunt, tap on keyboards and they flee the room. Then, a scrunching noise as the couch jerks into position. They put on some music, easy listening but not easy to hear when you are concentrating on strangling your short bladder neck with your pelvic muscles. Bladder itches and tickles. This is no laughing matter. Hope boys will not have this, but can’t go on saying don’t want the boys to have this, don’t want the boys to have that, everybody gets something. Ok, have something but not too bad and let the cure be much simpler than this.

We are off. I think of innervation of the bladder. Now how do I seize back control of the parasympathetic and sympathetic nerves, take control of my borders as the politicians say? I bite my lower lip. That does not work. All I get is a groove in it, so I try the other lip, even more useless. Cannot even wriggle my body, or squirm, but I risk a toe, far away from the area of interest. I close my eyes, sense the radiotherapy tube whine in its first sweep in a semicircle arc from right to left. Beep beep beep. It stops at the end of its travel. They input more figures. That brief stop, perhaps for half a minute feels like an hour, waiting outside the gates of will they let me in or not to 2019, 2020, 2021 and beyond – is that not what this is all about, eking out a few more years? Or, will it all be in vain. The radiotherapists calculate. You wait. You still have to keep your form, tighten muscles, stop this bladder exploding over the couch. That would be gross, grown man, heart specialist wetting the bed. Pathetic.

They’ve gone quiet. What if the numbers are wrong, the chief is tired or is a bully and will not take correction from the junior, what if there is nothing coming out of that turret or there is too much? But from the way my bowel explodes first thing in the morning there must be something coming out of that vast machine. If only it wasn’t invisible. Since this treatment started, no time even to grab a magazine, as is my practice – it is go go go, run or you know what. One Wednesday on the way to pick you up, caught short again, I had to swing the car into the New Malden branch of Sainsbury’s and dive into the toilet. No number of explanatory leaflets can warn you about that.

The couch jerks a tiny bit. A new position, crucially, infinitesimally different from the previous spot, but precise I believe. Bladder protests at the jolt. Hang on, not long now. Where on earth did I get you from? Off again we go. Left to right goes the turret, and back this time without a break. It clicks into place. A kind voice peels over the intercom. You can tell if they are happy with the readings. All done, made it, I don’t move until they say so, because the couch is so high above the floor. Once or twice had to wait whilst they replaced the stickers over the markers, but after they let me go, see you tomorrow, thank you, I am so full I don’t get changed out of the gown but race across the waiting area to the toilets holding my gown closed behind my back. The man in the next cubicle shouts out in awe at the sound of my urine thundering down. Freedom to do as you wish with your pelvis, should be the test of any civilization and whilst we are at it, access to world-class treatment without having to pay on the day.

Now comes the best part, the walk home with time and body back in your hands. Could even say worth the torment for this bit? I get dressed, take time set up Bluetooth headphones, Radio 3 for a blissful walk home, but if I want to bop along across the Downs, Afro-beat. I walk rather than take the train. It is not always straightforward because of the wild animals. In Surrey? Yes, once, over the sound coming from my headphones I heard this menacing barking, turned. A large black dog came charging down the hill, out of the sun as Messerschmitt’s used to in WWII comics. Blinded, I made a visor with my hand. The dog crouched, circled me, minatory low-pitched growling, looking as if it was about to pounce. Nearby, golfers suspended strokes. Paralysed, I wished the owner would turn up. Which part to protect, balls as footballers do in a free-kick wall, or what? I half turn away and see the owner jogging down the hill. He gasps out an apology and retrieves his beastly pet. Why man cannot walk home after his radiotherapy in peace only dogs know. Maybe they smell prostatic decay. http://prostatecanceruk.org

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