The rich are mortal, but their time spent between living and dying isn't the same as our brief dance to the music of time.

It's a long read- but it is a good and honest read about dealing with cancer during the worst days of the COVID-19 pandemic- in 2020. 

This week, four years ago, I underwent cancer surgery for rectal cancer. Cancer is a life-altering experience for anyone who undergoes it. It has forever changed me physically and psychotically. It will shorten my lifespan and it has diminished my quality of life. I am still alive and that is a great matter. April 9th I return for another CT scan to ensure the bastard sleeps and is not awake. But let me be clear, cancer may be an indiscriminate disease, but its treatment and recovery favour the wealthy. You and I, are not that tribe of the lucky few.

Sure the rich and powerful are mortal, but their time spent between living and dying isn't the same as our brief dance to the music of time. So, I feel empathy for King Charles and the Princess of Wales over their recent cancer diagnosis. But I also know their experiences with it have no relationship to my experiences or the majority of cancer sufferers. F. Scott Fitzgerald wasn't wrong when he wrote in The Great Gatsby "The Rich are different.."

If you can please subscribe because paid members help keep the legacy of Harry’s Last Stand alive which includes five books and his never published Green & Pleasant Land as well as my two books written after his death. Your support keeps me housed and going. Take care, John

Photo by Mufid Majnun on Unsplash

March 2020

The days before I was scheduled to be cut open dwindled down quickly. During that time, panic was my emotional dance partner. I couldn’t shake from my mind that a malfunctioning section of my body was going to be amputated soon, from my person. When I took a shower and washed my abdomen, I stared at the tattoo marks inked like a bullseye on a dartboard by the radiology department. 

Soon, I thought a scalpel was going to slice into my skin by the tattoo used as a target for the beams of radiation that burned into my gut- the week previous. 

The surgeons will saw through my rectum as if it were haggis. They will bin the cancer and the surrounding margins, drag the colon down, and then staple it to the shortened cancer-free part. 

Afterwards, my stomach will be sewn together the way a stuffed turkey is stitched up by a cook before a holiday meal. 

The week before my surgery, COVID-19 was all over the news. The death toll was enormous, and there was an endless B roll of bodybags. Chaos and panic ruled the world then.

I stopped talking to friends because their panic over their own mortality was overwhelming me. 

Forty-eight hours before my scheduled operation, my surgeon’s secretary informed me the hospital had cancelled all “elective surgeries.” They were concerned that people newly infected by COVID-19 would overwhelm their ICUs the same way hospital ICUs in Spain and Britain were overwhelmed. 

I knew I was fucked because, without surgery in a timely fashion, the cancer inside of me would grow, making it more difficult- to eradicate the malignancy from my body.

My life had little worth to anyone but me. I had no idea how long I’d have to wait for a new date for surgery, or whether, in the meantime, I’d get Covid and be dead or become debilitated from that. 

All I understood was that each day my surgery was delayed was another day for malignant cells to multiply and grow within me. I feared that my carcinoma would breach the outer wall of my rectum, like the Knights Templar at the walls of Saladin’s castle in Jerusalem. Without an operation, the cancer would travel through the conduit of my lymph nodes to settle on my vital organs- as easily as milkweed blows on the wind and lands in your hair.

In desperation, I spent that afternoon and evening drinking wine and drunk- tweeting my fury and outrage at having my cancer operation cancelled. By bedtime, I was spent, and I began trying to convince myself that postponement was simply an indication that my cancer wasn’t as bad as originally imagined. It could wait. 

In the morning, I woke up with the hangover of a university student after final exams. In despondency from the drink the day before, I made a full English breakfast for myself, and while eating said, this is a sure-fire way to kill the cancer in me.”  

Just before lunchtime, the surgeon’s office rang me. I was informed that upon review of my medical file, the surgical team noticed I had radiation therapy the week before and decided my operation should be performed as scheduled. “You can start your bowel prep and arrive tomorrow morning for your operation.” I was overjoyed. I was relieved and cried. I was spared the agony of waiting for a new surgery date. 

I wasn’t packed. I hadn’t picked up supplies or written my will. I was supposed to have done that the day before. But after my operation was cancelled, I said fuck it. I didn’t even know how to get to Toronto from Belleville to arrive on time for my operation, because public transport due to Covid restrictions was virtually non-existent between cities in Canada. 

As for having a friend drive me, none offered, and I asked none because I was too fearful that either I’d catch or give them the virus. 

Fortunately, I found an airport limousine company that would take me for a premium. 

I tried to remain positive, but I was nervous. I teared up when I packed my bag, and I put a picture of my dad in it. I was hungry, hungover, and alone as the hours dripped away until it was time for me to leave for my operation. I hesitated, I prevaricated, but in the end, I wrote my will and living will. 

Besides debt, I didn’t have anything to leave anyone. I felt guilty about the mess, which would have to be cleaned up in my apartment should I die. I left the copyrights of my father's books in the care of a friend, who I asked to protect your legacy as best they could. But I knew that if I didn’t make it, all that we had done would either be forgotten or misconstrued for the benefit of others. 

In the evening, I watered my few plants and tried to watch television. I couldn’t relax. So, I listened to some music, but nothing eased my mind. I thought by this time tomorrow, I could be dead or have a bag attached to me. At midnight, I lay down for a few hours. 

At three AM, I showered, dressed, drank some water, made my bed, and sat on it, until my driver arrived. When he phoned, I put on my coat, wrapped the scarf Mum knitted for you around my neck, and stepped out of the apartment with my carry-on bag in tow. 

Masked and gloved in the back of a giant SUV, I closed my eyes. Sadly, the driver wouldn’t let me rest and woke me up after 10 minutes with an inane banter about the famous hockey players who had ridden in this limousine before me. 

As the SUV raced through an empty 401, I stared towards the sleeping suburbs of Toronto. Electronic signs notified the few stray drivers on the road that travel should be for only essential reasons. I thought of how many times, my father and I had driven this route on the way to the airport for a trip as part of the Harry's Last Stand Tour. 

I yearned to be in that time when I was healthy and not being killed by cancer cells. 

At the entrance to Sunnybrook Hospital, my limousine driver grew quiet. He was spooked by enormous signs warning of COVID-19 and instructions about taking proper precautions to avoid the virus. Unnerved, and agitated, the driver dropped me off at the admitting room doors like I was a wounded gangster and sped off into the night. As the rear lights of the limo dimmed, I laughed and stood for a while in the cold. I wanted to enjoy the brisk, impatient air of that early morning. 

I feared it might be my last taste of living. Mum did this too when she savoured the rain that fell on her forehead as she was taken out of an ambulance and rushed into a cardiac care unit, after suffering a series of heart attacks in 1997. 

Outside the entrance, I breathed slowly in, then out to catch my racing heart. I am standing, here, I thought- at the threshold of my life, and I am so fucking scared. 

Hospital security took my temperature when I stepped inside the entrance. I was asked some questions to determine if I had COVID-19. I was given a sticker that said I was Covid free. Then, I strolled into the hospital’s empty shopping concourse- while my carry-on bag rolled against the floor, striking memories in my head of mad dashes to catch planes or trains with you. 

 I was not expected until six, so, I sat on a bench and quoted Wordsworth about being as lonely as a cloud. When it was time for me to check in for my surgery, I stood up. I walked while pulling my carry-on case behind me, with the nervous intensity of a first-time jet passenger after being instructed to go to a departure gate. 

We didn’t wear masks yet indoors to ward off this plague. So, I attempted to stand as far away from other sick people who were booking in for important lifesaving operations fearful, they were infected with Covid and would spread it to me.

I was checked in, and then a hospital employee told me to proceed to another room- where staff prepped me for my operation.

I took off my clothes and put them into a bag- with my name marked- on it. I thought, isn’t this what prisoners do when they first begin their sentence in jail, strip themselves of their street clothes and put on the anonymous garb of incarceration? 

I fumbled to correctly put on my gown, and a nurse helped me like she would, a five-year-old- who was having problems tying his shoe. With my clothes in a bag and me wearing a hospital gown, all the trappings of me before cancer were gone. I pretended this was all normal. I pretended this was not an important thing. However, in an hour, my stomach was to be opened with a scalpel. A section of my colon and rectum were to be removed, and then organs not meant to be joined by nature were to be connected by a robotic device that would suture me as if I were a pair of jeans at a sweatshop in Asia. 

To the nursing staff, I tried to make jokes while they began processing me for the operation. I brooded these may be your last moments of awareness before the vast and never-ending sleep comes for you. It made me wonder if I died, would these strangers remember me for even a moment? Or would the image they had of me slip from their memory like people you see on a subway car pass from you? I made sure I was extra polite to the nurses gathering my effects. I thanked them profusely for working under the frightening conditions of a global pandemic.

I wrote a draft tweet and instructed a nurse that if things went bad for me, could she tweet to my followers; “I stood my ground for as long as I could.” 

I then lay on a gurney in a hospital smock- stripped of any identity as a healthy person. I told my nurse inside my travel case is my living will and that “If anything should go wrong, no respirators, for me please.” 

As I lay waiting to be taken to the operating theatre, memories of waiting for my father to come out of surgery, came to my mind. But other thoughts also came of him struggling in terror while a BiPAP machine pushed oxygen into his knackered lungs during his final days in an ICU. Or of Peter in his final month immobilised in a hospital bed with a hole cut in his throat that held a plastic tube which pushed air into his lungs while all around him, monitors rang and buzzed like warning alarms in the cockpit of a plane in distress and plummeting to the ground. I saw Mum moaning from the intense pain caused by her cancer- the way an animal does when it is struck by a car and drags itself to the side of the road to die. Mum described the agony she felt as termites in her bones chewing her to sawdust. 

I trudged to the operating theatre, trying not to be afraid. There, I met the anaesthetic team, who asked me my name and confirmed I was the right person for this procedure. I jumped onto the operating table. At the end of the table was a concave plastic mould, I was supposed to rest my head on it. It was eerily reminiscent of an executioner’s chopping block. For a moment, I thought of when I had my heart attack and was flown by helicopter to Kingston for an angiogram. When the cardiologist did that procedure, I watched on a monitor the cardiac surgeon thread a probe into my heart and reflected, that it would be distressing if my heart stopped beating whilst I watched it happen. 

Shortly afterwards, my surgeon charged with cutting out my cancer strode into the small theatre. We exchanged pleasantries, and then a drip was placed into my arm to feed me narcotics and an anaesthetic. It gave me a two-martini on an empty stomach feeling in my head. I thanked everybody for putting the lives of their patients before their own during this pandemic. Within a minute or two, drugs to render me unconscious were put through an intravenous line, and I was gone.

Hours later, in the ICU, shouts and screams from my surgical team woke me. They seemed so far away as if I was on the water, and the shore was calling me back. But I remembered a voice shouting at me, “No bag, no bag.” And through the heaviness of the morphine exaltation erupted over me that I had been spared an ileostomy.

Chapter Eight:

Recovery

As my gurney was pushed to my wardroom, I was drunk on morphine. It made me giddy, optimistic, and chatty. I waved to the nurses at their stations as if I were a participant on a parade float saluting the crowd. 

When I was transferred to my bed, a porter brought me lukewarm water in a plastic cup on a tray with a thin tea bag, resting on it. “Drink,” urged the porter who raised my bed to better swallow the tea. I asked her if she felt safe, from Covid, and she said “No, but what can I do my family must eat.” 

When she left, I lapped up the tea and said to myself, “Drink, you are not a god,” like Omar Sharif’s character said in Laurence of Arabia to Peter O’Toole. It went down my throat with the smoothness of nectar, and it connected me back to the animal world of needs and wants.

I was still feeble from the operation, but I climbed out of my bed to sit on a chair near my room’s window. The faint rays of the afternoon sun warmed my face, and I whispered in amazement and joy, “Spring will soon come.” 

In the bed across from me was a woman originally from Leicester. She was scared and alone because her husband couldn’t visit, and she had major surgery for endometrial cancer. I heard her speak to her mother in England on a video call. While talking to her mum this patient near my bed cried with the frequency of an English rain while her mother tried to find words that might comfort her daughter. They talked of Britain’s lockdown but also spoke approvingly of Boris Johnson. “Tories,” I thought, I can’t ever shake them. 

I dozed for a while and upon waking touched the gauze bandage that covered my surgical scar. I recoiled at the knowledge that only hours ago, I was being operated on for cancer. But I was lucky because the man in the bed closest to the door of my room had the same procedure as me. He however required an ileostomy until his intestines were considered strong enough to be reconnected. Hidden behind curtains drawn around his bed, I heard him complain to the nurses about his pain and the shame he felt at being altered. 

When the sunset on my first night in the hospital, I listened to the nurses talk in agitated voices about the pandemic and their new responsibilities. They were frightened and angry with management because they believed they weren't protected. Among themselves, they chatted nervously about the patients being admitted to the ward, who tested positive for covid and were treated by them. 

“No one is protecting, us.” 

As the night wore on, my pain at the surgical site was intense. I was given more morphine by a nurse originally from Iran. I talked to her about Persia and the carpets my father once sold to Canada’s well-heeled that had been woven in Iran’s holiest of cities, Qum. 

The next day, I was allowed to walk the ward, which I did as if it were the lido deck of a cruise ship. I held onto my catheter bag pushed an IV drip in front of me and said each step you take is a step to the exit and home. On my stroll, I saw many rooms isolated and occupied by patients infected with COVID-19. There were giant posted signs not to enter their rooms without authorisation and a full PPE kit. I could hear them struggling for breath, their lungs wheezing, congested and overwhelmed by the virus. They were dying, and there weren’t enough ICU beds to treat them. So they languished in our recovery ward. Code blues echoed over the PA system.

I was concerned for my own safety that so many around me were infected by Covid. I would, however, never thought of complaining because the hospital was like a life raft- all of us were equally worthy to survive. Everyone there was in their own fight for survival and no complaining or praying from me was going to change that outcome. The vibe during my stay was the end of the world was nigh. So be of good cheer. 

On the second night of my hospital stay, I still hadn’t taken a shit and began to vomit up the broth I had been given, for my supper. The woman originally from Leicester began to weep and cried out, “ “I felt perfectly fine a month ago and now look at me. How am I ever going to manage at home?” 

A nurse cleaned up my vomit, and I asked why I couldn’t keep down even liquids. “If it can’t come out one way, it will come up another.” But in the early morning hours of that night, I farted, which indicated my bowels were not obstructed. The woman originally from Leicester applauded and laughed when I remarked, "Now that's a Trump I can approve."  

Nevertheless, my body was having a terrible and skittish time trying to understand why my intestines had been amputated. Even with the pain meds, I hurt too much to sleep for any longer than twenty minutes. Between these twilight moments of unconsciousness, I eavesdropped on the growing concerns the nurses of my hospital had for a pandemic that threatened to collapse our healthcare system. 

I heard nurses in the hallway chatter in fearful tones about Covid 19 and their insufficient protection. The cleaning staff also told me that with both anxiety and anger, the hospital only provided one mask per day for each staff member. They complained their unions weren’t doing enough for them. But no matter how much they complained about how higher-ups had made them vulnerable to COVID-19, they never shirked their work responsibilities. 

By the third morning, I was hoping I’d be released. But my body began to revolt against its new configuration. After a breakfast of eggs and tea, I was wracked by violent and never-ending bowel movements. The fear was so great that I might have COVID-19 or C-difficile that my nurses isolated me from everyone on the ward. A curtain was drawn around my bed, and I was provided with a commode to evacuate my bowels into. I was forbidden to leave my twenty-five-square-foot enclosure. Within hours, I was dehydrated, exhausted and raw from diaper rash. I still hoped I had nothing serious and spent a lonely day, sometimes drenched in my faeces and my stench. Every time a nurse cleaned up my bed or removed my bedpan, I apologised profusely. I was exhausted beyond definition by my operation and having to shit every ten minutes. To keep my strength up, I listen to an audiobook version of Svetlana Alexievich’s The Unwomanly Face of War. Listening to the tales of what soviet women endured during their fight against Hitler made my struggles against cancer and COVID seem mild in comparison. 

By the fourth day, my bowel movements settled down to a 30-minute occurrence, rather than four times per half hour. The doctor on rounds that day checked up on me and said the test had come back for c-difficile was negative. “I suppose you can go home if you feel up to it. Is there someone who can pick you up?” I said I had arranged for a friend to come and collect me. Before leaving my bedside, he noticed a copy of Harry’s Last Stand on my table. “He was your dad, wasn’t he?” I said “Yes.”

“I trained in the NHS. You don’t know how much hope and encouragement your dad gave to people working in healthcare in England. Your dad was inspirational.” 

When he left, my nurse appeared and got me ready to depart. I told her I was concerned I might have an accident on my way home, as it was a 2-and-a-half-hour journey. So, I asked if she could provide me with an adult diaper. It was a humiliating request, as it made me wonder if they were going to become habitual

After the nurse left, I gathered up my belongings, put them in my overnight bag, and walked out of the room. There were no porters, so I was told to find my way out. I wandered lost along the hospital corridors feeling faint. I was like the ancient mariner wanting to tell the tale of what I had seen and just experienced. But no one paid heed to me stumbling around- looking for an exit to the outside. 

When I walked out of the hospital, it was raining and fell onto my head and face with the gentleness of kisses. My friend pulled up into the patient pickup line with her passenger van. Before picking me up she scrubbed down her vehicle with Lysol like she was a murderer who wanted to remove all DNA traces from the scene of the crime.

 I climbed into the back seat of the van. As she pulled out of the hospital entrance onto Mount Pleasant Avenue, I began to whimper. I was overwhelmed. I had too many thoughts and feelings banging around in my head. While on the ward, I put on a brave face. I knew others were worse off than me. 

But alone in the car, it struck me how close I was to death. I sobbed. I knew I was going home to recuperate, and if I could skirt becoming infected with COVID-19, I had a chance of surviving for at least a few more years. But I knew it was far from over, and it was only starting for me and everyone else because of the Coronavirus. 

During that long drive home to my apartment, my raw wounds ached. The highway was desolate. Everything about Toronto, its suburbs, satellite cities and country towns far from it looked forlorn. We were coming into spring, but to me, we were going into a time of ending. I saw no new promising beginnings ahead for me or the world. 

Thanks for reading and supporting my Substack. It’s an SOS because the end of the month approaches and I am short on rent with only 5 days to go.Your support keeps me housed and also allows me to preserve the legacy of Harry Leslie Smith. A yearly subscriptions will cover much of next month’s rent. Your subscriptions are so important to my personal survival because like so many others who struggle to keep afloat, my survival is a precarious daily undertaking. The fight to keep going was made worse- thanks to getting cancer along with lung disease and other co- morbidities which makes life more difficult to combat in these cost of living crisis times. So if you can join with a paid subscription which is just 3.50 a month or a yearly subscription or a gift subscription. I promise the content is good, relevant and thoughtful. Take Care, John.