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Wynchgate and Carlton NHS Trust
Department of Oncology

Mr G Jewell
14 Oakfield Avenue
London N10 4RG

April 10 2011

Dear Mr George Jewell

We have now received the results of your recent biopsy and would request that you attend an appointment on the following date:

April 15 2011 at 11:30

where you will be seen by Consultant Oncologist Mr Graham Stonehouse.

Keith Waters-Long
Administrator

Over the past couple of weeks I’ve been going through the folders marked ‘Jonah’. They are beginning to form a tower on my bedside table. Each report is accompanied by emailed comments from Emma. I read her emails along with the reports, searching for clues and looking for excuses to contact her. But they are businesslike and insightful about Jonah and completely free of comments about me, or us. Through my obsession with them both, I have managed to push the terror surrounding Dad’s swelling neck out of mind – until today. Jonah is seated with a slice of toast in each hand and Dad is at the sink, rinsing his mug.

‘I’m busy,’ Dad says.

‘Dad …’

‘Bowls match, league.’

Oh for God’s sake. ‘You have an appointment with a consultant in an hour and you’re not going to miss it.’ And I don’t need this. My father acting like a child.

‘So what is he going to tell me, their Mr Stonehouse, that I don’t already know? What do you think he is going to do? Measure my inside leg and run me up a nice pair of trousers? It is cancer.’

‘What if it is? There are fucking cures these days.’

‘Don’t use that language in front of Jonah.’

‘Why? You think he’s going to repeat it? If he turns round and calls me a fucking bastard I’d die a happy man.’

We are both terrified, I realise. At a pivotal point in our lives where the future lies in someone else’s hands. I am used to being out of control, but Dad? I look at him fussing around, dropping things, trying to clear his mind of negative thoughts through mindless repetition like he did for years – polishing glasses in the warehouse.

‘It is cancer. They do not waste their money on old men like me these days. They have league tables.’

‘You don’t know that.’

He bangs the letter down on the kitchen table and pokes it with his finger.

‘No? Do you see where it says Clap Clinic? Oncology, Ben – cancer. Even an old fool like me knows the difference. Anyway, it runs in the family.’

‘What family? All I’ve had from you is a generic “gassed by the Nazis”.’

‘Yes, but if they hadn’t, they would have died of cancer.’

I look at him closer, my seventy-eight-year-old father with his neck like a prop-forward, and I notice his dilated pupils and the sweat on his brow and I know that he’s losing the battle with his demons.

‘I’ll come with you this time. No arguments.’

But he’s not listening. His left hand is stroking Jonah’s hair while the other feeds him cornflakes with a spoon.

‘You have a tumour on your thyroid gland, Mr Jewell.’

Mr Stonehouse is pinstriped and silver-haired and the lightbox next to his left shoulder has an x-ray clipped to it. It looks like Dad has swallowed a golf ball.

‘And unfortunately it is malignant.’

Dad nods.

‘Now, ordinarily, we would operate. Remove the gland and destroy any remaining cancer cells with a dose of radioactive iodine. Then it would simply be a case of taking thyroxine on a daily basis. Please sit down.’

Mr Stonehouse waves us to two chairs opposite his desk.

So that would be the simple solution, but we don’t do simple in our family. Dad has an anaplastic tumour, Mr Stonehouse tells us. It is extremely rare and very aggressive. They can’t operate, can’t guarantee to remove every single cell which would send it racing round the rest of Dad’s body – if it hasn’t already done so.

‘So what can you do?’ I ask.

‘Well, the first step is an MRI scan to check whether the cancer has spread to any other organs.’

‘And if it has?’

Mr Stonehouse turns to my father. ‘Mr Jewell, I need to be candid with you. Your cancer is incurable. The average life expectancy from diagnosis to death is three to fifteen months, depending when we catch it.’

And my first thought is of Jonah’s case and the money, not of my father’s pain, and it drenches me in guilt. Is this normal? Does the impending death of a loved one turn your mind to practicalities? And then I think of the old Luger and its two bullets, how I must hide them because he’s capable, pig-headed, fatalistic and fearless.

And then I finally notice him crying, and the sickness and shame I experience at this moment feels as untreatable as my father’s cancer.

‘Mr Jewell, I have arranged for a scan this afternoon, after which we will have a better idea of the appropriate palliative treatment. I would like to admit you now, Mr Jewell, and begin treatment as soon as possible. Mr Jewell?’

Dad is staring at the rain hammering the window behind Mr Stonehouse.

‘I sent him to school without a coat, he will get wet. Ben, go home and pack me some clothes and on the way back, drop JJ’s coat into his school. I don’t want him catching a cold.’

‘Of course, Dad.’

‘And Benjamin …’

‘Yes, Dad.’

‘Don’t mention this to Jonah, I don’t want him knowing.’

‘No, I won’t.’

A nurse arrives, as if by magic.

He stands and she takes him by the elbow, leading him out into the busy corridor. I follow on and turn left as they turn right. I would stay, I want to stay, but what could I say? I don’t know how to breach this crevasse between us, to cross it before it’s filled with all the longing, regret, hurt and the difficult, complicated love that I share with my father.

We eat in silence at McDonald’s. I have a Big Mac Meal – which I hardly touch; Jonah has his usual three large fries and two Fruit Shoots. Who is there to phone? I scroll back and forth among the list of contacts on my mobile. Only Maurice, but I don’t have his number and, even if I did, could I tell him? Emma? She deserves to know, I need her pity – so I call. Voicemail. Message left: Dad’s dying. Jonah begins throwing chips around. ‘Come on, Jonah, let’s go home.’

He’s an incongruous lump in his Bob the Builder pyjamas – too short in the arms and legs and stretched across his belly – but he feels warm against my naked chest and smells of the bubblegum shower gel I used in his bath.

Tonight, he is snoring contentedly, while I am wide awake despite the half bottle of brandy. Tonight he chose to climb into my bed and lie nose-to-nose staring at me until he fell asleep. Tonight is going to be very, very long.

I vaguely register a finger poking at my cheek, but as I turn on the bedside light, all I get is a fleeting glimpse of a dangerously overfilled nappy defying gravity. I throw back the duvet and stumble after it.

I chase him across the landing watching his nappy slip from his hips like the jeans of a schoolyard gangster. He’s halfway down the stairs as I reach the top and my momentum carries me forward in an arm-spinning slide.

‘Woaah …!’

Somehow, I avert disaster by pressing out against the walls and using my toes as brakes.

My toes.

My little toe.

Fuck! It’s pointing up at me at an angle it’s never done before, addressing me with contempt like a raised middle finger, and is beginning to throb.

I’m scared to touch it, as if it’s a dead wasp or a bank statement.

Jonah has returned to the bottom of the stairs. Naked. A bagel in his mouth, he stares at me poker faced, shining lumps of butter in his wild bed hair.

It’s not unbearably painful. Is that good or bad news? Surely it should be agony? Has my toe been killed off totally?

‘Jonah!’ He’s off back toward the kitchen.

I shuffle down the remaining stairs on my bum, then pull myself up on the banister and begin hobbling after him, my toe still flipping me the bird at every step.

‘Fuck you, toe.’

There’s a new pack of wipes under the kitchen sink and I manage to grab both Jonah and the wipes without putting pressure on my ailing toe, until he steps back and puts his full weight on my disfigurement. The scream is of shock, there is still no pain, and as he casually saunters off towards the lounge, half a wet-wipe still lodged in his bum crack, I look down and see that my lump of a son has restored my toe to its regular position. I perch on a kitchen chair and reach down to touch it – it moves easily in all directions like a video game joystick. Then the pain begins.

‘Aaron said you have to go to A&E for an x-ray in case there’s any blood-vessel damage,’ Johnny says.

‘Do I really? He always was a bit of a tart.’

‘Aaron’s the doctor, Ben.’

‘I can’t take Jonah to A&E. Can you imagine? Could you have him, Johnny?’

‘We’ve got the captains playing in at the golf club.’

‘Jonah likes golf.’

Johnny laughs down the line. ‘Just go there with him and explain about his autism. It’s a hospital, for goodness’ sake, they’ll understand the situation.’

Jonah’s sprawled on his back on the sofa, crumbling his bagel on to his bare chest. He smells a bit. I try to sit by his feet and he kicks me in the small of the back. I pour myself a medicinal whisky and slump on to one of the dining chairs.

This is a scene. Curtains closed at midday, behind which sit a naked father and son staring into space. I am devoid of options as my father, Johnny and Amanda are the only people Jonah trusts that can cope with his rock ’n’ roll lifestyle and will actually have him in their house. Why couldn’t it have happened on a school day?

School. His teacher, Maria! Where did I put her bloody number? I know it’s not in my wallet, but I search there nevertheless. It’s not there.

I think back to when she gave it to me in the school car park. What did I do with it? I got into the car, began arguing with Dad. The door pocket! It’s in the door pocket!

‘I’ll be back in a minute, Jonah.’

There’s no answer, so I leave a garbled message on her voicemail and begin the half-hour process of dressing, stroking my toe and licking my wounds.

Jonah won’t leave the automatic door alone, jumping up and down in wonder and excitement as people wander past him into North Middlesex A&E. Each passing emergency represents another twenty minutes’ wait for us and I’m getting edgy as my toe begins to throb.

‘Jonah, in you come,’ I say, slapping my thigh. ‘Come on, Jonah!’

I manage to pull his torso through the door, but not his legs. I put my arms around his chest, clasp my hands behind his back, lift him off the floor and swing him into the heaving waiting room. A fuzzy giant LCD monitor on the wall tells me the average wait is currently four hours – this is not even remotely possible. I pull Jonah with me to the reception window.

The nurse addresses me with her head down.

‘Name?’

‘Ben Jewell.’

‘Ben Jool,’ she repeats as she types. ‘Problem?’

‘Badly broken toe,’ I say.

‘Possible broken toe. GP?’

I give her details twice then pull Jonah in front of the window.

‘Look, I’ve had to bring my profoundly autistic son with me, he just won’t be able to cope with being here very long. Is there anything you can do?’

This time she looks up, her thick glasses reflecting the strip lighting back into my eyes. ‘Take a seat and a nurse will assess you as soon as possible.’

No points for that, then. Perversely and irritatingly, Jonah has calmed down. He’s fiddling with some thread-like thing he’s found on the floor. I daren’t imagine what it is.

This A&E is a United Nations of the unwell – babies, burkhas, hoodies, sandals, saris, smatterings of European languages I recognise, cluckings of African ones I don’t. I wonder what they make of Jonah and his personal, evolving language for one. Why does everyone in A&E have a cough, even if they’re here with a gashed head or a broken ankle? Are we that insecure that we always feel the need to embellish? I look at Jonah, quietly fiddling. Jonah doesn’t embellish, Jonah just does.

The piercing sound of unoiled trolley wheels announces the arrival of a miserable-looking sixty-something black man and his even more miserable selection of chocolate and crisps. Jonah sniffs the air like a meerkat. I’ve got no cash with me and the packet of pitta bread in my bag will be hurled if I offer it now. No, I’m going to have to say no.

He’s at the trolley before I have a chance to move, a family-size bag of bacon-flavour crisps gripped in both hands. I try to take it off him and the growling starts. He releases one hand from the packet and makes a grab for my neck, then he presses the swollen packet with all his force and bacon crisps erupt from it with a
bang!
This only makes him angrier and he turns back to the trolley and sweeps the remaining bags on to the floor and jumps on them and, as much as it hurts, I cheer him on in my head, ‘Go on, my son!’

In an instant, A&E is all activity and a triage nurse is miraculously available. An arm has gone around Jonah’s shoulder and is clutching him in an embrace. Maria’s red bob appears above his right shoulder.

‘Sorry it took me so long,’ she says.

‘No, no, I’m just so grateful that you’re here.’

Why do redheads blush so readily? I wonder.

‘Leave him with me, we’ll be fine, won’t we, Jonah?’ she says, as one of his tears rolls down her cheek.

They’re both waiting for me when I re-emerge from the x-ray room, little toe strapped to the next in line, clutching a box of high-octane painkillers. Jonah has his hand palm down on a pad of paper, fingers spread, while Maria traces round it with a ballpoint. Occasionally the pen touches the soft skin connecting his fingers and he giggles. Maria laughs back at him. They both spot me. Maria looks up with a smile.