By Chris Bateman*
Imagine an unforeseen event that will fundamentally alter your life, filling you with a paralysing foreboding as your mind thrashes about in a seemingly futile bid for answers.
That’s how my esophageal cancer diagnosis felt last November, (2019). I had no option but to blindly step forward on a journey towards an unknown destination, surrendering myself in all my vulnerable humanity to the expertise of an oncologist, bariatric surgeon and related healthcare professionals.
There’s a weird, (though sages will tell you it’s in the natural order of things), tension between, and paradox in, the seemingly opposing curses and blessings of a serious adverse event. I decided my biggest gift lay in the free choice I was born with. I would focus on the blessings, get the full data about my diagnosis and its prospects, and engage with the God of Reality. That ‘God’ had already been hard at work preparing me, (and no, I’m not religious in any traditional sense).
It started with a braai at my sister and brother-in-law’s home earlier that November. A jolly occasion with lots of wine, dampened only by some uncomfortable reflux I felt a few minutes after taking the first few bites of a tender, juicy steak. I felt a pain just below my sternum and started hiccupping, unable to eat more. Bile gathered in my mouth and I retired to the toilet, fully expecting to throw up. I didn’t, and things settled after about half an hour.
‘Sangoma’ sister casts a spell
Well, all except for my sister Marge Heirons, a bit of a Zulu ‘Sangoma’ in her own intuitive way, who was well stirred up.
“Chris, this has been going on for too long now! You’re going to see a gastroenterologist golfing buddy of mine. Here’s her number – call and make an appointment!”
I complied the following day, aware that these intermittent reflux attacks – once every few months – were becoming more severe. I pulled the medical history in my files to find that my last gastroscopy was six years ago, when they discovered a small hernia at the bottom of my esophagus. Barrett’s Esophagus was diagnosed and anti-reflux Lanzolac pills prescribed, which I took fairly religiously in the evenings for years, forgetting occasionally, as I did before that braai.
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Dr Estelle Wilken, a semi-retired gastroenterologist at Tygerberg Academic Hospital in Cape Town’s northern suburbs, lives around the corner from my Durbanville home. She duly, (and unexpectedly), picked me up on the appointed day, taking me to her unit and performing a gastroscopy and biopsy. Then she delivered me back to my front door.
Flattered by all of this, I learnt from her that my ‘slukderm’ hernia had grown from 2cm to 5cm, with the biopsy results due the following week. She sat me down and laid out the possible outcomes and treatments, including cancer.
Synchronicity
But back to blessings. Actually, I’d prefer to call it Grace. I’m harking back to how the Universe prepared me for this journey. Well before my diagnosis, I’d interviewed 20 cancer survivors for the digital oncology portal of a client – Discovery Health Medical Scheme. To a person, the survivors raised this peculiar concept of being gifted by their diagnosis and journey. I couldn’t wrap my head around it, but as they told their stories it became an enigmatic, golden thread. Gifts come in strange wrappings, this concept being alluded to by even those who were incurable and untreatable. It wasn’t as if they were natural-born Pollyannas, ageing former Flower-Children prone to burst into ‘Kumbaya’ song, or vegans who meditated, inviting in positive vibes. No, these were more mainstream folk, probably among the least likely to fall victim to confirmation bias. Yet there it was.
Grace.
On the day Estelle called to give me the biopsy results, I was about to go into an Emergency Medicine conference session on burnout and resilience, twin-burdens very familiar to our thinly-stretched healthcare workers in South Africa’s trauma-ridden society. I took my plenary seat numb and shocked from my fresh cancer news, my mind thrashing about, trying to figure out how I’d break the news to my nearest and dearest (my then 9 and 11-year-old daughters, wife Suz and elderly parents, then 87 and 89).
Strangely, the words of a transgender paramedic who contributed to the session on resilience sank in. I found myself fascinated and engaged as he challenged his audience to reveal their pre-existing prejudices before describing how these might impact on their Hippocratic Oath in treating patients whose identities don’t fit with traditionally-held views.
Other speakers gave tips on building resilience, while a Gauteng social worker revealed how her consulting rooms were flooded with Sandton executives suffering varying degrees of burnout. Self-care emerged as a top mitigation strategy. And here I was faced with building my own resilience and afraid of overwhelm and burnout with my new existential burden.
Numerous other synchronous events that speak of a Universe/God being ‘for’ me have enriched my life over the past 9-months; from unsolicited suppers delivered, many anonymously, on chemo days, to a chemo-therapy sister transferred to the ICU well before I landed up there after my op. Caroline Plaatjies, a soft-hearted, gentle-handed nurse whom I got to know well during my weekly chemo sessions, asked her unit manager if she could move her ICU shift to nights after learning that I would come out of theatre at 10.30pm. She got herself assigned to me and I woke up to a familiar voice and gentle touch.
Read also: Navigating cancer – with all its gifts and challenges
My six-and-a-half hour operation was a resounding success, albeit radical insurance against cancer spread by removing my stomach, keeping just enough to build a replacement esophagus for the one in which the tumor once resided. I was told by my talented bariatric surgeon, Dr Wimpie Odendaal, that the chemo-therapy had already nailed the cancer, but any chance of recurrence was now consigned to the medical waste bin.
I believe the word used for such brilliant and delicate surgical work, (in my case keyhole), is ‘elegant.’
Some last few words, based purely on my own experience of medical funding. Discovery Health Medical Scheme’s Coastal Saver Plan, (plus my registering for the linked R200,000 per annum Oncology Benefit), saw me through, with just a couple of thousand rand paid out of pocket that weren’t covered by my supplementary Gap plan. I’ve worked out that the medical costs alone came to nearly R400,000. Granted my oncology benefit ran out after seven months, but my Prescribed Minimum Benefits, PMBs, covered the tail.
Without this cover, I’d have had to sell property, deplete my pension savings and see my disposable income for my golden years shrink to an unsustainable pittance. Ironically, one series of stories I did for DHMS was based on their top-performing insurance brokers, at least two of whom offered me Dread Disease and Income Protection cover, the subs for which I found a bit too steep at 63-years-old. This was just months before my diagnosis and I was regaled with stories of double-million-rand payouts to clients who’d taken out a policy, weeks or just months before…
Now that is an accursed wormhole I’ll not dive into.
Cue in Frank Sinatra singing “My Way.”
My regrets are just too few to mention.
- Chris Bateman is a veteran freelance healthcare journalist and former News Editor of The SA Medical Journal. He is on the road to full recovery from Stage One Esophageal cancer. See thrive2write.co.za for his full back story.
