Into The Valley
Ahoy! Ahoy! Land, sea and sky!
On the phone, babbling utter cobblers to my wife. Random bullshit flowing from me with all of the grace and lucidity of a turbocharged pisshead who’s picked up a mobile and called the first stranger on it to ask if they can borrow twenty quid. From the sound of her voice though, I think I could have asked for a fifty and got away with it.*
I hadn’t actually made that call. It had been dialled at around half past three in the afternoon by the neurosurgeon - our longtime specialist (and new best friend) at Southmead Hospital - and then passed over to me. For the last eight hours, he’s been inside my head. He has cut his way in and checked out what was in there that shouldn’t be. He has issued a low electrical current across my brain via implanted electrodes and he’s mapped out all of the critical areas on the inside of my skull where the tumour might be. The edges, the borders, the wrinkles and crinkles. And then he has dug right in to get the thing out. Eight hours spent in a stark white room. Everyone in their right place, me included.
The phone call happened minutes after surgery ended. Everyone had left the white room, relief smiles on faces, scrubs off, weekend incoming. Moving through the corridors, the surgeon is walking and I’m being wheeled alongside him. I have thirty or so metal staples punched into the left side of my head and a massive ill-fitting bandage that’s attempting to cover up what’s just happened. Add a bed robe and a connected up giant pissbag and I could be modelling a ill-judged Halloween costume.
The phone call to my wife is the update she’s been waiting for since 8am this morning. That was the point she headed out of the admissions room with a genuine fear that she was saying goodbye to the version of me she’d known for the last twenty years for the last time. The surgeon’s breeze quick introduction is followed by the words, “I’ve got someone to talk to you.” Although I can remember very little, it feels like one of those rare moments where you can consider yourself part of a success, like when an album hits No 1 and you’ve been a central part of the team that made that happen. Or when the winning goal goes in at whistle time and you’ve been a connective piece of the machine that got it in the net. You’re not the start or the end of this. You didn’t cross the winning line with the baton. You’re right there at the centre of it all though. You’re the big beating heart that everyone’s reaching in to cuddle. Take that feeling, own it.
And quietly pray that this doesn’t happen to you or anyone else that you know, ever again.
As the operation approached, hospital meetings increased. New faces were introduced, people who would become more and more key in the procedure. Our neurosurgeon was still in control, he just needed me to meet the anaesthetist and the neuropsychologist who would be my points of contact on the day. Any nervousness about awake surgery had been pushed to one side - the spirit of the day was very much this is happening, this is the way it’s going, let’s get on with it. Natural state well and truly bucked, please meet the two people you’ll be happily chatting to as I work. All eyes on them and you’ll be ok.
Both the anaesthetist and the neuropsychologist were heroic from the first meeting onwards. The anaesthetist talked me through the drug cocktail as if it were something being offered just off the dance floor for minimal price and maximal mind expansion. We talked about my work. He’d seen most of my bands back in his university days, we’d both been at a Chemical Brothers gig in Cardiff University in the spring of 1997, me working, him a fan. He absolutely loved it (hearing that, the slow, sad awareness that so much time - my time - had passed became so monumental I couldn’t help laugh out loud at it). Endlessly calm, he was a Zen presence who was on hand to administer the good times and up the intake if I looked panicked. We talked about whether I wanted to be knocked out fully or mildly taken under.
“Why would I not want to be as far from consciousness as possible on the day?”
“General anesthesia will fully knock you out but bringing you back into the room during surgery will take longer. And you’ll feel more rotten afterwards.”
So. Awake surgery really will be done awake then.
The neuropsychologist was the person I would be talking to during surgery. We edited a series of tests that are designed to keep an eye on whether the brain still works correctly. She would be the person asking the questions. The tests are visual identifications and associations that give the surgeon a green light as to whether he’s digging in the right place or headed somewhere dangerous. Talking prior to surgery, any potential stumbling blocks were removed for sanity sake. On the day, you answer the questions and you raise your right arm and ball a fist as you do so. The tests would go on for the best part of an hour. Answer, raise, fist. Answer, raise, fist. Repeat, repeat, repeat. If my voice went into a stutter or my fist stopped in mid air, he would have touched somewhere sensitive. Patient has entered spinning pinwheel mode? Best move the needle sideways.
The two weeks leading up to the operation are strangely peaceful. Everyone in the hospital calm, in control, can handle whatever’s coming their way. Easy. And that spirit passes over. In the days before the operation, the wife and I go to restaurants we’ve pored over but never visited. Menus are long and lunches are boozy and pasta heavy as if we’re living out our own last days of the Roman Empire. The stress of the upcoming surgery is sat somewhere over there, just out of sight, chugging closer and closer while the waiter brings the dessert list over and checks if we’ve had enough to drink (guess the answer here). Hugs with our kids are a little tighter, a lot longer.
Awake. Blinking.
I’m blinking awake.
Centre of it all. Everyone right place. Me included.
Not sure what time is. Line of sight limited. Can’t feel much of anything. Like being high. Long way from feeling sober.
I’d had a gentle conversation with the surgeon at 7.30am.
How much do you think this would all of this cost if I had done a runner and hadn’t turned up?
Oh I don’t know. Maybe about the price of a nice family holiday to the Caribbean.
I spend a few seconds weighing up in my mind if there was a way I could ditch this and also get that nice holiday.
Stop thinking, put the bloody hospital gown on.
People moving about. Can’t make out much detail. Anaesthetist. Checking. Neuropsychologist. Masked up. Looking straight at me. Am I able to talk.
Head slightly on the wonk. Dialogue directed towards left ear. That one’s broken. Right is blocked. Surgeon needs that angle. Damaged receptor. Most crucial conversation today. Or any other day.
Before surgery, a friend had told me about their friend who had had awake brain surgery. Incomparable to anything else. An hour long trip. Properly psychedelic, a connection between you and the surgeon who is literally, actually inside your head. Questions, answers, over and over on a loop.
And they were right. So in this one-off moment - this unrepeatable union, all this glorious trust between you, the surgeon and whoever else in the room has a flash of your attention even if just for a second. This is the centre of it all right now. And it’s fucking wild.
Testing, testing. Continuous testing. Associations, pictures, connections. Answerraisefist. Answerraisefist. Repeatrepeatrepeat.
Between tests, conversation. Light and bright.
I have to add that there’s no pain here. That will come later in different forms. Blurred and fitful sleep, headaches and intense focused agony as the head staples are removed by a nurse at the GPs. In the white room, the anaesthetist has controlled things to the point where it feels like I’m up there floating above everything. No real sleep so far, just a controlled doze that I’ve now been pinged awake from. The questions the neuropsychologist asks are simple enough but the process itself is something of a puzzle cube - easy enough to deal with when talking about it in the pub, tricksy when repeated over again for an hour. But we forge on and no one blinks. This was always going to be the way to solve things. You knew it from the first meeting at the hospital. Let’s just get on with it.
Neuropsychologist looks tired. Long day this. Surgeon talking. Voice behind me somewhere. Hand in my head. Tells me about daughter. Introduced him to Chemical Brothers music**. Still talking, keeping talking until we can collectively turn the lights out again.
Because surely talking is always a good idea.
*My wife has pointed out that I was fine on the phone - happy, a bit groggy but generally ok. She has also pointed out that the following day I was like a mad old grandmother when she visited, very much ‘not you again’ before turning round and trying to go back to sleep.
**Three weeks later, talking back through things, the surgeon tells me we actually talked about Underworld, and how he introduced them to his daughter. Chemical Brothers, Underworld… there’s very good taste in the nuero-family, clearly. Maybe the anaesthetist, the surgeon and myself aren’t all so out of time after all.
Realise these posts have zipped back and forth time wise. That might be the definition of being scatterbrained but it wasn’t always intentionally the way I wanted things to go. Maybe there’s a director’s cut of all of this in the future, where events run sequentially and it all builds and builds to some crazed peak point. Scatterbrained - to be overhauled by James Cameron between crazed Avatar shoots.
Before signing off, I wanted to give a massive heartfelt thanks to everyone who’s subscribed and said nice things about what’s been written. It’s not always been the easiest process and sometimes these texts feel like pretty deranged once I’ve pressed send. So thanks for support and kindness, means the world.