The first time my oncologist explained it I didn’t understand. “If you get coronavirus I won’t be able to get you a bed in the ICU,” she said. “That’s OK,” I said cheerfully, imagining there would be abed somewhere else in the hospital in which I would lie coughing.
It was only when I put the phone down that her words hit home. What she was telling me wasn’t that there were no beds in the ICU but that there were no beds for me specifically. As the possible peak of the disease approaches and doctors face increasingly difficult decisions, so wartime triage will come into play. As a patient with stage IV cancer I will not pass that triage test. My life will not be considered long enough to save.
While they haven’t spelled it out, this simple, bleak truth is largely what lies behind the government’s shielding policy for people like me.
They are not so much shielding us because we will be worse-hit by the virus (although we may well be) as trying to prevent us from ever getting it. And they are doing this in order to ensure that the already overstretched and hardworking doctors of the NHS do not then have to condemn us to die.
This bleak realisation was just one moment in what has been an increasingly surreal week. The experience I share with everyone else – trying to adjust to working from home, in my case alongside my husband and two children, aged 12 and 10 – now runs side-by-side with the experience of being one of the vulnerable, who cannot take a daily walk outside, who must keep their children three footsteps away at all times, and who would be stuck inside my house for 12 weeks even if other restrictions were lifted.
In truth, my coronavirus paranoia had been raging for some time.
One of the strangest aspects is that no matter how terrible my situation seemed, I never entirely thought I was going to die.
There was always hope. Science was changing. New breakthroughs were coming all the time. Oncology is its own brand of witchcraft and there were always new spells to try. Checks and balances, different regimes and possible trials. When one chemo treatment started to stutter, my oncologist was always on hand with another suggestion, another tweak, another possible combination. It is 19 months since my triple negative breast cancer was found to have spread and I am still alive.
Then coronavirus arrived. At first I was furious. To have made it through 19 months of treatment for a particularly aggressive cancer only to succumb to something else entirely seemed too much to bear.
That anger was soon replaced by fear. I found myself interrogating every member of my family as soon as they stepped through the door. Who had they talked to? Was anyone ill? How much contact had they had? My daughter, getting the London underground to school every day, reported packed trains filled with people coughing. In the past I would have shrugged it off as the tail end of winter bugs but now…
I went into isolation. My husband had already decided to work from home, and I soon pulled my children from their schools, three days before the government shut them, worried that with each day my chances of survival were worsening.
It was only when we were all at home, rubbing along with only the occasional explosion, working and laughing and starting to enjoy the new regime of interesting movies each evening, that reality finally hit home.
My biggest concern wasn’t the virus itself – it was the disease I already had. It was the fact that I still had to get treatments and tests and scans but now I had to do it in hospitals that were likely to become increasingly stretched, with staff who were themselves liable to fall ill. Because what you don’t think about when you’re living in a pandemic is that none of the other illnesses cease to exist. Car crashes still happen. Heart attacks still happen. Cancer patients continue to need those tweaks and adjustments that have continued to keep them alive.
On Tuesday I spoke to my oncologist. She had patients who were stopping treatment. Some had chosen to; others had been advised to. Everything was about relieving the NHS burden and protecting those most at risk. I am currently on oral chemo so she felt I should continue; however, she’d prefer me to take a two months’ supply and a series of injections to prevent me coming into the hospital during the worst. Oh, but before that could I come in on Friday, have a scan and give blood, just so they could see how my tumours were behaving?
On Friday I went to Charing Cross Hospital in west London. The usually bustling building resembled a ghost town. Waiting areas were empty, corridors deserted, the lift had one passenger: me. Signs everywhere reminded us to wash our hands. It felt eerily like being in the eye of a hurricane, that moment when the storm is all around but has yet to break, when the true horror has yet to come.
Yet it was also business as usual. My PET scan was straightforward (and quicker than it can be). My bloods were taken, my injection given. I went home having touched nothing and followed my oncologist’s advice to wash everything I was wearing and have a shower.
Then the bad news. The scan suggested the cancer, subdued for so long, is growing. The oral chemo may not hold it. Weekly intravenous chemo could be the only answer. But what of the surge? My oncologist stressed again as she had at the beginning of the week that there would be no ICU bed if I caught coronavirus. This time I wasn’t confused.
So here we are. With 11 weeks of lockdown to go and the knowledge that I will probably spend every Friday, with face mask and gloves, crossing every finger and praying to every god, not just the Catholic one I was raised with, that the chemo works, that I don’t get the virus, that the nurses and doctors, the physios and OTs, the receptionists and cleaners, the pharmacists and restaurant workers, all those people who keep the great machine of this great hospital ticking over, stay safe and well.
The rest of the time I’ll probably fail to keep that three-step distance, hug my children a little closer, kiss my husband and continue the crash course in great movies that’s going down so well.