THE DEATH SUITE 9: PUMP PHASE
This was my third experience of chemotherapy, and the first two were more tolerable than I had expected. Was I going to miss out on the chance to write about a more full-on version? It turned out not… The chemo ran from October 2025 - April 2026, over 11 cycles - 12 were planned, but the last was cancelled following my hospitalisation after Cycle 11, when doctors judged that the severity of the side-effects outweighed any further benefits.
CYCLE 1
Someone offered me a seat on the tube today
First time ever.
Was it the age or the cancer?
I'm pretending it was my two big bags...
That's me, as reflected in the angled outer metal of Maggie's cancer support centre, Southampton.
Looking at it positively
this is the most efficient use
of our cancer table
since 2023…
Ten poos today!
Must be another positive:
my system working soft as poss
to flush out a passing enemy.
I'm not against death
I see the necessity,
so it seems a bit rich
if I plead a special case.
And what's the point
I might have asked, however long, of life itself?
But that gets a little grand:
I've only got four lines.
With a PICC line in place
the nurses say I must serve underarm -
my tennis reflecting
how cancer alters the game of life.
Chemo is pleasant
Four hours hooked up in quiet
with regular drinks and no distractions.
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Four poos per day’s
been my average now for eight months.
Have I missed my big chance
to make a thousand-image archive?
Why, today, do I think of death?
Same reason, I guess,
as every other day -
and yet, in a way, I think nothing of it.
First line combinwa the last two lines of James Schuyler’s poem ‘Labor Day’, 1974
My plan is simple -
live
until I die…
If you can call the unavoidable a ‘plan’.
Which tumour’s going to kill me?
may be my most macabre question.
Bowel, lung, mesentery or liver?
And does the difference matter?
CYCLE 2
Ha!
My first blood test with a PICC line in place
and the queue is an hour!
I switch to the wait-free needle-in-vein.
It’s a differently-staffed procedure to extract blood from a PICC line, and there were three nurses for the needle, one for the PICC line, and a considerable imbalance of demand
My new sleep buddy
is a pump.
But Steph can hardly be jealous
It’s only twice a fortnight.
‘I’m happy’, I tell the senior nurse when she asks for feedback
‘that you’ve kept me alive to answer that’.
That’s my schtick and I’m sticking to it
until it’s not true.
Three days with the pump each fortnightly cycle
Three others with appointments.
Four too coshed to do much.
I’d better make the most of the other four!
How can death be seen as bad?
A non-experience
with no ‘me’ to not-have it anyway.
All the same…
See, for example, Thomas Nagel: ‘Death’ in the philosophy journal Nous IV, no. 1, 1970. That's the PICC protector used when taking a shower.
I have this mental picture of myself
as a vigorous young man…
Aged 67,
dying of cancer.
Who wants immortality?
The Greenland shark can live five hundred years or more,
slowly-slowly down in the deep.
Sounds like a reasonable compromise.
It seems odd to be afraid
of replacing all your problems
with one that solves itself
in an instant.
How do I fancy it?
Should I slip away, pass on, join the choir invisible?
Leave the voting list, switch to counting worms?
Cash in my chips, turn turtle, or just go Father Ted?
All my food
is fast these days:
not so much arriving
as departing.
No-one ever asks me
if I’m going to die.
It’s as if they’re afraid
of hearing a spoiler.
CYCLE 3
Ah, my hair
is thinning!
Real chemo’s here –
at last!
I am starting to suspect
that I won’t be living long enough
to see England lift the World Cup again…
But I guess that’s not as doomy as it sounds.
(The next World Cup will mark 60 years since 1966. If it’s a centennial cycle, for example, I could yet be an exceptionally ancient man and fail to witness the next English triumph)
Measured by volume
I am a water addict.
Measured by urges
I am not so sure.
It is important to drink two litres per day when on chemo, but the chemo makes it harder to do so
Never mind why
all this had to happen.
Why did all this have to happen
after I'd retired from paid leave?
I had five days off sick in forty years at work. I'm approaching four months in hospital, never mind ill, in the last four years.
Chestnut – tawny – crimson - amber - fawn
Looks a tasteful sequence,
but is last month’s weekly spectrum
of the colours I have pooed.
Chemo is a chemical blast
that hopes to catch some cancer
in its fall-out.
No wonder I feel rough.
Four days
of wanting only sleep.
If this were permanent
it might as well be.
How come
though I prefer the state of sleep right now,
when I awake
I always hope it's time to get up?
It usually isn’t, as I wake every two hours or so
If love’s a consolation
then I have it –
although, of course,
that means there’s more to lose.
Now for night
That’s one day fewer
I have left…
Just the same as everybody else.
This won’t make a TV drama
We know the ‘who’.
We know the ‘how’.
How much can we really scrape from ‘when’?
The traditional detective tale is a whodunit. I love ‘Colombo’, which is a ‘howdunit’- or, more strictly, a ‘how-will-he-work-out-they-dunnit’. I’m not sure the ‘whendunit’ is a genre.
I don’t resent my sleep
the way I used
for wasting time:
I thank its for its service.
The irony is
that now I want sleep I can’t get much:
something in me wakes me
every hour or two.
Chemo is set
to sort the problem:
not of dying,
but of wishing to live.
Diarrhoea or constipation?
The chemo and the tumour are battling it out.
Can’t they reach
a sensible truce?
The answer to slow movement
is paper.
For the brain, not the bum,
I ought to add.
I write for Art Monthly as well as reading it.
I seem to have
sufficient people pitying me:
there’s nothing to be gained
by adding myself.
This is about as beautiful
as diarrhoea gets.
Don't make me
lift the lid!
More of this
and it’s ‘Fuck the Chemo!
Bring on the cancer
and see what that can do!’
Photo is of Hamwic House cancer treatment centre, Southampton Hospital
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diarrhoea
I’ve almost learned
to spell it!
To be regularly irregular
and irregularly regular
have become the ruling rubrics
of my life.
How should I illustrate
What I’ll call the poo-ems?
I don’t like
to use those photographs.
CYCLE 5
This is my ‘pump shirt’
specially sourced by Steph
with the perfect pocket,
plus style and warmth.
Steph is a wonderful organiser
She doesn’t trust me
to be the same -
and she’s probably right.
How can I not be grateful
to be awarded a Blue Badge?
Well, I see that means my doctor has certified
that I’m likely to die within a year…
Online information indicates that my doctor must have submitted an SR1 form to the Department for Work and Pensions stating that I have a progressive disease and, as a consequence, she ‘would not be surprised’ were I to live for less than 12 months. Details redacted.
I need to thank chemo
for my horribly late introduction to male grooming:
face cream is needed to offset
the dry and acned skin effect.
I ought to look forward
to what could be my last Christmas,
but it’s my fourth potential-last-Christmas
and I think I’ve had enough of those.
The tree in the cancer centre where chemo is administered
Boo to you
sore tongue!
I stick you out
defiantly!
Einstein's tongue
Six months chemo
is likely to last at least seven,
due to breaks, rewarding the bad behaviour
of side effects.
My first 5 x 2 week cycles have taken 13 weeks, due to week postponements – and that is typical according to medical staff. I wasn't actually in the treatment centre on Christmas Day - the clock isn't set correctly.
Thank you
diarrhoea and mucositis
for my Christmas break,
and a Happy New Year.
Mucositis is when your mouth gets sore and inflamed. Like diarrhoea, it's a common side effect of chemotherapy.
How different is the back of my chemo hand
from how it used to be?
I realise now I can’t have known it
quite as well as I'd have thought…
Jon Fosse's 'Septology' is my book of the moment
Should I mourn
my loss of pubic hair?
I don’t think so:
people pay to have that done!
Fortunately, it being Christmas, there’s no need to get too personal to illustrate bald balls
I guess my life has shrunk
to the pump and the keyboard.
But give me anti-sickness and a new idea
and it’s not so bad a shrink.
CYCLE 6
2026!
Not one I expected to welcome in:
deserving of a double drink
if that agreed with chemotherapy.
That is another view Hamwic House, the cancer treatment centre.
I answer to the name ‘His Fluffiness’
on account of my new dressing gown.
If you’re moved to throw in ‘Royal’,
go ahead.
Give it up for the Friday morning mix…
Double dexa, doxy, codeine, double lop with multivit.
However they land, I guess
they go down much the same.
The more formal description 2 x dexamethasone, 1 x doxycycline, I x codeine sulphate, 2 x loperamide hydrochloride, I x A-Z complete multivitamin
I seem to spend
plenty of time
in pyjamas,
unlikely to fly beyond them for a while.
One of my sets is patterned with birds. I’m planning no flights during chemo.
My hair is going fast…
Which might be good:
I’ve wondered what I’d look like bald,
but never quite enough to shave it off.
The world of logs
covers pills and poos
and appointments and weight
and life moving on towards whatever’s next.
I’ve found the key
to chemo comfort:
three pairs of socks
without increasing my number of feet.
What if life continues
through some mental equivalent of the Law of Conservation of Matter?
Surely my thoughts will be far too dissipated
to carry on constituting me.
It’s true I haven’t suffered much
but I have had to eat
crumpets, pancakes and bagels
I rather like them
At least it means that I can travel
further than I’ve ever done –
Mars, the Milky Way, planet Twix, the Galaxy -
by way of chocolate bars.
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Increasing amounts of loperamide
do nothing to stop me pooing.
I say ‘it isn’t working!’
The doctors say ‘you need more!’
The day had a neat symmetry: 8 x loperamide, 8 x poos. My diarrhoea has been the same at 0, 4 and 8 pills daily, but Dr Rees says she has patients on 16 loperamide daily, though the packs say 8 is the maximum dose. Who knows what the dose does?
CYCLE 7
The steroid night’s
disruptive, but productive:
I’m not sure what to think
of thinking preventing sleep.
I believe this is the 5th anniversary
of this kite getting stuck up a tree in the park.
Let that be my metaphor of the day
for cussedly hanging around.
Bad news, perhaps?
My skin’s improving,
when rashes tend to correlate
with chemotherapeutic effect.
I’ve taken to pooing
in the middle of the night.
Sometimes I make
no sense to myself.
Suddenly
a run that's not a run
of seven 4’s on the Bristol scale.
Just a blip, or solid progress?
Back to number 6
Maybe that sequence
was merely
a flush in the pan.
Dry skin alert!
Steph has to rub cream all over me…
I don’t ask her to pretend
she doesn’t enjoy it.
The good news is
I’m responding to the chemo.
The bad news is
I’m telling it to fuck off.
My CEA marker has reduced, but chemo remains an unenjoyable experience
Let’s face it
No-one likes
to take pills.
But here we are…
A breakfast mix of 2 x Adcal-D3 calcium carbonate, 2 x Dexame Thasone, I x Doxycycline Capsule, 1 x A-Z complete multivitamin
A booklet asks
‘Should I scalp cool?’
It seems like quite a faff
simply to repatronise the barber.
I didn’t notice this booklet during my first chemo courses. It proposes wearing a specialised, cold cap on the head. By lowering the scalp's temperature, that narrows blood vessels and restricts blood flow, decreasing the amount of chemo drugs reaching hair follicles - which reduces damage and promotes faster regrowth. The cap is worn for some 30–50 minutes before, during, and up to 4 hours after chemotherapy.
How quickly
norms are set!
If I woke without a sore tongue now,
I’d wonder what was wrong…
CYCLE 8
My tumours have shrunk!
I’ll have long enough to reread Proust
to celebrate finding
the time I thought was lost.
A scan revealed that the chemo was working. Among novels, Marcel Proust’s ‘In Search of Lost Time’ (1913-27) is the longest masterpiece - 4,300 pages, over 1.3m words…
What's a boon it is
to live five miles from the hospital…
If only we hadn't used to live
just half a mile away.
Ha ha, ha ha!
It’s a funny old world
if the best way to take life seriously
is to laugh in the face of death.
‘We take life seriously, laugh in the face of death’ – Bill Callaghan – 'The Man I’m Supposed to Be', 2026
Apparently I always smile
when the question is asked
and I list the sites of my tumours.
Well, I don’t think scowling will scare them off.
What was my hurry?
Almost four years in
I attend a Bowel Cancer Support Group,
discover a community of sorts.
The meeting concludes
that it’s easier to reach acceptance
if spared the trauma of uncertainty
by a terminal diagnosis.
Most of us will fall in love
all of us in death.
So yes, I am a fool
for death - who isn’t?
Several different songs have been titled ‘Fool for Love’ or ‘A Fool for Love’. I’m most familiar with that sung by Bryan Ferry (written by Ferry and Dave Stewart in 2002)
Is seventeen poos in forty hours
enough to trigger hospital admission?
So it seems, to my annoyance –
I have things to do, I have people to see!
Everyone has cancer in ward 4C
but no one else seems well enough
to make the most of that
as a conversation starter.
I cheer myself up with a chunk of madeira
and an online search for jokes about death:
a dying man’s allowed no cake
because it’s being saved for his funeral…
3 a.m.
It’s time to play my hospital song,
‘I Can Remember This Life’.
Hang on, I want that again!
I discovered – and repeatedly played - Julian Cope’s ‘I Remember This Life’, 2008, during my first stay in hospital, in 2022. That's the current - surprisingly subtle - state of my 2022-23 scar.
TWO WEEK BREAK BETWEEN CYCLES 8 AND 9
My ‘chemo breaks’
make plenty of sense.
What's the point of extending life
by rendering it unliveable?
From time to time my oncologist postpones a gap in treatment to allow fuller recovery from side-effects.
What is the cancer doing to me
inside? Is it anything like
what Maggie’s reflective cladding
is doing to me outside?
Maggie’s is the cancer support centre at Southampton hospital
Bristol poop chart cakes
are an on-line presence:
slightly disturbing,
even if they are made with flour, eggs and cocoa powder.
Hello, I am your cumulative effect
Here to tell you not to settle
into an over-predictable cycle.
I don’t expect to be liked.
How significant can
an absence be?
Quite significant, it seems to me,
but only because
I’m present to think so.
I got my Blue Badge
for the likelihood of not lasting a year,
but note that it’s valid for three…
there’s a best-use target!
Call it a chemo bonus…
I’ve read almost all
of Volume 5 of Knausgaard’s Struggle
while sitting on the loo.
Paradoxically, although I have diarrhoea and the initial movement can be more than urgent, it often takes a long time to issue forth in full. Karl Ove Knausgaard’s ‘Some Rain Must Fall: My Struggle Book 5' comes in at 662 pages. The full cycle of six was first published in Norwegian across 2009-11. Whether I’ll get time to read his second series of novels – as of 2026 he is working on the seventh and final volume – is a moot point. No-one has that much diarrhoea!
Here’s a plan
Die before the ones you love,
before you can be otherwise
Worryingly
I read that, although the sun will not die for 5 billion years,
it will grow too hot for photosynthesis to occur
in a mere 500 million.
Home comforts and a wonderful wife
remind me how many
miserable and lonely
endings are available.
The belief
that I’ll run out of worlds
after this one
makes me a little more reluctant to leave it.
CYCLE 9
If all I got was chemo-doze
and chemo-daze
I’d knock this on the fuddled head,
but half the time? OK.
Four years on I haven’t died
Not even once.
Perhaps I will have long enough
to get fed up with life.
Why did I wake with the question
‘Does Burkina Faso still exist?’
Nationalise me now:
the average state lasts 300 years.
It’s not in the news much, but that’s its flag, using Pan-African colors in which red symbolises the revolution, green represents agricultural abundance, and the yellow star signifies the guiding light of the revolution. The Republic of Upper Volta gained independence from France in the year of my birth - 1958 – and was renamed in 1984.Burkina Faso means something like ‘Land of the Upright’ in a mix of the two main languages: Burkina is Mooré for ‘upright’ and ‘Faso’ is Dyula for ‘fatherland’. In ‘The history and future of societal collapse’, 2025, Luke Kemp works with a dataset of some 300 states across the past 5,000 years to conclude that the average lifespan of a state is 326 years, not so bad for a human member – indeed, current life expectancy in Burkina Faso is only 65.
Given I only just found out
that Albert Einstein said
‘When you stop learning you start dying’
I won’t be starting quite yet.
It didn’t worry me
to come across an apparent end:
I can’t see the real thing
being orange.
Maybe Zeno can apply
to death’s arrow…
though I concede
it hasn’t worked for anybody yet.
Applying a Zeno-style paradox would be to suggests that to die, you must first experience half of your remaining life, then half of what remains, and so on, theoretically creating an infinite series of ‘near-death’ moments that can never reach the final and decisive moment. But I guess we live in practice, rather than theory.
I wake, my Panny-thickened
eyelashes all gummied up with scuz.
Is the message not to bother
opening them at all?
Death would be
too much for me today.
Not because I couldn’t cope,
but because I’ve too much else to do.
‘Should I have offered to go to the funeral of the girl’s father? Death would be too much for me today.’ – Clarice Lispector: ‘For the Time Being’ in ‘The Via Crucis of the Body’, 1974
You won’t think
my chemo look is beautiful –
unless you judge aesthetics
by the underlying purpose.
Advantages of cancer, Part 3
Dieting made easy, Maggie’s cups of tea,
savings on barbers, nurses good as gold,
all that fucking empathy and not getting old.
At what age do you tip
into starting to die?
Whatever, I propose to live
as if I’m not there yet.
According to Witold Gombrowicz in his novel Ferdydurke, 1937, as soon as you hit 30, you start dying rather than living – in line with his view that ‘dying’ is the loss of authenticity that begins when society forces ‘mature’ form upon the individual.
‘Irony’ may be going too far
but, whatever the right word is,
the paper cuts on the end of my fingers
made these lines awkward to type.
The medical summary states that ‘Panitumumab can cause some unique skin and nail side effects. You may develop a rash. You may also develop very dry skin, which may crack, itch, or become flaky or scaly… You may develop an inflammation of the skin around the nail bed/cuticle areas of toes or fingers, which is called paronychia…Nails may develop ‘ridges’ in them or fall off. You may also develop cuts or cracks that look like small paper cuts in the skin on your toes, fingers, or knuckles.’ As of March 2026, I have a fairly full score across those minor matters.
CYCLE 10
Why Panny should make
my eyebrows bushier
while the rest of my hair falls out
is baffling enough for a raised response…
Cycle 10 should be like death
You know what’s coming, if not quite when.
Yet chemo is full of surprise effects,
maybe death will be the same.
And, so far, Cycle 10 is good
a steady flow of little impact.
What’s gone wrong
to make things turn out right?
What lies in between
life and death?
Life, I suppose,
but hardly any of it.
It seems that I am full of shit
and I’m not being insincere,
deceptive, daft, or vulgar…
My stream is literal and plain.
Seven all-too-voluminous times
in seven hours?
Where does it come from,
especially when my bowel has been reduced?
My mantra for symptoms is
‘They’re nothing much’. If they were something
I’d have to stop doing things I don’t want to stop,
so they’re nothing much.
If life is a funny thing
that happens on the way to the grave,
should I be laughing
or is that for others, after I’ve gone?
Quentin Crisp: 'Life was a funny thing that happened to me on the way to the grave' - The Naked Civil Servant, 1968.
‘What's wrong with me today?’
‘You're dying’.
Oh yes,
I suppose there is that.
By the time I’ll have finished
acting out my death,
the real thing looks like being
some way overdue.
‘In the shadowplay, acting out your own death, knowing no more’ – Joy Division, Shadowplay, 1981.
It’s a shame for Steph
that ‘I will love you till I die’
doesn’t promise
long-term dedication.
For now, at least
I’m too busy to die,
though I guess I’ll get around to it
in the end.
CYCLE 11
It’s one of those days
when you wonder what it’s easier to survive –
the medicine.
or what it’s up against?
A second visit to the Bowel Cancer Support Group
persuades me that my chemo side effects
aren’t so bad as those of others.
All of whom – oddly – are constipated.
It’s curious to be in a social group
whose common denominator
is bowels, tiddly pom,
and the naturalness with which we discuss their movements.
From one poo to another: 'tiddly pom' was one of Pooh's favoured hums in A.A. Milne's books book Winnie-the-Pooh (1926) and The House at Pooh Corner (1928)
Time vanishes
all the time.
I’m relying on death
to solve that.
What’s the point of an adventure
you don’t actually experience,
however big
the prospect might seem?
JM Barrie described death as ‘an awfully big adventure’ in ‘Peter and Wendy’, 1911.
Can I write a poem
that doesn't mention
what I'm effectively spelling out now
in the name of its avoidance?
In our nth appointment with Dr Rees
she says my side effects are worse than average:
she takes my rashes and diarrhoea
more seriously than I do.
‘My Medical Record’ on the NHS system shows I have had 120 medical appointments as at April 2026 (many, but not all of them, with my oncologist, Dr Rees)
So much so she recommends
I stop the treatment – why object? –
a cycle early
in favour of my quality of life.
I may be a half-full type
yet I acknowledge
that the emptiness exists –
and in time it will be absolute.
The long term is as dead
as I will be in it
by which I mean I won’t be in it
to make my meaning clear.
It’s simple
for mayflies:
They have their dying season
and that’s that.
Here's my official diagnosis as at December 2025:
Diagnosis: · Metastatic colorectal carcinoma (T3 N1 M1c, primary removed, liver, peritoneum). · No DPYD mutation detected. · MMR proficient. · BRAF/KRAS/NRAS wild type. Treatment History: · Oct/22 ascending colonic primary T3 N1. · Nov/22- Jan/23 Capecitabine and Oxaliplatin chemotherapy x4 response to treatment. · Jun/23 exenterative surgery and right hemi hepatectomy. R0. · Decision to proceed with pelvic peritonectomy HIPEC and redo right hemicolectomy. No peritoneal malignancy was identified. · Aug/23 - adjuvant Capecitabine and Oxaliplatin chemotherapy x2 discontinued because of rising CEA. · Oct/23 PET peritoneal recurrence midline and left rectus abdominis muscle. MRI liver no metastatic disease. · Apr/25 PET avidity para-aortic and pre caval lymph nodes and in relation to SMA. · Sep/25 - Multi-site progression - Lungs, single liver lesion, disease encasing SMA. · 10/25 FOLFIRI panitumumab
I reviewed Paul with his wife today. His fourth cycle of FOLFIRI and panitumumab was delayed by 2 weeks because of diarrhoea and then mucositis. His bowels are now opening 3 times a day and continue to be loose but formed. He is currently using 3-4 loperamide a day. His mouth has improved although the tip of his tongue remains sore. He has regained the weight that he has lost. He still has a cracked heel but is moisturising his trunk, feet, and hands. There was no visible panitumumab rash affecting his face, but he does have a grade 1 rash affecting his back. He has grade 1 alopecia. I have advised reducing the FOLFIRI to 70% for cycle four with full dose panitumumab and this is planned for Wednesday. I have also given him some codeine phosphate in addition to the loperamide to experiment as to whether this helps to slow his bowels. I have suggested he starts taking the codeine phosphate at night. We have agreed that he will have a telephone consultation in 2 weeks' time with repeat bloods prior to cycle five. He has a mid-treatment CT scan booked for the 5th of January. The CEA has fallen with treatment.
Photographs
My photos taken at home or at the cancer treatment centre in Southampton Hospital are combined with abstract images - either of things that look abstract up close, or the results of accidental photographs over the years which I have saved for their abstract qualities. Those are supplemented by the occasional playful found image.
