In its way it was a miracle. They had found one another again. The young girl could only express her joy by dancing and tugging at her clothes. Her aged parents simply stood there, without moving a muscle.
I watched as the girl took her father by the hand and greeted him with a curtsy. Then she and her mother ran their fingertips cautiously over each other’s faces.
The last I saw of them was when all three clambered up onto a different lorry which then drove off in a cloud of dust.
Somehow or other the Stephansdom and the cloud of dust in Africa are linked together in my life.
Irrespective of whether or not I am now ill.
PART II
THE ROAD TO SALAMANCA
28
Shadows
There are some things I know for certain about cancer. The first is that illnesses caused by tumours have always affected human lives. There are certain forms of cancer that have increased in our society and our time. What we eat and the environment in which we live have created the circumstances in which some forms increase and others decrease. But tumours have been discovered in the skeletal remains of dinosaurs. Early human beings have also been affected – Neanderthal and Cro-Magnon people as well as Homo habilis.
That is not especially surprising. The basis of life is the splitting up of cells, a process that continues from the foetus stage to the day we die. Our cells are renewed millions of times. The fact that division sometimes goes wrong and starts a process that leads to the formation of benign or malignant tumours is understandable. In fact, one might well say it would be odd if that were not the case. One has to be rather cautious when one talks about nature being perfect.
The second thing we know about cancer is that no human being can be guaranteed to avoid it. The longer one lives, the greater the risk of being afflicted. The risk is slightly higher for men than for women.
It is also true that certain families are more likely to produce a genetically inherited form of cancer. And that some families are more prone to cancer in general than others. There is no plausible explanation for this.
As far as I know there have been virtually no deaths in my family for three generations due to illnesses caused by tumours, but on the other hand practically every male and female has died of heart disease or vascular disorder. For example, both my siblings and I suffer from high blood pressure.
I admit to being somewhat arrogant in this connection; I have often said that I didn’t expect to be struck down by cancer, but my death would be caused one day by a short circuit inside my head.
I was obviously wrong.
The third thing we know for certain about cancer is that it isn’t infectious. I can be surrounded by cancer sufferers without needing to worry. Cancer does not infect others by means of breath, bodily fluids or handshakes.
Nevertheless, some people behave as if the illness was infectious even so – they are not in the majority, but they do exist. When I say that I have it, they take an invisible step backwards so as not to come too near.
That is not especially surprising. It is not many years since a cancer diagnosis was more or less equivalent to a death sentence. The doctors were usually powerless and the disease was not only fatal, it was often also an extremely painful way of dying.
When I received my diagnosis it never occurred to me to keep it secret. Why should it? I don’t know of course how I would have reacted if I’d been told I had syphilis. That can be avoided. It is infectious. But there are only limited ways in which one can avoid developing cancer. don’t breathe in too many petrol fumes and succumb to the type of cancer that is common among lorry drivers. don’t eat too much red meat and find you have developed tumours in your bowels. don’t soak your liver in alcohol. And of course, don’t smoke.
But I haven’t smoked for over twenty-five years and yet, nevertheless, I get a tumour in one of my lungs. If I place bets on all the roulette numbers apart from 1, I can’t be sure that the ball won’t stop on that one. Cancer makes no promises.
The past still casts a shadow over the illness today. In spite of the fact that possible treatments and subsequent results are increasing and improving all the time, it is hardly likely that cancer will ever be eliminated altogether, like smallpox and, one hopes, malaria. But the death rates will continue to decline. Nowadays two-thirds of cancer sufferers are long-term survivors. And that number will increase.
But the shadow is still there. I notice it especially in the way various people react when I tell them about my illness.
When I told people I had torticollis, an extreme form of a stiff neck, some of them seemed to regard it as a sort of joke. It was like when people are hard of hearing and misunderstand what one says. But when I told them the pain was not due to a stiff neck or a slipped disc, but a metastasis in a vertebra at the back of my neck, it was no longer a joke. Some reacted as one would expect: with sympathy, worry and friendly understanding. Others simply disappeared. Ceased to get in touch. They hid away in the shadow of cancer.
During this time I have often thought about what Selma Lagerlöf wrote in Thy Soul Shall Bear Witness!: ‘God, let my soul reach maturity before you harvest it.’
There is no need to worry about the religious undertone. The truth is universal without anyone needing to burden it with Christian beliefs. People who have achieved some sort of spiritual maturity don’t need to hide themselves away in the shadows. They continue to make themselves heard. I am still completely alive, not somebody sitting by the side of my grave, dangling my legs over the edge.
I admit that I have been surprised during recent times. People I thought might well flee into the shadows have proved to be strong enough to remain in constant touch, while others of whom I expected more have disappeared over the horizon.
But I don’t pass judgement on anybody. People are who they are. One doesn’t need to have many friends – but one should be able to rely on those one has.
Cancer is a terrible disease. It is also something one has to deal with alone, despite being surrounded by doctors, nurses, family members and friends. There are seldom outward and visible signs that one is suffering with it. No one who doesn’t know the facts can tell by looking at me that I am seriously ill, since I have lost neither weight nor hair. I look like I always do, and behave as usual. The fact that I am very tired need not mean that I am ill. I might just as well have completed a book, or come to the end of a run at the theatre.
But what about me, how do I behave? Do I hide in the shadows too? Am I also heading for the shelter of thick bushes? Like the wounded animal I am, in fact?
In Zambia many years ago I once took part in the search for a male lion that had been shot and badly injured. There were four of us, each armed with a rifle. We were walking in line, fifteen metres apart. Paul was ahead of the rest of us, when he suddenly stopped and raised a hand. He was an African ranger and hunter, and impressed all of us. His raised hand meant not only that we should stop, but also that we should load our guns. Until now Paul had been the only one with a cartridge at the ready. He pointed at a thicket some fifty metres ahead of us. If Paul indicated that the lion was in there, there was no doubt that he was right.
The wounded lion would try to lie there, silent and motionless, for as long as possible. But if we came too close, he would attack in a last desperate effort to get away from both us and the pain that the wound was causing him.
When he came bounding towards us, it was Paul who shot him with a well-aimed bullet.
In which thicket am I lying hidden? What form will my final but vain attempt to flee take?
Things have not gone so far that I have tried to convince myself that I am not in fact seriously ill. Nor have I felt that I have been unjustly afflicted. That thought is totally alien to me. If cancer had been an infectious disease I could have made sure I avoided taking unnecessary risks. It is not difficult to avoid being infected with HIV, for instance. One can successfully take a minimum of precautionary measures.
It
sometimes happens that at night I dream about being healthy. That it is somebody else who has fallen ill. I stand looking at people I know, but somehow don’t recognise, and express sympathy at their fate.
The truth is that like everybody else no doubt I dream about being the exception. That one day I shall shake off this serious illness and be able to say that by some miraculous means I no longer have any symptoms.
But I know of course that it is not true. The illness is incurable. Even if I live long enough to die of something else, or at least become old enough for continuing to live not to seem all that important.
Facing up to cancer is a battle conducted on many fronts. The important thing is not to waste too much strength fighting against one’s own illusions. I need all my strength in order to increase my powers of resistance in confronting the enemy that has invaded me.
Not tilting at windmills that have taken on the form of shadows.
29
Luminous teeth
I received my first watch with a luminous face at some time towards the end of the 1950s. I remember it as a remarkable, even magical, experience.
I can still recall the green shimmer in my mind’s eye, from the first time I saw it when I was standing in a closed wardrobe.
In 1895 the German physics professor Wilhelm Röntgen discovered that certain beams could pass through various materials, but then adhere to photographic plates. Nowadays we are well aware of the importance this discovery had – and still has – for medical processes: the English expression is ‘X-rays’, but in many Continental languages they are called ‘röntgen images’ after their discoverer. A simple break in a wrist or a complicated fracture in a shin can be analysed with the aid of X-rays and the appropriate measures taken. X-rays can also be used to trace irregularities in people’s lungs that are difficult to find using other methods. But X-rays are not just used to discover illnesses: they are of equal importance when it comes to curing some diseases, especially those coming from tumours, since the rays can be directed to attack the damaged cells.
What was not known at first is that there are horrific side effects from X-rays. With hindsight one can say that the pioneers were not careful enough when they developed treatments without knowing about those side effects. And they affected many people who had no idea what was involved in being exposed to the invisible rays.
In 1915 an American invented a luminescent paint, which he called
‘undark’. His name was Sabin Arnold von Sochocky, and his aims were not scientific. He wanted to earn money. In the company he founded, his employees – who were often illiterate, uneducated girls as young as twelve – had to paint luminescent crucifixes or hands on clocks that would glow in the dark. In order to paint extremely fine surfaces, the girls needed to press the brush hairs together with their lips.
For amusement they often also painted their teeth and nails with the luminescent paint. Then they would go into dark rooms and show one another their glowing features.
Needless to say, nobody had warned them that the paint produced radioactive beams and could be dangerous. In addition, the medical journal Röntgen, which was published in America in 1916, announced that ‘X-rays have absolutely no poisonous side effects. X-rays are for human beings what sunlight is for plants.’
During the First World War the desirability and indeed necessity grew for instruments that were luminous in the dark. A few years after the end of the war it was calculated that there were about 2,000 full-time employees working with the paint.
But now some of the people who had worked with the paint started to die. Their illnesses varied.
Nobody told the truth about why this was happening. A dentist by the name of Theodore Blum did report that one of his patients had seriously damaged gums and that he suspected the cause was the patient’s work painting luminescent hands on clocks. The patient died soon afterwards. But no action was taken and clocks with luminescent hands continued to tick.
It was 1925 before the revelation that it was dangerous to work with X-rays broke through the wall of silence. And it was Sochocky, the man who had started the company, who made the biggest noise and warned about the horrific things that could happen to those working with the luminescent paints. By then he had left the firm he had set up. His own breath was now radioactive.
An investigation into the company disclosed how horrendous things really were. The girls working in the factory were sent into a dark room one by one, and doctors were able to establish that the women were more or less completely luminescent. Their faces, arms and legs, and their clothes, were all glowing as a result of the paint.
Nearly all of them were also ill. Their blood values showed that in various ways they had been poisoned by the radioactivity to which they had been exposed.
The truth that emerged was very simple: the people who thought that the radioactive rays passed harmlessly through the body had been wrong. The radioactivity remained inside the skeleton and in the end, if the amount of beams affecting an individual were too much and long-lasting, that person was smitten with cancer and most often suffered a painful death.
It became clear that the medics and others who examined the patients who had been working with radioactive paints were also exposed to serious risks. A chemist by the name of Edwin Lehman, who worked on the radioactivity, was healthy to start with but died a month later. He was attacked by a blood disease that killed him within a few weeks.
In 1927 five sick factory workers sued the company they had been working for – the firm that Sochocky had started and that he was now working intensively to shut down. There is a lot of evidence of the great despair and feelings of guilt he suffered when he realised the price his young workers had been forced to pay.
The newspapers dubbed the case ‘The five women who are doomed to die’. They claimed compensation for the injuries and suffering they had been caused. One of them had undergone twenty gum operations and the whole of her lower body was paralysed. She was carried into the courtroom on a stretcher along with two of the other women who were also unable to stand. One of them couldn’t even raise her hand to swear the oath when she gave evidence.
The five women lost their first case. The company’s lawyers succeeded in arguing that the injuries had been incurred so long ago that time had run out for any compensation claims. But the women didn’t give up, despite the fact that they became increasingly ill. Several of them were close to death when they appeared in the law courts.
They received support and encouragement from many people who were upset by their suffering. Marie Curie, who had discovered the basic substances that cause X-rays, sent a remarkable message: she recommended that the sick women should eat calf’s liver.
She herself would die within a few years as a result of a blood disease caused by her being in contact with so much radioactivity.
After many more years, by which time two of those belonging to ‘The five women who are doomed to die’ had actually done so, a mediator succeeded in achieving a result in the long struggle. Each of the women was awarded only a fraction of the amount they had originally claimed, but they didn’t have the strength to continue the struggle any longer. Much later it was discovered that even their graves were radioactive.
Six months after the judgement Sochocky himself died as a consequence of the radioactive beams. Cancer had caused his hands, mouth and gums to rot away. But he never ceased to fight for compensation to be paid to those who had been infected, and for conditions for those still working with radioactive paints to be changed radically so that they were issued with adequate protective clothing and equipment.
With hindsight it seems clear that this helped to ensure that those who eventually worked on the Manhattan Project could be confident that their protective clothing and equipment saved them from falling ill in the same way that the women working in the paint factories had done. None of the engineers, physics experts and technicians who created the atom bomb that was dropped on Hiroshima and Nagasaki w
as at risk of their jaws rotting away.
Similar stories can also be told about the injuries and the suffering caused by working with asbestos. Even today the Western world exports ships to India that are to be scrapped, for instance. The ships are crammed full of asbestos. And the workers who are compelled to do the necessary work are often not even issued with simple face masks. Many of them die from asbestos poisoning in which the microscopic fibres that are secreted by the asbestos are sucked into their lungs and eventually form a thick layer that prevents normal breathing. Many workers who are affected slowly choke to death. A worker at the Wittenoom mine in Australia compared the illness to ‘having your lungs filled with wet cement’.
It happens time after time, and will no doubt happen again. People start on new projects without first trying to establish if there are hidden negative aspects.
There is always a risk. And when it happens, a hideous catastrophe can ensue.
The young women working in those factories who decorated their teeth and nails with phosphorescent paint, and laughed at each other’s appearance, were sacrificed at the altar of our constantly inadequate patience.
It is so incredibly easy to take risks with the lives of other people.
30
Photographs
I have seen a lot of photographs over the years that I remember and keep looking at again. Images that capture a moment which, just as in dreams, says something about myself even though I am not actually in the picture.
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