When I Die

by Philip Gould

  When I Die

  Philip Gould

  Written during the last few months of Philip Gould’s life, this is a hugely inspiring and ultimately uplifting look at his “lessons from the death zone”

  On 29 January 2008 Philip Gould was told he had cancer. He was stoical, and set about his treatment, determined to fight his illness. In the face of difficult decisions he sought always to understand the disease and the various medical options open to him, supported by his wife Gail and their two daughters, Georgia and Grace.

  In 2010, after two hard years of chemotherapy and surgery, the tests came up clear - Philip appeared to have won the battle. But his work as a key strategist for the Labour party took its toll, and feeling ill six months later, he insisted on one extra, precautionary test, which told him that the cancer had returned.

  Thus began Philip’s long, painful but ultimately optimistic journey towards death, during which time he began to appreciate and make sense of his life, his work and his relationships in a way he had never thought possible. He realized something that he had never heard articulated before: death need not be only negative or painful, it can be life-affirming and revelatory. Written during the last few months of his life, When I Die describes the journey Philip took with his illness, leaving to us what he called his lessons from the death zone.

  This courageous, profoundly moving and inspiring work is as valuable a legacy to the world as anyone could wish to bestow - hugely uplifting, beautifully written, with extraordinary insight.

  Philip Gould

  WHEN I DIE

  Lessons from the Death Zone

  To all the staff at the Royal Marsden Hospital, London and the Royal Victoria Infirmary, Newcastle

  Cast

  DR JERVOISE ANDREYEV Consultant gastroenterologist at the Royal Marsden Hospital who has done extensive work dealing with the side effects of cancer treatment.

  DR MURRAY F. BRENNAN Leading cancer surgeon at the Memorial Sloan-Kettering Cancer Center in New York City.

  DR CRAIG CARR Consultant in intensive care at the Royal Marsden Hospital.

  PROFESSOR DAVID CUNNINGHAM World renowned oncologist and head of the gastro-intestinal unit at the Royal Marsden Hospital.

  DR ALISTAIR GASCOIGNE Head of intensive care at the Royal Victoria Infirmary, Newcastle.

  DR CONOR GILLAN Anaesthetist at the Royal Victoria Infirmary, Newcastle.

  DR KAZIMIERZ MOCHLINSKI Medical oncologist, specialising in gastro-intestinal cancers at the Royal Marsden Hospital.

  MR SATVINDER MUDAN Consultant surgeon and surgical oncologist at the Royal Marsden Hospital.

  DR MAURICE SLEVIN Consultant medical oncologist based in London.

  DR DAVID STURGEON Consultant to the University College London Psychology Therapies Service, specialising in issues arising from death and dying.

  DR DIANA TAIT Consultant clinical oncologist at the Royal Marsden Hospital.

  Image © Adrian Steirn

  Foreword

  I first met Philip Gould on 15 June 2011. James Harding, the editor of The Times, and I arrived at his house near Regent’s Park expecting to find a man on the edge of death. In fact we found someone full of life, who had that very day been given hope that he might have as long as another eighteen months to live. He was cheerful and gregarious and looking forward to a holiday in Italy with his wife, Gail Rebuck.

  We had come because he had written the long and detailed account of his treatment for cancer of the oesophagus that makes up the early chapters of this book. He was keen that it should receive as wide an audience as possible. At more than twenty thousand words it was a difficult proposition – too long for conventional serialisation, too short for a book – but he wanted The Times to publish it. What he had written was so powerful that James decided to print every word, four pages a day for a week.

  We settled on trying to give each instalment a cliff-hanging end, so people would want to return the next day to find out what happened next. Philip enjoyed this idea of treating his work almost as if it were a thriller. We decided to call the series The Unfinished Life, thereby giving a nod to Philip’s magisterial political book, The Unfinished Revolution.

  Philip took a very active part in the serialisation, bombarding us with emails, insisting on writing all the picture captions and reading all the proofs. He and Gail also gave a moving interview to Janice Turner for The Times Magazine.

  The serial was extremely well received and readers of The Times left Philip in no doubt of their appreciation. The message boards and our letters department were inundated.

  Philip departed on his holiday a couple of weeks later, planning to add another twenty pages to a new edition of The Unfinished Revolution. In fact he provided another 140 as he brought the book up to date.

  We agreed to serialise that too and every now and then he and I would exchange emails about his progress. In September the proofs arrived, but by then it was clear that Philip’s cancer had returned.

  This in no way diluted his enthusiasm for the new project. Once again he wanted to be involved at every level, arguing with me about the headlines and nagging us relentlessly to make sure his message was put across accurately. He also talked about his plans to continue the work he had begun with The Unfinished Life, to write an account not only of his cancer but also the next phase of his treatment and the growing certainty of his own death.

  He describes in these pages how at first he could find no purpose in knowing that he was about to die, a terrible moment for someone whose life had been built on the idea of having goals and creating the strategies to achieve them. But then he found that purpose: writing and talking about confronting death in ways that would not only comfort his family but help strangers too.

  When he and his great friend Alastair Campbell were planning political campaigns they had a saying: ‘Strategy is not strategy unless it is written down.’ Philip’s new strategy was to deal with his own imminent death. And so he wanted to write it down. Naturally the newspaper wanted to know more about this too, so he and I began to exchange emails again, this time with me doing the nagging.

  But his illness and its treatment were not so obliging now. Philip entered the Death Zone, as he put it, and although he was still writing, the words did not come as quickly as they had done before.

  He also gave some remarkable interviews. In one with Andrew Marr for the BBC on 18 September he spoke frankly about his cancer and its likely outcome. He talked about being in the Death Zone and his calmly courageous acceptance of his imminent death caused a considerable stir.

  Two days later another interview appeared, this one by Simon Hattenstone in the Guardian. Again Philip spoke honestly about his illness, and he made the point forcibly that he had accepted death and was ready for it.

  Philip’s frankness in these interviews was disconcerting for his family – both had been given to publicise the republication of The Unfinished Revolution, not his illness – but it was also becoming clear that he was very determined to be outspoken about dying.

  Amid all the treatment, and the debilitating effects of the illness itself, Philip continued to write, and if his words lacked the polish of his earlier efforts they were certainly not short of passion.

  Towards the end of October he gave two long interviews to Adrian Steirn, an Australian photographer and film-maker who had been commissioned to make a short film about Philip. Adrian and his team also arranged to go with Philip to Highgate Cemetery to take the picture of Philip at his own graveside which can be found on the dust jacket of this book.

  The two interviews Adrian filmed provided the material that makes up the bulk of the chapter called ‘The Death Zone’. I have adapted them using Philip’s notes and writings. He had barely a week to live as he spoke, but his energy
seemed limitless and his thinking clear.

  Philip continued writing until he could no longer use his laptop. He then started dictating his thoughts to Gail as she sat by his bedside in hospital. He outlined his ideas on the structure the book should have and listed chapter headings. Some of this material is understandably fragmented, but I have preserved as much of it as possible.

  Once Philip entered intensive care five days before his death, only three people had continuous access to him, although he saw visitors and emailed and texted friends. Georgia Gould, Philip’s elder daughter, undertook the difficult job of describing those last days in her chapter of this book. Grace Gould has provided a snapshot of her relationship with her father and Gail Rebuck surveys in a postscript the four-year history of Philip’s illness and this book’s origins. The last word is left to Alastair Campbell, whose email to his closest friend in politics was read to Philip a few hours before he died and again at the funeral service.

  Although his life was suffused with the world of British politics, particularly the Labour Party, no political affiliations are required to appreciate Philip Gould the man. He had in abundance one of life’s most underrated qualities: enthusiasm. His sense that things can be done informed everything he did, from politics to family and friends, even to Queens Park Rangers. Warm and open even towards complete strangers, he was staunch and loyal to his friends and decent and fair-minded to his opponents. It was noticeable after his death that some of the most moving tributes came from the other side of the political fence.

  As he had wrestled with the terrors and trials of his illness, however, he had begun to see a public duty in this private struggle too. He wanted to inform and comfort, to combat what he saw as the ignorance and misapprehension, not to mention the fear, he had found surrounding the issue of cancer and its treatment.

  An experience of death when Philip was younger had already left a powerful and lasting impression on him – he had been with his father when he died. ‘The last words I heard him say were, “That is my son and I am proud of him.” I was determined to justify that pride.’ Gould had been distressed by his father’s last hours, noticing how he had struggled to breathe, and his fear of the rattle he heard then was to come back to haunt him as his own illness reached its final stages.

  Once Philip himself had entered the Death Zone he decided to explore and map this new territory. He walked around its perimeter and he marched right into its mysterious centre. This book is his last great campaign. The fact that it is written by one of the most influential political figures of the past twenty years is irrelevant. It is true that prime ministers and other giants of recent public life do occasionally flit across its pages, but they always do so as friends rather than politicians.

  This is not a book about politics. It is a book about cancer and dying. It is the story of a man and his illness, his family and friends, his doctors and nurses. At its heart are his wife Gail and daughters Georgia and Grace, whom he loved above all else.

  Keith Blackmore

  The Glory of the Ride

  It starts at ten o’clock on Tuesday 29 January 2008 in a private clinic in London…

  I am lying on my side at the mid-point of an endoscopy, sedated but fully conscious, hearing the quiet hum of medical conversation as the endoscope gradually eases down my gullet, displaying all it sees on television screens. I prefer not to watch.

  Until now all has gone well, the voices calm and subdued, but then it is as though a goal has been scored at Wembley, the room exploding with noise and energy: they have discovered a cancer, and I hear the word ‘big’. They talk as if I am not there, a bystander at my own demise.

  Eventually the endoscope is removed and the doctor tells me with barely concealed excitement that they have found a growth that is certain to be a malignant tumour and that it is large. I fear the uncertainty more than the diagnosis. ‘What are my chances?’ I ask. ‘Fifty-fifty,’ he replies and I feel a combination of shock and hope. Not great, but better odds than I thought they might be. I have a chance.

  Suddenly a surgeon arrives as if from nowhere. He quickly inspects the images and tells me that it is a junction cancer situated between my oesophagus and my stomach. In a second I have lost control of my world.

  I am wheeled out of the operating theatre and return to my cubicle, now a cancer patient. My wife, Gail Rebuck, rushes in, her face full of love and hope, certain that I will be all right. Just an hour ago I had been told that the chances of cancer were remote and I had phoned to reassure her. It was a mistake to have done so, creating false hope.

  I tell her the new truth, harshly because I am nervous, and she almost physically recoils, as though punched in the stomach. She says that it will all be fine but does not believe it. I phone my daughter Georgia who is doing some research in Manchester and she is stunned, unable to take in the information. Gail takes the phone and leaves the room to talk to her. I can hear them through the door; it is clear that they are both in floods of tears. I am not the victim here.

  We drive home in silence. Gail is distant; she sees the contours of her life shifting in front of her. I feel guilty. I have let her down.

  I made an immediate decision to be as open and honest as I possibly could about what had happened, reaching out to people rather than trying to do it alone. I needed help but I also had to give help. I do not consider myself someone who naturally leads, and if I do so at all it is by creating a shared spirit, pushing forward with enthusiasm and energy. But this was different, I now had an explicit responsibility to lead. I was reliant on the support of others, but they too were relying on me.

  I started calling and the conversations went well. I sensed affection and it immediately lifted me. I thought, if only I had known they liked me so much before I got ill. Mostly they said one of two things: ‘You are too happy to have got cancer,’ or ‘You are so strong you are bound to get through.’ The first assumption had already been proved wrong; I hoped the second would not be.

  The first call after getting home was to my younger daughter Grace, who was in Oxford. I did not want to tell her the news over the phone, so I said that we would be coming up that evening to see her. I told her that it was serious, but I wanted to speak to her face to face. This was not perfect but it was the best that I could do.

  My sister, Jill, was shaken but full of kindness; she is a priest and she found the right words. Gail’s parents were beside themselves, difficult to console. Peter Jones, my closest friend from our days at the University of Sussex, was as always incurably optimistic, but I could feel his anxiety.

  Alastair Campbell was stunned. His life had already been touched by cancer, and now he was seeing another of his closest friends and political colleagues fall prey to the disease. But he was, as always in a crisis, totally solid and absolutely loyal. Nothing is too much for him at a moment like this.

  Afterwards he called Georgia to reassure her. She later told me that when I called she had felt complete panic, never having considered the possibility of my death or even illness. She was devastated, almost hysterical, walking aimlessly around the streets of Manchester until Alastair called her. Our children had grown up together and were as close as family, and Calum, Alastair’s younger son, who was in Manchester at university, found her and stayed with her. Together they brought her back to life.

  Matthew Freud, whose company I had just joined, reassured me that whatever happened he would stand by me, a constant friend. Anji Hunter gave me an uncompromising blast of Middle England fortitude, just as she had done so many times before as Tony Blair’s ‘gatekeeper’. Peter Hyman, a Blair strategist who left Downing Street to become a teacher, reacted with all his normal compassion and integrity. In the 1997 election we had jointly created the Labour Pledges, and had become very close.

  Then I called Downing Street, something I had once done often but which rarely happened now. But ‘Switch’, as the switchboard is known, remembered me and the telephonist was kind, sensing something was wrong. Th
e next day I was due to make a presentation to Gordon Brown on public perceptions of him based on some polling that I had done. I got through to someone deep in his office and said that I would be unable to do it because I had been diagnosed with cancer. Within minutes Gordon phoned back, his deep gravelly voice betraying genuine concern. This was the first of many calls he would make. The presentation went ahead without me: the findings about him were harsh and I felt guilty for inflicting them on him.

  That was how the day went, calling and being called. I knew that one part of me enjoyed being the centre of attention, and while wary of this, I was prepared to use it to help get me through.

  At about six we drove to Oxford. Resilient as ever, Gail had recovered. It was a quiet, reflective journey; mostly we were worrying about how Grace would take the news. When we arrived she was standing confidently outside her college, looking cool and contained. I said straight away that I had serious cancer and her response was typical – blunt with an edge of humour: ‘I knew when you phoned that either you had cancer or you and Mum were getting a divorce.’

  We had dinner, which was warm and close, but with an undercurrent of anxiety, and I was very sad to leave her. Gail and I drove back without speaking much.

  So the first day with cancer ended.

  That night I woke and for a moment felt fear and panic, black thoughts attacking like demons. A survival instinct kicked in and I treated my fears almost like a video game, repelling each negative impulse one by one, turning them from dark to light. This worked well enough, and the demons never got through. (In time I was to develop a crude form of meditation and used simple affirmations that worked almost all the time. I learnt how to change my mood, a basic skill of cancer survival.)