Round Three

So here I am in the Medical Day Unit at the Marsden, with a cannula in my arm and the monitor on, ready for another round of drips.

Since round two things have been much more stable, with symptoms moderating. My head has also shown steady progression, having to carry an ever lighter burden, one hair at a time. As to my insides, a CT scan has revealed that the largest swollen lymph nodes have shrunk by over 50%, but fluid has built up in the lung again. It feels like less fluid than before, but they've decided to drain it one more time, and have also referred me to the cardiologists in the Brompton to have an MRI. They want to know more about the atrial fibrillation discovered some time ago. But they seem to be very pleased with the results of the scan. Leni, whose opinion matters most to me, took me through it in detail and is delighted. The treatment is working.

Shortly after this picture was taken a nurse came along with the first bag to drip in.

No matter how often you have told them your name and date of birth they always ask you again, and then show you what's in the bag, how much of it there is, and its use-by date. Then they ask you if that is OK, rather like a sommelier showing you a wine you ordered. So, for example, you will be shown that it's 565 ml of rituximab and expires in September 2024. I'm not sure why they want my opinion about that and I'm not sure what to say in reply. I'm tempted to suggest that I'd prefer 565 ml of 2009 St Emilion, but usually just nod to indicate that as far as I am concerned what they are offering is just what the doctor ordered - which indeed I hope it is.

Some time before the picture was taken they did bloods.

Hospitals are obsessed with blood. They can't seem to get enough of the stuff. One line from Goethe's Faust which has always stuck in my mind is uttered by Mephistopheles when Faust questions why he has to sign their contract in blood. 'Blood is a very special juice' ('Blut ist ein ganz besonderer Saft') replies the devil. Indeed it is, but I suspect Mephisto didn't know the half of it. The information the medical profession can squeeze out of a few drops of it is astonishing. I get sent some reports on blood samples and one of them had 58 different readings on it, none of which meant a thing to me, but all of which reveal different aspects of what is going on inside me in remarkable detail. And as long as you are in hospital they measure your blood pressure and blood oxygen level every couple of hours. If you are in overnight, they wake you up to do this. They are ruthless in their quest for knowledge about this special juice and what it is up to.

The medical profession has even divided up the universe of blood specialists into the people who get it out of you, whom they call phlebotomists (if they can get their tongues around it) and I call the Sharp Scratch Club; and the people who work out what's in it, whom they call haematologists (hematologists if you are American) and I call the Dracula Association. They must collect gallons of it every week and can't possibly use it all, so I'm sure they have parties on Friday evenings with all the leftovers. I don't dare to ask.

You will notice that the ancient Greeks have got in on the act here. Doctors all speak Greek half the time. I gather it is partly because the first medics we know about were Greeks - yes, they were clever as well as short-tempered and very violent if the Odyssey is anything to go by - and partly to create a precise terminology which can be understood internationally. It's a sort of linguistic Trojan horse. They have taken over despite being long dead because we accepted their gift, with mixed consequences. So whilst it is with relief that I read in the report of my CT scan that I have no hydronephrosis and no abdominopelvic lymphadenopathy I am not sure what I have avoided having. I think it means my kidneys are OK and the lymph nodes in my lower body are not swollen. The important thing is that Leni was pleased.

I noticed no strong side-effects in the days after this third round and went back to have my lung drained. That procedure is invasive and felt less comfortable than before. They have to be careful putting in the drain and use ultrasound to help them avoid penetrating the lung itself (ouch!). I think they got a bit close, but it all worked as intended. This time they drained off 1.2 litres, compared with 1.7 last time and 2.4 before that. So the fill-rate has reduced, which is good news. Despite all the effort involved in getting this liquid no-one showed any interest in it. They just throw it away. Body fluid, it seems, is not a very special juice.

A few days later I had the cardiology MRI scan, which was more elaborate than I had expected. Whilst you are in the machine they inject some drugs that get your heart racing to stress test it, and then ask you how you feel. My answer was 'nervous and a bit breathless'. They thought that showed the procedure was working. The machine makes disturbingly loud noises when it takes images and the process takes over an hour. I won't know the results until the next round.

So overall the news is good, with one notable exception. Le Columbier is closed till September. I should have realised. It is August. They are French. I will be on sandwiches for a month.