Avila House - January 2014
I may not be an alpha male, thought Dominic, but – really – breast cancer?
‘I’m afraid so.’
He looked down sceptically at his chest which had been stripped bare for the purposes of examination. His left side felt very tender but, as midriffs went, it looked unremarkable for a man in his sixth decade: no moobs, at least, but only an historical trace of the muscle definition it had once boasted.
‘Well,’ he said slowly, ‘bugger me. I didn’t even know men could get breast cancer.’
Mr Turnball, the oncologist, sat opposite, looking appropriately serious. He was short and handsome, and looked younger than the ten years which in fact separated him from his patient. Through the garish 1950s redbrick casement, the afternoon blazed with inappropriate optimism.
‘It’s rare, I grant you, but not unknown.’
‘Also vaguely insulting,’ said Dominic, essaying a lightness he did not necessarily feel.
Mr Turnball gave a small, uneasy smile. He was always relieved when the first moment of bearing very bad news had passed.
As a veteran of breaking bad news himself, Dominic could only admire the consultant’s deftness – he had spoken in a measured tone, as one thoughtful man to another. Had he been gauche or flustered, or had he perhaps dropped his papers at the critical moment, Dominic might have had to deflect his own feelings and concentrate instead on feeling protective or sorry for him. Now all he could do was reflect on what he had been told.
A silent fifteen or twenty seconds passed which were broken by Mr Turnball, who suggested in tones of quiet encouragement, ‘You must have some questions.’
‘Must I?’ He thought for a moment. ‘I suppose I must. How rare?’
‘Male breast cancer. How rare?’
‘Ummm, about one per cent of breast cancers occur in men.’
‘And how many are fatal?’
‘There are about three hundred deaths a year. ’
Dominic kept his face impassive. Momentarily, he allowed his eyes to search the room, as though it might provide answers. The sign fixed to the door described it as a ‘consulting room’ and NHS bulk-buy furniture had been deposited within it, without much sign of interest or care. There were two hard chairs opposite the desk, one of which he occupied. Mr Turnball’s was more elaborate – a clumsy recognition of his status as a consultant – upholstered in royal blue cloth and with a swivel mechanism.
‘So,’ Dominic asked, ‘what happens now?’
For the first time, Mr Turnball tensed slightly. Dominic was aware that the nurse, who had been standing fiddling unconvincingly by the sink, was listening intently.
‘Well. As you know, we did the scans because of what we found when we examined your lymph nodes – that is, under your left arm, when we first saw you – what is it? Twelve days ago?’
‘It isn’t good news, I’m afraid. The cancerous cells have metastasised quite aggressively.’
‘I’m afraid we should start discussing treatment straight away.’
Dominic gazed at him, quite still.
‘It’s really a question of working out how you are going to cope practically. Is there anyone who will be able to help at home?
The nurse had given up any pretence of doing anything else other than staring at Dominic. She looked the very soul of compassion and, he realised, with a stab of humility, this was for him.
‘I am sorry,’ said Mr Turnball after a pause. ‘This is a great deal to take in.’
Dominic was aware that he was trying to assemble an idea, rather than struggling for composure. ‘Do I have to accept treatment?’ he asked quietly. ‘I’m pretty sure that I’d rather not.’
Mr Turnball shook his head ‘No, of course not. Not necessarily. But that’s not a topic for today. That’s – that’s for when you’ve had time to digest the news.’
There was a longish silence. Unbidden, the nurse appeared at his side with a plastic cup of water which, to his surprise, Dominic found himself sipping gratefully.
‘I know I want to protect what’s left of my life,’ he said finally. ‘I’ll take anything that’s going to control the pain and to keep me calm. But I’ve no desire to spin things out if I’m just going to be miserable.’
Mr Turnball said nothing, but nodded sympathetically.
Sly bugger, thought Dominic. He thinks I’m going to come begging for treatment once I’m past the first shock. But I won’t.
‘I’d like an idea of how long I can expect to live,’ he said finally, his voice sounding unnaturally slow and calm, even to his own ears. ‘I don’t have a family, but – well–- there are one or two people who will need to know.’
‘Of course. I imagine you’ll want to talk to Fr Maybury, for one.’ Mr Turnball was a long standing St Asaph’s parishioner.
Dominic nodded. ‘But not quite yet,’ he said, ‘I need a day or two first.’ He gestured ruefully. ‘Anything’s a cliché at this moment – I need a bit of time to get my head round it.’
‘I’d also like an answer to my question. How long?’
Mr Turnball folded his hands. ‘I understand that. You also know I’m bound to hedge. Everybody reacts differently to the disease.’
‘And you know I’m bound to push you. How long?’
The consultant grimaced, perhaps realising he had come against someone of strong will. ‘In my experience of patients who’ve decided against treatment for this kind of cancer – most have lived a good life for a year or more.’
They always over-estimated, Dominic knew. Six or eight months, he thought. Where were they now – January? Dead by Christmas, for sure. Finally absolved of the need to send cards.
‘Thanks,’ said Dominic, even more quietly. ‘It helps to know.’ He stood up and asked in a voice more like his usual what he needed to do next.
Mr Turnball looked at the nurse, rather as if he needed a prompt. She said something about Dominic’s medication, and about him needing to come to the dispensary on Monday.
‘And you and I can meet again next Friday, can’t we?’ he said, a little too heartily, speaking over her.
‘That’s fine’ said Dominic.
‘Good, good.’ He turned to the nurse. ‘Ella – could you arrange for a taxi for Mr da Silva?’
Dominic protested, smilingly, he wanted to take the bus. It was nothing to do with money, he assured the consultant – just habit. Eventually, he shook hands with them both, having agreed to come back in a week’s time to discuss his decision. He could always change his mind, he was told.
‘I’m a bit worried about you having to take all this in by yourself.’
Dominic smiled. ‘Don’t be. I have good friends. They’ll step up.’
Practicalities , he said to himself, as he stepped onto the double decker which would take him back to the centre of town. Concentrate on practicalities.
His will had first been written twenty-five years earlier, but he had made a hobby out of revising it every couple of years and so it was reasonably up to date. A bigger problem was what would happen to Avila House, the hostel for the homeless – or those otherwise on the fringes of life – where for over twenty years he had been warden.
His mind went back to – when was it? 1992? 1993? Avila House had consisted of no more than the old Victorian mansion and a couple of Portakabins in the asphalt yard at the back. It had been out of these that he and Breda Devlin had attempted to administer a home for twelve men, some recently out of prison, and whence many were destined to return.
The house had been a seminary until the late 1970s, by which time the flow of eager young prelates, mainly from Ireland, had dried up almost altogether. The diocese had tried to sell the house on several occasions, and it had been lying unused for months when squatters moved in, during a particularly bad time for the town in the 1980s. The bishop, anxious to raise some funds for the struggling parish, prepared his lawyers to order an eviction. But Fr Maybury, then the newly appointed parish priest at St Asaph’s, had counselled caution. Times were hard, he said, and the government appeared uncaring to those left in the wake of the hubris which appeared to have overtaken Britain. A few thousand pounds were raised and the hostel opened its doors for the first time in March 1993.
At once problems had erupted. Hostel wardens came and went with even greater rapidity than the residents, occasioning, as the bishop noted irritably, greater trouble. Within six months there had been one stabbing on the premises, one attempted suicide. The only clear legacies were a burgeoning trade in proscribed substances and ruptured relationships with the local community. On the Feast of the Assumption that year the bishop summoned Fr Maybury and told him he wanted the hostel closed by the end of the month.
Predictably, the priest pleaded for time. ‘I have an idea,’ he said. ‘There’s someone I know who just might turn the whole thing around.’
Looking out of the window as he passed the big Iceland warehouse, Dominic knew he was rather pleased that he seemed able to summon the composure to guide him through the first wave of shock. I have terminal cancer, he told himself slowly. I will be dead by Christmas. It would be an effort to say the words out loud.
He had lived by himself for a quarter of a century. Even though friendship was immensely important to him, the habits of a solitary life were ingrained. He thought about the evening which lay ahead. Roy, the assistant warden, was on duty in the hostel, so he would have no duties before the morning. As the bus turned in to Friary Lane, his gaze wandered from the top deck to Marks and Spencer.
An extravagant supper, he suddenly thought–- that would be an appropriately defiant gesture. In the light of the day’s momentous news there was also no incentive to economise. Impulsively he stood up and rang the bell. Inside the shop, he chose a baguette, cherry tomatoes, green salad, dressed crab pate, and a small rump steak. Then, feeling cheerfully naughty, he picked out an egg custard tart sprinkled with cinnamon and a half bottle of Rioja.
As he queued at the checkout, he felt himself salivate, but the brief euphoria subsided as suddenly as it had arrived and he felt almost too tired to remain standing. He rang for a minicab which deposited him at Avila House.
As it swung into the forecourt, Roy was standing at the front door, holding an old VHS player, which Dominic vaguely recalled having seen on the upper landing. Lacking hands to open the taxi door, he made a pantomime show of regret. Grateful at having a reason not to make conversation, Dominic nodded his understanding and prepared to carry his shopping up to his flat.
Avila House had transformed itself since the early days. Instead of the original complement of twelve residents, there were now thirty-six, each with their own room in the large purpose-built block built on what had once been the back garden. The old house was now given over to a range of offices and workshops.
‘Here, Dom. I’ll carry that.’ With classically inopportune timing, Lewis – the most obdurately unemployable and long-standing resident – suddenly materialised at his side. He was a shortish, overweight man, rather older than Dominic himself, but with an adolescent’s anxiety to be included.
‘Oh that’s nice of you. I’m sure I’ll be fine.’
‘No, I’d like to do it’
He made a beeline for the bags, and Dominic steeled himself to endure at least twenty minutes of Lewis’s rather unboundaried conversation. Fortunately, at that moment Roy materialised, claiming he needed help in identifying the owner of a mystery anorak, and took Lewis away.
His supper was easily made, and every bit as good as he had hoped. The two glasses of Rioja, enjoyed while stretched out on the sofa, made Mr Turnball’s news seem remote. Thank God for iPlayer, he thought, as he settled down to catch up with recent episodes of The Apprentice.
In the small hours, of course, he lay awake.
Bad news could be quite exciting, of course. It wasn’t like the time of his disgrace a quarter of a century earlier, when any blame could only really be laid at his door. This wasn’t like that. Once again, it gave him an excuse to do what always gave him comfort – organise and, where possible, control. He thought now with some satisfaction of the tasks which lay ahead: tell friends, inform the bank, fix hospital appointments. And while he dreaded to be the occasion of sorrow to those whom he loved, he was excited by the thought of the attention he would now receive. Come off it, da Silva, he told himself – this isn’t mainly bad news: I’m being spared a lonely and directionless old age.
The thing was that he didn’t feel ill exactly. Tired most certainly. But still curious about the future. It was bewildering and incredible that there were narratives in which he was deeply interested, to which there were resolutions he would not live to see.
If he died before the New Year, for instance, the Tory-led coalition would still be in power, which was irritating. He would prefer to die after Labour had returned – not ersatz New Labour (Blair was one of his deepest aversions), but Labour led by someone of principle and conscience. Nor, he thought unconcernedly, would he now see the accession of King Charles III. Robert Mugabe, most undeservingly, also looked set to outlast him. On the other hand, he was happy to die while America still had Obama as its President.
His mind moved on seamlessly to sex. The young man on the checkout desk in Marks and Spencer yesterday had been absurdly attractive. He chided himself for the thought: given that he had been given the death sentence in Mr Turnball’s office about half an hour earlier, it might have been more seemly for him to have held his carnal appetites in check. You are incorrigible, he told himself.
He wouldn’t have minded a pee, but it would have meant getting up, and he wasn’t sufficiently uncomfortable for the effort it required. The bedside clock suggested it was 3.20 a.m. Christ – there were hours of lying awake ahead of him.
He might as well start to plan his funeral. He vaguely hoped that some of those who had passed through the doors of Avila House over the years might show up – those who weren’t dead or in prison, anyway. He smiled as he thought of the hymns best suited to the kind of democratic send-off he would prefer: Lord of the Dance, Shine Jesus Shine, I the Lord of Sea and Sky. Hymns calculated to piss off the kind of person he enjoyed pissing off.
His former mother-in-law came into mind at this moment, as she very often did. It was extremely doubtful that she would attend the occasion, but he enjoyed the fantasy of her extreme discomfort should she choose to do so.
Next morning all seemed normal. Dominic was in his office from just before 8 a.m., veering between emails, phone calls and talking with the residents who milled in and out. When Fr Maybury arrived, Dominic gestured for him to close the door.
He spotted the priest’s uneasiness at once. ‘Something’s happened,’ he began.
It didn’t take long to lay out the bare essentials, and when he had finished the two men eyed each other in silence across the desk. An oasis of rosewood in a sea of plywood and Formica, it had been donated by the retiring senior partner of a local law firm. There were also a couple of paintings on the wall – one, given to him by his old Oxford tutor, was of the roof garden in his old college. On the desk were photographs of his parents, and another of a youngish man in a QC’s wig and gown.
‘Who have you told?’ asked the priest eventually.
‘Jack and Orla’
‘They’ll have been very upset’
‘Yes’ said Dominic, his eyes unhappy. ‘I rang them about half an hour ago.’
‘What about your family?’
‘I don’t really have a family, do I? My parents died years ago.’
‘No brothers or sisters?’
‘Wait a bit. What about the nun?’
‘Oh yes – Kate. Well remembered. She’s a cousin.’
‘You haven’t told her?’
‘She’s a missionary in Paraguay. We usually email at Christmas.’
Fr Maybury stretched his lips unhappily. ‘You might bring that forward a bit this year.’
Fr Maybury looked as if he were struggling to remember something. ‘What about the posh pair?’ he said finally.
Dominic laughed. ‘Posh is a relative term, especially round here.’
‘You know who I mean. Great bear of a chap. Beautiful wife.’
‘Ah – Digby and Cara. I planned on ringing them tonight.’
After Fr Maybury had left. Dominic washed up the coffee mugs and tried to think what needed to be done. It was Wednesday, he knew, and on Wednesday he and Breda organised fresh bedding.
The reservoirs of self-discipline, by which he had often propelled himself in darker moments, were enough to help him absorb the shock, but they could not inure him against lassitude and exhaustion. The Bishop persuaded him to take indefinite leave, while insisting he could carry on living in the flat which came with the job.
He had, however, been right in what he had told Mr Turnball – his friends did rally to him. He stayed at Jack and Orla’s every weekend. Knowing of old that his domestic expertise existed more in the telling than in the actualite, they urged him to live with them. For now, however, he clung to his flat. Digby and Cara drove him to their house in Hampshire for a few days in March. They had a farmhouse near Avignon, and tried to tempt him to join them for Easter.
‘We’ll get a nurse,’ Digby promised, in his rumbling patrician burble. ‘Or – well, perhaps a priest?’
‘A bit previous,’ Dominic said, smiling. ‘But I have a favour to ask.’
‘I want opium,’ said Dominic, ‘and a lot of it.’
Digby looked uneasy. ‘You’re not planning on…?’
‘No, of course not. I just don’t want to hang around any longer than I have to once everything starts to kick off.’ He pointed vaguely in the direction of his breastbone.
‘Won’t the hospital see to all that?’
‘I hope so. I want you to prepare to – make good any deficiencies.’
‘Ah, point taken. Not a problem, old boy.’
‘I need to know you mean it.’
‘I absolutely do. Now put it out of your head.’
Afternoons by himself on weekdays were sometimes hard: he made self-conscious efforts to read soberly – the Book of Psalms, the poems of Robert Browning, even the sonnets of Shakespeare – but more often than not he found himself switching on yet another re-run of Frasier or looking rather listlessly at YouTube.
After a few weeks of this strange half-life he knew he could put off no longer telling the person who mattered to him perhaps most and prepared, finally, to call Daniel.