Saturday. I’m in a ward in the Charing Cross Hospital with Bertha, another woman with breast cancer. All the lymph glands under my right arm have been removed. Bertha, who’s 60 and lives near Heathrow Airport, is talking to a woman with hennaed hair who was bitten by her own corgi, or her daughter’s corgi, I’m not sure which. The corgis are father and son. The son attacked the father and they fought viciously till the corgi’s father’s owner, the woman talking to Bertha, managed to force a hoover down one dog’s throat. She then shut one dog in the garage but the other one bit her in the wrist. Her wrist is poisoned and she has to stay in hospital Several extra days.

My friend Duncan arrives at tea-time bringing a copy of Viz magazine to cheer me up. The letter he sent to the Saturday Independent Magazine, explaining why he wrote about defecation in his travel book To Noto has been severely cut so it is no longer funny. Only the first sentence was used. His invented quote about Milton ‘he thinketh he shitteth chocolatel’ (the original Aztec word still being the current usage) was omitted. In the early Seventies Duncan had a pop column in the Spectator where he could say whatever he liked. Is this new puritanism a symptom of the Nineties?

Sunday. Ben, the Cockney newspaper boy, comes in even earlier than usual. (He is normally in uniform on his way to school.) He wakes me and Bertha up by waving the News of the World and shouting that the serial killer who murdered 17 people in New York has been arrested. He then describes two videos he saw at a friend’s house the previous night: Misery, in which a man gets ‘hobbled’ (his legs are tied to a plank and smashed with a hammer), and another film in which psychopaths dressed as clowns stab children. When he’s gone Bertha says without irony: ‘Happy little soul!’

After lunch Bertha and I go downstairs to have an ultra-sound. Tubes are dangling out of our arms, draining the lymphatic area. They lead into bottles discreetly covered with a flowery material. We have to carry these bottles with us everywhere. After the ultrasound I am handed a folder with these words on the cover: NOT TO BE HANDLED BY PATIENT. I open up the folder and read as much as possible without Bertha noticing: ‘In situ carcinoma. Some spread to the lymphatic area.’ I thought they didn’t know yet if cancer had spread to the lymph glands. I assumed they’d taken the lymph glands out to see if it had spread. I’m absolutely terrified. I wish I could find a photocopying machine.

This evening three friends come to see me all at the same time, which is annoying, because they don’t know each other and have nothing in common. My friend Emily brings a book on the Bristol Health Diet. (I’ve already been given two copies.) She is absolutely furious with Duncan for bringing Viz. She says it’s degenerate and has the wrong view of women. My cousin Cate, aged 40, who never went to school and now works in a hospice, says all she ever reads is Hello! Last Thursday she was propositioned by a dying man who asked her what positions she liked. She had been advised to humour the patients so she told him. Rachel, who brought me a mango and two pomegranates and a copy of the Observer, says seriously: ‘If you feel mutilated my brother’s ex-girlfriend knows a surgeon in California who can change everything to look the same.’ Until that moment I did not feel mutilated. After all, my breast hasn’t been cut off. Duncan rings asking me to come to a literary party with him in three days’ time. With luck my drain will be out by then. If not, Sandra, one of the nurses, says I might be able to go carrying the drain heavily disguised by a shawl. I may be on television as it is the launch of a famous person’s book.

When they’ve gone I read the Observer. There’s a two-page spread on breast cancer. ‘If three or more lymph glands are affected, 30 per cent of women survive for ten years.’ I don’t know how many lymph glands have been affected. I am extremely worried. I flip through the book on the Bristol Health Diet. Is my only hope of survival to live on pulses and bean sprouts for the rest of my life?

Monday 9 a.m. Isabel, the breast nurse, is on an ego-trip and likes following the doctors around instead of consoling the patients, which is what she’s meant to do. I wish that Dr Isaacs, the young doctor I find very attractive, had come instead of her. I’m sure he would have been more sympathetic.

Monday afternoon. Two other women have arrived for operations, a Spanish woman called Carmen and Rosemary, a vegan from Ascot. Rosemary has a strange health-food drink with her (made from acorns) and just before her pre-med she lies on her bed with headphones on, listening to soothing music, a blissful expression on her face. A few hours later the two women return from their operations. (Like me and Bertha, their lymph glands have been taken out.) Carmen’s husband, in a chef’s hat (he works in the hospital canteen) and her sister, in a dark blue uniform and a little white hat (she also works in the canteen), and Carmen’s son, who is a medical student in the hospital, all lean over her bed, expressions of concern and patience on their faces. She doesn’t wake up.

Six p.m. A man in a striped T-shirt rushes into our ward and shouts: ‘Have you ever tried to jump off a high building?’ Luckily a male nurse from Mauritius is there with a trolley full of pills. Bertha asks: ‘Who’s he?’ The nurse explains that the man’s escaped from the psychiatric unit on the third floor. ‘They’ve probably mislaid him,’ he says. During this disturbance Carmen comes to.

Tuesday. Something very exciting has happened. The person being wheeled up and down on a bed with a big bag of urine in front of her has just changed sex. The woman who was bitten by the corgi told Bertha about it. Apparently they’re in the same ward. She came in as a man and now is a woman called Caroline. There is no hot water in the hospital. After breakfast Carmen sends her son downstairs for bottles of water for all of us. This morning her sister came up early from the canteen with rounds of toast and offered it to everyone. Rosemary the Vegan refused. Later she said: ‘Carmen, I hope your sister wasn’t offended but I only eat brown bread.’

Just before lunch the person who had the sex change was at the nurse’s desk in a flimsy blue nightdress, asking if she could wash her hair. But there’s still no hot water. The nurse was calling her Caroline. She looked very excited about her new life. I am longing to talk to her but can’t think of the right approach. Carmen, who is now very lively, says she was once called up from the canteen to interpret for a man who had come especially from Spain for a sex-change. But the doctors told him he couldn’t have one: his tests weren’t adequate. He threatened to complain to the Spanish Consulate. Duncan, who comes later, is convinced he’s seen Carmen’s son in a sauna near Shepherd’s Bush. He says the hospital is famous for sex-changes. (He wrote a book on April Ashley and knows a lot about it.) I ask it he will come with me and talk to Caroline about her experiences. We can pretend we’re smokers and approach her outside the lifts, where she sits smoking in her blue nightdress. However Duncan thinks this is terribly vulgar and refuses to do it. Also, he says, according to research at Johns Hopkins University, people who change sex quite often commit suicide. I feel worried for Caroline, who at the moment looks so happy.

Monday. I am out of hospital but I missed the literary party. Still, my cousin Cate is giving one for single people. I am on three types of pain-killers, all suggested by different women. My neighbour Tanya suggested neat whisky; my American friend Lynne, who’s staying, pressed three Advils (American aspirin) into my hand; and my friend Louisa said Solpadeine was the thing. Lynne, who’s over here from New York to promote her book, is on my phone all the time. No one can get through to ask how I am.

Tuesday. Eight people ring, asking what to wear. One person says she might wear a ‘short smart cocktail dress’. My friend Jacob has just been mugged at the bottom of the Portobello Road and is also on crutches after falling over a post outside Charing Cross Station. I tell him to wear jeans and a jumper. However Cate now says she hates men in jumpers. Sarah, who used to run the Travel Bookshop, leaves a very sophisticated message on my ansaphone, saying: ‘Ring back with your sartorial costume.’ I don’t know what ‘sartorial’ means – has it got something to do with monkeys? Someone else rings saying she’s going to wear trousers as she’s very fat. Surely trousers are the last thing to wear if you’re fat? I am going to wear the beautiful grey shirt Lynne brought me from New York. I want to invite Dr Isaacs, the doctor at the hospital that I found very attractive.

Wednesday. I spend all day trying to find out if Dr Isaacs is married, but fail. (Lynne is promoting her book in Birmingham.) This morning I rang a nurse to get some pills I genuinely wanted, then I asked: ‘Is Dr Isaacs married?’ She seemed astounded and said she didn’t know who Dr Isaacs was. I then got Cate to ring one of the two Peter Isaacs in the London phone book but she said that at one number a Sloane Ranger woman’s voice answered so she put the receiver down. Louisa then rang the secretary at the hospital, pretending to be an old friend of Dr Isaacs who had just come back from abroad and wanted to know if he was married. By mistake the secretary put her straight through to Dr Isaacs’s bleep while he was doing an operation so she rang off in a panic. She then dropped his invitation off at the hospital.

Thursday. Dr Isaacs didn’t come to the party nor did he answer my invitation. How will I ever face him again during an examination? The party did not go well as there were too many women. Jane, who was at the Sacred Heart Convent with me when we were teenagers, tried to bring her bicycle up two flights of stairs, then rushed at Jacob shouting: ‘Are there any menstruating women at this party?’ It turned out she wanted to borrow some Tampax. Jacob is having the male menopause and is about to go into therapy on the National Health. He does not know anything about menstruation. I got very revved-up on Solpadeine and couldn’t sleep all night.

Friday. I go to the hospital to have my stitches examined. My arm hurts like hell. I see Dr Isaacs’s head behind a glass door but I don’t think he sees me.

Saturday. A very eventful evening. I went to meet my friend Emily at her club in North Kensington. As I was about to park my car I saw three young black men running like mad. I sensibly drove once round the block. By the time I got back to the street a man had been mugged and was sitting surrounded by three police cars. In the club I found Emily already drinking wine from someone else’s bottle. It was 8 p.m. I became tortured with guilt that I hadn’t offered myself as a witness and returned to the scene, although the doorman at the club advised me not to. When I got there an ambulance had arrived and a passer-by was describing to the police what had happened. The young policeman standing there did not seem interested in what I had to say and told me the victim didn’t want to press charges. The policeman did not even take my name or address so I went back to the club where Emily was having an argument with the barman about a bill she had incurred the night before at 2 a.m. She was also refusing to pay £3 for a jug of black coffee, having only asked for an espresso. At that moment a group of eight people, headed by Dr Isaacs, comes into the club and sits down opposite us. I am stunned. I hadn’t realised doctors would go to a louche club like this. Dr Isaacs appears to be escorted by a very pretty young woman in her twenties (I am 42) so I guess there is no hope for me. He doesn’t seem to recognise me. As we leave I check in the members’ book and see that his name is Andrew Isaacs, not Peter, as I’d thought.

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Vol. 15 No. 16 · 19 August 1993

I was amused to find myself appearing in Elisa Segrave’s Diary (LRB, 22 July) but wish to make three points:1. It was not I who took a copy of Viz to her in hospital. She is probably confusing me with her priest. 2. Her misspelling of the Aztec word chocolatl is ascribed to me. This correction is made also on behalf of the Aztecs themselves who aren’t around to do it. 3. She misleadingly glosses my remarks on transsexual research at Johns Hopkins University. In fact the reason fewer sex-change operations are performed now than in the Sixties and Seventies is because it has been observed that there is little change in the incidence of suicide which (along with that of self-mutilation) the operation was designed to allay.

Duncan Fallowell
Rhiw, Gwynedd

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