When the brilliant Christopher Hitchens was diagnosed with cancer, he wrote a piece in Vanity Fair where he observed that he had crossed over into the land of the sick.
It’s a stunning piece of writing. You can read it HERE.
I am very familiar with this land. I have been living in it as both a carer and a citizen for almost 15 years. I have written about my wife’s border crossing HERE.
I have not written about mine. Maybe one day I will. But that’s not what this piece is about.
This is about what I see happening around me to people I love and hold dear. And it’s also about trying to rationalise in my own head what is happening to me as well as to them.
That’s the creepy thing about writers. We are compelled to write, even if the subject matter is appalling and you’d rather just stick your fingers in your ears and make LALALA noises than be confronted by it. The subject matter appalls me too. I’m still going to write about it, though.
Ignorance is indeed bliss. For some. But only congenital idiots desire a life fuelled by ignorance. Ignorance has never been bliss to me. To me, ignorance is abject failure and cowardice. I am neither.
There is no excuse for ignorance. And there are few things worse than wilful ignorance. The desire NOT to know something in case it upsets you, or causes you to change, or rethink something, is inexcusable and it cheapens us all.
But I don’t have to tell you that. Life will tell you that. Life will teach it to you. And it will be a hard-learned lesson.
So let’s consider this life-lesson. Let us look across the border into the Land of the Unwell and see what lies in wait there.
Obviously, we’re all getting older. Clearly, we take less risks than we once did. The chemicals in our brains lean more towards self-preservation than going out in a blaze of glory – and as strange as that seems to me, I have no choice but to go with the flow.
So a few things start to happen as you get older. Your mortality becomes a constant reference point in your thoughts. You’re appallingly aware there is far more life behind you than ahead of you and you start teaching yourself to deal with this.
You may have not yet crossed the border into that other place, but I’m thinking you can see it from where you are.
Sure, you’re still kinda 20 in your head, but your body isn’t.
And so an ever-increasing cycle of betrayal commences. You wanna go and ride your mate’s fully hectic Husaberg chookie down that dry creek bed, and maybe essay a few dank wheelies…but maybe not as much as you did when you were 20. Or 30. Or even 40. Shit kinda starts to pull on the reins when you hit that magic 50, and it pulls ever harder as the numbers climb.
And that border appears.
I certainly do my bit to stave off the rot. Being hard to kill is a central tenet of my life. But keeping age at bay gets harder and harder. And yet I persist. Because of that damn border – that invisible but certainly there line that separates the hale and well from the sick and ill.
We all know you have to pay the piper. Everything you have done in your 20s, 30s, and 40s you are going to pay for when you hit 50.
Every cigarette you smoked, every line you snorted, every pill you popped, every bone you broke, every stitch you incurred, and every piece of crap you chewed and swallowed because you were too lazy/busy/indifferent/immortal to eat well, is to be paid for.
And it will be paid for. Make no mistake.
No-one gets out of this alive, as they say. And we shall all eventually cross that invisible line into the Land of the Unwell. And then we shall die. Hopefully in our sleep. But quite possibly squirming in our own filth, wracked with pain, crazed by drugs, and being tended to by people largely indifferent to our suffering.
As you get older you’ll also start attending more funerals than parties. I’m burying more dear friends as each year goes by, and it’s rare a month goes by when someone I love doesn’t call me to tell me they too have crossed the border.
Then one day, and I hope that day never comes for you, you cross that border in to that land. You get that diagnosis. The one you struggle to believe. The one you think is a mistake. It has to be. Surely. How can this happen to you?
But it has. And here you are. And nothing will ever be the same again.
We are all one blood-filled bowel movement, one strange-looking freckle, or one persistent cough away from endless doctors’ visits, crowded waiting rooms, and never-ending tests. Life in the Land of the Unwell is a very different life to what you may have been used to. Trust me on this.
Now when you find yourself on the other side of that border, you can still see all the people who are not unwell. There they are, all going about their business, while you confront the screaming horror and despair of the land you now find yourself in. The howling in your head sounds like it will never end.
Looking at all the healthy people, you’re jealous they’ve been dealt a hand perhaps less shit than the one you’re now playing. But you also know that disease and its accompanying despair can come for anyone at any time. And you also have very little energy to waste on jealousy. Everything you have you need to cope with what’s ailing you.
Of course, sometimes it is granted to us that we can come back across that invisible border and rejoin the Land of the Well. But how long you stay there is always in question.
As you get older, and you’ve once crossed into the Land of the Unwell, you’ll only ever cross back into the other land as a visitor. Your citizenship has been revoked forever.
Actually living in the Land of the Unwell is quite surreal. You may come to view modern medicine as both a blessing and a curse. They can give you drugs which will help you feel better, but have unwelcome side effects. Or they will keep changing your drugs until they find a combination that kinda works. But it has different side effects.
There are many people who swear on the souls of their children they will never undergo another round of chemotherapy. They would rather die. And yes, it is that bad.
Still, it does work in a lot of cases. But cancer is largely a lottery, and everyone plays it by the stats. What kills you may not kill another person. Or vice-versa.
Heart disease is another game of chance. Virtually all life-threatening or life-changing illnesses are lucky dips.
But while all of that is going on, while cadres of faceless doctors, radiologists, and lab technicians test your bodily fluids and run you through coffin-like machines that sound like stew-pots being banged together, you’re trying to come to terms with living in the Land of the Unwell.
Sometimes your bowels work. Sometimes they don’t. Sometimes you sleep like a corpse. Other times you can’t sleep at all. You don’t have much of an appetite. You might lose lots of weight, or you might gain it. You certainly don’t wish to socialise or even have visitors. Things hurt. All sorts of things, both on the inside and on the outside your body. You don’t even know what that’s about and you’re too scared to ask in case it involves more tests which might reveal still further horrors.
Your body has utterly betrayed you. The quality of your life is rubbish. You wonder how long this will go on for and if there is an end in sight.
And yet you hope there is. Humans are great at hope. Very few of us just throw up our hands and surrender. Even when all seems lost, many of us manage to find something to hope for. Sometimes it’s the hope that next week will be better. And sometimes it’s just hoping the next hour will be less awful than this one.
So while your body fights to stay alive, your brain is working overtime trying to keep you relatively sane. Most of the time it manages. Sometimes it doesn’t. But there are drugs for that as well. These drugs won’t make you feel better. These drugs won’t let you feel anything at all.
For me, illness is as much a mental battle as it is a physical struggle. Living in the Land of the Unwell fucks with your head, big time. Living in that land changes you. Of course it does.
That’s life across that accursed border.
Some of us have already crossed it. Some of us crossed it a long time ago. Some have yet to make that crossing. And some very few of us will not cross it until the very end.
But we’re all going to cross it. As sure as death and taxes might be, crossing that border is also a certainty.
Just make sure that when that border crossing appears before you, and you enter that terrifying, wearying, and rather less sunny land, you enter it with your head up.
And you keep that head up. No matter what. No matter how hard it gets. No matter how awful it seems. And shit can always get more awful. Make no mistake about that. There are rock bottoms and pits of despair beyond our ken.
It’s perfectly fine to be terrified. You’d be weird if you weren’t scared out of your wits. But courage is not absence of fear. It is mastery of fear.
And we must endure. Because we were made to endure. And what makes us endure is hope. Always.
Journey well, brothers and sisters.
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