- Growth
Annabelle was, and I think still very much is a lovely girl, tall, slim and pretty, kind and friendly by nature. Without any problem she wore rounded-squarish glasses that corrected her minus 6 myopia in each of her blue eyes, having been never able to wear contact lenses, but this was no huge problem since her lenses lacked the extravagant thickness of some of the glasses she’d seen. She thanked her stars that her vision had stabilised at the age of 22. She had a sister called Melanie, younger by a couple of years with slightly more myopia, and a young boy who had no vision problems as yet.
One evening, whilst driving her car home from work, she noticed a nagging discomfort in her neck. She wondered if perhaps the cause was that it had been a particularly busy day at work, and thus she was worn out from answering the phone and the countless other things that her office job threw at her every day. She got home from work, tried to ignore it, then took a pain killer and went to bed. The next morning the pain was gone. Unfortunately the pain came back the next time and every time she had a hard day at the office, but she got used to it, her life otherwise too busy to worry about it.
Then one Saturday morning she awoke with the dull ache still in her neck: this concerned her, so she felt around at the base of her neck. Her investigative fingers seemed to find a curious raised area around her spinal column. For a moment, she thought it might be entirely her imagination, or perhaps it was just the position of her head and neck that caused her to find this. It wasn’t painful to touch, but it seemed in her opinion likely to be the source of her nagging discomfort. All sorts of things ran through her mind about what it could be - surely it could not be that which she dreaded? She was too young to have that, she hoped. She went to see her younger sister and child that afternoon, who quite sensibly insisted that she get herself to the doctor and get a professional opinion on the matter, saying, ‘a least you will know what it is!’
Despite her fears, she went to the doctor for a diagnosis: he poked uncertainly at the lump, then took a sample and sent it off for analysis, before telling her to make another appointment next week for the answer. She spent a nervous week wondering and hoping: in some ways this was worse than knowing what it was and trying to do something about it. The next week came, and thus did the appointment. She sat quaking inside, hoping that she would get good news. Alas, it was not to be: the doctor solemnly and sympathetically told her it was a cancerous tumour. As if that wasn’t bad enough, she needed to be put on chemotherapy right away so as to shrink it, in order that it could be removed if possible. There was a chance that it would be too close to her spinal cord to remove completely, if so then the tumour would eventually regrow. She did her best to hide her dismay whilst there and subsequently, but only sleep held her mental shivering at bay. She had to return to her sister and get much reassurance that all would be well for her, which in her darker moments she feared.
- Malignant
A couple of months later Annabelle had been through six weeks of debilitating chemotherapy. It had been a horrific experience: her hair had fallen out in bunches after the first dose, she was vomiting all the time and had lost weight even considering that she had a fairly slim frame to begin with. Now she’d taken to wearing baseball caps in order to hide her bald head, but nothing could really hide the effects of fighting the cancer with such powerful drugs, least of all from herself. Several times her sister had come to visit with her child: The sight of them both delighted and depressed her: the support was welcome, but seeing them reminded her that quite possibly her life would be cut terribly short.
She went into a MRI scanner so that the specialists could have another look at her tumour. The news was both good and bad: the tumour was shrunken enough to be operable, but alas was clearly joined to her spinal cord. There was no way to remove it completely without paralyzing her from the neck down, and such an operation carried the possibility of causing her death. Nevertheless the subsequent surgery went ahead, and was successful in the sense that as much as possible was removed. Alas, the specialist told her that in all probability she’ll need to go through all this again within a couple of years at the latest. Melanie again offered such support as she was able, but came away thinking that her older sister would not be around much longer, although she dared not tell her that. She was depressed enough already.
She had monthly checks on the size of the tumour, and as she’d been told, it had begun to regrow. Thankfully so did her hair, and thus she could at last dispense with the baseball caps, if only temporarily. Melanie accompanied her on many of these checks. The specialist was surprised at how fast it was growing, and after a couple of months was unhappily forced to inform her that her life expectancy was no more than 4 or 5 years. It was fair to tell her this, so that she could plan her remaining life out, except this is not the sort of news Annabelle or Melanie wanted to hear: she’d not made more than the vaguest plans for the rest of her life, but had expected to have far more time to put them into effect than it now appeared she had, and Melanie was dreading having to try to explain to her young son that quite soon his Aunt wouldn’t be coming back from hospital. She held back the tears whilst the specialist briefly talked about some experimental drug that could apparently kill cancerous growth stone dead, but also had many side effects. At this point she was deep in despair, and thus only barely able to take in any more advice; she then returned home, whereupon she cried and wailed for hours, scarcely comforted by the efforts of her sister.
- Metastasis
After a few months the tumour was back in no uncertain terms: the specialist looked at the latest scan image and told her, ‘The tumour isn’t far from Metastasis: that is the final stage of cancer, when it starts to spread throughout the body.’ Annabelle was badly shaken by that news. She asked quietly, ‘how long have I got?’ ‘Six months at the most, I’m afraid to say.’ Her face fell into bleak despair. After some moments, she asked, dimly remembering something mentioned to her some months ago, ‘what about the experimental cancer drug you told me about?’ ‘What? Oh that… It’s been highly criticised because of the wide range of severe side effects.’ ‘I want to try it.’ ‘I wouldn’t recommend it - it does destroy the cancer, but also does long-term damage to the body. It’s like extra-strong Chemotherapy.’ Annabelle shuddered at the mention of that: but in reality she felt that there were no better choices available, so she repeated, firmly ‘I want to try it. Please.’ ‘OK, but I cannot be held responsible for anything that happens. I’ll need you to sign a disclaimer.’
He had a computer with an internet connection in his office, which he used to call up the website for the drug, and thus let her and her sister read some of the information about it: it did work spectacularly well on most of the people it was given to, but the long list of side effects from critical weight loss, muscle damage, organ damage, effectively you-name-it-and-its-there. There are some comments by other doctors and specialists mentioning that it worked very well, but recommending more research was done to make it safer before more trials could be started, and some highly critical comments saying it was too dangerous to use. Obviously he was trying to show them that it was a dangerous, highly experimental drug. Melanie said to her, ‘Annie, I don’t think this is going to help you. It looks like it might make you even more ill, not better. That chemo was bad enough, this sounds like it could be far worse.’ Annabelle glared at her younger sister and asked firmly, ‘what’s worse than dying?’ Melanie couldn’t think of an answer to that, thus Annabelle insisted he put her forward for it before it was too late, being as she couldn’t wait for the research to be done: it might take years, and all she had was a few months left. Reluctantly, he referred her to the drug company, and got her onto the existing trial scheme just before they were about to discontinue taking on new volunteers.
- Cause and Effect
Three weeks later she was sitting on a hospital bed, having just had a shot of the new cancer drug a couple of days ago. After all the talk about side effects, it all seemed a bit of an anticlimax: she felt far better than if she’d just had a dose of chemotherapy. What the drug was doing to her insides she didn’t know, but she hoped it had killed her cancer. She was about to find out, anyway, because the porters pulled her out and took her into the MRI room for yet another scan. A short time later her latest doctor was looking at the scan image: He smiled - slightly, and told her, ’there is good news. The tumour appears to have stopped growing, although it’s a little early to tell for sure.' ‘It hasn’t gone?’ ‘No. Your cancer was highly advanced, the latest we have ever tried to treat, so it might take another dose before it goes completely.’ Annabelle looked a little disappointed. He continued, ‘don’t forget, if you feel strange or ill, call a nurse immediately. We need to know quickly if you suffer any side effects.’ Melanie came in soon after that, and upon hearing the good news, began to smile for the first time on months. She commented rather dryly, ‘I’d got used to seeing you either bald or in a baseball cap, and vomiting everywhere. This doesn’t seem anywhere so bad as that. How do you feel?’ Annabelle nodded and replied, ‘I feel fine. They say my tumour isn’t getting any bigger, but it’s still there.’ Melanie held her sister’s hand and said, ‘Oh, but it’s a start. Perhaps soon… We will get you back in one piece?’ ‘I hope so. But it’s difficult to start looking forward right now.’
Annabelle went to sleep that afternoon feeling fine, wondering a little why she had no side effects when everyone else who used this drug seemed to get them in shiploads. And then when she woke, she blinked and found that the world looked a little different - was it her imagination, or was it a little more blurred? She grabbed her glasses and put them onto her face, so discovering that she couldn’t quite get the normal sharp, bright, hard clarity she was used to; instead everything seemed slightly blurred. Blinking didn’t help, so she called the nurse.
When the nurse came in, Annabelle told her what had happened. The nurse did a sort of quick improvised eyetest, asking her to look at a bit of paper pinned on a notice board across the room. Annabelle couldn’t quite read it, even with a modest amount of squinting, something she’d long known didn’t help that much. The nurse summoned a doctor to examine her. This time it was a late-middle-aged doctor with a slight German accent. He did much the same thing as the nurse, then took her into the MRI room for more scans, and then for a more conventional eyetest. He expressed his opinion that this was a “most fascinating phenomena” and seemed to muse and argue with himself for a while as to the meaning of it all. Annabelle cut through his reverie with a question, ‘Please, what’s going on, Doctor?’ ‘Ah, it appears the anti-cancer drug is attacking the rear of your eyes, I am not sure if it just the soft tissue or otherwise, ahem… You have acquired around another dioptre of myopia in both eyes. I cannot tell you what this means in terms of what will happen in the near future or after further treatment… We will have to see how it goes.’
During the next few days Annabelle’s view of the world steadily became more and more blurred. At the end of the week she squinted at the new chart written in her notes regarding her visual acuity: by now she had acquired another 4 dioptres of myopia and her old glasses, although better than nothing, were now rather inadequate, although thankfully the tumour had shrunken dramatically. This drug was so powerful and yet so dangerous, as she was beginning to realise.
After another week it appeared that the immediate effects of the dose had come to a standstill; her tumour was about two-thirds the size it was before. Alas, her vision was with her glasses pretty awful, simply because she was 5.5 dioptres short of the correction she needed. That was quite easy to correct, by the simple expedient of supplying her with new glasses. Melanie came to see her bearing her new glasses: she was quite happy to help her sister, although she was by now worried about her vision just as much as the cancer. When she came in, she had to call out to Annabelle, ‘hey, Annie, I’m here with your new specs!’ Annabelle recognized her more by sound than by sight: she’d never gone without correction for this level of myopia very long, more like minutes rather than days. She waved her little sister over to sit with her, saying irritably, ‘well, bring them here, Mel. I want to see again, this blur is so horrible.’ Melanie could well relate to that, but almost dreaded Annabelle’s reaction to her new glasses. She felt she ought to prepare her, having seen the new glasses. They were in very similar metal frames, but the lenses were about twice as thick, despite the best efforts of the optician. She said to her sister, ‘Annie, they’re really thick.’ ‘I don’t care. Give them here.’ Melanie thought for a moment that the snappy case she handed to her matched her sister’s mood, but then she was well entitled to feel that way.
Quickly Annabelle took out the glasses from the case, their appearance not really registering, given as she was far more intent on seeing clearly. Once on, she looked around at the ward, again able to see detail far away. She gave a little sigh of relief, then met her sister’s gaze. She asked, ‘what are you looking at?’ ‘Ummm… You need to see yourself.’ Melanie produced a small mirror from her bag and handed it to her. She saw her sister look into it, and her appalled expression, the way she briefly and gently explored with her fingers the outer edges of each of her new lenses, both being about 13mm thick. She looked up at Melanie, who upon seeing her sister’s face shoved in brutally each side, gave a wan smile. Annabelle sighed, and then said, faintly grudgingly, ‘well, at least I can see again.’ Melanie took her hand again, and told her, ‘and you’re getting better too!’ Annabelle wasn’t entirely sure that she was, but said nothing. Giving up a little vision seemed to her a small price to pay for her life.
- Another Dose
She felt much better, being as she was able to dress and walk around the grounds of the clinic, looking at the flowers in the garden and realising that maybe she might see them flower next spring instead of dying long before winter was finished. But although the drug had worked wonders, the tumour wasn’t dead, nor had it given up. It started growing again quite soon, and the attentive doctors there quickly noticed it. They were obliged to lay before her another terrible choice, perhaps more so than before, because they now knew what it might cost her: the German-accented doctor told her the cost to her vision might be as little as a few more dioptres or maybe as much as another ten, there was no knowing: but they were sure that she needed another dose of the drug in order to destroy the cancer, which was now recovering from the drug’s onslaught.
Melanie spoke to her again before she had the next dose: evidently she had expected that one dose would be enough, but now it seemed that was a false hope. Annabelle told her, ‘what do you expect me to do? I have no good choices left!’ Melanie held up her hands, and said, ‘the doctors did say you might end up with terrible eyesight…’ Annabelle huffed and crossed her arms, certain she was doing the right thing. Melanie left her to it: she had her own life to deal with.
Having agreed to it, they thus gave her another shot, somewhat more this time in an effort to defeat the cancer. When she awoke the next morning, she found herself looking at a ferocious blur, against which mere squinting was a pitifully inadequate response. She put on her glasses again, and found things around her still looked very blurred and fuzzy, even such things that were close to her. As before, the German doctor tested her vision, and found that another three dioptres had been added overnight. Again the drug had attacked the cancer in her neck, rapidly reducing it to half its previous size - but within the space of a week Annabelle was complaining that she couldn’t see across the room, even her feet at the end of the bed. For the German doctor this was both fascinating and disturbing: everyone had expected some further visual problems, but nothing like this: another eight dioptres, already!
Annabelle found it only disturbing, and then frightening. She complained that she wanted to see clearly again, and asked plaintively if they could get some new lenses for her? They agreed to this readily enough: within a couple of days she was supplied with a pair of myodisk lenses. She found them very hard to use, having to move her head instead of her eyes to look at things. The sheer strength of them made seeing small things in the distance hard, and being as they were for her prescription three days ago, they were already two dioptres short of what she now needed. Her eyes were already at the minus 20 stage and still worsening by the hour. However, there was excellent news on the cancer front: the tumour was still shrinking, evidently the second dose had done the trick, it was hoped that perhaps within a couple of weeks it might be gone for good.
Melanie came in a few days after she got her new glasses: she stopped at the sight of them on her sisters face, and her jaw dropped slightly. In a quiet voice she asked, ‘what have they done to you?’ Impatiently, Annie replied, ‘they’re curing me. What do you think of my glasses?’ Melanie tried to evade the question, then endeavoured to tell her that they weren’t too bad really. Annabelle cut her off, and told her, ‘Yeah, I almost believe you. But - you can see them, I can see your face well enough to know you’re not telling me everything.’ Melanie shrugged, then asked uncertainly, ‘so… You can’t see even with… Those? You mean it’s going to get worse?’ Annie nodded, so Melanie gave her a hug.
At the end of the next week, the myopic progression started to slow to a crawl, which was good but not that good, leaving her with minus 26 of myopia in each eye and very poor vision. She got taken in for another MRI scan the same day, and a short time later the younger doctor was looking at the results: He looked delighted, but Annabelle couldn’t see that. He told her, ‘it looks like we might have done it this time. It must be about a quarter the size that it was before you came in.’ Annabelle then had another eye test, and it was realised the deterioration had stopped, alas a little too late for comfort or good vision, though. A few days later her latest pair of lenses came in, and they were fitted: 14mm thick myodisk lenses capable of correcting myopia of minus 27 in each eye. She was appalled to find that even with these clunky, ugly things in her frames she could barely read half the eyechart. From now on driving would be something everyone else did, being as she couldn’t read the 20/40 line at all.
- A Little Bit More
Annabelle was there a couple more weeks before she was told the unpleasant truth: her tumour was still there, even after all of this. Albeit much damaged by the drug, it still had 20% of its mass that it had before treatment. The young doctor was ready to give her another dose, but the German doctor wasn’t so sure: he was all but scared that she might end up being blinded. They went to her one afternoon with the latest scans to discuss the situation.
By now Annabelle was getting pretty tired of all this: she felt much better, but with the tumour still active inside her she was scared - but also very scared of what another dose would do to her vision. Already she felt herself half blind, her view of the world a shrunken distorted thing, nothing like the harsh clarity she had once known. She asked, ‘how long do I have, if I don’t have the treatment?’ The doctors looked at each other, and the young doctor told her, ‘well, it’s hard to be sure, but possibly a couple of years. The cancer’s not been destroyed, unfortunately.’ He looked rather pained, because usually his patients had their cancer cured after just one dose, and here he was, proposing an unprecedented third dose.
Annabelle’s shoulders slumped, then she sighed, and then said wearily, ‘oh, go on then. I suppose I can see this through… I hope I can still see after all this, though.’ The German doctor commented, ’there is no reason to suppose that what happened last time will happen again. You might even escape all further side effects, because your body might get used to the drug. I must remind you that this is an experimental drug. I am sorry to have to say this, but we are - uncertain.' ‘You mean you don’t know what you are doing?’ ‘I wouldn’t say that, it’s just that we don’t know everything.’
And so Annabelle had a little more of the anti-cancer drug. As before, within hours she started noticing some difficulty seeing into the distance, and as before there was a rapid and highly effective assault on the remains of the tumour. After a week the results seemed clear, insofar as her vision was, or rather wasn’t: her myopic progression was far less than that from the last dose, the projections being somewhere between minus 33 and minus 35. After a couple more weeks, the scanner image showed no trace of cancer: she was cured, as far as everyone was concerned. Again she required new lenses, now 18mm thick and quite awful to look at. Behind her two minus 36 lenses she peered out at the world, squinting softly at the eyechart: her visual acuity was only around 20/80 by now.
Her sister Melanie came to collect her from hospital soon after that: she had watched her sister lose hope and nearly her life, and now she seemed, if not good as new, pretty much perfectly healthy. But she watched with concern how she couldn’t see well into the distance even with glasses: those awful things that gave and took away so much. But at least she was still alive, and would be so for the birth of her next child, now growing visibly inside her.
- Life Ever After
For a couple of years Annabelle had regular monthly checks on her neck and on her vision: there was no sign of a tumour there or anywhere else in her body. The drug seemed to have done something to her body that would probably prevent any tumours occurring again, since she’d had more doses of the drug than anyone else before her. She learnt that the trials were going to be abandoned completely, at just about the time of her latest eyetest, the result of which confirmed that her vision had thankfully stabilised, but at minus 37 each eye. She had trouble dealing with her new view of the world, and oftentimes the world had similar trouble dealing with her new look; thickly bespectacled, rather gaunt and perpetually tired-looking, even though she felt physically fine. She got herself back to work again, but life seemed much harder now than before. The whole of the last two years seemed like some nightmare she’d just woken up from, but no, it wasn’t just a bad dream, she had her high myopia as proof that it had all happened. As well as that, there was the fact that she could no longer drive, or recognize people beyond a short distance, nor see anything much at night. But there were some benefits she’d received in return for her sacrifice: she survived another 85 years, outliving her sister and even her children, a sad thing for her, but against that, she found herself being much loved by a man who wasn’t put off by her glasses.
Annabelle walked along to the bus stop and stopped at it to wait for her bus home. Pushing her glasses rather uselessly against her face, she squinted and looked into the distance: buses were fairly easy to see, but now hard to identify. She thought she heard someone stop beside her: turning her head to look, she saw someone - a tall man - not far away, but still far enough to make his features indistinguishable. She asked, ‘please, can you help me? I’m very poor sighted - can you tell me if that bus is the 385?’ He coughed and said, ’no, it’s not.' ‘Can you warn me when it does?’ ‘Yeah, OK. Don’t worry.’ Annabelle knew all about worry, but said nothing.
After a while, the number 385 bus came, and thus he warned her of this. When it stopped, he watched her get aboard in her accustomed uncertain and careful manner: that man was me, and I suppose if you see this tall, rather frail looking young woman, that’ll be Annabelle. She’s got these really thick glasses, you should see them. She’s got a hell of a story to tell, too: she told me all about it soon after I met her at a bus stop.