Philip Gould - When I Die

Earlier this week, I had a couple of really tough nights. My breathing was bad, my digestive system was bad, my diarrhoea was bad, my coughing was bad. Everything was bad. Gail was in a bad state too.

I just lay there and thought: ‘OK, this is bad. But this is death, and as long as I look death in the eye and as long as I accept it, I can choose – to an extent at least – the kind of death that I want. I have some freedom, I have some power here. I have the possibility to shape for myself my own death.’

At that moment I had a sense of freedom, and every time I experience that I am free of death, for a moment at least.

Fear of death is crucial to our understanding, but this idea of facing it square on is a core one for me, probably the core one, and it is the one that works best for me.

Entering the Death Zone provided a process through which, step by step, I became able to cope with the reality of dying.

I had always expected, ever since my first diagnosis of cancer four or so years ago, that I would be able to cope with it to some extent. Then, when I had my first chemotherapy, I was terrified. In a way, chemotherapy is a symbolic, iconic representation of cancer. It comes with these tubes, these side effects, these horrible things that seem so awful to contemplate as happening to you.

Before it started I thought: I simply cannot do this. I cannot do chemotherapy. It is too painful. It is too horrible.

But you do it.

Then the people treating you say: ‘By the way, mate, you are not going to have an oesophagus, you’re not going to have any of this or that or here or there, and you will never eat normally ever again.’

And you get used to that.

Then you realise – whatever they throw at you, you can deal with it.

And that is because your body and your mind have an extraordinary capacity to deal with what is going to come later. It is just an amazing thing. You learn how to cope with these challenges, one after another. There is more in the human body than you will ever understand, more physically, more emotionally, more spiritually, more religiously, even. The body can cope. You can cope. You can do it. You can deal with the pain, you can deal with the discomfort, you can deal with the uncertainty, you can deal with it all. It is possible to deal with it all.

Realising that changes you as a person.

Then there is the matter of courage.

You think: God, I’m scared, I’m a coward.

I thought I was a coward. I was the kind of guy who was frightened to go too fast on a bike in the evening. Too frightened to go on the big rides at Alton Towers, or do any of the scary swimming stuff, or even to duck my head under water. I just did not have the courage to do these things.

But when cancer came, bringing with it a great deal of fear and pain, I found I could deal with it. Time and time again I found the courage to deal with this acute and terrible pain.

The pain was and is bad. It is slow and mundane, day after day after day of pain, feeling sick, vomiting. Endless, endless, endless pain. But you get to be able to endure it. However horrible it is, cancer prepares you for what comes next. It prepared me. It braced me too for the fact that it might return; and when it did return, it prepared me to understand that it might come back in a much worse form.

It prepared me for all that, and then it tested me again. It said, actually, this is going to come back, and frankly it may come back in part because of human error. I am not, by the way, saying that necessarily happened. But nonetheless human error was a factor.

You have to live with that huge thing too. You live with the possibility that human error caused this.

So you are dealing all the time with a vast number of things. Fear. Uncertainty. Pain. And what I have found is that, as it goes on, you get stronger and stronger and stronger and freer and freer and freer. All the way through my cancer journey, my body and my mind have been able to cope with the next stage. Cancer prepares you to take the next step, even as you are completing the one before. In the end you lose your fear of the next step because you know you will be able to take it.

We all have to endure pain, but it gets in the way. Some believe that through pain you gain enlightenment. My experience has been quite prosaic. If I feel pain I stop. My creativity falls away. I really do not like pain.

I would be one week on chemo and one week off, and the week when I was not undergoing chemo was the creative week for me. In the non-chemo week I was able to write and do things.

The more pain can be got rid of, the better. What you need in the Death Zone are as many good quality days as you can possibly have, with your friends and with your relatives and with your books, or whatever it is you want. Get rid of pain as best you can. I really do not care how you do it.

I try to get rid of pain straight away myself. It does not help me in my creativity, it does not help me with my self-expression, it does not help me build relationships. Even when the kids talk to me they cannot have a proper conversation if I am in pain.

What’s the point of pain if it does not do me any good?

The only thing I ever really gained from pain came when I was suffering the most acute form of it in my entire life. I had just undergone the surgery in Newcastle. It hurt so badly that I remember thinking: God, I understand now what it is like to have pain.

And I found myself wanting to say to the world, I feel your pain and understand the pain you are feeling. I wanted to send an empathetic message to everyone.

When I had my second recurrence, the medical staff said: ‘Look, let’s be honest, you’ve got seven lymph nodes full of cancer, it’s not good.’

When I asked the doctor what my chances were, he looked down and shuffled his papers a bit, and I knew then that the game was probably up. I did not know what to do. I had no sense of purpose. I was lost.

But I found a purpose. To begin with, it was just to find what it was in this new stage of life that would give me meaning. In other words, finding a purpose became my purpose.

Then came that terrible Friday morning when the hospital rang to say: ‘Now you’ve gone through the 5 per cent tumour marker up to the 58 per cent marker.’

It was all over – completely and clearly.

I was not going to make it unless I was very lucky. No, I was not going to make it. That is what I mean by being honest. Fuck it. You must be honest.

Gail and I went to one absolutely bleak late-night session where the hospital staff were checking the scans. They were wonderful people but what they had to say was in effect: ‘Look, you’ve got cancer all over the place, and you know it is going to kill you. It is going to kill you in three months, four months or five months, but it is going to kill you.’ There was no question about it at all and I knew that. It was kind of like being hit by a roller-coaster, it was so hard.

Georgia, quoting Leonard Cohen, always says there is a crack in everything, that’s how the light gets in. There was no crack here. This was pure darkness and death. Whenever I tried to move the conversation on, the doctor kept saying: ‘You are going to die and that is that.’

Gail and I just looked at each other and started to cry. I cried endlessly for hours, I was so sad. We knew this was it and we knew there was no escape, and so we cried.

A day later we bounced back. We moved to a different place and a different time. It was a totally transcendent moment. I saw now that the purpose I had been seeking was to give as much love as I could. Even though I was dying I knew that was what I had to do. It was clear, there was absolutely no ambivalence about it. I was dying, I had to make the most of that and my purpose was explicit. And so my death became my life.