Having worked in palliative care for 20 years, when Nigel Dodds was diagnosed with cancer he expected the worst
I’m used to being around people with terminal illness. Death is a normal part of my job and although I think I’m compassionate and caring, the people I see are my patients and I look after them as any nursing professional would. But that professional exterior is difficult to maintain when it comes to your own health.
Six years ago I was on holiday in Lisbon with my partner David celebrating my 40th birthday. I spent the day on the beach and then went for a shower back at the hotel. That’s when I found a hard lump in my testicle.
Although I hadn’t noticed anything before then, I knew immediately that this was cancer and began to think my number was up, that I was going to die from this.
I work in palliative care and so when I see patients with cancer it’s because they’re dying.
Despite my discovery, I managed to push it to the back of my mind for the last two days of the holiday and when I got back home I tried to get an appointment with my GP. None were available so I found myself in the local GUM clinic at King’s College Hospital. I waited just two minutes to be seen by a doctor who told me that he was pretty sure it was cancer, which was later confirmed by a scan the next day.
”At this point I was convinced I was going to die”
I actually felt quite ashamed and embarrassed. They told me it was quite advanced and I wondered how I had missed it for so long. I’m a nurse so how did I not pick up on it?
At this point I was convinced I was going to die and even if I wasn’t going to die I needed to know immediately if I was going to live or die. I just wanted to know which, one way or another and for it to happen quickly.
Things moved quickly from here.
Within a couple of days I had an operation to remove my rotten testicle and went back to work at the hospice soon afterwards while I waited to start my intensive chemotherapy a few months later.
On reflection, this was probably the wrong thing to do. Returning to the hospice after my surgery, it no longer felt like a place of work as before, but a place that I could potentially need in the future. That was strange and I didn’t feel like I had the capacity to care for other people while I was going through all this, feeling the need to be cared for myself.
”I wasn’t sure that I could ever go back to nursing after this and certainly not palliative care”
I found myself over-sharing my diagnosis and fears for the future with my colleagues. I didn’t want to be around other sick people and I still thought I was going to die. At that point in time I wasn’t sure that I could ever go back to nursing after this and certainly not palliative care.
One day while I was waiting in the oncology outpatient department to see my oncologist I noticed a woman of a similar age to me, quite cool and trendy, also in the waiting room. Although I didn’t talk to her, she was attractive and charismatic and I somehow felt her presence.
Completely out of the blue she contacted me through Facebook the next day. She had heard my name being called and decided to track me down.
We met up for a drink and we got drunk together, she even propositioned me knowing that I was a gay man! Cancer does funny things to you.
”I always felt very guilty, knowing I could be cured while both of us knew she was going to die”
She had breast cancer and didn’t want to have chemotherapy but I persuaded her she should. She had her first session alongside me. It made her really sick and she ending up in hospital with an infection. She continued to have a difficult time with it and eventually decided to stop after a while and take her chances. Although we kept in touch I always felt very guilty, knowing I could be cured while both of us knew she was going to die.
My chemo lasted three months and I felt terrible for the entire time. Nausea, fatigue, no appetite, weight loss, hearing difficulties, pins and needles, numbness, and losing all my body hair.
However, I responded well to the treatment and over time it was clear that there was less and less evidence of the cancer in my body.
In the chemotherapy department I met a number of people who I already knew – not from my cancer experience, but as patients of mine from when I was well. This was a humbling experience and one that moved me from one side of the patient – healthcare professional divide to the other. I think many of us in this world separate ourselves from our patients, it’s them and us. Perhaps this is a way of maintaining a needed professional boundary but I learnt how easy it is to switch sides.
”Cancer is like that, even once it’s gone you can be haunted by the possibility of its return”
A few months after my treatment finished, routine blood tests alerted my oncologist to the possibility that my cancer had returned. However, more tests proved this was a false alarm. Cancer is like that, even once it’s gone you can be haunted by the possibility of its return – even six years later.
Following treatment, I went back to work pretty quickly two months after the treatment finished. Possibly too soon, but a year later I felt very differently. I really enjoyed working again, I learnt to separate myself from the illness and although I’m literally physically and mentally scarred by the experience I feel OK now, and manage to live an active life including a busy work life.
Ironically my friend with breast cancer spent her final days at the hospice where I worked. Her cancer was aggressive and without treatment to slow it down she became very unwell pretty quickly. She made very different decisions to me and took a different course of treatment. Although my cancer treatment was the most physically arduous thing I’ve ever experienced, I’m glad I took everything they could give me.
”I don’t think I’m any more or less compassionate or caring then I was before”
Today I don’t think I’m any more or less compassionate or caring then I was before, but I’m much more understanding of my patients’ experiences. I’ve been in a part of their world and it’s a difficult place to be.
I’ve been left with some side effects from chemotherapy that will last me a lifetime. My voice is now husky and not as reliable as it once was, so if I’m speaking in public I’m not as confident as I used to be. My hands are bad when it’s cold as I now have Raynaud’s, which affects the blood supply to your fingers. But I do have a false testicle and it’s even better than the real one!
So what have I learnt from all this? Any one of us, even those of us who look after people with cancer, can get cancer. My advice would be to face the fear head on, don’t go back to work too soon after the treatment finishes, take all the treatment you can get and then if you can, once it’s all over, leave it behind and live your life.
Nigel Dodds is a nurse consultant at St Joseph’s Hospice in Hackney, East London