In the blink of an eye, and at a fraction of the private cost, my oesophagus was gone

Portrait by Gary Calton for The Observer

Shortly before 11am on Tuesday, 10 February, I was lying on my back chatting about northern soul music with Graham, part of the anaesthetics team at Bradford Royal Infirmary in West Yorkshire.

I briefly closed my eyes, and when I opened them I was discombobulated; the lighting seemed all different. I asked: “Is the surgeon coming in now?”

Behind me, a disembodied voice spoke. “It’s all over.” I can’t remember if it was male or female. I closed my eyes again.

In, quite literally, the blink of an eye, I had undergone around eight hours of surgery to remove the bulk of my oesophagus, in which lurked a tumour that had been discovered some four months before. And now it was gone.

After receiving a shock diagnosis in the middle of October last year, followed by two months of gruelling chemotherapy, I was – I am – now, as far as anyone knows, cancer-free.

I say “as far as I knows” because cancer is a waiting game. For the past four months, my journey has been punctuated by markers along the road. Tests and scans to see if the tumour had spread beyond my oesophagus, which would have made it impossible to operate. Chemotherapy to hopefully shrink the tumour and make it more manageable (it did). And now, histology.

Since my cancerous oesophagus was removed it has been sent off for lab work, the aforementioned histology, which is the study of tissue to a microscopic level. This will determine whether the cancer was contained in the oesophagus and has not spread. As I write this, I won’t know for a further three weeks.

I think, from the beginning, I was hoping for some definitive moment of closure with my cancer. A certificate pronouncing me cancer-free, perhaps, doled out as though by the Wizard of Oz bestowing a heart on the Tin Man. A bell to be rung on some hospital ward, to rapturous applause, maybe. Or, at the very least, me walking away from hospital, punching the air like Judd Nelson at the end of The Breakfast Club, as the picture freeze-frames and fades to black and white.

Instead, more waiting. And the less-than-conclusive offering from my surgeon that the baseline assumption was that, after surgery, I would be cancer-free – unless there were evidence to the contrary.

Does it feel a little like an anticlimax? To the fiction writer in me, it does. Endings should be neatly tied-up, not ambiguous and open-ended. Real life does not always imitate art, however.

When I awoke properly from the anaesthesia, I found myself in the intensive care unit, receiving one-to-one care and wired up to a bank of monitors and devices. There were tubes and wires everywhere; a thick pipe in my side that emptied distressingly bright-red liquid into a bucket, a catheter, a feeding tube in the other side of my torso, something going down the back of my nose, the purpose of which I am still unsure. Cannulas to the left of me, central lines to the right. Something in my neck.

I felt as though I had been hit by a truck; pain that was alleviated by constant infusions of morphine, tramadol and paracetamol. Those first few days I drifted in and out of consciousness, punctuated by visits from my wife, Claire, and on one occasion a dog called Ellie, who wore a little jumper and sat on my lap. At least, I think that happened; it could well have been a morphine hallucination.

On my first full day in intensive care, a physio team came to get me out of bed. They wanted me to go for a little walk. No problem, I thought. Armed with a Zimmer frame, which I laughed at, and flanked by two nurses who pushed the wheeled stands containing all the things that were being pumped in or out of my body, I set off into the corridor.

Their target was for me to walk about 10 metres. I did more than that, but was astonished at how difficult it was, how breathless it left me, how the atrophied muscles in my legs trembled. It was then that people began constantly reminding me that I had undergone extremely major surgery.

The oesophagus had been largely removed, first through keyhole surgery in my abdomen. Then, in the second part of the operation, they had sliced into my back, prised open my ribs, and deflated my right lung so they could access my stomach, haul it up as though it were a balloon, then stitch it to what was left of my gullet.

I’d been warned previously that this was an intensive and difficult operation. The oesophagus is soft tissue, not conducive to being stitched to a stretched-out stomach. There was lots that could go wrong. The day before I went into hospital, I wrote out a document for my wife, detailing life insurance policies, bank passwords, that sort of thing, and ending with “bins go out Thursday”.

I survived the operation, of course, and was told that it had gone as well as anyone could have hoped. I posted on social media a picture of me wired up to the various monitors, making some joke referencing the old 1970s TV show The Six Million Dollar Man, in which Lee Majors is rebuilt after a devastating accident.

Someone – I presume American – quipped in reply that this was probably the size of the bill I would receive for the surgery and intensive care. And that brought everything home to me in one instant.

I had undergone an operation that took longer than a working day. I spent four days in intensive care, then a further nine days on a specialist post-surgery ward, eventually being discharged on Friday, 27 February. My life had been saved, the care I had received had been exemplary. The NHS had, as far as I am concerned, performed miracles. And it had cost me precisely nothing.

I shudder to think what it would have cost in a world that many would like to see: the NHS dismantled and sold off, all of us reliant on health insurance. I shudder to think that, in such a world, I might not even be alive to write these words. And yet people want this to happen.

I don’t have a certificate to say I’m cancer-free, I didn’t get to ring a bell, I never had my Breakfast Club moment. So what? Cancer is a waiting game, and there’s more waiting to be done before I know for sure that I’m cured, but that is an extremely small price to pay compared with what the cost could have been in a different world that some would foist upon us all.