So now I have cancer. And the issue arises. What do I say, who do I say it to, and when? It comes naturally to me to adopt a policy of full disclosure, as far as my immediate circle is concerned. By "my immediate circle" I mean the people with whom I have or will have face time on a regular basis.
        My wife knows. My family knows. My former employer, Dai Nippon Teaching, also knows. I've sent an e-mail to explain. They have to know that I'm not going to be back in January to resume teaching my classes. And any future employer is going to have to know, otherwise how do I explain a lengthy gap in my work history? So a policy of full disclosure seems very natural to me.
        But then someone, a fan of my fantasy novels, a stranger, sees my zenvirus.com web site and writes a friendly e-mail to me, a "Hello, I liked your books, how's life?" And I write back and say, all too bluntly, exactly how I am, that I have brain cancer, that I may possibly be dying. And I get back a shocked "I'm so sorry" response, and I realize that I've sinned, and that there are not just issues of privacy here but, also, issues of etiquette and timing. My cancer is not something that I have to dump on the world.
        So later, for example, some time later, when I end up in a bookshop, bandaged, and the bookshop manager kindly asks after my health, I deflect the inquiry, say "It's a long story", and leave it at that. There's a kind of etiquette of disclosure involved here.
        Anyway, what followed after my diagnosis was Christmas.
        Shortly after Christmas, I went to Auckland Hospital with my wife, my father and my sister and kept an appointment at the oncology department. Here, I met two doctors, Dr. Porter and Dr. Hamid.
        In retrospect, it is clear that I was not functioning one hundred percent on the mental level. At the time, however, I had no consciousness of this whatsoever. When I went to the appointment, I had a written list of questions which I intended to ask. I asked all my questions and got an answer for each of them, so I deemed the appointment to have been a total success. Only later did it emerge that I had failed to take in some things.
        If my memory is correct, then both Dr. Porter and Dr. Hamid were present at the appointment right from the start. As far as my memory is concerned, this is a fact. However, as it happens, my memory is not correct. My father and my sister concur in stating that I remember inaccurately. Apparently Dr. Porter was not initially present and arrived some way into the meeting.
        At the meeting, I was given a prescription for an oral steroid, dexamethasone, and was instructed to take eight milligrams of this a day -- one four-milligram tablet after breakfast and one four-milligram tablet after lunch. All going well, the dexamethasone should reduce the swelling in my brain and should reverse the partial paralysis that I was suffering from.
        During the course of the meeting, a bunch of things were explained to me.
        "Lymphoma is a very treatable disease," said Dr. Porter, and he made it clear that he was aiming for a cure.
        I already knew that lymphoma was "treatable". My aunt had been treated for lymphoma and went into remission and lived for years before the lymphoma finally killed her.
        "So what are five year survival rates like?" I asked.
        During 2003, I had been teaching English on a regular basis at a Japanese pharmaceutical company, Enoshima Pharma, and, as part of related curriculum preparation work, I had read a whole bunch of technical documents from the pharmaceutical industry. The term "five year survival rates" had often popped up in such documents, and I used it naturally, unthinkingly.
        "Forty percent," said Dr. Porter.
        Was that forty percent who were alive or forty percent who were dead? I wanted to nail this down absolutely. I sought and got clarification. My chances of being dead inside of five years where about sixty percent. My chances of being alive were about forty percent.
        So what were we actually told at the meeting? Were we told that I was probably going to live? Or were we told that I was probably going to die?
        Later, I found that my interpretation differed from that on which my father and my sister agreed. My interpretation was that the statistics said I was probably going to die. Their interpretation was that I had been told that I would probably live.
        At a later meeting with Dr. Porter, I tried to establish exactly which of these two messages had been sent. The answer was that both had been sent. Dr. Porter had intended to send an optimistic "aiming for a cure" message but, since I had asked a statistical question, he had supplied a statistical answer.
        "And do those statistics represent my chances?"
        "Yes."
        Yes, my chance of still being alive five years out was forty percent. I made sure that I was crystal clear on that. I wanted to know what my chances were. Supposing that I succeeded in making it to the five year point, then Dr. Porter would regard that as a cure.
        Anyway, while there was a little confusion over my chances at the outset, it was clear right at the first meeting that a cure was possible, and one step along the way would be to do a biopsy. This would involve drilling a hole in my brain and extracting part of my brain so it could be analyzed to see exactly which of the thirty-six or so possible treatment options should be offered to me.
        Rightly or wrongly, I gathered that the options were all variations of one basic pattern: first chemotherapy to bring the cancer to heel and then hard radiation to burn out the last bastions of resistance and, all going well, to prevent the cancer from coming back.
        However, before anyone began mining operations inside my skull, the oncologists wanted Dr. Mantell's opinion on the involvement of the eyes. Both eyes were so full of floaters, inflamed cells and other junk that it was difficult to see what was inside the eyes by merely looking. The question was whether the chaos in the eyes was caused by infiltrating lymphoma cells or whether there was some kind of lymphoma "structure" in the eyes.
        The decision that was arrived at was that I undergo a vitrectomy on the left eye to provide a tissue sample which could be analyzed at a lab. There were risks associated with the operation, and the risks were explained to me, but, for my part, the decision to go ahead with the operation was very easy.
        Back in Japan, when Dr. Lux had proposed that I undergo a vitrectomy of the right eye, I had been strongly resistant to the suggestion. My left eye had by then been effectively blind, so if some mishap were to result in the blindness of the right eye then I would be completely blind.
        In New Zealand, however, the situation was different. The proposal was to biopsy the left eye rather than the right, and the left eye was already more or less useless. Furthermore, I had been given to understand that the left eye was probably permanently damaged, and that I could not expect it to improve. Consequently, it did not seem to me that I was putting much at risk.
        On Thursday January 6th I showed up at the eye clinic at Auckland hospital and was examined by a Dr. Hirut Von Lany, who described herself as Dr. Mantell's "fellow", which I think means a kind of extremely high-level student. (Very high level, I think. Ascending the elite heights.) The eye operation was scheduled for the next day.
        My diary entry for the evening of January 6th follows.