This is the story of the scar on my neck.


In August of 2000, I was working in Enfield, North London when I had a 48-hour illness. When I recovered, I notice that one of my lymph nodes under my chin (which tend to swell up when you are ill) hadn't gone down, and there was a hard bit about the size of a small grape[0] under my jaw. After a month of waiting for it to recede, I went to see a doctor, who said: "Hmm. Well, that sometimes happens when you are ill. Give it some time."

On my return to Oxford in October, where I was studying, I went to see my doctor there. She said: "Hmm. Well, that sometimes happens when you are ill. Give it some time." In December, I persuaded her to refer me to a specialist at the local John Radcliffe Infirmary, five minutes down the road from my house, which is a head-and-neck centre of excellence. I saw the specialist in January, who said: "Hmm. Well, I don't think we're ready to operate yet, and there's not much else we can do." At the return visit in March, they agreed that we'd waited long enough, and that it had to go.

With my final exams coming up in June[1], I obviously wanted to get this out of the way. So, I was booked in for an operation on the Wednesday before term started. Apart from asking a few people to pray for me, and saying "Oh, I'm sure it's nothing" a lot, I didn't think too much of it. I checked in to hospital, and was given a bed in the pre-operation ward. I met the consultant, Mr Milford, who was to do my operation, that evening. The next morning, I was woken up at 6am to be given breakfast. This was, in fact, a rare luxury - I was allowed it because I was last on the operations list. Everyone else went without.

The day dragged on, and at last the time drew near. I was asked to remove my clothes (with curtain decorously drawn) and got into a paper hospital gown which tied up at the back, and some very fetching white knee-length embolic stockings[2]. I was also given green goo to drink, which was supposed to make me sleepy. It didn't have much effect - when the trolley arrived to take me away, I jumped onto it, causing some raised eyebrows and mutterings about increasing the dosage. I was under the anaesthetic for about an hour, woke up and was discharged the next day with three or four stitches in a two-inch incision in my neck.

After that, I got on with life. Term started, and I didn't have much time to sit around worrying. The possibility of the lump being cancerous did cross my mind, and I did consider what I'd do if that turned out to be the case. I decided that the only thing to do was not to worry[3], and leave it in the hands of God.


Two weeks later, I returned to find out the results of the biopsy. Somewhere in the basement of the Infirmary there are a team of dedicated professionals whose job it is to stare hard down microscopes at thin slivers of whatever has been removed from people that day, and make encouraging or discouraging noises on pieces of red paper. This had duly been done, and the verdict was handed down. Mr Milford came out, shook me by the hand, and led me into the consulting room. As the door closed, a large nurse slipped in behind me and sat in a chair at the back in a quiet, yet motherly sort of way, and looked at me with concern. Uh oh, I thought. That doesn't bode well.

He began talking. "How are you feeling?... Excellent... Results back... somewhat unusual... very rare... quite unexpected... adenoid cystic carcinoma... carcinoma... yes, I'll write it down... maligant... slow-growing... scans... exploratory operation as soon as possible... no plans, I hope?"

The news didn't shock me. I think God had prepared me for this moment quite well; I'm not sure what the consultant thought as he told me I had cancer[4] and watched me sit there and take the news with a big grin. I explained about Finals, now in about five weeks. Hmm. After negotiation, we agreed that the operation should happen as soon after Finals as possible, and that I should find out the exact dates and let him know. He wanted to open up the side of my neck and remove enough material to get some idea of the spread - then he'd know how to proceed. While he was there, he also wanted to remove my right submandibular salivary gland, as this form of cancer is often rooted in salivary glands, and this one was closest to the site.

I cycled home, and sat down for a think. What was I supposed to be doing today? Nothing really important, it would seem. I called my parents, and put together a list of people who I thought I should tell, and how I should tell them. I felt it would be more personal to tell as many people as possible face-to-face rather than by email. While I love email, there are some things (bad news, marriage proposals) for which it's not the ideal form of communication.

It was the OICCU summer barbeque that Sunday. I felt like the angel of Death, moving among the happy punters and spreading bad news wherever I went. There was definitely a difference between the way my Christian and non-Christian friends took the news. In general, the Christians took it very well - not getting upset, and promising to pray for me. Unfortunately, this meant that I became progressively less tactful about telling people as time went on, and at the very end, I basically called my cousin (who isn't a Christian) and said "Hi, how are you? By the way, I've got cancer" and she burst into tears. Oops.

During the next few weeks, through large amounts of prayer, I was able to focus on my work and not get distracted by evil thoughts of metastatis. Every so often, I'd have to go to one of Oxford's four hospitals for a scan - an MRI scan of my head and neck, a CT scan of my chest, and a fine-needle aspiration test[5] of a lump on my leg which caused concern. I intentionally wasn't given the results of these tests - I really didn't want to know until the last minute. Some of my friends organised a prayer meeting, and I was incredibly touched to be presented with a list of 30 email addresses, all of people who wanted updates on how I was doing.


Tuesday arrived - the day of my final Final, as it were. I started at 11.30am in my college. It was my worst paper of the seven I did - but this might have had less to do with thoughts of the operation, and more to do with pretending Finals had finished, and going out to celebrate with friends at the weekend instead of revising. At 2.30pm, I finished and the invigilator escorted me, in full academic dress, up to the Radcliffe Infirmary at the other end of town.[6]

I arrived at the ward and checked in. The pre-operation ward was mostly empty - which was good, because a large number of my friends started arriving from 4pm for a post-Finals party.[7] It was great - I was really touched by how many of my friends came. It certainly took my mind off the operation to come. My parents were there also - on their way down south for some reason. We left the party for a while to go and find out the results of all those scans. When they saw us returning, the party fell silent - you could cut the atmosphere with a scalpel.

It turned out that the test results were very encouraging - the FNA[8] was clear, and the CT was almost clear - just one tiny nodule in the base of my left lung to make sure that I didn't think I was out of the metastasis woods yet. The MRI of my head and neck was also excellent - no trace of cancer detected. So, what remained was either smaller than the 2mm resolution of the scan, or had gone completely.

This was excellent news, but they still wanted to do the operation as originally planned.

This time round, I was early on the list - apparently Mr Milford was away in the afternoon. Rogan Corbridge, his registrar, was going to be the man actually holding the knife. It all seemed so familiar - as if I'd been operated on hundreds of times before, rather than once. After the now-usual gown, stockings and green goo, I waited for the trolley to come for me. ("Bring out yer sick!") A quick trip upstairs, the traditional count to ten, and the next thing I knew, I was staring at the ceiling of the post-operation ward.

My friends Philippa and Brad (a lovely, soon-to-be-married couple) were there as I came round. I waved weakly before doubling up and retching violently. Nurses came running and curtains were rapidly drawn - I was faintly aware that those drops of blood on the nice white sheet must be coming from me somewhere. I was coughing so hard I was bleeding through my stitches. Ick. It turned out that I had reacted badly to the anaesthetic. "Didn't you tell the anaesthetist this happened last time?" said a nurse. Last time? I don't remember last time. "Ah."

As the day wore on, I felt better. I had so many visitors, it was a real blessing. I must have had over thirty people come to see me on the Thursday, and my table was soon piled high with flowers, chocolates and jerberas[9] (thanks, Gayle.) One of the nurses even asked how on earth I managed to get all the pretty girls! "Christian fellowship" I replied - which sounds sanctimonious, but is true. I sent some chocolates on to the poor technicians in the basement, who had half my neck to look at in little slivers under their microscopes. It must have taken one guy all day - by the end, he was probably muttering "If I ever meet the man with that DNA..."

You might want to skip this paragraph if you are a bit squeamish. They had put a tube into my neck, attached to a vacuum drainage bottle, to remove any fluid which might build up in the gap that they had left. When I came round, I noticed that it was working - the bottle was slowly filling up. However, over the next forty-eight hours, it continued to fill. They changed it. I filled another one. They changed that too. I was feeling better, but I had a feeling that something wasn't quite right here.


Late on Friday, I got up to speak to the guy in the next bed and nearly fainted. Looking at my notes later, it seemed that I had lost 2 litres (4 pints) of fluid, mostly blood. The nurses decided enough was enough, and that something must be done. And when they decide something, they really move fast. Within a minute I had my feet in the air, an oxygen mask over my mouth, and one doctor was taking blood from my left arm while another was starting a drip in my right. One more was on the phone checking my blood type and summoning four pints of Oxford's best A+ from the John Radcliffe Hospital, on the other side of the city.

They started giving me a blood bulking agent - a clear goo which has all the qualities of blood except for an unfortunate inability to carry oxygen. A litre of this raised my blood pressure, but diluted my red blood cells, so I turned a lovely shade of yellow all over. A measurement of my red blood cell level (haemoglobin count) came out as 8[A], and falling - 12 is normal, and 4 is critically ill.

The blood arrived in a taxi - apparently that's the most cost-effective way of moving it about - and the doctor got to work. Unfortunately, it was straight out of the fridge, and all the blood warmers were locked in theatre[B]. So the doctor was squeezing the blood bag, trying to get it to go in faster, and I was gripping my right wrist with my left, screaming "Cold! It's so cooold! Have mercy!" She felt so sorry for me that she put the second bag under her armpit to try and warm it up.

One of the nurses happened to go to my church, so she called Tony, the student pastor and a friend of mine, who kindly came round at very short notice. In a lull, we talked for a while and he read Psalm 23. As I listened, I understood again just how much God cared about me, and I started crying.

Eventually, the assembled body of medical knowledge decided it was safe to operate, and I signed the "Yes, please, save my life, if it's not too much trouble" form before being wheeled up to the theatre for another three-hour marathon. The anaesthetist ran out of fingers counting the different anti-vomiting drugs she was giving me. Paul, the nice oriental surgeon-on-call, opened my neck up again along all the same lines and spent three hours taking a tiny heat gun to all the spots where it was bleeding. "Yeah, I was lifting up your shoulder muscle and looking underneath for leaks." Cheers, mate. Too much information, perhaps.

I woke up the next morning feeling a lot better, but now with _two_ drainage tubes in my neck. From this point, I didn't lose more than an eggcupful - whatever Paul had done, it had certainly worked.


This all meant that my stay in hospital was somewhat prolonged. Sadly, I missed all the end-of-term parties and dinners. I was particularly sad to miss the Maths and Computation leavers' dinner at my college, but I wrote a speech which I hoped Bill (my tutor) would read out. It didn't quite go according to plan; the dinner was also a goodbye to one of the tutors, and there were about 250 people there, who had all been his pupils at one point or another. My somewhat gruesomely humorous speech, which would have been perfect after a dinner for thirty undergrads, probably wasn't quite appropriate for such an occasion. Unfortunately, Bill decided to try and edit it on the fly, and apparently ended up making me sound like I was still delirious from the medication.

Bill was wonderful, though. Originally, it looked like I was going to go back to living in the college Annexe, 10 minutes cycle ride from the centre, where I had lived before the op. However, Bill refused to take No for an answer from the Domestic Bursar (the person in charge of such things), and he and Philippa got me one of the nicest rooms on the College main site, within easy reach of the kitchen. So, I happily passed two weeks living in style, being visited and pampered by everyone, and only getting frustrated when my arm got so tired I couldn't hold a mouse.

I was late for the appointment to remove my stitches and, having run across Oxford to get there, felt like my arm was about to fall off. They let me take all 36 of them them away in a little plastic tube. Two weeks later, the Finals results arrived - despite all that had happened, I had been awarded a First.

The next day, my parents arrived to cart away me and four years of accumulated junk. Just before we left, we went round to the RI for the biopsy results. If the results were good, I was due to go off to America to work in Silicon Valley for three months. If they were bad, I'd be staying in England for horrible radiotherapy. Time to pray.

Mr Milford broke the good news - they had failed to find a trace of the cancer in any of the 56 lymph nodes and one salivary gland that they'd taken out - and so the chances were excellent that they'd beaten it, and there was certainly no need for radiotherapy at this stage. Praise the Lord! America was on, and I went home happy.

Nine months on, I have a very obvious scar (well, parts of it were sliced open three times) and a non-working right upper trapezius[C] muscle (they must have damaged the nerve), but am otherwise in great shape. The point of this entire account is to pay tribute to Him who sustained me throughout the entire episode, and without whom I would have fallen apart - Jesus Christ. He helped me to focus on, and do so well in my exams, and kept me from fear - just as He promises He will:

Lo, though I walk through the valley of the shadow of death, I will fear no evil.
For you are with me - your rod and your staff, they comfort me." (Psalm 23)

He died for my sins and yours, rose from the dead, and reigns today. I urge you to read more about the evidence for these claims.

Gervase Markham, 24th March 2002

[0] John Diamond, author of C, says that doctors always use fruit (grape, orange, grapefruit) when they don't know what's going on, and balls (golf ball, cricket ball, tennis ball) when they do. Now that's food for sport. (Groan) [Back]
[1] The system at most English universities is that what sort of degree you get, and whether you get one at all, is decided in a big set of exams, known as Finals or Schools at Oxford, at the end of your last year. [Back]
[2] This spectacle available for a small fee at parties, weddings and village fetes. [Back]
[3] Therefore do not worry about tomorrow, for tomorrow will worry about itself. Each day has enough trouble of its own. - Matthew 6:34. [Back]
[4] Although he didn't use the C word for at least ten minutes. [Back]
[5] A smart name for "stick a needle in, suck some stuff out, and look at it." [Back]
[6] Because students are theoretically allowed to turn up for Finals up to half an hour late, I could not be permitted to talk to anyone until 3pm - in case, presumably, I revealed all the questions to a breathless student at 2.35pm, who whipped his folder out of his rucksack, memorised model answers to the questions, and arrived breathless at the exam hall at 2.59pm, to score a triumphant First in the remaining 2 1/2 hours of exam time. [Back]
[7] Most people just go to the pub; it's nice to be different. [Back]
[8] It gives patients a sense of belonging and control of their illness if they are able to understand and use the technical terms associated with it. Or so I'm told. [Back]
[9] No, they aren't a heath risk in hospitals. It's a flower. [Back]
[A]I deplore the fact that I don't know the units of measurement here. But the dramatic effect is there. (A? As a scientist, I do footnote indices in hexadecimal.) [Back]
[B] Telling this story to a group of Americans completely confused them at this point. To clarify: not theatre as in Broadway, theatre as in Operating Theatre - O.R., in American speak. [Back]
[C] shoulder. If you rub the tops of both my shoulders[D], you'll find the right is more bony than the left - the muscle, unstimulated, has wasted away. This doesn't make much of a difference day-to-day - it just removes "weightlifter" as a possible career. As the scar has removed "secret agent", "model" and "actor", I'm beginning to worry about my options being limited. [Back]
[D] Ask first, please. [Back]

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