Christine Dwyer Hickey: I lost a kidney and gained a novel

I was at a book festival in west Cork in 2015 and about to go on, when I received the “good-news, bad-news” call from my doctor. A week or so earlier, in the course of a routine visit, I happened to mention a small niggle in my lower back and, as an aunt of mine had been a victim of ovarian cancer, I had been marched off to the local hospital for an ultrasound scan.

I could hardly even call it back pain, of which I’d had my fair share over the years. Three children, grown now, had used me as a sort of monkey-tree for most of their childhood. There was the horse-riding era where, whenever I fell off, which was often, I had an uncanny knack of landing arse-first. And that long-ago car accident on the quays when a truck smashed into the back of my small Austin Metro, folding it like an accordion behind me. All of these things had taken their toll. This was different, though, it didn’t even hurt. And as anyone who has ever suffered from back pain knows – it really, really hurts. It was, well, it was just there, I suppose.

In any event, there was no need to worry about ovarian cancer. Everything was fine and dandy in that department. However, there was a little something showing through on one of my kidneys and I would need to go for a further, specialist scan. I told the doctor I was going away in a few days’ time, and promised to make an appointment as soon as I got back to Dublin. She may have presumed I was going on a fortnight’s holiday. I may have omitted to tell her that I would be away for six weeks.

I saw no reason to get myself worked up anyhow. Since being diagnosed with psoriatic arthritis 10 years previously, I’d had many a scan and had long ago stopped worrying about all matters medical. Much of my spare time and most of my money seemed to go on my health. Rheumatologist, neurologist, dermatologist, immunologist, gastrologist – name an ologist and his or her number was in my little black book. Still, as I frequently reminded myself, it had all been worth it: I had gone from a fortysomething, claw-handed old crone, who often had difficulty walking, to a sprightly fiftysomething who could type at the speed of thought and trot around in high heels for a city mile. It had taken a long and painful time to find the right medication, but now, with the help of a self-administered weekly injection, I was finally sorted. And that was all I really cared about.

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New novel anxiety

Around this time I had started to tinker about with the bones of a new novel and was anxious to get going on it. I wasn’t sure what this novel would be, but could feel it taking shape in the shadows around me. For some time my first character had been wandering around in my head. He had been put there a few years previously, during a dinner at a book festival in Leipzig when a man told me a story about postwar Germany and how children suffering from malnutrition were sent off to farms to recover. Many of these children were orphans and some would later be brought to the US to be adopted. It had stayed with me, the vision of a little boy sitting on a train with other boys he’d never met before, all going off to be fattened up like little piggies for the market, while outside, a ravaged landscape rolled by.

I thought about him a lot in 2015 as the refugee crisis in Europe reached staggering proportions. Photographs and newsreels of African and Middle Eastern migrants dominated the media. In the midst of all these refugees were the faces of children – squeezed into inadequate boats, pushed up against wire fencing or sometimes just standing alone on the sidelines playing in the dirt. Some of them appeared to be unaccompanied, but in any case, they were, like everyone else, trying to make their way across Europe. Germany seemed to be the preferred destination, with Angela Merkel’s Wilkommenskultur (the culture of welcome) in its first fervent flush. Seventy years previously the traffic had been moving in the opposite direction, and the irony did not escape me.

I had also been reading Berlin: The Downfall 1945, Antony Beevor’s harrowing account of the fall of the city towards and after the end of the second World War. I hadn’t quite realised the full extent of the savagery perpetrated by the soldiers of the Red Army on the people of Berlin and particularly its women. Questions of redemption and forgiveness began to weigh on my mind – how do you begin to punish or, indeed, ever forgive something so vast and incomprehensible as the brutality of Nazi Germany? Perhaps more than anything else, it made me think about the inheritance of guilt.

Hills of rubble

I began to visualise the city; the cracked and broken buildings, the sandbags, the hills of rubble, the Trümmerfrauen (women of the ruins) crawling all over them as they attempted to clean up Berlin and at the same time scavenge for anything that might have a sale value. And, in the midst of all that, my three-year-old boy, coat down to his ankles, wandering lost and alone through the streets.

I gave him a father, a soldier in the Wehrmacht; I gave him a mother who had disappeared. I gave him a name: Micha.

My next step was to find a time frame and a location. I chose the US in the year 1950 – a period of significant transition. A new-found prosperity was giving rise to the age of consumerism and the idea of the perfect housewife was being heavily marketed. Women who had been working for the war effort, earning their own money, had stepped aside to make room for the returning heroes – heroes who hadn’t always settled back into civilian life. Many families had suffered loss, but in any case, the US had just about grown accustomed to peacetime. And then the Korean war broke out.

For the novelist, the casualties of war hold countless possibilities and my head was clogged up with ideas. The first thing I needed now was to sit down, cut myself off from the world and get going. The last thing I needed was another ologist in my life.

My husband was listening very carefully. I noticed the sudden draining of colour from his face. I decided it might be wise to shake myself up and concentrate

And yet here he was, eight weeks or so after I’d received the doctor’s call. This time, it was a urologist – and his team – frowning over and discussing scans of my kidneys. What they were saying, I had little idea. But this was quite normal for me – a peculiar side effect of recent years where I had developed a sort of nervous, selective deafness whenever a medical professional sent more than a few words in my direction. My husband, however, was listening very carefully. I noticed the sudden draining of colour from his face. I decided it might be wise to shake myself up and concentrate. I heard the word “tumour”. I heard the word “cancer”. Then I heard the word “nephrectomy” – what a beautiful word, I thought.

Silent walk

We didn’t go back to the car straight away but went for a mostly silent walk along the banks of the Grand Canal. When we spoke, it was about those leafy banks, the swans on calm water, the price of houses in the area. We talked about how well the autumn light suited this part of Dublin. We did mention the word nephrectomy but only in a general way as if it had nothing to do with us. Was it Greek or Latin, we wondered, and which part of it referred to the kidney, which to the removal?

As we walked through the front door, I heard myself say.

“Oh, I’m sure it’s a lot of fuss over nothing.”

And then my husband behind me: “They’re not even sure if it is cancer.”

These sentences, or variations thereof, would become a sort of mantra between us, over the coming days. Family and friends had their own mantras: nowadays, the things they can do! The miracle of modern medicine! My friend’s son has one kidney! My uncle’s wife was born with three of them! (and it is really astonishing how many people out there are walking around with three kidneys in their pouches). I was even told of two brothers who had four kidneys each but felt that was pushing it a bit.

If anything, morphine made me worse, plunging me into a migraine attack that lasted on and off for several weeks

In any case I wasn’t worried about the number of kidneys; it was the surgery that concerned me, the aftermath, the fact that I already had a badly compromised immune system and would have to go off my medication for some months.

The urologist booked me into the first available slot, which was 10 days later, and during those days I’m almost embarrassed to admit that for the most part I really did have a lovely time. Friends visited bearing gifts. My oldest friend who lives abroad “happened” to be in Dublin that week of all weeks. One day we went for a long walk and ended up back where we had started out as 10-year-old girls, in a boarding school overlooking the Phoenix Park. Later we sat by the fire in the Angler’s Rest, had a long lazy lunch, made unsavoury jokes about my predicament and laughed ourselves sick, as if there wasn’t a thing in the world to worry about.

I got the truth from two people – a friend of mine, who had a kidney removed when she was 17, told me to be patient and I would gradually feel better but I would never feel 100 per cent again. Another friend, whose husband had recently come through the process, gave it to me straight – perhaps a little too straight I thought at the time, although later I would be glad of her honesty. She told me exactly how the surgery worked, what would go on while I was on the table and what to expect afterwards. “It will be intense,” she said, “but it won’t kill you, and the morphine will make it so much better.”

Wrong about morphine

She was right about it being intense and she was right that it wouldn’t kill me – but it often felt as if it could, and as the weeks dragged by and I seemed to struggle more and more, I often wished that it had done. She was wrong about the morphine. If anything, it made me worse, plunging me into a migraine attack that lasted on and off for several weeks.

Yet the operation had been a success and, as the tumour proved to be cancerous, it had been the right thing to do. Kidney cancer spreads quickly and is difficult to diagnose. I was lucky. Lucky that I wouldn’t have to have chemotherapy. Lucky that the tumour had been contained. I had a superb medical team looking after me. The kidney was gone but so was the tumour that had been nesting in there like a sly, snug worm. Lucky indeed. Everybody said it; I said it myself. I said it so many times I began to feel like a backing vocalist on that Kyle Minogue song.

So how come I didn’t feel all that lucky?

I felt permanently anxious. I would wake in the early hours and lie in the dark and wonder. When I did sleep I was often pulled down into a recurring nightmare where I was trapped in a damp, black cave with some living creature cowering at the back of it. When I stood at the mouth of the cave and looked down, there was a void; when I looked behind me, the creature’s breath would deepen. I began to suffer from acute insomnia. The migraine continued. If it abated during the day, it woke me at night, coming down on my head like an axe.

It’s the loneliest time, waiting for daylight to appear through a chink in the curtain while the house sleeps around you. It’s a sort of prison, I believe. In the mirror I found a stranger waiting. A thin, dead-eyed stranger. I was exhausted, couldn’t seem to think, couldn’t write a sentence, nor could I imagine ever writing another book. I became convinced that there was something seriously wrong, that I was in decline – that, in fact, I was coming near to the end of my life.

Nobody tells you about post-surgery depression, which is a shame, as it seems to be a common enough occurrence. Had I understood it, things might have been easier. In a way it is to be expected. The body has been through a trauma; a violence has been forced upon it. Strangers have cut you open and pulled bits out of you; there is a lot of blood and indignity involved. The fact that the mind is asleep at the time doesn’t mean it hasn’t happened or that it hasn’t remained in the memory bank.

I couldn’t share this depression. My children and my husband had been through enough. I didn’t want my friends to worry or worse, to think I was a whinger.

Peaceful sleep

My husband had taken time off work to take care of me and if my progress was a little slower than he hoped, he didn’t say. In the mornings he walked me up to the top of the road or around the back garden. In the afternoons he put the fire on and I would lie on the sofa, read a little, or look at the wall. One afternoon I put on the television and found a documentary about the American artist Edward Hopper, which out of interest I had recorded some months previously. It was mostly set in Cape Cod and showed the summer house built by Hopper and his wife, Jo, the sea beneath it, the vacant beaches, the long swishing grass. The background music was repetitive in a soothing sort of way, the sea a thick silver liquid rolling into itself, over and over. I felt my eyes closing down. When I woke, the documentary had ended and I had had my first peaceful sleep in weeks.

It became an afternoon ritual, lying on the sofa, watching this documentary, sometimes falling asleep, sometimes just losing myself in its other-worldly atmosphere. It gave me a sense of peace, but also, a strange sense of elation.

I had always been a fan of Hopper’s work. Now I began to examine his life. I found a biography that ran to almost 800 pages. This book didn’t always put him in the best light. Claims were made that he was violent towards his wife and that he had deliberately blocked her career. I read the biography a second time and began to notice that all of these claims seemed to come from one source – his wife. She kept a journal and wrote letters to their friends. She often contradicted herself. One day he was the best, most gentle husband in the world. The next day he was a monster. There was no other testimony to back this up. In fact, any negative comments made by friends on the Hopper marriage seemed to be directed against Jo. More than one source claimed she kept him isolated and was controlling, both personally and professionally. At the same time I could find no record of Edward Hopper making any derogatory comments of any sort against his wife. When he referred to her, he always did so with respect. This I duly noted.

Entering their marriage

In the days of a bleak mid-winter, lying there on the sofa, listening to the sound of the sea coming from the television, I looked at Hopper’s paintings, heard his slow, cautious voice; studied his large hands and handsome face. And I watched Jo seated beside him, pretty and slight. I took in her fast delivery; her bird-like and determined movements; I heard the underlying disappointment in her voice, and gradually, I began to enter the Hopper marriage. I started to take notes. The notes grew into sentences. The more I wrote, the less depressed I felt and now when I slept, my dreams were of light and water. Everything began to lift, to open out, slowly behind and before me.

Scraps of my own life went into this novel. I gave Katherine, with whom Hopper would become infatuated that summer, cancer of the kidney – (in those days, the only way to perform a nephrectomy was by breaking the patient’s ribs with a hammer).

It was spring and then it was summer. In early autumn I had a scan and was given the all-clear. I went to Canada on a reading tour and heard a live performance of Holst’s The Planets suite. While I sat there the structure of the novel suddenly came to me. The first movement, The Bringer of War, reminded me of Micha’s arrival in America. But it also seemed to fit Jo Hopper so well. Argumentative, highly intelligent, a feminist who didn’t particularly like women, she was also given to violent bouts of sexual jealousy. A later movement, Saturn the Bringer of Old Age, would belong to Edward.

I travelled to Nyack and visited Hopper’s childhood home. I stood at his bedroom window and looked out at the glittering patch of the Hudson river that would have been his constant boyhood view. Then I went to Cape Cod, staying just up the beach from the Hopper house. I saw the light as they would have seen it, walked the same beach, swallowed the same air. It was as if I was standing behind them, as they looked down from their bluff over the sea.

I gave Edward a voice, and in doing so, came to understand and admire Jo. I kept at it, and at it. Three years later, I had a book.

The Narrow Land by Christine Dwyer Hickey is published by Atlantic Books