Michael Atherton is a lovely writer. This is a nice article.
His autobiography is a great read and he wrote it himself
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Thats generally the way with autobiographies 
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Most sports ones are ghost written these days.
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That would be a biography then
No a biography is book clearly written by an another author
Anyone with a times sub do the honours please
Itâs very much in the wrong thread
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Maybe. I know the subject though and wouldnât mind reading it
Not decent journalism as such, but I oddly enjoyed this article
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Could anybody with an Indo sub kindly post up the Kimmage/McIlroy piece from yesterday please?
AA Gillâs final piece
The great writer died on December 10, 2016, aged 62, following a cancer diagnosis. This article was published in The Sunday Times Magazine the following day
AA Gill: âThe face of real cancer wipes our expressions to a pale neutral humanâ
TOM CRAIG FOR THE SUNDAY TIMES MAGAZINE
AA Gill
Sunday February 06 2022, 12.01am GMT, The Sunday Times
Less than a month after AA Gill revealed in his Table Talk column that he had âan embarrassment of cancer, the full English,â he wrote the following piece on his diagnosis and subsequent treatment. He wanted to highlight the discovery of a drug, nivolumab, that could have prolonged his life but was not yet available on the National Health Service.
It seems unlikely, uncharacteristic, so un-âusâ to have settled on sickness and bed rest as the votive altar and cornerstone of national politics. But there it is: every election, the National Health Service is the thermometer and the crutch of governments. The NHS represents everything we think is best about us. Everyone standing for whatever political persuasion has to lay a sterilised hand on an A&E revolving door and swear that the collective cradle-to-crematorium health service will be cherished on their watch.
When you look at our awkward, lumpy, inherited short-tempered characters, youâd imagine we might have come up with something more brass-bandy Brit: a bellicose, sentimental military fetishism, perhaps, or sport, or nostalgic history, boastful Anglophone culture, invention, exploration, banking avarice. But no. It turned out that what really sticks in our hard, gimpy, sclerotic hearts is looking after each other. Turning up at a bed with three carnations, a copy of Racing Post, a Twix and saying, âThe cat misses you.â
We know itâs the best of us. The National Health Service is the best of us. You canât walk into an NHS hospital and be a racist. That condition is cured instantly. But itâs almost impossible to walk into a private hospital and not fleetingly feel that you are one: a plush waiting room with entitled and bad-tempered health tourists.
You canât be sexist on the NHS, nor patronising, and the care and the humour, the togetherness ranged against the teetering, chronic system by both the caring and the careworn is the Blitz, âback against the wallâ, stern and sentimental best of us â and so we tell lies about it.
We say itâs the envy of the world. It isnât. We say thereâs nothing else like it. There is. We say itâs the best in the West. Itâs not. We think itâs the cheapest. It isnât. Either that or we think itâs the most expensive â itâs not that, either. You will live longer in France and Germany, get treated faster and more comfortably in Scandinavia, and everything costs more in America.
Iâve wanted to write about the National Health Service for a long time, but itâs resistant to press inquires. While the abstract of the NHS is heart-warming, the truth for patients is often heart-stopping. And junior doctor strikes, executive pay, failing departments, slow-motion waiting times and outsourcing tell a different story, and Iâm regularly, ritually refused access by PRs and administrators, or they insist on copy approval or preplanned stories.
One of the doctors I approached was Professor Brian Gazzard, who has a reputation mostly for being an exemplary and inspirationally brilliant physician, but also as something of an ocean-going eccentric. He treats, teaches at and runs the Chelsea Aids clinic. I asked him what had changed most about his job.
âWhen I started, I told every patient that they were going to die. I could make it easier, make them live a little longer, but everyone died. Now I tell every patient they will live. They will need to do what I tell them, theyâve been silly, but theyâll live to die of something else. Thatâs astonishing.â He paused so I would understand the effect it has on a doctor. âLook, I really donât want to be written about. You wonât remember, but we met once before.â
A decade ago, Gazzard diagnosed my foreign correspondentâs dodgy tummy as acute pancreatitis, the result of alcoholism. âOf course I remember. You told me I could never drink alcohol again and I said, âYou havenât read my notes, Iâve been teetotal for 20 years.â And you gave a sigh and reached into a drawer and lit a cigarette and said youâd been dreading telling a restaurant critic he couldnât have a glass of wine.â
Gazzard laughed. âYouâre one of the lucky ones,â heâd said as he walked onto the street clutching an armful of patient files and raised a hand in farewell. He repeated again: âYouâre one of the lucky ones. I can always tell.â It was his first misdiagnosis of the day.
What neither of us could know is that my pancreas was already a stuffed wallet of cancer, though not pancreatic â a migrated, refugee, desperate, breathless lung cancer.
I stopped smoking 15 years ago and as a gift to myself, proof of the clarity of my lungs, I would spend a week stalking on Loch Maree in Wester Ross. Every autumn since, I have climbed the same hills, chasing the deer, and, trudging upwards, recited a doxology of mostly extinct snouts I no longer puff: Weights, Guards, Navy Cut, Olivier, Black Cat, Passing Clouds, Number 6, Sovereign, Gitanes, Gauloises (does anyone remember when Paris smelt alternately of Gauloises, pissoirs and Chanel?), Winston, Camel, Sobranie, my fatherâs pipe in the cinema â clouds of sweet latakia smoke in the flickering projection. A Greek cigarette in a red box with a lasciviously smiling girl that called itself SantĂŠ, without irony: an untipped fag called Health.
This year, for the first time, I couldnât make it to the top of the hill. I knelt in the heather, weak and gasping. It was the first time all was not well. There was also a pain in my neck that my doctor said was probably a cervical spine thingy and I should get a scan.
He sent me to Harley Street, where another doctor said: âYou havenât got insurance, itâs going to be expensive. Why donât you get it done down the road and send me the pictures. A third of the cost.â I said: âIâm here now, just do it.â And he shrugged. A couple of hours later I went back for the results. He had the bland bad-news face.
âThat was the best money you ever spent.â He turned the screen around and there was a beautiful spiral of colour clinging like an abstract expressionist collar to my spine. âThis is cancer.â
That afternoon I was back in my doctorâs surgery. He was wearing the antiseptic face, the professional-doctor tragedy mask. Iâm getting to see this a lot now. It is as much a protection against the infection of catastrophe for them as a respect for its victim. They glaze the bad news with sweet spittle. Theyâll say: âThe test results were not quite what we hoped. It might be trapped wind or it might be the thing that hatched from John Hurtâs stomach. Realistically, weâll have to assume itâs more alien than fart.â My alien was the most common cancer in old men, our biggest single killer: an aggressive, nimble cat-burglar lung cancer that is rarely noticed till it has had kittens.
Guy has been my doctor for 30 years â 32 to be precise. He was the doctor who put me into treatment for addiction and heâs looked after me and my kids ever since. Heâs private, so I pay. If I need a test, an x-ray, a consultant, Iâll pay. If I need anything more than a couple of antibiotics, Iâm going to the NHS.
AA Gill in his garden on November 29, 2016
TOM CRAIG FOR THE SUNDAY TIMES MAGAZINE
Within 24 hours I have an NHS consultant oncologist and early-morning appointments, for scans, blood tests and x-rays.
You couldnât make up Charing Cross Hospital. Well, not as a hospital you couldnât. Itâs a monstrous, hideous, crumbling patched-up mess â the Elephant Building. On the way in I notice a couple of posters on the street saying âSave Charing Cross Hospitalâ. Theyâre stuck on a municipal noticeboard thatâs falling over.
Itâs plainly the result of dozens and dozens of attempts to make things better and, in fact, it is the physical embodiment of how most of us, trying to make our way through the teetering automatic doors, feel. It has a very good collection of contemporary British art. In some back corridor there is a series of Peter Blakeâs best silk screens.
I love it: itâs how I feel. The lifts take hours to arrive, emphysemically, wheezingly opening their doors, and when they do, itâs without confidence or conviction. A man going up to the cancer ward puts his hand in front of the door and gets out. âIâm too frightened to take this lift,â he says.
In a waiting room, hundreds of us take numbers to sit like wilted potted plants in an autumn garden-centre sale, to take it in turns to meet the antiseptic face. If this were a set for a film, all the actors and extras would be pulling looks of agony and sadness and fear, but the face of real cancer wipes our expressions to a pale neutral human.
The NHS has one of the worst outcomes for cancer treatment in Europe. Itâs something to be borne in mind when youâre deciding to combine chemotherapy with a safari, or want to embark on a bar-thumping argument about health tourism. It was the first question I asked my oncologist, Dr Conrad Lewanski. âWhy is this such a bad place to get cancer, when we have lots of hospitals, when we teach doctors from all over the world, when weâve won more Nobel prizes than the French?â
âItâs the nature of the health service,â he says. âThe key to cancer outcomes is the speed of diagnosis and treatment.â The health service was set up with GPs separate from hospitals. The system means you probably have to wait a week or so for an appointment to see first your GP, or a clinic. The average time for that consultation will be seven minutes. Perhaps your cough isnât a priority. And then if your doctor thinks it does need a second opinion, heâll suggest you see a consultant, and thatâs likely to take a month. If the GP suspects cancer, that referral time is reduced to two weeks. He or she will probably write a letter, often two â all doctors still carry fountain pens.
And then there are all the appointments â for tests, a cancellation, a missed x-ray, a scan â which can put months on a diagnosis. Itâs not the treatment, itâs the scale of the bureaucracy and the Attlee-reverential, immovable-but-crumbling structure of a private-public doctor-consultant arrangement, which was the cornerstone laid down by the 1945 government at the insistence of doctors. That is the chronic tumour in the bowel of the system.
Iâm given a talk by a nurse on the consequences of chemotherapy. She uses three pens. Two of them have three coloured barrels each. The scribbling, the underlining, the stars, the acronyms, the exclamation marks become ever more emphatic and decorative. Finally she hands me a notebook that is unintelligibly runic, but says not to worry because itâs all on the computer, which she then turns on to show me a heart-warming film about sexual infections and high temperatures.
The hospital flutters with bits of paper like mayflies. Theyâre propped up against screens, wedged up against keyboards, stuffed into teetering files, and then there is the constant Touretteâs questions, âWhenâs your birthday? Whatâs the first line of your address?â, all to collide you with the right cancer, to go with all the forms, the signatures, the screens, the machines, the radiation disclaimers and destiny. It makes Kafka look like EE Cummings.
I like my oncologist. He doesnât have the morphine face; he looks amused, inquisitive, like a shaved, garrulous otter. All he does is lung cancer. This is his river, tumours his trout. Heâs been a consultant for 15 years. Two years in, his father got it and died: âThe worst thing Iâve ever had to go through. I do know what this is like â so how much do you want to know?â
âEverything, and the truth.â
Iâve never Googled cancer, but Iâve discovered that every one of my friends who owns their own house has a preferred cancer specialist and a hospital to go with them. They also have a perfect gardener, an ideal interior decorator and a masseur that they insist â insist â I use, because they are all the best and, of course, you only get what you pay for. Lots of them are astonished Iâm still in this country of catastrophic cancer statistics.
Those who donât have money for their own homes have magical diets, homeopathy and religious new-age cures, or at least a conspiracy theory about big pharma hiding the efficacy of vitamin C, kale, magnetism and mistletoe. If it doesnât make you better, at least you get snogged a lot.
And everyone, but everyone, will have a mantra story of their secretaryâs husband or a woman they used to work with who was given three weeks to live and is still stacking shelves or conducting operas 10 years later. These little homilies are handed out with the intense insistence of lucky heather, using the language of evangelical religion and locker-room encouragement.
Why is our reaction to cancer so medieval, so wrapped in fortune-cookie runes and votive memory shards, like the teeth and metatarsals of dead saints? Cancer is frightening. One in two of us will get it. It has dark memories, unmentionably euphemised. In the public eye, not all cancers are equal. There is little sympathy for lung cancer. Itâs mostly men, mostly old men, mostly working-class old men and mostly smokers. There is a lot more money and public sympathy for the cancers that affect women and the young. Why wouldnât there be?
âHow do men react when you tell them their cancers are fatal?â I ask Dr Lewanski. âAlways the same way â with stoicism.â
âBollocks,â I think. âI thought that was just me.â
Actually itâs not being told youâve got cancer that is the test of character, itâs the retelling. Going home and saying to the missus: âThat thing, the cricked neck. Actually itâs a tumour, the size of a cigar.â It ought to come with a roll of thunder and five Jewish violinists, instead of the creaky whisper of fear.
People react differently to different cancers: most women think theyâll survive, and statistically theyâre right. Most men think theyâll die â and likewise.
âSo, whatâs the treatment?â
âChemotherapy. Platinum in your case. It has a very good chance.â
Someone should write a paper on the euphemistic size comparisons for tumours. There should be an esite, Euphotumours. The images are very masculine: golf balls, cricket balls, bullets, grenades, ruminant testicles. No one ever says, âIâve got a cancer the size of a fairy cake.â
And what about after the chemo?
âWell, thereâs a new treatment, immunotherapy. Itâs the biggest breakthrough in cancer treatment for decades. Cancers camouflage themselves as chemical markers that tell your bodyâs natural defences that thereâs nothing to see here, move along. These new drugs strip away the disguise and allow your bodyâs natural system to clean up. Itâs new and itâs still being trialled, but weâre a long way along the line and it is the way cancer treatment is bound to go. Itâs better for some growths than others, but itâs particularly successful with yours. If you were in Germany or Scandinavia or Japan or America, or with the right insurance here, this is what you would be treated with.â
The doctor looks at Nicola, the missus. His otter face has grown a little sphinxy.
âYou remember asking if the treatment Adrian got on the NHS would be any different from being a private patient? And I said a better cup of coffee and more leeway with appointments. Well, this is the difference. If he had insurance, Iâd put him on immunotherapy â specifically, nivolumab. As would every oncologist in the First World. But I canât do it on the National Health.â
The National Institute for Health and Care Excellence (Nice), the quango that acts as the quartermaster for the health service, wonât pay. Nivolumab is too expensive â ÂŁ60,000 to ÂŁ100,000 a year for a lung-cancer patient; about four times the cost of chemo. And the only way to see if it will work for an individual patient is to give it to them all, and the ones it doesnât work for will weed themselves out. What Nice doesnât say about the odds is that immunotherapy mostly works for old men who are partially responsible for their cancers because they smoked. Thousands of patients could benefit. But old men who think theyâre going to die anyway arenât very effective activists. They donât get the public or press pressure that young mothersâ cancers and kidsâ diseases get.
As yet, immunotherapy isnât a cure, itâs a stretch more life, a considerable bit of life. More life with your kids, more life with your friends, more life holding hands, more life shared, more life spent on earth â but only if you can pay.
Iâm early for my first eight-hour stint of platinum chemo. The ward in Charing Cross looks like a cross between a milking shed and an Air Koryo business lounge. I am settled into a hideous but comfortable chair and a tap is jabbed into the back of my hand. A series of plastic bags full of combative and palliative cocktails slowly dribble into my body and every 10 minutes I have to shuffle to an invalidâs loo to dribble it out again.
I like it here. The nurses are funny and comforting, optimistic, and bear the weight of the sadness, the regret and the pity in the room on their shoulders with an amused elegance and sincerity that comes from their years of experience, or the naivety of inexperience. The other patients shuffle in with their partners to share sandwiches, talk about shopping and the cousins in New Zealand and window boxes. There are children with ageing parents, happy/sad to be able to repay an infantâs debt.
I manage to find the one dealer in the ward, or rather she finds me. Her boyfriendâs making hash cakes â theyâve definitely shrunk his tumour, I should definitely have some. I smile, shrug apologetically and say sadly Iâm already a junkie. I donât take drugs.
âReally? Even for this?â Iâm not giving up 32 years of clean time for some poxy lung.
And there are the ones who sit alone, who donât have any friends to play cards with them, to drip the will and the strength and the faith to face this. I donât know how anyone manages to do this on their own.
An old friend sits through the mornings with me, Nicola comes with lunch and Flora and Ali, my grown-up kids, share the afternoon. If it wasnât for the cancer, that would be a really lovely day. If it wasnât for the cancer.
Thereâs a natural break in the article here. It should have been finished two weeks ago, but I had a bad night, a really bad night.
Nicola called Guy, the GP, and he came round and took a look and said: âHe needs to be in A&E now.â
So Iâm on a gurney in Charing Cross at nine in the morning. On the other side of the blue plastic curtain, a bloke is being held down by three policemen shouting, âDonât flick your f****** blood over here, I donât want what youâve got.â
A young doctor comes and asks me questions. All doctors in A&E are preternaturally young. One of the questions after âWhatâs your date of birth and the first line of your address?â is inevitably âCan I put my finger up your bottom to see if thereâs any poo or blood?â
The other question is: âOn a scale of 1 to 10 â 1 being a scratch and 10 unspeakable agony â what do you think youâre suffering at the moment?â You wouldnât describe this as thin pain. Itâs 10 out of 10. My stomach is agonised with a terrible wrenching distension. Iâve lived a middle-class, sheltered, uncombative, anti-violent life, so I donât know how this compares to other more manly menâs pain, but this is by miles and miles the worst thing Iâve ever been through, thank you for asking.
More x-rays and blood tests and the surgeon returns with the complete granite face and says: âWell, it could be a burst ulcer, but of course it isnât. The tumour in your pancreas has increased in size very fast. Itâs as big as a fist.â And he shows me a fist in case Iâd misplaced the image.
Iâve decided to call the pancreatic tumour Lucky, as a nod to prophetic Professor Gazzard. So the chemotherapy isnât working. I ask my oncologist whatâs next.
âItâs a bugger,â he says. âIt looked so hopeful, but youâre right, it isnât working. The pancreas is a bad place. We canât operate and the side effects of radiation arenât worth the risk.â And thereâs pancreatic pain, which is famously in a league apart, so at least I can be stoical about that.
âWhat next?â
âWell, on the NHS we can give you another round of chemo, a bit rougher with slighter outcomes ⌠but there is really only one treatment for you: nivolumab.â
From behind the blue curtain, the nurse asks the policeman: âWhat do you want to do with him?â
âOh, let him go,â says the copper.
âI thought youâd arrested him?â
âNo. Let him go.â
That evening Iâm sitting in bed on the cancer ward trying to get the painkillers stabilised and a young nurse comes in.
âThere you are. Iâve been waiting for you all day. Youâre supposed to be with me down in chemotherapy. I saw your name. Why are you up here?â
âWell, it turns out the chemo isnât working.â Her shoulders sag and her hand goes to her head. âF***, f***, thatâs dreadful.â I think she might be crying.
I look away, so might I.
You donât get that with private healthcare.
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Beautifully, tragically put.
Great piece. Horrible, but brilliant. Heartbreaking and gut wrenching. But brilliant. Raw.
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His memoir is a beautiful piece of writing.
Thatâs one of the best articles Iâve ever read.