Teach Us to Sit Still

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About the Book

‘Just when the medical profession had given up on me and I on it, just when I seemed to be walled up in a life sentence of chronic pain, someone proposed a bizarre way out: sit still, they said, and breathe . . .’

Teach Us to Sit Still is the visceral, thought-provoking and improbably entertaining story of Tim Parks’ quest to overcome ill health. Bedevilled by a crippling condition which nobody could explain or relieve, he confronts hard truths about the relationship between the mind and the body, the hectic modern world and his life as a writer.

Following a fruitless journey through the conventional medical system he finds solace in an improbable prescription of breathing exercises that eventually leads him to take up meditation. This was the very last place Parks expected or wanted to find answers; anything New Age simply wasn't his scene. Meantime, he is drawn to consider the effects of illness on the work of other writers, the role of religions in shaping our sense of self, and the influence of sport and art in our attitudes to health and well-being.

Most of us will fall ill at some point; few will describe that journey with the same verve, insight and radiant intelligence as Tim Parks.

Captivating and inspiring, Teach Us to Sit Still is an intensely personal – and brutally honest – story for our times.

About the Author

Born in Manchester in 1954, Tim Parks moved permanently to Italy in 1980. Author of novels, non-fiction and essays, he has won the Somerset Maugham, Betty Trask and Llewellyn Rhys awards, and has been shortlisted for the Man Booker Prize. His works include Destiny, Europa, Dreams of Rivers and Seas, Italian Neighbours, An Italian Education and A Season with Verona.

ALSO BY TIM PARKS

Teach Us To Sit Still

A Sceptic’s Search for Health and Healing

Tim Parks

Foreword

I never expected to write a book about the body. Least of all my body. How indiscreet. But then I never expected to be ill in the mysterious, infuriating way I have. Above all it never occurred to me that an illness might challenge my deepest assumptions, oblige me to rethink the primacy I have always given to language and the life of the mind. Texting, mailing, chatting, blogging, our modern minds devour our flesh. That is the conclusion long illness brought me to. We have become cerebral vampires preying on our own life-blood. Even in the gym, or out running, our lives are all in the head, at the expense of our bodies.

I had no desire to tell anyone about my malady, let alone write about it. These were precisely the pains and humiliations one learns early on not to mention. You need only look at the words medicine uses – intestine, faeces, urethra, bladder, sphincter, prostate – to appreciate that this vocabulary was never meant to be spoken in company. We just don’t want to go there. My plan, like anyone else’s, was to confide in the doctors and pretend it wasn’t happening.

On the other hand, this is reality, and in my case there was the happy truth that just when the medical profession had given up on me and I on it, just when I seemed to be walled up in a life sentence of chronic pain, someone proposed a bizarre way out: sit still, they said, and breathe. I sat still. I breathed. It seemed a tedious exercise at first, rather painful, not immediately effective. Eventually it proved so exciting, so transforming, physically and mentally, that I began to think my illness had been a stroke of luck. If I wasn’t the greatest of sceptics, I’d be saying it had been sent from above to invite me to change my ways. In any event, by now the story had become too inviting a conundrum to be left unwritten.

What it boils down to, I suppose, is an extraordinary mismatch between the creatures we are and the way we live. I grew up in a family of evangelical Anglicans. They were also solid middle-class Brits. What they most instilled in us, as children, was purposefulness, urgency. Everything about the world had long been understood, so the right moves were obvious. We must save our souls, we must save other souls, we must perform well at school, we must go to university and get good jobs. And we must marry and have children who would share our same goals and live as we did. Even singing was purposeful. It was to praise God. Playing, we were soldiers bent on killing each other, in a good cause. When we did sports, of course, we had to win.

Meantime our bodies were the ‘vessels’ which allowed us to get on with all these pressing tasks. Confusingly, a vessel was a ship or a jug for storing liquids. Either way it was useful only in so far as it contained something else: the Christian soul, the middle-class self. In any event, the body had no purpose or identity as such. When we were dead we would be better off without it, though for reasons not explained God wanted us to hang on with bodily grief for as long as we could. Perhaps it was to purify the soul, to ennoble the self, the way some people find a sort of virtue in hanging on to an old car. The body was a necessary hassle on the way to success and paradise.

This will sound like a caricature. But it was entirely in line with school biology where they merely told us how complicated and alien that fleshly vessel was, a matter best left to the experts. Even today I meet few people who accept a substantial identity between self and flesh. At most, they have a more attractive vision of what pleasures and enjoyments life affords: sex, food, music, booze. Otherwise, everyone seems equally busy asserting their points of view, furthering their careers, saving against the day when the decaying vessel will start to leak. In the main, doing cancels out being as noise swamps silence.

To date I have written twenty books, with this twenty-one. I may have shaken off my parents’ faith, then, but not the unrelenting purposefulness they taught me, that heady mix of piety and ambition. And like my father I have lived under a spell of words. He read the Bible and wrote his sermons. He told you what was true and how you must behave. Rhythmically, persuasively, the way politicians do, and the pundits of opinion columns; the people who know everything and are sure of themselves. My novels have tended the other way, suggested how mysterious it all is, how partial anyone’s point of view, how comically lost we are. But even this is preaching of a kind. The fact is, as soon as you start with words you’re locked into a debate, forced to take a position with respect to others, confirming or rebutting what has been said before. Nothing you say stands alone or is complete in the present: it has its roots in the past and pushes feelers into the future. And as we grow heated, marking out our corner, staking our claim, we stop noticing the breath on the lips, the tension in our fingers, the pressure of the ground under our toes, the tick of time in the blood. None of my father’s admirers noticed how tense his jaw was, how much his hand shook when he raised a glass or microphone, what an effort it was for him to assert assert assert, to keep the 2000-year-old faith, giving encouragement to the doubters, finding clever arguments to confound the devil’s advocates. When I think back on Dad’s cancer and death – he was sixty and I twenty-five – there is a certain inevitability about it. Forever ignored, the carnal vessel cracked under strain. Sometimes I think it was the invention of language that started this queer battle between mind and flesh.

Shortly after Dad’s funeral I left England for Italy and have lived here ever since. The illusion of escape was reassuring. Another language plunged me into other debates. I worked and worked. I wrote and translated and taught. But in retrospect I see I never really deviated from the initial project, never looked to right or left, was always true to my parents’ obsession with vocation. ‘Your handwriting,’ I remember my brother observing, in those last years when one wrote letters by hand, ‘has never changed.’ He was right. It’s still the same: ferociously slanted to somewhere off the page, some distant goal.

Then at an undetermined moment in my forties, the symptoms began, the pains, embarrassments, anxiety, anger. Was I going my father’s way? But I mustn’t get ahead of my story. Suffice it to say that in choosing to write this book I have decided to set down, often in disagreeable detail, all the things I scrupulously avoided mentioning for years. Had what happened been merely a problem of diagnosis, one bunch of doctors getting it wrong – in their eagerness to cut me up – and then another finally suggesting just the drug that would fix me in a jiffy, I would never have bothered to write about it. Likewise, had the whole problem turned out to be in my skull, something to sort out with a psycho-drug and a few sessions on the analyst’s sofa.

No, it was infinitely more complicated and interesting; to me, I don’t exaggerate, amazing. I was amazed, when someone showed me a way back to health, to realise that I knew nothing of my body at all, nothing of its resources, nothing of its oneness with my mind, nothing of myself. And if the reader is surprised to find, in a book that might sound like a health manual or a self-help spiel, reflections on D.H. Lawrence and Thomas Hardy, Velázquez and Magritte, on Gandhi and Mussolini, Italy as opposed to England, Jesus and the Buddha, faith-healing and white-water kayaking, that is because illness is not a separate thing circumscribed in symptoms, diagnosis and cure, but part of a whole that has no separate parts.

‘All very well, but how do you want us to categorise it?’ the publisher asks. ‘Health, Psychology, New Age, Biography, Criticism?’ My immediate response is indignation: this is exactly the problem I have been writing about! Reductionism, labels. On second thoughts, though, I have to accept that if we didn’t slot things into categories we’d never find what we were looking for. I’m uncertain. I can’t decide. Until it occurs to me that, with books at least, the best experiences are not when you find what you were looking for, but when something quite different finds you, takes you by surprise, shifts your taste to new territory. ‘Put it where the true stories go,’ I tell him. It’s only stories that gather the world up in unexpected ways.

PART ONE

PART TWO

TURP

SHORTLY BEFORE MY fifty-first birthday, in December of 2005, my friend Carlo sketched a tangle of tubes and balloons on a corner of newspaper.

‘The prostate is like a small apple, right? Here. But it’s getting bigger and more fibrous with age, it’s pressing on this tube going through it, the urethra. It’s choking it, see? So, what do we do? We sort of core the thing, from the inside. With a laser. Going up your penis. Make it wider.’

I could see that Carlo had made this sketch many times before. Chewing a doughnut, his voice had a believer’s enthusiasm.

‘Then we just burn away a bit of this valve, or sphincter, here, to make sure it opens properly. That’s the base of the bladder.’

Now he needed a proper sheet of paper. He opened his briefcase. There was a complication. Expertly, his surgeon’s wrist traced out the same diagram a couple of times larger. ‘When you pee, there are two sphincters have to open, right? The one we’ve burned away a bit at the base of the bladder and another lower down. Well, when you climax, the sperm shoots in here, between the upper and lower sphincters. Got it? From the prostate into the urethra obviously. The lower sphincter opens and the upper one shuts tight. But, after the op, since we’ll have opened the upper one permanently, you can get a situation where the sperm whooshes off up into your bladder instead of down through your penis. So you get a dry orgasm. Same feeling, but no stains on the sheets. An advantage really.’ He smiled and took another bite of his doughnut.

I examined the smudgy tangle of tubes and cisterns. It was a question of dodgy plumbing. My sink was blocked. The loo tank needed looking at.

‘Not that painful. You’ll be in bed for a few days, then a couple of months before you can start sex again.’

I had quite a repertoire of pains at this point: a general smouldering tension throughout the abdomen, a sharp jab in the perineum, an electric shock darting down the inside of the thighs, an ache in the small of the back, a shivery twinge in the penis itself. If the operation didn’t solve these problems, why do it?

‘Your bladder will empty better. You’ll pee less at night. The pains will probably recede, it’s just I can’t guarantee they will.’

‘These problems tend to be hit and miss,’ he said. He would put me in touch with a colleague who was up to date with the most recent drugs; for the moment I could start with alpha blockers. ‘They inhibit the reaction to adrenalin which is connected to the impulse to pee.’ He thought I might wake up only once or twice a night instead of five or six times.

I tried the alpha blockers. After a couple of weeks I was still getting up six times a night and now I was constipated too. I stopped taking the pills and after another week things were back to normal. Normal bowel movements, normal pains. It seemed like progress.

Then shortly before Christmas, the ‘up-to-date colleague’ Carlo had sent me to, a small tawny haired woman with a strong southern accent, handed me a sample of something absolutely new. ‘Christmas present,’ she smiled wrily. ‘Different approach. Let’s see what happens.’

For a while I didn’t notice any change. Then I was happy to find I wasn’t peeing so often. Then I was concerned that I wasn’t peeing enough. Come New Year’s Eve I was in serious trouble. I hadn’t peed for ten hours. I had the impulse. I stood over the loo. Nothing but pain. I stopped taking the pills. I called Carlo, but his mobile didn’t respond. I didn’t have his home number. In the end he was only one of a circle of friends at the university where I teach in Milan, while I actually live in Verona, two hours away.

Should I go to hospital? The casualty wards would be packed on New Year’s Eve. There was also the consideration that I knew people in the local hospital. My next-door neighbour worked there. If I had gone to someone in Milan, it was precisely out of a childish desire for secrecy close to home. Who wants to admit to prostate problems?

I cried off our small party and went upstairs to bed well before midnight. I lay there rigid and angry. I was angry with the doctor who had given me these pills. I was furious with life for dealing me this card. My body seemed alien and malignant. We couldn’t get comfortable together. Perhaps I am a parasite in my own flesh, I thought; and now the landlord has had enough.

From downstairs, I could hear my wife and youngest daughter chatting and laughing with the neighbours and their kids who were getting ready to let off fireworks in the garden. Their voices sounded distant. I was locked up in this stupid health problem. The space between us, between myself and my family, suddenly presented itself to me as part of a story, a scene in a film. It was the story of my decline into a pissy, grumpy old man.

When the New Year’s fireworks began, I didn’t get up and go out to the balcony to watch. All over town people were celebrating. I was in a dark cell, trying to figure how to get out, how to shake off this unhappy story that had started telling itself inside my head. Self-pity is a great teller of boring tales. I was at a turning point, with nowhere to turn.

Towards three a.m. I managed a trickle of pee. It took a while, but afterwards I felt better. To celebrate I found what was left of the champagne and drank it. A good half bottle. Then I went down to the basement, turned on the computer, brought up Google and typed in ‘TURP’.

Trans-Urethral Resection of the Prostate is the gold standard to which other surgeries for Benign Prostatic Hyperplasia are compared. This procedure is performed under general . . .

Gold standard seemed an odd term to use. But what if my prostatic hyper-whatever wasn’t benign?

Following surgery, a catheter is used to remove blood or blood clots in the bladder.

I read through the same information on a dozen sites, then, without thinking, clicked on images. Immediately there was a photo of the grotesquely dilated opening of a penis suckering like a fish’s mouth around a metal tube. I quickly moved the cursor and clicked on a more reassuring pencil sketch. A man in a doctor’s coat and strangely old-fashioned hat was staring into something that looked like a cross between a telescope, a syringe and a gun. About eight inches long, the instrument had little pistol triggers and flexible tubes entering and leaving from above and below. The man had his fingers on the triggers and an eye pressed to an eyepiece; at the other end of the tube was the tip of a penis, lodged in a conical opening. A rigid tube protruded from the instrument, travelled down through the penis, which was unnaturally straight as a result, and penetrated into a shaded area about the size of a squash ball just beyond the scrotum.

Beneath the image, a caption announced: In TURP, a wire loop is used to cut away pieces of the prostate.

I remember gazing at this sketch for some time. What struck me about it was the hubris of its clarity. This handsome, clean-shaven young doctor with his curious hat was Renaissance Man exploring the heavens with his telescopes, Enlightenment Man discovering the power of surgical instruments. He saw clearly right inside the body, my body, right into the quick of life, and he made neat, clinical cuts there with the most sophisticated equipment.

I switched to the Guardian’s football page and read about a game settled by two goals in injury time. I need not decide about this operation just yet, I thought.

Stupid Pains

AFTER ALL, NOTHING had been proved. This enlarged-prostate diagnosis was mere conjecture on Carlo’s part. True he was a urologist but we had only spoken as friends. There was a battery of tests I must do. They were complicated and would take time. In a month the problem might be gone, the pains would disappear whence they had come. I had done the right thing to talk to him, but precisely because I had talked to him I could now stop dwelling on it and get on with my life. I would do the tests without thinking about them or what they were for, as if they were the merest annoyance.

The pains had different plans. The pains had no intention of returning whence they’d come, wherever that might be. It wasn’t something I had ever thought about. I wasn’t even sure when they’d put in their first appearance. For months I had gone around muttering things like, ‘God, you feel uncomfortable today, Tim,’ or, ‘Oh dear what a bore waiting for this pee to come!’ But without ever telling myself that what I was looking at was an array of interrelated and intensifying symptoms.

‘I feel a bit uncomfortable today,’ I would say to my wife to explain why I didn’t want to dig over the garden.

The word ‘uncomfortable’, I discovered, had something safe about it, something rather comfortable.

‘So, how long has this been going on?’ had been Carlo’s first question when finally I found myself talking to him.

I frowned. Now I thought about it, I realised that I had been ‘uncomfortable’ for a long time. It might even be a matter of years. Being uncomfortable had become part of being me.

I would have to do regular blood and urine tests, he told me. Plus, a urine flow test, a scan of the whole area, a urogram, a three-day urine test, and maybe a cystoscopy. Assuming the results were as he expected, I could look forward to being operated on in April or May. He made a point of never operating on his friends, Carlo said, but he would refer me to a colleague here in Milan, an excellent surgeon.

Look forward to it? Quite the contrary. In four months the pains would be gone, I hoped.

The pains intensified. I now found myself having to loosen my trousers when I sat down. Everything was stiff and sore. Waking in the early morning, at five, or five thirty, I couldn’t get back to sleep. There was a lump of hot lava in my belly. I got out of bed, wandered round the house, brewed up a pot of tea and ate some cereal. I knew this would send me running to the bathroom. The pain would then melt away a while and I could go back to sleep.

Could it be, I phoned Carlo to ask, that the real problem was with the intestine? I had bowel cancer.

I felt chastened. I was becoming a hypochondriac, spending all my time thinking about my bodily functions. How absurd to bother people with the details of my bathroom routines! I mustn’t speak to him again, I decided, until all the tests were done. What’s the point of speaking when you’ve arranged to do proper clinical tests? The tests will speak for you. All the same, it was a relief to know that if I went down to eat breakfast at five, I could rely on an immediate trip to the bathroom followed by a release from pain and an hour’s sleep.

But is it really true to say that I was thinking too much about these pains? I was often anxious. I did wonder about possible solutions. But on the whole I did everything I could not to dwell on the matter, not to ‘wallow’, as my mother would have put it. And if Carlo or any of the other doctors I would see had ever asked me to describe these various pains carefully, I doubt I would have been able to do so. The fact is that my body was not ordinarily present to me. I was only aware of it when it caught me by surprise, when it interrupted me. Pain was an intrusion into a busy schedule. I didn’t examine it. I didn’t give it time. ‘How can I finish all the stuff I’ve got to do,’ I would fume, ‘if I have to keep dealing with these stupid interruptions?’

I always referred to the pains as stupid pains, in much the same way as I referred to the noise of roadworks outside my office as a stupid noise. You wouldn’t catch me trying to find out exactly what it was they were doing to the road. No, I shut the window, sat down at the computer and inserted a fresh pair of earplugs. I had recently bought a five-year supply of the best quality earplugs from a mail-order company in the USA. To block out life’s noise.

All this was automatic, the only sensible reaction, I imagined, to anything that got in the way of a day’s work. So when, finally, I did acknowledge a feeling as pain, real pain, rather than discomfort, it was because it now constituted an interruption of such ferocity it could no longer be ignored. You couldn’t work through it. Even then, the imperative was not to explore the pain, to find out about it, but simply to return to normality as rapidly as possible. A good hot bath, I thought, might be a solution to a deep throb in the perineum. I could read in the bath. I could do some research.

The pain did not dissolve. Hot water was not a solution. I only remember flying into a fury when Calvino sank in the suds.

It reached a point where I could no longer sit down at the computer. I needed to stand.

I set my laptop on top of a bookshelf at chest height and, shifting my weight regularly from one foot to the other, continued with my work.

Physical exercise, I decided, might help. We live in the countryside and it’s easy to run. Not that I really liked running. The point of physical exercise, I had always imagined, was to keep your body in shape so it would leave you alone, leave you free to get on with the stuff you have to do, without stupid interruptions. I timed myself over six miles.

And I went canoeing. The Adige in Verona is not a bad river for paddling up and down. I had a couple of kayaks stored in the canoe club and there was no reason why I shouldn’t take them out more often. I actually liked canoeing far more than running, but it eats deeper into your schedule. You have to drive into town, you have to change in and out of your kit, you have to hang the kit out to dry afterwards. The advantage is that since canoeing requires more attention than running you don’t worry about the lost time while you’re losing it.

For a couple of months, then, in the autumn of 2004, I had run and canoed as many as four or five times a week and, so long as I was on the move, exerting myself, the pains did retreat into the background. But only to flare up again as soon as I had taken a shower, often more viciously than before. Considering which, it occurred to me that perhaps all this pounding up and down steep hills and straining my abs to paddle my kayak up the Adige might feasibly be making things worse rather than better. Perhaps the best thing was not to exercise more, but to cut out exercise altogether.

The thought was attractive. Acting on it, or ceasing to act, I confirmed that physical exercise was neither the problem nor the solution. These pains didn’t care whether I went running or not.

Diet, my wife insisted. I should look into diet. And I did. Again and again I tried to establish some relationship between the various items of food and drink I customarily consume (I’m a creature of routine) and the various pains that were plaguing me.

Coffee was an obvious suspect. Cut it out! For a month I went without my ten a.m. cappuccino and two p.m. espresso.

Next came alcohol. It’s always the pleasures that have to go. I cut out my evening Scotch. I was surprised how difficult that was. Around ten thirty, I would be overwhelmed by a craving for whisky. Apparently, this modest habit, pursued over many years, had become an addiction. Making myself, on my wife’s advice, a cup of camomile tea, to fill the gap as it were, I was half hoping that my body would rebel and take matters into its own hands; yes, my body, I thought, would start trembling and grow extremely itchy, until, brushing aside my noble resistance, it would walk resolutely to the drinks cabinet and splash out a Scotch.

My body did nothing of the kind. On the contrary, as the days passed, it seemed happier and happier with the camomile. Irritated, I took encouragement from the thought that if the whisky hadn’t agreed with my body as much as I had supposed, there might soon be some improvement in the pain.

Not so. The pains stayed exactly where they were, or rather moved around exactly as they had previously, and when, after a month or so, I terminated the experiment and poured myself a very ample tumbler of Laphroaig, I actually slept better than I had for some weeks. I had a pain-free night, with the Scotch. Naturally, I repeated the performance the following evening, only to find that everything had returned to normal. Normal discomfort, normal pain, excellent Laphroaig.

By the time I spoke to Carlo, such experiments had become a constant in my life. My diet was a speculative shuffling and reshuffling of a fairly limited pack in the hope of hitting the winning combination that would allow me to get on with my life without pain, without these stupid interruptions.

Not that I was scientific about it, I didn’t keep records, and more often than not at some official lunch or dinner, or maybe just out with friends, I would forget that I wasn’t supposed to be eating this or drinking that. I’d happily indulge. Afterwards I’d start the experiment again from scratch. Or just drop it altogether.

Waking to acute pain in the early hours, swinging my legs out of bed to escape the fiery rock in my belly, these dietary experiments seemed extremely important. I must find a solution. But in the evening, relaxing in company, I really didn’t know anything about the old guy who dragged his ball and chain back and forth from the bathroom half a dozen times every night. Or, yes, I did know him, but as a distant acquaintance, an elderly relative. Best forgotten.

The Waterseller

HOLDING A TEST tube between my legs and waiting for the pee to come, some words crossed my mind, something I had read about the nineteenth-century Italian poet, Giacomo Leopardi: ‘Reflecting on the subtleties of urination he would be unable to pass water.’ He had to wait until he could ‘steal a moment’s inattention from himself’.

What a crazy idea this was! All the same, the story stuck. Years after reading the poet’s biography I still remembered the phrase ‘steal a moment’s inattention from himself’.

It was mid-January, middle of the night; the following morning I had the first clinical tests. Blood and urine. True to form, I had contrived to put them off for two weeks in the hope that the pains would subside: first for a visit to London to see my brother, then for a few days’ skiing and walking in the mountains with my wife and daughters.

My brother lives in America and I in Italy, but we sometimes get together for a few days in London after the New Year. John is a painter and likes to take me to whatever art shows are on in town. He enjoys expressing provocative opinions in a highly audible voice and I enjoy listening to someone who sees and knows so much more than I do.

On the second day, between one museum and another, we stopped at Apsley House, the Duke of Wellington’s home, to look, among other things, at Velázquez’s Waterseller of Seville. In exactly the kind of chiaroscuro you get under a portico in summer, an old man in a tattered cloak, the waterseller, passes a brimming glass with a black fig in the bottom to a smartly dressed young boy. It’s a painting I’ve seen half a dozen times and always felt drawn to, but today I was almost shocked by its impact. Those two faces, staring so intently, but neither at each other nor at the water, their two hands, one old, one young, meeting on the stem of the glass, the light in the transparent liquid above the dark fullness of the near invisible fig, they seemed to hold some obscure message for me.

I asked my brother if there was a story behind the painting. Who was the third guy in the shadow behind the seller and the boy? ‘Just a street scene,’ John said, ‘just a moment in Seville.’ He drew my attention to the water dribbling down the jug in the foreground and began to talk about the kind of paints Velázquez used. There were two other versions of the Waterseller, he said, one in the Uffizi and one in the States somewhere. Gazing at the painting as he spoke, the precious fullness of the glass and its precarious passage between those two hands made me excited and anxious; leaving the museum, it was as if I had had an important dream and needed someone to tell me what it meant.

On the last day we took a long bus ride out to Finchley where our father had been a clergyman through the 1960s and ’70s. The grand old vicarage we lived in has long since been demolished and replaced with nondescript flats, but the ugly neo-Gothic church is still there. John was enthusiastic, talking a great deal about the past. He seemed at once nostalgic and scandalised. When he was four he had had polio, been close to dying. He has always walked with a heavy limp. Mum and Dad, he said, had never wanted to face up to the enormity of this. They went on singing ‘count your blessings’ as if nothing had happened.

It was raining and I needed a bathroom. Finding the recreation hall behind the church open, we went in and saw, in the corridor, a black-and-white photograph of Dad in his robes together with a plaque commemorating his many years of service. Harold James Parks, 1920–1980. He had his arms raised to give the blessing. The place smelt of damp. Peeing in a bathroom that hadn’t changed in thirty years, I wondered if maybe my problem had its origin in those childhood days. Had it been passed on to me in a brimming glass? But I wasn’t interested in exploring the past. When I got back to Italy I’d get the tests done, find out what my problem was, have it fixed, then forget it and get on with my life. I’ve always felt critical of my brother for his fixation with the past.

‘Remember how Dad used to peel oranges?’ John asked. We were walking into the wind on Finchley High Road.

Over drinks in the Tally Ho, we laughed about this. During the night, back in the flat we were in, I peed into a plastic bottle so as not to have to walk through my brother’s room to get to the loo. John is three years older than me but he sleeps the night through. I had no intention of letting him know what state I was in.

There were the same night-time problems the following week in the flat my wife and I had rented in the mountains of the South Tyrol. I couldn’t help feeling a sense of shame as I slipped in and out of the bathroom trying not to wake Stefi and Lucy, my daughters. How much easier everything would be, it occurred to me, if I lived on my own.

During the day, while the girls skied, Rita and I walked through the woods on the lower slopes, wrapped up in scarves and hats. We were mostly silent. In my head I was trying to solve a problem with something I was writing; I couldn’t make the plot come out. It was one of those situations where you think and think and nothing budges, not unlike the silent winter streams, choked with ice. Rita complained that I was withdrawn. ‘You’re more and more driven,’ she said. ‘It’s boring.’ The air under the dripping pines was raw. Every time we stopped at a Stube for coffee or lunch, I was aware, sitting on my pains, that things were not getting better.

For the urine test I had been told to bring a sample of the morning’s first pee, presumably because it’s chemically different from what you pee later; it has had a good few hours to stew in the bladder. But since I was going to the bathroom any number of times during the night and usually took a gulp of water before going back to sleep, in my case a pee at seven a.m. would hardly be like anyone else’s. It would be more diluted.

If that was so, and if this circumstance made a significant difference, perhaps I should give them my first performance of the night. Or maybe, so as not to offer something too close to the digestion process, I should give them the second. Or, even better, I could pee all the night’s pee into a single container – a bowl, say, or a jug – and then pour out a tube’s worth in the morning; after giving it a good swirl, of course. That way they would get the full minestrone.

I couldn’t decide. The whole thing was irritating. It seemed extraordinary that there weren’t specific guidelines for people in my predicament. Before going to bed, I phoned Carlo for advice.

I decided on the night’s second, which turned out to be around two, and stood there, over the loo, holding the test tube, thinking about Leopardi who used to think so hard he couldn’t go. In his case the problem could hardly have been an enlarged prostate because the description of him struggling to perform refers to the adolescent Giacomo. The source of the info, as I recalled, was the poet’s competitive father, Monaldo, who explained that to help his son to urinate he had to keep him company with the chamber pot and distract him. Imagining my wife waking six times a night to help me distract myself into passing water raised a chuckle and I began to pee, taking care to steer the thin thread of liquid into the tube. But the smile must have caused my hand to shake, or a moment’s inattention, because a few drops trickled over the rim and wetted my fingers. Quickly adjusting the position of the tube, I inadvertently touched it against my foreskin.

Damn! The instructions on the green box the tube had come in specifically said that you weren’t to touch the rim of the tube with your ‘genitalia’ because superficial bacteria would then get into the urine and alter the results.

What to do? The sensible thing would be to delay the tests for a day or so while I procured another tube.

The hell with it. I lifted the tube to check if it was full enough. The urine was a pale lemon colour, not exactly the waterseller’s brimming glass, but not unattractive, in its way. I pushed in the stopper and washed my hands.

But if I didn’t care about the bacteria and consequently misleading test results, why had I spent so much time worrying about when was the best time to pee?

Going back up to bed – we sleep in a room under the roof and have to go down a flight of stairs to the loo – it occurred to me that Carlo had been offhand about the timing of the sample because the readings that mattered wouldn’t be affected by the relation between the urine and my food intake. Right. What they were testing for was something ominously simple, like blood in my pee, or cancer cells.

But hadn’t I promised myself, I reflected, that I wouldn’t think about any of this until the tests were over and I could make a pondered decision?

I thought about Leopardi instead. Not only did the poet have problems in the bathroom but having spent his childhood bent over books he soon developed severe scoliosis. At twenty he looked like a hunchback. He also suffered from stomach pains, was lazy with personal hygiene and, later on in life, rarely washed his clothes. When asked why she hadn’t been to bed with him, a certain lady remarked, ‘My dear, he stank.’

Nevertheless, Leopardi wrote sublime poems. Just a few evenings earlier I had been helping Stefi to learn one for school. It tells how the poet takes pleasure in sitting behind a hedge high on a hillside. The fact that the hedge blocks the view allows him to imagine the vastness of eternity beyond it. His ‘thoughts drown in this immensity’, and in the last line he tells us that it’s ‘Sweet to be shipwrecked in this sea’.

How interesting, it occurred to me, pulling up the bed covers in the shadowy room while my wife snored softly, that Leopardi found it positive when ‘thoughts drown’. And how interesting, too, that he associated such happy moments with high water. Does water dissolve thoughts? In Velázquez’s painting, both the boy and the old man seem to have been placed under some kind of spell by that full glass of water with its fragrant fig.

I lay quietly. If anyone is dismayed at the idea of having to get up six times a night, let me assure them that I always loved the business of returning to my bed and going back to sleep. Sometimes I actually thought I was lucky to get the chance to drift into dreams so many times in a single night.

Worrisome Dissatisfied Individuals

THE ‘WORK’ I insisted on doing day by day, whatever state I might be in, was no more and no less than telling stories. Surely an innocuous occupation. But over the following weeks, I suddenly found myself wrestling with a disturbing and decidedly noxious story, something that came back to me from twenty years before with the dry clunk of a lock turning in a heavy door.

The morning of the blood and urine tests I had gone to the clinic, as was my wont, with the intention of not really being there. I had taken a book so that my mind would remain focused on my mental world, not my bodily fluids, nor the people around me. I had been asked to write an essay on the Austrian writer Thomas Bernhard. Certainly Bernhard, I thought – I was reading his autobiography Breath: A Decision – had a far worse deal health-wise than I ever did. Hospitalised for pleurisy at seventeen, then diagnosed with tuberculosis, he spent a year at death’s door, followed by a lifetime of debilitating lung disease, until in 1989, he finally succumbed, aged fifty-eight, two years younger than my father had been when he also died of lung problems, cancer in his case. One thing you must put in your essay, I told myself, was that Bernhard’s lungs were his destiny. Like D.H. Lawrence, he never breathed easy. It must have affected his writing.

Already I was aware of a small presentiment fluttering against the fogged window of my early-morning consciousness. I ignored it, concentrating on Bernhard and keeping half an eye on the illuminated number that showed where the staff were up to. Each ping was another patient dealt with.

My number eventually flashed up and I went to a window where, without any exchange of words, a young woman at a keyboard transformed my prescriptions into barcodes on adhesives to be attached to various test tubes. How reassuringly efficient and impersonal this was, I thought, compared to the old days when they would make you stand in line for hours.

The marvel is that I should have contrived not to remember for so long. Still, my first response was self-congratulation. Thank God, I told myself, you haven’t been asked to do the sperm test this time! The awful sperm test. But now it was only a question of seconds before my whirring mind settled on the words: ‘after decades of pain and frustration such patients will inevitably leave their problems on the operating table in their fifties or sixties.’

The lock turned. Waiting outside the room where they take your blood, I could no longer concentrate on Thomas Bernhard. All this had been foretold.

More than twenty years previously, suddenly finding I had to go to the bathroom literally every ten minutes, I had been diagnosed with acute prostatitis. I must do a sperm test to find out what bug had got in there, what antibiotic could treat it. On my arrival at the front of a long queue in this same clinic, the nurse, seeing my foreign name on the prescription, had announced with the kind of clarity and booming volume some people imagine all foreigners appreciate: ‘SPERM! MAKE SURE THE FIRST DROPS GO IN THE CONTAINER. IT’S THE FIRST DROPS THAT COUNT WITH SPERM.’

This was the funny side of the story, something I had told at parties a hundred times, mimicking the surprise on the faces of the others in the queue as the nurse yelled ‘Sperm!’ and then my embarrassment, minutes later, trying to produce that sperm in one of only three cubicles available while others queued outside to provide urine samples, coughing and shuffling and complaining that I was keeping the loo too long. I distinctly remember how relieved, pleased, even proud I was when the crucial first drops were safely steered into the little plastic container.

But that wasn’t the end of the story. Vital as it is for the continuation of the species, the prostate is particularly well protected by layer after layer of near impermeable membrane. It is not easily infected. Once infected, it isn’t easily treated. Once treated, it rarely returns to its pristine state. You get over the acute phase to find you’re looking at the chronic. About three months after these troubles began, I came across a young doctor who, in his eagerness to be candid, gave me a publication that was meant only for people like himself, doctors specialising in urology. The last paragraph of this booklet read as follows (I quote from bitter memory):

It has to be born in mind that the chances of a complete recovery from prostatitis are minimal, almost non-existent in fact. Prostatitis sufferers tend to be restless, worrisome, dissatisfied individuals who drag their miseries around from one doctor to the next in search of a cure they never find. The urologist must be careful not to let himself be demoralised by these people and their intractable pathologies. In the end, after years, perhaps decades of pain and frustration, the vast majority of such patients will inevitably leave their problems on the operating table in their fifties or sixties.

The urologist must be careful! Poor fellow. Nobody wants to be demoralised. But I was a young man of thirty being told I would be sick in my intimate parts for the whole of my virile life. My soul rebelled. I flew to London, paid a man in Harley Street who put me on more or less permanent antibiotics and after something like a year I was cured.

I remember yelling those words to myself in delight and rage, time and again. ‘Wrong, wrong, wrong! The book was wrong!’ I wanted to find the author and stick his miserable prophesy right up where his prostate was. ‘What a hateful story, and not even true. He got it wrong. I’m cured! CURED!’

I turned and slotted my test tube into a rack with a community of other test tubes, thirty or forty of them, in orderly rows, cosy and indistinguishable as crosses in a war cemetery.

Perhaps my condition had simply been dormant. Or I was lying to myself. I had always been uncomfortable. Just that I was used to it, to a certain level of it. I had told myself the tale of being cured because it made me feel better. I so much wanted the booklet to be wrong. Wasn’t it strange, for example, that I had been unable to tell Carlo when these pains actually began?

‘Clench your fist,’ the nurse said. She smiled. ‘No need to look so worried.’

In the past I have sometimes had trouble watching blood flow from my arm. Now I barely noticed. The dark liquid bubbling into the syringe had nothing to do with me. What mattered was this ugly story: ‘inevitably . . . on the operating table . . . in their fifties or sixties’.

For the following days and weeks I was in thrall to this version of my life, ‘the official medical version’, I kept saying to myself. That’s what you’re up against, the version you chose twenty years ago to deny and which now is taking its revenge. Here I was, barely past my fifty-first birthday, and a doctor, entirely innocent of my medical record, was prospecting exactly the operation that had been foretold when I was thirty.

Or was it rather a question of suggestion? The medical publication of so long ago, written in a style and from a point of view that were no longer acceptable, probably out of print for over a decade and read by absolutely no one, was nevertheless acting as a powerful spell, a hex, a curse. My primitive mind was unable to wriggle free from the words of a witchdoctor who had told me I would wither and die.

But he didn’t tell you you’d die! I protested out loud. I was in my office no doubt, pacing up and down by my laptop.