In My Bones

A conversation with my bones....

There is a whole lot of unknown up ahead of me. This is true for all of us - having a life-threatening illness merely sharpens the focus - you know what you don’t know with a bit more certainty. At present I am moving forwards, as my sister put it, “One biopsy at a time.”

I had one last Wednesday. I am quite experienced with the drill by now. Off to the hospital I go to the room with ‘Bone Marrow Clinic’ on the door. It is a small room with a narrow bed against the far wall. I lie on this bed, facing the wall. One of the highly skilled nurses numbs me up on the right side of my lower back where there is a bump of bone- the ilium - a knobble that makes up part of my pelvis.

Trigger warning: if you are squeamish skip over the next paragraph!

I don’t see the needle going in, but I feel it. There is very little pain - the numbing works - but the nurse usually comments on how strong my bones are, as she has to push hard to get inside them. Mostly no actual bone is extracted - only the fluid inside the marrow. It is an odd sensation. It isn’t like a blood test. I can feel something from deep within me is being drawn upwards and out. This essence - my bone juice - is then put onto little glass slides and these are strapped onto the back of a motorbike and sent off to King’s College Hospital in London. In about two weeks’ time, a result will come back- a piece of paper or, more often, a PDF on a screen, containing a number. Zero is the best number to receive. Anything higher is not so good.

While I wait for the result I am left with a large, white padded square bandage on my lower back, and the instruction to keep this on for 24 hours, and not to swim or have a bath for a week. To date - and I have had thirteen of these biopsies so far - I have always kept the bandage on for much longer, right up until I receive the result back, as if the white square were a kind of lottery scratch card and taking it off is going to be revelatory - the result hidden underneath.

I don’t mind the actual procedure - I even quite enjoy it, fascinated by the fluids that my body holds - but I don’t like the superstitious state of anxiety it leaves me in, nor the feeling that a London doctor, whom I have never met, has more information on the wellness of my marrow - my deepest core - than I do. So, from now on, every time I have a biopsy, and while I wait for the result, I am going to stage my own procedure of sorts - a conversation with my bones. I want an answer from the inside, not only a number from the outside. I did this once before in January, as part of my initial ‘Adventures in Wellness’ course of creative medicine. Now, I want this practice to be its own discreet prescription.

So, I’m going in, right here, right now. I am sitting on my bed at home to do it. No needles. I only need a pencil, a notebook and some quiet.

It feels a bit like scuba diving, except the sea is me.

I drop down.

Everything is muffled down here.

“Hi bones,” I say.

Silence. Only a slow, low pulse.

“I’d like to hear anything you have to say, or want to tell me,” I say into the gloom.

A groan, or a sigh, barely audible, like hearing the wind in a tree, four fields away.

“I’m in no rush.”

As well as being like a deep sea diver, I now also feel like a birdwatcher, hunched in a hedge, waiting to see if I may be graced with a fragment of song from a rare species, a shy one like the golden oriole that likes to hide in high leafy places.

“I’ve got all day,” I whisper. “All night if need be.”

A growl in reply, like an engine starting up, again heard from across the fields. Then a crackle, as of scree under the sea, or a record turning round before the music starts. I hold my breath. I dare not move lest I startle my bones back into silence.

“Weeeer. Weeeeeeeeer.”

It’s a kind of pre-voice voice, as when, as a child, I used to make my vocal cords vibrate slowly, fascinated that such a sound could come out from my throat. It is like when I press the sparker on the hob - not the hiss of gas, or the boom of it lighting, but the clicky, flinty sound before that. The tiny needle of possibility. My bones are doing this. I don’t say a thing - keep listening, because I can tell they are just warming up.

Sure enough, they start to hum - a deep, gravelly sound. Odd grunts slip out that could be words. Under the sea, up in the leaves, my bones are singing.

I imagine them, as I listen, as if they were separate from me: a skeleton dancing with surprising grace- a chorus of 206 (that’s how many bones we have), singing in creaky far-off voices. They sing as one, and I begin to hear a tune. It takes me a while to remember where I’ve heard it before, and when I do I want to laugh out loud, but I stay quiet, for they are moving into full song now, gathering volume:

“When I grow up, I will be tall enough to reach the branches that I need to reach to climb the trees you get to climb when you’re grown up.”

They are singing a number from Matilda. That’s not me, Matilda, but Matilda the Musical, which incidentally, I precede. I am older than the book, let alone the stage, or film version, but nonetheless my bones are singing When I Grow Up.

At first, this seems daft since they are definitely done growing. Recently my son has done a lot of growing. His bones have overtaken mine. He still cries out with surprise and barely suppressed delight when he hugs me, or when we stand together reflected in the mirror in the hallway - to be so much taller than his mother. But nonetheless, my bones are singing about growing up. I fell ill in April ’24 in the lead up to my 50th birthday. It is April again - it’s the season for growing, for shooting upwards into the bright spring light, still with a bite of cold in the air.

My bones sing on:

“When I grow up I will be smart enough to answer all the questions that you need to know the answers to before you’re grown up. And when I grow up I will eat sweets every day on the way to work and I will go to bed late every night!”

They are singing the whole number. I am surprised they know all the words, but then for years now the music to which I have listened has been whatever my daughter has been playing, so I have been on a diet of film songs, musicals and Taylor Swift. I suppose this song has got into my bones, just as a tune can get stuck inside your head. The fluid that they take from me in biopsies must have vibrated, jiggled, danced to a whole load of different tracks, but this is the one my bones have chosen to sing back to me.

“And I will wake up when the sun comes up and I will watch cartoons until my eyes go square and I won’t care ‘cause I’ll be all grown up!”

It seems to me, as I crouch on the bed listening, that my bones are dropping me a humorous but rather heavy hint: time to grow up at long last, if I am to last long.

I have always recoiled from the puer aeternus type, the eternal child - Peter Pan, The Little Prince. I never found them attractive or touching. They riled me. “Oh, just grow up!” I wanted to say. The irony of the eternally youthful is that there is nothing remotely eternal about them- they tend to die young. Since they can’t grow old it’s kind of the only option. Think Michael Jackson or James Dean.

My bones sing on:

“When I grow up, I will be strong enough to carry all the heavy things you have to haul around with you when you’re a grown up.”

Listening, it makes me wonder whether I have disliked Peter Pan because he reflects something in me. People have always said I look younger than I am. For a while my daughter used to ask me multiple times a day how old I was. I soon grew bored of giving the same answer and instead used it as an invitation to check in with how old I felt. I was amused and shocked to discover that I averaged at around aged six, and almost never felt older than ten.

“And when I grow up I will be brave enough to fight the creatures that you have to fight beneath the bed each night to be a grown-up!”

My bones no longer sound gravelly. Not deep, but light. As they sing of growing up, they turn soprano. I listen, remembering a bench we used to pass when we lived in Richmond by the river. I often read the inscriptions on benches, including the dates, calculating the length of life of the person to whom the bench is dedicated. This one was new, the wood still gleaming, not yet weathered, and every few months it would have fresh flowers strapped to it in a little glass jar. The man for whom this bench had been made was born a few years after me. He was only forty when he died. After his dates and name, was the quote from Lao Tzu:

“The flame that burns twice as bright burns half as long.”

It frightened me even then - long before I was ill - because intensity is familiar to me, as is burn out.

“And when I grow up I will have treats every day….And I will wake up when the sun comes up and I will spend all day just lying in the sun and I won’t burn ‘cause I’ll be all grown-up!”

My bones are singing me a song about growing up, and not burning. Because, actually, it’s a song about self-care, which is, perhaps, all that growing up really means - being able to look after yourself. It is not the song of innocence it seems, not a childish dream of what growing up might entail - at least not when my bones sing it. It sounds rather wise. It is a set of instructions that involves practicing strength, knowledge, courage, choice, chore, rest, pleasure and joy. The only piece of advice I might not follow is the one about eating sweets every day as apparently high sugar levels are not a great anti-cancer diet, but who knows really - happiness and a gleeful desire to break the rules probably outweighs all that. Everything else- the tree-climbing, cartoon-watching, facing the creatures under the bed, lying all day in the sun - I can get right behind. It’s a vision of the kind of self-care I have not practiced in my life up to this point. But now, I think, it’s time.

And as my bones sing on, their voice is heading so high, I can hardly hear them - they are showing off their extraordinary vocal range. They sound tiny, far away again, like you imagine fairies might, if ever you came across them.

When I grow up….

“Good advice, bones,” I say.

My biopsy will result in a number. I like that I have another kind of number now to offset against it - a musical number, a sound prescription, from my bones.

“Thanks bones.”

Silence. If they are singing still it is in too low or high a voice for me to hear. Maybe they are just resting in the sun, in this April light. Either way, I can feel them. Fizzing. Alive. Stubborn. Celebrating growing old.

Slides from my bone marrow biopsy