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Last Updated: Friday, 10 February 2006, 17:39 GMT
Life on one leg
By Nick Clarke
Presenter, The World At One

Radio 4 presenter Nick Clarke is recovering from an operation to remove his leg. He reflects on the experience of suddenly discovering he had cancer and looks ahead to life on one leg.

Nick Clarke
Nick Clarke won the Broadcasting Press Guild broadcaster of the year award in 2001
"How many legs do you need to be a radio presenter, anyway?'

I couldn't argue with Steve Cannon's logic. And in a curious way, it was comforting to hear someone talking about a bright future on a grim December day. My wife, Barbara, and I were sitting in a dreary consulting room with one of the country's leading orthopaedic surgeons.

I was propped awkwardly on a hospital chair, watching the surgeon inspecting a stack of X-rays and scans, and there was no comfort to be had in the grey, forbidding images. Eventually, he asked what we'd been told about my condition.

"Just that the cancer was too far advanced for chemotherapy - and that the removal of the tumour might involve the loss of my leg."

'I'm afraid I agree," he said. With that, he sealed the fate of the hapless limb.

Mr Cannon had fitted in our early morning appointment in Stanmore, at the Royal National Orthopaedic Hospital, before heading off to a conference. He exuded elegance, confidence and charm. Even though he insisted that he liked to be called "Steve", he remained "Mr Cannon" to me: it didn't seem right to be over-familiar with a man who was going to cut off my leg.

He talked through the prospects - from the risks of the operation, to the supply of a prosthetic limb and my chances of resuming a broadcasting career. "You may find the artificial leg rather unwieldy," he warned. "Some people only use them for Sunday best." And then he was off, leaving me to contemplate an uncertain and lop-sided future.

How had it come to this? I had never had an operation before, and never spent a night in hospital. I couldn't remember the last time I'd taken a day off work because of sickness. And now I had not only been confirmed as a cancer-victim - I faced the prospect of becoming disabled overnight.

First symptoms

Many people have asked me when I first realised that something was wrong and it hasn't been an easy question. In retrospect, I knew that the first symptoms manifested themselves months ago: a stiffness in my left buttock, which I put down to the aches and pains of middle-age, caused perhaps by toiling up and down stairs carrying three-year-old twin boys.

Even when the stiffness developed into a slight swelling, I did nothing about it, ignoring Barbara's advice that I should consult a doctor.

Then, the growth of what had been a slight swelling began to accelerate alarmingly: it also became increasingly painful. Finally I was persuaded to attend our local GP's surgery. He clearly didn't like the look of the protrusion under my hip. The word cancer was uttered. The doctor wasn't prepared to commit himself, but I knew straight away what the diagnosis would be.

A failure to act quickly would have only one outcome - I would die.

I rang my office and told them that I would be absent - for a few days at least - to undergo some tests. They weren't surprised. Everyone had been telling me how ill I looked, but I always brushed them aside, muttering something about a virus.

A few days later we found ourselves at University College Hospital, London, waiting to be seen by an oncologist, Dr Jeremy Whelan. It was dark outside by the time he ushered us into his room, high above the lights of the city. And for the first time we heard the name of the enemy: sarcoma.

In a softly-spoken voice, and with diplomacy worthy of the Foreign Office, he led us carefully through the likely cause of the swelling, the implications of a malignant tumour of such proportions, and the prognosis. There was no point in pretending that chemotherapy could be used to reduce its size - surgery was the only answer.

Nor should we be under any illusions: a failure to act quickly would have only one outcome - I would die.

He told this story in such an undramatic way, that the conclusion seemed not so much traumatic as inevitable: if the sarcoma was to be removed, there would be no way of saving my leg. So be it. At least I would be alive.

Low-lying beast

We found out a lot about sarcomas in the days that followed. They are rare, representing only 1% of cancers in the UK, around 1,000 cases a year. Mine was an epithelioid sarcoma, attacking the soft tissue.

The beast has a habit of lying low for long periods, biding its time, often undetected by the patient. One website put it succinctly: "innocuous presentation can lead to delay in diagnosis until growth prompts intervention." (That made me feel a tiny bit better about my tardiness in seeing the doctor...)

When it does start to move, however, the sarcoma can become aggressive, consuming all in its path. It can attack shoulders, forearms, hands or thighs - which is why it frequently leads to amputation. If it spreads further still, it tends to head straight for the lungs. Fortunately, the tests had shown my lungs to be clear. Which left me with the monstrous carbuncle on my bottom.

Nick Clarke
I could see them trying to think themselves into my shoes (soon to be shoe), and wincing

While I waited for a slot in Mr Cannon's operating schedule, I sat at home trying not to feel sorry for myself. To be strictly accurate, I didn't so much sit as lie on a sofa, curled up in the only way I could find to be comfortable. And all the time the weight was dropping off my body, until I could see the shock in the eyes of my visitors at my skeletal appearance.

I was dying.

It was hard for others to grasp what Barbara and I both knew: that the operation, and the amputation, would come as a blessed relief. Some people, understandably, found it hard to imagine how I could remain so cheerful at the prospect of losing a limb.

I could see them trying to think themselves into my shoes (soon to be shoe), and wincing as they did so. The very idea was peculiarly shocking, perhaps even more shocking than seeing a friend laid low with nothing worse than a case of cancer.

We were given a date for the operation: December 19th. I was installed in my hospital room on my last two-legged night: not realising that the nurses had given me a much stronger pain-killer than I was used to, I stumbled back from the bathroom, tripped over something on the floor and slammed my head into the wall.

This left me with a huge crescent-shaped wound from forehead to cheek, which - over the next few days - left many people baffled: why should a leg amputation leave such damage to my head?

I had been told that after such a serious operation I might be left under anaesthetic until the following day - then monitored in intensive care for a further 24 hours before being sent back to my ward. In fact, the three and a half hour "hindquarter amputation" went swimmingly - so much so that I was woken up immediately afterwards in the recovery room, and by lunchtime the next day I was on my way out of the High Dependency Unit, having already made a series of phone calls to family and friends.

Euphoria

I felt great. A beaming Steve Cannon stopped by my bedside to inform me that, as far as he could tell, he had removed the whole sarcoma, leaving no cancerous cells behind. This was the best possible news. And what's more, I was experiencing practically no pain.

The euphoria lasted for four or five days. That's when they removed the epidural drip (as widely used to induce numbness during childbirth). Instead, I was given a cocktail of pills, which - to begin with at least - were much less effective in suppressing the pain. I began to find out about the "phantom leg" phenomenon, which produces strange sensations - tingling, throbbing or itching - where the limb used to be.

I wasn't ready to look at the scene of the crime. It was hard enough learning to drag myself onto my side so that the wound could be dressed. It took me a while to notice that the excellent nurses always placed a pillow under the sheets where the leg should have been. After a while, however, I asked for the pillow to be removed. The flat surface turned out to be useful for papers, books and trays.

Nick Clarke - 2001
Nick Clarke at the time of his Radio 4 documentary about his cricket team in 2001
I suppose this was the start of the process of coming to terms with my new condition. At Barbara's wise prompting, she and I fell into a jocular approach to the whole affair. She relayed with delight the comment of the man who came to fit the stair-lift: "I love my job," he said, "because everyone I meet is worse off than me."

And then there was the fascinated reaction of children: one conversation between the boys and their friends involved a lengthy debate over where the leg had gone. Was it in the bin? Which bin? Would the white bin be big enough? My own children went around telling everyone that Daddy's leg had been removed with a very big pair of scissors.

Once the news had been made public, I received a torrent of letters, cards and E-mails from listeners. My favourite comments came from two members of the World at One audience: one said he had been deeply affected by my absence from the airwaves, rather as he had been by the withdrawal from service of the Routemaster bus.

Another wrote, "my feelings about your illness are a bit like my reaction to the trauma suffered by the whale in the Thames."

Milestones

Two weeks later, I still feel great, if tired. I have taken the children to school, attended a BBC party and eaten a meal in a restaurant. Each of these felt like a milestone in my recovery, but there is a long way to go. I have much to learn about living with disability: physiotherapy is demanding, and I struggle to find a way to sit comfortably on what remains of left buttock.

I have fallen over in the street. And even though there are no detectable signs of cancer in my body, I have been advised by Dr Whelan to take a course of chemotherapy - just in case: it will start in a few days time.

Once it's over, though, I have plans: a family holiday, a trip to France with my cricket team (I will not be volunteering to play, chaps: I promise) and a return to work in July or August.

But I must remember to be careful about the language I use. After describing myself (in a World at One newsletter) as legless, a listener wrote: "I hope you don't mind clarifying one point - are you really legless, or do you still have one leg remaining?"

I am glad to confirm that I have one working leg ready to step into the breach, ready to take me wherever the future dictates.


SEE ALSO
Nick Clarke diagnosed with cancer
08 Dec 05 |  About BBC News

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