Saturday 9th February 2019 - The day after diagnosis

It seems reasonable to assume that one may wake up the day after a shocking cancer diagnosis doubting that the whole thing did not actually happen, that it was just a bad dream. That was not the case for me. Once the effect of the sleeping tablet wore off, I woke up in the early hours of the morning in full knowledge of the huge trouble I was in.

I did not experience anxiety or fear, yet I was completely overwhelmed by a feeling of sadness. Sadness for myself, for my children, for Jane, for my parents and for my sister Ilaria. That is one of the many problems of getting an apparently incurable disease at a relatively young age – there are many more ramifications compared to somebody diagnosed later on in life as far more people are likely to get affected by it. I had already thought about this when my brother in law and two year old niece got sick and died a few years before.

Now it was my turn, and this issue immediately presented itself in full scale. I spent most of the day communicating the bad news and inflicting pain left, right and centre. I started by calling my oldest friends from Pisa, Gherardo and Cristiano. Their reaction was moving: a couple of hours after I spoke to them, they messaged me to let me know that they would fly to London the following day to see me. Not even 24 hours after telling them, they would already be there with me, knowing exactly what to say and how to say it.

Many phone calls with other friends followed, all very similar, all very sad. By the end of the day, I had spoken to most of my closest friends and of course I had spoken a few times to my parents and Ilaria too, who were still distraught from the call we had the afternoon before.

It was now time to start thinking seriously about the next steps. A few things sprung to my mind.

First of all, I promised myself to do anything to give myself a chance to survive for as long as possible. I was still completely overwhelmed by the developments of the previous day but I knew from the outset that I would have to pick myself up very quickly and start to fight. That was in my nature I thought, and in any event, I owed it to the family and the children in particular to maximise the time I would be around.

I had to start thinking immediately about what that involved in practice, but I knew from the outset that it would be a combination of huge physical and mental efforts.

My illness would become a full time job, incompatible with my current one. So one further call I made that day was to Simon, the managing partner of the company where I work, to let him know about the diagnosis, that I would not be around for a couple of weeks, and that once back in the office it would not be feasible for me to work in the same capacity as before. Simon was very supportive and in full agreement with my decisions, which was a massive relief.

I also wondered whether I should take control of how my life would end if, at some point down the line, all therapies were to fail and no further treatment was available. I pondered if in that scenario it would make sense to undergo euthanasia. Doing so would allow me to maintain at least some form of control during the very last period of my life. It would also mean that, at some point down the line, my house would not become a hospital and Jane my full time nurse. I hated the idea of becoming such a huge burden on her and, indirectly, on the whole family.

And I thought that perhaps euthanasia would reduce the level of trauma experienced by my children since they would not be forced to witness their dad’s body disintegrating before their eyes until the moment of my death. Should I decide to go ahead, my children’s last memory of their father would be an extremely sad one of course but it would be one where I would still be standing on my feet.

Crucially, however, just being able to stand on my feet would not be sufficient to implement any hypothetical euthanasia plan. Indeed, this practice is not allowed in the UK, meaning that if I was really determined to go ahead, I would need to be well enough to travel to one of the countries where, unlike in the UK, this practice is allowed. Needless to say, the option of terminating my life too early, the difficulty of how to communicate this to the children and the physical challenges that an oversea journey would likely present made the euthanasia option far less appealing.

Anyway, these were my initial thoughts – still very rough and superficial at this stage. But while I decided to park the idea of euthanasia (as this was clearly not an immediate priority and its implementation would be fraught with challenges), I would spend the next few days and weeks firming up my plans to fight the illness as effectively and for as long as possible.