Philip Gould: I'm enjoying my death. It's the most fulfilling time of my life

Philip Gould: I'm enjoying my death. It's the most fulfilling time of my life

One man's extraordinarily powerful - and ultimately inspiring - account of how he came to terms with the most devastating news of all...

By Philip Gould

PUBLISHED: 16:51 EST, 2 May 2012 | UPDATED: 19:38 EST, 2 May 2012

Philip Gould was the brilliant Labour Party strategist who helped bring Tony Blair to power in 1997, and was awarded a peerage in 2004. Here, in the first of two extracts from his new book serialised in the Mail he describes movingly the journey from being diagnosed with oesophageal cancer in 2008 to being told he had three months to live. He died at 61 last November, with his wife Gail and their daughters, Georgia, 25, and Grace, 22, by his side.

Sedated but fully conscious, I am lying on my side hearing the quiet hum of medical conversation around me. A small camera eases down my gullet, displaying all it sees on television screens. I prefer not to watch. It’s ten o’clock on Tuesday, January 29, 2008, and this is where it all begins.

The voices in the private clinic are calm and subdued. But then suddenly it is as though a goal has been scored at Wembley. The room explodes with noise and energy. They have discovered a cancer, and I hear the word ‘big’. They talk as if I am not there.

The camera is removed and the doctor tells me with barely concealed excitement that they have found a growth that is certain to be a malignant tumour and that it is large. ‘What are my chances?’ I ask. ‘Fifty-fifty,’ he replies, and I feel a combination of shock and hope.

Coping together: Philip Gould and wife Gail with daughters Georgia, standing, and Grace, in the last picture taken of him before his death last year

A surgeon arrives as if from nowhere. He inspects the images and tells me that it is a junction cancer situated between my oesophagus and stomach. In a second I have lost control of my world.

I am wheeled out of the operating theatre to my cubicle, now a cancer patient. My wife, Gail Rebuck, rushes in, her face full of love and hope, certain that I will be all right. Just an hour ago I had been told that the chances of cancer were remote and I had phoned to reassure her. It was a mistake, creating false hope.

I tell her the new truth harshly because I am nervous, and  she almost physically recoils, as though punched in the  stomach.

I phone my daughter Georgia in Manchester and she is stunned, unable to take in the information. Gail takes the phone and leaves the room to talk to her.

I can hear them through the door; it is clear  they are both in floods of tears. I am not the  victim here.

We drive home in silence. Gail is distant; she sees the contours of her life shifting in front of her. I feel guilty. I have let her down.

I am going to be open and honest with people about what has happened, reaching out to them rather than trying to do it alone. I need help, but I also have to give help.

'My immediate response to being told I had cancer had been that I would battle through and win. I had a vision of a dark road leading to a light'

I started phoning and the calls went well. I felt immediately lifted by the affection I received. I thought, if only I had known they liked me so much before I got ill.

The first call was to my younger daughter, Grace, at university in Oxford. I said we would come and see her that evening. I did not want to tell her the news over the phone.

I told her that it was serious, but I wanted to speak to her face to face. It was not perfect, but it was the best that I could do.

I called Downing Street, something I had once done often, but which rarely happened now. The telephonist was kind, sensing something was wrong.

The next day I was due to make a presentation to Gordon Brown on public perceptions of him based on some polling I had done. I told someone in his office that I would be unable to do it because I had been diagnosed with cancer.

Within minutes Gordon phoned back, his deep, gravelly voice betraying genuine concern. This was the first of m any calls he would make. The presentation went ahead without me: the findings about him were harsh and I felt guilty for inflicting them on him.

That was how the day went, calling and being called. Part of me enjoyed being the centre of attention, and while wary of this, I was prepared to use it to help get me through.

At about six we drove to Oxford. Grace was standing confidently outside her college, looking cool and contained. I said straight away that I had serious cancer and her response was typical: ‘I knew when you phoned that either you had cancer or you and Mum were getting a divorce.’

We had dinner, which was warm and close. I was very sad to leave her. Gail and I drove back without speaking much. So the first day with cancer ended.

In May 2008, after three months of chemotherapy, throat and stomach surgery is performed by Dr Murray Brennan at the Memorial Sloan-Kettering Cancer Centre in New York, followed by three months of post-operat ive chemotherapy at the Royal Marsden Hospital in London. As the result of much research and consultation, Philip Gould has opted for treatment in the U.S. instead of more radical surgery proposed by NHS specialists at one of London’s teaching hospitals. He is told he has a 75 per cent chance of survival. In December 2009, nearly two years after his initial diagnosis, he is given the all-clear by the Royal Marsden and resumes his career as a pollster, political strategist and the vice-chairman of Freud Communications. 

As Gail and I walked into the cold midwinter evening we felt we had done it. Now statistics were on my side. It was all going to be OK.

Political life: Celebrating Labour's 1997 win with Tony and Cherie Blair

And so I got on with my life. The General Election was coming up and I was determined to contribute to it. I felt this was the time for people like me to stand up and be counted.

But Gail was worried. She hated my involvement in politics, believing that it had been the root cause of my cancer. She wrote me a note begging me to slow down. ‘It is so heart-rending to see you destroy yourself like this,’ she wrote. ‘Nothing is worth that, nothing. At the centre of it all is politics, which is such a destructive force. It nearly killed you once. Please don’t let it kill you again.’

In June 2010, Philip Gould is told by staff at the Royal Marsden that, to their surprise and that of the medics in New York, his cancer has returned.

This time it was harder. I was not depressed, or in despair or even deflated. Just shocked.

Recurrence is a very different thing from the original diagnosis. My immediate response to being told I had cancer had been that I would battle through and win. I had a vision of a dark road leading to a light.

But the diagnosis of recurrence had a very different effect â€" the road ahead just collapsed, and I was left effectively with nothing, just the kind of fuzzy picture you get if your television stops working.

I had dinner with Tony Blair. I was not so much low as lost; I could see no way through. Why had it happened?

The first diagnosis I understood: I got cancer as others did and I fought it, with as much determination as I could muster. I had taken every pill, undergone every treatment, done e verything required of me, got through the crucial two-year mark and still it had returned. Why had it come back?

Tony paused for a second and said slowly: ‘Because the cancer has not finished; it is simply not done with you, it wanted more. You may have changed, but not by enough, now you have to go on to a higher spiritual level still. You have to use this recurrence to find your real purpose in life.’

Meanwhile, people at the Marsden were starting to say that this kind of recurrence happens only when there are issues with the original surgery.

'What I want to say to my daughters is that this is the most exciting and extraordinary journey of my life. My only regret is that it will end soon'

I called Murray Brennan, who had performed the operation. With some courage he said he believed he may have adopted the wrong strategy, and as a consequence had left too much of the stomach in, where he believed the cancer cells may have lain dormant.

He was saying he had not been radical enough. I admired his honesty. Gail groaned quietly, not with sadness but with suppressed rage at the unfairness of it all.

In effect, the British surgeons had been right: radical was best. But this could be said only with hindsight. The decision had been taken totally on its merits and the responsibility was all mine.

In October 2010, further surgery is performed by Professor Mike Griffin at Newcastle’s Royal Victoria Infirmary, which has the largest oesophageal unit in Europe. Philip Gould learns that his chances of survival have decreased.  

We spent Christmas out of London in the snow. Just us and the kids. There was no hiding here, we all knew the situation. The family was under strain, but we were close.

My relationship with my children was deepening all the time. We implicitly decided to bring the future forward, to compress ten years or so into one.

The kids sucked me dry. Georgia wanted to know all about the way I thought. How did I develop a concept? What were my values? Why did I believe what I believed?

Grace wanted hard, usable, practical advice. She asked me to write down every likely eventuality that might befall her and supply a satisfactory answer. Facing the possibility of my departure, she wanted a handbook for life.

With the children , all this was in a way easier than it might have been. It is in the nature of things that children outlive their parents.

Before the diagnosis: Philip, Gail and daughter Grace in 2006

For Gail it was different. She did not want intensity, or purpose, or accelerated living, she wanted quiet and normality â€" not the future brought forward, but the present extended. She had always envisaged a future free from work where we would just potter around, grow old as companions.

We had known each other so long that we had created a shared world. Pottering around in later life seems the easiest thing to achieve. But now it was something I simply could not guarantee. This was the hardest thing to bear.

In August 2011, Philip Gould is  told he has three months at the most to live.

I am going to die. My death is inevitable and is likely to come within the next few weeks, perhaps even within the next few days.

It is real. There is no way to avoid it. I am going to die soon. But as long as I keep telling myself that and do not seek to evade it, I am in the right place.

The awareness of death that I had throughout my life was, I see now, an illusion. Even when the doctors said there was a 25 per cent chance I would die, then a 60 per cent chance, there was always an escape.

It is only when they said: Philip Gould, you are going to die. Get used to it. This is going to happen in months or weeks, but it is going to happen. Only then do you become aware of death, and suddenly life screams at you with its intensity.

I have entered the Death Zone.

'My death has become my life. And my life has gained a kind of intensity and power tha t it had never had before'

When I had my first chemotherapy, I was terrified. It comes with these tubes, these side effects, these horrible things that seem so awful to contemplate. Before it started I thought: I simply cannot do this. I cannot do chemotherapy. It is too painful. It is too horrible. But you do it.

Then the people treating you say: ‘By the way, mate, you are not going to have an oesophagus, you’re not going to have any of this or that or here or there, and you will never eat normally ever again.’ And you get used to that.

Then you realise â€" whatever they throw at you, you can deal with it. Realising that changes you as a person.

I thought I was a coward. I was the kind of guy who was frightened to go too fast on a bike. Too frightened to go on the big rides at Alton Towers, do any of the scary swimming stuff or even to duck my head under water. I just did not have the courage to do these things.

But when cancer came, bringing with it a great deal of fe ar and pain, I found I could deal with it. Time and time again I found the courage to deal with this acute and terrible pain.

And so my death has become my life. And my life has gained a kind of intensity and power that it had never had before.

You can go for a walk in the park and have a moment of ecstasy. I go to the Frieze Art Fair in Regent’s Park opposite our house. I go to the exhibition tent and I sit there and have a coffee and I feel ecstasy after ecstasy after ecstasy.

This is built upon this feeling of certainty, of knowledge, of death. There is ecstasy because I am not dead yet.

Dealing with death: Philip said he was glad he had the chance to reflect on his life following his terminal diagnosis

I had a terrible night recently. It could not really have been much rougher; I was very, very tired and was sick for most of the night. I had to make maybe a dozen trips to the loo and was feeling dreadful. Gail stayed with me as I struggled. In the morning she came in to see me and by this time I did not look good. Gail just gave me this smile of tenderness that was almost beyond words, it was so wonderful.

I knew then that the tenderness I saw on her face was utterly dependent upon the knowledge that I was going to die. Without that knowledge there would have been no such tenderness, but with it, such tenderness was possible. Death is immensely cruel, but also immensely powerful.

I am enjoying my death. There is no question I am having the most fulfilling time of my life. I am having in many ways the most enjoyable time of my life, too. I am having the closest relationships with all of  my family.

You do feel sadness. I am leaving my children and my w ife. Georgia has said to me: ‘Dad, I want you to be there when I get married, when I have a child.’ Grace has said similar things.

What I want to say to my daughters is that this is the most exciting and extraordinary journey of my life. My only regret is that it will end, and end soon. I would like to be on this journey with you for ever and a day.

I want to be with you all the time. I know that it is not possible, but I wish profoundly that it was. Your own journeys lie ahead of you and you will take what I have started and turn it into something much more magnificent, much more extraordinary.

It is beyond my understanding to say which sides of this experience are most important. I just do not know.

But I do know this. I have had more moments of happiness in the past five months than in the past five years. Without doubt, for me the gain has been greater than the pain.

I certainly do not think that a sudden, unexpected death â€" dropping dead, as they say â€" would be better than what confronts me now. You would lose so much.

Of course, it would be nice to avoid confronting death, nice to blunt that sharp edge. And you would avoid a lot of pain, I suppose. But those things are far outweighed by the things you gain from knowing that you are going to die and having the chance to act on that knowledge.

'I certainly do not think that a sudden, unexpected death - dropping dead, as they say - would be better than what confronts me now. You would lose so much'

To have three months, or two months, or one month, or even a week in which to actually sit down and to fulfil and complete your relationships is almost the greatest gift that death can offer.

In the past few weeks I have had to come to terms with all that I have done in 60 years of living. Making sense of this is important.

All the extraordinary connections and relationships made during a relatively long life must be considered. And in the many reconciliations and reckonings of this process there is the power of fulfilment.

This is when you surge forward and grow. I feel I am surging forward and growing at a pace that I have never experienced before.

All of us tend to think in terms of  linear time. One thing follows another. But I can no longer think like that.

What good is it to me to think in terms of conventional time? Six months or nine months no longer exist for me. So I am trying to make sense of the world not through time, but through emotion, through relationships, through feeling.

Of course, for a short while at least, I can look forward to tomorrow. I have looked forward to every single day this week and every single day this week has been better than the day that preceded it. Every single moment is almost better than the moment that preceded it.

Missed: Philip died at 61 last November

I feel nothing but optimism. I know that the future will be bad. I know that it will be difficult. I know that there will be those horrible moments when the stomach does this and the stomach does that, and God knows what else. I know all that. But life cannot be better than this.

I know how life can be better for those who care for me and love me. I understand that, I do not try to deny that. But for me, even though this may well be the worst of times, it is also the best of times.

Given all that I have said I think it is reasonable to ask what I would do if I was offered the chance to have the death sentence suddenly, miraculously, lifted. Would I prefer that, even if I had to give up all the things that I have found here in the Death Zone? It is a difficult question.

I would have to accept the offer for the sake of Gail and for the kids. I do understand that my family wants more time with me and I respect that.

But I believe that this is the rig ht place for me and I want to be here in this state of mind and to die in it if I can. I am, I hope anyway, a different and better person than the one I was before this happened.

I have had a lot worse happen to me in the past four years than is going to happen in the next four weeks. It will be difficult, but I hope, I believe, I think, ultimately it will be sublime.

That is not to say it will be sublime in some great religious sense, although it might be. But I believe there will be a quality of the sublime about it.

I feel very calm. I feel at rest. I have found that the experience of the past few weeks has been as good as it is possible for the experience to be.

That’s how it is in the Death Zone.

• © Gail Rebuck/The estate of Philip Gould 2012. Extracted from When I Die: Lessons From The Death Zone, published by Little, Brown at £14.99. To order a copy for £12.99 (PP free), call 0843 382 000. All proceeds from the book will go t o the Royal Marsden Cancer Charity. Donations can be made at royalmarsden.org/philipgould and also to the National Oesophago-Gastric Cancer Fund. Donations can be made at justgiving.com/nogcf.

In the last weeks of his life Philip completed the book, When I Die, and collaborated with director and photographer Adrian Steirn to produce a short film. You can find it watch it here...

 

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