A good many moons ago, when Ireland was dubbed the ‘sick man of Europe’ and Wurzel Gummidge was being suitably saucy on tea time TV, I found out I was directly related to Oliver Cromwell. Although only ten years old, I knew it had to be De Da’s side of the family as he was particularly gifted at starting bloody civil wars in the house and claiming zero responsibility for the body parts.
American genealogists had dropped the bombshell in a registered letter to Dublin with a $2 note for a prompt reply. Oliver Cromwell’s mother was Anne Caldwell of Solway Firth. At some stage they moved to Northern Ireland and branches of sprogs settled in Fermanagh and Donegal, while others fled to America when Cromwell turned against them after Charles II returned to power. Cromwell’s right-hand General was also a Caldwell. You get the sordid sorry picture.
Whatever the truth, there’s skimpy point getting anal about it…or is there? Cromwell was obsessed with the bowels. His famous retort: I beseech you, in the bowels of Christ, think it possible you may be mistaken! wasn’t blurted in isolation. While he died of typhoid on the battlefield it was also documented that he’d ‘terrible trouble’ with his bum and may have been diseased in that region too. And he may have passed it on. Last summer as my 46-yr-old brother’s colon tumour made its way by courier to a fancy genetics lab in the EU, I sat the old man down to ask how his siblings and family members had snuffed it. “Oh the two brothers died of bowel cancer or…hold on, no, eh – can you get me some water for the whiskey – one died of a rectal disease…and the Da died of colorectal cancer at age 58 and I think an aunt did as well, at the age of 23…but I couldn’t be sure of her, there was talk she might’ve been a prostitute”. The glorious eejit had never mentioned it. I’d had my suspicions about bipolar disorder, alcoholism, schizophrenia and depression, hedging my bets for a lengthy stay at a nut house any day soon. A could-be related cancer to his lot was there too on my mother’s side: four near relatives were wiped out by the stomach variety, the youngest at 36. “Even aunt Lena the almost vegetarian!” she exclaimed. “And her who wouldn’t even eat peas from a tin!”
The brother in England (with the travelling tumour) rang the hospital with my mother’s family history and asked what was the difference between bowel and stomach cancer? “Basically a few inches,” the geneticist replied. Double whammy for our generation of Caldwell’s so. The results back from the lab confirmed there was a ’virulent’ familial strain. A few months later, by shabby coincidence, my mother was diagnosed with the same thing too. She’s just been through major surgery and follow-up treatment this summer. (An upside to the chemo for her is the restaurant in the Mater Private with its great array of delicious food, we always go for dinner afterwards. My brother also cited an unobvious benefit to his chemo many miles away in Ipswich: “the steroids give you a permanent hard-on”). The rest of us are currently marching along for tests. As I write I’m staring at a large box of ‘Klean Prep’ which I have to consume in a 4-litre load, to induce in vitro mud-slides, followed by a polite impaling at Beaumont Hospital in a few hours time.
Here’s the thing: genetics and predictive medicine is where it’s at. We’re on the cusp of a gilded age in science when a good old goo at your DNA code will reveal an accurate risk of cancer, diabetes, heart disease, etc. Medical folk will then be able to predict what drugs or treatment will work to keep you alive and well the longest. Within the next two to five years, geneticists maintain they’ll have the sequence of every major human cancer. Eventually they’ll ‘tinker’ with fated diseases when human life is still curled snug in the womb. In the bland old meantime, Irish families are still reluctant to talk about what killed those who came before them. “It’s not the done thing,” my mother said. “In my day people were dropping of TB and all sorts but we were too busy trying to get by to worry our heads about it”. Diagnosis was all over the place then, if anyone died of an unknown condition, it was generally lumped under the heading: ‘consumption’. The doctor, just like the priest and possibly the politician, was a sacrosanct golden cow you could only ever bestow a “thank you” to, and not bother with serious concerns or even questions.
Ireland has the second highest breast cancer rate in Europe, staggeringly high skin cancer rates too, and a steady stream of lung, ovary and prostate. We also have the third highest incidence of colorectal cancer for both males and females in the EU. Around 21,000 people are diagnosed every year with some form of the disease as well as a host of other auto-immune conditions, a lot of which could have hereditary starting points. The sooner you sit down and have that ‘genetics’ conversation with older family members, the quicker you’ll be able to jump on your health horse and deal with it. My near-genocidal ancestor (if I’m related to him) may have been a heinous shit, but he’s left me with a clear will not to kill indiscriminately and to breathe in and out for as long as is reasonably possible. How about you?