Some four years ago I made a small pencil mark on a blank sheet of manuscript. The relocation of stuff in my head to stuff on paper had at last begun. This project had been swirling about in my thoughts for quite some time and now my ideas had clarified, become defined to the point at which I knew I could take on the challenge of what I considered to be quite a daunting undertaking.

That moment was the first step on a long creative process which has involved the combined skills of a small group of supremely talented people – Mary Dullea, Alex Van Ingen, Scott McLaughlin, Peter Vodden and Stephen Sutton. For regular habitues of this blog these are familiar figures and need no introduction. Without them my ideas, my music, would not go beyond the confines of my studio. I am deeply indebted to each of them.

Entangled States extends my Non-Prescriptive methodology. For further explanation I refer you to Scott McLaughlin’s well-researched and detailed sleeve notes. These can be downloaded. The structure of E.S. is comprised of 48 pieces of short duration. 24 are written in my low-order format and 12 in middle-order/high-order formats each of these having 2 realisations. This to demonstrate the raison d’etre of Non-Prescriptive compositional and performance techniques – namely that each piece can be played (realised) in an infinite number of ways.

Divine Art has described Entangled States as an “astonishing masterpiece of contemporary complexity”. I hope that this epithet does not deter people from listening. It might be that many people are not attracted to the idea of introducing further complexity into their already complex lives.

Entangled States seeks to push against certain established compositional boundaries. An increasing body of opinion reckons that I am “taking music in a different direction”. If this is the case I must hope that I can take my audience with me to wherever my journey leads.

Now that the CD has been released I must await the comments and evaluations of the reviewers. Perhaps it should not be so, but as a composer I exist embalmed in permanent layers of doubt and uncertainty and, from choice, work in a self-imposed near- vacuum. Their generous comment and approval lends me some degree of assurance, a motivation to continue, so necessary on the many days I hit the compositional buffers.

To conclude this post I include a very recent brief review from Naxos which is the largest independent label in the world and one of the biggest-selling classical labels. It is also one of the largest global distributors of independent classical record labels such as Divine Art.

“Eric Craven is like no other composer – both because for most of his life, he has been a recluse from the musical establishment while living out his role as family man and teacher, and also because his compositional technique is his alone. Aleatory in general principle but more complex, his works contain elements of both high-order and low-order ‘non-prescriptive’ writing – in other works varying degrees of flexibility allowed to the performer. Totally abstract in form and concept, though inspired by a principle (here, the particle entanglement in Quantum Mechanics), the pieces, especially ‘low-order’ where the score is more prescribed, can take on the appearance of other forms such as baroque fugue, romantic prelude or even soft jazz. Moreover the music is hardly ever ‘challenging’ for the listener, with quasi-tonal, melodic flow. In many ways Craven is laying down a new direction for piano composition. Mary Dullea in her third album of Craven’s music demonstrates her amazing pianistic prowess but also her perceptivity and understanding of the scores which she realises in full showing wonderful expertise in interpretation. Dullea, as both solo artist and member of the Fidelio Trio, is becoming one of the ‘must-hear’ pianists in the contemporary music world.”

At the conclusion of my last post I perhaps foolishly promised to present you with good news about my condition. Foolish in the sense that I have very little control over the alien mutating cells that are impervious to the body’s natural defenses and are intent upon invading and ultimately assassinating the host.

If the self can be defined as an amorphous combination of thoughts, aims, imaginings, ego, memories, intention, then we can claim to have some degree of autonomy, of self regulation, of self determination over these. But to the cellular self, the host, we cannot make any such claim. Our cellular structure, without our knowledge, awareness or consent can act against itself and, in a subversive, anarchic and often disastrous manner proceed to carry out what it is so well equipped to do.

Yet The Alien has chosen a poor time to attempt its nefarious activities. As a consequence of the progress of medical science, the ongoing research, trials and testing, the boundaries of what is possible in terms of improving and extending the quality of life, together with the successful treatments, are rapidly extending. I count myself quite fortunate to have acquired my type of cancer at such an opportunistic time. Really.

I have now been on Prostap slow release HT for two months. Last week saw the first meaningful results of this treatment. And, at this point, I am so pleased to be able to present to you the promised good news. My PSA level has plummeted from 14.9 to 1.3 and my T-level to 0.2. In just eight weeks. Some powerful cocktail this Prostap. Perhaps my foolishness may be interpreted as optimism, belief, hope. One must always have hope. I have always kept in mind “To live without hope is to cease to live”. I forget the source.

This means that The Alien is now starved of testosterone, off which it feeds, flourishes, survives. Its progress will now be slowed and hopefully, at the same time, the enlarged prostate will be reduced in size which, in turn, will enable the RT to be more effective.

It is a powerful brew this potion. There can be side effects, different for each patient. I am quite breathless on exertion. I am slowly, reluctantly, accepting and putting into practice the good advice given to me by Nurses Florence and Beth, namely to recognise my new limitations. So, I have slowed my speed of walking to a sometimes barely perceptible forward motion so I do not become breathless. Stairs and inclines present a challenge. Four weeks ago I was ascending the steps at a tram station. Slowly. I had to pause halfway up and practice my now familiar fish- out- of- water- gasping act. Two elderly ladies came past me trailing their shopping trolleys, engaged in conversation. I was buried in an avalanche of conflicting emotions, so much so that I was unable to select any particular one upon which to fulminate. Florence, Beth, new limitations. This, the reality.

Again, the good news is that slowly my breathlessness is becoming less breathless. On the level I can sweep past any 4 year old, easy prey. They can’t focus. Soon I will be challenging the infirm and ancient. Well, progress has to be measured somehow.

And I am perpetually exhausted. I get up in the morning and I am running on empty. It is often difficult to achieve anything that involves thinking, reasoning or movement. Falling asleep in a chair, on a tram is effortless. Morpheus always has his hand near to my shoulder. Perhaps this is a causal effect of running on nil testosterone. Testosterone is given to athletes to improve performance. Zero testosterone …..? My composing is suffering collateral damage, it is a major casualty. I find it almost impossible to maintain concentration, focus for any length of time before Morpheus intervenes.

But it is working. It is doing what it says on the label. I am so fortunate to be a successful recipient of modern medical science when so many people are not. There is a long challenging path ahead. 34 months of HT and in August a month of RT. I can do this. I have my own resolve and so many people batting for me. And, once again, I wish to thank all of you who are concerned about my health. Not only the people who know me, perhaps through my music, but those from distant countries who are following my progress, or to use Florence’s term “journey”. I hope this post is some small reward for your support.

Lastly I cannot think of a pseudonym for my oncologist, Dr. James Wiley. Nurse Blond, The Cricketer, The Arbiter, Florence came so easily. But not so for Dr. Wiley. Any suggestions will be welcome via WordPress.

I am in a state of suspension, both physically and psychologically.
Two weeks ago the results of tests indicated that my testosterone level remains stubbornly high. This, given my cancer, is not good.For those of you who are not oncologists, a brief explanation.
Prostate cancer cells usually require testosterone to grow and flourish. Fortunately hormone therapy can stop the body from making testosterone. The effectiveness of the HT can be measured via the level of testosterone.So Dr. Wylie, he of The Christie,is concerned, has ordered more tests in three weeks. I am waiting, counting down the days, hoping for a better result.
At the moment, and it will be for only a short time,until my body learns to tolerate the HT, there are side effects.Before the course of HT commenced I was able to do 60-80 star jumps, press-ups, take stairs at a gallop and sprint along streets, after making sure I was not being observed,for the sheer delight of being able to do so. Things are now different.I am breathless on standing. I can walk, I can talk but not at the same time.I am slowly, reluctantly learning to acknowledge and accept my new physical limitations.
And I am tired, exhausted at breakfast time. I spend hours each day falling into a deep. dark, dreamless pit of unconsciousness. I am generating my own anesthetic.
I am desperately trying to maintain my composing. It’s what I do. It’s what I am but , at the moment, progress is minimal.I am finding it most difficult to maintain the necessary focus, intellectual activity for more than a very brief time.I have something to say and I cannot say it.
The next post will have good news. I promise.You deserve it after this protracted stream of miserable reports.

February 15th. Cirrus and contrails against a blue sky. A slight haze, a begrudging slightly higher temperature. Snowdrops, crocusses, the promise of daffodils. A day of composing lay invitingly ahead.I was about to leave to go to The Struggle when the telephone rang.The call was from my Medical Centre. I was to go immediately to the Urgent Care Unit at South Trafford Hospital. Immediately? Urgent Care?
Two days earlier I had had blood tests which, it appeared, had thrown up two items of concern.My kidney function needed to be re-assessed and, in addition, my PSA level had more than doubled in three months, from 7.1 to 14.9.I tried to contact Florence. She was unavailable. I did not believe that the spike in my PSA was linked to disease progression, not after all the recent tests, scans and biopsy, but I wanted to know what could be the cause of this sudden dramatic increase.The day had taken a most unwelcome turn.
I thought that I would be familiar with this hospital. Not anymore. Change had taken place.I was a stranger in need of direction and I was duly directed from the UCU to “bloods”.I am slowly becoming familiar with hospital code. Florence had phoned but I had missed her call.
The next day a GP from the Medical Centre phoned to inform me of the results of these latest tests.Grade 3 Chronic Kidney Disease was confirmed.
This weekend I am researching kidney disease with the assistance of Dr. Google.How it might develop, how it might affect me.I am not yet an expert, that might take a few weeks, but I am learning.My present understanding is that it is irreversible and usually progressive. I hope that further research may suggest that this is not always so.
Beware the Ides of February.

After reading my last post two women have responded by offering their spare bras. Thank you L, thank you S. My spirits are uplifted by this thoughtful gesture. My cup(s) are overfilled with your kindness. Your support(s)will be greatly appreciated. But please not lacy or floral, I still have a certain vestigial amount of pride.
On a lighter note. Yesterday I received the first of a three-year period of injections,Prostap SR DCS (11.25mgs)which acts to reduce the effects of testosterone and other androgens thus inhibiting the progression of the cancer. That’s what it says on the can, hope it works in practice.This, in addition to the albeit temporary 300mgs of cyprotene acetate which I take daily. Perhaps I might need those bras earlier than anticipated……
My sincere gratitude to all those who have said how much they are enjoying my recent posts (a bloke from Germany says “Hilarious”). I am resolved not to allow this blog, this record of my journey, (Florence’s term, remember?) to fall into some grim, miserable, cheerless, bleak cancerlogue.Do not misinterpret. Having cancer is not one of life’s delights but there is every day to be lived, an infinite number of things to be enjoyed and laughs to be laughed. Life is too incomprehensible,Delphic, to be taken seriously.

A Way Forward

Monday 5th February. I make an appointment.
Tuesday 6th February. I attend the appointment.
Wednesday 7th February. Treatment commences.

The meeting with Mr.Ramani which precluded radical prostatectomy provoked much consideration about how to proceed.I decide that the six months it has taken to reach this point is unacceptable.It is time to take the initiative. I decide to go private and, as you can see from the above,the process is expedited. What might have taken weeks has taken just a few days.I feel that the time line is critical. I have a tumour that is GS8,somewhat aggressive. My one great advantage is that it is still contained within the boundaries of the prostate.That state must be maintained, if not it will spread to the pelvic lymph nodes, the seminal vesicles, perhaps even to the bones.My prognosis would become much more unfavourable.
I drive to The Christie through snow.It is bitingly cold.
The waiting room is modern, bright, fresh, There is no waiting, no queues.Free drinks, newspapers, foot massage, pedicures,fortune tellers….and I am seen punctually by Dr.James Wylie who is a consultant clinical oncologist specialising in hormone therapy and radiotherapy inter alia.
He knows all about me, is prepared. He knows the name of the doctor who treated me for malignant melanoma 25 years ago.
He outlines his treatment plan.It comprises of three years of Hormone Therapy(HT). After six months I will have a course of 20 sessions of Radiotherapy (RT).The initial six months of HT will 1)reduce the size of my enlarged prostate(I saw the image from the CT scan which showed it to be 2 to 3 times the size of a normal prostate. How on earth did I manage to cultivate that?) 2) shrink the size of the tumour 3)make the tumour more receptive for RT.
Dr. Wylie proved to be irresistibly positive and reassuring. He informed that this method of combining HT with RT would have a similar outcome,as much success as surgery but, importantly, without the risks.
Of course there will be side-effects. Nothing too long-term I hope. HT might see my feet disappearing from a plan view and I might have to decide which colour bra would suit best. RT might necessitate me wearing nappies for a short time. There are other possible consequences but I feel it is best not to go into too much detail here.But it is important for me to state that different people have different side effects. Many have minimal side effects. It’s dependent on many factors. But what a small price to pay for a fix.
The interview is filled with positivity and I leave The Christie feeling quite elated, optimistic, hugely fortunate, remembering others who are not.Today I return to the Christie Pharmacy to collect my meds. First tablets then injections.I find that Dr. Wylie has, with great consideration, returned me to the NHS system.
I am already modifying my diet. I am making the ultimate sacrifice for the cause. I am drinking green tea.
I contact Florence to update her. She is delighted with my news.

Friday 2nd February. A cloudless vacant blue sky, a cold piercing northwesterly. I drive to Withington Hospital which proves to be a modern airy building, a primary care base. It is Lillipution compared to The Labyrinth. My letter of appointment gives directions which prove to be incorrect and yes, once again, I am having to ask the way.

I am here to meet with Mr. Vijay Ramani who is prominent in his field. He is a pioneer, an advocate for the advancement of robotic surgery at The Christie Hospital. He is a Lecturer of the European School of Urology. He has performed 800 – 900 robot-assisted laparoscopic prostatectomies.

There are many advantages of robotic-assisted surgery. These £2m machines have greater dexterity than the human hand, they have a high-quality 3D vision with 10X magnification affording a superior view of the operating field. The 5 or 6 incisions are only 1cm long which results in less chance of infection, quicker healing, less loss of blood and less scarring.

Significantly the survival rate of patients undergoing this state-of-the art procedure is greater than 70% even with patients presenting a GS of 8. There are, as with all operations, specific consequences but the combination of this man with his robot assistant presents an obvious pathway.

Mr. Ramani has a reassuring encouraging easy approach. He listens attentively as I explain the events that have led to this day. His secretary takes notes. He responds comprehensively to my numerous questions, asks for my jottings, pores over them intently, makes comments. But there is a problem. A huge significant problem. I have a pre-existing medical condition which causes Mr. Ramani great concern. Famial Hypercholesterolemia. My father and uncles all had vascular-related events. My father was subject to a DVT the day following a routine hernia operation. He never recovered. I, myself, have had TIA’s (small strokes) and have an accumulation of plaque in each carotid artery resulting in 50% occlusion.

This, says Mr. Ramani, defines me as a patient who would be at high risk both during and post-surgery. I could suffer thrombosis, stroke or possibly not survive. There is a probability that the quality of my life could be severely impaired. He seems not prepared to take this risk. It’s no good getting a fix if I am not able to benefit. Our conversation loses momentum and changes direction. I am to be referred to an oncologist who specialises in radiotherapy.

I sense that my best opportunity has slipped from me. I sit in the spacious,sunlit, quiet corridor feeling uncertain. How critical is this going to prove?
I phone Florence.

(The heading for this post is derived from the title of a 1966 film “Morgan – A Suitable Case for Treatment” which is based on a screenplay by David Mercer and features a memorable performance by David Warner).