Matilda Tristram has written a beautiful account of what it's like to find out you have colon cancer when you're 17 weeks pregnant. I called it a "graphic novel", which she delicately corrected to "comic". You get a sense of the person she is from that terminology. She's modest, yes, but what's more striking is her wry, determinedly unhysterical way of looking at things. Even if I could conceive of how hard it would be to go through a pregnancy while having chemotherapy, I would never be able to understand how you could go through all that and not freak out.
Sitting in the Hackney flat she shares with her boyfriend, Tom, she insists that she does freak out sometimes. "I do feel really unlucky, and it's hard not to be self-pitying. Especially with cancer, there's a whole lot of positive-thinking guff around it. People always talk about it as something you're battling or fighting, and if you don't think positive, it's going to come back; people imply that if you're a positive person, your body is better at dealing with the disease. It's all a bit" – she pauses, as if to consider and then reject 17 different swearwords – "suspect."
The illustrator got pregnant aged 30 – "It wasn't planned, but we were both really happy" – and the pregnancy proceeded for nearly four months without incident. Having studied animation at the Royal College of Art (after her first degree in Brighton), Tristram was working on various CBeebies shows. Regular children's tellyheads will probably be most familiar with The Adventures Of Abney & Teal, a magical animation for under-fives, dreamlike but full of unexpected, hard-to-explain humour. Tom was working part-time as a childminder, and they were co-writing a children's book about a beard.
Looked at from the outside, this life seems to have been absolutely built to accommodate a baby (the couple even work from home), but she looks surprised at the suggestion. "We hadn't ever really talked about having children," she says.
In a sense, this story without the illness in it would be way too perfect, which is one of the compelling things about Tristram's illustrations. They're direct, they're subtle, they seem simple, but they aren't (the balance between humour and fear is very taut) and, above all, they're generous, allowing the reader to treasure the world of regular good health by giving them the view from outside so poignantly.
Despite being so sceptical about that cancer cliche – in which you wage a war, your high spirits against its cellular mutations – Tristram seems, by nature, prone to looking on the bright side. "Even though it's a terrible thing to happen, they do keep saying how lucky it is. It's really lucky that the tumour completely blocked my colon, because it meant they could find it earlier. Also, the timing of the pregnancy: if it had been discovered any earlier, I would have had to have an abortion, because chemo in the first trimester is a complete no-no. And if it had happened any later, it would have been much more difficult to operate and not disturb the baby."
In the event, Tristram became ill when she was 15 weeks pregnant. There was a grim hiatus when everybody dismissed it as a digestive problem related to the pregnancy, despite the fact that she was lying on the floor of A&E to alleviate the agony. Then a tumour was diagnosed and tests were carried out. Since then, the medics have been amazing and the decisions the couple have faced have been horrific. "The oncologist is great," Tristram says. "She's very direct. The surgeon's brilliant – he's a very caring guy. He's expecting his first baby, too." (She tells me later that they'd like to name their baby after him. He's called Sanjay. We consider for a second whether it'll look like they're trying to misappropriate a heritage. I think probably not…) "They were very shocked that the tumour did come back as being cancerous, and they weren't all in agreement about what I should do. So it was really up to me and Tom to do our own research and decide."
On Tom's birthday, they were presented with three options: the comic depicts it very sparsely, little floating heads looking confused while the oncologist gesticulates, being as frank as she can. "Have chemo now and risk damaging the baby. Abort the baby and start chemo after that – and I must make you aware that the chemo might make you infertile. Or delay treatment until after it's born."
Their immediate reaction was to go up the Shard (they'd bought tickets months before), and decide to get married. Later on, she says, "we Googled like mad". They looked up the risk to the foetus of chemotherapy, "and it's only slightly higher: 5% of normal babies have problems and 10% of those whose mothers had chemo have problems. The problems didn't seem very bad; it was things like a flaky patch of skin on the baby's head.
"At the time, all the options seemed completely awful, but now it seems a lot less bad. Even though it feels risky, it's really nice to have a baby to be thinking about when I'm in a chemo room, surrounded by 80-year-olds who all look really miserable. In this air of death, to have new life to be thinking about is really helpful." The baby is due in July.
The decision to write a comic about the process was a complicated one – Tristram had put elements of her life into her work before, but she had never done anything so directly autobiographical. "Lots of people I don't know very well email wanting to know how I am, and how the chemo's going. To have something that I can show people is great. And I think they're able to see and understand what's happening."
It's such tricky territory – she doesn't want to be rude about the well-wishers. Who'd be rude about a well-wisher? "But some people do react weirdly. There's a lot of head-tilting pity and sympathy, and they talk to me quite nervously. It makes me want to be flippant about the whole thing, to put people at ease."
But that doesn't mean writing the comic allows her to seize the initiative over the disease. "I don't feel very in control of any of what's going on at the moment. I feel a bit like a broken car, passed from mechanic to mechanic. I just do what they tell me to do. Maybe doing a comic makes me feel slightly more in control of my thoughts, so that I remember the things that are worth remembering – there are some things I don't include, because they're just too grotty or nasty. But I also feel quite detached from my body. It's growing a baby, my cells are doing all these things at a molecular level that I know nothing about. It doesn't feel like the body that I know. They can be siphoning pints of bile out of you, and cutting bits out of you, and a few weeks later you're fine again. It's really amazing."
As soon as she got her diagnosis, Tristram invited her parents over, along with Tom's. She depicts an exquisitely awkward meeting during which the dads had to be set to DIY, otherwise they would all have just sat around wondering whether or not to talk about cancer – the upshot of which was that they assembled her an exercise bike, which sits pristine in the corner of the room.
"It's because the oncologist told me that, after chemo's finished, I should exercise for 40 minutes a day, every day. Eat 10 portions of fruit and vegetables every day." She makes a face that is a mixture of diligence and vexation – she was eating plenty of fruit and vegetables already. She doesn't need any naturopaths to tell her that shiitake mushrooms are good for you.
The cancer came out of the blue. "It is really unusual for someone as young as me, also unusual for someone who's pretty healthy, who doesn't drink or smoke." Yet there is a sense of blame that hovers over cancer, even in people so young that they haven't had time to develop an unhealthy lifestyle. I put this down to a hyper-individualised, tabloid‑ish message: "Eat enough tomatoes, and nothing bad will ever happen, and you won't have to empathise with anyone."
Tristram is much more philosophical: "Some people feel like they're in control when they grate lemon over everything they eat, whereas you're not in control of which chemotherapy drugs you're taking."
Anyway, most people don't get in touch with lifestyle advice or anything related to raw fruit. A lot of Tristram's friends have been really great, whether or not they know what to say. The people who have an optimistic story to tell are even better. "One girl's dad, all his body hair fell out but his beard and his head hair stayed on. I thought that would be great. You try so hard to remove your body hair, usually. Another girl emailed whose friend of a friend had exactly the same as me, and she was pregnant as well. She had her whole colon removed, but she's fine now."
Apart from how funny Tristram's comic is, it's hard to pinpoint what makes it so magnetic. Its mood is quite mercurial, but you can't follow it without questioning your own interest. If it were just voyeuristic, that would leave you feeling a bit of a scumbag. But there is something in the way it's pitched, the deft gear changes, the honesty, that makes you feel, as a reader, like a companion on her journey, rather than a spectator.
Tristram is quite droll about the demands of the narrative, and describes the distance it puts between her and the disease as a kind of relief. "What I really want at the moment are distractions. Writing the comic does feel like dwelling on it, but that's the one thing I don't mind dwelling on. I keep thinking, 'God, it would make a better ending if I died.' And then having to think, 'No, no, that's not a good ending.'"
• For more from Matilda Tristram, go to mmaattiillddaa.com/
