Precious Lives Page 8

  All that was many years ago by the time she found herself in hospital again, but the habit of supporting those she loved had continued to be ingrained. Her father had died years before, and even her mother was dead now; her siblings were all married with partners to whom they could turn instead of to her, but still she was the linchpin of her dispersed family. She thought of them before she thought of herself, but now their dependence had to stop. She couldn’t protect any of us from what was happening to her and we didn’t want to be protected. We wanted to help, even if we were all woefully aware of how inadequate our help would be. Going back to London in October was a relief, for me, because it meant an end to the frustration of enquiries by telephone and, instead, some possibility of being actively engaged in helping Marion. I said as much to my father before we left – ‘At least I’ll be there, at least I’ll be able to do something.’ His reply was, ‘When is Pauline coming?’

  Once home, I was not prepared to keep all news about Marion out of my weekly letter to my father, though I never mentioned her in phone calls. The phone calls were always just chat about the weather and whatever was in the news, but the letters were a record of my week and no record could now be complete without mentioning Marion. But I didn’t want to annoy or depress him, so I was restrained and careful and stuck to facts which told very little. I wrote that I’d been with Marion to the hospital where she was to receive her radiotherapy treatment, to see the doctor who would be in charge of it, but I didn’t describe the visit. I didn’t tell him of the misery of the visit, of the tension and sadness it generated. Such an airless basement we made our dispirited way to, such a dreary route down rubber-edged stairs and along low-ceilinged narrow corridors. And when we got there, to the waiting area, there were no vacant chairs or benches. For the first five minutes we were obliged to stand. Nobody looked at us, nobody stared, nobody showed any curiosity. They were all patients waiting for treatment, each withdrawn, some in what seemed a kind of trance, sitting with hands on knees or arms folded, staring straight ahead. Nobody spoke, nobody read. The only activity seemed to be looking constantly at wristwatches. A chair was vacated and Marion took it and got out her newspaper determinedly. It was hot, but she didn’t take her coat off and neither did I. It would have felt too much like making ourselves comfortable for a long wait and we didn’t want to acknowledge we might have to wait long; we wouldn’t concede it was inevitable. Nurses came and went, calling out names. There were coughs and sighs, feet shuffled, chairs scraped, eyes were closed, heads tipped back. It didn’t seem wise to look too closely at anyone, for fear of what might be revealed, for fear of having to confront abject despair. A great weariness smothered the room and gradually we were being suffocated.

  Marion was sent for after a mere twenty minutes and we were led to the doctor’s office. It was a small, drab room holding a desk with two chairs in front of it and one behind. We were invited to sit down but not to take our coats off. Time was precious: we mustn’t be deluded into thinking this was going to be anything but a brisk five minutes. We were humble. We understood that, and we had prepared ourselves accordingly by making out a list of vital questions that Marion wanted answered. I had the sheet of paper in my pocket together with a pencil to write down replies. Whatever this doctor said, I was going to make her repeat it and then I was going to write it down, knowing as I did how memory could play tricks in cases like this where the listeners were so fraught. Marion had been worried about this. ‘The doctor might not like it,’ she’d said. ‘The doctor can lump it,’ I’d replied, and she laughed, hearing echoes of herself.

  This doctor was a youngish woman. That must mean she was particularly brilliant, I thought. Hard enough to qualify as a doctor, doubly hard to have reached such a position in a London teaching hospital. But she certainly did not seem brilliant at establishing a relationship with a patient. She was perfectly pleasant but avoided eye-contact and never once expressed sympathy with Marion. Her attitude seemed offhand, almost flippant. Maybe this was a pose she’d perfected to cope with potentially emotional encounters; maybe she had to behave like that in order to get through these stressful sessions. At any rate, she plunged straight into an account of how the radiotherapy would be administered, talking rapidly and constantly opening and shutting the drawers of the desk, though never revealing what she was looking for. She sucked a mint during her homily, but at least offered us one each from the ragged packet. We politely declined. She said the air got very dry here. We agreed. She asked if there was anything else we wished to know which she hadn’t covered. Anything else? I produced my bit of paper. We hadn’t started yet.

  One by one I went through all our queries, which were mostly to do with how Marion was likely to react to each session and how much pain or discomfort she would experience as the treatment continued. The replies seemed carefully non-committal, full of ‘it depends on this’ and ‘it depends on that’, and ‘everything varies according to the patient’. Some could tolerate the effects much better than others, and so on. The doctor was beginning to sound quite up-beat until I moved on to the two questions Marion most wanted answered. The first was whether the doctor would give her a realistic assessment of the likely success of all this radiotherapy; and the second: ‘Had there been, originally, a misdiagnosis?’ The doctor swallowed the last sliver of her mint and sat up very straight. She picked up a Biro, drew a sheet of paper towards her and began to sketch something before turning the paper towards us, while still answering the first question (an answer so wonderfully vague and full of imponderables as to be useless). While she continued to talk rapidly, we stared at her diagram, unable to understand her drawing but understanding very well that she sounded defensive.

  It was bothering Marion at the time that if the nose tumour had been diagnosed as malignant earlier, when she had first been sent to hospital – after complaining to her doctor of that ‘something’ in her nose – her life might not now be in danger. She knew perfectly well that blame was irrelevant now, but she wanted to know the truth. She also wanted to know if the initial excavation of the tumour had not gone far enough. The doctor’s drawing was to demonstrate the normal depth of tissue removal and then how in Marion’s case the malignancy had in fact spread deeper without showing any signs of having done so. ‘Unless,’ Marion said, quite sharply now, ‘the surgeon had gone deeper.’ The doctor said that there were no indications that he needed to. It was just bad luck. Marion said she might take this enquiry further. The doctor shrugged. It was up to her. She stood up, making it clear it was time for us to go. Out in the cold street, Marion seethed. She was sure a cover-up was going on. She knew it was tedious and pointless to persist in trying to establish the truth, and that she would waste a lot of emotional energy she could scarcely afford to spare in doing so, but she couldn’t give up. It was her life and she wanted to know – even if it made everything worse – whether it had been put in peril through an oversight.

  It was tempting to suggest that, as things now stood, there was no point in going backwards. The surgeon had already told her that the cancer had probably spread even before the tumour was found. But the exact sequence of events mattered to Marion and so it was impossible to dissuade her from beginning an investigation of her own, starting with the demand to see her medical notes. She talked incessantly of this, with rage, but then when the radiotherapy actually began she had no energy for it (though the correspondence with the relevant authorities still went on in the background). The sessions were an ordeal for which she was mentally ill-prepared, though she had technically been told what to expect. The worst part was the wearing of a mask made of some sort of see-through plastic which tightly covered her face leaving only tiny holes for her eyes and nostrils and mouth. Even having the mask made had been bad enough, but now, when she had to have it fitted, she felt so claustrophobic she was almost hysterical. It was always so fiddly to fit – it was marked with red, green and black lines which had to be in perfect position – and the nurses would fuss and f
ret over it until they had it on exactly right. Once it was on, the radiotherapy itself was quick, a mere few minutes, and then she was free, until the next day.

  But very quickly she began to suffer from the effects and much more severely than had been predicted. The roof of her mouth felt as if it had been scalded and swallowing was agony. Liquid she could manage, with difficulty, but solid food, however soft, had to be forced down. We dreaded watching her eat. Not a single sip or crumb could be got down without her face reflecting the searing pain. After nearly three weeks of this she was coming home each day from the hospital fit to do nothing but lie on her bed and weep. Yet she was not going to give up, absolutely not. She’d been told by the nurses that lots of patients receiving this kind of treatment gave up halfway. They simply didn’t turn up one day – it was all too dreadful, surely life was not worth this torture. With three more weeks to go, Marion fully intended to continue, but she didn’t know if she had the strength. Frances, with her all the time, was at the end of her own emotional resources. Together they were both near to collapse by the beginning of December.

  The week of my father’s ninety-fourth birthday (celebrated with my brother and his wife, who always went north for it), Frances went away for a short break, to stay with a friend, and Marion came to us. She was used to staying with us and had done so many times, so there was nothing strange about it for her. She was quite at home. But what was strange, horribly strange, were mealtimes. She was trying to make sure that the little food she managed to eat was as rich as possible in protein because she’d been warned she might have to exist on fortified drinks only during the last two weeks of the radiotherapy. There she was, the woman for whom it had always been a joy to cook, sitting at our table patiently spreading rich pâté onto minute scraps of soft white bread, diligently spooning mousses oozing with cream into her poor mouth, slowly ladling thick soups down her burnt throat and all with a look of terror on her face, anticipating the acute pain that every bit of nourishment would bring. But to live she had to eat and to drink. Life had to be worth the pain. Something that had once given her such pleasure was now only a painful way of staying alive. And she wanted to stay alive at any price. How high could this price go? I had no idea, but watching her, watching the sudden collapses into tears after each meal was over, I wondered just how long even a determined person can go on, and why they would continue wanting to.

  I hardly dared to mention the word ‘hospice’. Hospices were for the dying. If I suggested Marion went into a hospice it would be interpreted as a sentence of death. But I knew hospices were not just for the dying. I knew, through a friend who worked in one, that they were also for respite care for those suffering from cancer. Patients could go in for a couple of weeks and come out again. I rang my friend and asked if there was even the most remote chance that the hospice where she worked in Hampstead, the Marie Curie Centre, would take in Marion so that she could survive the rest of her radiotherapy treatment. She said she was sure there was and would herself set admission procedures in motion if Marion was agreeable. I rehearsed what I was going to say, how I was going to explain the benefits of going back each day from the radiotherapy to a place where people would know how to look after a person in her condition. But I didn’t need to recite my lines – both Marion and Frances burst into tears of absolute relief. They had a bag packed in a flash and within twenty-four hours Marion was settled into a room in the hospice with immediate advantage. Because of the angle at which she had to keep her head and because of the soreness of her neck, she hadn’t been able to sleep. But once in the hospice a system of special pillows was devised which made her comfortable. It was all, in fact, a question of comforts – each one small but the sum total adding up to the feeling that she was in expert caring hands.

  There were some treatments the hospice offered which were not small but quite large comforts. One was aromatherapy. Marion loved this. She had the kind of massage called effleurage, which consisted of the oils being applied with the flat of the hand, the fingers close together, the tips turned upwards, smoothing across her sore face and neck very, very gently. The room where she had the massage was warm, the atmosphere relaxed, and she lay on a comfortable bed covered with a warm towel, her eyes closed, trying to picture a summer garden or the sea, the Mediterranean, as the aromatherapist suggested. She loved the scent of the particular oils used – peach kernel, evening primrose, lavender, rosemary, geranium and bergamot. She felt soothed by the massage and, after it was over, for a while she would feel generally refreshed. She knew, of course, that this aromatherapy couldn’t conquer the cancer but nevertheless it helped her to stay sane and calm, and that was important.

  But hypnotherapy, also on offer at the hospice, proved even more important. Marion had always been attracted to the idea that the mind could control the health of the body (hence her early interest in Christian Science), and also to alternative medicines. Once she knew she had cancer she wanted more than ever to believe in anything that came into these categories and before her time at the hospice she had already experimented with acupuncture. For several weeks a man came to her home to administer it and also left her with various herbs which had to be infused and drunk as part of the treatment. I infused them when she stayed with us. They stank and tasted vile but Marion was still devoted to them and dutifully swallowed the concoction as well as having needles stuck in her. But then she’d caught this man appearing to smile when she winced with the pain the needles were causing her, and had told him not to come again. She was finished with acupuncture. It might work for others but she had no evidence it was working for her and it seemed ridiculous to add unnecessary suffering to what she was already enduring.

  But hypnotherapy caused no suffering, and at first she really believed it was helping her deal with her fear and panic. She was taught certain mental exercises which she had to put herself through whenever she felt overwhelmed with despair, or so tense she wanted to scream. She didn’t think she was actually hypnotised, but that she was brought to a state of semi-consciousness which made her receptive to suggestions that she should let her worries go. She said she felt dreamy and seemed to float away, though she knew where she was, and who she was, and was certainly not in any kind of deep trance, and that she liked this. The rest of us, sceptics all, were simply pleased she was finding any kind of relief. There were still three weeks of radiotherapy to go and she needed all the help she could get.

  III

  MY MIND, AT the end of 1994, was barely on my father. I dutifully made the twice-weekly telephone calls, keeping up the family rota we had established, and wrote my weekly letters. But my thoughts were entirely with Marion. Pauline, my sister, who herself had known Marion almost as long as I had, knew this and understood perfectly. In any case, Pauline regarded herself as the main one of us on duty, as it were, during the winter months, because I was there to cover the summer. She was ready and willing for any emergencies even if Marion had not been so ill. At the end of the first week in December, directly after my brother had been with him for his ninety-fourth birthday – a quiet lunch out at a favourite pub in the Eden Valley – and just as Marion went into the hospice, an emergency arrived.

  None of us was aware of it at the time, but throughout November my father had been feeling ill, or rather ‘A’ had. He stayed in bed a lot while ‘A’ was ‘so-so’, following the usual routine of staggering up to take the evening telephone call and conceal his condition. His voice did indeed sound fainter, but when we picked up on this he’d say he had a slight cold but was managing. Which he was, in a fashion. He was still slapping bacon in the frying pan, still switching his ‘merser’ off and on, still keeping all systems at go, but increasingly liable to collapse – perhaps onto his tiled hearth, where he could have cracked his skull open. He told only his diary that ‘A’ had ‘Trouble. Water. Colour Red’ again. The last diary entry he ever made was for 7 December – ‘Sunshine. Dry. Cold day. Waiting for Doc. Sport on Radio. A. not so good.’ It was Pauline�
�s turn to telephone him that day and, hearing the faint whisper of ‘I’m managing’, which was all he could produce, she was not fooled and did not hesitate. She went at once, suspecting this was the real crisis point we’d been dreading.

  The doctor decreed my father would have to go into the infirmary. His knees were massively swollen, there was blood in his urine – his medical notes report him as telling the doctor his bathroom that day had looked like ‘an abattoir’ – and he was in urgent need of skilled attention. Pauline told me he was ashen and weak and without resistance. He’d had no energy to fight against admission to the infirmary. ‘Push me over the edge of a cliff, then,’ he’d said, ‘and have done with it.’ They took him to the infirmary in an ambulance. They carted him off to Ward 20, a fate he’d contemplated with horror. But Pauline’s arrival made an enormous difference – in his words, she could talk to the nurses and set them right. Luckily, she didn’t have much to set right. All my father’s memories of what the geriatric ward of the infirmary had been like when he visited his dying father there vanished. Ward 20, for a start, wasn’t a geriatric ward. It was a general male surgical ward in a new wing and he had his own little cubicle which gave him some privacy. Even better, it was near the sister’s desk, where there were constant comings and goings, so he had plenty of action to watch. He settled in wonderfully well, against all expectations. Instead of being difficult or surly he was obedient and polite. The nurses liked him. He realised this and he behaved even better, discovering from some place deeply buried within him a charm never witnessed before. ‘A’ was a model patient with a model daughter constantly at his side, with flowers and letters and postcards arriving every day, and with a small but steady stream of concerned visitors. He was well looked after and well fed and perfectly comfortable. To his own astonishment, he found himself quite content to lie there while his ailments were investigated and, as far as they could be, treated. Sometimes Pauline managed to wheel a telephone to his bedside and I spoke with him and could hear how amazingly buoyant he sounded.