by Nancy Peach
“I think you should stop the chemo,” she said. She had observed her senior consultant, Dr Fielding, approach the subject of ending treatment in a diplomatic and non-judgemental way, so she was confident this was the right thing to do, although the television host in her ear suddenly seemed delighted, as he often did when he sensed she was about to screw things up.
“Or…” she tried to back-pedal, “… how about as a compromise, you delay the current round of treatment at least? Give yourself a bit of time to think, to talk to Edward again, to explain?”
There was a pause. Mary looked thoughtful. The television host was quiet, and Tess pushed her advantage.
“That way, maybe you can see how you feel whilst not on treatment and, I don’t know, at least it kicks the decision into the long grass for a while?”
“It’s all a little dependent on how much long grass there is though, isn’t it?” Mary smiled. “But you’re right, a break does seem a very appealing prospect, and it couldn’t do much harm. I think certainly missing today’s session feels like a good idea. I’ve been dreading it, to be honest.” She sat up a little more upright. “I’m going to make an executive decision. Today’s chemo is cancelled. There. I feel better already.”
“Well, get a load of you! Let’s hang out the bunting!” Tess made a little trumpeting noise which masked the sound of the television host hitting his forehead with the heel of his palm, and Mary giggled.
They were both laughing when Edward entered the room. The sudden noise and cold draft of air startled them, and Tess’s smile faltered as she looked towards the door.
“Mr Russell. We were just catching up, weren’t we, Mary?”
His movements were brisk and businesslike as he removed his jacket and folded it over the back of a chair.
“Evidently. Although I can’t really imagine what you might have to catch up on. Don’t mind me; you carry on with whatever was so amusing.”
“Edward.” Mary sat forward. “Don’t be so snide. Dr Carter and I were just having a little chat. Is it against the law to laugh occasionally when one is terminally ill?”
“Not at all. God knows you should find your moments of entertainment where you can.” He turned to Tess but did not make eye contact. “Dr Carter. I must apologise for yesterday’s outburst. You were right. It was not appropriate given the circumstances and the potential audience. It will not happen again.”
Tess could feel a blotchy rash prickling at her neck but reminded herself that this was her turf. Edward’s apology was necessary, and although delivered with bad grace, it was an apology nonetheless. She acknowledged it with a cursory nod and forced a smile onto her face.
As she left the room she saw Edward pulling up the same chair she had been sitting in a few moments earlier and heard him say, “So, Mum. Ready for this afternoon’s session?”
Tess felt an ominous lurch in her stomach.
“Oooh!” said the television host happily. It sounded like he was clapping his hands. “I think this might really kick off!”
Chapter Eleven
Tess had cancelled the ambulance transfer to the hospital and had just put the phone down when Edward emerged from his mother’s room and crossed the foyer in five long strides to come to a halt at the desk.
“So! It appears that my mother is not going to be having today’s session of chemotherapy,” Edward said. “I suppose I have you to thank for that?”
She could see a pulse beating at the base of his neck near his shirt collar.
“It’s not really anything to do with—”
“In fact, it seems she has decided to stop it altogether. The entire course of treatment. I hope you’re happy now?” His fingers were back to their angry tapping on the counter and Tess could see Debs, one of the nurses, look over from the drugs trolley.
“Mr Russell, I think we are both in agreement that this is not a suitable location for this type of discussion. Would you like to accompany me to the office where we can have a little more privacy?” She returned his stiff nod of agreement and led the way down a corridor, past a concerned-looking Janice, to an empty room where she gestured for Edward to take a seat.
“Actually, I’d rather stand,” he said firmly.
“As you wish,” she replied, matching his tone and his stance.
He took a deep breath. “I’m really unhappy,” he began, “with the way that you are influencing my mother. She’s not well. She’s vulnerable. You’re giving her the wrong idea about what’s best for her, and I think you’re letting your own agenda dictate her treatment choices.” He folded his arms across his broad chest.
“My agenda? Right. I see.”
“Yes, Dr Carter, your agenda.”
“Are you… joking?”
“I am most certainly not joking. It seems it’s just you and my mother who think this is a laughing matter.”
“Okay. Mr Russell, the only reason she was so chipper earlier is because she was relieved not to be having today’s session of chemo. I understand that you have concerns, but you’ve got this the wrong way round. I’m trying to help.”
“And I’m not?”
“Well,” Tess paused. “I don’t think this is terribly helpful, to be honest. Have you actually talked to her about it, or asked her what she wants?”
“Do you have any idea how patronising you sound?”
She ignored his comment and tried to maintain a dignified air. “I can see that you’re angry but maybe you need to speak to her again, and listen to what she says. Your mum and I had a good chat this morning. I can’t share the details due to confidentiality—”
“Well, that’s mightily convenient, isn’t it?”
Tess felt her temper start to rise, his absolute refusal to see reason was exasperating. “It’s not convenient, Mr Russell. It’s actually the law. Which I thought was supposed to be your field of expertise? I think it is pretty obvious that my agenda is not the issue here. I don’t even have one, and I’m certainly not the person most guilty of coercion.”
There was a moment of silence and Tess knew she’d gone too far. Doctors were absolutely, categorically not supposed to get drawn into arguments with patients or their relatives. Edward looked furious.
“What are you saying exactly? Do spell it out for me. Despite it being so spankingly obvious, I haven’t quite grasped your point.”
“Okay.” She might as well just spit it out. “I think you’re bullying her.”
They stared at each other for a few moments, both of them arms folded, pulled up to full height, neither wanting to be the one to drop eye contact. The words bullying and coercion sat there like verbal grenades, waiting to explode.
When he next spoke, Edward was cold and controlled, channelling his anger into every syllable. “You know nothing about me. And you know nothing about my family. You seem to think that because we’ve shared a bit of small talk over the weeks, you know about my life.”
“I don’t think anything of the sort.” She tried to keep her voice level but his comments had shaken her badly because he was right; she did feel like she knew him. More than he realised.
“You do. You’ve made your little judgements already, caught my mother in a few moments of weakness, and jumped to conclusions that fit with what you’ve already decided, don’t you see?”
“Now, hang on—”
“No! I will not hang on. You’re busy painting a picture that supports your view of how my mother should choose to live her life, or end it, and you don’t even know her. You accuse me of bullying, Dr Carter? Well, I accuse you of wilful misrepresentation of the facts.”
Tess snorted in disbelief. He really was the most pompous, arrogant individual she had ever encountered. What on earth had she been thinking? Drifting about in a daydream of shared understanding and mutual regard. The gulf between them widened in that moment, and any semblance of a cool, professional demeanour was abandoned (not that there had been much of one to begin with).
“Oh, that’s great that
is,” she said. “Wilful misrepresentation of the facts! You don’t intimidate me with your legalese, Mr Russell. I’m just as clever as you, but I choose to use my knowledge to help people rather than, I don’t know, find gaps in the law that make money for bankers.”
He laughed at her then, a short derisory noise that seemed to come from a well of contempt he had stored up just for her. She realised she was being ridiculous, allowing this to deteriorate into a slanging match about their respective occupations. She had relinquished any moral high ground or advantage she may have possessed.
“And there we go.” Edward’s tone was almost triumphant, as if her words had confirmed all of his worst suspicions. “That says it all. You find me and my career choices somehow morally repugnant; as if it’s only you who understands about life being tough, you with your clichéd gritty-upbringing chip-on-your-shoulder. It’s pathetic, frankly.”
“That’s simply not true.”
“Isn’t it? Really? We’ve talked about this before. I don’t see why I should have to defend my financial situation or my career choices to you, but your prejudice is obvious. And it demeans you.”
Tess felt a flicker of self-doubt but quickly dismissed it. He was in the wrong here and his accusations of inverted snobbery were just further evidence of his bullying behaviour. Classic deflection. She was doing the right thing sticking to her guns, she felt sure of it.
“This whole notion you seem to have about my life being somehow easier than yours,” Edward continued, “is so embarrassingly unimaginative. You think you have this broad worldview, a knowledge of hardship and suffering, but you don’t understand any of it.”
“I’m not sure how this is relevant. You’re just being rude now.”
“And you don’t think it’s rude, the way you’ve spoken to me? Not to mention incredibly unprofessional. I think it’s fair to say you’ve overstepped the mark.”
“That’s completely—”
“No. Let me finish. You have already made your feelings about me and my family abundantly clear and I want you to have nothing further to do with my mother’s care. I will be requesting that she sees a different doctor in future.”
He turned and walked towards the door but waited on the threshold, his voice quieter and somehow more dangerous: “If she decides to stop the treatment – treatment that we know could cure her,” he paused, “and if that decision is down to you and your misguided advice… then you will have to live with the consequences. And you will have to consider whether it’s appropriate to continue practising medicine with her death on your conscience.”
Rage was etched into the lines of Edward’s face and he glared at her for a moment before letting himself out of the office, leaving a stunned Tess to crumple into her chair like a beaten dog. What had she done?
Chapter Twelve
Edward had just finished his phone call to Dr Fielding and was feeling a little calmer when the alert beep came through on the hands-free set and his sister’s number flashed on the central screen.
“Eddie, it’s me.” Her voice cut through the static with a slight delay.
“Madeleine. You all right?”
“Yes, you driving? Okay to talk?”
“No problem, I’ll just pull over. What are you doing up? It must be the crack of dawn.”
“Six in the morning, to be precise, and I’m completely exhausted. Annabelle’s being a little beast; she was up at five wanting to choose outfits for a party. Don’t laugh. I’m bloody furious.”
“You sound it.”
“I’ve plonked her in front of the telly now, dressed in some frightful combo. Given up trying to get back to sleep. Thought I’d call you instead. How’s Mummy getting on?”
“Oi! That was my space, you bastard… Sorry Mads, give me a minute. I’ll just slip in… here. Good. So, yes. Mum. Well. Long story. She’s decided to give up on the chemo, at least for now.”
“Oh!”
“Quite.”
“Given up? What, completely? Why?”
“Well. I suppose because it makes her feel like shit, but I reckon this Dr Carter, who seems to be on some sort of moral crusade, has had a hand in the decision. Just exactly the sort of misguided, clumsy approach you’d expect.”
“Sorry darling, reception’s shocking. Is this the doctor you talked about before? I thought you rated her? Mummy thinks she’s wonderful.”
“That’s part of the problem, isn’t it? They’re too close. There’s not enough professionalism. She’s admitted it herself, this doctor. She’s already said that she’s not good at keeping her nose out of other people’s business or understanding professional boundaries, and she’s proved her own point nicely. It just happens to be at Mum’s expense.”
“Really?”
“She’s got this bee in her bonnet about Mum’s right to choose. And it’s all terribly earnest and patronising. You can imagine.”
“Well. Ye-esss. But, Mum does have a right to choose, Eddie.”
“I am well aware of that, thank you, Madeleine, but she’s not exactly in a good place to be making those decisions at the moment, is she? She doesn’t feel well, it’s all a bit overwhelming, and so she’s really susceptible to persuasion.”
“And, you what… you think she was persuaded?”
“Well, yeah. I’m sure this doctor thought she was doing the right thing, but her interfering has caused real problems. You know as well as I do that if Mum doesn’t carry on with the chemo then that’s it, we might as well hold our hands up and admit defeat, game over.”
“Umm… Is it really that cut and dried? I don’t know, maybe if she doesn’t want to do this then perhaps we should listen to her?”
“Christ, Madeleine. I’m just trying to keep her alive, for God’s sake.”
“All right! Calm down. I just meant that maybe we ought to consider letting her take a bit of a break, if that’s what she wants?”
He sighed. “A bit of a break could make a massive difference. You weren’t there. You didn’t hear what the oncologist said, but the stats aren’t good if she stops now.”
“The stats aren’t good full stop, though, are they, darling?”
“No, but at least there’s a chance. He seemed to think it could cure her entirely if she continued the treatment.”
“Is… is that actually what he said? Because I was under the impression that a cure was extremely unl—”
“Sort of. He implied it. God! Why am I the only one who seems to be interested in Mum’s actual survival here?”
There was a pause broken only by static.
“That’s not fair.”
“I know,” he said. “I’m sorry. Look, I understand it’s hard for you stuck over there on the other side of the Atlantic, but the trouble is, you aren’t seeing this first hand like I am. She’s… she looks so bloody ill.” He smacked his hand against the steering wheel. “If you could see her you’d think differently. I mean it. I keep feeling like she’s a ticking time bomb and if we don’t do the right thing, don’t make her see what’s happening, she might just sleepwalk her way out of life altogether. We can’t let that happen. I just don’t know what to do.”
“How about if I speak to her?”
“Yes, that would be good. I think she’s a bit pissed off with me. Not as pissed off as she’s going to be when she finds out I’ve shouted at her favourite doctor though.”
“You didn’t really lose it, did you?”
“No! I did not lose it. I was very calm and collected actually. Don’t worry. Anyway, she needed putting in her place. She’s got a massive chip on her shoulder.”
“Well, if you’re sure. I can’t help but think it’s not going to be terribly useful if you end up alienating the very people who are looking after our mother though.”
“For God’s sake, Madeleine. I’m having to make all the decisions at the moment and I really don’t need a telling off from someone who is not actually here. It’s not that long ago you were giving me loads of shit about
not being involved enough, and now it feels like—”
“All right, fair point. Although could you keep a lid on the language, darling? I’ve just put you on speaker-phone so I can help Annabelle with her feather boa.”
“Her feather what?”
“Don’t ask. Look, I’m trying to arrange flights so that the kids and I can all come over in a few weeks, take some of the pressure off you for a bit? Are you going to be able to manage until then?”
“I suspect I’ll have to, won’t I?”
“Eddie…”
“Sorry.” He sighed.
“We’ve talked about this before. You know how guilty I feel about not being there. Please don’t make it worse.”
“Madeleine, to be fair, you were the one dishing out the guilt trips until recently, making out the whole thing was my fault, as if I could have prevented Mum getting cancer by popping in to see her more often.”
“I know. I’ve said I’m sorry. And I meant it. There is no sense in either of us doing anything but working together on this, so please let’s not rake all that up again? I’m worried about you as well. It doesn’t sound as if you’ve got any way of offloading this. Are you talking to Clara about it all?”
“It’s not really her thing.”
“What the fuck’s that supposed to mean? No, Annabelle, ignore Mummy, I was just sneezing. How can it not be her thing, darling? It’s not really anybody’s thing, for God’s sake!”
“No but she… she doesn’t like talking about it. Says I’m dragging her down, being morose. She’s right too. I am a proper grumpy old bastard at the moment.”
“Even more than usual?”
“Even more than usual. Yes. Thanks.”
“Well, please call me if you want to talk about stuff, or maybe think about speaking to a counsellor or something?”
“This isn’t America. We don’t all need to see therapists.”
