But on this particular day, as Mum was walking down the high street, out of nowhere someone tripped her up.
Apparently, it was a young man running to catch a bus. Mum was walking in front of him at the time. The man tripped her from behind by clipping one of her heels. She fell down on the ground. Fortunately, she fell in such a way that she managed to avoid hitting her head. The young man failed to stop. He shouted, “Get out of my way, old woman, I’m late for work.” He subsequently caught his bus. The incident was over in a split second.
Bystanders helped Mum up from the ground. She was visibly shaken. “I just want to go home and have a cup of tea,” she said politely. She thanked all the people who helped her. She brushed her coat down and, without any assistance, walked home by herself.
I was at work during the time of the incident. When I phoned her during my lunch break, she reluctantly told me she had fallen. But she insisted there was nothing to worry about. I immediately rushed home and discovered she had bruises on her elbow and around her face. It was as if she had gone three rounds with the boxer Mike Tyson. She didn’t want to go to the local hospital. In fact, she didn’t want any fuss made over her.
Soon after the fall, I noticed Mum wasn’t her usual self. She was anxious, fearful, and apprehensive. It was unlike her. She had suddenly lost her confidence. Since her fall, she would gaze out the kitchen window each evening, waiting for me to arrive home from work. She kept pleading for me to come home early.
On Tuesday, 1st April 2014, I suffered a bout of food poisoning. I laid in bed in agony. All I could remember is feeling sorry for myself.
At the exact moment I was delving deep into my own self-pity, Mum started to develop diarrhoea. We both naturally thought her diarrhoea was somehow connected to my food poisoning. That day, Mum asked me to go to the local pharmacy in order to buy some anti-diarrhoea medication. We both took the tablets, but whilst my diarrhoea stopped in a few days, Mum’s continued. The tablets simply had no effect on her.
Mum’s diarrhoea persisted for at least a week. Then, soon after, she started to feel constipated. I subsequently bought some constipation tablets from the pharmacy. They didn’t work either. Mum was now in considerable discomfort. At this stage, we didn’t know what to do. I then started to notice Mum was leaving her meals. She had never had a large appetite, but I could see she was not eating normally. I also subsequently discovered she was not eating during the day when I was at work.
I could see her symptoms becoming more acute since the fall. There was no doubt in my mind that Mum’s fall was the event that triggered her sudden deterioration. Looking back, I am sure the fall was the catalyst for the cancer cells to accelerate their growth within her body.
I tried to explain to her that it would be a good idea to see a doctor. But she refused point blank to be medically examined. Day after day, I would beg her to go. But the more I kept on pleading with her, the more stubborn she would become. I simply could not get through to her.
“Stop fussing over me,” she kept saying apologetically.
“I’m your son. I’m always going to fuss over you. I care,” I repeatedly replied.
The situation deteriorated. We would often get into a standoff situation. I would often become frustrated, exasperated, and annoyed with her. Sometimes, I would slightly raise my voice to her. Then at night, I would lie awake feeling guilty for having these emotions in me. Night after night I barely slept, thinking about how I could convince her to see the doctor. I just could not find the right vocabulary that would persuade her. I felt I was letting Mum down.
The next day, I arranged for the next-door neighbour to come round and see Mum. Even the neighbour couldn’t persuade her. Mum wouldn’t even listen to her brothers or sisters, who again pleaded with her to be examined by the doctor.
“I will go in my own time,” she said. “You are worrying about nothing. We are just going to waste the doctor’s time.”
“Do you think I am going to leave you like this?” I exclaimed sympathetically.
The reality, of course, was that Mum was in denial. And there was nothing I could do about it.
Despite her refusal to see sense, I could see she was anxious, scared, and fearful of what the doctor might say. Deep down inside, she knew something was wrong with her body. Also, I believe she was genuinely embarrassed. She did not want to talk about medical matters below her waistline. Given her age and the generation she grew up in, in hindsight, I should have understood more about the level of her embarrassment and self-consciousness. I regret this now.
I made an appointment to see a private medical consultant in order to seek his professional opinion, as to whether I could force Mum to see a doctor. I did so without her knowledge. It was my final attempt to help her.
He advised me that unless I had the power of attorney, I could not force her to seek medical treatment. “It appears your mum is of sound mind,” he concluded. “She is not incapable of making decisions. She is not suffering from dementia or Alzheimer’s disease. Mark, there is nothing you can do. You just simply have to accept her decision.” He solemnly concluded.
The next day, I could see that she was becoming more and more breathless. She could hardly manage to walk. Even getting up from the sofa into a standing position required every ounce of her strength. The turning point came one day, when she could not stand up from sitting on the sofa. She needed my assistance. I wrapped my arms underneath both her shoulders and then, with a gentle push, I lifted her up.
She then finally accepted that she was ill. That in itself was a blessing. In total, it took four weeks for Mum to go reluctantly to see the doctor.
I was so pleased and relieved that she had made the decision. Although I was reassured that she was finally in the healthcare system, I knew her journey had only just begun.
It was Friday, 2nd May 2014. The doctor’s surgery was about a fifteen-minute walk from home. With Mum clinging to my arm, we arrived five minutes before her appointment. Mum grumbled and muttered repeatedly throughout our walk, “I don’t want to go to see the doctor.”
When we finally arrived, we had to queue to see the doctor’s receptionist. It was going to be the first of many memorable and precious moments I can recall.
The receptionist asked Mum which doctor she wished to see.
“Doctor Coleman,” Mum replied.
“We don’t have a Doctor Coleman working here. When was the last time he saw you?” The receptionist politely asked.
“In 1981,” Mum replied with a deadpan expression on her face.
The receptionist looked amazed. I started to grin discreetly, which then immediately turned into a smile.
In so many ways, Mum had been blessed because she had never really been ill for the vast majority of her life. She simply did not entertain going to the doctor for anything. She did not have any women’s health screenings throughout her life. She would always say to me, “Your health is your wealth. I’ve never had money in life, but I’ve had my health.”
Given what I know now, it is highly likely that the colon tumour had remained dormant and silent for many years inside her. Every cell in our body contains DNA. In Mum’s case, the gene mutations of these cells, unbeknown to her, were building up slowly over decades.
Eventually the cancerous cells accumulated to such a mass, over a very short period of time, they started to eat away at her vital organs.
Without ever having been medically assessed, cancer could have cost her life at a much younger age. In this respect, Mum won the jackpot in life. Not in monetary terms, but with the span of her good health throughout her life.
Thankfully, the doctor saw Mum on that day. We waited about an hour in reception and then the doctor called out her name. She wanted to see the doctor alone. “I am here waiting for you,” I said, continually reassuring her. I waited in reception as she shuffled into the doctor’s room.
Within fifteen minutes, Mum came out. She sat down. “The doctor looked very serious. I think
I have diabetes,” she worryingly concluded.
The doctor immediately referred her for an urgent appointment for a combined colonoscopy and endoscopy followed by a consultation with the oncologist consultant at St John’s Hospital.
“We just have to wait and see what they say at the hospital,” I replied calmly, trying to reassure her. I knew, however, that her condition was far more serious.
Back home, we needed to make some quick decisions about our living arrangements.
At this stage, Mum could not handle the two flights of stairs to her bedroom or to the bathroom. She wanted to sleep on the sofa in the living room. Again, she didn’t want any fuss made over her. In many respects, it made sense as we had, fortunately, a downstairs toilet she could use. We agreed she could have a daily wash in the kitchen. While Mum was feeling ill, she was still in no rush to have the combined colonoscopy and endoscopy procedure.
Fortunately, I had some annual leave owed to me at work, so I decided to take a month off work to look after Mum twenty-four hours a day. My employer at this stage could not be more helpful, which I thought was strange at the time, given they were not friendly towards me. I thought nothing of it and was grateful for the time off.
Two weeks after seeing the doctor, Mum received a letter from St John’s Hospital, saying that she was due to have the procedure on Tuesday, 3rd June 2014. To say she wasn’t looking forward to it would have been an understatement. Mum was more worried about the procedure itself rather than the outcome of the results from it.
On 2nd June 2014, the day before the procedure, she had to drink a laxative solution. She was supposed to have it twice during the day, once at noon and once at 6 pm. After I had made up her first solution, Mum drank it in one go. I told her not to drink it like that, but she wouldn’t listen. About two minutes afterwards, she started to vomit violently. I didn’t know what to do, so I immediately rang the out-of-hours service. The nurse on the phone advised Mum just to take tiny sips of the solution throughout the day.
After Mum followed her advice, the laxative started working. That day, Mum spent hours in the bathroom.
On the day of the procedure, we arrived early at the main reception. Mum was visibly anxious. Once she saw the doctor, however, who explained the procedure, she seemed to be more at ease. All the doctors and nurses were professional, well informed, and so very kind to her.
During the combined colonoscopy and endoscopy, the doctor put a small camera up Mum’s back passage and down her throat. She was not given a general anaesthetic for the procedure. Instead they gave her a mild sedative.
About three hours later, the nurse contacted me and confirmed I could see her. As I walked into the ward, Mum was sitting up in her bed drinking a cup of tea. She looked so frail. “This is my angel,” she announced proudly to the nurse while pointing to me. The nurse smiled.
Not wanting Mum to see the tears flowing down my face, I had to turn quickly away.
The nurse explained the medical procedure had gone well, but there were a few things that “looked worrying”. She then advised me they were going to send for further tests to understand the abnormalities of some polyps. Mum stayed in the hospital for one night. As I left for home, the nurse pulled me to one side and said softly to me, “Mark, your Mum will be in safe hands. But it is important you should know that you need to hope for the best but plan for the worst.” I looked at her with my eyes still watering with tears, thanked her, and acknowledged that I fully understood what she was saying.
Until that time, cancer had not been something we thought about on a daily basis. Due to my own foolishness, I never imagined colon cancer would strike someone I loved. My ignorance will haunt me until the day I die, as I should have looked out for the signs of Mum’s deterioration.
Now, more than a year later, I repeatedly ask myself how I failed to add up the signs that Mum had colon cancer. But I honestly didn’t see them. There weren’t any flashing warning signals saying to me that this could have been cancer. Or if there were, they were not visible to me.
Of course, I noticed Mum was becoming frailer, slower, and her demeanor more vulnerable. If I am truly honest with myself, I did, however, notice some weight loss, especially in her face. But I simply put it down to old age. Never in a moment of my thoughts did I think she had cancer.
It had never occurred to Mum she would die of cancer. She had always thought she would die of heart failure. Cancer seemed to happen to other people, not to us. The terrible truth, however, was that it was happening to us right now, right this minute.
She was in total disbelief. She was scared, bewildered, confused, and angry. She had never smoked or drunk alcohol in her entire life. She had always eaten healthily. “How can this happen to me? It seems so unfair,” she kept repeating. Whether it was unfair or not, we were suddenly being dragged into a direction in life not of our choosing. We were embarking on a journey into the unknown.
Mum did not fear death. But she was fearful of the process of dying. She feared going into the unknown. She feared the pain that cancer could cause. She feared humiliation and degradation. She was afraid of incontinence. And the loss of her independence. Ultimately, she feared losing her dignity.
Over the course of a month or so, cancer seemed to be everywhere I looked. It was ubiquitous. It pervaded my life.
I would turn on both the BBC and Sky news. At the time, a new report on cancer had just been published—one in three people is diagnosed with cancer. By 2030, the number of people living with cancer in the UK is predicted to double from two million to four million. Whenever I turned on the radio, there was talk about cancer.
I would pass a newspaper stand and all I could see were the front-page headlines of celebrity after celebrity passing away from cancer.
I would walk down the street and see massive billboards about cancer. Or when I was doing the shopping, cancer charities would stop me on the street asking for donations.
After the combined colonoscopy and endoscopy procedure, it was another three weeks before Mum saw the oncologist. Once again, she was in no rush to attend the appointment. The hospital even allowed us to move the appointment earlier, but Mum didn’t want to cause any fuss to anyone. If she had her way, she would have been quite happy to postpone the appointment indefinitely.
In the meantime, Mum was rapidly deteriorating. She was becoming frailer and losing a significant amount of weight. She was increasingly more lethargic. She also looked jaundiced. She was now starting to get breathless, even when she was sitting down.
We were due to see the oncologist three days after my birthday, on Tuesday, 24th June 2014.
Typical of Mum, she was more worried about my birthday than herself and her illness.“For the first time in my life, I can’t go out and buy you a birthday card,” she said with a tear in her eye. So as a compromise, she gave me a few pounds from her weekly pension money so I could go out and buy a card from the shop.
2
The diagnosis
When you are caring for someone you love, there are certain key dates you will never forget. Listening to the diagnosis of a loved one saying that he or she has a terminal illness is one of them.
We arrived at the hospital early. Mum’s appointment was at 11 am. We were told, however, that the oncologist was running late. So we had to wait a further two hours before we were finally led into his office.
Mr Carmichael greeted us. “Please do come in and take a seat,” he advised in a self-assured and professional tone.
Straight away, Mr Carmichael could see Mum was anaemic and malnourished.
Five minutes afterwards, the nurse walked into the room.
After examining Mum on a medical bed in his room, Mr Carmichael sat down in his chair and started typing on his computer. He looked solemn. We were both sitting there, waiting in total apprehension to find out what he was going to say.
Then Mr Carmichael turned towards the nurse and whispered, “There is no staging on these notes.” They both glanc
ed at each other very quickly.
The nurse whispered back to him, “It’s T4.” Mr Carmichael immediately slumped in his chair and sighed.
I knew immediately what T4 meant. Colon cancer, like all cancers, is classified by four stages, ranging from 0-4, with the fourth stage being the most serious. T4 meant, effectively, the cancer will inevitably spread to other parts of her body.
Mum was completely oblivious as to the seriousness of her illness.
“We are going to keep you in for a few days,” Mr Carmichael said gently to Mum.
“Can I go home first?” Mum asked in a quiet but hesitant voice. “I don’t have any overnight clothes with me.”
“You won’t need them,” he replied in his smooth, reassuring voice.
He then leaned forward and looked into Mum’s eyes. “Mrs Carrington, I believe you have cancer of the colon. You have an extensive tumour. We need to carry out further examinations, but the initial test results indicate that the tumour is now malignant.”
In terms of the precise clinical terminology, Mum had caecal adenocarcinoma with necrotic local nodes. The tumour was on her right side. Mr Carmichael advised the nurse that Mum required major surgery urgently.
“We will need to run further investigations—a CT scan on the abdominal and pelvis to see if it has spread into the blood stream. We will also look at your lymph nodes,” Mr Carmichael commented sympathetically.
Staring at Mum straight into her eyes, Mr Carmichael whispered “you need to be admitted immediately. You are malnourished and anaemic. You need an urgent blood transfusion.”
The consultation lasted less than ten minutes.
We were then led out of the room. We sat in a corridor with a long row of seats. It was crowded, but all I remember is that we felt so alone. Mum looked so shocked. She began to cry. I couldn’t recall seeing Mum cry before in my life.
Peaceful Breeze Page 2
