Lizzie
Whenever Lizzie thought about Dr Habibi, she thought of the BFG. A tall man who had a kind way with his patients. When she was seven, she’d asked him: ‘Are you actually a giant from an ancient land?’ He’d smiled and said in his strong Persian accent: ‘You are half right and half wrong, clever Lizzie.’ His words were always shorter than hers. It wasn’t that he spoke the same words quicker, just that each word he pronounced was shorter somehow, fitting three words into her every one so ‘you are’ became ‘yu a’.
She’d mulled his answer over in her head whilst she played sleeping lions, waiting for the MRI machine to take its pictures, and wondered also if he would be able to see her thinking about him in the photos it took. If she was half right, did that mean he was a giant from this country, or a normal man from an ancient land?
It always surprised her then, when she stepped into his small, square office with its ever-growing wall of colourings and thank-you cards that covered the lifespan of his career, that he wasn’t much taller than her. His giant status had been nothing more than a childhood illusion. The knowing doctor who’d towered oh so high over her hospital bed.
‘Hello, hello,’ Dr Habibi said, ushering them into the four chairs opposite his desk.
Lizzie smiled at Dr Habibi and his energetic hand gesturing. Despite the circumstances of their relationship she liked him. He was thoughtful about the little things, like having four chairs ready instead of three because he’d known her brother was coming with them today. Saving them the awkward few minutes of shuffling and waiting whilst another chair was found and dragged in. They’d waited long enough.
Lizzie swallowed and tried to calm the fluttering of her heart. She’d been willing this day to arrive for weeks, waiting for the news like she’d waited for her exam results at university. Every day growing a little less sure, doubting herself and hoping all in the same breath. But now that they were here she desperately wanted to run far, far away.
‘So, how are you feeling, Lizzie?’ Dr Habibi asked, sitting down at this desk.
‘Better. The effects of the radiotherapy have almost gone.’
‘Sleeping pattern?’
‘Off and on, I guess.’
‘Any more symptoms – shaking limbs, numbness?’
‘No,’ she said, drawing her bottom lip between her teeth and biting. She should tell him about the colours, the spectrum of reds and yellows that had started to float like drifting balloons across her eyes, but she didn’t. The colours weren’t important right now. The results of her scans … that was why they were here.
‘So, I have looked at your scans.’ Dr Habibi’s eyes gazed into Lizzie’s as he spoke before drifting across to her mum, sitting beside her, then her dad, then Aaron. Lizzie didn’t mind that. Her family were in this as much as she was.
Her mum slipped her hand into Lizzie’s and gripped it tight. The skin around her mum’s fingers was slack around the knuckles, and icy to the touch.
Dr Habibi stood up and flicked on the lamps behind the white display boards, illuminating a dozen pictures of her brain, some sideways on showing the shady profile of her nose and mouth. Others more like an alien image or half a grapefruit. Her eyes fell to the tiny black kidney bean at the bottom of the first scan at the point her brain became her spine. A crushing feeling took hold of her, squeezing and squeezing her body. Lizzie knew what Dr Habibi was going to say before he so much as opened his mouth. It was her response she hadn’t planned for.
‘Unfortunately, the radiotherapy hasn’t been successful. As you can see,’ he said, pointing to the brainstem with the nib of his pen, ‘your tumour hasn’t shrunk in size. However, it hasn’t grown either. So, we have options. We can consider a clinical trial. There are some new treatments coming out of America for your type of tumour …’
Lizzie blocked out the sound of his voice. She couldn’t listen anymore. Why had she allowed herself to hope it would be gone? Allowed herself to think forward to the coursework she needed to catch up on, and the school placement she would be able to schedule. To her left, Lizzie felt her mum’s shoulders start to shake silently. Why had they all allowed themselves to hope?
The crushing feeling continued, squeezing and squeezing. Lizzie stood up, pulling her hand out from her mum’s ever-tightening grip and stepping over to the wall. Her eyes scanned the rows of thank-you cards and drawings, stopping every so often to linger on one then another. Right at the top, the scribbled picture she didn’t remember doing. A little girl and a purple dog, or a cat maybe. Someone had written her name and age in neat pencil along the top. Elizabeth Appleton, age 3.
There were pieces of paper pinned on top of other pieces of paper on top of thank-you cards and letters four or five deep on the wall, but hers were always visible. The intricate pencil drawing of a hawk that she’d stencilled from a book. Lizzie Appleton, age 9. Sat beside it was a card with a picture of the Suffolk coast; from her mum and dad, she guessed. More notes, more thank-you cards, from her and from her parents. She even spied a crayon scribbling with Aaron’s name on it.
She could have changed doctors numerous times over the years, but she never had. Dr Habibi knew her and her family, and they knew him. Her whole life was on this wall. The thought spun in Lizzie’s head. She stepped back and tried to draw in a deep breath, but gasped and coughed instead.
Dr Habibi paused and waited for her to finish before continuing. ‘So there you are. It is not the news we hoped for, but we have options.’
She shook her head. The wall before her blurred into smudges of colour. Her whole life, she thought again. Her whole life was on this wall. Year after year. Four tumours and countless scans, innumerable check-ups and tests. A lifetime of not living displayed before her on the wall.
‘No.’ She heard the word, but it took her a split second to realise she had been the one to say it aloud. Only when it was out there, in the room, did she realise she meant it.
Lizzie turned to Dr Habibi. She felt the wide, watery eyes of her family on her and swallowed through the pain tightening around her windpipe. She couldn’t look at them and say what she needed to say, so instead she focused on Dr Habibi. ‘If –’ she swallowed ‘– I don’t pursue a clinical trial, how long do I have?’
‘Lizzie!’ her mum cried out. ‘What are you saying?’
‘It’s impossible for me to give any exact numbers,’ he said, staring back at Lizzie, both of them ignoring Evelyn’s outburst as if they were alone in his office. ‘We don’t yet know how quickly the tumour will grow –’
‘Best guess?’
‘Based on the growth levels I’ve seen so far, factoring any effect of the radiotherapy, my best guess would be six months. I’m sorry, Lizzie.’
A strangled cry from her mum filled the silence that followed.
‘And there’s no chance that another course of radiotherapy will do anything?’
Dr Habibi shook his head. ‘No, there are no guarantees, but with every treatment we try we get a better feel for what doesn’t work, and therefore what might work. With the tumour at its current size, I would like to put you on anti-seizure medication, to reduce the risk of a seizure as the tumour grows. A clinical trial—’
‘No more treatment,’ Lizzie said, surprised by the confidence in her voice.
Six months.
She knew she should be devastated, and somewhere inside, she probably was, but all she could think about was the wall in front of her. Six months without being stuck in hospital, without throwing up, without sitting in a stuffy waiting room waiting for her turn to be pinned to a table in a dark room whilst radiation was zapped into her body. Six months without having to hope.
A jittery relief gushed through her. She could choose.
‘Lizzie.’ Her mum stood up and wrapped her in her arms, drawing out a hundred memories from her childhood of being in her mum’s arms. Goodnight hugs, hospital hugs, grazed-knee hugs, mean-friends hug, sick hugs. They were all there, unleashed from the nostalgia of her mother’s arms, her bosom and her floral perfume. Lizzie’s throat tightened again. All of a sudden it seemed as though she’d swallowed a gobstopper whole, and now it was lodged on top of her windpipe.
‘You’re disappointed,’ her mum said. ‘We all are. But don’t make a decision in the heat of the moment like this, please.’ Her final plea came out a whisper.
‘Evelyn,’ her father said, standing up. ‘Let’s hear what Lizzie has to say.’
Her mum sniffed and stood back. Four pairs of eyes stared at her. Dr Habibi’s were black and narrowed a little, his forehead furrowed with concern. Her mum’s, almost grey through the tears, and wide like a wild animal caught in the headlights of a passing car. Aaron, still rooted to his chair, his body twisted. His bottom lip quivered a little until he pulled it between his teeth.
Lizzie looked away. Hugging her mum, looking at Aaron, fractured the wisps of certainty she felt inside her, and she didn’t want that. Her dad stepped forwards and rested a large warm hand on her shoulder. She looked up and saw in his eyes the acceptance she needed. He understood. The gobstopper shifted and all at once she could breathe again.
‘I don’t want to have any more treatment,’ she said, turning her gaze back to the wall. ‘I’ve had a lifetime of radiotherapy and chemotherapy, and operations, and scans. And I’m right back where I started. Now, I want to choose. And I’m choosing to live. Six months might not seem like a long time, but it’s six months of living in a way I never have before. No more back and forths …’
As Lizzie spoke, the certainty grew and she clung to it. The only certainty in life was death, she thought, wondering where she’d heard that saying. She’d walked into Dr Habibi’s office with hope and she was going to walk out with certainty.