8 March 2005
Elaine sits in the waiting room in her wheelchair, her eyes staring straight ahead. She looks so different away from home, and I curse myself for not noticing the changes before. Slack, yellowing skin drapes over her cheeks and collarbone, as though her bones underneath have shrunk in the wash.
We both know this is not going to end well.
‘Elaine Palmer, please?’
A nurse leads us to a small office. The corridor is so narrow that it takes three tries to get Elaine’s wheelchair through the doorway. The consultant has a flamboyant mane of sandy hair that surfs up from his forehead. As the nurse follows us into the room and leans against the consulting couch, my sense of doom grows.
‘Mrs Palmer, I’m Mr Greer. Thank you for waiting. I’ve had the chance to look at the test results now from last week. We put you through the mill, rather, didn’t we?’
Elaine nods. I know her: she doesn’t want flannel. She wants facts.
‘I’m afraid that the results do confirm what we suspected, that you have cancer of the pancreas. It’s a very difficult cancer to detect early and in your case, the tests we’ve done show that unfortunately, we’re beyond the stage where surgery is an option.’
He leaves silence, for the information to sink in. It’s not a surprise to me, not really. I might not be a doctor, but I knew enough from the extent of the tests and the expressions of the staff carrying them out that I would need to postpone my med school applications. At least that’s one problem I could solve.
In the distance, I can hear a trolley rattling along, the faint nee-naw of a siren.
I reach out for her hand. She lets me hold it but doesn’t grip back. Oh, Elaine.
‘Is there any treatment?’ Her voice is clear and free of self-pity.
The consultant doesn’t flinch. ‘There is chemotherapy, which we will certainly recommend. This is palliative. By which I mean it is aimed more at controlling the growth and effect of the cancer both in the pancreas itself and elsewhere in the body. It is not a cure.’
‘This isn’t a good one to get, is it?’ she asks.
He shakes his head. ‘No. We’ve made some positive steps in recent years but still . . .’
‘How long?’
‘I am always unsure how to answer that, Mrs Palmer. But, um, I would say we are talking in terms of months, rather than years. I’m really very sorry.’
The journey to the cafeteria is long and complex, the warren of corridors and lifts hard to navigate, especially with a wheelchair.
Eventually, we sit down with our pot of tea and the scones neither of us feels like eating.
Elaine exhales. ‘Well, whatever I did in a past life, it must have been extreme to deserve this luck.’
I think about how cruel she’s been to Tim in this life, but that doesn’t mean she deserves to suffer. ‘It’s unfair, Elaine.’
‘At least I won’t be hanging around for years.’ Her voice breaks slightly on years but she picks up the knife and cuts her scone in half, focusing on spreading the jam evenly across the two pieces. ‘That had always been my fear, that I’d become even more of a burden to Tim.’
I’ve never realized Elaine has had any concept of how hard it’s been for her son. ‘Oh, Tim loves you to bits.’
‘Yes, hen, but I’m still a burden. To both of you. This way . . . it’ll be cleaner.’
I think of the 999 calls I take from people with advanced cancer, and I know that ‘clean’ is the last thing we can expect. The next months will be chaotic. Merciless. ‘We have to tell him now.’
‘Not yet.’
‘Elaine . . .’
‘Not till after his finals. I’ve been tough on him because the world is a tough place. But he’s so close now. We can’t risk him falling at the last fence, can we, Kerry?’
‘You’re going to get a lot sicker before then.’
She smiles. ‘Probably. But observation has never been one of Tim’s strengths. The longer we can keep him in his bubble, the better his chances of passing. We’ve all worked too bloody hard to let him fall at the final hurdle.’
Lying about this turns out to be doable. As Elaine says, Tim is not great at reading people.
Plus, it’s not the first time I’ve kept huge things from him either. He never knew what happened with Joel and me at Christmas, though he’s seen the aftermath. In January and February I felt lost. If anything, the blackness that descended was worse than the first time Joel let me down, because I felt like such a fool.
Tim didn’t push me. Instead, he was kind and he waited, and I see those qualities now for what they are: the mark of someone who is growing up and trying his hardest. However difficult it is, I know I made the right decision to be with him. That rebounding between them, like a ball in a pinball machine, had to end.
The confirmation of Elaine’s cancer has made me snap out of my self-obsession at long last. Now I am all about the practicalities as we hunker down. I make lasagnes and soups on my days off and parcel them up so Tim can stick a portion in the microwave between revision sessions, shovelling it down so fast I’m sure he doesn’t notice what he’s eating. The system works well for Elaine too, because I can reheat stuff for her when she isn’t feeling nauseated.
Though those times are getting rarer. Her weekly chemo is brutal. I go with her when I can, sitting in the overheated therapy room while she endures the poison entering her body, hoping it’ll buy her precious extra months. The only thing she’s made a fuss about is refusing a central line because she’s scared Tim might notice it.
The weather is cold enough that she can hide her cannula under cardigans but they keep having to put in new ones when the blood vessels fail. The bruising makes me want to take her in my arms – she’s almost light enough now – and carry her out of the hospital because this isn’t going to cure her.
At most, she’ll get a few extra months. But she endures it for Tim.
‘Oh, I’m colder than the Grampians, Kerry.’
‘Shall I get a blanket?’
She shakes her head, gently. ‘It’s not my body, it’s this bloody thing.’ She’s got a cold cap, even though this drug isn’t the worst for hair loss, but it’s the one thing she knows Tim might notice. He’s oblivious to the blue-black patches under her eyes, and the way she’s getting smaller and smaller.
As she shrinks, the residual fear I have of her shrinks too. I begin to forgive her what she’s done to her son because I see she hasn’t treated him any worse than she treats herself. Her response to her own sickness is self-critical to the point of brutality.
‘You could take it off, Elaine, for a bit. It won’t make a difference, I’m sure.’
‘No. Only two more weeks to go. I am going to see it through if it’s the last thing I do!’ She smiles at the irony.
The day after Tim’s last exam, and five weeks after diagnosis, Elaine arranges afternoon tea.
We all travel together in Mum’s car, with me driving. As Elaine climbs into the passenger seat, I notice how she winces when she pulls the belt across her sore, exhausted body.
‘So where are we going?’ Tim asks, clambering into the back. He’s a little hungover, after going out with Wilcox and the others to celebrate last night.
‘It’s a surprise,’ Elaine says.
Not to me. She’s treating us to the Grand. It’s her money and her choice. Why shouldn’t she enjoy every bloody moment that’s left? But it does mean that every time Tim walks past this place in future, he will surely remember the news he’s about to hear.
‘You’re teasing me, Mum.’ He catches my eye in the rear-view mirror as I reverse out of the drive, and smiles. He’s told me he is as sure as he can be that he’s passed, that all the work he’s done has paid off.
He chats as we go, about the possibility of a holiday before he starts his FY1 in August. Our local health deanery has turned him down for the foundation year because of his failed year four. He’s having to go further afield, to a less popular trust, at least a three-hour drive from here, double that in rush hour.
‘. . . we could get a last-minute self-catering deal somewhere,’ he’s saying, ‘near my new base.’
I hate knowing that this is all about to be irrelevant.
When we arrive, a liveried porter opens the car door and helps Elaine out, sensing that she needs to lean on him as she walks up the steps. Another one offers to park the car for me. I’m about to refuse but Elaine turns and calls out, ‘Go on, be a devil, hen, it’s all my treat. And you don’t often hear a Scotswoman telling you that . . .’
The conservatory area is flooded with light: beautiful but exposing. As soon as we sit down, Elaine orders champagne teas, not even checking the price. I’ve only been here a couple of times in my life, but the smiley, unobtrusive service makes up for the slightly stuffy décor.
‘I’m underdressed,’ Tim says, looking at the two men at the next table, three times his age, wearing smart suits and ties, with matching Paisley handkerchiefs.
Two waiters bring the tea stands laden with treats: triangular sandwiches, golden scones, cakes iced in pastel colours, and dishes of clotted cream and glossy strawberry jam. Blood and bandages.
I have zero appetite.
‘Well, tuck in,’ Elaine says. I catch her eye, questioning.
There’s no right time to tell Tim, no etiquette on whether you should share a terminal diagnosis before or after a meal. Tim and I practised breaking bad news as a roleplay a few times, so I know the basics – a warning shot to prepare someone for the worst, a euphemism-free statement of fact, an expression of sympathy, a question to confirm they’ve understood fully.
I chew a mouthful of cucumber sandwich, tasting nothing.
And now a pianist in the corner of the room is playing ‘As Time Goes By’ and our food is finished and the champagne flutes and teapots are empty and Elaine has still said nothing. I stare at her until she gives me the tiniest of nods.
‘I wonder if it’s too late for me to learn the piano,’ Tim is saying. ‘It’s one of those skills that I always thought I might enjoy—’
‘Tim, I need to tell you something,’ Elaine says. ‘I only kept it from you so as not to jeopardize your exams. And there’s nothing you could have done.’
Tim gawps at her. ‘Is this about Dad?’
She shakes her head. ‘That scumbag is still hale and hearty, as far as I know. Tim, it’s me. I have . . . cancer.’
I watch his face and I can see the exact moment that he really looks at his mother for the first time in months. ‘What kind?’ he whispers.
‘It’s pancreatic cancer. I’ve been having chemo for a wee bit and they think it’s put the brakes on, but it’s a tricksy thing and—’
He talks over her. ‘I know what pancreatic cancer is like, Mum. I’m a bloody doctor. I know what it does. I—’ He stops. His face ages ten years as the glow from the afternoon champagne fades away.
He turns to me. ‘How long have you known?’
‘Five weeks.’
‘Five—’ He thinks for a moment. ‘So this was why you deferred medical school.’ His eyes close as though he can shut this out. When he opens them again, he looks furious at the betrayal. ‘How could you do this? Treating me like a child who can’t be trusted . . .’
Seeing him so lost makes me well up but I have to hold the tears back. I touch his arm. ‘It wasn’t like that. Elaine made the choice for your future. You couldn’t have done anything to change the treatment. Or the prognosis.’ That last word was a mistake. Too soon to heap another dose of misery onto his shoulders.
Elaine takes over. ‘I don’t have all that long, Tim. I’m sorry. But let’s make the most of the time we do have. Starting today.’
I keep my hand on his arm. What would the advice on breaking bad news suggest now? Empathy, then a confirmatory question.
Instead, I stand up and wrap my arms around him. After a moment’s hesitation, he embraces me back and we stay like that for a few seconds. I hear him clear his throat and when he lets me go, I see a steeliness in his eyes.
He takes his mum’s hand and I see him flinch as he registers the thinness of the skin and the lightness of her bones.
‘I did it because I love you, Tim,’ Elaine says.
He nods. ‘I know. You did what you thought was best. Now it’s my turn.’
That night, in bed, he reaches for me and I think he wants to make love, which hasn’t happened since he failed his exams last year. I want to be close to him again.
But instead he turns on the bedside light and sits up.
‘You’ve been there for her when I wasn’t.’
I sit up too. If he’s angry, it’s part of the process. ‘Your mum made the decision not to tell you, Tim.’
‘No, I mean for months. Years. It was easier for me to play the precious medical student while you paid the bills and helped Mum when she needed it. Just like it was easier to let people think I helped to save Joel Greenaway’s life, when it was you on your own.’
‘That’s a long time ago, Tim, and it doesn’t matter—’
‘It does. Let me finish, please. I know I can’t stop her dying, or change how things have been for you or me in the past. The mistakes I’ve made.’ He leans across and kisses me on the forehead. ‘But you and Mum are going to be all I think about this summer. We’ll take her on trips to the places she’s missed out on. Maybe she wants to go to the Isle of Wight or on the Millennium Wheel in London.’
He’s speaking faster than usual, he’s wired and wide-eyed, racing against the clock to put everything right.
Except he must know that there is no grand victory ahead, no storming the building for a last-minute rescue.
‘You do understand it’s stage four, don’t you, Tim?’
He looks at me, and as I look back I see him as he is now. Not the boy I grew up with, or the wreck who failed his exams a year ago, but a man who knows what he has to do.
When people ask how we met, I always say we grew up together. Now I realize that the growing up is only just beginning.
‘Yes, Kerry. And I understand it’s time for me to make it up to both of you.’