“Maybe it’s time to put your affairs in order?” is a form of words that many patients with a terminal diagnosis are familiar with. It is intended as a form of words that gives the broadest possible indication to the patient that he or she has limited time left. In reality, it so often far too late for many patients to put their affairs in order. Those of us that are more fortunate are grateful for the warning and that we have some time to sort things out for those who are left behind. It is something that I have witnessed being said to patients a number of times, but often wished that I hadn’t intruded upon this most personal of life changing conversations.
It was chemotherapy time for me again, the fifth of the third round of six two weekly infusions. They are potentially very tedious affairs with an hour or so of preparation, followed by a four-hour infusion and finally another hour or so of disconnection and fitting a pump to take home, if required. Initially, it can all seem rather alarming and intimidating, but I have witnessed nothing but kindness, warmth and excellent care from the wonderful team that work at my cancer unit. There is often gentle teasing, jokes and raucous laughter from nursing staff and patients alike. Despite the serious issues of many conditions being treated, it is always a centre that promotes love, hope and care.
All the preparations having been completed, I was ushered into the far end of the ward, which has all the comfortable reclining chairs, in one of which I will spend the next four hours. I was pleased to be allocated to my usual chair in a prime position by the window. There was one middle aged lady to the right of my chair, whilst a very frail elderly lady was seated in the chair opposite.
“This lady is Lucy,” announced my nurse pointing to the lady on the right.
“I haven’t been called that for a very long time,” laughed Lucy struggling to swallow part of her sandwich. She smiled and said “Hello” to me.
“And this lady is Ellen,” continued the nurse referring to the elderly lady opposite. The frail woman, put down her book and nodded towards me. I could see that she was not at all well, and had been crying.
I sat in my allocated chair; the drip was placed beside me with four or five coloured bags of fluid hanging above me. The nurse fiddled with the connections, and finally connected one tube from the drip to the connection on my chest.
“We’re all ready to go. Are you ok? Do you need a blanket or another pillow, Barrie?
“I’m all good, thanks. Is that lot all for me? I guess I’ll be spending most of the day going to the toilet then?”
“It certainly is, my love. Now, you’re all connected and we are ready to start. You like hot chocolate, don’t you? Do you want biscuits as well?”
Although I rarely drink hot chocolate at home, I always look forward to one after starting an infusion. Amazingly, the team of nurses or ancillary staff always seem to remember.
It was a busy morning in the chemotherapy ward. Even though I was seated in a small bay with four chairs, there were several other bays nearby. There were patients waiting for treatment in the corridor outside, as well as in the treatment rooms. It was going to be a busy morning for all the staff.
I was pleased to be in my usual seat and the two women patients looked friendly enough. I enjoy talking to people and I am curious about the lives of others, as those who know me will recognise; I will talk to anyone if given the opportunity to do so. However, I hope I am sensitive enough to chat to only those who want to chat. Some patients, given their condition, prefer to be left alone, whilst others will happily talk, usually in the hope that it will briefly help them to forget what is happening to them. I usually find that it is men who are the most difficult patients in the cancer ward. Some will happily talk, but many prefer to sit in sullen silence. Some men are deniers that there is anything wrong with them, and are part of the ‘Why me?’ brigade, whilst others are abrupt, unnecessarily sharp and sometimes unpleasant to those who are trying to help them. Most women, on the other hand, seem to be much more pragmatic and appreciative of the care that they are given. These are generalisations, of course, and there are always exceptions.
Ellen, the frail lady opposite to me sat reading her library book. I could see that she wasn’t really reading her book, since she rarely turned any pages. She was clearly very troubled and had red eyes from crying.
“Would you like a cup of tea, Ellen?” asked the nurse. “I think the doctor is coming to see you shortly.”
“No more tea at the moment, thank you,” replied Ellen. “How long do you think she will be?”
“Not too long, my dear,” replied the nurse. “I think she is just outside the children’s ward. She will be along in a few minutes, I guess.”
A few minutes later, the doctor appeared. I had seen this doctor before, and she smiled at me as she approached Ellen. She pulled the curtains around Ellen and began to speak quietly to her.
It is difficult not to hear a conversation when someone is physically so close even though shielded by a curtain. The doctor was explaining the results of Ellen’s latest scan and blood tests to her. Ellen was clearly hard of hearing, and the doctor had to repeat the results to her several times. It was then that I heard the words that we all dread hearing.
“Maybe it’s time to put your affairs in order, Ellen?”
Lucy glanced at me and shook her head sadly.
After a pause, I could hear Ellen sobbing gently, followed by kind, supportive and reassuring words from the doctor. Eventually the sobs ended and the doctor drew the curtains back, clearly looking upset herself as she left the ward.
Ellen sat looking bewildered and continued trying to hide her face with her book. I could see tears still pouring from her eyes, which she continually mopped with a tissue. How I wanted to say something, or at least to get out of my chair and attempt to comfort the poor lady, but sadly I was trapped in my chair with tubes.
Suddenly, Brenda, a nursing ancillary, appeared. I often used to chat with Brenda, a kind gentle woman with a wicked sense of humour. I remember her pouring a jug of water over me, by accident of course, during one of my first infusions. She and I never forgot the experience, and we often used to joke about it; I often used to pretend to hide whenever I saw her coming.
Brenda walked over to Ellen, pulled across a stool and sat beside her. Brenda held Ellen in her arms whilst she sobbed quietly. No words between the pair were spoken, and Brenda sat with Ellen until the sobbing and tears ceased. It seemed to be an age, but I guess it was about ten minutes or so. Later, Brenda left briefly and returned with a “nice cup of tea”, which Ellen accepted gratefully. Ellen sipped her tea and started reading her book. Ellen looked at me and smiled and both Lucy and I gave her the thumbs up.
I had just witnessed a wonderful example of love and care for those in distress. No words were spoken; they were not needed. It was simply the feeling that someone cared enough to take time out during a busy morning to show love, compassion and support. It was an experience that I will never forget.
© Barrie Mahoney 2023
This article was published in the Quaker (Religious Society of Friends) magazine 'The Friend' on 19 January 2023
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