Leavetaking: Faced with two bad options, my mother chooses the chemo
With terminal cancer, you’re asked to choose the mode of your own death
‘Well, this is shite, isn’t it?’ she says. Photograph: Thinkstock
A cancer diagnosis changes everything, even when it isn’t yours. It sours the air in your home no matter how many windows and doors you throw open. It bites and stings in your muscles even when you work them hard enough to try to burn out the awareness. You see it in your face when you examine your features in the mirror, only to find that they’ve resettled themselves, and the expression isn’t recognisable as yours. The knowledge that someone you love is suffering is an intense kind of pain all its own.
It doesn’t start that way. At first, you’re not aware anything is wrong. My mother had cancer for a long time before any of us realised. The symptoms of her pancreatic cancer looked to us – and to doctors – like relatively routine digestive issues not uncommon in someone in her 50s. By the time her issues had slowly progressed over a couple of years and I became really concerned, it was much too late.
The waiting surprised me. From the time doctors suspected cancer, and started tests, there was a five-month wait for the final diagnosis. This leaves you in a state of permanent anxiety.
They found cancer in her ovary. It took months of testing to discover that the ovary wasn’t the source. It had wandered there, aimless and deadly, from her pancreas. Once it has metastasised in that way, you’re in trouble.
My mother’s situation is one of the least desirable. There is no option for surgery, so, despite the fact that she has just been told she has terminal cancer, she is asked to take a couple of days to think about whether or not she wants to have chemotherapy.
If you’re diagnosed with cancer in the early stages, the chemo question is an easy one to answer. You do a bit of calculating in your head, and it isn’t too difficult to surmise that a steep but temporary drop in quality of life is worth it if it saves you. With a terminal diagnosis, you start your calculation in the knowledge that nothing is going to save you. You can have suffering with extra time, or good quality of life for a shorter period of time. Your life comes down to however many minutes a group of health professionals have spent analysing and discussing your case. Based on the incomplete information they give you – which you can’t fully grasp unless you’re an oncologist – you must make a decision about your own mortality.
You’re basically asked to choose the mode of your own death from two completely undesirable options. How much is a few extra weeks or months worth to you? Is it worth feeling too ill to get out of bed? Is it worth being so constipated that you lie wrapped around your distended abdomen in agony? Some would say yes. Over anything, they choose to fight for life.
Others make what is probably the even harder decision: to accept death and live as fully as they can in the meantime. Neither decision is necessarily better. Both are torturous, and no one should ever be faced with that, particularly when they are vulnerable, ill and afraid.
Generally, though, we are only faced with these sorts of situations when we are compromised in some way. Delaying or refusing to deal with the question is in itself a decision. There’s no escape.
My mother chooses the chemo. Not to try at least, she says, would feel like giving up. The first session is difficult. We walk into a comfortable- looking ward full of soft chairs scattered around tables. Around us, people of all ages sit in the soft chairs; the obviousness of their illness varies – some have a pallor, some have the signature baldness, some look healthy.
We are informed of the risks. My mother looks straight at a young doctor as she lists hair loss, depression, painfully dry skin, nausea, and on and on. They place a little electric blanket over her arm where the solution enters the vein because “it can burn the vein. Heat will help.”
My mother turns and looks at me seriously as I sit on a stool beside her, knitting a hat. All day, I’ve worked hard to arrange my face so that not an ounce of pity shows through. This is normality now, and I have to help normalise this.
“Well,” she says ,”this is entirely shite, isn’t it?” A grin spreads across her face, and something snaps in me. Suddenly, we are giggling riotously in the chemo ward.
Whatever it takes.