Five Year Survival
Across the road. Up the long drive, past the learning centre and the ambulance bays. Across the car park, past the memorial garden, through the sliding doors. Past the coffee bar, sharp left along the corridor, through the double doors, up the stairs. Quick checkin at reception -, yes, still the same address, still the same GP. Into the waiting-room with the comfy chairs and the ticker showing how long the wait will be and the rows and rows of tense-faced women trying to read magazines. Get out the paperback and try to concentrate and fight down those old feelings of dread and panic. It’s been five years, after all. Surely everything will be all right.
Every woman sitting on those comfy chairs either has breast cancer, or thinks she does. Being a doctor does not make the experience any less terrifying. The paradox of breast cancer is that the disease may well be asymptomatic, it’s the treatment that makes you ill. Going through the slash, burn and poison routine of surgery, radiotherapy and chemo leaves patients very ill indeed and takes years to recover from. Besides the physical beating, there’s the psychological trauma: the fear of death, the pain, the uncertainty, the agonising waiting for results, then the sudden plunge off the cliff when all the treatment stops and you try to stagger back to your life and get on with things. Discovering that life has changed irrevocably, and you can’t actually go back. Coming to terms with weakness and disability, a different body that refuses to do all the things you want it to as effortlessly as it used to. Coping with other people’s reactions, especially those who want to regale you with the hair-raising story of their friend who had a dreadful time with her cancer treatment and then died, which may be true but is not uplifting. Trying not to lose patience with the “But you look so well!” brigade who are only trying to help, and don’t really want you to snarl “I’m sure I do but I feel like shit, I’m in pain all the time and I can’t lift the bloody kettle so forgive me for finding it a bit of a struggle to be positive………….”
And then there is the return to work. My Occupational Health department managed to make an assessment of my fitness for work without collecting any information from my treating team or GP, looking at my workplace or job description, examining me, or indeed doing anything other than look at me, which is pretty impressive – but I had not until then realised that the two categories of fitness for NHS staff are “upright and breathing, fit for work” or “incapacitated, off sick” and you aren’t allowed any shades in between. The culture of “unreasonable adjustments” in which disabled staff not only have no allowances made for their health conditions but are actively placed in settings which they have pointed out will make them worse is excellent too – cue lots of capacity processes and staff who have beaten their illnesses and triumphantly come back to work dumped on the scrapheap angry, isolated and betrayed. Unemployment is bad for people as we know, and the most damaging complication of breast cancer for me was losing my job – isolation, loss of routine and fitness, deskilling, depression, and the long, long, hard struggle to find a way back………………
Well done, says your treatment team, everything’s fine. See you next year. Clutching your appointment card, down the stairs, through the doors, along the corridor, back out into the sunshine away from the hospital’s fluorescent lights, full of relief and gratitude at another year’s reprieve, quick glance at the balcony where the in-patients are out for a breath of air and feeling a mixture of guilt and thankfulness at not being one of them any more…………and hopefully never having to be one of them again……….
