Innocence revisited – 22

Mother and son 

I had just finished my morning surgery when the radiologist rang.

 ‘You know Mrs N whom you sent for an upper abdominal ultrasound? Her liver is full with metastatic cancer.’

I suddenly felt a sinking feeling in my stomach, which I always get in stressful situations. The feeling of shame, incompetence and failure was overwhelming. I had looked after her for more than 25 years. How could I have overlooked the primary? On the other hand she had been quite well until now. 

I tried to calm myself – she had only complained about her rheumatism. Recently I had suggested hip replacement, but she would not hear of it.

Poor Mrs N. She was a World War II widow, who had remarried and had a son from her previous marriage. A small woman with a fair complexion and beautiful black eyes, she had recently retired from her job cleaning chickens in a factory. 

Since she had no symptoms of the primary lesion I decided not to investigate her any further and at that time no chemotherapy was offered. 

As life went on, my stomach settled. Then, about two weeks later Mrs N’s son came to see me.

‘I am OK, doctor, but since my Mum is so sick, I thought it better to have a check-up. Sometimes I feel a little discomfort on my right side’, he admitted reluctantly after questioning. He was a handsome 48-year-old man, athletic, with the same white complexion and beautiful eyes of his mother. I felt sure he was suffering from the anxiety so commonly seen when a close family member is sick. However, I examined him properly and sent him for an ultrasound. 

A few days later I received the report from the radiologist.

‘He has exactly the same as his mother!’ he said. 

‘What do you mean?’ I asked, in disbelief. 

‘His liver is full with metastatic cancer.’

After investigation we found a small primary in the descending colon. We decided to remove it to prevent obstruction. When I visited him in hospital, I probably failed to hide my sadness because he reassured me cheerfully, ‘Don’t you worry, doctor. I will overcome this. I am a fighter. They operated on me only two days ago and I am already up’.

I am not ashamed to confess that I was crying as I left the hospital. Poor man. He didn’t know the enemy and he could not accept that the battle had already been lost. He fought for many months, undergoing not only surgery but also several chemotherapy cycles. He also tried natural therapy and meditation. Near the end he was a pitiful skeleton and broken in spirit. His mother was luckier. We did not tell her anything and she died eight months earlier than her son.

Mother and daughter

One morning while I was busy with my patients, my obstetrician rang me.

‘I had a bit of drama last night with one of your patients – Mrs M.’

‘What happened?’ I asked.

‘As you know she had her second baby with a breech presentation and everything went as planned and she delivered a healthy little boy, but in the middle of the night she developed a severe postpartum haemorrhage. By the time I arrived she was so flat I couldn’t find a vein, so I had to ask my resuscitation specialist to come. He eventually found a vein in her axilla, so we were able to transfuse her.’

 ‘How is she now?’ I asked anxiously.

‘She is feeling just fine. We were lucky it happened at night and there was no traffic on the roads.’

 As I continued to work I could not help thinking how lucky I was to have such a good consultant. Naturally my thoughts were with Mrs M. What a lovely patient she was. A tall woman with a smiling, round face, her speech was somewhat broken as English was not her first language and she often had to think of the right words or translate from her native tongue. 

When Mrs M returned she told me what had happened. She had not felt well after the delivery. When she asked for help, one of the nurses just looked at her pad and reassured her. Only after she continued to complain did the sister in charge come. She rubbed up the uterus and then all hell broke loose. There was blood everywhere – on the sister, on the bed, flowing like a river on the floor. They rushed to ring the doctor, covered her up, lifted her legs in the air, and gave her oxygen. By this time she felt cold and clammy and was sure that the end was near.

Later we discussed the experience in detail but Mrs M somehow was not her old self. She visited me more frequently and her symptoms became more vague. Sometimes I wondered about the purpose of her visits. When she asked me to give her some sedatives I really started to get worried.

‘What is wrong?’ I asked her. She was reluctant to speak.

‘Something wrong with your husband?’

‘No, no. He is good and helpful.’

‘Is it difficult to cope with two children?’ I continued, trying to find the answer.

‘Not really. Although I must admit it is hard, since we have no relatives in this country, but we manage.’

‘Perhaps it still bothers you what happened in the hospital. You should not worry – it won’t happen again. Next time we’ll be more careful.’

‘No, no it’s not that. We won’t have any more children.’

‘Then you should put it behind you’, I answered reassuringly.

‘You don’t understand, doctor’, she said finally, ‘It’s not me! It’s my mother!’

‘Your mother?’ I responded surprised.

‘Yes. I told you some time ago that I was brought up first by my grandmother, then by my stepmother’, she continued. ‘You see my younger brother was my mother’s second child. I was only 3 years old when she had him and she died after the delivery. I just learned from the old country. She died of a haemorrhage – a postpartum haemorrhage.’ MT