Ministrations

Spending time in the cancer ward is confronting.

Dozens of beds. Occupied by balding wizened heads, rendered old before their time, attached to emaciated bodies. Poisoned and irradiated to within an inch of their life. Medieval-like therapies. Blunt. Brute force. Traumatic. Treatments almost as bad as the disease. Almost. A disease that can be delayed, but never defeated.

Each day about a third of the beds turned over. Their occupants destined for home, hospice, or grave.

Roughly half the patients received regular visits from loved ones. Friends or family providing comfort or company. A tough gig, not for the faint of heart. Leaving parents, spouses, or children quietly crying tears of despair in hospital coffee shops. Feeling guilty for wishing their loved ones would hurry up and die, because their current existence wasn’t living. Wishing it nonetheless.

Watching that journey play out once is hard. An experience of fear and uncertainty that wouldn’t be wished upon anyone. Repeating it is soul-destroying. Gone is the naïve false hope and medical mystery of palliative placebo treatments from the first go around. Replaced by weary fatalism and duty-bound obligation to see things through to their inevitable conclusion.

Those without nearby loved ones would finish their life’s journey as we all started it: alone.

The ward was eerily quiet and relatively calm. Acceptance rather than histrionics. No cursing the gods or railing against the unfairness of it all. Such reactions are futile, occurring upon diagnosis rather than months or years later when the long-anticipated outcome has finally arrived.

Medical staff routinely perform acts of quiet heroism and compassion. Doing so not for social media likes or humble brags, but simply because it was the right thing to do. Working horrendous hours, under trying conditions, for terrible pay. Performing at the vocation end of the employment spectrum. A noble calling rather than a lucrative career.

Patients in these surroundings tend to be reflective.

Speaking of lives and loves. Of opportunities seized and opportunities forsaken.

Relationships enjoyed or endured. Occasionally those foregone or best left forgotten.

Milestones and mistakes.

Achievements and atonement.

Though not in the self-aggrandising, vainglorious, status-chasing manner of social media, dinner parties, or school reunions.

Here, talk of legacy tends towards how children and grandchildren had turned out? Whether they had been adequately provided for?

For what, and for how long, the protagonist would be missed or remembered? Grudgingly acknowledging the inconvenient truth: not for much, and not for long. If at all.

Over the weeks spent visiting the ward, I got to know some of the patients. Lending a sympathetic ear or supportive hand to those in need of a diversion, while the person I was there to see slept.

None reminisced about the jobs they had performed. The nappies changed, houses built, essays marked, budgets prepared, businesses founded, or lines of code written. Beyond their former professions being a token of identity, they barely rated a mention at all.

None reflected on the things they had bought or experiences they had purchased. Cars. Holidays. Houses. Concerts given or attended. Sporting events witnessed or participated in. All irrelevant.

Fleeting.

Fun, in the moment.

But hardly noteworthy.

None discussed educational attainment, career ambitions realised, or net worth accumulated. Those things that seemed so important while living became mere trivialities when dying.

Nobody cared.

Nobody was watching.

What they did talk about were regrets. Of tragic ends and truncated potential. Caused by accidents, addictions, character flaws, illness, incarceration, random chance, or sheer stubbornness.

Estranged children. Falling out with friends. Philandering partners. When reflected upon in hindsight, from the perspective of an exit lounge observer, the causes seem trivial. The consequences outsized.

A recurring theme throughout the ward residents was the wholehearted lament to not waste time. Quotes from Hollywood’s greatest hits were repeated again and again.

Seize the day.

If not now, then when?

Why wait for the good stuff?

Live for today, we might not get tomorrow.

And the inverse: if something isn’t working do something about it. Why wait?

Act swiftly. Act decisively. But most importantly, act!

At the end of a glacial day spent sitting around, I collapsed into the driver’s seat of the car and mindlessly watched the sunset from the top of the hospital’s multi-storey car park. The overcast sky turned vivid hues of purple and orange, before fading to black.

I had finished the day holding the hand of a woman in her eighties. Cancer had ravaged her body, reducing it to a weight of just thirty-five kilograms. Spindly limbs, all elbows and knees, had propelled her around the ward for days, her irrepressible personality spreading delight amongst nursing staff and patients alike.

Then the reaper had come calling. Frightening away her husband of 40+ years, unable to cope with what was playing out before him. Abandoning her to face the end alone.

She had given his back a wistful smile as he scuttled away, cowardice triumphing over compassion.

“Thank goodness, I thought he would never leave!” she sighed. “He always was a disappointment. Safe. Boring. A good provider. But deep down, always selfish. A taker rather than a giver. Dependable only when there was something in it for him. I shouldn’t complain, I realised it early on. I knew it when I married him. People don’t fundamentally change.”

From across the ward, I had raised an eyebrow. The patient I was visiting snored softly. There was nobody else around.

She smiled, before weakly beckoning me over. The quantity of morphine she was on would have stunned an adult elephant, yet it barely dulled her pain. Yet her eyes sparkled mischievously.

“Oh, don’t get me wrong, we have lived a long and occasionally happy life together. I just wish younger me had possessed the self-confidence way back then to give voice to what she was thinking: I deserve better. Consciously sought out the right fit, rather than settling for the right now.”

Clasping my hand in both of her skeletal ones, she whispered “you deserve better too”.

She sighed again. Longer this time, becoming a death rattle. Mischievous eyes glazing over, staring into the distance at something only she could see. Jaw going slack, then gaping open.

I sat quietly for a moment. The old lady’s death was not the first I’d witnessed. Nor would it be the last. It was always a disheartening experience. The finality of life exposed. No fanfare. No theological extravaganza of angels and demons. Just the end. The person gone, their empty carcass remains.

I wandered out to the nursing station to inform the duty nurse, catching him just before shift change.

Minutes later the body had been wheeled away. Personal effects were gathered up. In less than an hour the bed had a new occupant, cared for by a fresh cohort of medical staff. Life going inexorably on, as though the old lady had never existed.

As I drove home, the old lady’s final words haunted me, as I suspect they would continue to do in the days ahead. Had she been correct? She had no reason to lie.

Given my age, my life is likely more than half over. The little half ahead unlikely to be as mobile or vigorous as the larger half stretching out in the rear vision mirror. Did I want to experience the same regret by reaching a similar conclusion upon my own deathbed? Recognising  I had sold myself short, through a combination of complacency and convenience?

She had been correct about people not changing.

Astute to observe that deep down we know their limitations early on in any relationship, be that friendship, professional, or romantic. Yet we persist, feigning surprise when they inevitably disappoint.

If I was being honest with myself, I already knew that conclusion to be true of several facets of my life. Facets only I could change. Changes that would require conscious decision and determined action.

The patient I had been visiting would soon leave the cancer ward on their own two feet. This time.

The outcome had been worth the high price of the treatment. This time.

But we would be back. As inevitable as tomorrow’s sunrise.

Without change the outcome is merely delayed, not defeated.

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