The Patient (13 page)

‘I don't know, doctor. What do you advise?' asked Jonathan. He and Tracy both looked worried and confused.

‘Look, I feel that BCG treatment gives us a chance to salvage your bladder. It entails coming into the hospital once a week. We place a catheter into your bladder, and then we place a solution into it, which stays in there for about 15 minutes and is then drained out. Nothing could be simpler, really.'

‘And you're
sure
it isn't dangerous?' Jonathan was nervous about the whole idea.

‘Of course, there are some possible complications. Some patients end up with cystitis – they need to go to the toilet all the time. There are other complications, some serious. There is a small number of patients who die from the treatment. These are usually older and less fit patients. If it doesn't work, then we still have the opportunity to take out your bladder. OK?'

Jonathan was getting really sick of hearing that ‘OK'.
Take out my bladder? What is he talking about? How would I pass urine then? And I thought he'd taken out the cancer already. Why is he talking about more treatment? BCG? Sounds like a cricket ground somewhere.

Tracy could see that Jonathan was overwhelmed and it was time for her to take charge. ‘If that's what you advise, what do we need to do next?'

‘I'll make the necessary arrangements,' Derek said.

That night, after the whole family had gone to bed, Jonathan stayed up, unable to sleep. He put his headphones on and selected Pink Floyd's
Dark Side of the Moon
on his Discman. This album was reserved for times when he needed to calm his mind. He had played it constantly when he'd been doing his high-school examinations. He'd played it the day he'd left home. He'd played it the night, a year before he and Tracy had got married, when she'd told him she was pregnant and they'd decided she would have a secret abortion. And he'd played it a couple of days later, after she'd miscarried. He'd played it the night he'd been planning to ask Tracy to marry him. He'd played it the night before he'd resigned from his previous job and later that week when he'd been offered his current position. Now, he played it because he needed to blast the negativity out of his mind.

Myriad thoughts haunting him, he walked around the house. At midnight, he went into his daughters' room. There was the essence of innocence asleep in their beds: Emma and Kate, breathing quietly. They were unaware of the man standing in their room struggling to hold back tears. They had grown so much, so fast. He was suddenly aware of the passing of time, especially his own. The realisation had struck him that he may not see his girls finish high school. He may not be the one to walk them down the aisle.

Why was he thinking these dark thoughts? The doctor had said they could control this cancer. They could cure it. Still, deep inside, Jonathan was preparing for the possibility that he might not survive. Disturbing questions haunted him, replaying themselves in his mind like a broken record.
Was his life what he wanted it to be? Was he at peace with himself? If this was as old as he was destined ever to get, and if he'd somehow known about it early on, would he have the job he currently held? Would he be married? Would he have this house or the mortgage or the car or the designer life?

Each time he thought about these things, he felt genuinely that he would not change much in his life, even if he'd always known his life was destined to end this way, at this time. However, the questions kept being asked. He decided to go down to the garage and get the car out. He drove as if on autopilot as the wailing woman on ‘The Great Gig in the Sky' improvised her orgasmic cries. He stopped at the local 7-Eleven and bought a packet of smokes and a lighter. The drag of that first cigarette was overwhelmingly comforting. He hadn't smoked for weeks now, but fuck it – what did he have to lose? He drove to the beach, parked the car and went and sat on the sand. If he knew for sure he was dying, maybe he would have smoked more right there and then. What would be the point of holding off? He giggled to himself, imagining himself smoking ten cigarettes at a time. The waves were pounding away not far from where he sat.

Months earlier, the family had had a long weekend up the coast, and he was reminded of it by the sound of the surf. They had lunched one day at a vegetarian restaurant in a boutique health spa that Tracy had just gone to for a massage. There was a large pond in the middle of the restaurant, and he was struck by the beauty of a fully opened lotus flower. A heavenly pink colour, its petals were perfect. Its beauty was the type of beauty that could almost
make a man believe in God. But as lunch was served, the lotus flower began to close. By the time they were having dessert, it was no more, just a greenish-brown bulb. The owner of the restaurant, seeing Jonathan's disappointment, came over and said to him, ‘Only change is constant. Everything is transient. At least, that's what Buddha said. Life is suffering: you're born and enjoy your youth and health and then it too withers away, like the lotus flower.' She smiled in a New Agey way and glided off to take plates from the next table. Jonathan and Tracy had rolled their eyes at each other, and he hadn't thought much more about it – but now the woman's words had taken on a new significance.

At dawn, as the sun rose and painted the dark water with a purple glow that gradually turned to yellow, Jonathan was sitting on the sand with several butts around him. He wearily returned home in time to see Tracy stir out of her slumber.

‘Did you get up early?' she said sleepily.

‘Yeah. I'll bring you coffee.'

Life went on. The profundity of his thoughts throughout the night were replaced by the profundity of making breakfast for the girls, getting them ready for school, having a shower and eating.

He drove to work that day, and every day. He was now leading a double life. There was the Jonathan who participated in day-to-day events, conversations and plans; and then there was the Jonathan looking upon his own life as though it were a movie he was watching. The inner Jonathan looked on. Here was a life living its life, like a fly feasting on faeces, before it begat other flies and then met its demise. No more nor less than a fly. That is what his life meant.

His friends started to treat him differently. They didn't know how to deal with the fact that he was now always withdrawn. They found the pressure of not mentioning the unmentionable too great. He had trouble sharing his fears with Tracy; he didn't want to scare her or the girls. And so Jonathan's life became quite lonely, despite being surrounded by the same people and the same worldly clutter.

Two weeks after he received his pathology results, Jonathan Brewster went for his first treatment session at the Victoria Hospital.

He stood at a reception desk that read ‘Admissions'. There was no one there. The phone was ringing. The desk was cluttered with patient records, notes and X-rays. Down the corridor, he could hear a woman screaming. Doctors and nurses were entering and leaving a room, and each time the door opened the screaming sounded louder.

‘Help me. Help me,' the woman called out in an Indian accent. She sounded young. ‘Please, God, make the pain stop. Make it stop!' The nurse was running now, carrying a kidney dish with a syringe in it.
A painkiller, probably
, thought Jonathan. There was a time when he would have been able to block out the woman's suffering, ignore it, but now his heart reached out to this poor woman.
It could be me screaming out like that one day.
He dismissed the thought.

The screaming down the corridor continued for several minutes but became softer, until eventually it stopped. Jonathan figured that the painkiller must have taken effect. The nurses and doctors came out of her room, walking
slowly. One of the doctors came around behind the desk, sat stiffly on the chair and opened up a folder full of notes. He looked up at the clock behind Jonathan, and then wrote down the time. Jonathan became aware of a different sound. Sobbing. Wailing. A child was crying, almost screaming with grief. ‘Please don't die, Mum. Please don't die.'

‘Where's the boy's father? For God's sake, the kid's only eight years old,' said one of the nurses under her breath to the doctor behind the desk, who simply shrugged.

‘Lives in another city now, with a new family. Hasn't even been in contact with his son. Would you believe it?' answered another nurse.

‘So who's been looking after him all this time?'

‘The woman's friends were popping in to look after him, I think, but he's going to be a ward of the state now, poor little bugger. Child services have got a foster home lined up for him – I'll call them to come get him.'

As she picked up the phone to dial, the first nurse finally noticed Jonathan and asked, ‘Are you OK?'

‘I'm here to have a dose of BCG for my bladder cancer. I have a letter from my doctor.' He was surprised by how articulate he had managed to be. The blood had drained from his face, and he felt shattered.

‘I haven't heard of that being given here. Let me see your letter.' The nurse was the unit manager. She had a graduate certificate in Management and Finance and was well on her way to leaving the wards and getting her promotion to administration, where she would be free of this constant screaming that filled her daily life. She felt impatient with Jonathan for being unaware of the department he was due to attend.

‘This is the cancer ward. You need to be in the day-stay suite. Go downstairs to level three and then turn sharp left. You'll see the reception desk there.'

As Jonathan headed to the lift, she turned and addressed the doctor behind the desk. ‘Do you mind using the doctors' office, please? This area is for nurses. It's not for you to write your notes here. We have precious little space as it is.' The doctor was obviously junior, and he apologised as he left, though he was clearly resentful. ‘They truly are stupid, some of them. There are clear policies that are there for a reason. Where's the ward clerk going to sit when we recruit one?' She seemed to be addressing no one in particular.

‘Can I help you, love?' Gail, the ward clerk for the day-stay suite, was a buxom rounded woman in her 50s who'd been in her position for over 30 years. She had seen a lot of changes in health care. There was a time when doctors ran the health service. They were the good times, she recalled. Now it was managers, nurses and bureaucrats, which meant her job had become far less about patients and much more about policies. She had to enter all kinds of details into a computer that had never been considered necessary before: how many patients were treated each day, who treated them, when they came and when they left. She knew she was only a small cog in a big machine, and yet she maintained her humanity, her compassion, and she continued to treat one and all with the respect they were due. The doctor was always addressed as ‘doctor' or ‘doc' and the nurse always as ‘sister'. Patients were ‘love' or ‘Mr' or ‘Mrs'. She never addressed anyone as ‘Ms'.