The Patient (14 page)

‘I'm here for BCG treatment for my bladder.'

‘Right, I'll get sister for you. Please take a seat over there. Won't be long.' Gail got up from her seat, and, as she passed him, Jonathan could smell her considerable body odour. Her nylon floral dress was well worn; he could see stains in her armpits. Yet he immediately liked this woman. She was warm, friendly and respectful.

Within minutes, a nurse appeared. ‘Would you like to come in now, Mr Brewster?' she asked.

‘No,' Jonathan answered instinctively, and the two exchanged wry smiles before he walked into the treatment room.

It was a simple room with a freshly made bed, a sink in the corner and a cupboard with a large vent over it.

The nurse took Jonathan's letter and read it, placed it on the desk next to the vent and then turned to him. ‘My name is Vera, and I'll be administering your medication today. Do you mind if I ask you some questions before we start?' Her accent was difficult to pinpoint, but Jonathan thought it may have been South African. Her compassion was overwhelmingly welcome. She was only young, perhaps late 20s, with blonde hair, blue eyes, clear skin. Jonathan just wanted to curl up in her arms.

‘No. Ask anything.'

‘You are very much younger than our standard patient for BCG. How did you know you had bladder cancer?' she asked with a concerned look on her face.

‘I had blood in my urine one morning. Then I had a bladder resection, I think they call it. That's when they found T1 cancer and CIS.'

‘Carcinoma in situ.'

‘Yeah, that's it. I know some patients go to libraries and do research on their disease. I really want to know as little as possible. I just want it gone.'

‘We get both types of patients here. It's OK not to want to know.' She went on to ask him about his health, his smoking history and his allergies. She was very thorough. ‘OK, now I'd like to tell you about what we'll be doing. I'll shortly be asking you to take off your clothing, and then I'll ask you to get into this gown. I'll then put a catheter into your bladder through your penis.' She showed him the tube in its sterile wrapping. ‘I know it looks large, but I'll inject you with a local anaesthetic first and use plenty of lubricant, so it shouldn't be too bad, apart from being a little uncomfortable. I'll then place the medication in your bladder through the tube and leave it in for about 15 minutes. During that time, I'll get you to move around from side to side so that we get coverage of the entire bladder. Then I'll drain it out, take out the tube and you'll be on your way until next week. Any questions?'

‘No, I'm fine. I'm ready.'

‘I'll leave the room now. Please take off your clothes and put this gown on for me.'

After she'd left the room, he did as she asked. He considered leaving his underpants on but realised that this was exactly the bit of clothing she most needed off. He donned the gown and sat down on the side of the bed. Shortly after, there was a knock.

‘Are you ready?'

‘Yes, I'm dressed. I mean, undressed,' he said.

‘Lie down, please.' She had brought in a trolley with various instruments on it. After washing her hands in the
sink and drying them with the paper towel on her trolley, she put on gloves.

‘OK, lift your gown for me, right up to the waist.' Jonathan was embarrassed to show this pretty young nurse his nakedness, and she quickly picked up on it.

‘I've seen hundreds, you know. Come on, I'll not tell if you don't tell.' She was smiling at him in a friendly way, and he reluctantly pulled up his gown.

The cold sterilising solution hit his penis and scrotum like a splash of ice. He felt his testicles retract. She worked efficiently and quickly. Before he knew it, she had his penis in her left hand stretched upwards and into the eye she had injected a local anaesthetic jelly. Jonathan yelped. It stung severely.

‘It will soon go numb.'

Sure enough, it did. Then, she took the large rubber tube – the catheter – and inserted it into his penis. He yelped again.

‘Oh, God!' he screamed as the tube went past his prostate into his bladder. His eyes were teary.

‘The worst is over now.'

She drained the urine from his bladder. Still working quickly, she took hold of a large syringe and injected its clear contents into the end of the catheter. It was the strangest sensation to feel fluid flowing up into the bladder instead of flowing out.

‘Now, five minutes on your back, five minutes on your left side, five minutes on your right side and then we drain the fluid. Do you have any pain now?' She had covered him up and had taken off her gloves.

‘No, it's fine now.'

Within minutes, Jonathan started feeling warmth in his pelvis. When it was all over, she took out the catheter and went through some paperwork with Jonathan. ‘OK, see you next week at the same time. You can get dressed now, and, when you feel up to it, you can leave. I'll be waiting outside to make sure you haven't got any dizziness or other problems.' With that, she left the room with her trolley and medication.

Jonathan got dressed, came out and Vera walked him to the lift. As they went down the corridor, he turned his head and saw a large room that contained patients sitting on reclining chairs, hooked up to intravenous drips.

‘They're some of our patients getting chemotherapy,' she said and stopped at the door of the ward to say hello to a few people. Most of them were bald or balding. Some of the women had scarves on. Some of the intravenous drips bore the skull and crossbones.

‘Are you OK? Does it upset you to see them?' she said, studying his face.

‘It's awful. They look so awful. I hope I'm never in that position.'

‘I hope not too,' she said and touched his shoulder with her hand.

‘I don't know how you work here. You must see so much suffering.'

‘Yes. But we also see the cures. It is not all doom and destruction.' Her voice was upbeat and professional, but, from a sadness he saw in her eyes, Jonathan thought she might not be entirely convinced.

Tracy was waiting at the end of the corridor to pick him up.

‘You didn't need to come. Honestly, I could've caught a cab.'

She wanted to know all about his treatment. He could think of nothing but the nurse, Vera, and the gentle way she had laid her hand on his shoulder.

‘Your father's waiting at home. He wants to talk to you,' Tracy said.

‘Oh, fuck. That's all I need.'

‘Your mother is dead. May she rest in peace.' Mr Brewster was short and to the point.

‘When … how?' Jonathan sat down, feeling light headed.

‘She died this morning, Jonathan. You were going in for your treatment, and I didn't want to disturb that, especially the first time. There was nothing you or anyone could have done, son. Her heart stopped, and the doctors and nurses worked on her for over three-quarters of an hour, but it was her time. The Lord chose to bring her back to His kingdom.' He pulled a hankie out of his pocket and wiped his eyes.

Jonathan felt his mother had been dead for several years; it was just that her heart had chosen today to stop. He was sad yet also relieved. Earlier on, when he had been visiting her regularly, every now and then he'd got the feeling that she was actually conscious and that she was aware of everything around her but was trapped in her non-functioning body. Whenever he thought that might be the case, he got a suffocating sense of claustrophobia. He imagined
his mother trying to scream, to say ‘I'm in here'. Often, he would suffer nightmares in which she called out to him and he was unable to respond. There was a barrier between them.

That barrier, of course, was her dead brain tissue.

Jonathan looked at his wife. ‘Did you know, Trace?'

‘Your dad told me this morning. He asked me to keep it from you until after your treatment this afternoon.'

‘I didn't want you burdened with this. I wanted you to concentrate on getting better. You need to beat this evil thing in your bladder. The Lord provides the wonders of modern medicine and –'

‘Dad, what are the arrangements?' Jonathan interrupted.

‘Your mother's funeral will be at the end of the week. It's all taken care of.' Tracy and her father-in-law had made all the arrangements while Jonathan was admiring the beauty of his BCG nurse.

When his father had left, Jonathan went upstairs to his study and put on his headphones; he needed to drown out his thoughts, his grief, his loss. Only a couple of months ago, his life was stable and within his control; his future had seemed limitless. Now, bit by bit, everything he knew was falling away, unravelling.

Jonathan read the eulogy at his mother's funeral and spoke well of her, remembering the woman she was before her illness. The family priest led the usual prayers and committed Mrs Brewster to the grave, as Jonathan stood with his father, family friends and relatives.

Two days later, it was time for Jonathan's next dose of BCG, and he was in the lift on his way up to the day-stay floor. He was running late, which made him agitated because this seemed to be the only department at the Victoria that was ever on time, and if he missed his appointment they might send someone in before him. He couldn't afford to take a second longer off work than he absolutely had to.

The doors on the ground floor opened, and an elderly man with sunken eyes shuffled in. Jonathan was irritated by the interruption to his ascent from the car park. Not only that, the man was slow and feeble, delaying him even further. Their eyes met momentarily, and the man could sense Jonathan's irritation. He apologised for holding him up, then, as the lift doors closed, asked, ‘Are you a patient or a visitor?'

‘Patient,' said Jonathan tersely.

‘I'm sorry to hear that. My wife's in having chemotherapy. They're so good here. Look after her really well. Bill's me name,' he announced, holding out his hand.

‘Jonathan.' He shook Bill's hand reluctantly. They arrived at the floor, and the lift door clanked open. Jonathan knew where he had to go and sped towards his treatment room, leaving Bill behind.

Vera was there again, and first she came in to ask him how he had felt after the previous week's treatment. ‘You seem really distracted today. Have you been sleeping?' she asked with concern.

‘My mother passed away. The funeral was only a couple of days ago,' he said, his tone flat.

‘Oh, that must have been really tough.' Vera sat on the side of the bed with her hand on his.

‘I don't know. In a way, it was a blessed relief for her, for us all. She was sick for a long time,' he answered. ‘It's never easy, though. Even when you're expecting it, it's never easy. That finality. All I can think of is the wonderful times I had with her. Hugs. Conversations. Before she got sick.'

‘Do you think it's harder, going through your mum passing away while you're in treatment?' Facing a loved one's death often made people think about their own mortality, and she imagined it must be even more confronting for cancer patients such as Jonathan, but she wanted him to voice it to himself.

‘I did have a strange feeling, like I could see myself down in that casket. I kept thinking: what would my daughters say or do? How would they get on? I have life insurance, so they would be OK financially – well, at least the insurance would pay the mortgage off. But how would they grow up without me? Would my wife marry again? I really hope this treatment works.' He had said more than he was usually comfortable to.

‘Are you religious?' she asked.

‘No. I don't even know if I believe in God any more. My father's trying to get me to start praying again, but I can't be bothered.'

Suddenly, a loud beeping noise interrupted their conversation.

‘Oh, shit. Cardiac arrest. I'll be back as soon as I can,' Vera shouted as she ran from the room.

Jonathan was left alone in the treatment room. He could hear shouting in the corridor outside and people running.

He opened the door out of curiosity. There, in the middle of the corridor was the elderly man he had seen in
the lift, lying on the floor. Doctors and nurses were kneeling around him. Someone had ripped his shirt front open and was doing cardiac massage, while another was trying to insert a tube into his mouth.

‘Where is the defibrillator? For God's sake, this is a circus.' It was the Oncology resident whom Jonathan had seen around the hospital before.

Vera came over, struggling under the weight of the defibrillator. The doctor placed both paddles on the man's chest. ‘Ventricular tachycardia! Give me two hundred and stand back.'

They were all looking at Vera as she dialled up the electrical current on the defibrillator.

‘Ready,' she shouted. Now all eyes turned to the doctor.

‘Stand clear,' he said and pressed his thumbs down on the paddles. The patient's back arched up, the electrical current contracting his muscles as if he were in an electric chair. The patient soiled himself, and the smell wafted throughout the ward.

‘Bill! Bill!' a woman was hysterically screaming.

Jonathan looked down the corridor and saw a frail old woman standing in the doorway of the chemotherapy room. Trailing on the ground behind her was her drip stand and the tubing that she had been hooked up to for receiving chemotherapy. She seemed oblivious to it as she began to make her way down the corridor.

‘Bill!' she screamed again. She pushed past the crowd of nurses, doctors and orderlies and flung herself on the man's chest. It was pandemonium.

‘Bill! What are you doing on the floor? Get up, Bill. You're making a fool of yourself, Bill. Bill?' She was out of
control now. As one of the orderlies tried to pull her away and allow the resident to use the defibrillator again, she cried out, ‘Leave me alone. Get your hands off me.'

The oncology resident looked up at the clock. ‘Time of death, 4.43 pm. I'm sorry, Mrs Jeffreys. We have done all we can.' He stood up and signalled to the orderlies to move him onto a bed. Mrs Jeffreys was trying to resuscitate her husband.

‘Wake up, Bill! Wake up! What is going on? What are you doing? Leave him alone. He will get up in a minute. He has probably tripped. Get your hands off me.' Vera had her arms on Mrs Jeffreys' shoulders.

‘I'm sorry, Mrs Jeffreys. You have to let them put your husband on the trolley so we can move him out of the corridor. I'm sorry. He is gone.' Vera was whispering softly. Mrs Jeffreys was now sobbing.

Jonathan stood staring as they moved the man's body onto the trolley. A nurse attended to Mrs Jeffreys' arm and gathered up the felled equipment, spilt chemotherapy and debris. They moved the man's body and his wife to a spare treatment room, and within minutes the corridor was back to normal. A man in a white coat accompanied by what appeared to be eight medical students walked up the corridor, discussing some aspect of medical science or other. They walked over the exact spot where Bill had died only minutes previously. Almost every square metre of this hospital must have seen a death, a tragedy, a passing.

Jonathan hated life, hated disease. Here was a man who only a short time ago had been in the lift with him trying to strike up a conversation. The suddenness of his demise caught Jonathan's breath. He didn't know he was going
to die today. Had he made preparations? His wife needed him. Jonathan was lamenting for himself as much as he was for Bill and his wife. The tragedy of her being left alone at her time of greatest need struck at Jonathan's soul.
This is a terrible place
, he thought, looking at his surroundings. It had revealed to him that humans are vulnerable, subject to the whim of life's roulette table. Unaware of their fate, they wander around convincing themselves of the permanence of the things about them that they can touch, hold and feel.

Vera returned and saw that Jonathan was deep in thought. Whenever there was a death on the ward, there was a lot of repair work to be done, restoring hope to the hopeless. But Jonathan needed time to process the full force of what it meant to be mortal and suffering from a life-threatening disease. The association with recurrent deaths seemed to be instilling in him a sense of his own mortality, and he did not like facing the abyss. He tried to steady his feelings by recalling that the doctor had told him his cancer was amenable to treatment, curable even. Vera saw the fear in Jonathan's eyes, as she had seen it in a thousand patients before him and would see it in a thousand more again. She knew that there was nothing she could say or do to help him alleviate it.

Jonathan left that day a very troubled man, struggling to digest the tragedies of the hospital. Later, at home, he mechanically turned on his answering machine. There was a message from Carter.

‘Please ring me when you get a chance. I think you and I need to talk.' Jonathan's heart sank. He knew the tone. He knew the content. Jake had been making advances on his
job ever since he got sick, and he was in a position to take over all of Jonathan's projects.

‘Why have you got all your stuff from the office here?' Tracy was confused to see two boxes on the dining-room table containing the various goods that Jonathan had at the office: pictures of the girls, a framed ‘Desiderata', his desk set.

It quickly dawned on Tracy what the boxes meant, and her eyes got teary. ‘Girls, go up to your room and do your homework. I'll fix dinner,' she said, in a slightly too bright tone.

Jonathan just sat on the lounge with his head in his hands. He didn't know what to say or do. He had been sitting there almost the whole day.

‘Carter – what a heartless bastard.' Tracy was shaking her head now. She took a deep breath and walked over to sit beside her husband. ‘Jon, only one thing matters now, your health. We'll work through this together.'

‘Tracy, let's face it, we're fucked. Who's going to take me on while I'm in the middle of cancer treatment? Everybody's heard about it. I couldn't possibly get the kind of job that pays what we need to live the way we do,' he said.

‘Jon, I can try and get a job.'

Jonathan didn't want to cause Tracy any more anxiety, but the time for mincing words was past. She had to understand the extent of the financial straits that they were now in. ‘My redundancy will hardly last us three months. Even if you do get a job, it's unlikely to be able to cover all the mortgage, love. We've got nothing saved up in the bank.'

Tracy nodded slowly, trying to deal with this new reality.