The Quilt (32 page)

“How was your Christmas?”

“I worked double shifts most
of the time but had Christmas Day off.  You have lost weight.”

Joanne looked at the bones that
had erupted from Sandy’s shoulders.

“The food was terrible and
I am sure they have given me a virus.  I have been coughing for a week.”

Sandy handed Critter to Joanne and absentmindedly rubbed her shoulder.

“I think I have even pulled a muscle.”

“You know your immune system is compromised. 
If you need medication, I will get in contact with Doctor Martin.”

Sandy waved a dismissive arm
.

“Ring him if you must
.” She walked towards her room. “I am going to get some sleep.  Don’t worry about me if you are cooking.”

Joanne left a message with the receptionist and waited impatiently for Doctor Martin to return her call.

“Sandy has returned from Christmas w
ith a virus.  She coughed constantly last night.  Can you prescribe antibiotics over the telephone or will she need an appointment?”

“If it is a virus
, antibiotics would not be effective.  Is the cough dry or productive, Joanne?”

“Dry and
persistent.  She is complaining about shoulder pain and seems to think that is a result of her coughing.”

“It would be normal procedure to examine Sandy and then
, given her medical history, send her for a chest x-ray to eliminate anything sinister.  I think given her resistance to appointments I will organize a referral and see her tomorrow after the x-ray to discuss their findings and prescribe medication if necessary.”

Sandy sat with her arms crossed glaring furiously at the opposite side of Doctor Martin’s office.

“Why could you not prescribe antibiotics instead of insisting I had
to have another x-ray?”

He appeared unconcerned by her outburst.

“
Sandy, the chest x-ray was done to ascertain whether the tumours in your breast and lymph nodes have spread.”

He hesitated.

“I am sorry, but they have confirmed the cancer has travelled to your lungs.”

Sandy’
s eyes settled on the doctors face.  He remained expressionless and continued to speak in a measured, controlled voice.

“At this stage our only
option is to radiate and try to slow the progress down.  I suggest you also continue with the chemotherapy.”

Sandy’s face flushed angrily
.

“And how
, exactly, has the chemotherapy helped me so far?  Like hell I will continue treatment!’

She pushed her chair back and it toppled to the floor with a dull thud. 
Without saying another word Sandy walked out of the office and slammed the door behind her.

“Let her go.” Doctor Martin rubbed his eyes before looking across the table at Joanne.

“I really can’t continue this conversation
unless disclosure is authorised by Sandy.” 

“Please do not quote confidentiality to me.  With the utmost respect
, I need to be made aware of her prognosis.”

“Sandy has a next of kin
.”

“That next of kin is her m
other.  The same mother that appears unable to attend even one chemotherapy session with Sandy.”

Doctor Hansen studied Joanne
and doubt spread over his face.

“I will speak in general terms.  I am
not referring to any patient in particular.”

Joanne nodded.

“If the cancer cells are allowed to spread to other organs, the term we use is metastatic. They have the potential to travel to almost any region of the body.  Damn it, lets stop playing word games.”

“Thank you.  Please
, be honest.”

“Sandy’s primar
y cancer was in her breast and lymph nodes.  Unfortunately, with the delay in diagnosis, and despite our aggressive treatment, it has travelled from the original tumour site to her lungs. I suspect if we were to do a scan it would also be detected in the bone.”

“Joanne
, the prognosis is poor.  There is a very real chance that even if she did agree to further chemotherapy it would not be effective.”

He paused briefly to rub his eyes before continuing.

“Assuming we continue treatment, she will require further chest x-rays and a CT. If that shows progression of the lung metastases Sandy will gradually decline in health.  Often treatment focuses on relieving symptoms and pain while extending as far as is possible the woman’s life.”

“There is also a chance the cancer will spread to her brain and liver.  At this stage she would need intensive pain relief which is often best managed in a hospice environment
.”

“
There is no chance of recovery?”

“We are human
so, of course, there is always a small chance.  But on the evidence I have in front of me I think it highly unlikely that Sandy will even experience remission let alone a recovery.  Unfortunately, the tumour was well progressed by the time she was diagnosed.”

“But t
here are new drugs and procedures that are publicized regularly.”

“Joanne
, if a cure was found tomorrow I think its benefit to Sandy at her stage of the disease would be questionable.  As far as trials are concerned her immune system is compromised to such an extent it is unlikely she would be considered a suitable candidate.”

H
is expression softened. 

“I know a very good nurse that specialises in
palliative care. I would highly recommend Raewyn to anyone requiring in home support.  Would you like me to pass on your contact details?”

J
oanne nodded.

“Sandy is not even twenty five years
old.  How do you cope with this?”

Doctor Marti
n smiled but there was no humour in his expression.

“I go home to a beautiful wife and
healthy children every night.  Each Thursday I receive a generous pay packet and, after you leave, I get to tell a mother that she is in remission and will live to spend precious time with her young son.  Joanne, can I offer you some advice?”

Joanne nodded.

“Make sure, when the time comes, you have something else in your life, something that is important to you and something that will still be there when Sandy no longer needs you.”

“Thank yo
u for your honesty Doctor Martin.  Everything you have said will remain in confidence.”

There was only one woman sitting in the waiting room.  She was middle aged with light brown hair and anxious, brooding, dark eyes.  A small boy of about four hung on to her arm, on his lap was a book that they had been reading.  The woman looked up as Joanne walked passed, she smiled nervously and placed her hand over the small fingers of her son. 

Sandy’s car was no longer in the parking area.  Joanne reached for her mobile and rung Simon.

“Sorry
, I am going to be late.”

“Weren’t you going to the specialist with Sandy this afternoon?”

“I’m here now.”

“Is everything alright
, Joanne?”

“No.  Sandy has just been told
the cancer has spread to her lungs.  I have no idea where she has gone.”

“Stay where you are.  I will be there as soon as I can
.”

“Is she likely to harm herself?”

“Only
, if by harm, you mean picking up a total stranger or spending money she doesn’t have on things she doesn’t need.”

Simon carried two cups of coffee over to the table.

“I am not sure that this is the appropriate time to discuss an idea.”

Joanne
sipped her coffee and eyed Simon.

“Would you consider t
aking a hospitality management course if the café offered it to you?”

“Simon
, that is very generous.  But you know I intend to return to law as soon as...” Joanne struggled to find the words and Simon finished the sentence for her.

“As soon as you have the time.  Yes
, I realize that, but my offer is not totally unselfish.  I haven’t had the opportunity to take time away from the business for a number of reasons.  The main one is that I have never had anyone capable, or that I would trust, to take over the responsibility in my absence.  In the future, would you consider taking over the role of manager while I travel for a few weeks?”

“Of course.  But you don’t have to invest thousands of dollars in me to insure I would be there to help
.”

“It is all tax deductable
.  Anyway, I might have the advantage of your knowledge for months, or even years if Sandy was to go into remission.”

Mari and Sid knocked on the door but didn’t wait for it to be opened. 

“Paul, have you spoken to your m
other?”

“No
, what has she been up to now?”

Mari walked forward and placed a brochure in front of him.  She took the remote control
out of his hand and turned off the rugby.  He groaned and sat up looking briefly at the coloured advertisement depicting a luxurious canal boat cruising in the Bordeaux region of France.

“So when are you leaving?
”

“We leave from Graves in four weeks, with Jean and Sean.”

Chapter 30

“
A Time for Choice”

Joanne spread the first modules across the dining room table.  She was thumbing through the suggested timeframes and course outline when Sandy entered the room.

“You look terrible
.”

Joanne watched her walk across the room and p
ick Critter up before she responded.

“If I look terrible it is because I have spent a week worrying about you,
about where you were and what you were doing.  Sandy, you have been missing for days.”

“
I’m sorry.  I needed time.”

Guilt
passed briefly over Sandy’s face.

“It really isn’t fair
that I get the lump and you live with the cancer.  What are the papers on the table?”

“Simon has asked me to do a hospitality management c
ourse.”

Sandy frowned and glanced at
one of the modules.

“
Looking for a change in profession? Joanne, you do realize he is gay don’t you?”

“Of course
, I do.  Is there anything you would like to talk through?  You must have thought about what Doctor Martin said” 

Sandy considered the question for a moment.

“If you were in my position would you continue with the treatment, Joanne?” 

There was a slight hesitation
.

“I would follow the advice of my specialist
.”

“I think that answers my question
.”

There was an ice like calmnes
s in Sandy’s expression.  She gently placed Critter on the ground and a brief moment of pain was reflected in her expression.

“Is your shoulder still uncomfortable?”

Sandy made no effort to reply.

“You didn’t have any of your medication with you.  Doctor Martin has recommended a nurse that will be able to offer support in the home
.”

Joanne spoke
, cautiously watching Sandy’s stony expression for a glimmer of emotion.

“That’s fine
, as long as no one is recommending I am put in a hospital.” 

Sid’s gruff voice echoed through the barrel room.  He had wandered around the property trying to locate Paul and was feeling irritated by the change in climate and the long return flight back to New Zealand. 

“There you are.  I saw the truck was here but I couldn’t find you.  Jean asked
if we could bring this album to you when we got back.  She insisted on sending post cards from every place we visited and asked if you could put them in here for her.”

He put
the bulging photo album on the bench and rubbed the rough stubble on his chin. 

“Jean and Sean should just about be home by now.  Perhaps
you should give them a call later tonight?”

Paul smiled.
 

“Tell Mari
I will come up tomorrow after you have had a chance to unpack and she can tell me all about the trip.”

Reluctantly, Paul got out of the pool.  It had been tempting to leave the telephone to ring but the insistent caller had hung up and then redialled.

“Yes
?” his voice bristled with annoyance.

“Paul?  Your m
other took a fall in the shower yesterday.”

“
She is alright?” Sean added quickly before continuing.

“
She fell heavily and has a compound fracture in her right forearm.  We have just got back from the hospital.  It is quite nasty; she broke both the radius and ulna.”

“I tried to ring you last night to check you had got home safely
.  I was wondering why there was no reply.”

“
I saw your messages on the answerphone when we came in.  They kept her overnight after the surgery.  They had to put in titanium plates and screws to hold the old girl together.”

Sean tried to sound reassuring but his voice was heavy with concern.

“Would you like me to come down?  I can easily get Sid to stand in here and someone to cover me on Coastguard.”

“No
, there really isn’t anything that you can do at this stage.  Let’s just see how things go over the next few days.”

Mari turned the tea towel around in her hands until it formed a thick coil.

“Bones do not always heal well when you are older.  Please give Sean a ring and see how
Jean is doing.”

She put down the towel and handed the telephone to Paul.

“For the sake of peace, please call them.” 

Sid chuckled before retreating behind the paper.  

“Hi, how is she doing?”

“Your mother was bored after we moved from Twin Pines, now with a broken arm there is even less she can do.  She can’t even work on that
damned quilt.  Her arm will never have a chance to heal if she doesn’t stop fussing.”

“Do you want me to come down and help?”

Mari extended her hand and prised the telephone from Paul.

“Sean
, we have plenty of room here or I am sure the cottage at the vineyard would be available.  Book a flight and we will pick you both up from the airport.”

Simon stretched his long, slender arms.  Joanne looked up from the roster and shifted uncomfortably under his intense stare.

“You still look tired.  How is that nurse working out?  Is she taking some of the responsibility away from you?”

“Raewyn?  She is working out well.  She spends time with Sandy even when she is not required to.  I am not sure how I would have managed without her.”

Joanne looked down at her pen
.

“I also don’t know how
I would have managed without this course to keep me from dwelling on the situation.”

“So
, the situation isn’t good with Sandy?”

Simon
leaned forward and put his hand over hers.

“No
, not really.
  The latest chest x-rays and CAT scan have confirmed the lung and bone metastases have progressed.  Raewyn manages her pain relief.”

Joanne’s voice trailed off and she seemed to consider her choice of words before continuing
.

“She is so
thin and tired.  But it’s more than that.  She doesn’t talk anymore about the treatment or the long term prognosis.” 

Joanne narrowed her eyes
.

“Maybe she
has reached the stage of acceptance,” Simon offered.

“
How can anyone of her age reach a stage where they can accept their own mortality?”

“When they have no other option
available.   I realize that Raewyn specialises in the care of terminally ill patients but as Sandy’s condition deteriorates...”

Joanne looked up sharply
enough to interrupt Simon mid-sentence.

“No
.  That is the one choice Sandy has made clear.  I will respect her wish to remain at home.”

Joanne shrugged as if releasing tension. 

“There are still good days.  Someone wise told me not so long ago I should take one day at a time.”

Chloe watched intently as Paul settled into the chair and applied pressure to his temples.

“
Your mother has moved into the cottage?  Perhaps you would like something for that headache?” Geoff grinned.

Paul
self-consciously removed his hands from his head.    He looked up to find Chloe’s expression unfathomable, her eyes clouding with concern.  Abruptly, she stood up and excused herself leaving the room in an awkward silence.

“Apologies
. Chloe has been tense for a few days.”

There was a sarcastic snicker from across the room.

“Shut up
,” Geoff retorted angrily he then turned to talk directly to Paul who sat quietly observing the interaction.

“We see things as
tangible; Chloe sometimes sees things in between.  It is normal for her to become unsettled when she can’t understand or get direction in something she is picking up.  I really don’t question this part of my wife’s life.”

“
There is nothing normal about this when it happens.”

Geoff turned an icy stare towards
the source of the comment.

“I agree.  But I also notice that you do not come to her for a read
ing.  Incidentally, your wife has made an appointment with Chloe next week.”

There was an appreciative murmur
that ran around the room.  Geoff continued.

“Perhaps we s
hould delay meeting for a few days?”

“Should we drive
our cars with more care?”

“
Care on the roads has nothing to do with her being unnerved. All Chloe feels is that someone is making a choice and what they decide will affect the future of someone she is close to.”