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Two
Teresa's arrival brought new vitality into the house.
She came
with special recipes for nourishing, health-giving foods to re-
build her friend's resources, so sadly depleted by three weeks of
a hospital diet not intended for vegetarians. Jane had been scorn-
ful of the food given her: "Cheese, tomato and white bread with
a lettuce leaf one day. Tomato, cheese and two lettuce leaves the
next . . ." Teresa fed her protein the way she liked it, tasty and
sustaining, and also brought more energy into the struggle to
keep up her spirits.
To deal with her worst enemy—fear—Jane needed company,
she needed distraction, she needed hope. She tried to fight off her
fear by learning about melanoma, but this wasn't easy to do.
People were reluctant to give her the information she sought.
Friends promised books on cancer and mysteriously failed to
deliver them. The statistics on the mortality rates for melanoma
which she constantly requested were never provided. Rosemary
couldn't tell her the stark facts and wouldn't let anyone in the
family do it. Jane had friends who were nurses, and they came
and spoke to her for hours about cancer in general and mela-
noma in particular, but Rosemary never learned what was said
except that they talked about the various kinds of therapy. That
much Rosemary knew from what Jane told her, yet her daugh-
ter didn't share everything. Rosemary was very afraid that she
would learn the truth about melanoma—the terrible truth.
Jane tried to be philosophical. She spoke of accepting what-
ever came without a fight. If another tumour grew—"and I sup-
pose deep down, as a natural pessimist, I'm ready for the worst"
—maybe she would live what was left of her life without any
further operations or treatments.
Rosemary promised that if that was what she wanted,
they
would go away together and find a quiet, beautiful place to live,
by the sea, perhaps. Or a special place for people with cancer
she'd read about. "It's not a hospital or a nursing home, it's more
like a real home," Rosemary recalled. "The article said they
treated everyone like people, not just patients, and looked after
them with love and compassion. Shall I try to find out a bit
more?"
"Yes . . ." Jane sounded doubtful. "It may be a religious
place. They wouldn't like a God-less type like me there. Even if
they did take me, I don't know that I'd want to be in that sort of
atmosphere. I wouldn't fit in. I'd feel bad about being there just
because I needed to be and not because I had the same values."
Nevertheless, Rosemary made enquiries and found out about
St. Christopher's Hospice, designed to care for the terminally ill.
It was indeed "religious," but not in the sense Jane suspected.
Although Dr. Cicely Saunders, who had founded St. Chris-
topher's and thereby launched the modern hospice movement,
was a committed Christian, she did not require her patients to be
religious. The hospice was on the outskirts of London,
set
among green lawns which Jane would find a welcome sight.
But would she qualify for admission?
Patients who still have a reasonable hope of being
cured do
not usually go to a hospice, whose aim is to improve the quality
of life for the last weeks or months. An individual is admitted for
the control of distressing symptoms or because the family is un-
able to cope, or to give relatives a rest. Of those taken in, more
than two-thirds are suffering unrelieved pain. A hospice prefers
not to admit a patient only for the last few hours of life, for the
last day or two, because so much less can be accomplished in so
short a time. Generally a hospice would seek to assure itself that
the prognosis promises enough time to let the patient benefit
from its special kind of help, to make it possible for her to live
as fully as her physical condition allows. For this she must first
be made comfortable, and helped to remain clear-headed, so that
she may appreciate the love and care of family, friends and the
staff, reciprocate their feelings, and not imagine herself to be un-
wanted and abandoned, as happens to so many patients when
those around them decide nothing more can be done. At St.
Christopher's, Rosemary learned, there was always something that
could be done for the patient, right to the very end. If the first
attempt to relieve the pain and ease the discomfort didn't work,
other approaches would be tried until the right one was found.
All the time the patient would know that she mattered as a
human being. As Cicely Saunders summed it up, "You matter
because you are you. You matter to the last moment of your
life, and we will do all we can not only to help you die peace-
fully, but also to live until you die."
Rosemary discussed what she had learned about St.
Chris-
topher's with Teresa, who waited for the right moment to
broach the subject with Jane. But when Teresa suggested that
they should all go to the hospice to give it the once over, Jane
was no longer interested. By then she had decided not to give
in, but to fight. She would insist that "they" give her every pos-
sible treatment to drive back the cancer. She wanted to live.
Yet so much depended on her mood. There were times when
she thought of death, the kind of planned death that she had
confided to her diary at the time of the second operation. Now she
was quite willing to speak openly to Rosemary about it, as if to
prepare her and ask her help. "If I'm going to keep growing
lumps and having them cut off—well, I don't know that I want
to go on having that kind of life. I think I might just get out."
Rosemary picked up her meaning immediately. She'd been
thinking along the same lines, wondering whether such a life
would be worth living. She too decided it was time to speak
plainly.
"You know, Jane, if you really want to kill yourself,
I'll help
you as much as you can. You can be sure of that."
"Thanks, Mum." Jane smiled wanly.
"You remember my potter friend, Frances?" Rosemary
went
on. "She nearly did it by mistake—at least, she said it was a mis-
take. She took sleeping pills and then carried a bottle of booze
to bed with her in case they didn't work. It would have been
lethal if she hadn't been found in time. She said it was delicious."
"There's only one snag." Jane giggled. "I don't like
alcohol.
So I'm not likely to do it."
The conversation lingered in Rosemary's mind. Had
her prom-
ise of help been too facile? How could one be sure that Jane
really wanted to commit suicide, however ill and pain-ridden she
became? Might there not be down-days followed immediately
by up-days? Suppose she had hung on a little longer and a cure
was discovered? Wasn't the taking of life—any life—a terrible
thing? Rosemary also wondered if her offer of "help" to Jane
wouldn't be in itself a form of pressure, a hidden suggestion that
they would all be much better off without her. Since her illness,
Jane had often expressed concern that she was "mucking up"
Rosemary's life. And what would the rest of the family think
about it?
Early one morning Rosemary was awakened by a phone
call
from Victor, his voice made unfamiliar by the distance, high
and strained.
"Have you thought any more about her coming to America?
There could be a lot of advantages here."
"She's much too ill to cross the Atlantic," Rosemary
said
wearily, pulling her nightgown closer around her for warmth.
"I told you, she's very weak. Her leg is still swollen.
She won't
even come to the park in the car."
Victor said urgently: "Listen, Rosemary, I've been
talking to
some of the world's top cancer experts. They're making a lot of
progress in treating cancer here. They'll take her in at the Na-
tional Cancer Institute . . ."
"I've told you she's much too weak . . ."
"They're doing a lot of work on melanoma. They'll
take
her as a research patient. They'll give her all the latest—"
"My God, research?"' Nobody, Rosemary swore silently to
herself, would use Jane for experiments, for testing untried
drugs. "What would that mean, for God's sake?"
"They really are some of the best doctors in the States." Now
he was trying to placate her, his voice gentle. "They'd look after
her well and she'd have a better chance."
"I keep telling you, she can't walk properly yet,
much less hop
in and out of airplanes. She doesn't want to come," she almost
shouted. "She wants to be near her friends."
"Are you all right?"
Suddenly Rosemary felt exhausted, limp. "I'm all
right," she
murmured. "Goodbye," and she hung up on him. She knew that
it was time for Victor to come to England. Jane was in for a
terrible experience: pain, operations, treatments. The pain would
probably change and destroy her. Victor should see her as she
was now, strong—at least most of the time—determined, and full
of humour. She could still turn her despair into a joke. Victor
ought to talk with her at leisure and clear up their past differ-
ences, get to know her better, while there was still time.
After Jane had breakfasted and was enjoying the first cigarette
of the day, Rosemary asked her: "What do you think about Dad
coming over? I feel he's missing a lot by not being here now."
"Wouldn't it be easier if he didn't?" Jane responded. "Dad al-
ways makes such a crisis over everything and we've got quite
enough crisis already." She lit up another cigarette. "Let's wait
and see what happens when I visit the doctor next week."
She was quiet for a long time. Then she said sadly: "They told
me that if melanoma 'crosses your womb'—whatever that means
—you shouldn't have a baby for at least ten years. Even if I do
make it that long, I'll be getting a bit old. It'd be risky. Did you
know the incidence of brain-damaged or retarded kids gets much
higher when you're near forty? I'd have liked to have had kids."
She asked Rosemary to make a cup of coffee. Then, as soon as
her mother was out of the room, she turned to Teresa. "It's OK
now, but suppose I get much worse and have a lot of pain? I
really can't take pain well. I've been storing up pills, just in case.
Olivia has a whole bottle, but if I ask her for them she'd feel in-
volved if I took them. I don't think I should put that on her."
(Olivia was the friend in whose house they were staying.)
"Have you talked about it with Rosemary?"
"We did a bit. But I think she'd feel guilty if I
involved her.
If I do myself in, I'll do it on my own."
Teresa said nothing about this conversation to Rosemary,
who, unaware of Jane's real feelings, brought up the subject
again a few days later. "I told you I'd help you if you wanted to
commit suicide, Jane. I've thought about it a lot since—of course
I'll help you. But we'll both have to be really sure that you mean
it. Things can change from day to day. And Dad and
Richard
ought to know . . . they have a right to be part of such a big
thing." Jane listened carefully but didn't reply. "Besides," Rose-
mary tried to make a )oke of it, "they might think I'd done you
in because I couldn't take it!"
Later Rosemary was to regret that conversation. She
wished
she hadn't seemed to renege on a promise, a matter of trust be-
tween them.
Jane was home for just over a week before she saw
the special-
ist. He said she should enter a London hospital for further tests.
She wrote in her diary of the help and support she was getting,
but added: "Despite all this I feel totally alone. It is good to have
people around and I know quite a few are really affected by the
whole business. It reminds them of their own mortality and of
humanity's abysmal ignorance of what cancer is, and of course
they are aware it isn't much fun for me.
"The ignorance is one of the worst things. And it
isn't just
that doctors are so bad at telling one what they are doing and
why, and what is likely to happen. But also that so little is actu-
ally known and there is so much difference of opinion among
the specialists."
This time Jane was in hospital for ten days. Every
possible area
of her body was tested for the presence of cancer, and every test
came up with the same result: negative. This should have been
cause for rejoicing, but she still had the brain scan to experience.
At one time frequent attacks of dizziness made her think that the
cancer had spread to her brain, and she was very frightened.
"The possibility of a brain tumour is too awful to
contemplate,"
she wrote. "I know that it's just that they're doing everything to
rule things out. But this has upset me more than anything. I'm
simply terrified. . . ." When this test also proved negative, she
allowed herself a tempered sense of relief. "But just because the
X-rays are clear doesn't mean there is nothing there."
It was the bone marrow test she found most painful and ob-
jectionable. They should have prepared her, she said crossly.
They'd told her it might be "a bit uncomfortable," but it was
actually much worse than that—"absolutely disgusting."
She wasn't in much pain, but her diary revealed the
anguish
she was experiencing: "It is frightening to be so weak. One is so
used to a more or less normally functioning body that it takes
both physical and emotional adjusting to a situation in which
walking is difficult and something of an ordeal. Then there is
the feeling of envy—of ten near jealousy—of those who are able
to walk, run, move with ease and simply keep going all day.
"At times I've felt so ill it's an effort to move
at all. And it's
then that I really do feel there is something seriously wrong with
me. Other times I don't feel too bad and wonder whether it's
my mind or body that holds the weakness. When I do feel ill I
have very little interest in cancer or in anything else. Also I get
very scared of being alone and getting the horrors. But I do only
seem to break down when there's someone around to help.
"I've just realised something that is probably very evident.
That is that there are two types of fear. The first is the irrational
kind, what I call the 'horrors,' when all I can think of is the can-
cer probably in my body eating away at the healthy parts and
taking over. And the best way to cope with this is by trying to
analyse what it is I'm scared of. Pain, or death, or uncertainty, or
the effect on my life and psyche. And these are fears which can
be coped with. The 'horrors' are not rational and I cannot banish
them by trying to concentrate on something else, but I can cope
with them by trying to translate them into the second kind—into
other, manageable fears."
Jane was able to come home for the weekend, but the
return
on Sunday night was like escorting her back to some gruesome
kind of boarding school. She had to be taken to the hospital like
a child—a child unable to manage the journey alone. She needed
an arm to lean on while walking, someone to carry her bag,
someone to pay the cab driver quickly so she didn't have to be
on her feet longer than was necessary to walk to the busy,
anonymous ward.
When Jane was with Teresa and Rosemary, they were
all a
family; but when she was in the hospital, Teresa and Rosemary
were strongly aware of their isolation, separated not only from
Jane but from the everyday world. Nothing could be planned
or taken for granted. They fought off their despair, struggling to
behave as if life were still the same, but always aware how
fragile the pretence was. Friends did their best to give support-
there was always someone to offer strength and practical help
when needed.
One evening Rosemary was coming home from visiting
Jane
alone, stale from the long hospital hours and thinking of how
little could be done for her daughter. She remembered how Jane
had always valued solitude, and now she was trapped in a
crowded ward. Rosemary was seized by a violent desire to cut
and run, to escape. A cab rounded the corner and she wanted to
jump in, drive to the airport, get on a plane, and fly—where?
There was nowhere to go. Jane needed her. This was not the
time to give in to despair. And there was some good news.
None of the other hospital tests showed the slightest trace of
any more tumours in Jane's body. It was settled that she could
leave; the next step was for the doctors to decide what preven-
tive treatment she should have. Our hopes revived again.
The evening before Jane was due to come out of the
hospital,
Teresa and Rosemary went to a play in London to celebrate. It
was Jane's idea. But they returned home to find that Jane had
been trying to reach them. She had just been examined by the
doctor she liked and trusted most. Dr. Byrd was an elegant
woman who had always been most patient and understanding in
answering Jane's many questions about her illness. Jane used to
compile lists before each of her visits. Sometimes she would still
be busy writing when the doctor arrived. Dr. Byrd hadn't said
much, but later a nurse brought a message telling Jane to ask her
mother to come to the hospital the next day. The surgeon
wanted to see them both together. The unexpectedness of this
request made Jane very anxious. She wanted consolation from
Rosemary and Teresa, but they, too, were fearful. Was the run
of good luck already over?
The surgeon was grave and direct.
During the routine examination another lump had been
no-
ticed at a higher location in Jane's body. It would have to be re-
moved as soon as a bed was free. Jane and Rosemary exchanged
hopeless looks: a third operation. First the black spot on the
foot, then the lymphatic gland in the groin, and now a tumour
on the wall of her stomach. It seemed like a deadly progression.
Jane kept her composure until she was back in the ward. Then
she was suddenly crying out loud, the tears streaming down her
face. One of the nurses appeared with surprising speed, carrying
a tray with a syringe.
"I'm all right. I don't want anything," Jane protested
quickly.
She tried to control herself, sitting up on the bed and feeling
blindly for her clothes, her eyes still blurred with tears. "Let's
get the hell out of here."
Now a doctor appeared behind the nurse. "Tell them
all to go
away." Jane sounded angry, and the doctor and nurse hesitated.
Rosemary tried to reassure them. "She's all right now, thank
you."
Jane regained control and they quickly left the hospital.
But it
was a slow crawl home by cab through the rush-hour traffic.
Jane caught glimpses of the daffodils massed under the trees in
a park—it was the middle of March and there were flowers
everywhere.
Meanwhile, Victor had learned that Britain and the
United
States share the results of cancer research. Jane would get
equally up-to-date treatment in either country, so the pressure
on Rosemary to persuade Jane to go to America was off. No
one could be sure of Jane's future; the family could make no
definite plans. They must live from hour to hour, day to day,
coping with the continuous anxiety and uncertainty as best they
could.
Jane stayed in bed, read a lot, wrote letters and
telephoned
and entertained her friends. These visits helped by giving her a
life of her own, keeping her from feeling too much the helpless
invalid. It wasn't all gloom. She had stories to tell us, news and
jokes from visitors.
"I don't know why they come," she said one day. "I
seem to
spend most of the time talking about cancer; it must get pretty
dull. I hope to goodness nobody gets sick of me and stops
coming."
"I'm certain they get pleasure from being with you,"
Rose-
mary assured her. "It's a mutual thing. People might come once
or twice out of pity or sympathy, but they'd soon stop if they
didn't enjoy talking to you."
Jane burst suddenly into a happy laugh. "Michael
says I'm the
worst advertisement for health foods he's ever met!"
Michael had been Jane's first love in her Sussex University
days. The two years they spent together in Brighton, the vaca-
tions they had taken in Europe and the United States, proved to
be the great adventure of their lives. They each explored the
other's personality to new depths and were astonished at the
treasures they found. Jane stimulated Michael's political awaken-
ing and guided his emergence from a sheltered middle-class
background until he came to exceed her zeal for left-wing
causes. But Jane's interests were turning to the women's move-
ment. They had been so absorbed in each other, so close, that
at times it seemed as if she hardly had a life of her own, and this
scared her. She began to pull back. This in turn caused tensions
which neither of them knew how to handle, until she decided
to make a clean break, to free herself from this new dependence.
Michael tried to understand her need for "space," as they
termed it in their long, anguished, deeply analytical discussions
of the relationship, but he didn't think it called for such a drastic
step. Jane, however, was not to be talked out of her decision.
Michael could only vow to himself that he would always be
there when she needed him. In the years that followed they were
to come together again several times when Jane's loneliness got
the better of her determination to protect her independence.
Now, as her illness grew, he returned once more to give her the
support she craved, and a new love began to develop between
them, hesitant, uncertain of the future, but very important to
Jane at this crisis in her life.
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