Pancreatic Cancer

A genuine letter sent to Mr Saxon Connor (Pancreatic Surgeon, Christchurch Public Hospital) in August 2013.

Dear Mr Saxon Connor

I am writing to thank you.

I am not sure about you (or any others for that matter) but the dusty eaves of my memory carry a bank of visual bites of moments I have captured. While I’d like to think the shelves would be full of beautiful vistas or those, oh-so-ever elusive Zen-moments, I have found instead that they tend rather to be stocked with life-altering flashes, both good and bad. Not so much the outcomes that sneak up on you but the ones that are so blatantly defining that when they are happening you know life is never going to be the same again.

I have a new moment and it contains you. You, a near stranger – and my beloved mum.

We had not met until the day I came to Outpatients with Elaine Berry. We met once again the following week but I doubt, because you will not be operating on her, that we will ever meet again.  Thus I am writing to tell you how grateful I feel. As an aside, we fully endorse your strong guidance not to operate. I once read that the operation with the best outcome can be the one a surgeon decides not to do. Independence matters and your encouragement to leave my mother with hers at a time when the things she actually has left are diminishing, is appreciated.

There is another reason I am writing. I imagine you know that you make a significant difference through the art and science of surgery. You heal. And I guess there are quite tangible times that illustrate this function of your action. As I write this I ponder whether that moment is when you take your scrubs off after a successful operation, or is it when you wave farewell to a discharged patient or at some other point, perhaps when you have sliced a rogue growth into submission. Or not. I don’t profess to understand the multiplicity of healing others. In this instance, with my mother, you did not hold a scalpel but you did make a big difference. Perhaps people have not stopped to tell you about this scalpel-esque skill you possess because, if like me, once they receive the information that death is near there is so much to digest and be getting on with, looking forward and looking back, but not reflecting on the moment of actual realisation. (The time granted becomes something to make the most of – how does one live up to that?).

Perhaps I would not have written this if I had not taken time off work (allowing the clip to replay in the silence, attendant to pausing) due to this merciless strep throat that refuses to heal, its red fury unquestionably encompassing the anger I hold (just now) at the world and My Maker for planning to seize my mother.

My mother and I both dislike germs (ick), hospitals (ick), medical centres (ick), and especially germs in hospitals and medical centres (ick). Other than that I would have loved a career in medicine! My visual memory bites of Christchurch Hospital consist of being left in a small, windowless ‘viewing’ room with dirty salmon-coloured walls, faded plastic flowers and a dead family member, alarmingly cold and tucked between crisp white sheets. Wrestling with the angst of not wanting to be there to witness the person changed in death coupled with a reluctance to leave, knowing they will be wheeled back to the morgue fridge alone. It was deep in the darkness of night in that aesthetically stomach-churning room when I viewed both my grandmother and years later my father. I’ve imagined my mother’s earlier experience of being in that same room (also in the hours of darkness); the tale she shared with me about embracing her unrecognisable son Christopher who died suddenly and staggeringly of cot death before I was born. (Do I remember that story right? I must check with her before it is too late. There are so many stories to capture).

Prior to our visit with you there had been a flurry of medical appointments (more ick, my standard germ-phobic phrase when dropping my mother at the hospital doors before heading off to find a park became “Don’t lick the lift buttons!”). Cloudy moments of waiting rooms and waiting. Waiting for appointments. (Why do I bother to turn up to a medical appointment on time?) Waiting for results. Waiting a week for the next appointment to roll around. Waiting for answers. We found ourselves powerless on one of life’s conveyor belts. Little did we know yours was the grand finale of appointments on that grey wintery Christchurch day? We had begrudgingly seated ourselves among (coughing, limping, frowning) people in the waiting room, holding the little concrete information her doctor had given us and a few clues about what you were going to say to us. Sitting beside a person from the generation that doesn’t talk their worries to death, or unnecessarily about death but instead just pulls their socks up and get on with life, I inwardly hoped (maybe we both did) that you would operate and find the growths were not, luck upon luck, cancer. Hurray, we could all live happily ever after!

But, it was not to be …

However with your scalpel in your back pocket but hands still connected to heart, you healed us both in some way that day. It was your unfortunate duty to tell my mother that she has 9-12 months to live. I was blindsided by the news. I physically recoiled. I bit my lip as hard as I could, an old trusty trick to stop me crying. Those damn tears wouldn’t obey, drowning my eyes. You became blurry because I daren’t move to dry them. I didn’t want my mother to see my pain, for she wasn’t crying and I had no right to let her team down. You leaned forward and looked into what I imagine was my mother’s startled soul and were there. My clumsy simplistic words will never capture your message but the essence seemed to say ‘it is going to be okay, you’re going to be okay even though your time is near, worry yourself not’.

Your manner and your words gifted a safety net and right then and there it stopped us from dropping into a chasm. You didn’t rush us despite nightfall descending outside or push back against the emotion in the room we were choking on, but sat with it and supported us as the information sunk in. You were generous with your time and tried to find the other surgeon to talk about that other cancerous growth not as nasty or angry as the one on her pancreas. You followed my mother’s lead, her signature mark humour, and kidded that the kidney surgeon had left for the day because he was either more efficient or preferably more lax than you. The joking continued and laughter melted the fear. We put a plan together and I have no doubt you helped us crawl out of the momentary despair we both found ourselves in. You safely walked us out from shellshock to new spaces to where we needed to be to tell our loving family and march forward.

It is funny what else takes place in one’s mind at a moment like that. I suddenly realised the woman who entered the room with you (who I thought was a trainee doctor) was actually a cancer nurse.  Up until you told us it was most certainly cancer, I had not noticed the c-word stamped on her name badge, and her lanyard and her face. CANCER. CANCER. CANCER.  Gulp, gulp, gulp. In the car on the way home my mother told me that at that same time I was working that out, she was reading the label on the chest of your scrubs. Despite it saying CH-CH Hospital Outpatients, the fabric fell and folded in a way that the letters seemed to read, ‘OH-OH Hospital Outpatients’. ‘Oh, Oh, alright!’ she remarked. We laughed and it became a family story.

When I was a teen my grandmother underwent a huge operation. Until the day she died she had a photo of the surgeon in a frame. A stranger to us yet his picture took pride of place. With things still to be done before she could go I think she was saying to her saviour, ‘I owe you the sight of the morning’. Even though you couldn’t offer an extended life to my mother, my interpretation is that you supported her inner strength to come to the fore enabling us to see that her last days can be filled with sincerity, connection and humour. It is almost like you helped build a splendid framework for how we could bravely go forward into our respectively altered lives – the new lives which started from that exact moment of time, before we stepped out of Christchurch Hospital’s doors and into winter’s dusk.

My ever-resilient mother has a goal. She wants to outlive the timeframe you have given her (nothing personal!). It is about looking death in the face and not flinching. It is about being positive when it would be easy to be otherwise. It is about stepping up when she has every reason not to. And she is content in the knowledge that when her time comes she will embrace her husband, son, parents and others dear to her whom have already departed. And maybe, with my splendid new framework, I won’t feel resigned to leave her behind at OH-OH Hospital. Instead, I will carry her out into the rose-pink light of dawn wrapped in a beautiful, lush blanket, (figuratively speaking that is – no need to warn security).

So thank you Mr Saxon Connor. I am extremely grateful to you. I envy your grace and compassion. I am in awe of the responsible tasks you undertake in a regular working day at the coalface of life and death. Suddenly my own semi-responsible job looks like child’s play. You took an unbearable situation and made it not only palatable but also meaningful. I hope to be better from the privilege of watching you in action, fully present with us and the emotion of the moment, in that moment.

Surgeons put things right, and even now, I feel that writing this to you has assisted in healing me.  Thank you for helping me to piece the bits together.

Indebted,

Janine Harrington

Elaine Berry died at home with family without a single night (alive or dead) at CH CH Hospital.