· cancer,dying,palliative,doctor,it's ok to cry

You meet some people who change you, the way you live, irrevocably.

When 42 year old Hayley entered my consulting room I didn’t know we were about to embark on a journey of such poignancy I would be writing about her years later.

We’d met before. She’d trusted me in some of her darkest times. I was genuinely delighted when she told me of a new business venture, a new partner, a lust for life which had been missing for some time. She felt young, happy and care-free.

She had come to see me for dietary advice, she was being whisked away for a romantic break in the Caribbean and wanted to look her best. She had been following a highly restrictive vegan diet for the last 8 weeks in which she only ate fruit. Losing 5kg she felt it was working however was keen to ask my advice on its safety. Since starting it she had been experiencing looser bowel motions and had a feeling of “butterflies” in her stomach.

My knowledge regarding fruitarian diets is some-what lacking, as I imagine the diet itself is in nutritional value if continued long term. We discussed the looser bowel motions, coinciding with the time she had been dieting, was not entirely unexpected given the increase in dietary fibre intake. The consultation ended with her agreeing to slowly reintroduce other dietary sources, with my door open as always should she have any further concerns.

The following week she came back to see me. Her bowels had returned to normal, her weight remained the same but the fluttering sensation persisted.

She started crying at this point and delivered the line which changed everything;

“I think I’m dying”.

Her pain was evident as she told me about her dreams to get married, have children, how her new start-up had just won an award. She cried for her life, for all she was losing. For everything she hoped to achieve and never would. The life she had just found after so long searching, now gone.

I forgot to ask how she knew until 6 weeks later. She was in the car and promised she’d tell me the following week when we met face to face. This was my last conversation with her.

She was diagnosed with pancreatic cancer shortly after our second consultation. In the 9 short weeks she had until she died she married her love, her “inspiration” as she called him in the letters she left.

As a doctor I’m sadly no stranger to dying, tragedy and those haunted by thoughts of their own mortality. I rarely take patient’s home with me, being able to leave work behind, with my husband and children being the greatest of levellers.

Yet Hayley stayed with me those whole 9 weeks, longer. She represented a young, ambitious, radiant lady with everything to look forward to. She represented me, my friends and our future. But it was more than that. It troubled me that she knew she was dying and I never got to learn why or how. That somehow she had answers and I hadn’t even thought to ask the question until it was too late.

Whilst I still feel it was an opportunity lost I am able to appreciate all that I learned.

The biggest realisation is that you don’t know what’s round the corner, no one does. Life which seems so robust can go to hanging by a thread in a heart-beat. For the main we are not in control of this. What we are in control of though is the day to day. How we interact with the world around us, how our comments, our actions, can make or break another’s day. How our behaviours are like holding up a mirror, they will always reflect back to ourselves.

As we are all starting to reflect on the year behind us and contemplate on our goals for the year ahead I too think of mine. My husband has listened to this story countless times, he had a necklace engraved for me with the words, ‘here and now’. This is my resolution, it’s the same every year.

Be present.

Live for the here and now.

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