Breathing

I still remember standing there, in that hospital room, decades ago. We had news to tell the patient and her family. Although at first it didn't look like it was going to be a bad diagnosis, it was indeed, very bad. That is medicine in a nutshell: we see behind and beneath and in the end the news is ours to tell, but not to craft.

As we told them the news the patient and the family held their breath. A whole room not breathing. Me too.

Afterwards, my supervisor, not fooled by my tough exterior - which I have found fools no one at all- gently said to me ‘When patients tell us their stories and let us help them, it is a privilege. Never forget that. Even if the story ends in tragedy, it is a privilege. Honour it by serving those who trust you.” Sometimes you are lucky enough to find people who define you, who are in your life and shape you to be better. This was the man and he shaped my approach to patients for the decades. It taught me to serve. To know it is a privilege. And that patients don't breathe when the news is bad.

I scuba dive. In the boat, at the dive site, the ocean stretches out, and there is a sense of glass and ripples. Diving in, there is coral, turtles and fish. I love that there is another world under the water. I love the beauty of it and how hidden it is. Most of all I love being able to breathe underwater as I move forward deep in the ocean.

Back to patients. There is nothing that prepares you for what medicine is either. What the surface of medicine looks like is nothing like the truth of the practice. Yes, you help. Yes there are medicines to offer but the reality is the stories. The ability and privilege to immerse yourself in the lives of patients where you see their hopes, their loves, their fears and finally, even their deaths. And this brings me back to breathing.

In many books, authors will say that, in response to bad news, people feel ‘punched in the gut’ or ‘their world collapsed’ In reality, what I have seen is that patients, and the people that love them, hold their breath. And I recently learned why.

I have had many people who have shaped me, made me better, because goodness knows, I have needed that, perhaps more than most people.

The person who shaped me most, I met when I was about 6 or 7. She had a blond pixie cut and bright blue eyes. We were the same age but she was much smaller than me. When the large school bully kicked the cello she was carrying, she grabbed his arm and twirled him around and around and sent him flying into a wall. She would wander streams, ride her bike in the woods, and strangely, at the corner store while the rest of us bought chocolate, she would buy a carton of milk. An original from start to finish. I did what any sane person would do: loved her for life.

In our teens she grew and became a 5’10” blond beauty, who towered over me. Which was fitting because she was built for the life she wanted to lead - bold and strong.

Over the last fifty years, she and I have talked every few days. When she headed off to Europe at 18, with a backpack and panache, I stayed in university and worried about her. When she wandered into the woods for long camping trips on her own, I would worry while writing my exams. She got a PhD and turned into a crack research scientists who still takes off for lone camping trips that worry the crap out of me. The real truth of who she is to me is that she was the first person who came when my children were born and the first to come every time I needed her. If she detected a tremor in my voice, I would find her on my doorstep even if we lived in different cities and she had to travel for miles.

This summer, while we sat sipping coffee on a patio of a restaurant, she gently told me that she had breast cancer. I stopped breathing. I looked at her, blond hair now darker and longer, lines around her eyes, and I finally took a breath. Because the not breathing was wanting to stop the world, to go back to before, when illness wasn't real. And the breathing part was because I knew that I had to breathe and move forward. Because she needed me. Because I needed to be there. Every step.

And I was. The mastectomy was hard, and I was there for that. I was there at the hospital, and when she was home, we laughed in our zany way about all things cancer related. Then after she had eaten the food I had made for her, she gently told me that that cancer had spread to her bones. I couldn't breathe. This time, my lungs simply refused to take in any air. Then I did. Because I had to be there for that too.

When tragedy hits, and in books it must, I think it is important to dive in and write about breathing. Because that tells the story. Of wanting to stop time, and go back. Of breathing and moving forward.