‘I’m not going mad then?’
‘Definitely not.’
The question they never failed either to ask, or to leave in the air unspoken between them for the doctor to pick up. Iris Chater relaxed, and her face took on a little more colour.
‘Apart from missing Harry, how’s your own health?’
‘I’m just tired really. I can’t eat much either. It comes and goes.’ She shifted about in her chair, picked her bag up from the floor and put it down again. Cat waited.
‘Harry lost his appetite.’
‘I know. He lost it because he had cancer, and he’d had a long struggle. You’ve lost yours because you’ve been bereaved. Don’t worry about it at all. You say it comes and goes, so just eat when it’s there. Eat what you fancy … Your appetite will get back to normal when it’s ready.’
‘I see.’
‘Are you worried about being in the house on your own at night?’
‘Oh no, Dr Deerbon. He’s there with me, you see … Harry’s always there.’
Like many of Cat’s older patients, Iris Chater was not ill, she needed reassurance and a listening ear. Nevertheless, Cat sensed that she was holding something back, in spite of her gentle probing. She waited a moment, but nothing came.
‘Well, pop in and see me again in a month. I want to know how you’re getting on and in the meantime, if there’s anything at all …’
Iris Chater made a business of getting up, gathering herself, going towards the door, then, at the very last moment, she turned.
‘There is something, isn’t there?’ Cat said gently.
The tears filled the woman’s eyes again.
‘If I could just know, Doctor. If I could just be sure that he’s all right. Is there any way I can be sure?’
‘Aren’t you sure? In your own heart? Come on … Harry was a good man.’
‘He was, wasn’t he? He really was.’
Still she did not go.
‘I wondered …’
She glanced at Cat, then quickly away. What is it, Cat puzzled, what is it she wants to ask me, to get reassurance about?
‘I get this funny breathing.’
There was nothing wrong with Iris Chater. She was afraid … afraid of dying as her husband had died, and vulnerable after his death. Cat examined her briefly. She had no symptoms, had had no chest pains or breathlessness and her lungs were clear.
‘I don’t want to prescribe you sleeping tablets or tranquillisers. I don’t honestly think you need them.’
‘Oh no, I wouldn’t want anything like that, Doctor.’
‘But you do need to relax.’
‘It’s just what I can’t do, you see.’
‘Have you ever listened to one of those relaxation tapes … soothing music, and exercises to do to calm your breathing?’
‘Like in those Eastern religions?’
‘No, these are much more straightforward – just aids to relaxing. I’m afraid I can’t prescribe them but they sell them at the health shops. They’re not expensive. Why don’t you go and have a browse … ask them if there are any they recommend? If you buy one of those and try using it to help you relax every day even just for quarter of an hour, I think you’ll find it will really help. But you’ve lost your husband of fifty years, Mrs Chater. What you’re going through is normal. You’re not going to feel yourself again for a while yet, you know.’
The rest of the surgery took its course through sore throats and period pains to children’s ear infections and arthritic joints.
At twenty to twelve, Jean brought in a mug of coffee.
‘There’s just Mrs McCafferty.’
For the past busy couple of hours, Cat had been able to put it to the back of her mind.
‘Give me a couple of minutes.’
Jean smiled sympathetically as she went out.
*
How often, Cat wondered half an hour later, have I been helped through a difficult consultation by the patient? Been comforted myself by people who have just been told that their illness is terminal? Even had to tell parents that their child is going to die, only to be reassured by them that they were certain she, the doctor, had done everything she could and that they knew she was as upset as they were.
And now, Karin McCafferty had been calm, controlled – and sympathetic. ‘It’s rotten for you as well … probably worse with a patient you know as well as you know me.’ Those had been her first words, as she had given Cat a hug. ‘But I’m OK … and I liked Dr Monk very much.’
It had been three weeks since Karin had first come to the surgery about the lump in her breast, and Cat had suspected at once that it was malignant, but she had been shocked at the results of the X-rays, which had shown extensive involvement of the lymph glands. The biopsy had highlighted a particularly aggressive type of cancer.
Now, Karin had had her first consultation with the consultant oncologist, Jill Monk, whose report Cat had already seen.
‘You can’t begin to know how sorry I am.’
‘Yes I can. And look what you’ve done … got me X-rays and an appointment lightning fast and I know what a difference that can make.’
Karin looked bright – too bright, Cat thought. ‘It’s early days,’ she said carefully, ‘it takes time for all the implications to sink in.’
‘Oh, it’s sunk, don’t you worry.’
‘Sorry, I don’t mean to patronise you.’
‘You’re not. People are meant to agonise … ask “Why me?” But why not me, Cat? It’s random. After I saw Dr Monk, I got home, had a huge Scotch and howled my eyes out. But that’s that. So let’s talk about what’s next.’
Cat glanced down at the oncologist’s letter. It did not make cheerful reading.
‘Surgery is the immediate way forward, as she will have told you … in this instance, she won’t want to be too … conservative.’
‘Full mastectomy, including the glands, yes, she said.’
‘Then chemo, certainly, and radiography, possibly, depending on how she decides after the operation. There is a possibility that she might want to do a double mastectomy, you know that?’
Karin was silent.
‘Bevham General is a centre of excellence for oncology and I wouldn’t recommend you go privately … though if you want an amenity bed, by all means pay for that. I would … If I’m feeling rough, I like to be by myself to do it.’
I’m babbling, Cat thought. Karin was unnerving her. She sat without fidgeting, apparently quite relaxed, and for the most part she kept her eyes on Cat’s face. Her wild red hair was tied back in a black velvet snood, to reveal her bony face – large nose, high cheekbones and forehead – it was an interesting, intelligent face, with the repose of a woman entirely comfortable in her own skin.
‘Cat, I have thought about it … well, as you may imagine, I haven’t done much else. I have thought very hard and very clearly and carefully. And I’ve talked to Mike. And now I’m telling you. I don’t want to have any of this. No, hang on, let me say it all. The only suggestion of Dr Monk’s I did consider seriously was the surgery. I know it’s radical, but oddly enough the idea of it is still acceptable … I want to keep the possibility in reserve. Chemo and radiotherapy I won’t go near.’
‘I’m not sure I understand you.’
‘I want to go down the other route … alternative, complementary, whatever you call it. The gentle way. I’m thinking of going to America to the Gerson Clinic. I’m absolutely sure that it’s a better way, Cat … physically, spiritually … everything tells me so. I won’t poison my body and destroy my immune system with toxins and I won’t be subjected to overdoses of radiation. I am quite sure about it, but you’re my doctor and of course I will listen to what you have to say. I’m not a fool.’
Cat got up and walked to the window. The car park was almost empty. It was still pouring with rain.
‘Did you say any of this to Jill Monk?’
‘No. I hadn’t thought it through then. Besides, I don’t think she’d have been sympathetic.’
‘And you think I am?’
‘Cat, whatever the outcome of this, it is my body, my illness, my decision, and I live with it. Or not, I suppose. But whatever, it isn’t yours so don’t worry.’
‘Of course I bloody worry … all my training and knowledge and experience and instinct tell me to worry because you are wrong. Just plain wrong.’
‘Are you washing your hands of me?’
‘Look, Karin, you are my patient and it is my job to give you my professional advice and counsel. It’s also my job to support you in any medical decisions you make because, ultimately, those decisions always are the patient’s. And you are a good friend. And the more certain I am that you are making the wrong decision, the greater my support and help have to be. OK?’
‘Sorry. I’ll need you.’
‘You will.’
‘I didn’t think that you’d be so against the alternative way.’
‘I’m not – in some circumstances, quite the contrary. I send patients to Nick Haydn for osteopathy, and to Aidan Sharpe who does acupuncture. He works miracles on a few stubborn conditions. Just now I sent a bereaved lady who can’t sleep and is in a generally anxious state to look through the relaxation tapes in the health shop … and an aromatherapy massage is a lovely thing. But none of them are cures for cancer, Karin. The most complementary therapies could do is help get you through the proper treatment, make you less sick maybe and relax you generally.’
‘So why don’t I just get a facial and have my nails done?’
Karin stood up. Cat knew that she had upset her and put her back up, and she was furious with herself. She walked with Karin towards the door.
‘Promise me that at least you’ll think hard about it.’
‘I’ll think. But I won’t be changing my mind.’
‘Don’t burn your boats, don’t close any doors. It’s your life we are talking about here.’
‘Exactly.’
But then Karin had turned and given Cat another warm and accepting hug, before walking, calm and confident, out of the surgery.
‘You can’t go along with it, for God’s sake.’ Chris Deerbon faced Cat across the kitchen table, as they sat drinking mugs of tea late that night. He had just come in from a call.
‘You mean I should ask her to change GP?’
‘No, I mean you have to try much harder to make her see why she can’t go down that road … it’s not an option, you know that … she hasn’t the luxury of choice.’
Chris was totally opposed to any form of alternative treatment, with the exception of osteopathy for his own bad back.
‘It worries me, of course it does, but she was very adamant and you know Karin.’
‘She probably hasn’t taken it in properly yet.’
‘I think she has. If I’m going to support her I’m going to have to do some research … at least steer her clear of the real cranks.’
‘I don’t think you should encourage her even that far … she has got to have surgery and chemo. What’s got into you?’
‘Just Karin, I suppose.’
Chris got up and put the kettle back on the hob.
‘There’s too much of it about. All those loonies up at Starly Tor.’
‘Oh, they’re just New Age airheads … crystals and ley lines.’
‘Where’s the difference? Let Karin McCafferty loose and she’ll be dancing round Stonehenge at dawn.’
When Chris had left on the next night call, Cat had a bath, and then got into bed, propping her laptop on her knees. ‘Cancer,’ she typed into Google. ‘Therapies. Alternative. Complementary. Gerson.’
An hour and a half later, when Chris came in from dispatching a teenager with acute appendicitis to hospital, she was deep into a research article discussing the effects of a sustained programme of meditation and visualisation on cancer patients in New Jersey.
She had filled several pages of a notebook on the pillow beside her. The least she knew she could do for Karin McCafferty was take her seriously.
The Tape
When I speak to you here it is like being in the confessional. I am shriving myself by telling you everything. The difference is that I am not asking you for your forgiveness. It should be the other way round.
But I will feel better once you know everything. Some of the secrets of the past have become a tiresome burden to carry alone, though it is not guilt that has weighed me down, simply the knowledge.
What I am going to tell you today was a secret I did not carry alone. From the beginning, I shared it with Aunt Elsie. She went to her grave with it, as she had told me she would. Uncle Len knew, of course, but you know how meek he was, how he would have said nothing unless she told him to.
It happened one of those times I went to stay with them. You knew how I loved it there, how I always asked when I could go next. I wanted to live there. I loved the bungalow, because it was a bungalow, there were no stairs. I loved the breakfast she cooked for me every morning, and the small bookcase against the wall beside the telephone where I sat on the floor and read ‘Your Body in Health and Sickness’ by Dr Roberts. I learned so much from that book. It helped to shape my destiny.
I loved opening the door of my bedroom slightly and listening to the murmur of talk in the sitting room just along the short corridor, and the voices from the radio.
That was how I first heard of Arthur Needham. I heard his name on the radio, and then, them talking about him, so that he became a mysterious figure in my dreams.
‘Who is Arthur Needham?’ I asked one morning in the middle of my scrambled egg.
Aunt Elsie and Uncle Len looked at one another. I can see that look now. He frowned and I was sent to clean my teeth. But later, she said, ‘You’ll hear about it soon enough, so I’m going to tell you. You’re quite old enough to know.’
The tone of her voice seemed to change, to go lower into her throat, though she wasn’t whispering. I caught an excitement in it. She was enjoying this, behind the solemn expression.
Arthur Needham was a small draper who had married a widow with a bit of money and, a year later, murdered her. When he discovered that she had in fact left the money not to him, as she had made out, but to her only daughter, he had murdered the daughter too.