Chapter 3
3
Isla had been so close to telling her mother and sister about her plans to be an egg donor on her father’s sixtieth birthday. Her grandparents had gone out to the kitchen to open a bottle of champagne for the toasts, and Lexi’s husband was doing the same on their side of the Atlantic. So it was just Isla and her mother and sister on the video call for a few moments. It was the perfect opportunity to have the conversation she wasn’t even sure why she’d been putting off. But then Lexi had said something during the virtual celebrations that had stopped Isla in her tracks.
‘You’ll never believe what’s happened to one of the women in my antenatal exercise class.’ Lexi had been balancing a paper plate with a piece of cake on it, on the top of her already obvious baby bump, when she spoke. ‘She agreed to be a surrogate for her best friend, but the friend has now split up with her husband and has decided she doesn’t want to be a single mum. She doesn’t want the baby and now Misty is seven months pregnant, and has no idea what to do.’
‘Oh my God!’ Their mother, Clare, clearly hadn’t heard the story before either. She might have been thousands of miles away, but her shock had been tangible. ‘How could anyone turn their back on a baby like that?’
‘It’s even more complicated because carrying the baby automatically makes Misty the mother, as far as the law is concerned, even though she doesn’t have a biological link to the child. It’s such a mess.’
‘I’m just so glad the law was different when we had the two of you.’ Clare had taken Lexi’s hand, reaching out to place her other hand against the iPad screen propped up in front of her, as if she could physically connect with Isla too. ‘I never had to worry about the donor being a part of our lives. It’s so much trickier now. I admire anyone who’s willing to be a donor, but I’m not sure we’d still have done things the way we did, if the law had been like that then.’
Lexi had nodded in agreement, and revealed more details about just how devasted her friend, Misty, was. The news that Isla had been so desperate to share had died in her throat. She couldn’t tell her mother that she was planning to donate her eggs after what she’d said. It was a world away from being a surrogate, but Clare had always been a worrier. She’d done her best to wrap both girls up in cotton wool their whole lives, terrified that she might lose them, especially when she’d known she was going to lose the love of her life. Clare had asked the girls to promise they’d never join a DNA website that might uncover who their biological father was. Sperm donation had been anonymous at the time of their conception, so a site like that was the only possibility of discovering where half their genes came from. It had been an easy promise for Isla to make, and she was pretty certain it had been just as easy for her sister. Nick Marlowe was their dad, and Isla had no desire whatsoever to discover the man who’d helped him become a father. Now things were different, and she could understand her mother’s concerns, but being an egg donor was nothing like as much of a commitment as being a surrogate. She’d just have to wait until another time to mention it, when Misty’s story wasn’t so fresh in her mother’s mind.
Isla had been sent a health assessment by the fertility clinic, and was due to have a session with their counsellor to discuss the implications of egg donation in the next week. If the counsellor signed her off as being ready to donate, there’d be a screening process with blood tests for genetic conditions and infections. It had felt like she was already a long way into her journey with the clinic she’d chosen, but the conversation with Aidan had thrown all of those plans into question. She hadn’t hesitated in making the initial offer. It had seemed so natural, such an obvious solution to Aidan’s dilemma, and something that might even calm her mother’s fears. Her friendships with the whole A that won’t stop her believing she’s dying, and nothing I said in triage helped. Even telling her that retinoblastoma is almost unheard of in adults just seemed to stress her out even more. I’m going to put a call into The Sycamore Centre now, but I don’t know when they’ll be able to send someone down.’
‘Shall I give it a try?’ Isla looked at her friend, who nodded. The Sycamore Centre was the hospital’s mental health unit, but the demand for their services seemed to be getting greater with every passing week. As a result, A&E often had to deal with patients who needed specialist help for far longer than was ideal. For some reason, Sarah had taken a shine to Isla, and she seemed more willing to listen to her than the other nurses. Maybe it was because Isla had confided how much losing a parent had affected her too. None of the team dismissed Sarah’s fears. Just because they were irrational, it didn’t mean they didn’t feel real to her. But it was hard sometimes, with a backlog of people needing urgent treatment, and the resulting frustration had a way of coming to the surface for Isla’s colleagues at times. It was different for her. She’d seen firsthand what living with the fear of a deadly disease could do to a person. Some people couldn’t just push the fear of something like that to one side and get on with life, whether they’d been diagnosed with an illness or not. It consumed Sarah’s whole life, and Isla was happy to help in any way she could.
‘You’re a star.’ Amy was already opening the door out to the waiting area. ‘I think she’s in danger of having a full-blown panic attack, but hopefully you can get through to her.’
‘I’ll give it my best shot.’ Isla moved past Amy and through to the waiting area, Sarah’s head turning towards her, as soon as she heard the doors open.
‘Oh thank God!’ The older woman ran a hand through her hair as she spoke and it would have been easy to believe she was every bit as unwell as she believed herself to be. Her hair was thinning, to the point of being able to see her scalp in places, and her mouth was set in such a grim line that her lips seemed to have disappeared altogether. She looked pale and exhausted too, but the truth was that she spent so much of her time worrying about her health that she’d stopped taking care of herself in other ways. Sarah had admitted before that she sat hunched over her laptop for hours on end, convincing herself that every tiny twinge she experienced was the cancer taking hold. She’d had ten times more scans and tests than most people would experience in their lifetime, but the relief of a negative test never lasted long. ‘They won’t listen to me Isla, but everything I’ve read online proves I’m right. I’ve got cancer in my right eye and, if they don’t treat it soon, it’ll spread and I’ll go blind, or even die!’
The desperation in Sarah’s voice wasn’t an act, or a way of seeking attention. She genuinely believed she was going to die if someone didn’t take action soon. Other patients were looking in her direction, a couple of whom were laughing at how melodramatic she seemed to be. But it was clearly making some other patients anxious. ‘Okay Sarah, let’s get you through to a cubicle so that I can take a proper look at you, and we’ll take it from there.’
‘Thank you.’ Sarah’s body slumped with relief and, if Isla hadn’t put an arm around her, she had a feeling she’d have fallen to the floor.
‘Are you okay to walk?’
‘My heart feels like it’s beating twice as fast as it should and I keep going dizzy. I’m terrified it’s because the cancer is already spreading.’
‘I think it’s because you’ve been so worried, but I’m going to get a wheelchair to take you through to the cubicles. Just in case.’ Thankfully there were a couple of wheelchairs available in the waiting area, and Isla quickly helped Sarah into one. But even after she was sitting down, her whole body was trembling. ‘It’s okay Sarah, I’m going to get you the help you need, I promise.’
‘Thank you.’ The older woman grabbed hold of Isla’s hand for a moment, pressing it against her cheek, before letting her hands drop back down onto her lap. The kind of help that Isla was going to get might not be what Sarah was expecting. But, either way, she was determined that when her patient left the hospital she wouldn’t be feeling anywhere near as awful as when she arrived. A cure might not be possible, but there were things that could help, and the hospital’s mental health team had already been alerted. Isla just had to try and keep Sarah as calm as possible until they arrived.
Joe Carter, one of the consultant psychiatrists from The Sycamore Centre, had come down to see Sarah, and had given Isla an update on the plan for further treatment. Joe was Danni’s older brother, and Esther’s boyfriend, so Isla had got to know him quite well in the time they’d both been working at St Piran’s. He radiated kindness, and it made Isla feel much better to know that Sarah had someone like him to turn to for support.
‘She’s been having CBT for a couple of months, but I think we need to look at something else. She’s been keen to avoid medication in the past, because she thinks it will increase her chances of getting cancer, but she can’t go on like this. Otherwise, she could be at risk of having panic attacks on a regular basis, and her anxiety could get really out of hand. She’s already missed out on so much because of it, but it seems to be getting worse.’ Joe kept his voice low. ‘You did a really good job of making her feel heard, and helping her calm down. If you ever fancy a change from A&E, we could always use nurses like you in my department.’
‘It’s something I have thought about, and I want to do a Master’s eventually, so maybe I could look at specialising then. Although I’m not sure I could bear to leave emergency medicine completely.’
‘Esther’s the same.’ Joe smiled. ‘I think it turns you all into adrenaline junkies working here.’
‘You’re probably right, although I’m sure your department has its share of drama.’ The previous autumn, one of Joe’s patients had experienced a psychotic episode and had abducted Esther. Thankfully no one was hurt, but it had been terrifying just hearing about it, let alone what it must have been like for Esther and Joe to go through it.
‘None of us go into this for a quiet life, do we?’ Joe gave her a wry smile, and she nodded.
‘We certainly don’t. Sarah’s carcinophobia definitely feels like it’s escalating. She was ranting at one point about how unfair it was that she’d ended up with cancer of the eye, when she’d made sure to find glasses that didn’t contain any plastic. She seems paranoid that everything is capable of causing cancer. She said she stopped using any sort of deodorant, shampoo or washing powder last year. And I don’t want to be rude, but I don’t think she’s found an alternative that works.’
‘No, she hasn’t.’ Joe sighed. ‘Looking at her history this has been going on for well over fifteen years, and her behaviour was already making her isolate herself, but even if she goes along to one of the support groups I recommended to her, I think the hygiene issues are going to make it hard for her to develop any relationships.’
‘It’s really sad.’ It was obvious how lonely Sarah was and, from the way she spoke about her late mother, it was also clear that she was still grieving. She’d talked about how her mum had told her to go out and live her life before it was too late, but she’d been left with no one once her mother had gone. Sarah had cried when she’d recounted that story, and how true it had turned out to be. Her mum seemed to have been everything to her, and it was no surprise that her existing hypochondria had spiralled into something that was now affecting her ability to live a normal life. Thank God for people like Joe, who she was certain wouldn’t give up on Sarah. ‘Do you think you’ll be able to persuade her to try some medication this time around?’
‘I hope so. I’ve promised to go through the side effects of all the medications with her, talking through any risks. I’m also hoping she might be willing to try EMDR.’
‘I don’t think I’ve come across that?’ One of the things Isla liked best about working in A&E was that, once they’d dealt with the initial emergency, they directed their patients to treatment with other specialists, which allowed her to get some insight into the work of so many other departments.
‘It’s a kind of therapy that involves the patient moving their eyes in a way that helps their brain to process traumatic experiences. I think it could help Sarah to work through her feelings around her mother’s death, and some of the other issues that have contributed to the decline in her mental health.’
‘That sounds fascinating and, from what Sarah has told me, her mother’s diagnosis came much later than it should have done, which made an awful situation even more traumatic.’ Isla knew firsthand how losing a parent could change someone. Witnessing the progress of her father’s disease had changed her in so many ways – some obvious, others less so. It was the reason she’d become a nurse, because she’d wanted to give back. And it was the same reason she’d decided to become an egg donor. But there were other things she deliberately kept to herself, because of what she’d been through. Like however worried she was about something, she’d never share that fear with her mother. Her mum had been through more than enough for anyone, and Isla had become her protector when she’d still been at secondary school. She’d never told her about the bully who’d stolen her trainers or taunted her on the bus. She’d put on a brave face when she wasn’t sure she was going to get a place on her chosen degree course, and she’d never admitted how much she wished her mum had stayed in Cornwall, instead of moving back to Florida. She wasn’t a martyr, but there was no way of knowing for sure whether she’d have been as careful around her mother if she hadn’t watched Clare go to hell and back, losing her husband in the way she had. It was what made it so easy for her to understand why Sarah had been as affected as she had been by her mother’s death.
‘The good news is she’s agreed to be a voluntary in-patient for a couple of days, and even better news is that we’ve got a bed available immediately, which is pretty rare these days. So there’ll be a chance to talk to her about all of her options, and I hope this time she might be willing to try something new.’
‘Me too.’ Isla could have chatted to Joe all day about his work, but waiting time in A&E was already at over two hours for non-urgent cases. ‘Thanks again for coming down so quickly.’
‘I would say any time.’ Joe gave another wry smile. ‘But we both know it’s impossible to make that kind of promise, and I make it a rule never to say I’ll do something unless I’m sure I can keep my word.’
‘That’s a good rule, and I think it’s one everyone should try and stick to.’ Isla might have been talking to Joe, but she was thinking about Aidan when she said the words. She’d made him a promise, and it wasn’t one she was prepared to go back on. As long as he could promise her one thing in return.