Chapter 2
LOUISA
Tom hasn’t been able to look at me since Mr Whitelaw said the word ‘cancer’.
He’s tried a few times, but every time he does, his eyes fill with tears, and he has to look away again.
Right now, he’s busying himself searching for something at the back of the fridge, his head buried deep in every sense.
It’s hard for me to hear what he’s saying, but it doesn’t matter, because I know he’s repeating what he must have said a hundred times already, and it’s been less than four hours since I got the results of my tests.
‘…we’ll find the best doctors and you’ll be okay.
Holly was.’ Even muffled by the walls of the refrigerator, I know my husband is doing his best to sound upbeat and positive.
From the moment we got back to the car and he started talking, it was clear he was only prepared to focus on the best-case scenario that Mr Whitelaw had outlined.
As desperate as I am to believe that Tom might be right, I know from his online profile that Mr Whitelaw is renowned in his field.
He’s the sort of doctor patients cross oceans to see for a second opinion, and he didn’t think the best-case scenario was the likely outcome.
There was a sadness in his eyes when he said that.
I wish I hadn’t seen it, but I did.
‘I’ll make some tea.’ My words sound so every day and normal, and as I catch sight of my reflection in the side of the kettle, I find myself peering closer, unable to believe that I look the same as I did this morning.
They must have got it wrong.
Surely I should have ‘likely to be incurable’ tattooed across my forehead, because it feels as if those words have seeped into every cell in my body, circulating through my system, even faster than the cancer that started in my pancreas and may well have spread beyond that, given that the initial scan indicates it may already have spread to my liver.
Mr Whitelaw has booked me in for a PET scan to see whether surgery is possible, but he didn’t sugar coat things.
‘Pancreatic cancer is horribly sneaky, because the symptoms often don’t appear until it has begun to spread, which means the chances of it being in other parts of the body are much higher.
If that is the case, surgery won’t be advisable, unless we can significantly shrink any tumours we find.’
Even now I still can’t believe the word cancer applies to me, let alone the likelihood that it’s spread.
I can’t be ill, there are too many people who need me.
I haven’t thought about how I feel yet, not really, and I suspect it’s my brain’s attempt to protect me so that I don’t collapse at the enormity of what we’ve been told.
It means the news hasn’t really sunk in yet and Mira said that’s quite normal.
She took us to another consulting room after my appointment and told us she was there if we had any questions.
I had so many things to ask, but I couldn’t find the words and I just stared at her blankly, still waiting to wake up and discover it had all been just a bad dream.
Mira explained that I might be numb for a while, and that shock could delay the reaction to news like this.
She had kind eyes and a soothing voice, but when she gave me her details to contact her whenever I’m ready to talk, I wanted to tell her that she’ll never see me again.
I’m not the sort of person who has a cancer support nurse in the contacts on her phone.
I’m Louisa, or Lou to those closest to me.
I’m a very occasional freelance writer, a wife, a daughter of dysfunctional parents who need me more than I need them, a sister, and a friend, and most of all Mummy.
It’s the name that means the most to me and I felt my heart start to pound at the thought of one day not being there to answer when my children call out to me.
I promised myself before they were even born that I’d never allow them to be hurt or let down the way Holly and I were.
Every time I think about it, I feel as if I’m being crushed from the inside out.
So even though I nodded as Mira spoke, I couldn’t accept that anything she was saying could really apply to me, because if it did I’d be responsible for inflicting pain on my children and I can’t bear that.
When I asked Mr Whitelaw how long I’ll have if the results of the PET scan reveal the worst-case scenario, he couldn’t answer.
Or he wouldn’t.
I’m not sure which and I don’t want to know.
The whole conversation is something I wish I could wipe from my mind, but it’s playing on an endless loop through my head.
Every time I asked the doctor a question, I braced myself for the worst, and each time Mr Whitelaw delivered.
The cancer in the pancreas was large enough to see on the CT scan and leave absolutely no doubt about what it was.
There are also suspicious areas in my liver and some other possible areas of spread, and yet it still didn’t feel as if he was talking about me when he delivered blow after blow.
I keep putting my hand on my torso wondering if the tumour is growing beneath it.
Surely, I’d be able to sense it, if something like that was taking over my body bit by bit.
I want to believe he’s wrong, or just being pessimistic and trying to prepare me for the worst, but Mr Whitelaw doesn’t seem like a man who is prone to being over dramatic, just someone who’s honest even when it hurts.
‘I wish I could give you better news, but it appears to be a highly aggressive cancer.’
When Tom asked if they’d be able to operate, I wanted to snatch the question back and beg Mr Whitelaw not to answer.
I knew exactly what it would mean if he said no and I wasn’t ready to face that.
I’m still not.
‘Like I said, we’ll need to do the PET scan so we know the full extent of any spread.
That will allow us to select the right type of chemotherapy for the type of tumour, and to see whether surgery is an option.
However, pancreatic cancer is often quite difficult to treat…’ Mr Whitelaw didn’t look me in the eyes, and the numbness that Mira described meant I barely even reacted.
I couldn’t grasp the implications of what he was saying, at least not for myself; all I could think about was Flo and Stan.
I couldn’t imagine how my babies could survive without me, and all my terror in that moment was reserved for what my diagnosis means for them.
My primary purpose is to give the children the best possible childhood, but losing me would rip their worlds apart and it’s completely out of my control.
My throat burned as Mr Whitelaw paused, and I could barely breathe.
All I wanted to do was run, so I could get to Stan and Flo as quickly as possible, but I was rooted to the spot.
So it was left to Tom to ask all the questions.
‘But the chemo can cure the cancer, right?’
Mr Whitelaw pulled a face and bile rose in my throat as my children’s faces swam in front of my eyes.
He was handing me a death sentence, without saying a word.
That was when he shifted in his seat, giving the kind of response a politician might when they’re trying to avoid giving a straight answer to a question.
He talked about treatment ‘options’, which could help slow down the growth of the tumours and alleviate some of the symptoms, but he never once mentioned the possibility of a cure.
I looked at Tom, willing him to say something that would convince me I’d misunderstood, and that the voice in my head telling me I wouldn’t get to see the children grow up had it all wrong.
My mind went to the strangest of places, panicking about who would know how to make Stan’s toast the way he likes it if that happened (with just the right amount of honey), or whether Tom would remember to check the class WhatsApp group for the latest information about what was going on at Flo’s school.
My heart hurt at the thought of their little faces if those little routines, and a thousand other things they’d always been able to rely upon, suddenly changed.
Stan and Flo couldn’t lose any of the things they took for granted.
I had to have misunderstood, but when I turned to Tom, he looked broken, and I knew there was no mistake.
‘If the extent of the tumour and any subsequent spread makes the cancer inoperable, we’ll be able to treat it, but we won’t be able to get rid of it completely.’
‘It’ll be incurable?’ Tom’s question seemed to pulsate through my veins.
‘I’m afraid so, but we’ll know more about our options when we get the results of the scan.’ Tom clenched his fists in response to the doctor’s words, and for a moment I thought he might actually throw a punch, but he didn’t move, and it felt like no one in the room knew what else to say.
My husband was furiously wiping away tears, and that’s when I asked Mr Whitelaw how long I had left.
I had to know and, in that moment, I would happily have made a deal with the devil if he’d guaranteed I’d be around to see both children leave school.
‘A prognosis is always very hard to give but around 10 per cent of patients can become disease free, if it’s caught early enough.
If not, the outcomes depend on so many factors, including how you respond to the treatment and most importantly the size of the tumour and extent of the spread.
For those patients whose tumours can be surgically removed, up to 50 per cent will survive for at least five years, when surgery is combined with six months of chemotherapy.’
‘And if I can’t have surgery.’ I held my breath, but I should have known I wouldn’t be able to pin him down.
‘I don’t think it would be helpful for us to talk about that until we know more about what we’re dealing with.’
Part of me is glad that he refused to tell me just how bad it might be, because I need to hang on to hope.
But I can’t be like Tom and bury my head, pretending it’s all going to somehow be okay.
I know Mira is right and that my muted response won’t last.
I’m winded every time I think about the children and the strangest part is how easily I can visualise their pain if they lose me, and how much that hurts, yet I can’t picture myself dying, even as part of that.
It’s not because I’m some selfless, earth mother, it’s because the idea of me not being around just seems impossible.
As stupid as it sounds, I’ve always been here, for every moment of the life I’ve lived, so it’s impossible to imagine a life without me in it.
But what I can picture all too clearly is what it’s like for a child without their mother around, because I’ve lived that experience already, when Mum was trying to get sober and would disappear for months on end so that she could ‘get well’.
Our paternal grandparents became mine and Holly’s safety net, they were our contingency plan and our happy place, providing respite at the worst of times, when Mum was absent and Dad seemed to sink even deeper into the well of his addiction.
Mum boomeranged in and out of our lives and every time she came back home, she and Dad swore to my grandparents that they were making a go of it this time.
Sometimes she managed to stop drinking for several months, but she always gave into temptation at some point.
Anything could trigger a relapse, from a row with a friend, to a final demand for an overdue bill.
My grandparents kept hoping that each time would be the one where things finally came good, and much later they confessed that they didn’t know for a very long time quite how bad things had become, mainly because Holly and I covered for Mum and Dad a lot.
When my grandparents finally realised how bad things were, they tried to persuade our parents to sign over custody, but my mother told them that she’d fight until her last breath to keep us.
We were all the family she had, after all.
So I know she loved us, she just loved booze even more, and nothing has changed in the two and a half decades since Holly and I left home for university at eighteen, and never again lived full time under our parents’ roof.
Understanding the impact of an absent mother is why, right now, all the impact of my diagnosis is focused on Flo and Stan.
I know at some point the shock will wear off and, when it does, I’ve got to be ready.
I need to have as many plans in place as possible, in case I don’t have the strength to make them if the cancer is incurable.
I’ve got to hold the family together and prepare them for what’s to come, the way I always do.
Except this time, I’m going to need help, and there’s only one person in the world who I can be completely honest with.