MJA Dr Eric Dark Creative Writing Prize - Joy to Mary

I could see the fear in her eyes as the nurse assisted her onto the emergency room couch and began attaching ECG electrodes to her chest and limbs. As I approached the couch, stethoscope in hand, her eyes met mine for the first time in 2 years. Many a time I had seen her in the corridor, following one of my colleagues into the consulting room. Each time her gaze studiously avoided mine, pretending to look at something on the opposite wall or waving to a convenient friend in the other direction. Today she had no choice. I was the only doctor here. Was that fear in her eyes of me or for her health?

I pulled up a seat at the bedside and took her hand, partly to reassure her and partly to assess her pulse, two fingers resting casually on her wrist. She did not flinch. The nurse continued her work around us. The fluorescent lights faintly buzzed their blue-tinged glow overhead, brightened by the stark white walls. The hum of the crowded waiting room formed a distant backdrop to our cosy conclave.

Her eyes darted from one thing to another, only fleetingly landing on mine, until her gaze came to rest upon a scrape on the wall, and then I knew we were both thinking the same thing. How many times had he lain on this couch? Wasn't that the place where his wheelchair had scraped the wall?

After the last electrode was placed, the ECG sprang to life, tracing its serpentine form across the screen. Its appearance seemed to heighten her anxiety, her eyes now glued to the screen, trying to decipher the indecipherable. Her pulse fluttered and leapt beneath my fingers betraying the diagnosis. We were like intimate strangers. Two years previously we had shared 3 intense months. The threshold of her home had become as familiar as my own. And then it ended as suddenly as it had begun, with pain and suffering. Had I expected to go on seeing her afterwards? Was that reasonable? To her, clearly not, as her avoidance was studied.

I automatically slipped into the comfort of the basics of history and examination. Safe and secure!

“When did you first become unwell? Can you describe the palpitations? Was there any dizziness? Any chest pain? Any shortness of breath? Nausea? Sweating? What made it worse?”

Her answers came almost in a whimper. Then followed the detached intimacy of physical examination, the placing of the stethoscope, the laying on of hands. As I did so, I remembered the first time I had examined him. A few weeks of nausea was his only symptom. Otherwise, he had been completely fit and healthy. He'd joked about his rude good health as he'd clambered onto the examination couch, muttering something about wasting my time.

“It's probably just stress”, she had offered hopefully. “He just needs a holiday.”

I remembered that sinking feeling as the hard craggy edge of his enlarged liver moved beneath my hand. Had they detected my sudden change in demeanour?

The scans that followed only confirmed the initial suspicions of my examining hand. There was little to be done. Yes, we went through the motions of the oncologist's opinion, as they rode the initial roller-coaster of hope and despair.

Soon I was wearing the well trodden path of palliative care across their threshold. As his belly swelled and his colour yellowed, his pain was relieved and his suffering minimised. Her suffering, however, proved much harder to manage. As he slipped peacefully from this world, I couldn't help but wonder, did she blame me for not saving him?

Did she lack confidence in me now? Did she fear for her life? Again I took her hand as I explained what was happening to her and what we needed to do to treat it. The hum of activity behind the drawn curtains seemed to recede and her hand became faintly tremulous. It was only then, for the first time in years, that her eyes finally locked with mine, full of unspoken questions, and I knew I had to make it clear.

“This is treatable Mary. You are not going to die”, and she promptly burst into tears. It was some minutes and a number of tissues before she could speak.

“I am so glad it is you today”, she said. “I am so glad it is you that is here.” Her hand now clung to mine. “I wanted to see you so many times, but every time I did, the panic I felt during that awful time kept flooding back. I couldn't help it and I couldn't bear it.”

“It's OK Mary”, I reassured.

“For 2 years”, she said, “I thought I wanted to die. I almost wished for death. Today I thought death was coming, and then, just now, when you told me I was not going to die, I felt joy.” She smiled. “For the first time in 2 years, I felt joy! And I want to go on feeling it.”