a bedside nurse, like me, for many years before she became a nurse educator and I became a clinical nurse specialist. Every summer for ten years we registered for the same Therapeutic Touch workshop, on Orcas Island, to enhance our skills and catch up on each other’s lives. Rachel and I always looked forward to it.
My phone rang a couple of weeks later.
‘Brace yourself,’ Rachel said. The pause felt interminable. I could hear her rapid breaths. ‘The lump you felt on my leg is a sarcoma. My oncologist told me he might have to amputate my leg.’ Her voice cracked.
‘Oh, shit. I’m so sorry, Rachel,’ I said. I knew not all sarcomas required such radical surgery, but I also knew that if surgical amputation was given as an option with such an aggressive cancer, they were going for a cure. This diagnosis would mean several hours of surgery followed by multiple rounds of chemotherapy and months of rehabilitation. Just three weeks after celebrating her sixtieth birthday, Rachel would have to find more fortitude than anyone should have to. She had already gone through breast cancer ten years earlier, but this was a new primary cancer, a different beast altogether.
‘Sarcoma is not good, is it?’ she asked.
I inhaled deeply but didn’t want to pause for too long before I answered. ‘It depends on the pathology, doesn’t it? Let’s not get too far ahead until we have more information,’ I said, trying to suppress the fear swirling in the pit of my stomach. The cancer was one nightmare, the amputation another.
Rachel didn’t need me to say, ‘Hey, you’re a fighter. You’ve been through cancer before and beaten it. You can do it again.’
People become disoriented and vulnerable when the fear of death snatches ordinary life out from under them, the moment destiny reveals itself. It’s not the time for bravado from friends.
Grappling for words that were slow in coming, I tried to push my love down the phone line, hoping she’d feel it.
‘I wish I was with you right now. You’ll get through this, one step at a time.’
I heard the whimper of her crying and felt the urge to move the conversation along. Had Rachel been in the chair across from me I’d have held her hand, my love more easily conveyed through physical touch.
‘What happens next?’ I asked.
‘I’m coming to town next week to see the surgeon, Dr Lestin. Have you heard of him?’ she asked.
‘The word on the street says that he’s the best, though he doesn’t get such high marks for bedside manner,’ I said.
‘If I had to choose one quality over another, I’d rather he be good with his hands than be a good listener, wouldn’t you?’ she replied. ‘I can get my emotional support from other people.’
‘I suppose,’ I said, wishing he could be one of those doctors who was an expert on both counts. The doctors I know who are brilliant surgeons and excellent communicators understand it is the emotional relationship, as well as the expertise, that builds resilience in people to tackle what would feel impossible without both. We rise up to meet an experience when we know someone cares about us.
‘Could you come to the appointment? Another set of ears would help. Michael and I will be pretty stressed out,’ she said.
‘Of course.’ I knew she’d be there for me if I were in the same spot.
A few days later, on a rainy November day, Rachel and her husband caught an early ferry to Vancouver. They were sitting side by side on beige plastic waiting-room chairs at the hospital when I tracked them down. The room was packed, though nobody conversed; an eerie quiet that exuded uncertainty. Michael held an unopened newspaper on his lap and rested one arm loosely across Rachel’s shoulders. His forehead wrinkled as he gazed at the wall of patient-education brochures across the room. Rachel looked surprisingly cheerful. She wore a long indigo cardigan over black jeans and her deep blue eyes intensified the white of her thick, straight, shoulder-length hair.
‘Hey there, Janie. Sorry to get you out of bed so early,’ Rachel said brightly, as she stood up to greet me.
‘Couldn’t think of anywhere else I’d rather be,’ I said with a grin. I hugged her, then Michael, and sat down on the only vacant chair.
Forty minutes after the scheduled appointment time, a nurse called loudly from the nurses’ station, ‘Rachel McLeod. In there.’ She pointed to a door and walked away.
The doctor’s office looked like a physiotherapist’s room, with coloured gym balls of different sizes pushed into one corner and a collection of weights stacked neatly along a rack in another. Wheelchairs, walkers, crutches and canes were set along one wall, and a treadmill with sturdy handrails sat in the middle of the room.
Dr Lestin slid off the table on which he had been sitting when we entered. A thin paper chart lay on the table. ‘RACHEL MCLEOD’ was written in red ink along one edge of the file folder that contained her future. He shook Rachel’s hand, then Michael’s, and nodded at me briefly. He gestured for us to sit down.
‘Let’s cut to the chase, shall we? We both know why you’re here.’ Without waiting for a response, the doctor continued. ‘I’m afraid we have a very serious situation here that requires immediate and extensive surgery.’ He looked down at his shiny brogues, perhaps hoping they would walk him away. Direct eye contact might have helped to soften the blow.
‘Say more,’ Rachel encouraged, as though she was talking about someone else.
‘Well, I always hope to salvage the leg, but in your case I can’t. We need to take off the leg and fit you with a prosthesis. Most people do very well, and with good physiotherapy you’ll be back on your feet, so to speak, within a couple of months.’
He smiled as his quip fluttered in the air and landed heavily on the grey linoleum beneath our feet. The leg, rather than your leg, suggested it had to be difficult to deliver such information.
‘Oh, and the good news: this cancer hasn’t spread anywhere else in your body,’ he said.
Rachel jumped out of the chair and with a smile said, ‘So now I know why I’ve practised yoga all these years. The tree pose, one of my favourites.’
She tucked the sole of her right foot high up on her left inner thigh, balancing steadily on her left leg. She raised both arms up over her head with her palms pressed together. She showed how flexible she was and how adaptable she would be with only one leg. Rachel had always had a quirky sense of humour, and I could see that Dr Lestin was not sure whether to smile.
He had other patients to see, made evident by the speed of his words and his backing up towards the door. ‘Okay, I want to get you in sometime in the next week or two. The anaesthetist will see you the morning of surgery. Any questions?’
Rachel looked at Michael, who shook his head. No questions. Shock can seize the mind in these kinds of interactions between doctor and patient, and freeze any questions until later, when they arise, often in the quiet of night. Doctors sometimes give patients only one opportunity for questions after delivering bad news, and time feels pressured. A question Rachel might have asked if she had had time to assimilate the information would have been: Could I have a moment, please? Or, When questions do come up later, how can I reach you?
Grasping the doctor’s outstretched hand as we headed towards the door,
