The Choice Read online

  ‘Hmm,’ he said as he examined the lump in my groin. ‘This might have been caused by an infection. Have you had a nasty cut at all, on your foot for example?’ ‘No,’ I replied, unable to think of anything. ‘Well, you have been abroad and you never know what you might have picked up. I’ll put you on antibiotics for a week and I’ll see you back here after that, whether or not this lump has gone.’ We chatted then for a bit about my holiday and how the children were doing. I rose and thanked him for the prescription. ‘Bye now,’ I said.

  The door clicked behind me, but as I left I heard it open again.

  ‘Mrs Bohan?’

  ‘Yes?’ I turned round expectantly.

  ‘Don’t not come back,’ he warned.

  I took the antibiotics and checked the lump daily. That weekend we went to the christening of my sister Aquinas’s baby boy, Dean. It was a joyful occasion, and everyone was in high spirits. I didn’t mention anything to my mother or sisters of course – there didn’t seem any point involving them until I knew what this thing was. At the end of the week it was still there. ‘I’m going back to see the doctor,’ I told Ger. ‘The antibiotics haven’t done a thing.’

  ‘Do you want me to come with you? I have a few meetings on today.’

  ‘No, you’re all right. I’ll be fine. I’ll call you when I’m done.’

  So I went back to the doctor by myself, trying to ignore a nagging sense of unease.

  He felt the lump from all angles, his brow furrowed. ‘I think you ought to see a specialist to get this lump properly checked out,’ he said. That sounded ominous.

  Then I remembered something else. It had almost slipped my mind because of the worry of the lump. ‘I’ve missed a period. Do you think I might be pregnant?’

  Ger and I had been toying with the idea of a third child. Sarah was four and it seemed like it could be a good time to start thinking about the next one. It had not been uppermost in our minds, but we had not particularly been trying to avoid having a baby. Because it wasn’t a huge deal for us, I hadn’t mentioned to Ger that I was late. Yet here I was, suddenly facing the possibility that I may indeed be pregnant. It didn’t occur to me that my timing was appalling.

  He looked up and I saw a flash of concern cross his face. ‘That might complicate things,’ he said slowly. ‘You’d better come back tomorrow with a urine sample to confirm whether or not you’re really pregnant.’ There was something in his grave expression, and the fact that he phoned then and there to make an appointment with the specialist that made icy fingers creep around my heart. Something was clearly terribly wrong. I didn’t want to leave his surgery before getting more information. I needed to know what I was dealing with. I looked at this kind, straight-talking man.

  ‘Please, doctor,’ I said, ‘I’m worried now. What do you think this might be? I need a straight answer.’ There was a long pause. He shuffled his papers for a moment then looked me in the eye.

  What he said then shocked me – I was used to doctors being somewhat secretive and evasive in their habit of drip-feeding information to patients.

  ‘I think it’s either lymphoma or Hodgkin’s disease.’

  The words spun through my mind: I had heard of Hodgkin’s and I knew it was rare and bad. I had never heard of lymphoma, but I sure as hell was going to find out about it before I did anything else.

  I can’t remember driving home that day. I must have gone to the school to pick up Sarah, because I know that later on I left her with a neighbour. Richard came out later. I needed to be alone when I phoned Ger at work.

  ‘Ger,’ my voice trembled as I held the phone, ‘I have some bad news.’ I heard him draw breath as he waited for me to go on. I couldn’t say the words. ‘Stay there. I’m coming right home,’ he said. I knew he had guessed what it was.

  An hour later we were standing together in our kitchen, arms locked around each other, silent tears falling. I had just told him what had happened. Ger was confused – ‘What else did he say?’

  ‘Nothing. That was it. Lymphoma or Hodgkin’s.’

  ‘OK. We need to find out what we’ve got here,’ he said eventually, as he reached for the giant medical reference book I kept on the shelf. Like my mother before me, I tried to deal with family health problems myself. Unlike my mother, though, I always wanted to find out all the facts.

  This is what we read: The lymphatic system is one of the body’s defence mechanisms. It filters out organisms that cause disease, produces certain white blood cells and generates antibodies. It is also important for the distribution of fluids and nutrients in the body, because it drains excess fluids and protein so that tissues do not swell up. So far, so good. A lymphoma is a painless swelling of the lymph nodes in the neck, underarm or groin. Mine hurt! I rejoiced – perhaps it wasn’t this after all.

  Other symptoms may include the following: unexplained fever; night sweats; constant fatigue; unexplained weight loss; itchy skin; reddened patches on the skin. Again, I had not had any of these symptoms, most of which sounded to me like flu. I had been feeling better than I had felt in ages. I had loads of energy. Surely this was all a bad dream. I couldn’t be ill, could I? There must be some mistake. We read on: Lymphoma is a general term for cancers that develop in the lymphatic system. It occurs when cells in the lymphatic system become abnormal. They divide too rapidly and grow without any order or control. Hodgkin’s disease is one type of lymphoma. There is only one way to tell the difference, and that is when the cells are looked at under the microscope. Both types of cancers can spread to almost any part of the body, including the liver, bone marrow, and spleen.

  Until this moment the words ‘lymphoma’ and ‘Hodgkin’s’ had been just that, mere words. Now I realized they were both words for cancer.

  The Big C.

  It hit me like a slap in the face. Dumbstruck, I stared at Ger.

  ‘There’s something else I haven’t told you yet,’ I said. ‘I think I’m pregnant.’

  Ger’s face lit up for a brief moment before darkening. A mass of contradictory emotions was welling up inside him, but he spoke calmly: ‘Well, sure that’s great,’ he said carefully, ‘but the most important thing is for you to be well. How certain are you?’

  ‘Well,’ I said slowly, ‘I’ve missed a period, I have a painful, dragging feeling here,’ I placed my hands over my lower abdomen, ‘and I’ve got a strange metallic taste in my mouth.’ He looked dubious, but these were clear signs for me – I had been pregnant twice before, after all. And my breasts already felt fuller and slightly sore. My mind leapt forward: March. The baby would be born in March. I couldn’t help but feel excited.

  ‘Bernie,’ he said softly. ‘Let’s not jump to conclusions on either count. We don’t know it is definitely Hodgkin’s or lymphoma – GPs don’t know everything, and there are lots of symptoms in that book you haven’t got. Let’s wait for the specialist to tell us exactly what’s wrong with you. And anything might happen with the pregnancy.’

  He was being too calm, too conciliatory. I was touched, but that scared me almost more than the idea that I was going to be ill.

  ‘Well, I’ll find out tomorrow if I’m really pregnant, and on Thursday I’m seeing the specialist.’ Put like that I thought it sounded perfectly possible for the two different issues to exist side by side. I wanted to sound confident and in control, as if I was taking all this in my stride. Ger smiled with the confidence he always exuded. ‘Look, we’re in this together. Whatever happens, I’ll be here to look after you and the children.’

  I could not sleep that night. My doctor’s words kept echoing through my mind: this might complicate things. Was I pregnant? What would it mean? What was the lump? Could it really be cancer? I was only thirty-two – surely much too young to be given a death sentence. I lay awake for hours, and eventually slipped into a fitful sleep.

  I dreamt of my father, who had died when I was twenty-five. In my dream he was once again lying in his hospital bed, ghost-pale and thin. I tried to hug him but I c
ouldn’t, because of the mass of tubes snaking into his arms and neck. I couldn’t get close enough to him. Suddenly he was sitting up and my sister Aquinas was in the room too. He said to her, ‘You used to be my favourite, but this lassie is my favourite now.’ Then I was washing him, and he was ashamed, hunched over on the bed. He looked shrunken, defenceless. I felt like I was the only one who could look after him, and I was saying ‘Don’t worry, you did this for me, it’s OK.’ He could barely lift up his head but he managed to whisper, ‘And I will again, pet, I will again.’

  I woke up, my face wet with tears. Dad had died of lung cancer, and I did not know if I was crying for him or for myself. I loved him dearly, so I did. Reaching over for Ger, I buried my head in his chest and felt comforted by his warmth and strength.

  Chapter Three

  The Right to Life?

  I was right. The pregnancy test was positive, but I hardly allowed myself to dwell on it. My mind was a mass of conflicting emotions: it was lovely to be pregnant, but devastating to be facing a major illness. I did my best to blank out both things and absorb myself for the next two days in Richard and Sarah and their little lives.

  It was the night before my appointment with the specialist. I cooked Ger’s favourite supper – steak, onions, peas and potatoes – spending more time than usual preparing it. Mundane tasks like chopping vegetables calmed me, and as I smoothed the white linen cloth over the table and laid out the dinner plates and glasses it seemed to me that it was possible to lend some order and certainty to our lives. Sitting there later with Ger, the evening breeze drifting in from the open patio doors, I almost felt that everything was all right with the world. It was so perfect, yet so brittle. I wanted to freeze this moment, stop the hands of the clock, and stay just as we were.

  We talked about plans for the following day. Ger said, ‘I think you had better pack a bag, just in case.’ I was surprised. ‘But I’m only going in for an out-patient appointment. Even if I need to be admitted it surely won’t be straightaway.’

  ‘It won’t hurt to be ready. If you bring the bag home again, so much the better.’ Ger was adamant. He always likes to be one step ahead of the game, prepared for every eventuality. This is a wonderful quality and was to be crucial for me in the months and years ahead – during my treatment, when I was stumbling weakly through the days, I always knew that Ger was buoying me up, making me feel secure and looked-after. If I fell I knew he would be there to catch me.

  We were lucky enough to have private health cover, and we were being sent to a hospital half an hour’s drive away. The journey seemed endless, and I sat quietly while Ger chatted away: I knew he was trying to take my mind off things. Dear God, I prayed, Help me to get through this ordeal. We arrived at the new, modern hospital building with plenty of time to spare. I was amazed at the plush corridors and shiny chrome and glass interior – it looked like the sort of place no one could be sick in. ‘I wouldn’t mind spending a few days here myself,’ joked Gerard. ‘It looks like a hotel.’ I looked at the signs we were passing. Renal Department. Ear, Nose and Throat. And I remembered the medical book: Both types of cancers can spread to almost any part of the body…This was no hotel.

  The specialist, or the oncologist as I learnt to call him, was a distinguished-looking man in his early fifties with pepper-and-salt hair. His eyes were penetrating and I sensed a sharp mind and a quick brain. He shook my hand and smiled at me.

  ‘Good morning, Mrs Bohan. I’ve read your notes. Why don’t you start by telling me when you first noticed this lump?’ I told him everything I could remember, Ger chipping in from time to time. Then he examined me.

  ‘We’ll need to organize a biopsy. No need to worry, it is a simple procedure in which we take a section of tissue and send it off to the lab for analysis. Wait here for a moment while I ask Claire to check the calendar.’

  Ger followed him out, saying hurriedly to me, ‘I won’t be a moment.’ I knew what he was doing. He wanted to buttonhole the oncologist himself, and later he told me what transpired.

  ‘Can you do anything tomorrow?’ Ger asked him.

  ‘Tomorrow? Not really. It’s Thursday today, and Friday is a bit soon to get things sorted. We don’t do biopsies at weekends, so I think the soonest we’re looking at is Monday or Tuesday.’

  ‘We have a bag packed. If you can fit her in she’s all set.’ Ger hates waiting, and always wants to get the job in hand sorted. ‘I just want to find out what this thing is and get on with it.’

  The oncologist was taken aback. ‘You’ve packed a bag? That’s efficient. Now, let’s see then.’

  While he looked at the schedule Ger wondered how to phrase his next question. He decided the direct approach was best.

  ‘You know my wife is pregnant. Tell me if she can have the treatment or … or will she need an abortion? I need to know what our position is.’

  ‘Mr Bohan, it really is too early to discuss anything like that. Let’s take this one day at a time. In a few days we will know what we are facing and what the possible treatment might be. Then we can talk about the pregnancy. What I can say is that if she has what I suspect she has, she cannot wait nine months for treatment. And treatment would damage the foetus. My job now is to make your wife well. Would you mind waiting with her while I make some calls?’

  We had had a referendum in Ireland on abortion a few years earlier, as a result of which it was confirmed that the unborn baby’s right to life was equal to that of its mother. So for Gerard to raise this question was deeply contentious. However, as happened in my case, doctors must not refuse life-saving treatment to any mother even where it is likely that the treatment may damage the baby.

  It was clear the oncologist would not say any more at this point. Later he told me that this was quite common: patients would bombard him with questions, desperately wanting to know everything all at once.

  ‘I can’t possibly tell them what is ahead of them when they are just embarking on treatment, or sometimes not even needing treatment at all,’ he said to me one day. ‘Every patient reacts differently, every tumour is different, and it’s not very helpful to tell people they are possibly entering the hardest period of their lives. My way of helping them is to take them through each stage as gently as possible – and, hopefully, eventually to cure them.’

  We were lucky that Thursday. The oncologist managed to find a surgeon to do the biopsy the next morning, and before I knew it I was upstairs in the ward. After I had been booked in and the various formalities gone through and we were alone, Ger drew the curtains around my bed. He told me what he had asked the oncologist. I was horrified.

  ‘An abortion? Wh-what in God’s name are you talking about?’

  It may sound odd, but I hadn’t admitted to myself the possibility of terminating the pregnancy. I knew it complicated things, that was all. I simply had not faced up to what that might mean in reality.

  ‘Ger, I am carrying our baby. You know there is no way I can get rid of it. I just can’t. I haven’t got it in me.’ I needed time to get my head together – it was all happening too fast. This was the sort of thing that happened to people in movies, not ordinary people like us. I had a mental image of this tiny baby clinging to me, fighting for its life.

  ‘Jesus, Bernie. You have two healthy kids at home. What are you thinking?’ I realized that Ger was naturally concerned for me and our children, and his protective instincts were focussed on keeping the status quo. I knew he was trying to introduce me gently to the prospect of not having this child. But he was a man: how could he possibly understand what it was like to be carrying a baby? It was a precious gift. I was a mother, and I was being given a chance to be a mother again. Nothing was more important.

  The next morning I was given the pre-med to make me a bit dozy, but as I was wheeled into the operating theatre where the anaesthetist was waiting there was only one thing on my mind. ‘Remember I’m pregnant won’t you?’ I said to him. ‘Make sure you don’t do anything to harm the baby.’
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  ‘Don’t worry, Mrs Bohan. It’s only a local anaesthetic.’ He spoke calmly and soothingly. Nevertheless, I felt sick with fear and anxiety.

  After the biopsy I lay in my bed watching the other people in the ward. In the bed opposite me was a woman in her early forties. One of the nurses told me she had leukaemia. ‘Say a prayer for her,’ she said. I looked at her – her skin was grey, she had no hair, she could barely set one foot in front of the other. She smiled back, and I went over and asked her how she was feeling. She told me about her family, and how she was hoping to go to Australia to see her youngest son for Christmas.

  Ger was in and out of the hospital that day, rushing around for the children, bringing me in things, waiting and waiting for the results. We were hoping to hear something that day. The hospital food was amazing (yes, that’s right, the hospital food was amazing – if you can believe it), but I couldn’t touch a thing.

  ‘Can I eat it then?’ he asked me. ‘It looks gorgeous and I’ve had nothing all day.’ Poor man, he was running himself ragged. ‘Take it,’ I urged. ‘Don’t forget to look after yourself – we are all going to need you!’ I looked at the food and thought I was going to throw up.