Читать книгу Further Confessions of a GP - Benjamin Daniels - Страница 10

‘It’s my leg, Doctor. It doesn’t really do what I want it to do. It’s as if it’s not really part of me any more.’ Maggie tried to crack a smile but I could see she was really scared.

‘Right, let’s have a look then.’

Maggie was quite right. Her left leg wasn’t doing what it was supposed to be doing. She could sort of move it, but her coordination was shot and she had resorted to walking with a stick.

‘I’m walking like an old lady, but I’m only 56. It just came on over the weekend and it’s getting worse.’

Maggie was clearly looking for some reassurance, but the truth was that I was worried too.

‘We need to get this looked into,’ I said, stating the obvious.

I’d met Maggie a few times, but usually only when she was accompanying her husband for his blood pressure appointments.

‘Any medical problems in the past?’ I asked as I scanned through her notes.

‘No, I’m fit as a flea. Well, I had breast cancer in 2003, but that’s long gone. It can’t be anything to do with that.’

I looked up from my computer screen and she held my gaze. I was trying to find words that might be both reassuring and honest, but before I could even open my mouth, Maggie was crying.

‘The breast cancer’s all gone,’ she blubbed, trying to convince herself more than convince me. ‘They discharged me from the clinic five years ago.’

‘It may well be nothing to do with the breast cancer, but let’s just get some tests done.’

Maggie clearly needed to see a specialist and have a scan. She didn’t really need to be admitted to hospital that morning, but then it wasn’t appropriate to make her wait two weeks for an outpatient appointment either. When stuck with this sort of quandary, I generally default to the ‘What would I want if it was me?’ option. This turned the decision into a bit of a no-brainer and I phoned the medical consultant on call who agreed that she should go straight up to the hospital.

Sometimes it’s really satisfying to get a diagnosis right, but I took no pleasure in having my suspicions confirmed this time. Maggie’s leg symptoms were due to her breast cancer returning. It had already spread extensively and it was lesions in the brain that were causing her leg symptoms. After being told the result of the scan she was discharged with some steroids.

Maggie had still been in a state of shock when they’d given her the diagnosis in hospital, so she made an appointment with me to go over a few things. First of all she wanted to know how the cancer had lain dormant for all those years before coming back. I would like to have been able to answer that question, but the truth was I just didn’t know. It wasn’t something she’d done wrong; it was just one of those awful facts about cancer. Sometimes we think we have beaten it, yet somehow this horrible disease has a dirty habit of reappearing. Maggie hadn’t even noticed a breast lump, but by the time she had her scan there were cancerous lesions in her liver, bones and brain. The cancer specialist offered her some chemotherapy that might temporarily shrink the tumours, but he made it very clear that he could offer her no cure.

‘What now?’ was her next question.

Again, this was a hard one to answer. ‘We’ll get the palliative care nurses involved and will always make sure that you’re never in pain or distress with the symptoms. You might remain stable and fairly well for some time …’

‘But basically I’m going to die.’

I thought about trying to counter that remark with something upbeat and positive, but in reality Maggie was right. She was going to die and I couldn’t say anything that would change that fact. I stayed quiet, handed her a tissue and put my hand on her hand. We sat in silence for a few moments while she sobbed. After she left, I made myself a quick cup of tea, splashed some cold water on my face and pulled myself together enough to see my next patient.