The Windsurf Boy, page 9
At that thought, Anna checked herself. The life was not ebbing, because she, Anna, knew about breast cancer; that is, she had read perhaps a half-dozen articles on the subject, and so attributed to herself the collective wisdom of half-a-dozen journalists. On the surface of her mind were vague facts and generalised statistics, all combining to reinforce her faith in science, if not in miracles. But underneath that surface was a swamp of speechless terror which sought to bubble through the rational calm with inarticulate murmurings about ‘the disease’, and ‘the worst’ and ‘a growth’, and all the other misshapen fantasies.
Dr Jacobs’s office was on the fourth floor. It had a distant view of the sea, sparkling between the trees, but lack of space had forced a large grey triple filing cabinet up against one corner of the window, so that a section of the vista was cut off by its ugly shape. Similarly, the room was spoiled; once larger, it had been divided, so that what was probably once a spacious board-room in the old hospital was now partitioned into areas without proportion, the cornices brutally chopped off.
‘Miss Lewis, yes.’ He walked forward, his arm outstretched, I am so pleased to meet you at last. Your mother has told me a lot about you. Do sit down.’
For some reason Anna had expected a small dark man, maybe foreign. Dr Jacobs was very tall, so that his shoulders hunched automatically, as if to disguise the height. He had an angular profile and grey, receding hair; his voice had the accent of a third generation successful in the profession.
When she was seated, he leaned forward, both elbows on his desk, hands clasped very precisely.
‘How much do you … er … know about your mother’s illness, Miss Lewis?’
‘Not, not as much as I should. She only told me the day before yesterday. I live in London, you see.’
‘You don’t see Mrs Lewis very much then?’
‘Oh yes. Well, no. I came down to see her just after she had her fall. She was in the new hospital then. She seemed fine then. She didn’t write, or tell me.’
He nodded. That’s not altogether surprising. We sometimes find that patients are reluctant to involve their families. It is as if they are afraid of being a burden. It’s an interesting fact that we often ask old people if they have children – when filling in forms, you understand? – it is one of the first questions. Very often the answer is no. Then it emerges that they do in fact have children, but grown-up children, of course. They say no because the children have grown up and gone away, and so in that sense they do not have children. I think I can understand why your mother didn’t want to tell you. But it would have helped if we had known sooner. Obviously from our point of view it would have been better had your mother gone to her doctor as soon as she noticed the lump. But like many patients, she simply hoped that it would go away. Unfortunately it never does.’
Anna buckled and unbuckled her watchstrap, digging her forefinger into its prong. ‘Dr Jacobs, can you explain to me just how ill my mother is? I thought, for instance, that if someone had breast cancer, and had not gone to the doctor early enough, you could … take the breast off, and stop it?’
He held his fingertips together and shook his head. ‘That’s the way it used to be done. Now we very rarely perform such radical surgery, unless it is absolutely necessary. If by removing the breast we know that we are removing the primary, we do so, but – I emphasise – only if we are sure it will effect a cure. If there is evidence of a secondary, that is, a secondary cancer, then the patient is spared the trauma of a very unpleasant and psychologically disturbing operation.’
‘Are you telling me that my mother has more cancer?’
‘I’m afraid so, Miss Lewis.’
Anna looked down. There was a tiny spot of blood on the ball of her thumb, where she had applied too much pressure with the prong of the watch. ‘She said, she said … it had spread to her leg. I thought she was getting it all wrong.’
He smiled faintly. ‘Children never quite believe their old parents, do they? No, she was quite right and it’s a very common symptom. It’s what we call a pathological fracture. You would be surprised how often it is a symptom of breast cancer, although a secondary – you see? It is an easy break through a part of the bone already eaten away with disease, and sometimes it can happen even with a very minor fall.’
His hands had not moved; still the cleanly manicured fingertips rested against their opposite numbers in perfect symmetry. His calm affected Anna, who took a deep breath and clasped her own restless hands in her lap.
‘Is that all?’
He shook his head. ‘Did you notice, Miss Lewis, that your mother was slightly out of breath?’
She nodded dumbly.
‘Well … I feel it’s only fair that I should tell you everything, even if your mother has not. I know, she told me, that she finds it all very hard … In fact, we have discovered a lung secondary. By that I mean, of course, another cancer. Again, it is not uncommon for all these symptoms to go together. The lining of the lung is infiltrated with tumour which secretes fluid. We can take the fluid off; it’s what we call tapping. But it means there are days when Mrs Lewis finds it hard to breathe, as you have noticed. However, I can assure you that the treatment causes her no pain.’
Anna made her voice as flat as she was able. ‘Can you tell me, Doctor, if everything you have said means that … means my mother is bound to die?’
There was a pause while he looked across at her. Instead of answering, he rose, looked out of the window, then talked to the far-away sea.
‘During these months I feel I have got to know your mother quite well, Miss Lewis. When people have cancer they often see their lives very clearly. They will sit in that chair and tell me things about their lives and their needs that they have never considered before. It is all in very sharp focus. And although I don’t altogether subscribe to the currently fashionable theory that cancer is a purely psychological disease, I will say this – that one must place the clinical notes alongside the knowledge one gains in those conversations, before one makes a prognosis. It is not for me to presume to tell you things about your own mother; there is no doubt that you know her much better than I do. But one thing I will say: very few old people willingly give up their homes, their whole lives, to go into a nursing home, when nobody has told them that they must, and when that action itself is likely to increase, rather than decrease, the probability of an early decease.’
Anna stared at his back. It was as if she had suddenly walked into a country where people spoke her own language yet abandoned the familiar sentence structure, so that words might be clear, but the meaning remained hidden. Several clauses behind him, she struggled to catch up. ‘I’m sorry … do you mean to say that my mother shouldn’t be here at all?’
He turned and sat down again. ‘The nurses say that Mrs Lewis could manage if she wanted to. And they are right. To be frank, Miss Lewis, it can be exasperating for staff when a patient proves to be so negative.’
‘Negative? How?’
Dr Jacobs sighed with an air of impatience, as if to say that he should not be telling Anna things she already ought to know. ‘Your mother is a widow, and has been for about nine or ten years – is that right?’
Anna nodded. ‘Ten.’
‘Well, I can tell you that your mother’s attitude to her illness is quite typical of many women in that situation. Widows. They are fine – often for many years – coping with life, alone. Then at the first sign of physical weakness, it all catches up with them. They never really wanted to manage on their own, you see. So, as I said, at the first sign of physical disability, it is as if their minds follow suit; they want – if you’ll excuse the expression – to pack it all in.’
‘Are you saying that my mother wants to die?’
He made a slight brushing movement with his hand, and shook his head, ‘I don’t think it helps to be as … well … blunt as that. It isn’t as positive as that. Let me just say that she has a negative impulse where her own life is concerned. When someone has breast cancer we can safely predict that she will go through periods of recovery when she can lead an apparently full and normal life. There are ups and there are downs and this can continue for six months, a year – who knows? I had a woman in here, oh, about eighteen months ago. Breast cancer again. I gave her six months at the outside, and just last week my wife met her serving on the cake stall at the church fête. An amazing woman, full of determination and spirit. She told my wife that she has been kept alive by prayer … but I would say it is her own will that’s done it, not anyone else’s. This is where the theorists come in to their own. Because so much of it does depend on the attitude of the patient. And of the patient’s family.’
He looked at his watch. ‘I’m so sorry to have had to tell you all this, Miss Lewis, it isn’t something that one gets used to. Sometimes it’s worse telling the families than the patients themselves. But I must be brief now, because I have to go down and see your mother. Are you staying to see her too?’
‘I’ll do something. I’ll go for a walk and then come back.’
‘Good.’
They hesitated, not looking at each other. Then Anna, conscious of a quiver in her voice, said, ‘It’s so hard to take in. I feel as if … I don’t know … that I want you to tell me what to do. I don’t know – on my own.’
His voice was kind, ‘I know just what you mean, Miss Lewis. To put it in a nutshell, your mother could live at home and go to hospital two or three times a week for treatment, as long as she had someone, you know, on hand. You asked me how long, and I didn’t answer. But although I don’t like making predictions, I’ll take the risk and say that your mother could enjoy perhaps six months or a year of life, perhaps more. Remember what I said about the cake-stall lady? But she has to have a purpose. Like so many patients of mine, she needs a real purpose for living. If you could persuade your mother to try to lead a normal life at home I know she would improve. If you allow her to stay here … then I’m afraid that she will probably die by Christmas.’
Chapter Ten
Anna could not face a walk in the grounds of ‘The Park’. The little figures in dressing gowns being pushed in wheelchairs or leaning on the arms of anxious relatives, the nurses flitting along under the mullioned windows like spirits from the hospital past, the dappled light beneath the trees – it would be intolerable, she felt, today. So she walked quickly from the front door of the building, out of the gates, and turned right along the road.
After about a hundred yards the quiet street in which ‘The Park’ was situated led out on to a main road. On the opposite side of this ring road that bypassed Synemouth was a new housing estate. Looking carefully to right and left Anna crossed this road, the noise of the passing cars buzzing loudly in her ears, yet not drowning the perpetual scream of seagulls overhead. Stranded on the island like a crab out of water, she heard a bus change gear, the intensity of its hum shifting into a higher key. Somewhere someone was using a chainsaw and that insistent whine separated itself crisply in her consciousness from the faint drone of an aeroplane, yet both united with all the other sounds into a murderous symphony inside her head.
It reminded Anna of when, just before John left, she would be attempting to persuade Tom into bed, and he would turn the chattering television louder to drown her instruction, reverting to crying babyhood when she snapped the button off, and then the shrill ring of the telephone would increase the din, until she wanted to beg for mercy. Later John would slam the front door, late as usual, and they would eat a meal in silence, punctuated by her anxious questions about his day, and who said what at his office, anything to draw him back, but then her husband would answer in monosyllables (‘And did we answer our father in that way, all those years ago?’ she wondered, picking at her food) and she would long for noise, to fill the empty air.
Quickly she left the road, striding down one of the many little streets that led off at right angles, lined with identical houses. Each house was red-brick, with grey-tiled roof and pale yellow windows and doors; they were pleasant, with decent proportions and no acres of unbroken brickwork as a whim of architectural style. Each had its own garden front and back, pocket handkerchiefs on which people had constructed miniature landscapes in grass, crazy paving and soil: the borders studded with gaily coloured bedding plants – pansies, primulas, wallflowers. Anna looked over the low-brick walls as she walked past, noticing each flower, and the way in which the shadow of a red-hot poker made a small hard dot of darkness, with the sun at its height. In one garden five gnomes smirked at her from amongst the foliage, one of them standing in the middle of a cascading blue and white rockery, like a travesty of Venus in the waves. Next door, an elderly man bent over the central flowerbed, turning over the rich soil with a trowel and carefully removing impertinent weeds. He was in his late sixties she guessed, stopping for a moment and staring at him so that he looked up, nodded, then frowned slightly as the woman did not move, their eyes meeting in a sort of recognition, before dropping and shifting away. ‘He is my mother’s age, no older … Dad’s age, what he would have been now if he had lived. Oh Dad, Dad, why did you have to die? Why did you fucking well die?’ she thought, grinding her fingernails into her palm and turning from the man in his garden, all blurred before her eyes.
Gardening, like sailing, was something William had always talked of with enthusiasm. Walking on, not seeing the gardens any more, she recalled how he had allotted to each of his children a small patch of ground, saying that they must look after it well and grow whatever they liked. The Fulham garden was not large, a rectangle of lawn surrounded by herbaceous borders, with a shrubbery at the end. William had little time, except for weekends, and Barbara believed that gardens were to sit in, so their garden bore little resemblance to the tidy pictures in William’s gardening books. Anna smiled. She had begged for a gnome to sit in her own little garden, but Barbara had refused. Her compromise was the purchase of two well-carved forms that sat mysteriously amidst the shrubs – a stone lion and stone elephant who silently guarded their patch of earth.
Hilda had edged her own garden with pebbles collected that summer from the beaches around Synemouth, and filled it with velvet pansies, purple, blue and yellow. Richard said that flowers were girls’ things, and discovered that his mother liked fresh parsley, thyme and sage for her cookery. So, always wanting to please her, he grew them, and chives too, and mint which over-ran the lot. Anna had wanted to grow roses but her father had dissuaded her, and besides there were plenty of roses along the fence. Nothing he suggested pleased her. At last she tried to grow primroses from their tiny, tiny seeds, and when the patch of soil remained bare she cried because her seeds had failed. Then William had taken her to a garden shop, bought a little fuschia with its drooping ballerinas, and firmly packed the manure around its root with his boot, telling her that her garden was beautiful.
Now, behind the terraced house in Stockwell she and John had bought eight years ago, a garden showed itself as a patch of paving stones fifteen feet long, and five shrub roses in concrete pots with dirt upon their leaves. He had joked that it was his ‘prison exercise yard’; Anna had hated the towering flats behind, with washing strung along each balcony, ‘I must sell it,’ she thought, ‘I can’t stay there any more. It’s foul and ugly and unhealthy. I could move down here, live in the cottage, help Mummy …’ Then she remembered, stopped; and in that instant it seemed as if all the houses in the road, neat and innocent though they were, stared and mocked, their flowery gardens a threat.
‘Why does everything go wrong – for me?’ she cried inside her head. ‘And why are all these people so lucky?’ Watching a hugely pregnant young mother half-walk and half-drag her screaming toddler up a garden path towards a yellow front-door that stood ajar, Anna hated her suddenly, resenting her presence, her fecundity, her pink cheeks, her crossed net curtains and orange tiger lilies. The old man in his faded jersey, weeding, had no right to be there. It seemed to her that none of these people – each one existing in a walled paradise not thinking of those outside nor caring to seek a key – not one of them should dig the earth, or listen to their children’s breath, or relax at night with a cup of tea, the day’s work over … whilst all the time Barbara, her mother, was dying.
‘My mother is dying,’ thought Anna, and then she said it aloud to see if the words, hanging in the air in front of her mouth, would gain meaning from the ordinariness around them. And what if, illuminated with neon, those words had floated up above the rows of houses for all to read; would anybody rush to her, she wondered, with words of comfort and gestures of tenderness? Or would the shiny doors close silently, one by one, leaving her alone in the empty street, stared at by grinning gnomes? ‘What else?’ she thought, throwing back her head and looking at the cloudless sky.
Then she turned, shoving her hands in her pockets and retracing her steps. She thought that if Kindness did come along to offer her a cup of tea and words of sympathy and understanding – naturally because we all have mothers – she, Anna, would refuse. She would throw back her head and shout that her mother did not want to live because there was nothing to live for, nothing for anybody to live for; and so it was right and fitting to die, there in ‘The Park’ amidst neutral colours and an utter absence of hope for all – for each patient in a pleasant room, or each person hopefully planting seeds in the dry earth.
Barbara was sitting in the chair by the window, threading a needle with a long piece of crimson wool for the tapestry that lay on her knee. She was listening to a play on the radio, but switched it off as soon as Anna entered.
‘Hello, Mummy. Don’t let me interrupt what you’re listening to,’ said Anna, her voice unconsciously timid.
