Columnist Dr Shaba Nabi shares the story of an exceptional caring journey
I first met Beth (not her real name) in 2016, when she was in her mid-30s and presented with a breast lump. As she was breastfeeding her toddler at the time, I made reassuring noises about a blocked milk duct and referred her to the breast clinic to rule out the worst. As with all my cancer referrals, I made a diary entry for a month later, to ensure she had been seen. To my surprise, the letter from the clinic did confirm the worst and I promptly called her to check on her wellbeing.
What I was not expecting was for this simple call to lay the foundations for a relationship like none I had ever encountered in my 31 years of clinical practice. I was initially stunned to receive a heartfelt ‘Thank you’ card despite her receiving news of cancer, but it soon became apparent that Beth was an exceptional human being.
We shared the journey of surgery, chemotherapy and radiotherapy, as well as the accompanying side-effects. When this physical passage was over, I shared her everyday mental challenges of work and domestic stress.
When she had a recurrence a few years later, she remained optimistic but was cognisant of her mortality. Another round of treatment followed, even more disabling than the last, but she was determined to get back to work as soon as she could.
All was well for a few years and I didn’t see her again until the beginning of this year when she complained of being a bit breathless when exerting herself. Despite a massive pleural effusion, she was still exercising and carrying out her daily yoga.
Facing stage four cancer is like being adrift in an ocean of uncertainty with no way of reaching the shore. But I felt privileged to act as a float for a short period, to reflect back her myriad options. She was surprisingly insightful about the futility of active treatment, despite it being offered by the oncology team.
‘I’m not afraid of dying, Shaba. I just don’t want to spend the rest of my life in hospital and not living.’
I knew this was the right choice for her, as she had suffered the side-effects of excruciating nausea and bonecrushing fatigue. But it was not my place to share my own values; I needed to listen and advocate for her.
The serial PET scans confirmed an aggressive cancer, with each one bringing us closer to her death. When it was time to discuss the contents of her ReSPECT form, I will never forget the image that met me in the waiting room. There stood a strong, beautiful woman with flowing, golden locks. It seemed impossible to grasp that her body was riddled with cancer.
‘You look like a mermaid!’ I said as I greeted her. That made her smile as she always loved her hair. She spoke with dignity and grace about her end-of-life wishes and helped me to navigate this painful conversation. It wasn’t until she started talking about her young son that we both cried – openly and unashamedly.
She continued living life to its fullest until her last few weeks, which led me to reflect on my own life. It seemed appropriate that her last outing was to an amusement park with her son and she sent me a picture of the fun they had. She knew it would be her final trip.
On my last visit, she held my hand and told everyone how happy she was that I was present because she loved me, and all the people she loved were in that room with her. And then I realised something. That I loved her too.
Dr Shaba Nabi is a GP trainer in Bristol. Read more of her blogs here
READERS' COMMENTS [5]
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Thanks Shaba,
Both moving and inspiring in equal measures.
Continuity of care at its best. One of the reasons I signed up to being GPs. Being there for those we have been privileged to be able to share part of their lives with. No doubt the patient who came in after your intense consultation was cross because they had been waiting two weeks with their sore toe that had now got better, despite the twelve hour wait in A+E they had had to do in between, and decrying the laziness of doctors who are being paid with tax payers money! Sadly the lack of access as perceived by some is an easy target for the nay-sayers in Government – again, sadly – by both sides of the house – and the actual ‘day job’ of providing the continuity seems to have been ‘thought up’ recently, as a good idea by politicians. It would be so positive if those that pontificate about how GPs do their job actually found out what it involved before opening their mouths.
Absolutely heart warming!
RIP to Beth ( I know it’s not her real name)
You are the GP I would like to ha
ve but may sadly never get in this climate of broken care
Incredibly moving.
Best and worst job in the world.