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Sometimes you’re in a race you can’t win

Sometimes you’re in a race you can’t win

On the theme ‘A case I’ll never forget’, Dr Simon writes about paying a visit to a patient with terminal illness

We’ve all been there.

In the pitch-black and driving rain. With a torch out of the car window searching for a non-existent name plaque belonging to a house in the middle of nowhere.

At this point, I’d normally be chuntering a stream of obscenities while simultaneously demanding novel legislation to be passed requiring all new-build homes to erect 60-foot neon name signs to prevent my inconvenience.

That’s normally. But not today.

This is the first and final time I’ll visit Kate.

She had first arrived in my office three months earlier. I’d met her a few times before when she had brought her children to see me, but this was the first time on her own and she looked perplexed.

‘It just stinks, Dr Simon.’

‘What does?’ I asked, expecting one of the usual: my urine, my breath, my armpits.

‘My vomit – it’s like I’ve got shit coming out of my mouth! I’ve brought you a –

*please say picture* 

– sample, doctor.’

I’m generally not squeamish but I’m certain that the sight and smell of a faeces-filled Tupperware tub will stay with me even as my other memories fade to white.

There was even a brief reflexive-reflux moment where I wondered if my own stomach contents might join Kate’s. I’ll always remember her mischievous grin as she recognised this breach in my defences.

The next few days followed the time-worn path of admission, bloods and scans, which finally determined that a 38-year-old woman had been fated to have widespread invasive breast cancer.

The oddest part? Her bowels looked fine. (Although if any one is interested, a vet friend of mine assures me that this is quite a common presentation in cats…)

Sometimes you’re unknowingly part of a race that you have no chance of winning, and it was clear early on that this was Kate’s situation. She was declining just so rapidly.

But she was 38 with a young family, so I smiled and lied about how effective I thought her treatment would be and that her young age meant that she would have all the more reserves to fight with.

How Kate had made it to the practice the previous week I will never know. But after she was unable to get out of bed this morning, I had finally convinced her that a visit was not unreasonable.

So now I’m here. Finally.

At her door, soaked through and hoping that my greeting to her husband George has the right level of professional sincerity and gravitas. Her two children are in the hall. I can’t help but think that my black coat, black hood and black bag will leave some indelible memories.

Only a week has gone by but Kate is nearly unrecognisable, and I have – what is for me – a rare moment of a lump building up in my throat. We agree to start a syringe driver and I promise to her and George that she will be comfortable and well looked after.

As I turn to leave, that mischievous grin weakly reappears.

‘Just so you know, I knew it was worse than I thought when you were being so upbeat,’ she says. ‘You’re a terrible liar.’

Back in the car, I’m struggling to see out of the windscreen.

It’s probably just the rain.

Dr Simon is a GP in Cumbria