Lestin slid off the table on which he had been sitting when we entered. A thin paper chart lay on the table. ‘RACHEL MCLEOD’ was written in red ink along one edge of the file folder that contained her future. He shook Rachel’s hand, then Michael’s, and nodded at me briefly. He gestured for us to sit down.
‘Let’s cut to the chase, shall we? We both know why you’re here.’ Without waiting for a response, the doctor continued. ‘I’m afraid we have a very serious situation here that requires immediate and extensive surgery.’ He looked down at his shiny brogues, perhaps hoping they would walk him away. Direct eye contact might have helped to soften the blow.
‘Say more,’ Rachel encouraged, as though she was talking about someone else.
‘Well, I always hope to salvage the leg, but in your case I can’t. We need to take off the leg and fit you with a prosthesis. Most people do very well, and with good physiotherapy you’ll be back on your feet, so to speak, within a couple of months.’
He smiled as his quip fluttered in the air and landed heavily on the grey linoleum beneath our feet. The leg, rather than your leg, suggested it had to be difficult to deliver such information.
‘Oh, and the good news: this cancer hasn’t spread anywhere else in your body,’ he said.
Rachel jumped out of the chair and with a smile said, ‘So now I know why I’ve practised yoga all these years. The tree pose, one of my favourites.’
She tucked the sole of her right foot high up on her left inner thigh, balancing steadily on her left leg. She raised both arms up over her head with her palms pressed together. She showed how flexible she was and how adaptable she would be with only one leg. Rachel had always had a quirky sense of humour, and I could see that Dr Lestin was not sure whether to smile.
He had other patients to see, made evident by the speed of his words and his backing up towards the door. ‘Okay, I want to get you in sometime in the next week or two. The anaesthetist will see you the morning of surgery. Any questions?’
Rachel looked at Michael, who shook his head. No questions. Shock can seize the mind in these kinds of interactions between doctor and patient, and freeze any questions until later, when they arise, often in the quiet of night. Doctors sometimes give patients only one opportunity for questions after delivering bad news, and time feels pressured. A question Rachel might have asked if she had had time to assimilate the information would have been: Could I have a moment, please? Or, When questions do come up later, how can I reach you?
Grasping the doctor’s outstretched hand as we headed towards the door, I surprised myself by saying, ‘Thank you. This isn’t an easy path you’ve chosen. Very few could do your job. I appreciate you being there for my friend.’
His composure softened, and as our eyes met I felt the impact of hundreds, if not thousands, of past patients’ reactions and rejections, people who were so shocked by bad news that they’d attempted to shoot the messenger. I hoped that Rachel had noticed the shift in his expression.
The attempt to humanise healthcare professionals comes naturally to me now, after years of witnessing professional–patient interactions lacking warmth and connection. We are educated to create distance between ourselves and our patients, supposedly to protect us from the difficult emotions that inevitably arise within us. I believe this distance actually dehumanises the professional and the patient, and it removes the possibility for an authentic and mutually caring relationship. I believe this caring relationship often provides the foundation for a sound recovery.
Dr Lestin reached for Rachel’s hand and quickly shook it, while his eyes landed on the file folder in his left hand. ‘See you soon then,’ he said, as he opened the door to let himself out.
Sipping lattes in the coffee shop down the street from the hospital later that morning, I asked Rachel how she could be so calm in the meeting with her surgeon.
‘I have a story to tell you,’ she said.
She recounted how she’d dragged herself out of bed that morning with an enormous sense of dread at the prospect of meeting the doctor. He would tell her the results of the tests and whether the sarcoma had spread to other parts of her body. He would also recommend the type of surgery she was to undergo.
Rachel had slumped low in her seat on the ferry, oblivious to the presence of Michael, her husband of twenty-five years, beside her. She told me that she felt as though she was alone on a raft set adrift at sea, no way back to shore, and no land in sight. About fifteen minutes after departure, Rachel recalled being vaguely aware of hearing an announcement over the ferry’s PA system. She heard Michael mutter something about a pod of orcas off the starboard bow. Rachel shook her head when he suggested she come out on deck with him. She remembered looking down at her running shoes and noticing that her laces were undone. She hadn’t bothered to tie them up when she’d left the house earlier that morning.
I don’t want to go out in the rain. I’ve seen orcas before. I’ll see them again, she thought. She felt unlike herself, estranged from the person who loved to kayak in the Johnstone Strait and sleep outside on warm summer nights.
Suddenly, a strong invisible tug pulled Rachel up and out of her seat, a force too powerful to resist. She stepped outside into the wild and blustery early morning light. The sea was steely grey and the almost-black sky merged with the ocean at the horizon. The ship’s deck glistened in the wet and the rain pelted her uncovered head, plastering her hair to her scalp as the wind pushed open her unzipped fleece jacket. She noticed Michael and three other people huddled together at the furthest point forward on the starboard deck, looking out to sea.
Joining them, she leaned over the deck’s railing and saw the first flash of black and white as a large orca surfaced about one hundred feet from the ferry. A thrill of delight coursed through her body. Soon she counted seven or eight orcas, surfacing and diving in and around one another, their dorsal fins pointing to the sky. A plume of spray from a blowhole shot up into the air before the orca disappeared beneath the surface of the frothy backwash. A couple of young ones mimicked their mothers, dipping and diving, and Rachel knew that this was likely a resident pod, which would include up to four generations.
Standing on the deck in the wind and rain that day, Rachel thought it was likely just a lucky moment, seeing the orcas, but she hoped it was more than that. She wanted to believe they had come to support her, to lift her out of her isolation and despair. She had read that when one orca in a pod gets sick, the others take turns supporting their ailing family member from beneath.
Rachel’s perspective expanded. She sensed a lineage of multiple generations of west-coast people who had lived and died along that shoreline for thousands of years. No matter how long she lived, she knew she’d always be remembered within that collective story. Whatever the surgeon would tell her later that morning, whether she would die soon or live for a long time, it didn’t matter.
Life was unfolding for her, as it had for countless people and species throughout time. At that moment of expanded awareness Rachel had fallen into a profound stillness. She called it grace. She told me that the peacefulness had stayed with her all the way through the meeting with Dr Lestin.
Eight days later, I made my way through a series of Staff Only doors to the intensive care unit. Working in hospitals gave me the confidence to push through forbidden doors. Unconscious patients attached to ventilators, tubes and IVs occupied most of the beds. Diligent nurses with clipboards in their hands monitored screens and forgot about their lives at home. Every so often a machine alarm would beep, requiring attention.
I had promised Rachel I would do Therapeutic Touch as soon after her surgery as possible. We had both read the research that confirms that this energy work can significantly decrease pain after surgery, and especially phantom limb pain.
I leaned over and kissed Rachel on the cheek. The peppery smell of anaesthesia lingered on her breath and she looked like most post-op patients do the day after surgery, tired and relieved.
She smiled wanly. ‘Thanks so much for coming. How are you?’
‘I’m