and then reached the tricky bit.
‘Do you do regular breast examinations, Mrs Robinson?’ Polly asked, and waited while the silence stretched out.
‘Sometimes.’ The reply was strained, quiet. Polly watched her unobtrusively.
‘You’re cleared now, aren’t you?’
‘So they said.’
‘What about contraception? You aren’t on the Pill, are you?’
‘No.’ The reply this time came quickly and was abrupt. Polly glanced through the notes.
‘Have you still got an IUCD?’
‘A coil? Yes.’
Polly made a note on the card. It was like getting blood out of a stone, she thought.
‘Periods still regular? No change in flow, or longer gaps, anything like that?’
She seemed to relax a little, as if they had got off a difficult subject. Not for long, Polly thought grimly.
‘No changes,’ Mrs Robinson said. ‘I just tick on, as regularly as clockwork. It’s quite reassuring.’
Polly thought she must mean that she was relieved not to be pregnant, and at forty-eight that was understandable.
‘When did you have your last cervical smear, Mrs Robinson?’
Immediately she stiffened up again. ‘Eight years ago, but I don’t need one.’
Polly frowned. ‘Eight years is a long time, you know. It’s a very simple procedure, and it doesn’t hurt at all. I can do it for you, so there’s no need for Dr Gregory to be involved unless you would rather he did it?’
‘I don’t want it done.’
She was emphatic. Polly pressed on. ‘Really, you know, it’s quite routine. All women from puberty to late old age are at risk to a certain extent, but certainly anyone who is sexually active should have it done—and by sexually active, I don’t mean carrying on like rabbits! Anyone with a partner is included, however much their sex lives may have slowed down, or even stopped.’
She didn’t reply, but something in her stance alerted Polly. She reached out and took the woman’s hand.
‘Do you want to talk about it?’
‘He hasn’t touched me, you know,’ she blurted. ‘Not since I had the operation.’
Ah! Polly thought. Here we go. ‘Why? Is he afraid to hurt you?’
Her high, thin laugh cut Polly to the quick. ‘He doesn’t care about that. He just doesn’t want to touch me any more—he calls me—an udderless cow.’
‘Oh, dear God,’ Polly whispered, her soft heart torn apart by the pain and anguish in those simple words. Reaching out, she wrapped her arms around the woman and rocked her against her shoulder as the tears fell, released at last after all this time.
‘He hates me,’ she sobbed, ‘he said it would have been better if I’d died. What use am I? All those models lolling about on the brochures, bursting out of their bikini tops, and him going on about going to topless beaches and getting a bit on the side—he hates me, and I wish I were dead!’
Polly had never felt so hopelessly, overwhelmingly useless in her life. She knew that Mrs Robinson had to grieve for her loss, but the way ahead wasn’t clear to her, and there were many things she wanted to check up on—like the existence of a local mastectomy support group, or the possibility of reconstructive surgery. In the meantime, she wondered if Mrs Robinson didn’t need more than emotional support.
Once the worst of her tears were shed, Polly handed the woman some tissues and slipped out of the door to phone Matt at home and ask his advice. To her surprise and relief, he was coming out of his room, and she grabbed him by the sleeve and hustled him back through his door, pulling it shut behind her and leaning on it gratefully.
She became aware that her knees were trembling and Matt took one look at her and led her to a chair.
‘What’s up?’ he asked gently, and she told him all that Mrs Robinson had revealed.
His face went taut with anger, and he stood up and paced around the room, waves of rage pouring off him almost visibly.
‘How could he do that to her? How could anyone say that to another human being? God, Polly, I wouldn’t treat my dog like that!’
‘Do you think she needs anti-depressants?’
He stopped pacing and turned to face her. ‘Could be. I’ll prescribe some for her if I think she does, just to take the edge off, and only for a few days, and then I think we need to talk about reconstructive surgery—I can think of some surgery I’d like to do to him!’
Polly smiled, and then her smile faded as she remembered Mrs Robinson. ‘Do you think he needs help too? Perhaps no one has given his feelings any consideration, or given him an opportunity to grieve. If they didn’t have any professional counselling during the time of her illness, then it’s not surprising that they can’t cope with it.’
‘I would have thought all that had been done at the time,’ Matt said, surprised, and shook his head. ‘We are much more aware now than we used to be about the emotional effects of radical surgery, I think. Polly, see if you can get them to go along for counselling. I’ve got the address somewhere of the Breast Care and Mastectomy Association—it’s a charity, but the work they do is excellent. The head office is in London, but I think there’s a branch in Cambridge. They’re very good with this sort of thing, and if the Robinsons’s marriage is salvageable, they’ll probably find a way.’
She nodded. ‘Are you going to come and have a chat to her?’
‘Yes. Would you mind making some coffee, and then come and join us? I think I’ll make more progress if you’re there, somehow.’
By the time Polly had made the coffee and gone back to her room, Matt was in there with Mrs Robinson, holding her hand and smoothing the skin on the back with an age-old gesture of sympathy.
‘But how would you feel if it were your wife?’ Mrs Robinson asked, pulling her hand away.
Matt straightened up. ‘I can’t tell you, Mrs Robinson, and that isn’t really the issue here. How your husband feels is what’s affecting you, and I think, and Polly agrees, that he’s probably very distressed and unable to cope with his feelings. I think counselling could help you, if you want help. You don’t both have to go, but of course it would help if you did.’
She lifted her head. ‘What about reconstructive surgery?’
‘Mammoplasty? It’s usually done sooner. What they would do in your case, I suspect, is make a small incision in the skin and insert a silicone implant to help to balance the other breast, and they can create a nipple if necessary using pigmented tissue from elsewhere. Results are variable; usually physically very successful, but it isn’t going to cure your marriage problems or make you the way you were before. It’s become quite common to do it at the time of the first operation, to reduce the kind of emotional stress that you’ve been through. In fact, I’m surprised you weren’t offered it at the time. Results after this length of time, though, may not be so successful.’
‘What do you think are the chances of it working?’
‘Depends on the level of residual scarring, shrinkage of the skin and so on due to radiotherapy, and how much was removed. Also the size of the other breast—it’s much harder to get a satisfactory result with women who are more well-endowed. I can’t really tell you much more without examining you.’
She seemed to shrink into herself, but Polly wasn’t about to allow it. Squatting down beside her, she took her other hand and squeezed it. ‘I’ll be here with you. If Dr Gregory thinks you would be a suitable candidate for surgery, then if you decide that’s what you want, he can refer you and get