An Excerpt From The Diary Of A Patient
I was twenty-four and expecting my first baby, thrilled, ecstatic. I was trying not to get too excited, get ahead of myself, “just in case”. We kept the news secret from everyone except the expectant grandparents. My first visit to the GP was uneventful, nothing to be felt, no outward sign of a life inside. My next visit to the midwife was three weeks later and she thought that I was “too big for my dates”. It might be twins! There are twins in my family; it is a possibility, two babies at once! How would we cope? How exciting, maybe a girl and a boy, that would be nice. “You’ll need a dating scan to know for sure”.
Four weeks later, bladder bursting, cold jelly on my tummy and my husband by my side, the radiographer told me that there was only one baby and I was not as pregnant as I thought, only ten weeks. That lengthened my pregnancy by three weeks, another three weeks until I would meet my baby; an elephant pregnancy. But the baby was healthy, floating in fluid without a care in the world, sucking its thumb, waving at us every now and then, strong heart steadily beating. I went straight into work and told everyone the good news.
Two weeks later I was booked for my first visit at the hospital; my booking-in. I wasn’t nervous as I’d had a scan already and the baby was healthy. I felt tired and nauseous and I couldn’t fit into most of my clothes because my tummy was so large, but that was to be expected? I wasn’t worried, really.
At that same time I was treating a boy, well a man, a year younger than me. He was undergoing abdominal radiotherapy every day and I saw him just before I went to my hospital appointment. His cancer, a rhabdomyosarcoma, was growing so quickly we couldn’t cover it completely with our machine. He was twenty-three and going to die. I had a lump growing in my tummy, the same signs and symptoms as him but with such a different outcome.
I went upstairs and changed out of my uniform. I was on my coffee break. I walked up the hill to the hospital. My husband didn’t come with me because we wanted to save all his holiday for when the baby was born. I went alone. I was shown into a room very promptly and was “clerked in” by a nice female doctor. She asked me all about my family history, my medical history, my social history, every history.
She scanned my tummy, “Yes, I agree, you are twelve weeks pregnant. Now if that’s all….?
That wasn’t all! I thought about my patient, a year younger than me with the lump in his tummy. I plucked up the courage to ask about my size. “If I am only twelve weeks pregnant, why am I so big?” There, I’d said it! “Have you been eating a little bit more than normal?” she asked in a very condescending manner. “No”, I replied indignantly, “I have lost weight and my tummy has got firm edges!” This got her interested. She got the ultrasound machine back in. We did the scan together. I had a 15cm solid tumour in my abdomen.
I had to go for an emergency ultrasound within the radiology department just across the corridor. At this appointment, hurriedly arranged, they did not know that I was a therapy radiographer. I didn’t want to go in like Mrs. Know-it-all, intimidating them, so I just kept quiet. They started the scan, more cold jelly on the tummy. “I’m just going to see if there is a Radiologist around” said the ultrasonographer, “I’m not used to scanning anything other than babies!” This was definitely not a baby.
A Radiologist was found: The environment quickly changed and the healthcare team, six people had also suddenly appeared, swiftly switched into medical jargon. “Pancreatic adenocarcinoma” was a distinct possibility, as was “rhabdomyosarcoma” apparently. They unfortunately did not realize that I understood every word they uttered until I suddenly burst into tears with the full enormity of their differential diagnoses. At this point I had to confess, reveal my true identity and profession. They were very shocked, mortified that they had spoken like that in front of me, thinking that their words were disguised by code when in fact they could not have been more succinct. They made me a nice cup of tea in time-honored British tradition whilst I collected my thoughts and they hastily arranged for me to meet my Consultant Obstetrician who had the responsibility of deciding my fate.
He was waiting for me in a large airy consulting room, female registrar at his side, more tea and a box of tissues awaiting me on the coffee table in front of him. Shit, I am really in trouble here. I had been present at many “bad news” consultations before during my career, usually as the sympathetic female present for comfort and reassurance that everything would be alright when we knew it wouldn’t. Now, it was my turn.
Thank you for sharing this piece. I couldn’t imagine experiencing this type of shock at a time which is meant to be so happy. The idea of experiencing a ‘bad news’ consultation from a patients perspective is something I will reflect on and consider for my future practise.