My wife Judith developed breast cancer twelve years ago. Her reaction followed the five stage theory suggested by Elisabeth Kübler-Ross in her 1969 book “On Death and Dying”.
Judith had successful surgery and after a course of chemotherapy was eventually given the all-clear. However, her personality changed during this process. She remained depressed as she feared the possible return of the disease. She also had bouts of anger that led to arguments with family and friends.
Two and a half years ago the cancer came back. This time it was in the spine. Judith’s consultant told her that this time he could do very little for her. He said that she could only expect to live six months.
I now became her principal carer. I enjoyed looking after her and it gave me an opportunity to show my love for her. For most of the time she was very appreciative. However, occasionally there were outbursts of anger directed at me. As Elisabeth Kübler-Ross pointed out, this anger stage involves questions such as: “Why me? It’s not fair!”; “How can this happen to me!”; “Who is to blame?”
This appeared to be caused by a combination of grief, fear and the drugs she was taking. It was the hardest thing of all to take. In the past these outbursts would have led to us having an argument. Things said in anger would result in further conflicts creating a vicious circle without end. Having an understanding why she was doing this I refused to retaliate. I passively took even the most outrageous accusations about my motives for looking after her. On one occasion she suggested that I was poisoning her drink and food. I later discovered that she was storing food that had not been prepared by me. My GP explained to me that the drugs she was taking were making things taste different and she was interpreting this as me trying to poison her. Luckily, my daughter was also caring for her was able to explain to her that her fears were mistaken and were being caused by the side-effects of the drugs she was taking.
Our GP pointed out that it was a normal reaction for terminally ill patients to turn-on the ones who are caring from them. This was confirmed by members of staff at the hospice who said that sometimes they had to provide respite care in order to help reduce the conflict between husband and wife.
Judith died yesterday morning. Several of the nurses at the hospice commented on the peaceful way she died. Apparently, many patients who die of cancer become very angry and agitated during that final period. They pointed out that their loved ones often become very angry and aggressive towards them. I was really surprised by this comment as I could not fault one member of staff who all showed their care and love for Judith and the rest of the family. I do really mean love. It is difficult to explain as the environment created by the hospice is different from any other thing that I have experienced. In a strange sort of way the hospice is like a utopian world, an oasis of love. If only hospitals could be like this. If only society could be like this. It was like the world created by William Morris in his book “News from Nowhere”.
On my return from the hospice I had to get Judith’s birth-certificate from the box where she kept all the important documents and found a card addressed to me from her. The card was of Dante Gabriel Rossetti’s “Hand of Dante holding that of Love”. Inside was an incredibly moving letter from Judith about our life together. It dealt with the major conflict in our lives: the fact that I spend so much time working. This was also the theme of her outbursts of anger. I know my passion for work is a form of illness that was probably triggered by the death of my father. I have read that the early loss of a parent makes you constantly aware of the limited time available. I have always felt guilty about this but in her letter she acknowledged that it was this dedication to work that enabled me to achieve so much and that she was “proud” rather than “angry” about it. As we have always been together for the last 45 years, it is the first letter she has ever sent me.
I tell this story in the hope that patients and their relatives get a better understanding of the emotional turmoil caused by cancer. We came to terms with these conflicts during those final months. I urge everybody reading this to do the same. Don’t only say it, put it in writing. I know my letter will give me consolation for the rest of my life.