I estimate the tumour to be nothing short of a death sentence. The moment I drop the diagnosis like an unavoidable bombshell, time becomes finite and limited – limited for the patient and, by extension, for me. At least for the next half-hour, I reckon. But I haven’t uttered those words yet, so I find myself suspended in this transformation, teetering between the finite and the infinite, within the realm of a delicate, fluid time.
I discuss the scan findings with my supervisor and the neurologist. Given the busy schedule, they ask if I can manage the conversation with the patient on my own. I’ve done it a few times before, but always under supervision. This would be my first time alone. However, it wouldn’t be my first time doing something alone for the first time.
I walk to the patient’s room, deep in thought. The void of this moment involuntarily fills with vague memories of my own first times.
The first time I flew the proverbial coop and left my parents’ house. The first time I heard from my sister how much my mother cried on that day. The nostalgic scent of my old, weathered leather sofa – the first time I called my mother because I felt lonely in my student room.
My first piano recital, the first time I broke something. The first time I met my in-laws, the first time I sampled a snail. The first suture, the first caesarean section. The first kiss, first sting of nettles, the first solo cycling trip, the first night of heavy drinking My first column about my first gravely ill patient.
So many first times.
We’ve directed the patient to a spacious, sunlit room, isolated from the world outside. Lost in my reflections within this cocoon of time, I am startled when I step into the patient’s room. His face, in this brilliantly lit space, is just a sombre and indistinct silhouette.
His wife tenderly holds his hand as he’s lying there, with a sheet pulled up to his navel. I settle in beside him and deliver the news without preamble. “I have some difficult news. We’ve identified a tumour on your scan.”
I give them a moment to absorb the news. Tears follow, along with the customary barrage of questions.
The bomb has been dropped, the cocoon has shattered, yet even after the conversation time remains strangely unsteady. The usual tight schedules at A&E seem irrelevant for a moment – my next patient can certainly wait a little while. As I leave, I linger just outside the door, gazing through the window. The patient, too, remains motionless. The nursing staff will need to collect him. For now, he lies still in his bed, with his devoted wife by his side.
In this pause, I realise that the patient’s experience of this period must have already begun when the scan was taken or, God forbid, when his symptoms first appeared. I recognise that I was too preoccupied with my own feelings. Thankfully, I managed to regain my composure in time.
I come to understand that, just like me, the patient too must have heard the news of his cancer diagnosis for the very first time. Thankfully, he wasn’t alone.