And The Beginning of the End

It was the end of another summer. Nearly two years had passed since Ann had first been diagnosed with cancer.

We were walking with the dogs at Bewl Water when she suddenly cried out in pain. She had stumbled on a root and pulled a muscle. A week later, she was still limping; and it still hurt.

We weren't particularly alarmed. Ann had been born with arthrogryposis, a very rare, congenital condition affecting the joints and muscles. In Ann, you could only really see it in her wrists. They curled more than they should. When she lifted a drink to her lips, she held the glass a little like you sometimes see left-handed people holding pens, swooping their wrists around from the top so that they can see what they are writing. She hated anyone noticing. At school, the other children had called her 'monkey'.

A hidden aspect of the condition was that her joints were weaker generally. She would 'pull a muscle' quite often; and, sometimes, she would take a few days to recover fully.

Yet, as August turned to September, I started to become concerned. It wasn't a rational fear; nothing I could annunciate. Just a deep disquiet.

Throughout the autumn and all the way up to Christmas, Ann was usually fine. Just now and then, her left leg ached and she would favour it. "I keep hurting the same leg." she said.

In January, Ann had a routine scan. Two weeks later, we went along to hear the results. "Everything is fine", said the cheerful oncologist, looking at his computer screen. "Nothing to worry about." As we left his little room, I hung back a little.

"Did you do a whole body scan?" I asked quickly. He shook his head, distracted, riffling through medical notes, preparing for his next patient.

"I don't think so. It's not usual."

Winter turned to spring and things were much the same. Ann's leg was still not right, but she put it down to the arthrogryposis and that bad stumble. I was involved in a big fraud case which took me off to Birmingham a lot of the time. Ann was having to do all the dog walking and her leg just wasn't being given the time to recover.

In early May, Ann's right shoulder began to hurt.

At first, she thought she had slept badly on it. But the pain got worse. We went to the doctor and were referred to an orthopaedic surgeon. He examined Ann's shoulder and didn't appear particularly concerned. We mentioned her leg.

"We'd better have a look at that too," he said, adding a little squiggle to a card on his desk. "I'm arranging for you to have a scan. Then we'll have you back."

On 21st June, at about 5 pm, Ann went to see the doctor again. She wanted some pain killers for her shoulder. The scan had already been done and we were waiting for our next appointment. I was just arriving home when she 'phoned me.

"Can you come and get me? I'm at the surgery."

When I got there, she was standing on the path outside the door. Silently, she handed me a piece of crumpled paper. It was a typed note from the radiologist who had performed the scan. When I close my eyes, I can still see the words:

"...lucency... extremely worrying for a focal bony matastis..."

Ann had secondary cancer in her left hip. She looked at me.

"I'm so sorry Philip," she said.