2. The Tests

With the birth out of the way, the doctors had given Maria a few days rest before they would press ahead with the endoscopy. Left in the maternity unit, she was finding little support from the midwives. The maternity unit worked much like a production line, with a quick turn-around of patients. As most of the midwives were unaware of the other problems Maria was having, they expected her to be back on her feet and out the door in a day or two. The fact she was still there a few days later they saw as her playing it up and treated her quite badly, getting impatient at the numerous requests for help she made. A large, middle-aged, Ghanaian nurse went as far as telling her off, saying, that because Maria was Brazilian, she should be a strong woman and should have gone home by now.

Over the next few days as we awaited the endoscopy I had taken to becoming a medical expert and, when not at the hospital, researched Maria’s symptoms on the Internet. I had not liked what I was finding, and when Maria asked me about it, had been reluctant to share all, instead side stepping many of her questions. I had not wanted to believe what I was finding and certainly did not want to worry Maria any further.

Finally the day of the endoscopy came. I had to stay in the maternity unit with James, our newborn, while Maria was taken for the examination. She had been very nervous about it, not so much about the outcome, but about the procedure itself. The thought of having a thick tube forced down her throat was not one she relished. I remember sitting there on the side of the bed, holding James as the porter pushed her in a wheelchair down the six bed maternity room, and out into the corridor. As they turned into the corridor, Maria looked back with foreboding etched across her face and my heart ached for her. I pulled James into me and my eyes teared up. The whole procedure took two hours, though sitting, waiting for her return seemed like an eon. Finally the porter brought her back, drowsy but well.

The day after the tests were completed, the nurses began to  understand that Maria had not just been shirking. There seemed to be a new respect for her, and, while no one said anything, I wondered if they knew something we had yet to learn. A couple of days after, Maria was discharged and we took James home.

Despite being obviously drained of energy, Maria did her best to be with James and spent as much time with him as she was able, while I took care of everything else. We were blessed that James was a great baby and cried little.

Almost three weeks later we got a telephone call asking us to come meet with the doctor to discuss the test results.

I remember the day of the appointment. It was a warm day. The bright Spring sun beamed through the large window, illuminating the empty desk before us. The trees outside, now in full leaf, wafted gently in the breeze. The sound of bright bird song fluttered through the air. Inside the room a cold, eerie emptiness prevailed. An old black and white photograph hung on one wall and a poster depicting some aspect of anatomy hung opposite. Along with the desk there was, a small trolley containing an assortment of instruments and medical aids, and a weighing scale. Besides the chairs we sat on there was one other chair, behind the desk. It lay empty, silently waiting in anticipation with Maria and I for the doctor to arrive.

The door opened and in came the woman doctor. She was in her 40s, dark shoulder length hair, her white coat contrasting with the dark clothes beneath. She held a thick file of medical papers in her hands. Sitting down she opened the file on the desk before her. She greeted us cordially. Then she spoke bluntly: “You know why you’re here; I will get right to it. Unfortunately, Maria, the results of the endoscopy shows that you have stomach cancer.”

There was silence in the room. Tears welled up in my eyes as I looked at Maria and took her hand. Her eyes were also moist, a look of shock on her face. Over the days since the endoscopy, I had finally shared with Maria what I had found on the Internet relating to her symptoms. We had talked about it and worried together. However, neither of us really thought it would be true. Now here in that small room we faced reality. Time seemed to stand still, everything suspended. I struggled to understand my emotions, my thoughts race everywhere. I could only imagine what must have been going through Maria’s mind.

The doctor broke the silence. Maria would have to have a CT scan to ascertain the extent of the cancer. Then they would schedule her for surgery. I cannot remember what else was said that day. It seemed to be a very short meeting and very business like, almost unreal. In just a few minutes our lives seemed to have been turned upside down. Before the meeting we had still been celebrating the birth of our new son, and now death was knocking at the door in a very real way.

Most of us tend to go through life, especially when we are younger, with a certainty that there will be a tomorrow. Day to day there may be changes, but we go to bed each night with an expectation that life, as we generally know it, will be the same when we wake up the following morning. Facing the reality that that may no longer be the case leaves you numb. Your mind goes through a million thoughts at once and yet seems empty. We all know death lies ahead somewhere but when it comes knocking unexpectedly at the door it is always a shock.

Before we realized it the meeting with the doctor was over. We had just received the worst news of our lives and then we were shown the door and left to ourselves. There was no support offered, no help on how to process the news. Just a "you may be dying, we'll call you soon to arrange more test." I remember finding out weeks later that the doctor was supposed to have provided us with details of support and counseling services, and felt immense anger that she had overlooked doing so, and had left us to fend for ourselves in processing it all.

As we left the hospital building and walked back to the car, neither of us knew what to say. The silence was almost unbearable, but neither of us had the means to express our thoughts or share our feelings.

1. The Pregnancy

It was late 2001, when we found out that Maria was expecting our fourth child, and we both were excited and knew this one was going to be another boy long before we had the first scan. His name had been picked out long ago, James, after my maternal Scottish grandfather. We were both excited for this latest addition to our family, who was due to be born the following May. But as the weeks progressed, Maria had begun not feeling well. It was hard to put our finger on any particular thing but it began turning into her most difficult pregnancy.

Our oldest daughter, Moyra, was coming up to her 7th birthday, while our other two, Lucas and Alexandra, were 3 and 1 respectively. They all were great kids, but, being so young, could be a handful to look after. I was running my own IT and Internet consulting company at the time. The business was small and it had been hard work striking out on my own, but I enjoyed the freedom of being my own boss. That year though, the dot com bubble burst, companies, that had previously been falling over each other to get on the Web, suddenly paused and stepped back, new investment dried up and things had slowed way down. With Maria's difficult pregnancy, and business being slow, I took the decision of closing the business, temporarily, to become a full-time father for a few months. Maria certainly need to relieve the stress the pregnancy was causing, and I only anticipated it being a few months until after the baby was born, then I'd be back at work. It was great that I had the flexibility, being self-employed, to do that and was only too happy to help out. It certainly would not have been as easy as an employee. Life though, has a way of not working out the way you anticipate.

As the pregnancy progressed so did Maria’s problems. She started developing a pain in her chest. The pain progressed beyond a mild discomfort and she started visiting with the doctor about it - on multiple occasions. Our doctor at the time was a short Indian man, Dr Shah. He was a pleasant individual, but like many general practitioners in the United Kingdom, was overworked, and while he was nice enough, you often felt like he was just anxious to get on to the next patient. Each visit Maria made to see him resulted in the same answer. The doctor put the problem down to indigestion and heart burn, common with pregnancies, and his remedy was to simply try anti-acid medication. Maria felt like his attitude at times was almost: "You're pregnant! Of course you've got indigestion, go away and stop bothering me." But the problems continued and worsened as the pregnancy developed.

Despite her difficulties, everything else connected with the pregnancy had been going fine and the baby was healthy. As May rolled round, everything had been planned and prepared, and we excitedly awaited the birth. Then just a week before he was due Maria seemed to take a turn for the worse. She started vomiting, and had been concerned with what was being brought up. Maria was always the one that tended to over worry. The first day she vomited, I dismissed it, she had been eating black grapes and surely that was what the source of the dark content in her vomit. The second day again I dismissed it; then, she had been eating malt loaf. The third day we could no longer ignore the black, tar-like substance she had been bringing up. We had decided to speak to the visiting mid-wife about it when she came for her scheduled visit later that day. We had gone out earlier in the day, and due to the London traffic had been late getting home. By the time we arrived home that Wednesday evening, the midwife had been and gone. Not wanting to delay talking to someone about it any longer, we called the maternity unit at the local hospital, and explained what was going on. The maternity staff didn't hesitate and asked Maria to come down for an immediate examination. The hospital was about five or ten minutes from our home, but Maria had packed a bag, feeling she would not be coming back home that night. We quickly arranged for someone to come and watch our other children and headed to the hospital.

As Maria described what had been happening over the previous three days, there was obvious concern among the medical staff and, as Maria had anticipated, they asked that she be admitted for observation. At this stage we  were both beginning to worry. The medical staff were saying little and seemed unsure as to the cause but wanted to observe things and if possible get a sample of what Maria had been bringing up.

The following day she seemed fine and the vomiting had stopped. The doctors seemed to be of the opinion that she might have a gallstone and had planned to send her for an ultrasound scan, but that had been clear. 

The following afternoon George had arrived to see her. George, a South American doctor from the general surgery department, had thick black hair and just as thick an accent. He wore a ready smile that beamed out at you. Being a born-again-Christian his approach had been a little different. He had told Maria that he was there not as her doctor but as her brother. I remember feeling initially upset at that, thinking a doctor is what we need. But George knew his stuff.

It was George who had first suggested that Maria was having problems with her stomach. He was anxious to have her under go an endoscopy as soon as possible and had begun scheduling her in. When the maternity staff heard, they had gone up the wall and verbally tore into him, telling him he was not touching her until after the baby had been born. That is when the decision was made to induce Maria.

They schedule to start inducing her couple of days later at 7 am. All our children had been born in the late evening or early morning and I must admit I was looking forward to finally having a child born during the day. Mother nature had her own ideas however and James eventually arrived sometime after midnight, on May 14th. Once delivery started, everything seemed to be going well, until the head appeared and the maternity staff realized the cord was wrapped around his neck. He came out looking a dark shade of purple. As soon as the cord was cut they whisked him out of the room leaving us waiting and wondering what was happening. Ten minutes later he was brought back in looking a normal healthy color.

The following day Maria had been looking through her medical file and found a note written at the time of birth: “Baby died, given oxygen.” We were totally floored that things had been that serious and no one had said anything. We both started worrying if there would be any lasting effects. Finally Maria asked one of the nurses about it and she was as surprised as we were. She asked to see the notes and read the entry. “Oh, that should say ‘Baby dried,’” she told us, turning and walking out. What a spelling mistake to make I thought. With everything else going on, it had been a stress and worry we could have done with out.