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ur practice is involved with final med GP teaching and before I got sick, I was really enjoying my Monday afternoon tutorials with the six or seven eager students, pens poised to jot down any crumbs of wisdom that might fall from my lips. Generally, their pages stayed pristinely ink-free, but I like to think I taught them other things, such as how failing a few exams does not mean the end of your career, and how it is possible to spend all your book-money on, ahem, developing your social skills, and still come out with a reasonable degree.
I stopped doing the tutorials when I was undergoing chemotherapy, as my poor brain cells were only barely holding it together to get me through the day without forgetting my own name, and my technique of asking the smartest kid in the group to answer all the other guys’ questions was only going to get me so far before I was rumbled.
I decided to dip my toes back into the teaching pool this year though, but with just one tutorial per month, and with the scintillating topic of ‘Me and My Illness’, one for which I need very little background reading.
I use my experience to illustrate a few teaching points, such as breaking bad news, false assumptions about cancer and its treatment, and self-care. On this last point, I always urge them to ensure they have their own GP and to avoid treating themselves or their relatives once the magic MCRN number is attached to their name.
Sometimes they ask me about how my own bad news was broken to me, or about my own GP.
This has been the most difficult part of these encounters for me, much more difficult than describing the pain or misery of cancer and its treatment.
It is difficult because my GP had to give me the news of my devastating diagnosis over the phone, when the radiologist phoned her late one Thursday evening to say that my MRI showed multiple liver metastases with an unknown primary. She knew that I knew what this meant. When I saw her number coming up on the phone, I knew it was probably serious, but when she told me to sit down before she said anything else, my head started spinning and my mouth went dry. She told me about the mets, then she told me to be at the hospital at 8:30 the next morning and the radiologist would meet me there. The oncologist was already lined-up too, and perhaps a surgeon as well. She told me she would phone me back in half an hour, once I had told my husband, and she said she would talk to him too.
As I was about to hang up, I asked one more question: “Are we really having this conversation?” She just said: “Yes. This is really happening.”
It was nearly a year later before I was able to fully understand how difficult that whole experience must have been for her. In the few days before I had had the MRI, we both knew that my LFTs had suddenly gone up dramatically and that something was probably fairly amiss. But neither of us was prepared for what was to come. I have no idea how she was able to pick up the phone to me that afternoon, knowing that what she was about to say would be so life-changing, and possibly life-ending. She had obviously been to a lot of trouble contacting various hospital consultants before she even contacted me, so that a smooth plan was in place before I could even begin to think about what the next steps should be.
I brought her a bottle of champagne for Christmas two years after my diagnosis. She wasn’t able to drink it, as she had started to have difficulty swallowing in the previous weeks. She told me some of her symptoms and we both came up with non-life-threatening differentials, just as we had done when my original liver ultrasound was a bit iffy. And once again, our hoping-against-hope proved pointless, when she was finally diagnosed with motor neurone disease.
Her speech started failing, so we communicated electronically. We knew each other so well that we didn’t really need to say that much anyway. One hand started getting weaker, but she was still able to take blood from my two-year-old whose growth was faltering, and the injection she gave me in my right shoulder saved me a trip to the orthopaedic surgeon. We had email chats about the pros and cons of various life assurance policies.
Her funeral was without doubt the most beautiful and most agonising experience of my life so far. It was an almost exact replica of the funeral I have already planned for myself (except mine would be much more about ‘Me, Me, Me’, and hers was all about everyone else). Her daughter described her as never having a bad word to say about anyone, and I vowed that from that moment on that my children should be able to say the same about me. She was a truly amazing person and I will never forget her.
RIP Dr Orla Batt.