The Dean encourages us students to wander the wards, to seek out patients and talk with them. I approach the bedside of a thirty-year old woman lying in her bed in the Medical Ward. I’m not hunting a diagnosis; the nurse has already given me the answer – breast cancer. Cancer! All I know of the disease is it’s a killer. Here before me lies a person of my generation who is going to die. The knowledge fills me with horror. Does she know her diagnosis? Does she realise she will not live long? How do I talk with her? I turn to sneak away, but she’s seen my approach and heaving herself to sit.
Good afternoon. I’m a student doctor. Would you mind talking with me for a while? Or would you prefer me to come back another time…?
No, doctor, we can talk.
My name is Howard.
The woman returns my smile of greeting with a weak smile of her own.
What brought you to the hospital, Anastasia?
My breast. The woman points to the right side of her chest. Before two weeks I see the skin looks different, sort of rough, like an orange.
At first I put moisturiser. But when I have pain I see my doctor. He sends me here. But soon is worse.
No, the skin is break, then is bleeding, now smells bad.
A pause. My thought is all too clear: roughened skin is evidence of something growing within, tethered to the surface by fibres. The skin breaks down and bleeds
as the tumour grows. Any bad smell would indicate bacterial action on tissue that has died. You stink before you die! You live in self-disgust.
Anastasia, I cannot smell anything bad.
I put perfume, after shower, many times in day. I want smell nice when my little girl come after creche. Now I pregnant but I don’t see this baby. Is cancer, I dying. Anastasia points to her belly, which I had not noticed until now, is quite rounded. Anastasia does not look wasted, the contrary. She has plump cheeks, her hair is black and lustrous, her eyes shine. A closer look and I see her eyes shine with tears.
Perhaps, the doctors are wrong, perhaps the diagnosis is mistaken. Anastasia looks too well. But no, beneath the scent that Anastasia has applied liberally I catch a whiff of rotting.
My mind rebels. Anastasia, they can do operations for cancer…
I stop. Anastasia doesn’t look at me. Face down, upper body shaking, she weeps quietly. She shakes her head: Is too fast, is too late.
Anastasia, you’re upset. I’m sorry I disturbed you. I’ll leave you now and let you rest.
I rise to leave as the woman weeps.
I can’t bear it. I add, I don’t think you will die. The doctors will make you better.
I leave the young woman with her knowledge and my lies.
I know the meaning but I cannot say it.
I leave her alone.
I retreat and I forsake her and I deprive her of moments when she might have sat quietly with another and shared meaning.
On the day of our encounter, that idea never enters my mind.
But fifty-four years later I feel disgusted with myself.
While writing this in some discomfort, a name or a title for the piece eluded me
I wanted to register my severe judgment of the clinician who will not face and share truth with a patient who is ready for truth
But i was a student. Like anyone else, I’m still learning
The title for the piece has mow come to me; it’s the motto of my university, and before that, the motto of Michelangelo: ANCORA IMPARO
– I am still learning.