Tonight* my wife will light a memorial candle for her father. Her sister Robyn will do the same. Tonight will mark the anniversary of his death, in both the Jewish calendar and the secular. The two dates coincide only once in nineteen years; this is the second time they’ve concurred; Zeide died thirty-five years ago.
(Someone told me recently a blog post is supposed to be of six hundred words. It sounded like one of the Laws of the Universe, like when we have an Equinox and when we have a Solstice. The Law reached me too late to stick. What follows is a story longer than the prescribed six hundred words. If you read it to its end you will understand I post it now to encourage a friend.)
Wrestling with the Murderer
It was in the late ‘nineties that I first met Chief Inspector John Bailey, the son of a policeman who had been awarded the George Cross posthumously. I had come to Albury expressly to hear the story of Eric George Bailey, the police officer who arrested his own murderer.
In the course of that first meeting John Bailey showed me the George Cross that the King of England awarded to his father. A large man, he hefted the silver cross in his palm, raising and lowering it slowly, in time with the cadence of his weighted words, as he told me of his father’s life and death. Then he passed it to me. The medal, small in John Bailey’s hand, surprised me with its weight. Bailey said, “It’s what I have had to remember my father. It’s a rare and precious thing, a George Cross, but it’s not a father.
“I’ve got to pass it on, the medal. The Police Museum wants it, but I won’t let it go to them. I’ve seen too many things disappear from there, precious things, things that ought to remain when a man is gone, things that honour a person. This one was my father’s. “I’d trust the War Museum in Canberra. I’d be happy to see it go there, but not the Police Museum.”
The Chief Inspector was a tall man, stooping more for courtesy than for age, more or less pear shaped. Only his nose and his fingers were thin, arrows of curiosity projecting into the world before him. His eyes, hooded in age-loosened skin, looked at me, hawk-like, as he nodded slowly, “No, not the Police Museum.”
Bailey excused himself: “There’s a book I want to show you. I’ll bring it out.” I sat in the late afternoon sun on the Baileys’ small verandah and pondered the old man’s words: it’s not a father.
John Bailey returned carrying a copy of “They Dared Mightily”, an account of all Australians who had won the Victoria Cross or the George Cross. I learned that only about 400 of the latter have ever been awarded; in the echelons of courage it is the full equal of the Victoria Cross; and together with the VC it is the only royal honour ever awarded posthumously. Bailey opened the well-thumbed volume at page 279, pointed to his father’s citation and handed it to me to read. A quietly spoken man, he wanted me to know how history recalled his father, but he would not declaim or boast. The record must speak for itself.
The full citation was published in a supplement to the London Gazette of 25 October 1946 and read in part:
St. James’s Palace, S.W.1, 29th October, 1946.
The King has been graciously pleased to make the undermentioned awards of the GEORGE CROSS: —
Eric George BAILEY (deceased), Sergeant 3rd Class, New South Wales Police Force.
At about 8.30 p.m. on the 12th January, 1945, Sergeant Bailey (then a Constable 1st Class), whilst on duty in Adelaide Street, Blayney had occasion to speak to a man whose movements were suspicious. During the questioning the man pulled a revolver from his pocket and fired a shot which struck Bailey in the stomach. The Constable immediately closed with his assailant who fired two more shots. Although fast succumbing to his injuries and suffering from the effects of shock and haemorrhage, Bailey continued the struggle with the offender and held him on the ground until assistance arrived. Shortly afterwards he died. The fortitude and courage manifested by this Police Officer, in spite of the mortal injuries sustained by him at the outset of the encounter, constitute bravery and devotion to duty of the highest order.
Almost in passing there follows an account of an earlier act of heroism, desperate and unsung:
On 20 April 1939 he moved to Moruya, here he was highly commended for his part in the rescue of survivors from the fishing trawler, Dureenbee, which had been attacked by a Japanese submarine on 3 August 1942. He was transferred for the final time, to Blayney, just eight days before his death.
The face of Eric George Bailey looks out from his photograph on page 280. It is a young face, small and fine-boned beneath the broad visor of his police hat. The gaze is steady. I looked up at John Bailey and there was the same steady look. The look of the young man who was his father. In coming to Albury to learn about Eric George Bailey, GC, the father. I had no expectation of this man, his son. I had not imagined him. The son, I soon learned, was a story in his own right.
I asked John Bailey for his own recollections of his father’s passing. He was glad to oblige: ”Just before my father left the house to go to work, he paused and bent down to me and rubbed my head. He kissed my mother. He reached down to pat my little sister. Then he went through the doorway. I never saw him alive again.”
When John Bailey spoke he was irresistible. Speaking slowly, his voice emerging from his deep body, he chose his words carefully, simple words, spoken steadily by the old policeman, who regarded me steadily as he spoke. John Bailey looked across the small verandah towards me – and beyond me – to the scene he described. He looked at me, bringing me with him into that scene. It was alive in him as he spoke. I was soon to see that it had been alive to him ever since his father died, on January 12, 1945.
“The previous evening my father had said to all of us, ‘Tomorrow is the start of a new life.’ He and mother had brought us to the town of Blayney a week previous. Father had a week of leave that he used to settle us into our house and into the town.
“I remember Father brought a whole trailer load of onions and garlic with us to Blayney. He was a great gardener. He had grown them at his previous posting and he spent the last day of his leave fixing chook wire high under the roof in the garage to keep the onions and garlic dry.
That night Father said: ‘Tomorrow’s the day, the start of a new life.’
The next afternoon he walked out through the door for the 3.00 o’clock shift… I can still see him going out the door…”
“Father was one of nine children, the youngest. His family didn’t have much. My father didn’t own a pair of shoes until he was ten years old. He left home when he was fourteen to join the Post Office. He was a telegram boy. When he was twenty he joined the Police Force in Sydney. He worked for a while in Traffic, like all of them. Then he asked for a posting to the country. He was from the country himself… from Tenterfield. His people were farmers there.
“Father had married my mother in Sydney. She was a Sydney girl. When they were posted to the country it was to The Rock, not far from here…
“The Rock is a pretty small town. There were only a couple of hundred people. It was a one-man police station. It must have been a terrible shock to my mother, coming from Sydney to a place like that. But she accepted it.
“After The Rock Father was posted to Gundagai. I was born in Gundagai, in 1929. Then we went to Narrandera, then to Deniliquin, then Balranald. Every posting we went further west. Do you know Balranald?”
I shook my head. I knew the other towns he named: Narrandera is only 19 miles up the road from my home town of Leeton.
“Well, you would know Hay then – Hay, Hell and Booligal – Balranald is further out still… I remember the summers in Balranald. They were hot. The police house was very hot. A low roof…it was tin. One day the Chief Commissioner called in at the Station and Father invited him up home. He stopped with us for the night. I remember him and Father, both sitting out the back in the hot night. There was Father in his singlet, sitting with the Chief Commissioner of Police. He stripped down to his singlet too.
“That’s my first memory of the Chief Commissioner.
I met him again… after…
The Chief said to Father: ‘How can your wife live in this heat, a woman, with a child?’ So we were posted to Moruya. We were there from 1939 to 1945.”
“We arrived at Blayney on January 3, 1945. Father started work in Blayney on January 12. He was shot that first day.
“My father was the only police officer to arrest his own murderer.”
A John Bailey pause. He lifted the little black leather casket and hefted it a couple of times. He put it down again.
When he resumed John Bailey shifted to the present tense: “Father walks the three quarters of a mile to work. On his way he stops at the picture theatre, to introduce himself to the proprietor. Father is the new police officer; he wants to meet the people who do business in the town.
Just then a man runs in, shouting that a man is waving a firearm about in the Exchange Hotel. Father knows the Exchange. We stayed there our first few nights in Blayney while they got the Police House ready for us.
“Father goes straight to the Exchange. In the Lounge they point out a man wearing a sort of uniform. He’s talking excitedly. Father doesn’t want an over-excited man with a firearm inside with all those people. He says: ‘You had better come outside with me.’
“They go outside. The man is wearing the uniform of the American Merchant Marine. Father questions him – name and address and so on. His answers aren’t satisfactory. He does say he is staying at the hotel. Father says ‘I think we had better search your room.’
Now the man becomes really agitated. He pulls out a handgun. Father says: ’Give that to me.’ He takes a step towards the man. The man shoots at my father. The bullet enters the left side of my father’s abdomen, passes through his liver, then up into his chest and lodges finally in his right shoulder.
“My father begins to bleed. My father closes on the man and grabs him by the arm. They wrestle and my father throws him to the ground. He comes to rest in the gutter, where they continue to wrestle. My father is getting weaker, but he manages to get on top of him.
The man still has the weapon in his hand, and my father attempts to take it while the man tries to shoot again. He manages to discharge the weapon but Father has deflected the gun so the shot goes astray. The bullet is found later in the ceiling of the hotel verandah. The man shoots again but my father has forced his wrist forward so the shot goes this time into the man’s forearm, where it shatters the bones and lodges in his elbow…”
There is another Bailey pause. The old policeman is looking downward and across his own verandah, across the years, at two wounded men in their mortal struggle. There is no anger in his expression, only sorrow.
The voice, the telling, is delivered like the plain fact testimony that I’ve heard police officers give in a court of law – no verbal colour, nothing in the words to convey hurt. Only the silences between words, only the pauses, allow me a sense of the speaker’s experience.
Old Man Bailey does not once refer to the killer by name – he remains ‘the man’ throughout – but the police officer is ‘Father’, flesh of his flesh. The father and his memorialising son have the colour and heat of human relationship. ‘The man’ has no human connection.
John Bailey resumes: “The gunman cannot escape. My father’s body is heavy upon him, his gun arm is shattered. My father has been bleeding heavily. Two railway detectives arrive at the scene from the railyards close by. They had heard the shots. Father says: ‘Take the handcuffs and cuff him. They are on my belt.’
The detectives put the handcuffs on the gunman, and someone calls an ambulance. The ambulance takes Father to the hospital in Orange, thirty miles away. My father dies on the way to hospital from loss of blood.”
Then John Bailey repeats: “My father is the only police officer that I know of who arrested his own murderer.”
“An officer came to the house and told Mother that Dad was hurt. She went away with the officer and I took my little sister to the neighbours’ house. We stayed the night in the house of Death. That was the neighbours’ name – Death. They pronounced it Deeth.
“ I saw my father once more – in the casket, at the funeral. My father was 38 years old when he was killed…
“The Force paid full Police honours to my father. There was a procession at the funeral, with the Police Band, the Mounted Police, a motor cycle escort, officers marching in formation.
Afterwards we packed up and went to Mother’s people in Sydney. That was Bondi. Later there was a function to award my father the Geoff Lewis Trophy – that’s the annual police award for valour. At the function the Chief Commissioner said to Mum, ‘I want your boy John in the Police Force.’ He wanted to look after me for my father’s sake and for my mother. But mother didn’t want it. I didn’t either, really.”
“My father said I should go into the Post Office and that was the plan. I never intended to join the force. But after the funeral, the Chief Commissioner said to Mum, ‘How old is your son, here?’
Mother said I was fourteen.
The Chief said as soon as I was old enough I should join up: he would keep an eye on me.
So, when I was fifteen I went to the Recruiting Office. I wasn’t very big. Officer Russ Sadler was a big man. He said: ‘You delivering a telegram, son?’ I told Officer Sadler I was going to join the force.
He measured me and he weighed me and he said they wouldn’t take me. I was too small. ‘Go home and eat some Weet Bix, son’, he said. ‘Come back when you’re bigger.’
But the Officer-in-Charge, a Scot called Gordon McKechnie, bellowed and wagged his finger at the junior officer and told him off. ‘This young bloke is going to be a policeman. Sign him in.’
“So, even though I was less than five feet nine tall and I weighed less than ten stone, they let me into the Police Cadets – on a condition: I had the three years as a cadet to become tall enough and heavy enough. And I soon grew and I made the height and weight comfortably.”
I could see that he did. John Bailey, even in old age, was tall enough and heavy enough. Ample in fact.
John Bailey pointed again to the book. I read again the citation. It described the actions of Officer Bailey. It steered well clear of any feelings. The officer saw his duty and he did not hesitate.
Only one year after his father’s death, John Bailey enters the fatal force. He serves for forty-five years. I wondered aloud,” Did you sometimes remember your father’s death during those years? Did you look over your shoulder as you went about your work?” What I did not ask – but I wondered – when he was a young father, did he not recall the night when grim-faced officers took his stricken mother away, leaving him, a fourteen year old boy to take his small sister to the neighbours called Death?
“I never forgot my father. I thought about him whenever I worked alone. As a country policeman I was usually alone. One night I was at home. I heard someone screaming wildly in the front room. I pulled my trousers on and there was a man in there, terrified, in a panic. He was shouting – something about a man, a gun. Someone had been shot in a house close by. “I pulled my boots on and ran straight there. I went into the house and saw the body. He was dead. I could see that straight away. Half the face had been shot off. It must have been a shotgun.
The gunman had to be somewhere close by. There was no-one else in the house. I went outside to look for the killer. It was dark. I didn’t want to turn on my torch and show him a target. I listened. There was no sound. I was pretty sure he was in the garden somewhere. I spent three quarters of an hour trying to find him.
“I did think of my father…
I tried to move quietly. Eventually I found him. He was sitting against the back fence, dead. He had shot his own face off.”
I did some research into ‘the man’ who murdered Eric George Bailey. I read he was released from gaol only two days before the murder. The man was a professional crook whose specialty was stealing passengers’ luggage from railway stations. He’d spent some time in prison for theft elsewhere in country New South Wales. On his first day of freedom he stole a couple of suitcases from a railway station. In one of these he found an American uniform.
It was just after closing time at a gun shop in Sydney that ex-prisoner Thomas Couldrey (alias Cyril Norman) knocked on the door of the shop. He persuaded the proprietor to admit him on the pretext of Couldrey’s planned departure before opening hour on the morrow. Couldrey examined a number of guns as if to make a purchase, loading one. He distracted the shop-keeper then attacked him, shooting him dead. He then looted the shop of weapons and ammunition and cash, which he packed into a suitcase. He travelled with that suitcase to Blayney, where he booked into the Exchange Hotel. Here, dressed in the American uniform, he proceeded to drink rapidly. It was there that ‘the man’ met Eric Bailey. It was outside the hotel – where Bailey chose to question him for the greater safety of patrons – that the officer said: “I think I’d better search your room.”
In time Couldrey recovered from the injuries he sustained in the struggle with the policeman who arrested him. He stood trial, was convicted and sentenced to death by hanging. In the event the sentence was commuted. Couldrey died in prison some years later of natural causes, thought to be tuberculosis.
By the time I met the son John, he had retired from the Police Force. We met at his home in Albury where he cared for his wife whose memory was failing. It was not old age or his wife’s infirmity that brought about Bailey’s retirement; it was, he said, disgust.
Four decades after his father’s murder Chief Inspector John Bailey underwent an exhaustive sequence of interviews and assessments that would have seen him promoted to Commander. He progressed smoothly through every stage. Next, Bailey underwent examination by an Ethics Panel. This was the final stage. From here promotion would be a formality: “There were five examiners on that panel. I recognised the faces of a couple of them, I knew the names of a couple more. The fifth was a senior man in the magistracy. I knew that name too. Everyone in the force knew him, the greatest paedophile in the state. Everyone knew, everyone turned a blind eye. And that… that man was about to determine my ethical fitness. It sickened me. I withdrew my candidacy. Not long after I retired.”
Much of this account I wrote shortly after first meeting John Bailey. Earlier he had recovered from ostensibly successful surgery for colon cancer, only for it to recur. His daughter Chrissie knew what this must portend. Her young children did not know and, she decided, should not know. Not yet.
So the time was not right for me to tell the story of John Bailey’s long, long struggle. Meanwhile he had other things on his mind, a great task before him in the care of his failing wife. After many years, when Mrs Bailey was beyond caring or knowing, John allowed his wife to move into professional care. Now he could retire from his second career. In the years that followed John Bailey wrestled with his own murderer, an opponent more like a tag team, returning now as cancer, now as open heart surgery, now as diabetes, now as blindness, finally near his heart. He yielded only at the final fall.
My oldest friend Johnny Wanklyn phoned me from Albury. He produced only a few words, the bare few. Long before my friend became John Bailey’s son-in-law he’d been the elder man’s close friend. John married Bailey’s daughter and the two Johns remained tight.
Johnny had called a few times over the previous week or two. The first time Johnny wanted to know: “What’s the best place in Melbourne for chest diagnosis?” Unspoken was our shared knowledge of the colon cancer. The new problem was a mass in his chest. More calls followed: “The local specialist wants a biopsy – should it be taken in Albury or in Melbourne?” The last call: ”The old man’s too ill for any procedure.”
John Bailey’s son flew from Far North Queensland; his grandchildren gathered from Melbourne, from Geelong, from Christchurch. And now, the minimum, the inevitable: “Doff, John has passed.” My friend’s voice failed him.
Eventually he managed, “Bye for now.”
It was only six weeks previously that John Bailey and I talked over a long dinner at the house of his daughter, Chrissie and his son-in-law, John Wanklyn. I was about to fly to Wadeye, reputedly one of Australia’s most lawless towns. After a long career spent as an officer of the law in rural and regional areas, John Bailey was keenly interested: “I’ll be anxious to hear what you find in Wadeye. Tell me what you think.”
I readied myself to offer the veteran copper my apologetics, some extenuation of Aboriginal lawlessness. Old Man Bailey put down his glass. He raised his right hand, clawed by age and arthritis, and waved away my preconceptions of his preconceptions: he had none; he had, in his eighties that rare attribute – a genuinely open mind on Aboriginal matters. “Howard, I am glad you are going. Be sure to write and tell me about the town and the life there. Write and tell me what you see.” I did go, I did write. But I didn’t manage to complete my long piece about Wadeye – one of Australia’s hidden cultural capitals – in time to share it with John Bailey.
The uncompletedness of my task was a weight. I felt I owed some personal debt to John Bailey, to his remarkable life and lineage and service – this man who lost a father and gained a vocation through a murder.
A year after her father’s passing, John Bailey’s daughter supplied information he had not seen fit to mention to me. “Pa was honoured many times by the force. In 1972 they awarded him the Police Long Service and Good Conduct Medal; in 1986 he was awarded the National Police Medal; and in1988 they gave him the NSW Police Medal with 6th Clasp. Do you know what that means?”
“It means they awarded him with that honour on six separate occasions.”
A Bailey pause.
“So the force honoured Pa lots of times in his lifetime. And one final time after he died: that was at his funeral. There was a motor cycle vanguard and a motor cycle rearguard. Police officers in numbers. The local chief commander spoke. Pa was buried in his dress uniform, with all his decorations attached. A Police flag covered the casket and Pa’s police hat rested on it.
“One funny thing happened that day. I wouldn’t have seen the funny side at the time: a member of the motorcycle escort recognised the driver of the hearse. The man was a disqualified driver who’d lost his license through drink driving or some other offense. I don’t know what the copper did about it, but I know what he didn’t do. He didn’t arrest the driver on the spot and spoil Pa’s funeral.”
Postscript: I sent John Bailey’s daughter my notes. She wrote: “It took me a little while to brace myself to open it…You tell a story that I know, and have known for most of my life. But you have woven into the fabric of this new telling, the very essence of my father and his long-felt and deep loss of his father. I often think that the answer to the question “who would you invite to the ultimate dinner party?” would be, my father and grandfather, just to see and hear them together.
Thank you for reuniting father and son in words. I know Pa would have seen it as a precious and tangible thing to hand on to his children, grandchildren and beyond …”
I dedicate this story to a friend who is wrestling in another mortal struggle.
The right to die has found its voice. Past generations heard little of that claim, the cri de coueur of our day.
I imagine we never wanted to die so much as we do now. In previous times when life was short, brutish and mean we struggled to stay alive. But now Medicine has taken over. Deaths are prevented, delayed and deformed. Few families in advanced societies have been spared the grotesque spectacle of a loved one subjected to medically prolonged dying.
Because we enjoy better health we live longer lives. Because we reach old age we accumulate the mutations that overwhelm our defences. Cancer results. The cancer epidemic is the trophy won for us by medical advances. And so Medicine sets out to fight its ugly daughter. We cut out tumours, we poison them with chemotherapy, we shrink them with X-Rays, we outwit them with genetically engineered antibodies. Many are the gains, great are the costs.
Eventually dying happens.
Death frightened me when I was younger. Now I can see death as a sometimes friend. John Keats nursed his brother through the long death of tuberculosis. Then Keats himself became tubercular. He knew what lay in wait for him: cachexia then death. The terminus he contemplated was like late–stage cancer, the body self-starved, the mind too aware, the complexion ghastly pale, the skin empty, disfigured:
The weariness, the fever, and the fret
Here, where men sit and hear each other groan;
Where palsy shakes a few, sad, last gray hairs,
Where youth grows pale, and spectre-thin, and dies;
Where but to think is to be full of sorrow
And leaden-eyed despairs –
Keats wrote dreams of an easy death (in his Ode to a Nightingale):
Darkling I listen; and, for many a time
I have been half in love with easeful Death,
Call’d him soft names in many a mused rhyme,
To take into the air my quiet breath;
Now more than ever seems it rich to die,
To cease upon the midnight with no pain,
While thou art pouring forth thy soul abroad
In such an ecstasy!
Still wouldst thou sing, and I have ears in vain—
To thy high requiem become a sod.
When recently I posted ON EUTHANASIA I anticipated readers might react strongly. I was right: most who responded – on–line and off-line – experienced my thoughts as a wound. I learned how a doctor is expected to relieve all suffering. A doctor is a trusted friend. Once the doctor denies his patient her right, she feels he has betrayed her. The wounded person’s gaze is not directed here to the doctor as a moral agent, not as a person entitled to moral autonomy, simply as one who could help, who now, abruptly, at this last critical and defining moment, acts selfishly.
I wrote that changing a law does not necessarily serve wisdom. The reality here is no conceivable law can resolve all of the problems of our competing needs and values. We need relief. We need a doctor who respects our autonomy. We need a doctor who will not sit in lofty judgement. We need a doctor who will protect life and now we need one who will take life. And we need to know he’ll protect when he should and take when we seek it. The forgotten need is that of the doctor to reconcile those parts of his work. Putting it a different way, if the doctor, in trying be all those things, violates her own being, inevitably she disintegrates. She must give away her integrity. And then all lose.
I read the responses. I felt them, the tremor of the soul that prompted brave, naked, passionate disclosure of self. My mind went back to deaths I have known, deaths I have conducted. I recalled the baby who aspirated meconium in the birth canal. The baby’s chest heaved as it worked to ventilate lungs clogged with a material of the texture of bitumen. We ventilated him, he did not improve, he did not die. He would not die. Morning after morning I entered NICU and there he was, his skin marbled, his chest rising and falling in obedience to our machine. His life felt like a reproach. We had turned on the machine. I learned then that the decision to bring in the technology is more onerous than to withhold, to wait.
I recalled the first person to ask for my mercy. That person was my mother, the one who had given me life. Mum would have been sixty, I thirty. ‘Darling’, she said, ‘I have high blood pressure, I have high cholesterol; one day I’ll have a stroke. When that happens, I want you to slip me a mickey.’
I understood Mum’s reference to ‘a mickey finn’ – a lethal draught.
‘Mum, NO!’ – was my instinctive response, which I quickly softened with promises to read favourite literature to her.
Twenty or more years later Mum duly suffered stroke after stroke, the final one devastating. My son and I carried her up the stairs one day and I asked her whether she recalled our conversation. She did, clearly. I asked Mum whether she regretted my failure to ‘slip her a mickey’. Mum’s blithe response did not surprise me. Whichever way she might have responded would not prove any argument, would be particular, not general, would not resolve the next sufferer’s dilemma.
I sat with the heat and the passion and the pain of this debate. Having little faith in lawmakers to solve the problems of human existence and oblivion, I searched for some useful fragment to proffer. I recalled those numerous patients who had made written Advance Care Directives. For the simple doctor these expressions of your wishes are a godsend. I read them and I am ruled by your refusals. Some decline ventilation, some explicitly forbid ICU, some decline antibiotics or feeding by tube. Many directives are less specific: ‘Do nothing more than keep me comfortable.’ ‘Let me die with dignity.’ These last call for my deepest self-search. They challenge me to imagine what comprises and what violates your dignity. They draw my mind into the unknowable tomorrow. But these directives too are helpful. Your opaque request demands my vision of your humanity. It’s a big ask and it’s a fair one. My parents asked of their children that we allow them to die with dignity. We did our best and we saw Mum and Dad pass more or less peacefully from us with our honest best. It’s a big ask but I feel equal to it.
So that’s my first suggestion: COMPOSE YOUR THOUGHTS, EXPRESS YOUR WISHES, WRITE THEM DOWN, GIVE THEM TO YOUR DOCTORS (IN THE PLURAL), TO YOUR LOVED ONES, TO YOUR LAWYER.
The second idea came to me as I wondered about by own expertise in the matter of ending life by intent. I must do it unerringly. You don’t want to wake up mute and paralysed after I have botched it. Your family doesn’t want to see you struggle or convulse or vomit then inhale, gag and gasp. I’d need training. Then it came to me: the legalized euthanaser must be trained, supervised and certified. You’d want him to know the relevant law, the protocols. The euthanaser might benefit from ethical training. I am sure the practitioner will need pastoral support and peer supervision. He’ll need to be able to recognise and resist the opportunist heir-designate who wants Aunt Nancy knocked off before her care costs consume too much of the inheritance. (I had to do this once.)
So here’s my second suggestion, this to the lawmakers: A PERSON MUST BE LICENSED TO END LIFE. THE LICENSE WILL ASSURE THE COMMUNITY AND PROFESSIONAL PEERS THAT THE PRACTITIONER IS TRAINED, COMPETENT, HONEST AND WILLING. That final adjective might save many patients from the painful disappointment of denial of help by a doctor not prepared to end a life. (That doctor might be me.) You might or might not be able to respect the difficulty of a doctor who feels torn between your need and his vanity/arrogance/integrity/different sense of defining mission, but you need not suffer a humiliating rebuff in your extremity of need.
As I wrote earlier, a change of law cannot resolve everything.
In late 1969 the new doctor emerges half-baked from his progressive medical school. After graduation he spends three years in residence in major hospitals. He emerges from that great womb and enters family practice, feeling underdone still. But he blazes into his new work in a rural general with a few guiding verities. He will not create distance from his patients. He will not wear a white coat. He will wear bright socks, a signal to the young that he too is – was – is young. He will not hold himself aloof. He will not frighten children.
He starts his work and his feet are rainbows. When he treats children he sits next to them on the floor. Instinct rather than ideology guides the new doctor: he needs to be close; he wants to do away with barriers.
On his very first day, the ninth of April, 1972, the new doctor delivers a baby, a little girl. He becomes a long-term friend of the new mother. Every April ninth he remembers and often contacts the ‘baby’ – long after she grows, graduates, becomes a musicologist, a linguist, a creator of Aboriginal dictionaries.
He keeps changing his colourful socks but he does not change his ways. So long as his patients are, for the most part, young, the thin membrane that separates doctor from patient suffices for safety; the blurring of the professional and the human nurtures both the doctor and the doctored.
A young mother passes terrifying nights seated by her firstborn, watching him, willing his breathing as he gasps his inbreaths and wheezes his outbreaths. She brings the child to the new doctor. His concern comforts her. In time the boy’s asthma improves. The doctor meets and treats all three of that young woman’s children. He is drawn to the three, the thin boys gangling, the coal-eyed little girl, a faun. The children do not fear him. These too he befriends.
A few years pass and the young parents bring Grandfather to the doctor. The young family have taken the old man and Grandmother in to their home, thoroughly alarmed by the pneumonia he narrowly survived during the previous winter. Sixty years previously that man survived gassing in the trenches. His lungs are ruined, he might not get through another winter. Would the young doctor resume his care? He does, and further friendships grow.
Grandfather survives a dozen more winters in cheerful semi-invalidism, dying eventually in his late eighties. Grandmother, born in December 1899, lives to see three centuries and two millennia, living beyond all arithmetic probability, dying eventually, aged 104.
The father of the asthmatic boy likes to run. He’s a graduate in Architecture, a landscape artist who turns to teaching maths. He teaches at a school fifteen kilometres distant. Sometimes he runs those fifteen kms, up and down hills, across a couple of creeks to the school in the valley. The teacher shows his doctor friend the secrets and joys of running sandy country tracks. Up hills they run, sharing vistas of white, off-white, pale grey, deep grey, their breath white in the frosty mornings. Summer sees the two up and running before the heat strikes. Sweat-born raptures bind them in close friendship. The doctor showers and dresses for work in the en-suite bathroom of the aged matriarch. He tiptoes past the old lady lying asleep in her bedroom, greeting her after she has awakened.
Years pass. Decades pass. All are older now. The Medical Board sends letter after letter to doctors, warning them to keep proper distance from patients. The Medical Board has never had the pleasure of being a country doctor. The doctor wears his garish socks still, unconsciously. He knows by now the byways of health, the pathways along which he and patients alike, stumble; ways that lead slowly or rapidly towards the universal destination. He knows his own vulnerability to the pain of others, the sorrows that seep through a thin membrane; and the power of hope to seep osmotically back. He knows too the cases where hopes of cure are cruel illusion. He seeks in these cases to be a guide, to keep company with his patient his friend. That a friend not pass, lost or alone, into finality.
The running friend becomes unexpectedly breathless. Time passes and he cannot catch his breath. Tests show a shadow on a lung. Other tests reveal a tumour in the bowel. The years of torment begin. Surgery, chemotherapy, surgery again, scans and biopsies that show a third disorder, a serious chronic lung inflammation, nemesis now of three male generations. The teacher painter architect runner friend – what word can encapsulate a human person? – must take strong steroid medicines to stay alive, to breathe.
The breathing man works on a new painting. He paints a square-rigged ship negotiating a strait. He paints the ship then repaints it. His work reaches no finality. He shows the work to his doctor friend, who comes – as he used to in the running days – for breakfast. That’s a sound in New Zealand, a fiord really. It’s called ‘Doubtful Sound.’ Captain Cook came to the entrance, felt uncertain whether he’d get ‘The Endeavour’ out if he were to enter. He felt doubtful and he named the place for his doubt.
The painting shows a tall ship heeling before a strong wind. Its bow points bravely into the wind. The wind bears it towards the reef that guards the mouth of the sound. The rocks are a maw, open, baleful. The sails are close rigged. This is a ship under strain. Relieving that strain is a smaller boat whose heaving oarsmen pull the larger one towards safety. The doctor looks at the picture doubtfully. He was raised on boats. He’s negotiated dangerous narrows, but he had a motor to see him through.
That small boat, that’s a whaler. I used to row boats like that as a boy, on the Thames. In earlier times the master of a square rigger would launch the whaler to sound depths, but also, to help the mother vessel in places where the going was tight. When he felt doubt that he’d make it through.
The cortisone voice crackles, phrases punctuated by breathing pauses. The creator looks at his unfinishing work. Artful brushstrokes of blue, of greys, of white, create waves, wake, bow-wave. The ship holds its own. In all the stresses and forces it has not reached finality.
I can’t see Manny anywhere. I stand and fret in St Kilda Road. The spring gale blows a clatter of discarded plastic drink cups along the great boulevard. The cups fly and land and take flight again, baffling the redshirted volunteers who try to arrest them. In all the great sweep of road it is only the volunteers who run, no others: the marathon field has swept past me as I keep my watch and ward, as I wait and wait for Manny.
It is eight thirty-five. The marathon runners have passed, the half-marathoners too. Where is Manny? We’d arranged to meet at seven thirty. When we saw each other a week ago Manny told me he could run only two hundred metres without breathlessness. I was treating him for the respiratory infection that he’s prone to: whether it’s his cancer therapy or the cancer itself or a recurrence of pneumonia, he’s been unable to train. ‘Until the other day’, he says hopefully, ‘I did 10K on the treadmill.’ Then he concedes, ‘I had to walk and jog.’
Last night Manny sent a message: I’m hoping miracles do happen. This will be my thirty-ninth Melbourne Marathon. I am determined to start. I don’t want to embarrass myself. I hope I make it to the five kilometre mark. I’ll meet you there around seven-thirty I hope.
I have been watching since seven-fifteen, searching faces, peering into the throngs for sight of Manny’s familiar features, his labouring body. The road has been full, but empty, empty and desolate. So Manny has been defeated at last. After running thirty-eight successive Melbourne marathons, one of only eight people who have started and completed every one, Manny has admitted defeat. And it is not the event that has defeated him, but his illness. The wind howls in my ears, dust flails my face. I am almost relieved that Manny does not have to run into the gale.
I turn for home then look back over my shoulder. At the extreme of sight two figures are dimly seen. Their bodies are shapes, undefined. They seem to move: are they moving towards me or away? I wait. Yes, two figures, moving slowly, making slow progress in my direction down St Kilda Road. Can this be Manny and another, a support person? I wait my turn to become the next in Manny’s chain of supportive escorts. The figures approach, they gain definition. They move comfortably, they laugh and wave. They are young, female, they are not Manny.
Sombrely I jog back, keeping pace now with some lagging half-marathoners. Sloggers, these, a sub-sub-sub elite, united in dour resolution. These runners have the Manny spirit, the spirit that brought him through and home in the last two full Melbourne Marathons.
Back home I try to call Manny. No luck. I call his devoted son – all his relatives love and cherish him: no answer. I leave an anxious message. Restless, I await news. Day ends without word. I send an email.
Finally the following arrives: With help from my wonderful family I did the impossible and finished the thirty-ninth Melbourne Marathon.
I did the Cliffy Young shuffle and someone was with me all the way to help me along. I’m feeling very sore and tired.
I’m sorry I missed you. Hopefully we can run together next year.
‘Next year’. Two years ago Manny’s cancer doctor warned him against running: You fractured a cancerous rib just by coughing. You might have cancer in any of your bones. You can’t afford to run. But Manny did run. In 2016 with the same warning echoing, he asked his GP what he thought; this GP said, I’ll run at your side. And that was our plan again this year. But I missed him.
I missed him but Manny ran. He shuffled through the spring gales and he completed the full forty-two kilometres, plus the final terrible two hundred metres. And I missed witnessing one of the great athletic feats, one of the triumphs of the spirit over the flesh.
Next year, Manny, next year.
Most of us have no intercourse with our forty-six chromosomes. They perform their work honourably in intracellular obscurity and we leave them alone. Not so for my friend Manny Karageorgiou: his Chromosomes Numbers 13 and 14 have conspired to mutate. This mutiny came to light late in 2013 when he broke a rib without trying. He simply breathed or coughed or heaved a carton and the rib quietly cracked.
What Manny has tried to do – what he has managed to do every year for 37 years – is to run the 42.195 kilometres of the Melbourne Marathon. Manny is one of a tiny and diminishing band of brothers to achieve this feat. This, their 38th year, they number only eight.
When Manny’s rib cracked he consulted his doctor. In their shared innocence, patient and doctor initially believed they were dealing with a painful area in Manny’s chest, a mere nuisance, an impediment to running: and Manny had a marathon to run. The Marathon would call him. Come October Manny would obey the call and run. Always the Melbourne Marathon, always and only Melbourne. Athens too, has called Manny. Deep in his Greek heart’s core he hears that call. He feels aeonic tremors, he hears echoes across time of Pheidipides at Marathon field. Manny feels, he hears and he yearns to join the runners in Athens; but year after year that marathon clashes with Melbourne’s.
Manny could not run both. Melbourne held him: captive of his love for the Melbourne, of his obligation to its history, of his loyalty to his old comrades, Manny stopped his ears to Athens in October, he turned his back on the Aegean and, busted rib and all, he ran Melbourne. That was last year. For a period of time between the fracturing of the rib and that Sunday in October, my colleagues filled Manny’s body with poisons – thalidomide, dexamethasone, bortezomib – in their attempts to put down the chromosomal mutiny. The short term for that poisoning is high-dose chemotherapy.
When I wrote of Manny’s marathon in 2014, runners from around the world responded in awed respect of the man who’d run thirty-seven Melbournes, and who’d prepared and run it this time with a diseased rib and a poisoned body.
All that was in 2014. Since then Manny has undergone autologous haemopoietic stem-cell transplantation. The chemical savagery of this procedure – doctors have to poison every blood-producing cell in his body – can cure or kill. It did not kill Manny. But the mutiny grumbles on, bones everywhere are eroded, they await their moment of innocent impact or small tumble. One crack and a marathon runner will have run his last.
Manny’s haemato-oncologist, a compassionate and scholarly man, forbids running. He knows too well Manny’s disease. My guess is he has never run a marathon, is innocent of the joy, has never known the intensity of that blood-filled, tear-filled passage through space and time to self-realisation. For his part, Manny knows little about his proliferating mast cells, rogue daughters of his body’s revolution; he knows less of the osteoclasts punching holes in his bones; and nothing of the dysregulation of an oncogene translocated to his perfidious chromosome 14. But Manny knows enough. He understands the doctors do not speak of cure, he accepts the unending medication, he understands the risks of running. But he takes the occasional light run.
I haven’t asked Manny, ‘Do you run to live?’ I sense that the occasional light run is the answer that Manny’s mind or body drives him to. When Manny asks this family doctor, ‘Do you think I can run the marathon again this year?’ – the question I hear is: ‘Am I permitted to live before I die?’ And who am I – captive of my own marathon dreaming – to deny Manny? I decide I will run Melbourne at Manny’s side.
Lining up at the rear of the field of seven thousand dreamers before the Start, Manny implores me for the seven thousandth time: ‘Promise you’ll leave me behind once I’m too slow for you, Howard. I don’t want you to sacrifice your time for me.’ Manny never dreams he’s honouring me. But even before the gun sounds, runners reading the rear of Manny’s shirt salute him: ‘Legend!’ – they cry – ’Thirty-five Melbourne Marathons! Amazing!’ They clap him on the back, not realising Manny’s shirt sells him short by two marathons. Manny does not correct them. The same people spill glory and goodwill onto me in my Spartan’s shirt: ‘Go Spartan!’
A beautiful morning for running. Beneath low cloud a light breeze cheers and cools us as we snake along boulevards and run spirals through Melbourne’s parklands. Manny’s prudent pace suits me. I search for bodily pains to fret about. Nothing: silence from the supposed stress fracture in my left foot, nothing from the torn right calf muscle that I have rested from four weeks. The opposite calf sends alarms, but these are false. Pheidipides Goldenberg has no complaints.
Running half a pace behind Manny I take him in, not as the indoor person I have known, but Manny as runner. His build is not classic Kenyan: Manny is constructed of old materials, a series of chunks assembled one on top of the second. Impressive that he has lugged this unpromising torso through thirty-seven marathons. Projecting below that torso are the legs which are Manny’s secret. Beautifully muscled, elegantly defined beneath skin shining with vitality and sweat, Manny’s legs look decades younger than he as they pump smoothly, rising, descending, devouring distance.
Approaching the thirteen kilometre mark, Manny grinds on steadily, shouting out greetings to figures who come into view and earshot, his comrades, these, fellow members of the hallowed eight. To a man they look old. And calm. The marathon is their familiar foe. It holds no terrors, no surprises for them. Not for the first time, I recall Tennyson’s Ulysses as he looks upon his comrades:
Souls that have toil’d, and wrought, and thought with me –
That ever with a frolic welcome took
The thunder and the sunshine…
You and I are old;
Old age hath yet his honour and his toil;
Death closes all; but something ere the end,
Some work of noble note, may yet be done…
With a cry of a different temper, Manny swerves, his voice joyous. He mounts the kerb, sweeps a good-looking woman into his arms, kisses her face, her hair. She pushes him away a little, looks at him searchingly. Satisfied, she smiles: ‘You look good, darling, you look wonderful. You’re running smoothly.’ The good-looking woman is Manny’s wife Demetra. She plenishes us both with cola and kisses, promising to find us again ten kilometres down the route. Manny releases his wife, takes a step, turns back, grabs Demetra again, crying into her hair, ‘I love you, darling’, and sets off again. I look down and try to deal with a lump that has risen in my throat.
Heading out toward the beach now we are bathed by sun and cooled by the breeze. Aaah, blessed day. The first Kenyan, having turned and now heading homeward, glides past us on air. Shouts of wonder rise from all throats as runners and spectators alike react to this shock of the beautiful.
‘That’s my street there, Howard, Number 141. Please join me and my family at any time from 3.00. Bring your wife. Please.’ I want to join Manny and his family. If I finish in time I’ll certainly be there. Until now, Manny has spoken little while I have spoken more. A quieter person, he places one foot before another, repeatedly, steadily, and runs inwardly. I ask from time to time, ‘How are you going, Manny?’ ‘Not great. Not as good as last year.’ Not feeling great but not complaining either. As we swing out along the beach road and past Café Racer, a bunch of bystanders suddenly flows onto the road in our path and Manny’s face relaxes and falls into a wide smile. Hugs, handshakes, claps on Manny’s back, kisses on Manny’s face from two toothsome young women, and Manny keeps smiling and keeps on running. The interlopers pump sunshine up Manny’s arse and run alongside him. For the best part of an hour we run with the posse and through all that time Manny is smiling.
We come to the turn and the posse whoops and cheers as Manny turns for home. Manny is brother to one, uncle to a couple, second cousin to a few more, godfather to another. The kissing females are godson’s girlfriend and her girlfriend. The brother is shorter than Manny, genial, younger, rounder and pretty fit. He stays the distance for the full hour as do godson and one of the kissers. Others, out of shape or out of condition, fade away and re-join us later. Finally, with farewells, more clasps and shakes and blessings the mob falls away. ‘See you at my place, darling!’ ‘See you after three, Manny!’ The mob loves Manny and he them. Afterwards he tells me, ‘They’re here to meet me every year. Every year at the same spot. They never fail.’ A little later Manny says, ‘Dem and I are taking the whole family to Athens next year…it won’t be at marathon time of course.’
Increasingly I relish Manny’s invitation to join him and the family. These people run to the beat of a familiar drum.
‘Manuel. They call me Manny. Also Manoli.’
Manny, Manoli – these affectionate diminutives are the aural furnishings of a life. Cushioned at every mention of his name, the man lives his life in relation, in connection, not alone, never – so long as these names are heard – alone. Back on the road, the solid road, returning from my abstractions, back with Manny-the-person I notice him struggling wordlessly. What silent erosion within his skeleton, what deposition of para-proteins in his kidneys, what mischief in his marrow, hampers this champion? Conversely (and most striking), how remarkable the redemptive effect of the loving presence of Manny’s family!
Around the corner and into Fitzroy Street where the crowds thicken and the cheering is a roaring without end, we allow ourselves a fifty-metre walk up the ugly little hillock placed here for the torment of the tiring runner. I reckon we’ve run better than two thirds of our 42.195 kilometres. Manny bursts into joyous shouting: ‘My baby! My baby!’ Emerging from the midst of the thronging cheerers is the adoring Demetra, bearing encouragement and affection and more Coke. And a baby! – their first grandchild. Manny cradles the pink bundle, adores her like a Magus. To me Demetra passes chocolate! I’m dubious about this; I’ve never eaten chocolate in the middle of a run. Will I like it? Will it like me? Too late – it’s melting in my sweaty paw. Now it’s inside me, followed by a bottle of Coke. Supercharged with caffeine and sugar and fluid I am invincible. In Demetra’s arms, holding his pink grandbaby, Manny looks the same, but once around the corner and out of sight, he looks and feels utterly vincible.
Around the corner now and into St Kilda Road, the broad thoroughfare closed to traffic in honour of us marathoners. The sun shines, the day has warmed, everyone who is not running enjoys the balm. Runners enjoy the painful raising of knees, the heavy hurt in the thighs, the weight of weary, weary bodies that started running almost four hours ago. The 32 – kilometre sign tells us there are only ten kilometres to go. Only ten kilometres to go feels to a runner as welcome as only ten more years might sound to a prisoner serving life. The experienced runner knows the second half of a marathon starts at 32K.
We plod in the sunshine. The field has thinned as faster runners leave us behind and others – the broken, the breaking, the bleeding, those limping – fall behind us. Here to one side of us, runs Eeyore, a young woman from England. She runs smoothly ahead then stops, bends forward in apparent pain, and breaks into a slow walk, and soon she is at our side again. Eeyore replies to my clinical enquiries morosely. I encourage her, I pump sunbeams, I tell her she should be proud. I should shut up and allow her to enjoy her misery. Eeyore and Manny and Pheidipides keep company intermittently until the final few hundred metres. Just ahead and to our left runs an aged, arcuate Japanese runner. His age might be anywhere from fifty to seventy. He clings to a line, a crack visible in the road’s surface where one layer of tarmac meets its neighbour. Dourly, silently, mute to my greetings, his spine twisted into a boomerang convex to the left, Japan runs the lines. His speed is no better than ours but I bet he could run all the way to Hokkaido without stopping.
A soft sound issues from the female who runs half a pace ahead on our right. The slight sound recurs – the grunt of a person in pain? – pulls me close. No not a grunt, it’s a moaning, the woman’s lament for her suffering self, her threnody sung for self-comfort. She’s about forty, shapeless, pale, a moving emblem of tortured humanity. The moment brings me back to the Olympic Marathon (I think it was at Barcelona) where a Swiss or French runner, whose name I seem to recall was Dominique Something approached the Finish. No-one who witnessed the sight of this tall, thin woman, faltering and staggering in her final lap of the stadium will forget her in her extremity. The brutally hot day, the merciless steeps of Monjuic in the approach to the stadium, the criminal timing of the event in such heat had all but undone her. She lumbered into view, slowed, stooped, seemed to recover herself and advanced. Time and again she seemed at the point of falling. Officials were seen to move toward her, then to retreat. Appalled viewers on screen and in flesh begged wordlessly for it to end, but Dominique stumbled on. Twenty, thirty metres from the Finish she fell. Officials came to her aid and in so doing ended her chance of completing the Olympic Marathon. It is Dominique whom I hear now as this woman moans.
It is no disrespect to acknowledge that we belong to the dregs of the marathon world: among the select who run marathons, possibly the most resolute and vigorous of people, our sub-group group is the most enfeebled. And all the more honour to us who persist. On we go, pausing for drink every three kilometres, enjoying the excuse to walk twenty, thirty metres. Then up again with weary legs, up and back into the slow steady tread that our heartbeats allow us, that is all our breaths and our body salts and our fluid reserves and our moral reserves can support. We walk, we pause to walk thirty guilt-free walking paces, then on again we run, and on. Manny and I negotiate small contracts: we’ll run without stop to the top of this short rise, then we can coast down the farther side; we’ll run and not stop until we reach the next drink stop, then we’ll reward ourselves with cool fluids and a splash of water; we’ll run now and will not stop until we reach the MCG, and then…
We enter the great stadium side by side. The huge grandstands tower about and above. We insects crawl the margins below. At my left Manny says, ‘It’s magnificent, isn’t it?’ It is, it is indeed. We swing our arms, pumping our reluctant thighs into action, we raise our heads, then hoist ourselves onto our toes for the final 150 metres. Two aging men, one with an intact skeleton, the second much ravaged, swing around the bend. We pass the bent man from Japan: his face, transmogrified, is a rising sun; and Manny and I are sprinting, and sprinting we fall across the Line.
POSTSCRIPT: I have written elsewhere of my inadvertent double entry (and double payment) in this year’s Melbourne Marathon. I duly wore two bibs – each with its distinct number – and with them, both electronic timing chips. I had speculated that Pheidipides Goldenberg might record a finish in both last and second-last places. If you google Melbourne Marathon Results 2015 you will see how closely I anticipated the result. And you’ll find, ahead of me by one second, Manny, Manuel, Manoli Karageorgiou.
The mother of identical twin boys sent me this story by Ranjava Srivastava.
“Losing my twin baby boys for ever changed the way I treat my patients.
I will never know the kind of doctor I would have become without the searing experience of being a patient, but I like to think my loss wasn’t in vain.
‘My obstetrician’s tears stunned me but also provided immediate comfort. They normalised the mad grief that had begun to set inside me.’
Around this time 10 years ago, I was poised to start my first job as an oncologist when personal tragedy visited in a way that would forever change the way I would practice medicine.
I had returned from my Fulbright year at the University of Chicago, blessed with only the joys and none of the irritations of being pregnant with twins. Landing in Melbourne, I went for a routine ultrasound as a beaming, expectant parent. I came out a grieving patient. The twins were dying in utero, unsuspectedly and unobtrusively, from some rare condition that I had never heard of. Two days later, I was induced into labour to deliver the two little boys whom we would never see grow. Then I went home.
If all this sounds a little detached it is because 10 years later I still have no words to describe the total bewilderment, the depth of sorrow and the intensity of loss that I experienced during those days. Some days, I really thought my heart would break into pieces. Ten years later, the din of happy children fills our house. But what I have found myself frequently reflecting on is how the behaviour of my doctors in those days profoundly altered the way in which I would treat my patients.
An experienced obstetrician was performing my ultrasound that morning. Everything was going well and we chatted away about my new job until he frowned. Then he grimaced, pushed and prodded with the probe, and rushed out before I could utter a word. He then took me into his office and offered me his comfortable seat. Not too many pregnant women need a consultation at a routine ultrasound.
“I am afraid I have bad news,” he said before sketching a picture to describe the extent of the trouble. I thought for a fleeting moment that my medical brain would kick in and I would present him with sophisticated questions to test his assertion that the twins were gravely ill. But of course, I was like every other patient, simultaneously bursting with questions while rendered mute by shock.
I was well aware that doctors sometimes sidestepped the truth, usually with the intent of protecting the patient. I knew he could easily get away with not telling me any more until he had more information but I also knew that he knew. I read it in his face and I desperately wanted him to tell me.
I asked the only question that mattered.
“Will they die?”
“Yes,” he said, simply holding my gaze until his tears started.
As I took in the framed photos of children around his office he probably wished he could hide them all away.
“I don’t know what to say,” he murmured, his eyes still wet.
Until then, in 13 years of medical training, I had never seen a doctor cry. I had participated in every drama that life in bustling public hospitals offers but never once had I seen a doctor cry.
My obstetrician’s tears stunned me but also provided immediate comfort. They normalised the mad grief that had begun to set inside me. Yes, the doctor’s expression said, this is truly awful and I feel sad too.
“You are sure?”
“There is a faint chance that one lives but if you ask me, things look bad. You know I will do everything I can to confirm this,” he said.
The obstetrician had told the unflinching truth and in doing so almost surgically displaced uncertainty with the knowledge that I needed to prepare myself for what lay ahead. I had test after test that day, each specialist confirming the worst. I think I coped better because the first doctor had told the truth.
Two other notable things happened that week. Among the wishes that flowed, another doctor wrote me an atypical condolence note. His letter began with the various tragedies that had taken place that week, some on home soil and others involving complete strangers. “I ask myself why,” he wrote, “and of course there is no answer to why anyone must suffer.”
Until then, everyone had commiserated only at my loss – and I was enormously grateful – but here was someone gently reminding me that in life we are all visited by tragedy. All the support and love in the world won’t make you immune to misfortune, he was saying, but it will help ease the pain.
Finally, there was the grieving. I lost count of the pamphlets that were left at our door to attend support groups, counselling sessions and bereavement seminars but we were resolutely having none of it. My midwife called me out of the blue – it was a moving exchange that taught me how deeply nurses are affected too. But I didn’t need counselling, I needed time. I valued the offers but I knew that my catharsis lay in writing. I wrote myself out of suffocating grief, which eventually turned to deep sadness and then a hollow pain, which eventually receded enough to allow me to take up my job as a brand new oncologist. How I would interpret the needs of my patients was fundamentally altered now that I had been one myself.
Cancer patients are very particular about how much truth they want to know and when. I don’t decide for them but if they ask me I always tell the truth. A wife brings in her husband and his horrendous scans trigger a gasp of astonishment among even the non-oncologists.
“Doctor, will he die from this?” she asks me.
“I am afraid so,” I answer gently, “but I will do everything in my power to keep him well for as long as I can.”
It is the only truthful promise I can make and although she is distressed she returns to thank me for giving her clarity. Sometimes honesty backfires, when the patient or family later say they wanted to talk but not really hear bad news. I find these encounters particularly upsetting but they are rare and I don’t let them sway me from telling the truth.
Oncology is emotionally charged and I have never been afraid of admitting this to the very people who imbue my work with emotion. I don’t cry easily in front of patients but I have had my share of tears and tissues in clinic and contrary to my fears, this has been an odd source of comfort to patients. In his Christmas card, a widower wrote that when my voice broke at the news that his wife had died he felt consoled that the world shared his heartbreak.
It can be tricky but I try to put my patients’ grief into perspective without being insensitive. It’s extraordinary how many of them really appreciate knowing that I, and others, have seen thousands of people who are frightened, sad, philosophical, resigned, angry, brave and puzzled, sometimes all together, just like them. It doesn’t diminish their own suffering but helps them peek into the library of human experiences that are catalogued by oncologists. It prompts many patients to say that they are lucky to feel as well as they do despite a life-threatening illness, which is a positive and helpful way of viewing the world.
I will never know what kind of a doctor I might have become without the searing experience of being a patient. The twins would have been 10 soon. As I usher the next patient into my room to deliver bad news, I like to think that my loss was not entirely in vain.”
I read this story with alarm. It made me feel anxious because I have and love a pair of identical twin boys. I felt involved because, like the writer’s doctor, I am a doctor who cries; and like the writer, Dr Srivastava, I am a doctor who writes. Finally we two are products of the same medical school (Monash) – Dr Srivastava graduated at the top of her class, in the present century, I graduated at the opposite end of my class, in antiquity (1969).
A final point of commonality was her reassuring remark that ten years after her doctor wept her home is full of the noise of happy living children.
I found the piece helpful. Dr Srivastava identifies and untangles the strands of her experiences with surgical deftness. Her doctor weeps, her colleagues show support and care and empathy and she heals. As a trained observer, the writer dissects her experience of grief, lays out its anatomy and reflects upon its organs and parts.
Like the writer, I find relief and understanding in the act of writing. I suspect that a part of this relief results from word search. The writer is obliged to seek the precise word for the experience. In my case this forces me to test and taste a number of words. Perhaps a dozen words might work more or less passably, but the acts of searching, of choosing, of trialling, help me to clarify what my feelings were not quite like. I mean I discover what I mean. Perhaps this functions as a working through, a self-conversation, something between analysis of an experience and re-imagining it. In my case too, the pleasure of words is an aesthetic joy that comforts me.
Medicine is a pursuit conducted with the living in the shadow of death. It is a pursuit packed with anxious questions: what is wrong with me, will I die, what can be done, will it hurt, how much, how will I know the answers, when will I know? This crying doctor feels the patient’s fear and his own and has to know the border that divides the two. My fears are for the patient, of the patient, of failure, of failing a person of flesh and feeling. My fears include the terror that strikes me when I see my patient slipping away, the knowledge of my mortal inadequacy.
The writer who lost her twins precisely names the elements in her emotional experience. With remarkable poise she traces the costs and the benefits of the loss. So coherent are her reflections I could feel myself learning as I read. I learned about her life and her work, how the two are not the same but never severable. I learned more of how a doctor feels, who she is, who I am.