It is 12th May 2015. Dad has an appointment at the Macmillan unit at UCLH with his oncologist. My sister and I say we will go with him. We have left him to go to too many appointments on his own. We cannot let him this time.
This appointment is different from all the others. Today we will not be discussing treatment. We will be discussing amputation.
The orthopaedic surgeon who removed Dad’s tumour has observed how Dad’s leg is refusing to heal. He has advised that Dad would be ‘more comfortable’ if his leg were amputated. This is not something we have seen coming. It is also more than our mentally ill mother can bear. If she could not handle Dad having an open wound in his leg which needed dressing, debriding and vacuum-pumping, she cannot abide the thought of him being, as she sees it, mutilated.
For once, I can see Mum’s point of view.
My sister and I know we will have to navigate the appointment carefully. We have so many questions we want to ask, but it is Dad’s appointment. We have to keep reminding ourselves of this fact when Dad seems, at first, only to accept what he is told, when he stays quiet, when he simply ‘hmmm’s and nods.
At no point does the oncologist explicitly say ‘there is no more we can do’. She offers more painkillers and a further course of chemo, or ‘mouse pills’ as Dad calls them. She is reluctant to endorse the view that amputation is the best way forward.
‘You say you don’t think I should take Professor Briggs’s advice,’ Dad says, his jaw tight, ‘but you’re not giving me much of an alternative. I don’t want to go back home and sit around, waiting to rot.’
The oncologist shifts uncomfortably in front of her computer as she explains again the pros and cons. It is clear she is struggling to find the right words. She talks about this being a very ‘unusual situation’. She says she is ‘alarmed’ at how ‘aggressive’ the cancer is and that ‘it is spreading fast’.
‘The amputation may well solve nothing,’ she says. ‘The top of the leg has already been compromised, the cancer has spread so far. The surgeon would have to perform a disarticulation through the hip and possibly cut into the pelvis as well . . .’
I stop listening as unwanted images crowd my mind.
Instead I watch Dad closely. He is not reacting well to the oncologist. Even as he listens to her outlining ‘the options’, I can see he has already decided to ignore her opinion. He has been dismissive about the mouse pills for a while now. I can’t blame him. They haven’t worked. But still: amputation?
‘Are you sure you have thought about this, Dad?’ I ask. ‘You’ll be in hospital again. You have only just been discharged. You’ll have a long recovery from a major operation. Are you certain you want to go through with this?’
I have to sit on my hands to stop myself from screaming the subtext to all this which is, of course: You have less than three months to live! I don’t want you to do this!
But it is not up to me. It is not my leg. It is not my life. And it will not be my death.