The previous Thursday she had seen the doctor about her cough. It was probably just a winter cold, said the doctor, but given her history she booked an X-ray ‘just to be sure’. The phrase made Magteld twitch with déjà vu. Her coughing was gradually getting worse and so was my creeping sense of dread. Some nights she sat up in bed, shaking and spluttering until her lungs were almost spent. Her eyes swam and her cheeks flushed with the effort of breathing. ‘I’m OK, really,’ she gasped.
We went to Edinburgh to try to settle our minds. After thirteen years in Scotland I felt like a tourist again. I had an ambition to see the castle one last time. Magteld toiled up the Royal Mile, and by the time we made it to the Esplanade, beneath an indigo sky, there were only fifteen minutes to go till closing time. A guard staunchly barred our way. ‘Come back tomorrow,’ she said.
I had an urge to charge past and growl something about not knowing if there’d be a tomorrow. Magteld looked at me, weary-faced, and said, ‘Come on, let’s go.’ My cold anger drained away. We walked back down to a café just off the main road and warmed ourselves over hot chocolate and marshmallows. We focused on the positive things: the house was sold, Magteld was flying out to see Sanneke in a few weeks, and in three months’ time we would be sailing to IJmuiden, with our lives boxed and packed into a removal van. It should have been fresh and inspiring. But every time her cough erupted I heard the hard clink of footsteps behind us.
The solicitors who handled our house sale worked out of a compact, bustling office in Giffnock, just outside Glasgow on the south side, loaded with papers and filing cabinets. Across a table was Nicky, the sales negotiator we had been in almost weekly contact with for four months without ever meeting. There was relief all round: for the lawyers, because the market was on the rise again after a long slump, and for us, because at last we could embark on our great adventure. Magteld’s cough had subsided and good-hearted chatter buzzed round the room as we skimmed the legal papers and signed our names at the bottom.
The next day we walked up to Adam’s school in the afternoon, bouncing lightly and feeling bound together. I had to cut my pace up the shallow hill to accommodate Magteld, whose breathing was still a little laboured. Her news stirred a flurry of excitement among the other mothers in the playground. At home we drank coffee while Adam went out to his trampoline. It was a bright winter’s day, and the future had suddenly opened, like a crocus in bud.
An uncorrected legacy of the previous owners of our house was that the main telephone was upstairs, in Adam’s bedroom. Magteld’s doctor had been due to phone in the afternoon about her appointment, but as darkness fell we had heard nothing. About an hour after coming home I climbed the seventeen steps to the first floor and checked on Adam’s room.
The light on the answerphone was blinking. I pressed the ‘play’ button. The message was from her GP. It was a request to call back.
I called Magteld upstairs and watched as she returned the call. She stood with her back to me, looking out over the back garden where Adam was bouncing on his trampoline in the dim glow of the streetlight. I heard a tremble in Magteld’s voice as she spoke to the doctor, and then saw a violent change in her body shape, as if an invisible man had punched her in the stomach.
She blurted out the words: ‘Is it bad?’
Even before she ended the call I knew it was worse than bad, horribly worse, and felt my blood freeze in the interminable seconds before she hung up. When she did her voice was crumbling.
‘Gordon, what are lesions?’ she asked with darkening eyes.
I wasn’t sure, but the X-ray had shown up quite a few of them. We were cast back into interpreting the brutally precise language of the medical profession. Whatever they were, they bore no goodwill. I imagined the scan showing a cluster of grey blotches like dead insects.
She let rip with a vile scream of rage, a shriek from the pit of despair that defied her weakening lungs. ‘No, I can’t die!’ She sobbed bitterly, the only real bitterness she ever showed through the whole process.
The doctor booked an appointment with Miss Winter for Wednesday. We were back where we had been eighteen months earlier, drifting into an uneasy sleep and wondering what on earth we were going to tell the children.
For the forty-eight hours before Magteld saw Miss Winter we clutched each other like mountaineers hurtling down a hillside. Hope and fear were rolled up together. Perhaps the ‘lesions’ weren’t full-blown tumours; perhaps they could still be blasted away; perhaps some miraculous new treatment was in development that would allow her to live for years yet. Perhaps, perhaps, perhaps, in a perpetual motion of wistful denial.
At other times I brooded on the cruel binary nature of cancer treatment. The odds mean nothing: you live, and then you die. The tips of Magteld’s fingernails were still brittle and yellow from chemotherapy; she had spent months watching the new pink enamel rise from the cuticle.
Her appointment was just after lunchtime. A nurse called us through from the waiting area. As we approached the room I glanced through the doorway and saw Miss Winter preparing herself. Her eyes met mine for a fraction of a second, and in that moment the last thread of hope snapped.
I clasped Magteld’s hand a little tighter, gently, soothingly, so as not to alarm her as I led her to the gallows. She would know her fate soon enough.
Miss Winter sat us down. ‘Have you not been feeling well?’ she asked. Magteld described, in a trembling voice, her wretched persistent cough.
Then came the confirmation. The dark spots in Magteld’s lungs were outposts of secondary cancer. All that rigorous treatment, the pain and exhaustion, had brought barely six months’ relief.
‘We can treat it, but we can’t make it go away this time,’ Miss Winter said in an apologetic tone. The phrase ‘quality of life’ marked a shift of emphasis. The first treatment had been focused on cutting out the cancer and restoring the years she was due. Those ambitions were now replaced with lesser, more urgent ones. Miss Winter booked a CT scan, to check if the cancer had spread to other organs, after which Magteld would see Dr Barrett again. ‘Come back and see me in three months,’ she said finally, and made an appointment for April, a few days before we sailed. At least there was a comfort: that the future could still be measured in months.
I felt a vapid, gnawing anger and a sense that time was suddenly very precious. Our hopes of a new life together in the Netherlands had been smashed while the ship was still in port. Now Magteld was racing against time to get back for whatever remained of her life. There were twelve weeks left until we set sail for The Hague. Beyond that we would cherish every day that dawned.
In the supermarket that Sunday afternoon Magteld felt something jabbing at her lungs from the inside. It came on rapidly and without warning, like toothache. She sat down in the foyer with Adam while Euan and I finished shopping. By the time I came back she was groaning through clenched teeth. We drove up to the A&E department at the Victoria Hospital with our supper still in shopping bags in the car.
We sat and waited in a row of red plastic seats while a doctor was found. Sunday afternoon was quietly ticking over into evening and the late weekend rush was yet to come. Magteld was called through, placed on a wheeled bed and given an examination. She explained her situation without fuss or alarm. Euan and Adam, too, were remarkably accepting of this sudden deviation from routine. They noted every flinch and grimace, trying to sense their mother’s pain. We had not yet mustered the energy or honesty to tell them the dismal truth.
It was likely that the tumour was prodding against the edge of her lung, the doctor declared. He gave her a dose of painkillers and ordered her to be kept in for the night. Dr Barrett had booked her CT scan for the next morning, after which she could go home. Once again I was dispatched to go home and pack an overnight bag. Our next-door neighbour minded the boys as I dashed back out in the rain.
Magteld was put on the emergency ward, on one of the lower floors of the hospital. When I returned and located her she smiled weakly
. A trickle of grey light found its way in through the small window of her room, and the corridor echoed to the rhythmic bleep and hum of monitors. The painkillers had blunted the agony and allowed her to recuperate, a little. She was looking forward to getting some sleep and told me not to worry. I pressed a fretful kiss on her lips and went back home.
The next morning she told me about the patient across the corridor, evidently close to death, whose stertorous breathing and rasping cough filled the darkness. What thoughts circled in her mind that night I cannot imagine. She had crossed into that rarefied domain where only the dying are admitted.
In the New Victoria Hospital, in the consultation room where none of us wanted to be, Dr Barrett guided Magteld through the results of the CT scan. Her soft voice was solemn and compassionate. The scan revealed several tumours in one of her lungs and a spot in her liver. Dr Barrett repeated Miss Winter’s awful admission of a week ago: all the medical expertise in the world in 2013 had been unable to exorcise the cancer.
Magteld’s had been a particularly vicious type; we already knew that the chemotherapy had hardly dented the tumour, but now it seemed the radiotherapy hadn’t managed to snuff it out either.
She had followed all the prescriptions: lived healthily, submitted to the withering regimen of chemotherapy and taken her medicine dutifully. None of it counted for anything. Her cancer had withstood a battering, and now it was coming back to destroy her. What doesn’t kill you makes you weaker.
‘I’m so sorry,’ Dr Barrett said.
Magteld faced a new round of chemotherapy. More gruelling treatment, blood tests and enforced sickness, but this time with no hope of recovery. If it worked, she would simply go on taking it until the cancer grew too strong. This was not a battle but a last stand.
The prospects began at terrifying and went up to unbearable. ‘If the treatment goes well and the tumour is under control, we might be looking at two to three years,’ Dr Barrett said. ‘Perhaps longer.’
‘And if not?’ Magteld asked.
‘If it doesn’t respond – and there’s still lots of things we can do – it could be less than a year.’
We looked at her in dumb silence.
‘I’m really sorry,’ Dr Barrett said again. Meaning: I’m sorry I can’t cure you. I’m sorry medical science isn’t the miracle you needed it to be. I’m sorry to be the one to tell you you’re going to die young. I’m sorry you will be a dim memory to your children. I’m sorry they’re going to watch you suffer.
But she couldn’t say any of those things. She gave Magteld a sympathetic smile, and we gathered ourselves up, and booked another appointment for next week, and walked out into the pale sunlight, barely able to feel the ground beneath us.
Now that the horror was roaring in our ears, Magteld started writing her blog again. ‘The one thing I was most scared of happened. The cancer had spread to my lungs,’ she wrote. ‘It felt like we had woken up in a nightmare, but it was really happening.’
A year after she died I met one of her friends for coffee in Glasgow. Claudia had got to know Magteld at Maggie’s. Like Magteld, she was an expat, from Germany, and she acknowledged it was a matter of chance that she had survived cancer while Magteld had not. She was one of the first people Magteld told about having ‘secondaries’. As the boys played on the swings in Kelvingrove Park, Claudia recalled that conversation. ‘She just accepted it,’ was her assessment. There was no wailing, no bitterness, no metaphorical rending of clothes. Bitterness and regret were left to others, like me. Magteld was entirely focused on wringing the minutes from the days. She resolutely declined to learn any further details of her prognosis; she studied her treatment with a microscopic gaze but didn’t care to speculate about how long she had left. Death was lurking beneath the window; it could wait a while yet.
In that moment of diagnosis, Magteld entered what the political strategist Philip Gould called the ‘death phase’. Gould died in November 2011, three months after receiving his own terminal diagnosis, something he accepted with intimidating clarity. ‘The moment you enter the death phase it is a different place,’ he said in an interview.* ‘It’s more intense, more extraordinary, much more powerful.’ That is what I think Magteld must have experienced. Life acquired a violent sense of urgency. Most of the time mortality is a vague hum in the background that we only occasionally notice, but in the ears of the dying it rises to a scream. She drew up plans like an architect given a day to build a cathedral. What caught me off guard was the lack of panic. Her urgency was focused, not frantic. It was simply now or never.
She liked to tell a story she had heard of a man whose doctor told him he only had three months to live. ‘When he heard that,’ she said, ‘he looked up from his newspaper and smiled.’ The man had been told the same thing, ten years earlier, and was still breathing unimpeded. It wasn’t that he thought himself invincible, she explained, but the first experience had cured him of the mania for trying to second-guess fate.
There were regrets, but not for a lost life. ‘The thought of not seeing my boys when they become grown men hurts the most,’ she wrote. She felt guilt at abandoning the children when the job of raising them, which had consumed her last decade, was still half-finished. She had to trust me to take up the responsibility of caring for them single-handed, in her country. The life we planned was in ruins; all we could do was build another one from the rubble.
I understood, now, why she had resisted seeing the doctor about her cough. Though it tormented me at the time, I cannot condemn her for it. She dismissed my entreaties with that flint-like gaze she had sharpened in her dealings with council officials. She hid her fear with the determination of an alcoholic stashing whisky bottles. But there was a logic in wanting to delay the inevitable. She had no desire to spend hours sitting in the doctor’s surgery and weeks waiting for test results while her nerves turned to soup. Who would choose to stare into the abyss when a new branch of life is hanging above their heads, bursting with succulent fruit?
The first time we sat down with the boys to talk about cancer the bad news had been wrapped in the protective membrane of hope. The medicine that was going to make mummy very sick would also make her better. This time there was no redeeming balance, no fig leaf, no consolation. She would not be there to watch them grow up, or cycle with them to school, or join them on camping holidays, or share all the other quirks of Dutch life that we had written into our mythical future. All these dreams would rust away like wrecks on the seabed.
So we sat around the kitchen table, just as we had eighteen months before. Magteld talked about her treatment, and then explained that the doctors hadn’t been able to cure her. To me her voice seemed eerily calm and firm, because I still didn’t understand that she was in the death phase now. Adam, however, seemed to grasp this. When Magteld told them she wouldn’t be there for them later, he replied simply, ‘But you’re here now, Mum.’ He was eight and a half. I, more than four times older, was uselessly raging at the injustice of the universe.
Euan offered no visible response at first. But a few days later he went up to Magteld, buried his face in her shoulder and cried silently, leaning into her, yielding to his grief.
Calling off her trip to The Hague was unthinkable. Our house was sold, and we needed to find a new one. Flights had been booked, viewings arranged. Magteld was even more determined than before to see her sisters, especially Marlies, who was eight months pregnant. Life simply had to go on. Moving to Holland was a show of defiance against cancer. What we were supposed to do once we were there, and she was gone, was a question I mostly ignored.
It is the ghastly privilege of the dying to live in a kind of exalted present. As Dennis Potter remarked in his famous TV interview: ‘The nowness of everything is absolutely wondrous.’ Erasing yourself from the future is wretched, but all the worries about later life – what will happen with my career, have I saved enough for my pension, who will care for me when I am old – suddenly evaporate. You worry not for yourself but for
the people you will leave behind. Gordon Aikman, who was diagnosed with Motor Neurone Disease in his late twenties and became a passionate fundraiser, wrote in The Scotsman: ‘I have experienced immense pain, but far greater happiness. Dying has taught me how to live.’ I’m not sure what use these lessons are to us when we are held captive by the delusion of endless time, but they suggest that our last days will not be as riddled with fear as we tend to think.
As the date of her flight drew nearer, Magteld’s cough became worse. Just a few weeks earlier she had bought a running magazine as motivation to start training again in the spring. Now a short walk left her gasping for breath. At the airport she clung to my arm, like a caricature of a doddering grandmother, as I steered her towards the wheelchair we had booked in advance. It was our first experience of the logistical puzzle that travelling becomes when you’re disabled.
With the help of a wheelchair, procured by Sanneke, Magteld viewed four houses in The Hague, two of which she swiftly discounted because of their location or condition. I realised we were becoming the pernickety buyers we had cursed when our own house was up for sale. But we had new concerns: Magteld had to consider that she would soon be unable to climb stairs.
It came down to a choice of two. Both in the same neighbourhood, both with bedrooms on the ground floor. Magteld had her sights locked on an appartement met tussenbouw – a curious construction that was essentially a ground-floor flat with a garden, but with two upstairs bedrooms, stacked one above the other, up a staircase off the main hall. The courtyard garden was lined with mature trees and the main rooms had high ceilings reminiscent of Glasgow’s tenements, creating a sense of light and space. It was close to Adam’s school and just over a mile from the beach.
All the Time We Thought We Had Page 9