From Bray to Eternity

by Andy Halpin

  Annette wrote, “Orla (a member of Dr. Kinsella’s team) examined me the night before and said my airway was open. I need my voice, I was not expecting this. Tynan is supposed to be very good, maybe when they looked inside it was different. Did he say anything else?”

  I did not tell her the rest of what he had said. I told her that I hoped to see Dr Kinsella later and maybe he would be able to tell us more. Another effect of the trachie was that Annette could not eat or drink through her mouth. They had fitted a peg in her stomach through which food and water would be given to her. It was also impossible for her to lie flat on her back or on her side. She had to sit upright in the bed so she could breathe through the tube in her neck. In the space of one day a huge emotional burden had been inflicted on Annette, a woman who loved to talk and sing was now rendered speechless, though not voiceless. She used the note pad to express her needs and views as strongly as ever.

  Later when she was given a plastic voice box, she did her best to master it. It was great to hear sounds coming from her mouth again. As soon as Annette was recovered sufficiently from her operation she went around the other wards in Private Two, blessing people with a Padre Pio relic a friend had sent her. Despite her own difficulties she was still concerned about others.

  This is not an easy time to recall or write about. Indeed a lot of what happened immediately after Annette had her trachie operation is very hazy now. It was an appalling time for all the family, to see a once vibrant and loving person reduced to a shell of her former self and unable to speak. In truth, I can’t distinguish one day from another during this period. I went to the hospital every morning, staying until nine or ten every night. Then I went home to a cold, empty house in the worst winter I can ever remember. The snow seemed to never be going to thaw. For weeks on end, I trudged home from the Luas through the ice. I had a quick cup of coffee and something to eat and went to bed in a back bedroom, amid the dust and rubble of a building site. During this time we were getting the two front bedrooms converted into one. We had been told that when Annette did come home we would need room for all her feeding equipment and medication and also just to give her more space and comfort. We had moved into a front bedroom from the big back bedroom many years before when all the children were at home. We had divided the large bedroom so that they would have a bedroom each. We had always intended to reconvert the back bedroom or to enlarge the front bedroom over the years, but we had always spent the money on travel or some other luxury and continued to sleep in the small front room. It was no hardship to do this as the front room was cosy, with a view of the mountains and very conducive to intimacy. We spent many happy years in that little room and filled it with love. I sleep in the “new” big bedroom alone now, but I just cannot feel it was ever “our” bedroom.

  When I did speak to Dr. Kinsella a day or so later he was more positive than Dr. Tynan had been, and felt it was possible to operate. He said all the scans taken so far indicated that the cancer was confined to the throat and had not spread elsewhere. This was a bit of good news amid all the despondency we now felt. He also said the chances of complete success were very slim because of the size of the cancer, but he felt it was possible that he could prolong Annette’s life. He said that as long as the cancer had not spread he would operate on Annette to remove the tumour from her throat. To be sure this was the case he said he would make arrangements for Annette to have a “PET scan in Blackrock Clinic. If this was clear he would operate as soon as Annette had recovered from the trachie operation which he assured us had been necessary.

  During this time Annette was visited by other medical people and members of Dr. Kinsella’s team. Arrangements were made by the speech therapist for a lady who had had a similar operation fifteen years previously to come in and talk to Annette about what to expect after it. We were all very encouraged by this lady’s visit. She was able to speak quite well with the aid of a stoma in her throat. She was leading a perfectly normal life, including working in a job where she had to use her voice. Annette took great heart from the visit, and provided the PET scan was clear, felt she could cope just as well after her operation.

  A few days later Annette went to Blackrock Clinic for her scan. For two days we all held our breath as we awaited the result which we hoped would allow her to have the operation. As soon as the doctors told her the good news, that the cancer was confined to her throat, she sent me a text. I’m writing it down exactly as I got it, ‘docors around pet scan clear surgery for tuesday love xx’

  I later spoke to Dr. Kinsella who said the scan had confirmed that the cancer was localised in the throat and that subject to a bed being available in the intensive care unit the operation was to go ahead on Tuesday, 20th January.

  I continued to visit Annette each day and we were very positive that the operation would be a success. Apart from the difficulty she had talking, Annette was feeling fine. She had recovered well from the trachie operation and was up and about. She loved going for a walk around the hospital. When the grandchildren were brought in she was always concerned about them visiting the ward as she was afraid they might contract something so she always insisted on meeting them in the cafe. She loved to see Senan, Ella and Mina, but she was sad that Senan, who was four, seemed to be afraid of her new voice and appearance. The two girls, who were only two years old, were less aware of the difference in Annette and did not react in the same way.

  As the day set for the operation drew near, Annette was visited by the various teams of doctors who would be assisting Dr. Kinsella and each of them explained the part they would play in the operation. All this attention was very encouraging. They all seemed to believe that everything would go as planned and Annette would soon be rid of the cancer. We knew that even if the operation was a success, it would still be a long time before Annette would be back to anything like she was before all this had started. But talking to the various teams of doctors and seeing the confidence they displayed, in turn gave us confidence that things would turn out right.

  The night before the operation we still did not know if the intensive care bed would be available. We were told they would only know that on the morning of the operation, but that everything was going ahead on the assumption that a bed would be available.

  On the morning of the 20th I was in the hospital by eight o’clock. I sat with Annette until we got word, at about ten o’clock, that a bed was confirmed and the operation was going ahead. It was then all systems go as Annette was prepared for surgery. She was very composed and did not seem to be in the least worried about what was ahead of her. As usual, she had her rosary beads with her and her Miraculous medal was pinned to her gown.

  I went down to the operating theatre with her and stayed with her until the anaesthetist came and took her into the theatre. This was around 11.30 a.m. I can remember it clearly. I kissed her as she was sitting up on the gurney. She was smiling and waving to me as she was taken through the doors of the theatre. I waited until she was gone from view and then left.

  I got the Luas home to wait the seven or eight hours we had been told the operation would take. On the way I rang the family to let them know the operation was underway. That was the start of a very anxious day.

  After I got home I listened to the radio for a while. It was Inauguration Day in America so there was plenty to listen to. It was good to be distracted from the thoughts that were in my mind. Later that day Gina and Robert came over. We were all looking at the Inauguration on the TV at about 5.45 p.m. when the phone rang. It was the hospital. They wanted us to come down as soon as possible. The person on the phone would not give us any information about Annette, just asked us to come down as soon as we could.

  I knew at once this was not going to be good news. We went straight away. When we reached the hospital we went directly up to Private Two. We were met by a nurse who brought us to a waiting room and told us Dr. Kinsella would be with us soon. We did not say very much to each other. We were all caught up in our own thoughts and afr
aid to express them.

  After a few minutes Dr. Kinsella arrived and the expression on his face said it all. I thought Annette had died during the operation. He sat down and seemed to be gathering his thoughts, working out what he was going to say to us.

  We remained silent and waited for him to speak. “I’m afraid it’s not good news,” he said.

  There was an audible gasp and I immediately asked, “Is she dead?” Dr. Kinsella replied, “No, she’s still in the theatre, but I’m afraid the operation was not a success.” He then went on to explain that five hours into the operation he had discovered that the cancer was in the oesophagus. There was no way of operating there. He had removed some of the tumour in her neck but he said he could not cure Annette. The operation had to be abandoned. Annette was being moved to the intensive care unit and we could see her there later.

  After more talk and discussion I asked Dr. Kinsella how much time Annette had left. He said he would be surprised if she was alive by Christmas.

  This was shocking news for us. Despite all we had been told we had never contemplated Annette dying. We just did not think of it at all. I for one had been convinced that Annette would beat the cancer. She had not seemed sick at all. Even going into the operating theatre she had been sitting up and smiling, with seemingly not a care in the world. Hearing what Dr. Kinsella had just said was shattering news.

  The doctor tried to console us by saying that everything possible would be done for Annette. He toned down his assessment that Annette would be dead by Christmas, saying that was only his opinion and he had been wrong in the past. Someone, I don’t know who, phoned David with the bad news.

  After Dr. Kinsella left we made our way to the intensive care unit and waited to be allowed to see her. When we were admitted into the ward we were completely unprepared for the condition she was in. I knew Annette had to be cut in the neck but I was appalled when I saw the extent of the wound. She had been cut from ear to ear, as if her neck had been slashed open. A semi-circle of staple like stitches was visible, like a necklace around her neck.

  Annette was unconscious, still under the effect of the anaesthetic. She was not aware we were there. We stayed for a while and then spoke to a nurse who told us she would be like that for the rest of the night.

  I honestly do not remember going home that night but I know we did.

  CHAPTER TWENTY SEVEN

  The next few days are just a haze. I do not remember much about them at all. I remember being with Annette after she was released from Intensive Care into the High Dependency Unit. At this point she was fully conscious but she did not know that the operation had been unsuccessful.

  She was released from High Dependency after a day and was back in Private Two. She continued to make a rapid recovery from the operation. The family spoke about the situation, and what we should do about telling Annette that the operation had not removed all the cancer. We had a meeting with Dr. Kinsella where he explained that Annette, as a fully comprehending adult was entitled to know the truth about the operation and he was obliged to tell her. After a very helpful discussion Dr. Kinsella said that he believed Annette would benefit from radiotherapy and chemotherapy and, while he did not believe this treatment would cure the cancer, it could prolong her life. This treatment would be carried out at St. Luke’s Hospital. Dr. Kinsella said he would speak to his colleagues about this course of action.

  Annette seemed to be getting stronger all the time and it was hard to take on board what Dr. Kinsella was telling us. She was coping very well with the situation though she was finding it hard to sleep in an upright position. We somehow managed not to mention how the operation had gone and I continually told her she was going to get better.

  We had agreed at the meeting that we would accompany Dr. Kinsella when he told Annette about the operation. He also agreed with my suggestion that he would not mention the word “terminal” or say anything about the length of time Annette had left. The day Dr. Kinsella was to tell Annette the operation had failed was finally upon us and we were dreading it.

  I did not know how Annette would react to this awful news as I had never stopped telling her how much I believed she was getting better. Whether this was the right thing to do or not I just did not know. I wanted to boost her spirits and not be moping around her with a glum face. Maybe I believed that if Annette saw how confident we were she would get better again, that this belief would actually make her better. In the situation we were in you tend to grasp at anything.

  I had arranged to meet Gina, David and Robert at the hospital cafe on the day we were due to meet Dr. Kinsella. When Dr. Kinsella was ready, we would all go with him to see Annette. We were waiting for him in the cafe but as he approached our table he did not look happy. He sat down and said there had been a hitch in the plans. Prof. Hollywood who was attached to St. Luke’s Hospital had, unknown to Dr. Kinsella, visited Annette that morning. He had told her about the operation and the plans to treat her in St. Luke’s. To say that we were annoyed is putting it mildly. We had wanted to be with Annette when she was told this news so we could support and console her. We also did not know just what or how much Prof. Hollywood had told Annette. Everyone, including the nurses on the ward, was very annoyed by this development.

  When we went to see Annette we did not know what to expect or what her reaction to the news would be. We entered Annette’s room in trepidation but she was as composed as could be, sitting up in the bed smiling and looking great.

  I said, “I heard Prof. Hollywood has been to see you.”

  Annette, “Yes he told me about the operation not being a success, they did not get all the cancer.”

  Me, “But they are going to send you to St. Luke’s for more treatment and they’ll get it there.”

  Annette, “I don’t know if I’ll be able for that.”

  Me, “Of course you will. Look at how quickly you’ve recovered from that major operation and the scar on your neck is healing very quickly as well. You’ll be fine, you’re going to beat this.”

  We told Annette that we had hoped to tell her ourselves and we did not know that Prof. Hollywood was going to see her. Annette did not seem to be upset about the news. She said that he had explained that the tumour was much bigger than they’d thought and it had spread to her oesophagus. He’d told her it was not possible to operate there. She seemed to know everything Dr. Kinsella was going to tell her. But we did not know if she knew that the cancer was incurable and terminal and we were afraid to ask.

  Annette made great progress from the operation and most of the time was in good form. From time to time, but not very often she did get a bit down and asked how she had got this cancer. I never said anything to her about what Dr. Kinsella had told us about the cancer being incurable and that he did not expect her to live until Christmas. I was always positive and continually told Annette she was going to get better. I wanted this to be true and for her to remain optimistic. I wanted her to see that we were positive about her recovering as well.

  It was very distressing to see her struggling to speak. For Annette this must have been a very frightening experience as she loved to talk and express her opinions. She used a copy book to write her questions and answers to us and her visitors. A horrible side effect of the tracheostomy was that from time to time mucus would block the tube in her neck. This would cause Annette to have difficulty in breathing. If she could not cough the mucus up she would have to be “suctioned” by a nurse. This meant that a thin tube would be inserted into the larger tube protruding from Annette’s neck and the mucus would be drawn up and out of Annette’s system, with the help of a machine. This allowed her to breath normally again. It was a truly horrible procedure and one we would have to learn to do ourselves when Annette was sent home. Another cause of pain and distress was the “peg” that had been inserted into her stomach to feed her from a bottle and to give her liquids from a syringe. This was heartbreaking to see, and Annette often said how much she would love a glass of water.


  In spite of all these handicaps Annette recovered well from her operation. Within a week or so she was up and walking around and we used venture to the main door of the hospital and look out at the real world beyond the hospital gates.

  By St. Valentine’s Day Annette was getting ready to go home. I brought her up a bouquet of balloons which said “I love you,” a card and a candle holder engraved with expressions of love. It was to be our last Valentine’s Day together. Annette gave me a card and a box of Roses’ sweets. Arrangements had been made for her to have seven weeks of treatment in St Luke’s. We were hoping it would start in early March. She had been to St. Luke’s to be assessed by Prof. Hollywood and his team. She had also been fitted out with a face mask she would have to wear while having radiation treatment on her neck. There was nothing more the hospital or Dr. Kinsella could do for Annette now. Arrangements were made with the relevant people for supplies of food, syringes, a suction machine and other necessary medication to be delivered to our home in Tallaght and Annette was allowed home.

  On 20th February, exactly one month after her operation, Annette was released from St. James’s Hospital and she came home to her new and bigger bedroom, which had been made by taking down the partition wall and making one large room out of the two smaller rooms. Annette loved the new room with its views of the snow-covered mountains and we positioned the bed facing the windows. There was plenty of space for all the food and other equipment Annette now needed.

  I cried when I saw the room being filled with all the medication. It was no longer our bedroom, the little cosy room where we had enjoyed such happy times and made passionate love so often in the past. It was now a hospital ward. Even today, so many months after those terrible events I still cannot think of it as “our” bedroom. We never made love in this room.