‘Chris is having his scans?’ Michael asked.
‘Yes,’ she said. ‘Michael, can he be cured?’
Again he looked into her eyes with a compassion that said he wished it were not so, but an unflinching gaze that said he could not alter reality. ‘No, Gail.’
She looked across Missenden Road and into the distance. ‘But . . . but he’s so magnificent,’ she said, partly to herself.
‘Yes, he is. He is magnificent.’
She looked back at him. Their eyes filled with tears.
The next day Gail and Chris went to Professor Besser’s rooms. He put the scans up on a screen so the light behind shone through and illuminated images of Chris’s brain. It showed a tumour about three centimetres in diameter lying slightly above and behind his right ear. Close by were two smaller nodules known as satellite tumours.
Chris said what Gail wanted to hear. ‘I know this tumour has a bad reputation but I want you to do your best to fix me. I want to be cured.’
‘Chris, I can operate on you but you won’t be cured, not with those satellites there.’
Chris instantly revised his wish: ‘I’d really just like to get next year.’ James would turn eighteen and sit for his Higher School Certificate.
‘You will get next year,’ Michael said. Then later he volunteered, ‘If you want to, you could get a second opinion.’ They said they didn’t want to. They trusted him implicitly.
Chris knew enough about glioblastoma multiforme, which has one of the worst survival rates among all human cancers. Its malignancy comes from its tendency to spread its cells aggressively like a spider’s web, planting more satellite tumours around itself; this web-like formation makes it impossible to completely extract and it is near inevitably lethal. The median survival time after diagnosis is in the range of twelve months. Patients who live more than three years are considered long-term survivors.
‘What a thing to get,’ Chris said in disbelief.
‘It’s not a bad way to go,’ Michael offered. Not surprisingly, Chris didn’t find this reassuring at all.
Michael Besser explained that Chris would need to continue taking medication to keep the cranial swelling at bay, as well as anti-seizure medication. Chris would never be able to drive again. To preserve his quality of life, Professor Besser would not seek to remove the entire tumour in the operation; he would remove the main mass, but the satellites would remain. As they made their way through the corridors, lifts and car park, my mother quietly sobbed. He was fifty-four years old and she fifty-two. How transient our happiness had been.
That night, they lay together in each other’s arms.
‘Tough week,’ Chris stated.
‘We just have to grind through this. That’s all we can do.’
Brain Surgery
Dad looked cosy in a navy blue jumper on the day he was to undergo brain surgery on 30 November 2006 — five days after his diagnosis in emergency. James was at school and Adam had returned to Goulburn. The roads were quiet as Dad, Mum and I drove to the hospital at seven o’clock. On previous early morning drives with Dad, he would flick between radio stations in order to capture a cross-section of news and opinions of the day. (Even the way he listened to the radio was efficient.) But on this day he didn’t turn the radio on. We listened to the hum of the engine as Mum on autopilot guided the car towards Royal Prince Alfred Hospital.
The perioperative room was small and dark. I could see that the nurse’s light-hearted chatter tired Gail, but she smiled and politely responded to questions. When we were left alone, Chris sat on the edge of the bed, closed his eyes and breathed deeply and rhythmically.
‘Hello!’ Dr Anthony Durrell, a psychiatrist a few years my father’s junior at medical school, appeared in the doorway. Wearing a straw fedora and holding a long, painted canvas in front of him, he was not someone we expected to see in this place and moment. Dad seemed pleased by the distraction.
‘I thought I’d come and catch you. I brought this.’ He held up the painting, which was his own work. It showed a vibrant pattern of colours, depicting four quadrants. As he explained how the quadrants represented moods of fear, anger, sadness and happiness, I looked at my mother. She seemed oblivious to the conversation and was looking down at her hands holding Dad’s phone and watch.
It wasn’t long before Dad was lying on the trolley that would take him into surgery. Wearing a hospital gown and with his hair under a cap, he pulled Gail close as she blinked back tears. He caressed her cheek, then mine, smiled at us both, and was wheeled away.
‘I don’t know how anyone does this with television cameras watching,’ Mum said as we trudged upstairs to the café. She was referring to all the RPA patients who had agreed to let Channel 9 cameras film them during these moments. We took a table outside where the air was warm and fragrant with the smell of jacarandas. Mum looked depleted but appeared to be holding up. She walked to the counter to buy coffees. When she got back to the table, she found me bawling and her strength seeped away. She hugged me close to her chest and sat on the chair beside me. The tears streamed down her face like rain on a window. Over the coming years, my mother’s strong exterior would often be overpowered by the sight of one of her children crying. ‘I need to go to uni to finish a group assignment,’ I eventually told her, and she agreed that it would be easier if we were not together. Gail drove down to the southern suburb of Caringbah and spent the morning at her parents’ house. Being with her mother and father, she felt lighter and cheerier. When Dr Besser rang to say that the surgery had gone very well, she was elated. Adam, James and I breathed sighs of relief as she relayed the report to each of us over the phone. We didn’t know what the future held but at least it was hopeful in a momentary way.
When I returned to the neurosurgical intensive care unit, Mum and James were already there. Dad was propped up in bed with a white bandage wrapped around his head. He gulped down two cartons of cold chocolate milk through a straw as Mum held them for him. Later, he ate tasty salt and pepper prawns that James and I had gone out and bought.
After taking a long sip of the cold, sweet milk, he leaned his head back and closed his eyes. ‘Why did you get this brain tumour, Dad?’ James asked.
‘Being completely overworked,’ Mum said. ‘That’s what did this to him.’
Dad smiled without opening his eyes. He said, ‘In the main hospital foyer downstairs, there’s a stained-glass window with the inscription, Mortalibus non arduum. Hard work never killed anyone.’
Chris’s mobile phone rang and Gail answered it for him. She covered the receiver. ‘It’s Frank Sartor. He wants to know how you are.’ Sartor was the New South Wales assistant minister for health (cancer) by that stage, and he and Dad had come to know and like each other. ‘Tell Frank I’m going into politics now I’ve only got half a brain,’ Chris said from his pillow. Frank’s laugh cracked through the phone’s speaker. We heard him say, ‘We need you, Chris.’ Mum laughed too; Dad seemed so well.
James reminded us that RPA was on television that night. Dad was likely to be on it, having been filmed recently treating a young woman for a benign tumour in her neck. We turned it on and increased the volume on the patient audio handset to maximum. If we all gathered around it at the head of the bed, we could just make out the tinny sound coming out of the speaker. There we were crowding around Dad as he lay on a hospital bed in RPA with his head extravagantly bandaged, watching him in his familiar role as surgeon in the same institution. At the end of the program the familiar voice of Max Cullen announced that Professor Chris O’Brien had been diagnosed with a brain tumour and had undergone surgery earlier that day. ‘We wish him well with his treatment,’ he added. We were later told that this announcement had prompted the hospital switchboards to light up as viewers rang to ask if they’d heard the announcement correctly, and to convey their shock and concern. We could see how completely he had captured people’s hearts and attention. This was the first step in his journey becoming public.
; We stayed together for a while longer with Dad resting his head against the pillow. Mum asked whether he was warm enough and arranged his pyjamas, phone, toiletries and other belongings in the cupboard and on the bedside table. I perched on the edge of the bed.
Dad started to tell us the story about when James was born. ‘You know, when Jamie was so sick, and it didn’t look like he was going to survive, Carmel came with me to mass just up the road here,’ he said. ‘We went in and I looked up. There was a big banner hanging at the front with gold letters.’ His eyes looked beyond me and his hand glided through the air. ‘It said “He Lives.” His voice cracked and his face crumpled and he wept ever so briefly. Adam, James and I had never heard this story before. How potent the memory must have been for it to stir this emotion in my father at this moment.
Dad stayed in hospital for three days, while a parade of people shuffled through the door to his room. When we were there we wheeled him outside for fresh air. As he sat in a wheelchair, wearing his pyjamas, he closed his eyes and offered his face to the warm sunshine and gentle breeze.
Back at home, my mother was wrestling with the practical implications of Dad’s diagnosis. She decided to contract everything. Rein it all in. It was as if we were expecting a blizzard and needed to bring everything inside. She cancelled credit cards and talked about getting rid of one or two cars; the family had four at the time. The study was swamped with paperwork as she tracked our outgoings: leases, bills, James’s school fees, a weekly gardener and cleaner. Then there were Chris’s consulting rooms with rent, staff, insurance, other bills. The phone rang constantly and people were forever knocking on the door. It was the beginning of a tidal wave of love and support that would sustain us for years to come, but life was busy and chaotic.
I escaped the frenzy at home by spending as much time at the hospital as I could. I was lucky to have been able to clear my days, with university over and the flexibility to rearrange shifts at my casual jobs. James had one more week of school term, and Adam’s training in Goulburn only allowed for a short break over Christmas as he worked towards graduation only a few months away. On those hot December days, I sat by Dad in his cool, dim room. I enjoyed the quiet moments when they came, listening to Dad’s deep, rhythmic breathing as he napped, attempting the Herald crossword and watching the Australian cricket team wallop the Poms. I had found myself a still and peaceful place that offered nourishment, which my mother could not afford to seek. I knew little of the torrent of problems that raced through her mind day and night.
Dad was eager to come home. He couldn’t rest well in hospital and the one time he had managed to fall into a deep sleep he was woken by a nurse concerned by his heart rate slowing down to forty beats per minute, when, in fact, that was the resting rate of his big, strong heart.
When Dad was to be brought home, I felt frustrated with my mother as I peered through the study doorway and found her sitting in front of the computer. ‘Mum, what are you doing?’
She looked over her shoulder, tired and frowning. ‘I’m just trying to put the Volvo up for sale.’
‘Why do you have to do that now?’
She sighed loudly, ‘I just need to get some things done before he gets home.’
‘We can do that later, Mum, Dad’s waiting for us.’
She stood up and walked past me. ‘All right, let’s just go.’
We double-parked in a small lot in front of the hospital and followed the corridors to intensive care. Dad was dressed, packed and ready to leave. I knew he would be annoyed at having had to wait so long, and he was.
‘I thought you were coming this morning.’
‘Christie, it has been frantic with the phone ringing and people everywhere. I’ve had so much to do.’
For the first time his wound wasn’t covered. It was a long gash about ten centimetres on the right side of his head with more than a dozen black staples pulling the skin tautly together. We carried his bag to the car and drove home in silence.
The second night he was home, Gail woke to find Chris in a highly agitated state. Anxiety combined with steroid-induced hyperactivity was making his mind a chaotic whirlpool of dark thoughts and fears. They went downstairs, sat in the study and discussed Gail’s future life as a widow. She said she couldn’t and wouldn’t go on, and cried floods of desperate tears. Chris shed some of his own. For almost thirty years they had been together in everything and now they were together facing something that was bigger than both of them.
Then, as Dad would describe it, they slowly fought their way to the front of this runaway train, trying to grasp the controls and at least bring some certainty to their domestic circumstances. They wanted control and control meant maths. They calculated Chris’s superannuation and the insurance payments. The business expense insurance wasn’t enough to cover the ongoing costs of the practice. That could be supplemented with the income protection insurance, but they still had to pay the mortgage as well as myriad other costs. Gail said she could return to practising as a physiotherapist. But it seemed unavoidable that we would have to sell our home. She suggested that they inspect a smaller house for sale nearby. The unspoken rationale was that it would be a more appropriate size to accommodate Gail as a widow.
The next morning, Gail called the estate agent and arranged an immediate inspection of the neighbour’s house. They walked through the small, pretty rooms, envisaging their own furniture, paintings and belongings in them. It was being rented by two teenage schoolboys who went to Riverview, the private school that Adam had attended and James still did. The pair recognised Chris and Gail.
‘G’day, boys,’ Chris said casually. Gail was conscious of the large gash and sutures on the side of Chris’s head with the surrounding hair shaved. She thought she saw one of the boys eye the wound and felt awkward; here was a senior surgeon inspecting a house that two teenagers were living in. The image Chris and Gail presented to the outside world was being transformed.
Finding Hope
The post-surgical plan was for Chris to begin radiotherapy and chemotherapy concurrently. The chemo would be taken orally first thing in the morning on an empty stomach. The radiotherapy would involve his head being fitted into a fibreglass mask bolted to a treatment table so he would be completely immobilised, allowing the radiation machine to target the tumour with pinpoint precision. The mask needed to be moulded to the shape of his face and head, and an appointment was scheduled at radiation oncology in the first week of December.
On a sunny midweek morning, Gail parked her car outside the building where she had spent much of her final two years of physio study. The radiation oncology unit was lively and bustling with staff and patients. Professor Chris Milross, the head of the department and close friend of my parents, greeted them with characteristic warmth but unfamiliar concern. The three of them chatted about the diagnosis quietly, before he summed it up. ‘Fuck,’ he exhaled.
Dr George Hruby, a senior radiation oncologist, took Chris and Gail into a separate room for the consultation. After discussing the treatment plan, George looked Chris straight in the eyes. ‘We’re going to go after this, Chris,’ he said. This attitude was reinforced by Professor Brian McCaughan. A cardiothoracic surgeon at RPA and long-time friend, Brian listened as Chris told him about the previous days and the poor prognosis he had been handed. ‘Well, that’s all bullshit and you know it,’ Brian asserted. ‘Patients decide how long they will live, you know that. Doctors don’t decide how long patients have. We’ve both made that mistake. You just have to decide that you are going to fight this and prove them all wrong.’
For my parents, the impact of these words and attitudes was almost immediate. How powerful positive reinforcement can be. Absolutely nothing had changed about the circumstances or Chris’s prognosis. Yet George Hruby’s and Brian McCaughan’s defiance and encouragement were compelling. It was as if Chris and Gail had just swallowed a pill that helped them to think clearly and optimistically.
Later, Noelene visited with detail
s of how the insurance and finance safety nets would work. The good news was that the income protection would indeed allow us to keep the house.
The tide of desperation was rolling back. What they now needed was deep, restful sleep and more than a week after the operation and more than two weeks after the diagnosis, they finally managed to get that. The healing and nurturing effects of sleep worked to buoy their spirits and thoughts.
Invariably, the medical literature about glioblastoma multiforme contains a terrifying graph that depicts patient survival rates. Along the y-axis is the number of patients still alive, and along the x-axis is time. As the curve moves from left to right, it plunges from high to low. It sweeps through milestones — three months since diagnosis, six months, one year, two years — falling towards the x-axis and illustrating fewer and fewer survivors. The curve falls to a place just above the straight black line. But it never quite reaches it. A small gap remains between the curve and the axis. This is where hope lives.
Against all the odds, Christmas 2006 was one of our most joyous. For as long as I remember we have spent Christmas Eve with my father’s side of the family. This year we were joined by Mum’s parents and a wonderfully eclectic group of Dad’s colleagues, his fellow radiotherapy patients and other orphans and blow-ins. Jatin Shah, the leading head and neck surgeon at Memorial Sloan Kettering Cancer Center in New York City, had flown from the USA to spend the afternoon and evening with us. Our neighbour Col Joye, who announces himself on the phone by saying, ‘G’day, sweetheart, Col Joye of the Joy Boys, from down the hill’, regaled us with stories and songs on his ukulele.
The lounge room doors opened onto the lush garden, towering hedges and tinkling fountain. We peeled prawns in the kitchen and drank wine and tea by sprawling wisteria and bougainvillea. overlooking the beautiful river. Mum’s father swam gentle laps in the pool as James back-flipped and bombed into the water around him. Our little old dog, a miniature schnauzer named Mr Menzies because of his bushy eyebrows (Dad’s idea), raced up and down barking at the splashes. Adam, our cousin Matthew and Gareth sat on and stood beside a weathered cane sofa next to the pool. The house was full of people, sound and activity. In the middle of it all was Dad. Wearing just his Speedos and straw hat, he was sprawled on a wooden sun lounge. He smiled at me and raised his cup of tea in one hand and plate of cake in the other. ‘It doesn’t get much better than this,’ he said.
This is Gail Page 6