The second patient to whom I will refer here was a 60 year old woman who upon entering my room deliberately and painstakingly placed her chair less than three feet away from mine. There she sat, at first bolt upright in a somewhat formidable pose, though clearly very tense and ill at ease. She related her ‘story’ with fluency and at an astonishing pace. Apparently a few weeks earlier she had routinely presented for mammogram. However, on this occasion the discovery of apparent abnormalities had led to referral to the Breast Clinic and, beyond that, to a diagnosis of breast cancer. A Consultant Breast Surgeon had seen her promptly recommending early surgery to remove her right breast. At the same time he had referred her on to me.

From her initial and – as it seemed to me – well rehearsed account (the rising tide of which I had made no attempt at any point to stem) I also came to learn something about her as a person. It seemed that she was (in the Lanarkshire area of Scotland where I worked and we lived at that time as a family) regarded as, “A pillar of the Kirk” and one of those local society stalwarts, who clearly possesses a penchant for motivating and mobilizing action groups and the like within the community. She was at pains to stress that she had “Never smoked or drunk alcohol, even socially” and had lived, as again she referred to it, “A fairly exemplary life”.

She ended her account somewhat abruptly and I allowed the ensuing silence to linger for several seconds before gently enquiring, “And so…how are you…really?” In an instant the well-rehearsed (if by now laboured) composure vanished like ‘snow off a dyke’. Broken and becoming increasingly distraught by the minute, she cried through her tears, “After all I’ve tried to do…you know, to live a decent life…why? Why should this happen to me?”

Here, then, together with the contents of my most recent posting are, might I suggest, two fairly typical responses to really bad news, whether it concerns illness in oneself or a valued and rated other; or loss of a loved one or dear friend, especially by death. Quite possibly you have already noted their similarities, as well as their distinguishing features. They both articulate the same question, “Why me?” However, whereas the first appears to have at least fastened on to a response, which is not entirely pointless, the other is unable to find consolation of whatever nature. Indeed, she required a great deal of continuing support and encouragement to enable her to move on from what could of itself only ever be a sterile and irresolvable quest.