In my own experience of cancer patients and their families, the real and troubling issues which concern them most about chemotherapy is ‘how can I know that it is really working?’ and ‘why – with treatment, which is presumably being given to cure or at any rate control my tumour – does it invariably seem to make me feel so unwell?’ It is my intention to deal with these questions in detail in my next item of correspondence to you.  However, I will close this one on a possibly somewhat different but decidedly related note.

As all of us who have been involved in the cancer treatment scene well know, sound and well-researched literature of high quality abounds.  Here then, is a “cautionary tale” for author and reader alike, which proves the truth and wisdom contained in the saying of an old mentor in English Literature of mine, now long gone, namely, “any volume, however celebrated or prestigious, remains just that, a book, until it is read and inwardly digested”.

Writing as one who has worked for many years in oncology clinics and wards and who has not infrequently been in the company of colleagues and patients – sometimes from first thing in the morning until late in the evening – I know that in the vast majority of cases, every effort is taken to inform patients about treatment intentions and expectations. Indeed, I have witnessed such accounts being repeated and yet further explained, sometimes by the same, at others by different staff members several times in the one-day. However, stress and anxiety plays tricks on all of us from time to time. Consequently, those who work with patients at the “muck and bullets” end of encounter must always be vigilant and attentive to such aberrations in otherwise perfectly normal and often highly intelligent individuals.

The experience which I am about to relate took place on a ward just as the evening visiting hour was drawing to its close.  I can still see in my mind’s eye one extremely irate and distraught patient, vehemently making her point from her hospital bed and frantically waving a piece of paper, which she had picked up from her locker nearby. As I approached she, in a moment of uncontrolled fury, threw it in my face. An hour later – the anger, frustration and sobbing now having subsided – (more out of exhaustion than in response to my ministrations) I sat down on the bed beside her, having earlier picked up the pamphlet, which I had returned to her locker.

Filled with evident remorse and embarrassment, she now rested her hand on mine, apologising profusely for what had admittedly been, a quite uncharacteristic outburst.  She said, “It’s a good job it wasn’t a milk jug to hand, rather than that pamphlet”. I asked her what the leaflet was about but she had no idea.  Rather had it been, I suspect, the first thing to hand. In reality, it was a pamphlet and fact sheet, which had just been released from within the department (and which I had had a hand in composing) containing what at that time were regarded as “state of the art” answers, in fact to several of the very questions that she had just been raising.

We need to remember that reading and concentrating on written text is not a strong point with any of us when feeling disturbed, angry and misunderstood.  Moreover – and as later she herself so lucidly put it – “When I am feeling better, I just want to forget everything about hospitals and treatment and get on with life”. It all sounded reasonable enough to me. Perhaps you too will be familiar with a saying, which I often heard around the homestead as a child; “There’s none so deaf as them that will not hear”.  In this instance of course, it is not so much a case of “will not” as “cannot”.  More often than not, such words of wisdom and intended advice fall on ‘deaf ears’; and the reason? It is because beyond certain levels of tolerance, people who are stressed and grieving what they have lost, go decidedly “deaf”, if you see what I mean.