Carol had survived metastatic breast cancer for seven years – far longer than many. Every time the tumour deposits began to escape control from her current treatment, it seemed the oncologists had another trick up their sleeve. She was lucky: each new drug worked wonders, knocking the cancer right back, buying her precious more years of life. Sometimes they caused nasty side effects, but it was a price she was more than willing to pay.
She kept working as a personal assistant to a local politician. Petite and gregarious, she loved being in the thick of things, knowing what was going on, chatting to all and sundry about intrigues and issues. She would see me periodically to get repeat prescriptions, or to discuss the latest scan. Always she was upbeat, optimistic. She was aware there could be no cure; that her disease would, at some point, catch up with her. But she would talk about the latest research, about novel drugs coming onstream. It must have seemed that if she could just keep running, just keep ahead of the cancer, even more treatment options might become available.
Through all this she was supported by her husband, Ian. Twenty years her senior, he was her polar opposite – tall, taciturn, shy. I wondered sometimes what had brought them together, but some pairings just work: she was the bright butterfly; he the sturdy brown stem on which she rested between her gorgeous, fluttering flights.
Eventually, the inevitable happened: a surveillance scan showed progression of the disease, and the oncologists told her the next drug was the last in the line. Although, like all the rest, it had some effect on the tumour, she began to lose energy. Reluctantly, she gave up her job. I thought this marked the beginning of the end, but she didn’t come to see me for some months and so I assumed she must be keeping reasonably well.
One of my colleagues brought the news to a coffee-time meeting: Ian had made an appointment to see him, heartbroken that Carol had left him. Before long, Carol herself booked into one of my surgeries and turned up with a new man in tow, a tanned chap, also around sixty, with a Scouse accent and blond highlights in his shoulder-length hair. Over the coming weeks the story unfolded: Mark was her childhood sweetheart from Liverpool days. They’d reconnected through social media, arranged to meet up, and found that the old chemistry was still there, as strong as ever.
Carol was energised, effervescent. She and Mark did their best to make up for lost time, holidaying in Greece and Turkey and moving in to a flat together. During one appointment that she attended alone, Carol did express guilt about Ian, but said she felt helpless to do anything but follow her heart.
Our loyalties as a team were painfully divided: it was great to see Carol so full of joy and vigour, but Ian cut a tragic figure, lonely and struggling to rebuild his life following the rejection. And yet, throughout it all, he never spoke ill of her to any of us.
In time, the tumour deposits in Carol’s chest began to progress. She became permanently breathless, and needed repeated drainage of fluid from around her lungs. Her energy dwindled. Then came the news I’d somehow known would come: Mark left her, and was off back up to Liverpool. The honeymoon, in every sense, was over.
Ian welcomed Carol back to their home. It was one of the most humbling experiences of my career, witnessing the quiet dignity with which he forgave her. Despite the pain she had caused him, he saw the affair for what it was: Carol, finally facing death, coping the only way she knew how, desperately drinking of life.
We talked briefly about it after she’d gone, her liver overwhelmed by the advancing cancer. It was something Ian had come to accept, the price he’d had to pay for sharing his life with a beautiful butterfly. To his eternal credit, he remained faithful to her until the very end.
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This article appears in the 20 Jan 2016 issue of the New Statesman, The Middle East's 30 years war