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THE EIGHTH SUMMER – 2018

‘Well, the good news is you’re young,’ said the doctor, as if he was telling them something they didn’t already know.

‘That’s the good news!’ Sophie found herself saying. Tom put a calming hand on her leg.

‘OK, so what’s the plan?’ he asked, so calmly that Sophie wondered whether he’d heard the same diagnosis as she had.

The two doctors glanced at each other. ‘Well,’ said the younger of the pair, ‘well, with stage 4, we tend not to be able to operate.’

Sophie stood up then. ‘NOT operate?’ she cried. She felt hot, white rage coursing around her body. ‘You have to operate. You have to give him a chance. You can’t just give up on him!’

The two doctors regarded her impassively. This, clearly, was just part of an ordinary workday for them. But they didn’t understand! This wasn’t some ordinary patient. This was Tom! And he was absolutely, completely essential to her life.

‘I’m afraid it wouldn’t do any good,’ Dr Sullivan said, his face grave. ‘The cancer has spread.’ He pointed to the CT scan on screen with his biro. ‘We can see traces here in the liver and there’s a possibility it’s migrated elsewhere too.’

‘Then operate there too!’ she said.

She wondered, suddenly, why Tom wasn’t standing up next to her, demanding to be heard. This was the expensive private healthcare his parents raved about – surely they should be able to do anything?

‘Sit down, Sophie.’ Tom didn’t look up at her. His gaze was fixed on his hands, folded neatly on his lap.

‘But Tom… I…’

‘Sit down.’

She sank back into her chair obediently.

Tom looked up then, making eye contact with the doctors. One looked away, the other held his gaze. ‘So, what’s the plan?’ he asked again.

It struck Sophie later that his choice of words were exactly the same as he might have chosen if he were talking about what to watch on Netflix, or planning a holiday itinerary. Innocuous, simple.

The doctors nodded, exchanged infuriating eye contact again, then Dr Sullivan opened a beige folder. ‘So,’ he said, pointing to a printed text with his biro, ‘in these cases where the cancer has been caught quite late and, ahem, spread’– his eyes remained fixed on the paper, he didn’t seem able to look up at Tom – ‘what we aim for is to drive the cancer into remission with chemotherapy.’

Sophie felt something lift. So there was hope! She’d assumed no surgery meant no options.

Tom took a deep breath next to her. She reached over and grabbed his hand, squeezing it firmly.

They sat silently as the doctors mapped out the next twelve weeks of their lives. Appointments and scans and check-ups and chemo sessions and recovery time. Side effects and risks and outcomes and schedules and support. They nodded; two schoolkids being assigned a new timetable with very little say in what would happen and when. Sophie felt Tom’s hand – hot, slightly sweaty. She gave it a squeeze.

The worst of it was that she’d been impatient with him. His tiredness, his nausea. In recent weeks, he hadn’t always wanted sex, even when she’d been ovulating and explained to him the small window they had in which to conceive. She’d noticed that he looked a bit paler than usual, a bit run-down – but had reasoned that she probably looked similar. Teaching was a full-on, full-time job and the constant fact of infertility was weighing heavily on her at all times.

Now this. The feeling that if she’d taken him more seriously more quickly, they might have caught the cancer before it became inoperable. Her rational mind overruled this emotional leap – he was a grown man, quite able to go to the doctor’s any time he saw fit. But she also knew that he would have gone if she’d encouraged him.

Then a thought: ‘What about fertility?’ she found herself blurting out, interrupting Dr Sullivan’s explanation of cold caps and hair loss.

He looked at her. ‘We do recommend that men freeze a quantity of sperm before treatment begins, to make parenthood a possibility in the future,’ he said. ‘At your age, it’s definitely something we’d recommend.’

Tom nodded. ‘So I’ll be infertile, after?’

‘Not necessarily, but treatment can and often does decrease sperm production.’

‘Right, OK.’ Tom looked at her worriedly and she felt a stab of guilt that this was the first time he’d raised his head to look her way. As if he was more worried about this than any other aspect of what they’d just been told. She squeezed his hand again, hoping he’d be reassured. It didn’t matter. Nothing mattered. She just wished she’d realised that before they were on this journey.

The doctor finished his talk and sat looking at them expectantly. ‘If that’s all OK, we could get your first treatment booked in for later this week,’ he said, as if he was a hairdresser fitting them in for a cut and colour. What were they supposed to say – ‘Brilliant news!’ or ‘Wow, thanks – really appreciate it!’?

‘What’s the prognosis?’ Tom asked, his voice seeming loud in the tiny room.

Sophie stiffened.

The two doctors glanced at each other again. She wanted to stand, reach over and bang their heads together. But she managed to stay seated.

‘Well, it’s always hard to say,’ Dr Fieldman said, his voice seeming far too young and light for the situation. ‘Obviously, as Dr Sullivan says, you have youth on your side. You’re very young to have any sort of cancer, and pancreatic in particular is much more prevalent in the over-fifties.’

‘Right?’ Tom prompted. Sophie wondered how he was managing to remain so calm.

‘There have been cases – admittedly rare – in which the patients have lived for ten years or more, with regular treatment and monitoring.’

‘OK, and what about the less rare cases?’

Another glance. ‘Well, on average, people at this stage have six months, perhaps a little more. But again, you’re young. It could be up to a year, perhaps more,’ Dr Sullivan said, as if this were good news.

‘Six months!’ Sophie’s voice sounded shrill, unlike her own.

‘But of course, there are exceptions, and I think in someone so young?—’

‘He’s only twenty-eight!’ Sophie cried, outraged, as if the doctors themselves were responsible for choosing cancer’s next victim.

‘Yes, we realise that. I know this must be very distressing for you, Miss… Miss…’

‘It’s MRS,’ she said coldly. ‘Mrs Gardner.’

Tom was looking at her intensely as they walked out twenty minutes later, still hand in hand.

‘You were formidable in there,’ he said, shaking his head, a slight smile on his face.

‘Tom!’ she said. ‘Is that all you can say after… all that?’

His head dropped a little and she was immediately sorry that she’d spoken.

‘What should I say?’ he asked her, his face impassive. ‘Obviously it’s a shit diagnosis. Possibly the shittiest. But it just means I have to be the unicorn.’

‘You… what?’

‘You think I’m going to quit, leave all this?’ he said. ‘No. I’ll be the ten-year survivor they tell people about during their appointments. Why not?’

She looked at him, incredulous at his optimism. ‘Yes,’ she said, buoyed, ‘yes, you have to be.’

‘And before all of it, Paris?’ he said to her.

‘Are you crazy?’

‘Why not? It’ll get our mind off things. And after all, it is a tradition now.’