In the Midst of Life

growth, and dry up a little of the exudate from an ulcerated breast that was virtually sloughing away as the malignancydigested her chest wall, it would be worth it for her.
    Until the early part of the last century, when mastectomy became a common operation, thousands of women fell victim to the ghastly ‘stinking death’, as this type of cancer was sometimes called. Women afflicted with breast cancer would hide it beneath blouses and shawls, saying nothing. Perhaps a daughter would be let into the secret, but ‘women’s matters’ would be kept strictly away from the men. Very often a husband did not know of his wife’s condition, until the smell of the sticky black exudate became so overwhelming that eventually he noticed, or, reluctantly, his wife confessed. The word ‘confessed’ is used deliberately in this instance, because often women were ashamed of their bodies and even more ashamed if something went wrong. I have seen many a woman with a uterine prolapse hanging down halfway to her knees, yet uttering no complaint. A prolapse was common with multiple childbirths, and one woman had kept hers up with an apple for years, she told us, before she eventually had a pelvic floor repair.
    Mrs Cox was typical of her generation: patient, uncomplaining, enduring passively all that was heaped upon her. She was in a side ward, with the windows kept open at all times, and a fan continually blowing the air in the room away from the corridor, and hopefully out of the window. But still we could not prevent the dreadful smell from penetrating the corridor. Mrs Cox barely spoke; her dull eyes flickered from the massive erupting growth, as large as a dinner plate, to the other breast, where a few smaller sores had started to discharge and bleed. Like many women of her age, she had withdrawn from her friends and family to await death, but a daughter had insisted on calling a doctor, an older GP who had seen this sort of thing before, and was unsurprised. An oncologist was consulted, who said that surgery was impossible, and advised radium treatment, which might dry up some of the exudate, and hopefully reduce some of the growth.
    If we, at the Marie Curie, could make the last weeks of her life more comfortable, the treatment would be worthwhile. We were also able to administer drugs to relieve the pain. The Brompton Cocktail was frequently given, which contained morphine,cocaine, belladonna and gin. Every four hours Mrs Cox drank it gratefully. She was grateful for everything – a glass of water, a clean sheet, a face wash, or a hair brush drawn through her stringy grey hair. She did not express her thanks in words, but her eyes showed it. I often performed these small tasks myself, because I could see how close to death she was, and I knew that the young nurses, who were of another generation, and had seen nothing like Mrs Cox’s ulcerating cancer before, were afraid to go near her. We could not cover the excoriated breast with any surgical dressing, because dressings have to be changed when they become soaked in body fluids. This occurred frequently and quickly, and when we pulled the dressing off, lumps of decomposing flesh and cancerous material came away with it, causing pain. It is not surprising the nurses are afraid of her, I thought, and I wondered how the radiographers, two healthy young men, viewed this tragic woman.
    ‘Your treatment is helping, isn’t it, Mrs Cox?’ I said as I handed her the Brompton Cocktail. I did not say ‘making you better’, as we were taught to say, perpetuating the lie that modern medicine makes everything better.
    She nodded. ‘And you will have another on Friday.’ I continued, ‘that makes four. When you have had six treatments I’m sure you will feel a lot easier.’
    Again she nodded wearily.
    ‘Your daughter said she would come and see you tomorrow.’
    Her lips moved, but any words were unrecognisable. I did not want to say any more about the daughter, who might or might not come, and I suspected that her sons never would. Mrs Cox would probably be left to die alone.
    But in this I, as ward sister, had control. I had no control over the inexorable course of the disease, nor over the treatment, nor had I any influence over the sons and daughters whom she had borne and brought up, and who were now rejecting her, but I was absolutely determined that she would not die alone. In those days it was regarded as an essential nursing duty to be with a person throughout the