Sink or Swim

Chapter 1

By the way, I think I’ve got a little lump here.’ I was visiting my doctor on a now forgotten minor matter and casually mentioned the lump as I was about to leave.

My doctor felt the area on my right breast. ‘Hmm, I don’t think it’s cancer, it feels too small and round. But we’ll find out anyway, and get it cut out.’

I rolled my eyes, thinking about the surgery and hoping maybe the tiny lump would just go away. My doctor poked a needle into the lump, a procedure I later found out was called a fine needle aspiration or FNA. The lump was so small that she struggled to pin it down.

I walked out feeling relieved. I’d owned up to the lump and my doctor didn’t think it was anything. Eventually I’d hear from the hospital and get it cut out, but hopefully not for a while. My thoughts shifted to swimming. In three months’ time I’d be flying to the South Island with my husband Bruce to take part in the New Zealand Masters Games in Dunedin. I’d entered four swimming races, the first time I’d ever done anything like this. I was incredibly nervous and excited. I’d started swimming four months ago, and had been lucky to find a coach who was interested in coaching a 41-year-old mother of two with virtually no swimming background. Within weeks I had progressed to three early-morning sessions a week, swimming up to 100 lengths a time. My coach Alan had been a competitive swimmer in the UK, and had a wealth of knowledge that he was happy to share. After years of struggling to combine work and motherhood, I was overwhelmed with the joy of having regular time to myself and delighted by my ever-increasing fitness.

It was December 1999—a busy time at work and at home. There’s that ‘get it done before Christmas’ feeling and the looming obligations of present-buying and socialising. Then there were the usual end-of-year school concerts and prize-givings. Rose, our eight-year-old daughter, was rehearsing for her ballet recital, which meant extra trips to the studio and theatre. Jacob, our three-year-old son, was in an end-of-year performance at his pre-school. As a shepherd, he only had to stand mutely, which he managed to do, although not in the right place, as most of the time he was hiding behind me instead of being out on the carpet with the other children.

On top of all that, there were extra millennium celebrations, not to mention the grave predictions of Y2K disasters. In my work as an investment adviser, the implications of worldwide chaos were alarming and my job of managing clients’ investment portfolios was more challenging than ever. I started underweighting my clients’ international equity holdings, moving more funds into cash and domestic fixed interest. This was contrarian behaviour, as international sharemarkets were at record highs and fund inflows were huge. It was a strategy that paid off later, as international equity markets started falling in August 2000 and didn’t recover until early 2003.

As the weeks passed, I didn’t hear back from the hospital, and I put thoughts of the lump out of my head. Then one evening I was in the shower when I felt a lump under my right arm. It was as big as a grape, but kept elusively ducking into my armpit and away from my probing fingers. How long had it been there? My hand travelled to the almost forgotten lump in my right breast and sure enough it was still there. I felt my stomach twist into a tight knot. This was not good. This was not good at all.

Chapter 2

I called into my doctor’s surgery to get her opinion on this new development, only to find that she was away on holiday. I saw another doctor, who was concerned that the hospital had not yet made an appointment for me. He told me that the results of the FNA had been ‘inconclusive’ rather than negative, so I should have further investigations done. I sat in his rooms feeling sick. He said that he would upgrade my hospital appointment to urgent, and told me to come back soon so that my regular doctor could do an FNA on the lump in my armpit.

The hospital sent me a letter telling me I had an appointment to see a surgeon on 17 February. It would be just one week after the Masters Games, but at least I could still make the trip to Dunedin with Bruce that I had been looking forward to so much. My training was going well; in fact, it was wonderful to swim hard up and down the pool and forget about suspicious lumps for a while. Otherwise, the threat of cancer skulked in my mental peripheral vision, along with dark thoughts of mutilation and dying.

On Tuesday 8 February Bruce and I left our children with his mother, Fay, and flew from Napier down to Christchurch. Once there we hired a car and drove the 370 kilometres south to Dunedin, through some favourite countryside that we’d discovered during the 10 years we’d lived down there. I thought back to those early days together.

It was in 1988 that Bruce and I had headed to the South Island in search of adventure. Bruce had spent four years overseas, travelling overland from Australia to Asia and on through Pakistan, Iran, Turkey and Europe. I had met him in London at the end of 1985 when I was 27. His travel tales were astounding; he was by far the most daring traveller I had ever met. He was saving up for a long trip back to New Zealand, going from London by train to Moscow, from where he would travel on the famous Trans-Siberian railway all the way to Vladivostok. Then he would go by boat to Japan and Hong Kong before heading into China for five months’ extensive backpacking. It sounded like a tremendous adventure and I would have loved to join him, but I didn’t think I could match his savings as I only had part-time jobs. Instead, we agreed to meet in New Zealand for Christmas 1986.

Hastings, a rural town on the east coast of the North Island, was a sad, run-down place in the mid 1980s. Up and down Heretaunga Street were empty shops and dirty, windblown corners. It was not a good place for an intrepid traveller like Bruce to come home to and he found it dreary and depressing. It was easier for me as it was all new, and charmingly quiet and rural compared with the heart of London, where I’d spent the past two years.

After 18 months of casual work, which for me included a stint of relief teaching in Central Hawke’s Bay, we decided to head south. Bruce had done some fishing off the west coast of the South Island a few years before, and thought he would look for a job on a fishing boat. To me it sounded wonderful, and I imagined it would match the challenges he’d enjoyed as a traveller. We squeezed most of our possessions into ‘Emma’, our 1969 Ford Escort, and headed down the West Coast. When we arrived in a town we’d look at the Situations Vacant pages of the local paper, but jobs were few and far between. We reached Te Anau at the edge of the beautiful Fiordland. Leaving our gear in a rented caravan we hiked the newly opened 60-kilometre Kepler Track (encountering a blizzard on the second day), a great experience. This was our first proper hike together in New Zealand. Tramping was something we talked about doing, but we couldn’t afford the proper gear, so we generally settled for shorter walks in the hills. As it was, our clothing was feebly inadequate for this trip—I wore Bruce’s threadbare Swanndri jacket—but we survived the cold and rain. We were tempted to stop awhile in Te Anau to see if we could find work, but decided to head on up the east coast to the city of Dunedin. With its university we knew it would be a more stimulating and interesting place, if without the stunning scenery. As it turned out, we were to spend the next 10 years there.

Now it was 2000 and we were heading back. The long drive from Christchurch brought back many memories, especially as we approached North Otago. In 1988 we’d rented a rundown old cottage in Waikouaiti, with prehistoric plumbing and large rats behind the wood panelling. Bruce had found work as crew on a fishing boat in nearby Karitane. We’d bought our first home, an old wooden villa in the isolated village of Seacliff, when our daughter Rose was born in 1991. I commuted the 30 kilometres to work in Dunedin each day, a long drive over the hills in winter when the roads were often covered with snow and ice.

On this return visit, we stayed with our good friend Mary, an artist in Port Chalmers. The city was buzzing, full of people who’d come for the Masters Games. On Wednesday I had appointments with several clients who had kept their investment portfolios with me after I’d moved north. That evening we headed up the hill to the swimming pool for my first two races. I was beside myself with nerves. I couldn’t believe I was actually going to swim in a race. Despite living near Dunedin for 10 years and seeing the Masters Games hosted there every two years, I’d never found the time nor the confidence to get in the pool and give it a go. Only now that Jacob was a bit older and I had Bruce’s mum to help with baby-sitting, could I make time for swimming. So here I was, travelling nearly the length of the country for my first race.

I felt sick stepping up onto the blocks for the first time. My first race was the 100 metres individual medley—one length of each stroke. I gazed down at the water, waiting for the gun and praying that my goggles would stay on. Suddenly we were off. I used a long, fast dive to get down the pool, then launched into my butterfly. This was a stroke that I was still learning—the long dive simply meant fewer exhausting strokes before I reached the far end. The woman in the next lane looked like a good fly swimmer, as she was pulling ahead of me, but amazingly the adrenaline carried me down the pool far quicker than I’d expected. Next was the backstroke leg, and it was a relief to be able to lie on my back and get some air into my panting body. When I turned into breaststroke I pushed myself as hard as I could. This was my favourite stroke, so I made up some ground. By the time I turned for the final length of freestyle my lungs were burning. I kicked hard and tried not to think about how much it hurt. The wall came up and I flung my hand on the big yellow time pad. It was over, what a relief! As I got out the pool I asked the timekeepers how I’d done. One minute 38 seconds, they said. I was speechless—I’d taken nearly 10 seconds off my personal best. With a huge grin I ran up to Bruce in the stands. He’d timed me himself on my stopwatch and knew why I had such a big smile on my face. There was a big field of swimmers in my age group, and I’d come fourth. I was thrilled.

After a short rest my next race was on. This time it was the 200 metres breaststroke. I was much less nervous for this race, although the thought of racing eight lengths was scary. I went out fast for the first length—it was amazing to be out in front, breaking the calm surface of the water. I ran out of energy and slowed down after three lengths. One by one the other swimmers caught up and passed me. By the time I’d swum six lengths I wondered if I’d be able to finish; my legs were burning with lactic acid. The long underwater turns were murder and it seemed forever before I could come up for a breath. Eventually I turned on the last lap and pushed my aching legs down the pool for the last time. My time of 3 minutes 53 seconds was a bit disappointing after my big personal best in the previous race, but I came third in my age group, which meant a bronze medal. My very first medal!

The following evening I had my last two races. The first was the 50 metres breaststroke, which is one of my favourites but a hard race to swim well. As it is so short you have to make every second count, and get a really good start off the blocks. My time of 49 seconds wasn’t as quick as I’d hoped for, but again I came third in my age group, so earned another bronze medal. My last race was the 50 metres freestyle, which was my best event. It is such a fast race that you don’t have time to think at all, and you have to visualise your race in your head beforehand and then swim by instinct. I remember standing on the blocks and looking down the pool, thinking about the looming hospital appointment and wondering if this was the last time I’d ever swim in a race. In case it was, I wanted to do my best time ever, and go under 36 seconds. I was in the outside lane, which I don’t like, as the concrete side of the pool unnerves me. I tried not to think about that. The gun went and we were off. I try to hold my breath for the first length until just before the turn, which is a long time to go hard without breathing, but I figure the anticipation of that breath to come makes me push myself harder. I timed my turn badly and came too close to the wall, but I didn’t lose much time. Although I could feel myself slowing down, I only took two breaths on the way back and reached the wall feeling I’d done my best. I approached the timekeepers nervously, wondering if it had been enough: ‘35.60 seconds,’ they said. I was beside myself with delight, I’d finally cracked the 36-second barrier. Later I learned I’d again come third in my age group, so that was yet another bronze medal. Three medals in four races: what a great result. But my happiness was marred by a bitter aftertaste. I had a hospital appointment in less than a week’s time, and my world was about to turn upside down.

Chapter 3

Back home in Hastings I had nothing to distract my mind from the impending hospital appointment. When the time came I was stiff with nerves.

The surgeon was business-like and clinical. Like my doctor, he asked if there was any history of breast cancer in my family. Well, the answer was both yes and no. The only person I knew of was my father’s Auntie Grace. She had been diagnosed with breast cancer more than 20 years ago. I knew that she’d had a mastectomy, had made a full recovery and gone on to lead a very active life until she died of heart failure in her late 80s about 16 years later. I knew all that because we had been quite close. After my grandmother had died, my Auntie Grace had taken her place for me. She was a dear silver-haired lady who had retained her strong Cockney accent despite living in Cape Town most of her life. I wrote to her regularly after I’d left South Africa, and enjoyed the letters she wrote back. But as far as I knew, she was the only person in my family with this deadly disease. The surgeon dismissed this as no family history at all, although I knew I took after that side of the family. I remember looking at Auntie Grace’s teeth when she smiled, thinking how much like mine they were. The surgeon told me that I would have to have a mammogram, and I’d be contacted about this.

The next morning I was busy at work when the phone rang. It was the hospital ringing to make an appointment for the mammogram. Could I come in at 4.30 that afternoon?

‘Yes,’ I stammered.

I was horrified. This was all happening way too fast. Nothing happens fast in the public health system unless it’s a matter of life or death. This felt like death. The rest of the day passed in a blur. I left work early to have the mammogram. I was told that the mammogram would be followed up on Monday with a biopsy. The radiographer was very gentle and reassuring. I apologised that my smaller breasts might make it harder for her and she laughed. ‘We do mammograms on men too, you know!’ She took slides from every angle, coming back and re-doing several shots. At the end she said, ‘Now try not to worry all weekend’, which only made me worry more.

It was hard to behave normally over the weekend, with a possible cancer diagnosis hanging over my head. I went swimming on Saturday morning, and felt strong and fast in the water. The thought that I might never feel so fit and strong again made me incredibly sad. Some of the time I allowed myself to hope that the lump would turn out to be benign, but most of the time I knew it was probably malignant.

Night-times were the worst. Every time I woke up I would lie peacefully for a fraction of a second before the word ‘cancer’ came rushing into my head. It was a sickening physical jolt every time. I wanted Monday to come so I could find out for sure either way.

My appointment was at 10.30 a.m. The radiologist was reassuring, but I could tell that things did not look good. She explained that she would fire a needle into the lump, having numbed the area first. She lined it up carefully before letting rip. It felt like it was going right through me and the noise made me jump.

‘How was that?’ she asked.

‘Not too bad,’ I said cautiously, ‘but I wouldn’t like a dozen of them.’

‘We probably won’t need to do quite that many,’ she replied.

Quite that many? I rolled big eyes towards Bruce on the other side. How many times was she going to fire that needle into me? In the end I had to endure quite a few ‘shots’ before she let me go. I was given an ice pack and I went off to the office, where I tried unsuccessfully to bury my panic in work.

The next two days were the longest of my life. Waiting for a diagnosis that might be cancer is worse than having the disease itself. No matter how much you try to push the thoughts out of your head, they are always there. It got harder and harder to hope that it wouldn’t be cancer. Especially after seeing the serious faces at the radiology clinic. I tried to prepare myself for the worst outcome and read up on breast cancer on the internet. I didn’t know whether to tell my friends and family, but I decided not to in case the tests came back negative. In hindsight, that was a mistake. The old saying ‘A problem shared is a problem halved’ is as true today as it ever was. Back then, though, I felt terrible about what I was about to put my family and friends through and I wanted to put it off for as long as possible. On Thursday 23 February I headed out of the office at lunchtime as I was feeling really wound up and thought a walk through the streets would relax me a bit. Instead, I found myself thinking about the worst-case scenario. What if the cancer had spread throughout my body and I had only months to live? I felt far removed from the people bustling past me in the hot summer sunshine. I thought about my children and my family. Was I going to be dead before the end of the year 2000? Long ago I had wondered what I’d be doing at the turn of the century, at the age of 41. None of my dreams had come near this. What sort of funeral would I have? I thought about the music I’d want played. Could I find music that would be uplifting rather than sad? I’d been to a few funerals. Hymns like ‘Abide with Me’ were beautiful, but unbearably sad. Just hearing the music in my head made my eyes fill with tears. I walked back to the office.

‘Bruce has been trying to get hold of you,’ our receptionist said.

I phoned him straight away and he said my doctor wanted to see me as soon as possible. ‘I think she’s got the results. She said you should come in at four o clock if you can.’

I don’t know how I got through the next two hours at the office, but eventually the time came for me to head out the door. When I walked into the clinic I was surprised to see Bruce waiting for me. He’d driven the 25 kilometres from home to be there when I got the news. I was touched and taken aback. My doctor called me into her office and got straight to the point.

‘It is cancer,’ she said.

They were the words I’d been dreading, but when I finally heard them it was almost with relief. At least there was no more waiting. My doctor explained that I would need surgery and probably chemotherapy. She said they might remove my ovaries as well. Listening to her, I felt myself age 10 years in an instant. But she assured me they had probably caught it early, and if so my outcome should be good. She explained that I should have a chest X-ray, blood tests and a bone scan just to make sure that the cancer hadn’t spread to other parts of my body. I could also have a free flu vaccination, usually only available to the elderly or chronically ill. It was scary to think that I had suddenly joined that category of patients when I still felt so fit and well.

My doctor had worked in a breast clinic in South Africa for several years, so was a great source of information. She encouraged me to go to a specialist breast surgeon for the best outcome.

Bruce drove me home, both of us shell-shocked. Our immediate worry was how to break the news to our family and friends. Reluctantly, we started phoning around—family first, then friends. It was horrible ringing with such bad news, and I found it very draining. I asked some friends to pass the news on to others, and eventually the bush telegraph took over. Rather to my surprise, I felt a huge weight being lifted from my shoulders. Everyone was so encouraging and supportive. I no longer felt I was dealing with this alone.

I phoned my friend Mary in Dunedin. It had only been two weeks since we’d stayed with her, when she’d been thrilled to see me looking so well. She was stunned to hear my bad news, particularly as her mother had died of breast cancer, something I’d forgotten. Her mother had first been diagnosed in 1970, when she was 48 and Mary was nine. She had had a mastectomy, but 15 years later another tumour was found on the other side, and she had to have a second mastectomy. Tragically, the disease spread and she died in January 1988.

‘She always said she should have had both breasts removed the first time,’ said Mary. ‘She found the large prosthesis awkward, but more important than that, it might have saved her life.’

Thinking about Rose and Jacob, I asked Mary how it had affected her as a