‘Practice on me, use me as a guinea pig,’ Dad would joke, presenting himself on the sofa for my nervous first-year-medical-student fingers to palpate and percuss.
‘Did you learn anything?’ he’d ask, his eager questioning draped in a thin veil of anxiety.
’It all seems okay,’ I would murmur, wondering if I actually had the skills to find an abnormality if there was one.
Twenty-two years later, he said the same thing: ‘Learn from me.’
This time, however, his anxiety was not veiled, but exposed for all to see.
This time, my father was a shrunken figure, sinewy hands resting on a distended abdomen that would have been a medical student’s delight. Within it lurked a huge, aggressive liposarcoma.
Hugging his cardigan for warmth, he patted the skin stretched tightly across his abdomen.
‘They say it’s rare and there’s not much they can do. But maybe you can learn something from me. Maybe I will be useful for your patients, somehow.’
And afterwards, as I adjust, shakily, sewing tentative stitches into a life that is differently shaped, I wonder if my dad’s death can be the silver thread in this new landscape. If it can help to sharpen my clinical skills, slow down the time meted out by the consulting room clock, soften and embolden my touch.
Dad’s palliative care nurses saw every grimace, heard every rattle and, seamlessly, relieved it all.
We could not give Dad all of his last wishes – we never got to have that last cup of tea with him overlooking the ocean – but he did die peacefully at home, with his family around him and, for that, I will forever be indebted to his wonderful palliative care team.
On what turned out to be Dad’s final night with us, one of the palliative care nurses asked me about his life.
I held Dad’s hand, silhouetted by the almost-dark sky, as I told her about the Catholic boy from Belfast who sang Irish folk songs, and who left to join the RAF. About the young man who married a Protestant, moved to Cyprus, ran the gliding club. I told her of distinctions in Latin and fluency in French and German.
The letters from my Dad’s specialists had noted ‘interesting clinical signs’, including nicotine stains on his fingers and nail-clubbing, but, oh, what those fingers could do.
Since Dad died, my patients have also lost loved ones. Fathers, sons, partners, best mates, beloved pets. Old age, inherited neuromuscular conditions, catastrophic stomach or bowel bleeds, lung cancer, heart attacks. Some of them I knew and some I didn’t. I used to trot out the reliable platitudes, conscious that I needed to show the patient I was acknowledging their loss.
Now, it hurts a bit more keenly. Now I know that my patient wants their loved one to be remembered, wants their name to be used out loud, not side-stepped.
They don’t want platitudes, just as I didn’t and still don’t. Maybe they want space and silence, maybe they want to cry and gulp back big, ungraceful tears, raging against a world that carries on revolving, regardless.
I try harder to find the time for that silence. The space to ask them if they want to talk about it today or maybe tomorrow.
I am very lucky to work in an incredibly diverse, busy, inner-city community health clinic. The stories that my colleagues and I hear, daily, can be hard to hear, stories that show us the very best, and the very worst, of humankind.
When my patients heard my news they showed me, in their own way, their kindness and empathy too. Firstly notes, cards and gifts appeared, rippling in on the tide of each new day: flowers, Greek biscuits, brownies, a vegetable peeler (‘Cooking helped me get through my own Dad’s death’), a Chinese acer tree (‘This was my beloved mother’s favourite plant. She would have liked you’), a fridge magnet of a cat from Cyprus (‘I remembered your Dad had worked in Cyprus’).
And then, from a community in which so many members have been damaged, forever, by actions of their own parents, or other trusted adults, came the spoken words and the physical gestures of kindness.
The 184 cm, 135 kg, heavily-tattooed motorcyclist who was subjected to horrendous abuse by his own father, and then incarcerated, aged 16, for attempted murder who, with the lightest of touches on my shoulder, whispered, ‘I’m sorry for your loss, mate’.
And the ex-heroin user who never knew her own Dad, and has acquired psychiatric labels throughout her life ranging from ‘borderline personality disorder/complex trauma disorder’ to ‘paranoid schizophrenia’. The lady who, by her own admission, hates physical contact, but asked me if she could hug me when I returned to work.
Maybe I can be a better GP for having felt the raw grief of a parent dying, for realising that I am loved a little bit less in the world now, that part of my harbour wall has gone and so I am less sheltered from life’s storms.
Maybe I have really understood now the beauty of life, its transience and fragility, and the immense privilege that is afforded to us when we become doctors. A privilege that is easy to lose sight of, sometimes.
Maybe I really understand now that grief is an inevitable human experience, but, from my patients, I have seen and felt the capacity of the human heart to heal, repair and love once more.
Dr Claire Denness
23rd December 2019
First published in newsGP, republished, abridged, with permission