It has taken me two years, six months and eighteen days to write about you.

I hadn’t wanted my thoughts on our brief encounter to come across as some arrogant attestation to my compassion. But after countless months of reflecting, it is time I put my unsettled feelings down; to make some sense of what became both a pivotal life moment and one that broke my heart.

I have had my heart broken numerous times before, my first recollection being in grade nine when I didn’t make the basketball team after an entire summer of intensive practice. And over and over again, through breakups, rejection letters, the demise of elderly relatives… the heart takes a beating as the slow grind of life takes its toll.

I weathered these like everyone else, but it is the unprocessed sadness your cancer inflicted on me that continues to haunt my heart.

I sheepishly admit that I don’t remember your name or diagnosis, but I can tell you exactly what you were wearing, where I left you sitting, what your final words were, and what impact your story has had on my life.

I met you during my training as a GP oncologist. My scholarship allowed me a paid 3 -week break from my own medical practice in order to pursue the extra training I required to start working at the regional cancer center. I felt this additional training would help me to understand my palliative patients’ cancer journey better, and, after 17 years of family medicine, to satisfy the elusive dream I had always carried of working as an oncologist.

I respect my oncology colleagues immensely. They juggle huge and complicated caseloads. The medicine they encounter is multifaceted and ever-changing. The patients and families are often highly distressed. I have always admired this area of medicine for both the academic and emotional intelligence it requires. I often thought that if I hadn’t been so young and impatient in medical school, I would have become an oncologist. But life, love, and the desire to start a family veered me towards the wide-open possibilities of family medicine and more freedom in my earlier life.

Just weeks before our encounter, I had chosen to abandon this autonomy, throwing my family life into chaos to pursue an opportunity that, I hoped, would open the doors to the next chapter of my career.

It wasn’t until my final week there that I met you, right in the middle of a busy clinic day. Everyone was in a rush. We were all running behind, as always.

You had come alone. You’ve always lived alone, in a small town up north, but you have good neighbours who volunteered to drive you down. You politely answered the oncologist’s questions. No, you didn’t have children. No, you didn’t have a partner; you’d never been married. You have one sister and a family doctor who referred you to the clinic and made the diagnosis, but obviously hadn’t told you. Or at least not in a way that registered with you. It was partway through the doctor’s explanation of why you were here that it occurred to you that it might be important to have your sister listen in. An extra set of ears is always beneficial when receiving important news.

Your disability has not only left you wheelchair-bound, but also without fine motor skills. You fumbled a lot getting your flip phone out of your pocket and open. You had to interrupt the oncologist to ask him to help you to call her.

He was in a rush. I stood helplessly in the shadows.

I suspect it was your disability that also limited your ability to keep your mask on. Some seemingly helpful person had put it on you incorrectly as they rushed you into the room. It was upside down and backwards. No wonder it kept slipping off your nose. I could tell that this bothered you—not because of the annoyance of having something repeatedly grazing your nose, but out of respect for this very busy oncologist. You repeatedly asked for forgiveness as you tried with your feeble deformed hands, to coerce the mask back over your nose. It was for the same reason that you had clearly dressed up that day—a nice sweater, what I could tell were your dress shoes, and clean, khaki pants. You had been taught, sometime in your life, to respect authority and doctors. I’m sure you’ve spent many days in their presence.

But all of these small annoyances repeatedly interrupted the flow of information inundating you. Even I was confused. An unusual cancer, found incidentally, with various suspicious lesions in other organs that were yet to be biopsied. There was a mention of a possible (but unlikely) cure that hinged on multiple rounds of chemotherapy and radiation treatment. But all of that depended on biopsy, PET scan and MRI scan results. Of course. Even to me it seemed an overwhelming amount of work and chaos for something that we still weren’t able to offer a name for.

How would you get there and back for treatment, and would you be well enough to still live alone? Your independence was important to you; you didn’t like to burden your neighbours.

I would like to think there was at least a kind smile under the oncologist’s mask as he shrugged off your questions with the reassurance that this curative pathway was the least likely one. He mitigated this statement with the usual cancer idioms, offering promises “to walk with you through this journey” and “to take each step as it came.”

Had you even grasped what was being said?

It was hard to tell. The visit was nearing an end. Your sister had never been included over the phone. It was clear that the oncologist’s time was up.

You were left with some paper handouts and various requisitions for MRIs, blood work and ultrasound- guided biopsies. How you were going to manage to carry all the paperwork, your still un-dialed flip phone, and your flailing mask, while wheeling yourself back to the front of the cancer center? Did nobody else wonder about this? I assumed this busy clinic had a delegate who took care of these nuances.

I rushed out of the room behind my preceptor, my mind racing to find some excuse to return to you. Perhaps fifteen minutes later I found one, arriving out of breath, relieved and yet disheartened to find you still sitting there. Your mask was still beneath your nose, your misshapen fingers clinging desperately to the papers you had been handed.

“Oh, hello!” I said cheerily, finally having the opportunity to speak to you. “I wonder… did you need some help getting out?” Your watery eyes welcomed my suggestion. I once again placed your mask up over your nose, tucked your phone back into your coat pocket, and relieved the brakes on your wheelchair, so I could push you out.

I wasn’t sure what to say to you next. The hallways and rooms I escorted you through were filled with the usual hustle and bustle of people coming and going. It didn’t seem appropriate to ask a loaded question in front of everyone. Yet I yearned to know what you were thinking. Were you processing the doom that had been forecast or did the foreignness of the rushed information spare you a sense of dread?

My thoughts were interrupted by your calm hand, which you gently placed on mine as we waited for the elevator.

“Do YOU have children?” you asked.

 “Yes,” I replied hesitantly, “Two.”

You looked me in the eyes as you delivered your verdict. “Good,” you said. “I only wish I had had some too. Time goes by so quickly…”

We said nothing more until we reached the outside. The cool breeze welcomed us with a renewed sense of freedom as we escaped through the final set of closing doors. I asked where I should leave you to wait for your ride and you pointed down the ramp. “Would it be too much trouble to push me down there so I might sit in the sunlight?” you asked apologetically.

I wish I could have stayed with you until your ride arrived and asked you the questions that lingered in my head. Clarified your concerns. Called your sister for you. Held your hand while you waited. But that was not my “role.” I knew I was already throwing the team even further behind by escorting you out. And so I left you there, contemplating your life, lifting your face to the lone ray of sunshine that managed to find its way through the clouds that blanketed our sky that day.

I never went back to the cancer clinic. Perhaps I would have enjoyed the mental stimulation and emotional challenges of oncology: the rhyming out of fates based on complicated stats and probabilities. Perhaps I would have found a way to accomplish this while still offering hope and a reassuring presence to patients like you. Perhaps I would have found a way to juggle it all while still nurturing my own family life. But maybe I wouldn’t have. Some risks are not worth taking.

What I do know is that it took the encounter with you to settle my decade and a half of second- guessing myself. I have a career that allows me the luxury of being the hand holder, the carer and the listener, in the midst of medical chaos. And I have a family to lean on when the world feels too heavy.

I think of you sometimes. On cloudy days, when I spot a rare beam of sunlight peeking through. I sit under it and lift my face to the sky just as you did. I hope that you, too, have found peace.