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SARAH


A love story


by


Peter Steele

TABLE OF CONTENTS


Also by the Author

Dedication

Thanks

Preface

Letter #1

Letter #2

Letter #3

Letter #4

Letter #5

Letter #6

Letter #7

Letter #8

Letter #9

Letter #10

Letter #11

Letter #12

Letter #13

Letter #14

Letter #15

Letter #16

Letter #17

Letter #18

Letter #19

Letter #20

Letter #21

Letter #22

Letter #23

Letter #24

Epilogue

About the Author


ALSO BY THE AUTHOR



Two and Two Halves to Bhutan

Doctor on Everest

Backcountry Medical Guide/Far From Help

Atlin's Gold

Eric Shipton: Everest and Beyond

Winner of the Boardman Tasker international

prize for mountain literature

The Man Who Mapped the Arctic: The Intrepid Life of George Back, Franklin's Lieutenant.

A Globe and Mail and Amazon.ca Book of the Year

Over the Hills

And Far Away

SARAH

A love story


Copyright © 2017 by Peter Steele

Image and cover copyright © Peter Steele

Photo of Sarah Steele © Jocylyn McDowell

Photo of Robert Philips © Peter Steele

Cover design by Keara Hlewka

Author photo by Cathie Archbould

Computer consultant: Sacha Masson


ISBN: 978-0-9940614-5-4


All rights reserved.

This book is licensed for your personal enjoyment only.

No part of this book may be reproduced, stored in a retrieval

system or transmitted in any form or by any means without prior written permission from the author.


peter.steele@northwestel.net

For Adam, Judith, and Lucy


With heartfelt thanks, yet again, to Marcelle Dubé and Keara Hlewka who helped produce this book



PREFACE


Sarah, my wife, was diagnosed with breast cancer in 1976. She had sixteen years clear of the disease, and as each year passed it seemed likely she was one of the lucky ones who had escaped its clutches. Then in April 1992 she felt discomfort in her chest wall that was shown to be due to spreading of the tumour in her bones.

The shock of this discovery was devastating for us both. Sarah set about dealing with it in her most pragmatic way – by reading all she could find about breast cancer, by using relaxation self-hypnosis, and exploring alternatives to conventional radiation and chemotherapy treatments, yet complying with the advice of her doctors at the Cancer Hospital.

Sarah slowed down little because of her illness. With her bold natural sense of colour she became a fanatical and skilful quilter. She travelled widely – twice to Britain alone to visit family and friends, thrice to the United States with me, and a couple of times across Canada as Yukon representative of the International Year of the Family. Then she began to feel pain in her hip where a fresh spot turned up on X-ray. “Oh, what a nuisance!” was her response.

In December 1993, a few days after returning from seeing her mother in England, she developed pain in her back and nerve symptoms in her legs that showed one of her spinal vertebrae had collapsed. Thinking that sunshine would do her good in the middle of a Yukon winter, in January 1994 we went on holiday to stay with a friend in San Miguel de Allende, Mexico. Despite her pain Sarah insisted on accompanying me round Central Mexico by train and bus on an adventure styled after the manner of several long overland journeys we had made abroad together in recent years.

In San Miguel we met Robert Philips, on holiday from his home on Hornby Island off the coast of Vancouver Island. Swiftly we formed a close friendship with Robert, who was a generation older than us. He had led a fascinating, peripatetic life, somewhat like our own. After a childhood in Brazil he went to school in England. In World War II he commanded a landing craft during the invasion of Italy. When a shell killed most of his boat’s crew, he was posted to India. The war over, he rebuilt a derelict farmhouse for his family in North Wales. Then he moved to Canada where he became successful in the world of finance.

Robert retired early, along with his beloved wife Monica, to Hornby Island in an Arcadian setting of wild seas, rocky cliffs, and cedar forest. Then Monica developed Alzheimer’s Disease, from which she slowly and remorselessly deteriorated. Robert nursed her at home until she finally had to enter a nursing home.

Sarah and I visited Robert’s waterfront home on Hornby twice in 1994, enjoying his company and deepening our friendship. When Sarah’s symptoms worsened I started writing letters to Robert telling him how she was doing, and how I was feeling about the whole sad situation that was full of anxiety and foreboding for both Sarah and me. I am usually rather a guarded fellow, but Robert had my total trust and I was able to pour out my concerns to him in these letters in a way I could not have done to anyone else.

I stored the letters away in my word processor and never looked at them again until after Sarah died, on 5 November 1995. Then I printed them out and read them to remind myself of the sad but happy roller coaster we had ridden together. The letters struck me as a tribute to a very courageous woman and, through them I wished to honour her despite the discomfort of opening my own soul on the way. Perhaps that in itself may encourage someone out there trying to support the person they most love, who is dying.


Letter #1


Whitehorse, Nov. '94


Dear Robert,

Sarah and I spent a very happy month in Victoria, especially our visit to you on Hornby. We enjoyed goofing around, visiting friends, but most of all just being together. I treasure every moment in a heightened way since I have no idea how many moments are left. There's no one I'd prefer to spend long spells of time with than her, we so enjoy each other's company. We've been very lucky to share in our travels so much that is out of the ordinary. I'm sure you and Monica must have been the same, and that is why your own present pilgrimage with her illness is so cruel.

Recently I've been through some emotional stages that I'm sure you'll understand. At first when we knew Sarah's cancer had recurred I was devastated and just felt like crying all the time, partly for her knowing what was ahead and what she would have to suffer, partly for myself in selfish realization that I would before long be deprived of my jiban sati – as they say in Nepali – meaning my ‘lifelong friend.’ It's how I always think of her, lover though also she is. If I felt like this, I told myself, just imagine what she must be feeling. But I can't. She has to put up with the daily anxiety of living with a disease that is slowly eating her away, with pain that can only worsen, and with an uncertain future.

I got used to the idea that she was not going to die immediately, and for me the hurt became less acute. She needed all my empathy and understanding. Sometimes selfishly I have found this hard to give. She’s the power of this pair, and I’ve found it really hard to be that strong one for a change. I listen to her troubles (which she vents so rarely) and yet I must not lean on her as I am used to do. Sometimes I want to tell her I’ve had a lousy day, or that I’m feeling low. Then I remind myself that my little worries are small fry compared to hers. I shut up and feel resentful, and despise my selfishness.

We seem to have settled into accepting this gremlin sitting on her shoulder. If he does not foul up her machinery at least we’ll be prepared for him. She’s getting quite a lot of pain from her spine, also from her hip. We know from her X-rays that she has lesions in both places. I just dread the day when these bones will collapse and fracture because of being weakened by the spreading metastases. Then she’ll be in deep trouble. One of the problems of being in the medical business is that I know too darned much. I’ve seen it all before – but always it was someone else’s problem, someone else’s wife. Cancer never goes away, it just abates for a while but it usually comes back to haunt one. We’ve just been lucky to have seventeen free years – gratis you might say.

Anyway we still have a few good years together. First we plan to spend next spring in Europe, then if we can travel on the Trans-Siberian Railway, that’ll be a bonus. It would be a nice way to round off our long overland journeys of the last few years.

Sarah’s illness has made the future seem much more immediate, and I’m not obsessed with salting stuff away for our comfortable retirement. We live modestly and have ample. I’ve taken heed of what you said about preparing living wills and powers of attorney. I feel I can talk to her about it now, which I couldn’t before – but in quite a detached way, as though we were always talking about some third party, not our very selves. Perhaps doing that will be a big relief for her because she’s so much more pragmatic than me. We never talk about dying; it doesn’t seem to be on her agenda yet. Perhaps it never will be.

You know, Robert, it’s wonderful for me to be able to write all this to you. I could never be so frank with anyone else. I so appreciate your friendship, wisdom and empathy; no hidden meanings, no game playing. What I sees is what I gets, and I like it that way. It’s the only way I know how to relate, and I haven’t the patience to have it otherwise. Also it’s the medical business again – you’re not meant to have problems of your own when you spend all day dishing out potted wisdom like some oracle. When something like this hits you between the eyes it soon brings you to your knees.

Sarah has called a couple of times from England. She’s having a good time in Suffolk with her mother who is a sharp and interesting lady, incredibly well-read and brimful of gossipy historical snippets. Sarah is going up to London tomorrow to spend time with her sister, Jean, near Hampton Court. Then she’ll visit one of her friends in Bristol where we used to live before we came to Canada. I just hope she doesn’t rush around too much because rest is so important for her. She’ll be back a week tomorrow by when I’ll have worked my way through all the President’s Choice frozen dinners – cannelloni with three different cheeses, and two-cheese lasagna – so I never want to see pasta again.

To go back to our holiday, we had a very sociable time in Victoria where we have lots of Yukon friends. We were comfortable in our one-bedroom apartment on Penzance Street that we built in the basement of the house we bought when we moved down there five years ago – supposedly permanently. We look out across the old Chinese cemetery to the sea where gigantic boats pass on their way to drop off the pilot before they head out down the Strait of Juan de Fuca to the Pacific. As you know, I only lasted six months living in Victoria. One wet, windy day as I cycled home I thought the tulips were shaking their heads and mocking me, and I couldn’t stand the daffodils! So I turned and fled to our north country of the Yukon, while Sarah followed after she had finished her upholstery course.

Driving over the Coquihalla on the way to Kelowna the van gave a few coughs but settled down. In Banff Sarah insisted we stay in a motel, while I was quite ready to sleep in the van as it’s so cozy. I put Sarah on the Calgary airport bus to fly to Montreal for a conference of the International Year of the Family of which she is the Yukon representative. There she spent time with our son, Adam, who is doing his Ph.D. Later she flew off to England – the gadabout! I then set off to drive the 2,500 kilometres back to Whitehorse in a spluttering van.

We’ve had lots of good snow and I have skied on our cross-country trails every day. I’m working on my stories (autobiography sounds so bombastic). At least it gets me into writing mode until I find the inspiration to start something more original. I once wrote an appalling novel about a crooked doctor on the Amazon, and I may try to revive it because the story itself is good.


Letter #2


Whitehorse, 5 Dec. ‘94


Dear Robert,

Sarah isn’t well and I just wanted to write to you about her. She had a wonderful time in England, staying with her mother and visiting friends. The only thing that bothered her was her hip that has been sore for weeks now. We know she has three spreading lesions there, so pain is to be expected. On her return, apart from jet lag, she looked radiant.

Then she started to mention some pain radiating from her back to her shoulder blade. It got worse and settled in the centre of her back right over the vertebra where X-rays show a metastatic lesion. Now she’s in bed and is only comfortable propped up with pillows. Even sitting up is very painful. I’ve known for a long time that a compression fracture of her vertebra might happen, but I’ve closed my mind to the thought of it.

One of my partners, an anaesthetist who specializes in pain management, came to see Sarah at home and put her on morphine in fairly large doses. The pain settled a bit, but morphine doesn’t touch it if she is up because the weight of her body puts pressure on her spine. She’s due to go down to Vancouver in a week anyway as she had put off having some more radiotherapy to her hip until after her visit to England.

I’m scared rigid for her, Robert. Does this mean she could become paralysed and be totally bedridden? I understand perfectly well how that could happen, and I can’t bring myself to face the thought of it. Again, the only thing she’s said about it is, “Oh, what a nuisance!”

At present she’s on a pull-out couch on the floor of our living room. It’s bright and airy with pictures and her quilted wall hangings right up to the ceiling. The woodstove stands opposite her. She’s in the centre of things and can boss me about, stumbling and fumbling as I do in the kitchen. One way she can look into her sewing room, the other she sees who is coming in the front door, and even sees out to Grey Mountain when the weather is clement.

It’s a blessing we live in this small house. My criterion for the right-sized house is one that when you plug in the vacuum the cord stretches to every corner of the house without having to move the plug. These ‘tin’ houses were made in the US of steel sections twelve feet long by one foot wide that interlock like Lego, hence their name, ‘Steelox.’ They were erected in the war for servicemen maintaining the Alaska Highway – ours definitely for ‘other ranks.’ Unfortunately they were designed for the tropics but were shipped north as an emergency, and the insulation in the walls is made of stuff like padded envelopes.

The house is very compact and everything Sarah needs is all around her. We could always put up a bed there permanently if it comes to it. I doubt if she’ll ever be able to use the loft over my study where we usually sleep because it involves some quite athletic climbing to get in and out of bed. Of course I’m thinking the worst; but I must be practical, which is against my better inclinations.

Dear girl, we have so many journeys still to do. We want to go on the Trans-Siberian Railway together. And she wants to come out to Nepal next year because she has never seen the Everest region where so much of my life has been focused. Now she faces the prospect of being a permanent invalid. I may be prematurely gloomy, but being in the business I know too much for my own comfort.

In Vancouver next week she will have a CT scan that shows what is happening in her bony spine. Even if it does show progression of the disease, what can they do about it? Nothing much. Just offer all sorts of nasty treatments that may be worse than the disease she is contending with already. I probably won’t go with her to Vancouver because she prefers to be alone when she goes to the cancer clinic. It isn’t just that she’s being unselfish and sparing my feelings, she really does prefer to manage this on her own as long as I’m there to support her when she comes home. She likes to know all the answers, and she questions her two doctors unmercifully for the exact picture of her disease. Luckily she has total confidence in them, solicitous and caring as they are.

Oh, dear Robert, I’m not being very strong about this. It’s wonderful to be able to write to you because I don’t know anyone else with whom I could be as open. We both feel lucky to have met you so recently and to have become such good friends. I don’t want to burden you, but just telling you makes me feel better because I know how much you care for her.

Perhaps by the time I write next things will turn out not to have been as bad as I am positing now. Let’s hope so. I’m also frightened because I don’t have any religious faith, and it’s a bit late to be making overtures to St Peter now. I don’t know what happens after this is all over, but I’m sure there are many things – death being paramount – that we were not meant to understand on this earth. I can’t really imagine life without her. We’ve done everything together, wandered the world, and have had thirty-four wonderful years in partnership.

Letter #3


Whitehorse, 20 Dec. ‘94


My dear Robert,

It was grand to hear you on the phone. Thank you so much for visiting Sarah in the Cancer Hospital. She said she returned to her bed and found you waiting, which cheered her no end. It’s been a hellish two weeks, Robert, and I want to tell you about it. The therapy is in the writing the letters and knowing that you are reading them at the other end – and caring.

Let me go back to Monday two weeks ago. I told you Sarah had been having pain in her shoulder blade, but it got much worse and was centred over her T4/5 spine where we knew there was disease (also at T12). She had noticed some numbness in her feet, and difficulty in knowing when her bladder was full. Fortunately one of my partners recognized the neurological signs of spinal cord compression. He arranged for her to fly down to Vancouver immediately. I returned from skiing to find a message on our answering machine telling me to be ready in an hour to escort her down on the plane.

In Vancouver right away they realized Sarah was an acute emergency. They put her on big doses of steroids to try to lessen the swelling causing pressure round her spinal cord. Her two doctors took the trouble to explain everything and to answer all her questions, which makes her feel more in control. She’s mighty nosey, as you know. An MRI scan showed that the disease has slowly extended into her spine. So she had nine short, sharp bursts of radiation aimed right at the lesions. This was enough to knock her socks off. Now they plan to give her chemotherapy after New Year to try to halt the systemic spread – not a happy prospect. The hospital staff obviously love her because she is brave and uncomplaining.

I hate hanging about in hospitals, being on the other side of the fence. Everyone is so bossy, so efficient, so clinical. What else should I expect? I found myself continually on the verge of tears, and would suddenly get a crack in my voice at the most inopportune times. I just wandered round Vancouver in a state of deep gloom, trying to gather my wits for the next time I visited, so I wouldn’t appear as feeble as I was. Sarah suggested I return home before the weekend to keep things on a level for the kids, as she was due to be discharged early next week.

I wrote the enclosed piece (q.v. Hugs) when I got back home. It came straight from the heart, and Sarah really liked it. I sent it to Derek Cassels, editor of The Medical Post, who has become a good friend over the years when I’ve been writing for him, and he will publish it as an editorial.

I had the weekend on my own at home. For precious moments I could ski in the woods where it is utterly silent and still, apart from the squirrels dashing across the tracks and up into the trees. I could pretend that it was going to be alright with Sarah.

She came home on Wednesday. We are lucky to live in so tiny a house – cozy like yours on Hornby. I bought two new sets of fitted sheets, green and burgundy, and she sits propped up with lots of pillows, holding court. Even the mail lady broke off her walk to stop by for a confessional of all the traumas in her life. When visitors come I make myself scarce in my study, but I hear the gist of chat from next door. Sarah has the incredible ability to move the conversation away from herself and turn it to the woes the visitor has come to lament.

Sarah can get up to the bathroom, but she’s pretty whacked after a few minutes and has to return to bed. That break gives me time to straighten the sheets, brush off the crumbs, fluff her pillows, and turn back the quilt under which she likes to lie by day. I give her tea and toast for breakfast (she’s just developed a yen for crackers and Marmite); then she gets her own lunch, and I make a fine line in moist scrambled eggs for supper. I’m a useless cook, but I’m learning.

Our elder daughter, Judith, lives next door and pops in often. She runs a family day home out of her house, and the kids play in the whole of our fenced backyard. She runs a tight ship – as we sometimes hear through the party wall – but the kids love her, and we think they get a very good deal. Grandson Tim frequently drops in here with his miniature dachshund, Rosie, who immediately gives Sarah a good licking all over her face, especially behind the ears. She had dachshunds as a child so she’s very indulgent. Tim gives Sarah enormous pleasure (“Oh! I do love that little boy”) and they play together, or watch The Lion King for the umpteenth time, while Judith goes out skiing.

So everyone is gathered around her; she always likes being the centre of attention. For the time being, while she has to be confined to bed, the house is about as ideal as if it was architect-designed for her. Thankfully we don’t live in a huge, multi-level house with stairs and separate rooms. I often think of your comfortable house on Hornby – unpretentious, but beautiful and practical.

All the kids will be here for Christmas. I wonder how many days it will be before they get up each other’s noses. It’ll be grand to see them. Adam comes from Montreal where he’s finishing off (so he assures me – but he’s been reassuring me for rather a long time now!) his Ph.D in computer mathematics at Concordia University. We talk at least once a week on the phone – a family ritual – always collect. You’d enjoy him, Robert, he has such a quirky sense of humour. He’s very bright and disputatious – unlike his retiring father – so you’d have fun philosophizing with him.

Lucy and Alain, our friend-in-law, come home tomorrow. She has just won a Canada Cup race series and qualified for the Canadian team to compete at the World Nordic Ski Championships in Thunder Bay in March. We are very proud. She has established her place as Canada’s #1 woman cross-country skier. Not bad considering only a month ago she had surgery to repair a torn tendon in her thumb, dislocated in a fall while training in Italy. It’s been very painful skiing with her pole splinted in place and strapped to her hand. As she says, when the race is underway everything hurts so badly she doesn’t notice the pain in her thumb.

Lucy is thinking of hanging in to compete in another Olympics (she was racing in the winter Olympic Games in Albertville in 1992) – she had decided to retire at the end of this year, but is having second thoughts. Why not? At 26 she’s only just coming into her own at the sport. The cross-country skiers often don’t peak until their early 30s, and so many of the women, especially the Russians, have babies which they leave at home with granny. Lucy has put off her schooling and career for so long, what matter if it’s another few years? Skiing is a full-time job now – no more the Chariots of Fire dilettante stuff. Alain has a good position with the national team as waxing technician (he retired last year after three Olympics – one cycling and two cross-country skiing) so they travel together. They’ve got lots of savvy so they’ll get by somehow. Sarah and I always say it’s no use worrying about our kids. They will live their life as it comes along, as we’ve all had to do. Sometimes things work out well, sometimes not. Them’s the breaks.

I’ve gone on far too long and your eyes are probably strained by now. Give our love to San Miguel. Caitlin Press in Prince George is going to publish my Atlin book under the title Atlin’s Gold. There’s still lots wrong with it, even after five years’ work and three re-writes (as suggested to me by Jan Morris), but it’s the best I can do. Some of it is well written. It’s me, and that’s how people will have to take it, warts and all. The focus of the theme is the cabin; we all fit in as peripheral players, radiating out from, but always returning to, the cabin.

I’ll write again soon to keep you abreast of Sarah’s news. Poor girl, she’s been through hell with the pain, and then the misery of radiation. And now there’s more to come with the prospect of chemotherapy and no guarantee she’ll ever get out of that bloody bed on the floor. She remains eternally hopeful and is planning how we will travel round Europe by car in the spring.


HUGS

Touch them. Go on. I dare you, touch your patients. It’s your job and don’t let any Royal College smart-ass tell you otherwise. There are many times in practice when words have no place, and a hand on the shoulder, a hug, or even a kiss are the only appropriate way of communicating our deep caring for our patients. Depriving ourselves of this essential tool, that costs not a penny, diminishes our armamentarium in a job where we have few enough tools to work with – just a prescription pad and some human kindness.

Hippocrates didn’t deny us the right to touch our patients with love – but we transgress the line between agape and eros at our peril. If you can’t distinguish between the two, the kitchen’s too hot, so get out of it into some closet where you don’t need to feel for people.

We’re a touchy-feely family, and thankfully touching comes easily, even with patients. When my wife and I went to the airport to see Rosemary off for her liver transplant, I kissed her goodbye – a kiss that told her I had cared deeply for her these past years. Now she was off on a dangerous road and we were with her. Words would have been clumsy and redundant. Now, six years later, on each anniversary, I keep a special kiss for her. At the end of every visit of Mrs D, aphasic from a stroke, I kissed her farewell – a parting greeting. When young Irene, who I have cared for over a couple of decades, returned from being donated a pair of lungs, I hugged and kissed her with joy in front of my colleagues.


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