A Husband's Story Of His Wife's Battle With Breast Cancer
An article about Charm, Grace, Elegance and Calm in the face of adversity.
Maria Assumpta Hodgson, (nee Rickard) died on the 12th of August 2009, following a rapid decline in her well being due to a failing Liver. It was the culmination of 3 years and 10 months as a beautiful woman dealing with the daunting challenges of living with and fighting Breast Cancer.
I am Maria’s husband Jeremy, and am writing this article from my apartment in Abu Dhabi, in the Breast Cancer Awareness Month of October 2009, which aims to highlight the need for women of the UAE to be ever more vigilant in the early detection and treatment of Breast Cancer. Maria shared her birthday with the National Day of the UAE, 2nd December.
To women of any location reading this, the view is from a close observer of Maria’s struggle, and from a person concerned for all patients receiving treatment for Cancer of any kind but especially for those women and their special ones aiming to survive Breast Cancer.
Maria was always concerned about the risk of Breast Cancer, and in 2005 attended a specialized clinic in Dubai for a Mammogram. The Doctor was not entirely happy with the result and carried out an Ultra-sound examination. Maria was given an all clear. In October of the same year, after complaining of pain in her shoulder area, scans revealed a 4 cm tumour in the right breast and a biopsy confirmed our worst fears. A mastectomy was carried out within a few days. I never saw my wife without her wearing a tee shirt or vest from that day on. She was a proud woman and sometimes expressed a “not a complete woman” view, which of course no protest on my part was ever 100 percent honest. My disappointment was more linked to the fact that she did avail of the methodologies of detection, so how was the tumour so developed in the 6 months since the Ultrasound examination? I guess I never really asked that question to any of the 6 doctors involved in Maria’s various treatments due to other pressures at the time. However, it will always be a small nagging question in the back of my mind, was the examination performed effectively, and should the Doctor have recommended a follow-up exam in say three months? Could a tumour have been detected earlier, and have been treated before the Cancer began to spread to other sites in the body? I see long-term survivors like Olivia Newton John, and more recently, Kylie Minogue and I wonder, what if?
I was also very aware of the limitations it put on Maria, in terms of simple things like a choice of Brassiere, choice of tee shirt or top, and her reluctance to swim in public places even with a suitably modified swim suit. She was a woman who took great pride in her appearance and over the ensuing years her frustration with her wardrobe began to cause a reluctance to go out to functions or any event where she might not look her very best.
Other than these frustrations, the mainstay of this article is that Maria did pursue all opportunities and experiences life had to offer. She packed so many things into the time available to her. Of course, we lived as if we had Cancer under control, until just a month or so before her passing away. You have to have that degree of positivity, you have to believe that you are winning. Every day that you get up, drive to the office and put in a full day’s work is Winning. Maria was an Office Manager and was entirely dedicated to her work and her colleagues. She only officially declared herself “ill” to her employer in the latter months when she realized that she would have to take more time away from work to travel to her home town Dublin, for PET scans, as the UAE did not have this essential equipment and staff available.
The nearest options were Mumbai or Beirut, but Maria chose to go back to Dublin every 3 months to catch up with her elderly mother and consult the Specialist Oncology and the results of the PET scan. (I understand that PET scans are now available in the UAE) After one such trip in late 2008, and after complaining of lower back pain, a new tumour was detected in the lower spinal area, causing great concern. Maria had the choice of more radiotherapy immediately in Ireland, or endure the flight back to Dubai in some discomfort and start treatment on arrival. She chose to travel immediately, as having the treatment in Dublin would mean that she would be unable to travel for 3 weeks. Thus, in a sense of déjà vu, we started our daily trip to Al Ain and back, but mercifully, only for a 5 day period. Many thanks to the staff at the Al Ain hospital for their extremely prompt administrative efforts in getting treatment started within 2 days of Maria’s return. The Radiotherapy seemed to control the tumour, as Maria was able to live without the back pain and resumed work immediately. We had to cancel our planned trip to Australia for Christmas, but Simon and Mark compensated wholly by coming to Dubai. Maria simply loved a real Xmas tree, and I was able to obtain a beautiful specimen imported from Northern Europe. Even after the festivities had ended, Maria was reluctant to throw out the tree as it was still fully green and in great condition. It was only on her next trip to Ireland in March when I finally disposed of it, still quite green, 5 months since it was harvested in Europe and exported to Dubai.
Other than that Maria was a workaholic, enjoyed her work immensely, valued the daily interactions with her colleagues and was often one of the last to leave the office. It should be noted here how much value is attached to being able to carry out meaningful work to any Cancer patient well enough to do so. The busy hours spent at work are an essential need to substitute the pain, the worry, the not-knowing-when thinking that could easily take over were there too many hours in the day to kill. I thank Maria’s employer and staff for their understanding and support after she informed them of her condition.
Maria’s treatment commenced in November 2005 with daily trips from Dubai to Al Ain and back, a round trip of approximately 300 KM. We would leave Dubai just after 6am to arrive promptly for the 10 minute Radiotherapy, and then turn back to Dubai. This was five days a week, for 5 weeks. In addition to this, Maria’s Chemotherapy was started. In 2005, there were limited resources for treating Cancer patients, and so in a crowded room in the Welcare Hospital, we began to get used to the frequency of visits, the duration of visits varying in length according to how many drugs were being infused. We began to realize just how many patients were relying upon the one Oncologist, a small team and very little room. Eventually, Welcare lost the services of their Oncologist, (a Professor of Oncology) and fortunately, the Oncology dept. of The American Hospital was available to continue treatment. Thus, most of Maria’s treatment was carried out at The American Hospital, where we got to know the staff very well.
At this point it is important to relate how all this specialized treatment was covered under Maria’s health Insurance. An old friend of mine, James, was in financial services, I mentioned that Maria was looking for a corporate health insurance and James happily obliged and set Maria and her colleagues up with William Russell’s Global Health plan. We were most thankful that James had recommended a very reliable, quick to respond, there to listen health insurer in William Russell. Maria & I often wondered how anyone could cope without such a dependable partner in what is a very expensive treatments environment. Maria was aware of much less fortunate sufferers who would have no choice but to leave the UAE and seek the limited facilities and treatments available in the home country.
This is the time and place to thank the staff at William Russell.
Maria grew up in Dublin, Ireland and spent many years living in New Zealand and Australia before moving to the UAE in 2003. She has two beautiful sons in their late twenties, both living in Melbourne, one of whom has just proposed to his long term girlfriend, with the wedding scheduled for next year.
Maria went well out of her way in ensuring that the boys had every opportunity to develop professional careers and experience life’s bounties. She may have had to struggle a bit too hard in this regard, but simply considered it another challenge to excel at.
Maria’s Celtic soul blended with an Aussie “fair go” attitude culminated in a well-rounded personality that made her easy to get on with no matter where you were from in the world, or whatever your status. She had an instantly disarming personality that always sought how she might do something to help you, smooth your way or offer advice.
On her last trip to Ireland in June 2009, Maria enjoyed a mini break in the west of Ireland with her mother and son Mark. After that few days of joy and freedom from troubles, Maria had what had become almost routine Pet Scan. She didn’t fully reveal to me the extent of her doctor’s evaluation and simply told me that the next treatment was to target the Liver more specifically, whilst other drugs were also to be continued.
After the start of the first cycle of this latest round of treatment Maria went to work on the Sunday morning as normal, but left early as she felt to tired to continue. It turned out to be the last time she went to work. Her appetite began to fail and she started to become jaundiced. Her doctor had advised high calorie milk shakes to get something of nutritious value in her as she just could not keep food down. We supplemented it with ice cream, and she hardly consumed anything else. Her muscle mass was clearly diminishing. The oncology specialist requested ultra sound images of Maria’s vital organs. I could see how uncomfortable even this procedure was for Maria to endure. The jaundice became severe and we managed to get Maria into hospital for treatment. This was the first time that anyone had indicated to me that it was the beginning of the end. One member of staff said how serene Maria looked as she was transferred to her room on the ward. Over a coffee, I was advised about such things as DNR, or ‘do not resuscitate’ instructions. This unnerved me terribly, it was then that I realized that I had to let Maria’s sons know the current situation. I was unable to get the words out on the phone, and had to call back to complete the task. We discussed the need for hospice care in the near future, in Maria’s home city of Melbourne where her sons reside. Hospital treatment for the jaundice improved Maria’s condition a fair bit, and we went home. Her main need was simply to sleep and I had to almost force her to consume the milk shakes.
On Monday the 3rd July, at around 2.45pm, we were sat in the Oncologists room at the Gulf Cancer Clinic, waiting for her Doctor. We had used a wheelchair to help Maria get from the parking area, and she sat there, in the wheelchair, very quiet. Her Doctor, whom we had known for nearly a year and a half, delivered the bad news in a manner that he had obviously become accustomed to when informing his patients that there was nothing more he could do. The recent treatment had failed to have any effect on the Liver, it was time to give up the fight, and go home immediately. Thus it ended, 3 years and 9 months of a harrowing journey. Maria took the news calmly, stoically and without much emotion. She had obviously been steeling herself for this time. As we left the treatment room, I was unable to push Maria in the wheelchair, I felt like a ton of bricks had fallen on me, as I did the crying for Maria. The drive back to Dubai was done without much talk.
Essentially, we “de-mobbed” from Dubai, leaving early on the Friday morning, just enough time to arrange for packers to empty the house after we had left, for the neighbour to look after Max, our cat and to close accounts etc.
Friday morning, we were up very early in fact I had not really even got to bed after packing things for the journey and putting essential paperwork into boxes and securing our personal effects. The limousine came and Maria was just able to manage the steps down from the front door, weak from pour nourishment and her legs very swollen. The cat was no where to be found, having had his breakfast and disappeared for the day.
At the airport lounge, I managed to get Maria to eat a little yoghurt as we waited for boarding. We took her on board in a wheel chair, and she managed the short distance to her seat in business class, and settled in for the journey. The Senior Steward asked to see me in the galley. He was very concerned about Maria’s condition and her fitness to travel. I assured him we had discussed this at length with the Doctor, we had one “knock-out” pill should it be required and it was, I informed the Steward, “her last ever flight” He was either satisfied with my little speech, or afraid of the alternatives, as God only knows what I would have done had we been denied travel as I was just about at breaking point. I thank him for his compassion and understanding. He did everything possible to make Maria’s journey home a comfortable trip. It was during the flight, with Maria asleep, I saw for the first time her hand shaking.
After a 14 hour flight, we arrived in Melbourne, Maria was in good spirits and chatting to the staff member pushing the wheelchair. It was a beautifully crisp and clear dawn, as were driven from the airport with the sun not yet above the horizon, whilst there were stars still shining brightly.
It was surreal, having travelled from the Gulf’s 45 degree heat to Australia’s chilly winter mornings of around 5 degrees. Reaching Mark’s apartment, we helped Maria up the stairs to the first floor. It was arduous and painful for her. Maria’s oldest son Simon came by shortly, and Mother and Sons were able to chit chat for an hour or so before tiredness took over again and she needed to rest. This was Saturday, an appointment having been made for first thing Monday morning to see a GP and start the process of getting Maria admitted to a Hospice. Maria’s condition worsened significantly over the weekend. She had immense difficulty walking, and I had to help her to and from the bed, bathroom etc. She began to lose cohesion and seemed confused. I had recently had back surgery, lifting Maria up from the bed, etc, was risking my recovery. At one point, after midnight she insisted on getting up from the bed and going to sleep on the sofa instead. I found some blankets and slept on the floor beside her, listening to her breathing that had now become rather laboured. I could sense she was wrestling in her mind and she often spoke briefly but incoherently in her sleep.
Monday morning came, and we had to get Maria down the stairs from the apartment. Simon, Mark and myself manhandled Maria in her wheel chair and then into the car. There was a bit of a wait at the surgery, but when the GP saw Maria, sitting in the wheelchair, now with a noticeable shaking, jaundiced and tired, she immediately made a recommendation to take Maria just a few hundred metres around the corner to a Hospice, fast tracking the process of getting Maria admitted. Maria was settled into bed, the hospice Doctor appraised of her condition and a sigh of relief from me, that I could at last relax a little and let others take over caring for Maria. I was just done in, physically and emotionally.
I wasn’t sure what was going to happen now that we had Maria in the hospice. Quite naively I had hoped that Maria would have a couple of weeks, maybe a month or even more to spend with the boys. I had uploaded many photo’s of all the families times together over the last five years, thinking it would be nice for her Maria to be reminded of the great times we had all enjoyed. I had told my new Employers I was entirely uncertain when I would return to work. I was thinking I would stay a week or so in Melbourne, go back to work in the UAE for a couple of weeks and then return over the EID break. Perhaps I wasn’t thinking clearly, perhaps I was still unprepared for this final stage of Maria’s illness, which ever way, I was shocked to visit her on the Tuesday morning. To see her lying there, making horrible sounds in her breathing, her face expressing every nuance of the pain and suffering was unbearable. I felt so angry that having gotten Maria to Melbourne, back to her beloved sons and her beloved city, all that could be done was to endure the hours of Maria in her fitful state. Whilst I was sat with her, the Doctor was asking Maria questions but not getting any proper response from her. I tend to think that from the very moment she was put into bed at the Hospice, Maria decided to let go, to dispose of the armour she has been wearing for so long now, to put down her weapons and to say c’est la vie. The Priest performed the anointing of the sick for Maria.
On Wednesday morning, Mark and I returned to Maria’s bed side where Simon had spent the night in the room with his Mum. He looked wrecked, and I asked Mark to take Simon down the road and get some breakfast into him. I was sat at Maria’s side, watching her, listening to that hoarse, laboured breathing when the nurses came in to wash her and re-arrange her position etc. One of the nurses brushed Maria’s hair. I thought I could have done that but she was obviously well into her routine. As they were concluding there work, trying to ensure Maria was as comfortable as they could make her, Maria suddenly stiffened and breathed a long rasping breath, her eyes wide open, and then, just like that, in just one small moment, she became still. I wasn’t sure what was happening, the nurses stood back a little and looked at me and then, left me alone with Maria.
I called the boys and asked them to return immediately. There was their mother, silent and still. When a nurse returned I asked if Maria was dead, I didn’t quite know. I of course assumed she had died, and the nurse confirmed that she had. My concern turned to the boys, who had missed their mother’s final moments whilst they went for breakfast. During the remainder of the morning, Maria’s face relaxed until there was almost a smile there, and that serene look of peace and respite from all your troubles is how I will remember her. We spent most of the day there with Maria until she was collected in the evening by the Funeral Director.
I do regret the little time left between the Oncologists final words in the UAE and Maria’s passing away just over a week later. We did not have an opportunity to talk about things. I was hoping for more than just medical help in Australia, I wanted counseling for Maria, I wanted her to release the tight grip she kept on her emotions and finally let some tears fall. It was not to be.
I wrote the following a few weeks later, having returned to working in the UAE.
“The morning of your passing was cold and grey, still and quiet. Nature seemed to have ordered all the elements to mark you leaving. A little sun was allowed to break through later in the day, pale and wan, not able to muster enough strength to warm the air for fear of causing offence. Showers prevailed, matching our tears.
A few days later we gathered outside the church on a beautifully sunny Monday morning, with the wind being cruel and shelter from its bite keenly sought. It was a beautiful service, very uplifting. Your brother James travelled from Ireland to be at your funeral and spoke lovingly about you and on behalf of your elderly Mum, who was being consoled by friends back in Dublin. The boys and I continued with the Eulogy. So here at the church, we took our final time with you, placing a few small and significant things alongside you in the coffin. We invited mourners to donate to the McGrath foundation to promote “breast awareness” among young women & support women diagnosed with breast cancer. As was your wish.
There you were, just as in sleep, retaining all the elegance and grace of your time amongst us. I kissed you for your Mama, as she had asked me to do. Then it was time, the moment from which the only time I will see you is in my memories of the short time we were together. Goodbye Maria Assumpta.
We arrived in Ballarat, where you used to live, in the middle of the afternoon with light grey clouds replacing the blue sky. The hearse parked close to the grave, and the boys and I helped carry your coffin to the prepared place. We then gathered by the grave, with our hearts breaking, and with the bitter wind blowing at our backs, listened to a few nice words spoken by the Funeral Director. When he was done, we listened to “Amazing Grace” and “sitting on the dock of the bay”, as your coffin was lowered into the earth. My eldest daughter Danielle and my sister Jenny and I huddled together for comfort and warmth. When your coffin had reach its final depth, resplendent with its display of native flowers we applied a little earth as is the custom. My heart went out to Mark & Simon, burying there mother in their old home town.
Tears flowed as we began to think of how our world was going to be without you in it anymore. Safety barriers were placed over the grave, in a slightly industrial fashion. Numb with loss and numb with cold, we proceeded into town for tea. Once we were indoors the sun came out again and shone on the shallow waters of the lake where you had spent happy times. Your old friend talked of how supportive you were to her in difficult times, and how happy you had been recently, despite your illness. We then returned to Melbourne. Not happy to leave your grave in its unfinished state, I returned a couple of days later. The newly placed earth stood a little proud, but settlement had already started. There were no flowers at your grave, and getting a little angry and upset I drove into town to buy some. Again I chose aussie natives for you, red banksias, with some blue statice etc. that would last awhile. Placing the bouquet into the earth, I poured a generous measure of Irish whisky into the ground above you to help you on your way.
The day was mild and sunny. I was pleased to see a couple of Kookaburrahs hopping around in the trees adjacent to your resting place. A “round” from my childhood in England came to mind;
“Kooaburrah sits in an old gum tree–ee
Merry little king of the bush is he-ee.
Laugh Kookaburrah laugh
Kookaburrah gay your life must be!”
Keep Maria in good company guys, as we depart to our various corners of the world and the opportunities to visit this special place will be few and far between.”
Maria was amazingly generous and friendly to all, amazingly focused and dedicated, sometimes amazingly stubborn, independent and guarded, but always amazingly beautiful, elegant and graceful.
Jeremy Alan Hodgson