Yesterday I met with the breast surgeon.

I’d last seen her six months ago. By then we knew that the ovarian cancer had returned, and would thus be fatal. Treatment of the breast cancers would only have been necessary if there were immediate symptoms to resolve: if one of the cancers had broken through the skin, for example. So, at that time, she said ‘come back in six months’. I made the appointment then, and, time having rocked around, yesterday was the day.

Six months on, things are clearer still. In that last six months, the ovarian cancer has progressed. My CA-125 levels have skyrocketed to around 8,500 (normal is 0-35). I’ve done nigh on 6 months more chemo, and it recently became clear that this last chemo drug, Caelyx, was not working. Both legs are swollen. The swelling is getting worse, it’s hard to walk and is becoming very painful. Any movement or exertion makes me breathless, and that’s getting worse, too. And I’ve decided to do no more chemo, and choose quality over quantity, albeit bucked up by much analgesia.

So the breast surgeon will never get a chance to wield her carving knife.

(As it happens, I never had any intention of letting her do so. At the beginning it seemed easiest to just go along with the flow, front up as suggested, and wait till someone actually asked the question before I said ‘no’. Now, she’ll never have to ask the question.)

Since the breast surgeon can’t do anything for me at this stage, I had considered cancelling the appointment. But I decided to go along, partly because the surgeon and her breast care nurse are good people, have helped me a lot, and, frankly, I like them. It seemed mean to just skip out without saying goodbye.

Six months ago I arrived at her office dressed well, feeling pretty good, planning another holiday, working hard on my project that I’m so keen to finish.

This time, I arrived with grungy shoes, because they are all I could manage. I parked illegally in a permit zone directly across the road to avoid having to walk. I walked as slowly as I could along the corridor, but I was still huffing and puffing when I arrived at her office. My left leg was hurting very badly—I should have taken some more pain killers before I left home, but I hadn’t.

And the minute I hit her rooms, I burst into tears.

It was the sudden shock of contrasting how I felt when I was there six months ago, and how I am now. I suppose I hadn’t realized just how far the slow day-by-day decline had progressed, how poorly I’m doing compared with 6 months ago. And, I knew there would be no point in meeting with the surgeon and her nurse again. This was to be yet another goodbye, yet another loss.

I told her what had been happening to me (oh! how a control freak hates the idea that something just happens!). We agreed that there was no point in considering the need for treatment of the breast cancers. They are a second-order problem. I’ll be gone before they need any attention.

This time, there was no suggestion of ‘well I’d like to see you again in x months’.

This time, she just said “Good luck”.

One more loss. One more step to the necessary end.

I couldn’t bring myself to say ‘goodbye’.