Five Stages of Reflection

DENIAL

“I’m so sorry you came home to this nasty surprise. It’ll be wrong anyway – I’ll read it again in a minute, it’ll be wrong.”

Bold eyes glare back at me as I sigh before them. They've had a long day and are almost as dark a blue as the tunic uniform in my wash basket. Will those eyes accept anything I say?

“It was definitely addressed to me. How can it be wrong?”

I let out a low sigh and drop my head.

“It makes no sense. I haven’t done anything to cause this for decades. Why would they write to me about it now?”

Decades. Entire decades. I've been in this job for seventeen years and it stopped well before I did my training, well before I took up my first post. How can something I did so long ago possibly have an effect this serious now? It can’t. Can it?

“I never did anything to warrant this. Surely not. I’m certainly not phoning that number just to have some administrator tell me they got it all wrong. They'll have messed it up somehow.”

ANGER

But I did, didn’t I? There’s no denying it, really. Blame youth, blame stupidity, blame myself. I was young, and very stupid - very, very stupid. Everyone did it. Didn’t they? So why has this letter turned up here? Why now?

My stomach churns, and a creeping nausea slithers up my throat. I swallow the saliva that pools behind my lower teeth as my mouth waters in preparation for the onslaught of vomit. I glance at the toilet bowl. How long can I delay the inevitable?

“You useless bitch!”

Why did I do it? There were plenty of warnings. The information was everywhere, even back then. And it’s not like I’ve never thought about it since. It’s not as if I haven’t wondered. My job exposes me to this kind of thing all the time. I should have bloody well expected it!

“You’ve ruined everything.”

I swallow and bend down to grab the white, branded envelope from the tiled floor again, pulling the single page letter out from within in it. The name and address at the top are correct. There’s no mistake.

I crumple up the envelope and cast it back onto the unforgiving tiles. I narrow my eyes and stamp on the bastard, twisting the sole of my shoe on top of it, as if driving it into the ground. Then I switch my attention to the letter itself.

Holding it out in front of me with one hand on each side of the top edge, I spit into the centre of the hateful text. I stare as the gob of liquid runs down over the print, distorting the words.

“That won’t help anything. You’ll just make it harder to read.”

My hands shake and I exaggerate their movement, pulling one towards me and one pushing one away until the paper tears down the middle. I swallow again.

“I don’t want to bloody read it! It’s not as if I’ll ever call that stupid number.”

I scrunch both halves into one fist and shake it at myself.

The harsh florescent bulb makes sparkles of the tears caught in my lashes. In a different mood I’d find them pretty. But not now. Right now, they inflict jarring savagery on my constricted pupils. The excess light only contributes to the dull throb building behind my temples as I let the torn-up page drop, crumpled, to the floor.

BARGAINING

“I’m sorry.”

I sink to my knees and grapple with the pieces, smoothing them out beside each other, wiping the sweat off my palms onto my denim jeans between passes. My nails have grown past acceptable-work-length and they snag on the seams.

“I’m sorry. I’ll make it right. If I put you back together well enough, will you bring a different message?”

I line up the text and scan it again through welling eyes. Though the words blur, they still carry the same meaning. A meaning I've explained to others a hundred times.

“No amount of pleading will change it.”

I lift the letter, grasping it tighter in my shaking fingers. My eyelids, dropping shut, propel the tiny pools of hot saline down my burning cheeks. With the world temporarily on hold, I try to wish the letter away while I wipe my face with my sleeve.

No amount of pleading will change it. The die was cast in the endless summers of twenty years and more ago. A time when we all felt indestructible. A time when we all believed anything was possible. We were the generation brought up to think that if we just worked hard enough and never gave up, we could achieve anything we put our minds to. Anything. Nothing could stand in our way. Certainly not a little habit like that.

I swallow again and open my eyes. I'm back in the room. Back to staring at that face.

“Of all the things I could have done. Why did I have to…?”

It’s impossible to finish that sentence. An apology is stronger if you can spell out exactly what it is you are sorry for, but faced with this, faced with those eyes, those lips, that brow. . . I close my eyes again and shut them out of my mind.

“I’m still here, you know.”

I do know. The one person I can never really be away from. No matter how far I run.

Perhaps it wouldn’t have been so bad if I’d been told in person. If I had had the chance to sit down and discuss it, to talk it through before . . .

Maybe if I call the number they will give me different news.

DEPRESSION

Apparently, they tried to ring several times and even sent someone to the house once. I should have known that my holiday was so badly timed, and that I should have cancelled Bermuda to be in Birmingham just in case. Eventually, they sent a letter. A letter marked urgent. A letter with a direct dial number. A letter I MUST NOT IGNORE. A letter I picked up nearly a full week after it was sent. I know these letters well, but from the other side. Oh God.

Saliva builds up in my mouth again and I force it back down my throat. It’s harder this time.

“I’m sorry I went away.”

A single tear falls. It turns cold as it skirts the bottom of my nose and drips over the tiny cliff-edge of my top lip onto the tiled floor.

“That’s not my biggest concern.”

A second and third tear follow. Then more. They gather in strength. By the fifth or sixth I can’t distinguish between them anymore.

“I’m more concerned about what comes next. What kind of future there might be.”

I put one hand to my mouth as the anticipated ripple of acid finally scorches the back of my throat. I reach for the toilet seat with the other hand and lift it just in time to puke two rounds of semi digested toast and half a mug of coffee into the water. I kneel down in anticipation of more to follow and stare at the disgusting mess I’ve made. It’s almost a relief that I can’t see that devastated face anymore.

“It is a disgusting mess I’ve made. There’s no phone call on earth that could make it any better.”

I don’t even attempt to dry my cheeks now. My arms are too heavy, and the discomfort is well deserved anyway. It seems uncertain whether I will ever move again.

I sob in the crouching position, eyes firmly shut, nose streaming, stomach retching, head pounding. I lose track of time as I let the bottom drop out of my world.

ACCEPTANCE

My ankles are numb and my face is raw. My front of my top is sodden and my knee is resting in a damp patch on the tiles. The streetlights have come on. I pull a few sheets of tissue from the roll and wipe my mouth. A few more and blow my nose. A few more and dry my eyes. The tissue is always rougher when you’re sad. I throw the used sheets into the toilet and flush as I stagger to my feet. I can hardly balance as the tingling starts in my lower legs. Pins and needles remind me I am still alive and still have decisions to make.

Unable to stretch my knees, I take a clumsy step towards the wash basin, leaning on the cold ceramic rim with both hands to steady myself. My sleeping feet follow my stooped back across the floor. As soon as I am balanced in a stable position, I grab the cold tap and turn it on. Using my right hand as a cup, I scoop fresh water to my lips and slurp it into my mouth, cooling my acid-burned tongue and washing away the taste of self-pity.

A few full swills of my mouth take my cheeks off the boil. Though my feet are now in tingling agony, I manage to adjust my posture. Still bent at the waist, I turn my head to glance at the cause of all this misery. Both parts of the letter are resting on the corner of the bath. They’re out of reach, but maybe that’s for the best.

Hands on the basin edge, I straighten my elbows and raise my heavy head to look at her, the woman I have wronged. There she is, scowling at me with swollen eyes set back in dark circles. The tiny dots where blood vessels have been broken across her cheeks with the pressure of being sick, stare back at me like a hundred accusatory freckles. I hardly recognise myself.

I search the reflection of the bathroom behind me for a sign of comfort. But all I get is an inverted view of the torn letter on the corner of the bath. Even in mirror image I can make out the NHS logo and my name at the top and the words Oncology Department.

I wrap my arms around myself in a one-woman hug. It’s time to face the truth. With my feet starting to regain normal feeling, I tread softly across the room and pick up both halves of the page. Sitting down cross-legged, I smooth the paper out on the floor in front of me, matching the jagged edges against each other, and start to read.

Consuming the meaning of every word several times gives me unexpected hope. Even the words Inoperable, Tumour and Lung have lost a little of their sting.

My watch says it’s 5.13pm. There are seventeen minutes left before the line closes for the day. I take my phone from my pocket and dial, and hope someone sympathetic picks up.

“I’m sorry to call so late, I had the dreaded letter from you. It's Deana Marco, the senior nurse from ward 32.”