Patrick collected Elizabeth from the waiting room, opened the door to the clinic room and beckoned for her to take a seat.
“Thank you for coming Mrs Valtrey.”
She was thinner and appeared to have aged five years, though only three months had passed since the chemo started. But she was doing well, nevertheless. Patrick had seen the latest CT scan result. The tumours had not shrunk much. The decision of the multi-disciplinary team was documented in the notes – not for surgery. More chemo, for as long as she could take it.
“I didn’t expect to be sent an appointment Dr Elliot. I thought I was under the cancer team now.”
“Yes, we don’t usually have much to offer at this stage, but it’s good to see how you are getting on.” A pause. Elizabeth let the silence reign. He had asked her to come, after all.
“Actually, I have something I want to talk you about Elizabeth. Concerning the tests you had when you first came to see me.”
She let him continue.
“You had a blood test after you saw me, and it showed that you were anaemic. Mildly anaemic, but anaemic nevertheless…”
“Yes doctor. My GP Dr Atwal mentioned that.”
“Did she? Did she?” Patrick looked past Elizabeth towards to the blinded window. He wished he was on the other side. “Well you were anaemic at that time, but… I didn’t see the result of the blood test. I didn’t know you were anaemic.”
“And was that important?”
“It was. If I had seen that you were anaemic I would have, I’m pretty sure I would have, arranged a colonoscopy for you.”
Elizabeth understood immediately. In fact, Patrick’s confession did not surprise her. She had worked it out in her own mind, from scraps, looks, evasions. But larger concerns had pushed the need to hear it explained openly and honestly to one side. And now, here it was. The truth. The doctor continued,
“Elizabeth. It was my responsibility to see that result. I made a mistake. It’s very likely that if we had found the cancer when you first came to see me, it would have been smaller… and curable. We can never be sure, but it’s possible. I’m sorry.”
Elizabeth saw, briefly, an alternative future. But she banished it. It was useless. Harmful. Fantasy.
And anger. What of anger? No, it was too late for anger. Too late.
“Well I don’t know what to say Dr Elliot.”
And neither did he, now. How to close a conversation such as this? Like every other medical conversation. Constructively. With hope.
“I have made some recommendations, so that this does not happen again. From now on we are going to print out all the blood results on the letters automatically, with abnormal one highlighted, so that we, and a patient’s GP, are made more aware. It doesn’t help you, I know, but others… I hope.”
“Thank you doctor Elliot. That is good to hear.”
Her tone was rather automatic. He feared Elizabeth was just being polite. Making him feel better.
As he drove home that evening, he realised that he did feel better. It had cost him, yes. Saying sorry always costs something. But it was the only way forward. Elizabeth might well go home and report the conversation back to family, sons, daughters, and who knew what would come of that? For Patrick this meeting was the only way.
Even now, it was about him.
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