to treat you would make you feel a lot worse, for a very limited benefit. You have an advanced cancer, and it has already had quite an impact on your physical abilities. There is no treatment that we can give you that is going to be what we call curative.”
It was the final word that did it. Curative. It made sense to Tom, the idea of a cure, or rather the lack of it. Now he understood what Alice and Elizabeth had understood right from the start of this conversation: not only did he have cancer, but it was going to kill him.
“There’s nothing they can do,” he said to himself, but also to Elizabeth. He looked up at Alice, who was lost somewhere in a thought no child should ever have to contemplate. A single tear escaped to his cheek, which Elizabeth hurried away with her tissue.
“There’s a lot we can do, Tom,” Dr. Jones pushed. “We can treat you with medications, pain relief, get you walking properly. We can really improve the quality of your life.”
“But not quantity,” he said.
“No, I’m afraid not.” The doctor leaned forward. “And because of that there is one more thing that I am obliged to raise with you, especially now, while your family is here. It’s important that they are involved in this decision. We must decide, on the back of what I’ve told you, about what we should do if an emergency with you was to arise. In your notes I see that you’ve had some heart trouble in the past, a heart attack if I’m not mistaken.” Elizabeth looked at him; he had gone ashen.
“That’s right.”
“And do you ever get any chest pains now?”
Tom was struggling to focus. After a while he rejoined the conversation. “Sometimes. I have my puffer spray, and that helps if I get a twinge.”
The doctor took a deep breath. It was quick, but Elizabeth knew he was finding it hard. She didn’t suppose you ever got used to having to tell people that they were going to die. “Well, if while you are here with us you were to have any further issues like that, we would have to know in advance to what extent you would want us to treat you. For example, if you were to have another heart attack that led to a cardiac arrest, whether or not we should try to resuscitate you.”
Tom sat up a little straighter then, his shoulders back. “I’d want you to do everything you could.”
Again the doctor faltered. He had thought, as had Elizabeth, that Tom had begun to understand where this was going. He reached for Tom’s hand; Tom didn’t resist or try to stop him. That was an indication of just how out of his depth he really was. When you’re drowning, you’ll cling to anything or anybody.
“As your doctor, I would have to say that I believe it would be better if we didn’t try to revive you should such a situation arise. With the location of the cancer you have in the brain, and the extensiveness of it, even if we were able to bring you back, you could be left with a serious deficit in your abilities.”
Tom snatched his hand away. “Not do anything? Well, I’d like to know what my daughter has to say about that.”
All eyes flicked to Alice, who had remained until then remarkably quiet. She had been steeling herself, every muscle tense. Shreds of tissue fluttered like winter snow to her knee from where she’d been wiping furiously at her nose. Elizabeth wanted so much to tell her it would be all right, but it would have been a lie, nothing but false placation. Although Alice was a forty-two-year-old woman, in that moment Elizabeth thought that she could see the fear of a little girl who had been thrust into a world she wasn’t ready for, with decisions to make that were too grand for her to even begin to comprehend.
“I think . . .” she said, pausing for breath. “I think that if the doctors could bring you back and you’d be you, then obviously,” she said, emphasizing the word, “I would want them to. But if you would be different, like not you, then maybe they shouldn’t.”
Tom stared at his daughter, his eyes wide and wet. His words were soft and sorry. “Shouldn’t even try?” he whispered.
Alice was trying so hard to fight the tears, trying so hard not to let her father feel that