There have been many emotional and logical treatises made over the last couple of months, in favor of a Yes vote in Ireland’s marriage referendum today. If you haven’t been convinced yet, I’d like to share one last compelling reason to vote yes (in fact, when all is said and done, I think this is the best reason of all). In the photo there you see my brother, Michael on the left and on the right is his civil partner, Des. Des is a doctor. My mother, Cecilia, raised her children with very clear expectations; one of us was to marry a doctor. Des is Cecilia’s last chance at achieving the dream that she has held dear for over forty years now. Please, get up and go vote yes right now, and make Cecila’s dream come true. Thank you, Ireland.
How Cancer Got Rita
Rita Walsh was an adventurer. She was a world traveler and an avid explorer of the wilds of West Cork and Kerry. Even at 82, she was wildly independent; living alone and tending her half acre garden a few miles outside of Blackpool. Prior to a Walsh family reunion in the summer of 2013, family traits were being discussed. Someone offered optimism as a potential. “Optimism? I should think so,” said Rita, “I just planted three trees”. We laughed till we cried. Rita was going nowhere anytime soon; another Walsh trait is longevity. Never having had children of her own, Rita was a deeply embedded and adored feature of each of her brothers’ families. We felt certain we would have the pleasure of Rita’s company for many more years to come.
Shortly after the reunion, Rita was involved in a car accident. She was pretty badly beaten up, and her shoulder and arm hurt. She applied her usual positive outlook to it all, and we applied our Walsh optimism to her chances of a full recovery. She would be fine.
Rita did heal. She had physical therapy, and the bruises disappeared. About six months later, early in 2014, she began to experience low back pain. She went to see her GP. He attributed the pain to a remnant of the car accident. Rita was happy to accept that diagnosis. Like many of her generation, much as she liked her GP, Rita wasn’t a big fan of going to the doctor. There was always the fear that he’d find something wrong with her. “I’ll be grand”, she would said. She wasn’t a complainer. The pain continued, and Rita didn’t say much about it to anyone. Possibly, she thought it was just part of getting older. We could sense there was a discomfort though. She didn’t verbalize it, but she would, uncharacteristically, refuse invitations and outings.
By Christmas that year, she began to share more frequently that her back was hurting. We noticed that she wasn’t eating much. When asked if she had talked to her doctor, and she said yes. By the end of January she was losing weight, and low on energy. My father insisted on driving her to the doctor. “I suppose I’d better tell him everything this time”, she said on the drive in. This alarmed my father. What hadn’t she been telling him? What hadn’t she been telling us?
Whatever it was, was sufficiently concerning that her doctor had an appointment for her at Cork Maternity Hospital to have tests done just three days later. That Thursday Rita went in, for what she expected to be an outpatient visit, but ended up being admitted. We assume they broke the news to her that she had cancer the next day. My father, brother and youngest sister were in London for my brother-in-law’s Masters’ graduation from Kings’ College. My other sister, who lives close to me in Orlando, called Rita in the hospital. She sounded very down, and told her that it was bad, and she didn’t want to talk about it. Never once, in the coming weeks, did Rita mention the word cancer. A gamut of tests were run and it became apparent that not only did Rita have cancer, but it was ovarian cancer, and quite advanced. When Dad, her health surrogate, returned to Cork on Monday, Dr. Matt Hewitt told him that there would be no cure; that it was just a matter of making her comfortable and extending life.
In Orlando, I sent my passport away for renewal, planning on bringing my children home to spend the summer with Rita, just in case it would be her last. The family plan to all join us in Orlando the following Christmas was also being revised. Instead we’d go to Cork to spend the season with Rita.
After a few days of tests, Rita was discharged. Dad invited her to stay with him. She was in a lot of pain. She had to prop mounds of cushions behind her in an effort to get comfortable. She couldn’t sleep well. She wasn’t eating still, and when she did, whatever she got down, came right back up. She still managed to smile, and to sound cheerful when I called her. A few days after she was released, some tests results came back showing a lot of fluid on her lungs. Dr. Hewitt’s nurse called and asked Dad to bring her back into CMH so they could drain it. She went back in on Thursday. She began to sound brighter once the fluid was drained, and she was on stronger pain medication. She had loads of visitors and the nursing staff was wonderful. She told me all about the parade of handsome doctors. She mused that being handsome was a job requirement at CMH. Knowing Rita, there was a lot of batting of eyelashes going on!
On Sunday she took a turn for the worse, and things began to devolve with a speed we couldn’t have imagined. Her kidneys were shutting down. They put her on morphine. I shared this news on a private Facebook page I has started to share news of Rita’s condition with my many cousins who, like me, adored Rita. My brother in law called me from Ireland Sunday night. He’s a doctor, and he told me that it was time for my sister and I took come home. That she was being given morphine, he advised, was not a good indicator. Audrey and I were on a plane to Cork on Monday afternoon.
Sadly, disembarking our connecting flight in London, we got the call that Rita had passed. It was Tuesday, February 17th. Just over two weeks since Rita had been diagnosed with ovarian cancer. There would be no long summer sitting in her garden with her, and no more Christmas memories. Rita’s adventures had come to an end.
The staff in CMH were amazing. Dr. Hewitt and the nurses there had become very attached to Rita in her short stay. They allowed her to remain in her bed until Audrey and I could get there to say goodbye to the woman we had loved so much our entire lives. I sat by her bed, tears flowing, as I read aloud the letters my three children had written to her, and given to me to deliver.
Two days later Rita was laid to rest; the number of people attending her funeral was testament to the lives that her own enthusiasm, energy and love had touched.
We wish she would have spoken up about her symptoms. We wish she had paid better attention to herself. We wish we had known more. Maybe things could have been different, and my children would, right now, be looking forward to long summer days with Rita, going on picnics and jaunting car rides, instead of knowing that their last communications with her are buried with six feet down in St. Finbarr’s cemetery.
Rita was part of a generation who don’t like to talk about their health, other than in the vaguest of terms. That is especially true when it comes to female problems. I do wish that Rita had known the symptoms of ovarian cancer. I do wish that we had. Maybe we could have put two and two together a bit faster. Though not doubting the emphatics of her statements of well-being, we wish her doctor had pressed her a little harder about her back pain. Having no children put her at a higher risk for ovarian cancer. There are a lot of would have, could haves.
If you have a “Rita” in your life, please be sure to familiarize yourself with the symptoms of ovarian cancer. Don’t be shy when dealing with family members who might be uncomfortable visiting a doctor, or admitting to not feeling well. If you are a “Rita”, and have concerns about symptoms you are experiencing, please spare your family the pain we are enduring, and go and talk to your doctor, openly and honestly.
Here are the most common symptoms of ovarian cancer, from http://www.SOCK.ie (Supporting Ovarian Cancer Knowledge website):
- Bloated feeling
- Persistent swollen abdomen
- Trapped wind
- Pain or dragging sensation in your lower abdomen or side
- Vague indigestion or nausea
- Poor appetite and feeling full quickly
- Changes in your bowel or bladder habits. For example, constipation or needing to pass water urgently
- Abnormal vaginal discharge or bleeding (rare)
There are things we take for granted about our culture, and I am certainly guilty of making assumptions which mash Irish culture into American culture, without really thinking through the differences. Over the course of my 23 years in America, my lack of cultural insightfulness has occasionally had repercussions.
Not long after arriving in Florida, I began my first teaching job. I was co-teaching a class of 36 children, aged between three and six. My co-teacher and I had an assistant. Three adults were absolutely needed to shepherd that big group of children successfully through each day. From time to time, one of us would be out, and finding substitutes was often a problem.
My mother lived not far from me, having moved to the States fifteen years earlier (she was the reason I’d ended up in Florida). She often heard me complain about the substitute situation, and she volunteered that she’d be willing to help out next time we were stuck. I have always been a bit wary of mixing personal life with work life but, even knowing my mother’s history of low levels of self regulation, the absence of alternatives made me seriously consider the offer.
Not long after that conversation, our teacher’s assistant came down with the flu, and we were, once again, badly stuck for a sub. I remembered my mother and considered how having her help out might go. It could work. All she had to do was help supervise and be nice to the adorable little children. After raising three children of her own, and being exposed to American culture for more than a decade, it seemed likely she could pull that off. It would be grand.
The next day Mum showed up to school on time and smiling, and the morning went well. She helped make sure the children were all on task and prevented any major catastrophes. I congratulated myself for having made a good call in asking her in to assist. My co-teacher seemed delighted. All was going swimmingly. I had saved the day.
Then came nap time. The children all lay down for 45 minutes after lunch and recess every day. Most of them napped. The ones who didn’t could lie quietly on their mats with a book. Mum asked what I wanted her to do. “All you have to do is sit with our little friend Brandon, over there, and make sure he stays quiet”. I explained that Brandon was a bit of a terror at nap time. Not only would he not lie quietly, but he insisted on disturbing all the other children in his proximity, making it hard for anyone at all to sleep. “Just sit next to him, Mum. Rub his back and remind him to be quiet. That’s all. I’ve got the rest of the room”. “No problem”, said Mum, with a smile.
So nap time kicked off. I turned down the lights, and put on the relaxing music and busied myself around the room, tucking in and rubbing backs. Every now and again I’d peek over at Mum and Brandon. I saw her whisper to him once and smile sweetly. Perfect. It’s all under control. I continued helping the children get to sleep.
About fifteen minutes into nap time, I stuck my head up over a shelf dividing the room, and saw that Brandon was lying ram rod straight, arms by his side, eyes closed. “Wow”, I thought, “Mum sure has a way with children.” I considered that my own childhood memories must have become skewed over time. I never really would have considered my mother as someone with a natural knack for kids. She caught me looking at her and gave me a smile and a wink.
Once all the other children were asleep, I walked over to mother and saw that Brandon was, unbelievably, asleep too. Really unbelievable. A nap time miracle. For the first time that whole school year the entire class was happily asleep. I invited Mum over to sit with me at a table in the corner.
“Mum that is amazing! Brandon absolutely never sleeps. You’re going to have to tell me your secret,” I told her. She gave a self-depreciating smile. “Oh, it was nothing”, she said. “I could see that he was planning on being difficult so I just whispered in his ear that he was to lie still and be quiet and that if he moved a muscle I was going to break every bone in his body”.
I felt my blood pressure drop. What? What did you say? Please tell me you didn’t just say that. It’s a joke. Ha, ha. Dear God, I thought you were serious. I scanned her face. Nope, totally serious. Smiling at me. Waiting for me to congratulate her on her ingenuity. Well done, Mum. I simply had never thought to issue death threats to the children before. I feel I’ll be much more successful now.
“Mum, you didn’t actually say that, did you?” I whispered. “I did, of course”, my non-plussed mother answered. “And it worked. You just said so yourself”. “Oh dear Jesus, Mother. This is America. You can’t say those sort of things to American children. It’s not done. You could be arrested. I could be arrested. F******ck!” (all said quietly, so as not to wake the children). Suddenly, I wasn’t the bright spark I thought I was, inviting mother in to help. Now we were all going to jail. Mum failed to see the problem, and actually got a bit defensive. She had gone from miracle worker to felon in record time.
I explained what had transpired to my co-teacher. She, being American and not having grown up in a tradition of daily death threats, was even more alarmed than I had been. We decided to see how Brandon was acting when he woke up. We would assess the damage then. Nap time over, a quick check in with Brandon suggested no lasting trauma. He seemed all the better for his nap, in fact. Mother glared at me. One year in America and I had turned into a politically correct hysterical, apparently.
At the end of the day I confessed all to Brandon’s mother. Though slightly horrified, she listened to me plead the case for cultural differences, and seemed to understand that my mother had never really intended on inflicting any actual damage on her son. I was so relieved, and resolved to keep my personal and work life totally separate from that point on.
I also resolved to do a better job of remembering that Irish people and American people are not quite the same thing! As a child growing up in Cork, part of the daily routine of parent child interaction involved a variety of threats of bodily harm. The litany included; “I’ll break your neck.” “I’m going to chop your head off.” “You are about to get a right clip around the ear”. “I will break every bone in your body” (of course). “I will kill you”. And the ever popular, “I’ll sell you to the tinkers”. None of them meant. Terms of endearment really. Since we knew the threats weren’t real, we weren’t traumatized in the least by them. They rarely even impressed us enough to cause the correction in behavior that was the desired outcome of their very issuance. We all went on to live perfectly happy, therapy free lives.
But I have to say that I had never really considered the literal value of the threats, nor how an American child might perceive them. And I had most certainly never expected to be the conduit for such an exposure to occur. I do hope that Brandon did go on to live a perfectly happy life, unmarred by his encounter with my Irish Mammy. And now, a couple of decades on, I have three American children of my own, who have never known anything else but an Irish Mammy. Check back with me in a few years to see if therapy was actually needed.