The Meandering Social Worker

wandering : wondering : learning

4.A PECULIAR ADULT

The green hedgehog

The money box sat in the cupboard under the sink.  It was glazed pottery, dark green, with smooth lines and feel.  It felt comfortable to hold in the hands and she had always liked the feel and look of it.  It was in the shape of a hedgehog but without the prickly spines.  The hole at the top to put the money in was large, it had to be as there was no removable plug in the bottom through which to get the coins out again.  It had been an engagement present from Peter’s best friend.  Except now there was no engagement.  Karen had seen to that.

Karen and Peter had been together for nearly four years and had been living together for a year of that time.  Except that Peter had begun talking about building their own house and having babies.  She thought she loved him but she was getting increasingly scared by Peter’s level of commitment, the intensity of his love for her, and the commitment she thought she was expected to give in return.  She did the only thing she knew how to do.  She ran away.  She had taken only what was originally hers, except for the hedgehog.

Karen was still a bit ambivalent about love, she’d never really found out what it was from the Love Is cartoons she had read so many of as a teenager.  She knew she cared for Peter but after living together for a year there were tensions.  Were they all from her own imagination?  What else was going on?  Was the relationship still working?

Now, all she knew was that every time she looked at this money box it hurt her inside.  She didn’t really know why.  Was it love?  Was it guilt?  The pain had begun when Peter came to see her in her new flat.  He was upset, “You even took the hedgehog Greg gave us”.  After that she couldn’t look at it anymore without feeling the pain, and had hidden it under the sink, behind the bottles and containers of cleaning materials, where should could find it when she felt she needed to feel the pain again.  She only hoped that over time the pain would go away.  She didn’t like the pain of feelings.  She wasn’t used to them.  Maybe the money box could tell her more about something she didn’t understand.

Je t’aime

Karen wrote the words on the outside of the cigarette packet.  She had no idea if they were true but Matt had declared his love for her a few days previously.  And he was waiting for a response.  She wanted the relationship to continue, at least for now.  But she could not bring herself to say the words he wanted to hear, they were not words that were familiar to her lips.  She could not even bring herself to write them in the familiar English.  So she wrote them in French, a relatively meaningless language she had barely studied for three years in school.  Matt was delighted.  With tears in his eyes he threw his arms around her and hugged her.

What is grief?

The first of Karen’s grandparents to die was her maternal grandfather.  He had died when she was 18.  She had always thought she had been reasonably close to her grandparents yet she had not shed a tear when he died.  Nor had she shed a tear for him since.  That had always worried her a little.  Karen had learned a little about the grieving process over the years.  Most people seemed to go through some kind of grieving process when someone they cared about died.  Why hadn’t she done the same?

In fact, his death had passed virtually unnoticed in her life.  He simply wasn’t there any more and she had neither looked back nor been aware of caring.

Karen had heard that some people bottled up grief and that made it worse later on.  She wondered if that was the case with her.  So, five years after his death, she tried really hard to feel the grief of his loss.  It just wouldn’t come.  She had no recollection of having ever felt grief, no markers by which to measure what it should feel like.  Eventually she gave up, saddened more by her inability to grieve than the old loss over which she was attempting to grieve.

She never told Matt about her concerns but somehow he knew she didn’t have the ability to grieve.  He would sometimes say to her that she wouldn’t cry if he died.  He even asked her if she would cry if her mum died.  She truthfully couldn’t imagine herself crying if anyone she knew died.  She thought maybe it was because she had grown up living next to a cemetery and death was always easily talked about in her house.  He couldn’t understand her, he would be grief stricken when his grandparents or his mother died.  And she dreaded the day when that would happen, knowing her lack of understanding of the meaning of grief would mean she would be of little comfort or help to him.

Buttons

Karen studied the buttons in the pile on the floor in the middle of the room.  She was conscious that she was becoming one of the last of the group still sorting through the buttons.  She was taking part in a work related training course and this was the opening exercise.  The group had been told to sort through the buttons and select three each: one to represent their childhood, one to represent the present, one to represent the future.  Gradually people were returning to their chairs, that formed a circle around the outside of the large room, their buttons in their hands.

Karen had already found an ornate gold button with a purple glass centre to represent the present.  A smaller, square, plain black button represented her future, but she could not find a button to represent her childhood, her past.  The problem was not the choice of buttons, there were plenty there, it was just that her childhood had no relevance to her, she never considered it to be a part of her life.  Eventually she chose one of the smallest buttons; it was clear plastic, without colour, a button that might be found on the inside of a jacket to help hold the front in place when being worn.

In pairs the group explained the buttons to each other.  Karen’s present felt golden.  She was in the final months of her treatment for breast cancer and her faith in God had been strengthened by her cancer experience; the purple centre of her chosen button represented God at the centre of her life.  The medium sized black button was a statement of fact.  Her husband suffered from a long standing physical disability and she could reasonably expect to be a widow well before she retired.  But of her childhood she had no emotional memories; her childhood meant absolutely nothing to her.  Even the smallest clear button she had finally selected felt stronger and more ‘present’ than she felt her childhood to have been.

Karen wondered for a moment if her problem with finding a button had anything to do with what she now called ‘the Father Christmas experience’.  It had been about six years since the night she had sat in the pew and remembered all those Christmases past.  Maybe there was more to understand still.

Karen didn’t think much more about her childhood experience.  She had accepted it had happened.  Just having retrieved the memory of those childhood events had softened her a little.  She still didn’t like it when parents told their children about Father Christmas but it no longer made her so angry or agitated.  She understood why the parents did this, and why she reacted as she did.  She could rationalise it.

She was a little more relaxed about surprises too, even to the point of wishing that maybe someone would give her a nice surprise sometime.  Except that now it was too late.  She had long ago trained her parents and anyone she was involved with not to give her surprises.

Finding the lump

As she lay in bed in the dark Karen became conscious of her surroundings.  The light from the lamppost outside the bedroom window cast a light glow over the room, but she didn’t see the mirrors, the wardrobes, the storage chest, the dressing table, that furnished this room.  She didn’t notice the feel of the sheets and was barely conscious of the heat of the sleeping body next to her.

As Karen lay there, her right arm flung above her head, her left arm across her chest, she felt with all her awareness the tiny pea sized lump underneath her fingertips.  Karen began by manipulating the lump with her finger tips.  Was it really a lump?  Was it really there?  Would it disappear if she moved her arm to a different position?  Would it come back again if she returned her arm to the original position?  After a few minutes of experimentation Karen could only conclude that there really was a lump.  It was right at the edge of her right breast, where the soft tissue met her armpit.

In her heart she sensed, rather than feared, that this was cancer.  It was an instinctive understanding.  A calm knowledge that God was allowing this for a reason but that all would be well in the end.  She didn’t expect to die.

Karen turned to face the bedside table and looked at the green electronic digits on the alarm clock.  Nearly 4.30 am.  Karen assessed the situation and smiled to herself.  If this was her mum she would be waking her husband Tony, getting up to make the first of endless cups of tea, pacing up and down, and worrying.  But Karen wasn’t her mum.  Instead she carefully felt the lump again, memorising with her fingers its exact feel and location, before turning over and going back to sleep.

When she woke again at 7.30 am, Karen felt carefully and found the small lump again.  It was still there.  She felt totally calm.  She knew what she had to do. Leaving Tony asleep Karen went to work.  If anyone thought anything might be wrong it was only because she left work on time instead of after almost everyone else.  Her GP didn’t have an appointments system, patients just turned up, and that’s what Karen did on her way home.  There were a handful of people waiting before her and it was gone 6.00 pm before she was seen.  The process had begun.

When Karen got home that evening she felt obliged to tell Tony where she had been and why.

As far as Karen was concerned there was no need to tell anyone else.  Why set up fears and start discussions when there was nothing to tell except negative speculation.  As far as Tony was concerned though he immediately wanted to tell everyone.  Begging him not to she had to virtually stand over the phone to prevent him from phoning her parents, until eventually she agreed he could tell his brother in Devon.  The only trauma of the next couple of months was Karen’s perpetual fear that Tony would not be able to hold his tongue and blab to her parents.  After all, it wouldn’t be the first time he had dropped her in it that way.

The cancer year

Despite his protestations, Karen had been relieved that Tony had not told anyone other than his brother about the appointments she was having to investigate the lump in her breast.  There had been a series of appointments with the GP.  They had discussed the probability that, at the age of 35, the lump was benign and likely to disappear of its own accord in a matter of weeks.  Then, when it hadn’t, her GP had arranged an appointment with the hospital.  She was too young for the mammogram to be effective at showing up the lump, her breast tissue still having the density of youth.  The next scan had been inconclusive.  Then finally a needle biopsy had been carried out.  The conclusion was that the lump was malignant.  The next stage would be a hospital admission to remove the lump.  It was three months since the process had begun.

Now Karen finally had to face the one thing she had been putting off during all this time.  She would have to start to tell other people what was happening.  The hospital admission was booked for first thing Monday morning.  She would only be admitted for one night.  Sunday evening Karen sat down with the phone and rang her parents.  Who should she ring first, each would ask if the other already knew, each would expect to be the first to be told.  Eventually she decided to ring her dad first.  He would be the easiest.  Karen anticipated he would be upset but he would also not show it.  She was right.  He heard what she had to say, took it all in and the call was over.

Then Karen rang her mum.  As she expected it was a difficult call.  She couldn’t understand why Karen hadn’t told her before.  Had that been her mum finding a lump she would have been turning to her own mum and sisters for support.  Karen said it was because she hadn’t wanted to worry her unnecessarily, knowing what a worrier she was.  The truth would have been that Karen didn’t want to be bothered with her mum’s worry and emotionalism.  She much preferred to cope alone.

As the weeks passed it was obvious that although Karen had given her mum all the information at the beginning her mum had not heard anything beyond the word ‘cancer’ in that first conversation.  She had to repeat everything numerous times before her mum began to remember any of it.

Following the operation the surgeon came and told her it looked as if the tumour was benign.  He had to take back his words when the pathology results came back.  He was known for his appalling bedside manner, his tendency to leaving crying patients in his wake.  In Karen he found a rare patient, one who had done her research, was prepared for his answers, and could ask questions for herself.  Karen felt she could see him relax as their consultations progressed as he realised that whatever he said did not produce signs of distress.

With a malignant diagnosis of the material that had been removed it was necessary to have a second operation to remove some additional tissue and lymph nodes for testing.  This was a longer operation and involved a longer hospital stay.  Four months of chemotherapy, two of radiotherapy and a further two of chemotherapy followed.  Karen continued to work throughout her treatment, albeit on a flexible basis and partly from home to fit around her treatment.

Tony was worried.  He wanted to look after Karen.  He expected to be her crutch, her support.  He expected her to need to be ferried around.  He expected her to fall apart, like he was.  Instead Karen knew the treatment would reduce her physical resilience over time and it was more likely she would need his help towards the end of the treatment.  She drove herself to her chemotherapy appointments, finding she had a few hours to get home before the debilitating effect of the drugs took effect.  Tony was not happy about her independence.  She explained it would not help if he made himself ill running around looking after her in the early days of the treatment when she would least need it, and then not be available to help her when she did.  It was the truth.  It was logical and made sense, at least from her perspective. Did he understand?  She doubted it.

Throughout her treatment Karen felt she was always managing other people’s expectations and uncomfortable emotions.

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