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Keeping Mum

May 16, 2013

The following is a short story I wrote for the BMA News Writing Competition 2012. It was highly commended and I got a nice notebook for my troubles. It is quite fictional. Please enjoy.

“What do you think it is, doctor?” mum joked.

“How long did you say it had been there?” I asked, poking at the lump on her shoulder. I wasn’t a doctor, not even close. In fact, I was barely out of my first year of medical school but that gave me the greatest level of medical knowledge in my entire family. As such, ever since I had come home for summer, there had been a steady stream of relatives with ever more unusual aches, pains and rashes. My advice had universally been, “If you’re worried about it, you should see your GP.” And now there was mum with her lump.

“Oh, a month or so now,” she answered.      She was sitting on the kitchen stool as I stood by her side. It wasn’t quite how I pictured my first consultation. The lump was the size of a marble, sitting in her skin, and felt like one too.  I tried to roll it between my fingers but it wouldn’t budge. It was squatted down just above her left collarbone, almost defensively. “I was thinking of getting some cream to hide it before summer starts but I wanted to get your opinion first.”

“Does it hurt?” I asked, suddenly conscious of how much prodding I had just subjected my own mother to.

“Not at all, darling.” mum smiled as I went to the sink to wash my hands, “Diagnosis?”

“Dunno.” I glanced over my shoulder and shrugged, “I’ll have a look in my books later.”

Later, I did indeed open my books. Part of me felt a thrill. Diagnosing lumps! I could be just like Doctor House from TV. It didn’t take me long to find that the lump was probably a lymph node. Ah! Deeper study revealed it to be the supraclavicular lymph node. Aha! It can be enlarged in infection but the description didn’t really match what I had felt. Or, as I read on, an enlarged left supraclavicular is known as Virchow’s node which is can indicate…my breath caught and something leaden dropped in the pit of my stomach…which can indicate gastric malignancy.

I flipped to the index so fast, the gust blew the papers off my desk. I found the page number. I turned to it with such haste, I kept missing it by a few pages, and spent anxious peeling the last few leaves back. I didn’t want to think my mum had this but I had to know. Gastric carcinoma is notable for its gloomy prognosis and non-specific presentation. Five year survival rate is ten percent. Signs of incurable disease include epigastric mass, hepatomegaly, ascites and a large left supraclavicular lymph node, known as Virchow’s node.

I put the book down. There was a burning pressure behind my eyes. I tried to rub it away with the heel of my palm but the tears still came. I tried to control my sobs, a wretched affair. If mum came in to check on me, I’d have to tell her. How was this fair? Why mum? She didn’t work with asbestos or radiation or anything dangerous. She didn’t smoke (much). Why did she have to get cancer? The chances of her watching me graduate were miserable, just like most of the long-term future now. All because of a lump.

Calm down. Deep breaths. After a few minutes the tears slowed to a few shudders. It was just a lump. A lump could be anything. Who said it had to be cancer? Not me, a humble first year medical student. I hadn’t even had my results yet. I might not have passed. I could have got it all backwards! There was no point putting the funeral cart before the horse. That lump could be anything but until someone looked at it, it was still just a lump.

Someone should tell her what it was but that didn’t have to be me. The GP could have a look at it or better yet, a dermatologist. Yes, a specialist in lumps in a hospital far away. Then he could tell her the grim news (or good news, maybe?) and I wouldn’t have anything to do with it. Until mum came home, all quiet, saying she had something to tell me. But I’d already know.

I bit my tongue. I couldn’t not tell her, not if it was something so serious. She needed to be told! But did it have to be by me? Have courage, I chided myself. There was still hope. All the books said that outcomes were more positive with early diagnosis. There was still hope that it was just a lump. Either way, mum had a right to know what it was growing on her shoulder.

“Knock knock,” mum, as if on command, chimed as she gently opened the door. I turned around, assuming the bravest face that I could muster. I hoped my eyes weren’t too red. “How’s my little doctor?”

“Fine, mum. Just fine.” I smiled, the greatest performance of my life.

“I see you’ve got your books out,” she said, nodding at my textbooks. Surreptitiously, I turned over a few pages. “Have you worked out what my lump is?”

“Mum, I…” I paused. My mum, who made my lunchtime sandwiches all through school, who continually embarrassed me in front of my friends, who always looked me when I was sick. The hopeful expression on her face, so proud of her young diagnostician. Somewhere inside her, there might be a monster, slowly eating its way through all she was. Or, y’know, it might be just a lump. I smiled.

“If you’re worried about it, you should see your GP.”

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