Elizabeth Bryan - Singing the Life: The story of a family living in the shadow of Cancer

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First published in 2007 by Vermilion, an imprint of Ebury Publishing

This edition published by Vermilion in 2008

Ebury Publishing is a Random House Group company

Copyright Elizabeth Bryan 2007

Elizabeth Bryan has asserted her right to be identified as the author of this Work in accordance with the Copyright, Designs and Patents Act 1988.

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ISBN 9780091917166

The publishers have made every reasonable effort to contact the copyright owners of the extracts reproduced in this book. In the few cases where they have been unsuccessful they invite copyright holders to contact them direct and corrections can be made in reprints.

Extracts from Anam Cara by John ODonohue, Its Not Like That Actually by Kate Carr and C: Because Cowards Get Cancer Too by John Diamond have been reproduced by permission of The Random House Group Ltd.

Prayers by Reinhold Niebuhr, Margaret Torrie, and Thomas Nerton, as quoted in A Practical and Spiritual Approach to Death and Dying by Bill Kirkpatrick, have been reproduced with kind permission by Darton, Longman and Todd.

For
Max, Liz, Ben and Catherine

And to the memory of
Alice

I HAVE HAD three bolts from the blue that have changed my life. One in 1948 at the age of six, one in 1973 and then, the third, in 2005 when I developed cancer.

My first bolt I remember mostly through the memories of my parents. Having watched a film about African children in hospital, I decided to be a childrens doctor. Thereafter I never wavered. When doubt over exams loomed, I would sometimes weaken in my medical ambition, but never in my wish to work with children.

I always loved being with children. As a teenager, I would be called upon to arrange childrens parties, or to conduct the under fives class at pony club. Later, an unmarried and childless paediatrician was the obvious choice for godparent, and over the years I acquired 14 godchildren, all of whom have given me enormous pleasure. For several years I held godchildrens camps in the orchard of my little cottage on the North York Moors. It is touching how many of them still remember the fishing expeditions to Whitby, mystery tours over the moors, the leaking tents and damp barbecues.

They would teasingly suggest potential husbands for me and plan their bridesmaids dresses. We talked of the children I would have, of the help they would give when they eventually arrived. As it turned out it is I who enjoy my godchildrens own children. I have 16 grand-godchildren and more are due this year. To my sadness I have never had any children of my own.

The second bolt hit on a cold night in March 1973 at Hammersmith Hospital. I was the junior paediatrician on call. Twins were about to be delivered. I do not know who was the more surprised, the mother or me, as the two baby boys emerged. One was a bouncing, bright red six-pounder and the other pale and wizened, weighing little more than three pounds. This was my first experience of twintwin transfusion syndrome, where during the pregnancy one baby transfuses blood, and hence most of the food supply, into the other one. I decided to find out more.

The quest marked the beginning not only of a two-year research project on the placenta in a twin pregnancy but of my preoccupation ever since with the nature and nurture of multiple births and their families. A few minutes in the delivery ward had given birth to one pair of twins and a lifes work.

The third bolt should have arrived in 1975 but its full impact did not hit me for another 30 years. For in February of that year I received what should have struck me as a highly significant letter from Dr Nancy Maguire, one of my fathers eight first cousins from his mothers side of the family. She wrote:

I am writing this circular letter with its enclosures, to the medical members of the family. As you will see from the enclosed family tree there is already a 50 per cent incidence of ovarian cancer diagnosed in our family on the Hall side in two generations. Both I and Farquhar Macrae [another of my fathers first cousins] feel that it is vital that the girls of the next generation to us are fully informed and can discuss this family case history with their gynaecologists.

Before this I had no idea that cancer was common in our family. Nancy Maguires letter went on to discuss the family tree and possible source of the cancer, pointing out that my grandmother, Sylvie, and my grandmothers half-sister, my great-aunt, had both died of ovarian cancer as had Nancys own sister and her first cousin, my aunt Sylvia. Another cousin Margaret, ne Macrae, had been successfully treated for the same cancer by radiotherapy.

She enclosed pathology reports from various members of the family showing that all had the same type of cancer of the ovary, an adenocarcinoma. She also pointed out that the age when the cancer appeared was falling. The two cases in my grandmothers generation were both in their sixties, in Nancys generation two had been in their early fifties and one was 47. Of those afflicted, not all had had children and for four out of five the cancer had had a rapid course with none surviving more than two years.

She continued:

However the question arises as to whether it is male transmitted. This question is very important for Paul Bryans daughters [myself, Felicity and Bunny], Farquhar Macraes daughters and Norman Macraes daughter... My personal feeling is that to be on the safe side, one has to assume the possibility of male transmission, at least to the extent of careful specialist gynaecological monitoring.

Nancy said that, in view of the family history, which meant that she herself had a 50/50 chance of inheriting the cancer gene she had recently had a hysterectomy with both ovaries removed and was encouraging her younger sister to do the same. She went on:

I am most thankful that I had an understanding of the implications of the family history in this very silent disease, and was in the hands of a gynaecologist who took it seriously and was prepared to take preventive action.

I have written this letter to alert some of the more far-flung members of the family who may not be aware of the details of this medical family tree, so that they can contact all the Hall descended female cousins they know of who come into this at risk category, so that they can present the facts to their gynaecologists for evaluation and careful monitoring.