Missy and her invisible disease
I’ll call her Missy, not because that was her name but because it wasn’t: she valued her privacy and wouldn’t want you to connect her story and her real name. And because she was my patient. She’s long gone now, her name on one of those multicoloured files you see in doctor’s offices. This is her story — the story of an invisible disease.
Blonde, although in her late 70s the blond came from a bottle or a wig shop and not from natural sources. Tall, elegant, beautiful in her day I’m sure. Beautiful in the days I knew her too, though it was the beauty of a rustic farm fence, or classical painting, not the beauty of youth. The weather-worn patina came partly from her years, partly from the two pack a day habit she consumed for the decade I knew her. That was the reason for her visit on that Friday — the X-ray report had come back.
The persistent cough she complained of, the one that didn’t go away with antibiotics and puffers, the one that had made her sputum become blood tinged, had revealed itself as a bronchogenic carcinoma.
Its location, its size, its look was as clear to the radiologist as it was to me: it was as though it had spelled its own name in the reversed black and white of X-Rays. Its name was cancer.
There was some good news mixed with the bad. Cancer of course is a hard word to absorb, but the tumour was very small, there was no sign of spread, she was otherwise in good health. I was optimistic that the hospital’s best-in-Canada lung surgery team could remove it and — with our oncologists — give her years of good health. She accepted the news calmly enough, even taking the extra time we had booked her for to hear it. At the end, I asked, “Are there any family members you can call? Any friends? How about neighbours?” She lived in a senior’s building, her neighbours as close as across the hall.
Bob (also not his name), her ‘husband’ of 20 years had family but they were not hers. She was the other woman, never formally married to Bob: they resented or rejected her, or so she believed. Her status was like a physical object for her — binding her to him like a rope, walling herself off from friends, neighbours and relatives, like a moat. And the physical object, this moat, kept them at bay, I’m sure. She had loved Bob deeply, and I just bet passionately. When he died, she settled into widowhood gently, with good humour, but in a most solitary way, not recognizing or misreading invitations to friendship.
“No, there’s no one doctor, I’ll be all right.”
“No one? Not even a neighbour to spend time with you on the weekend? This is hard news, Missy. Here’s our number. Please call us if you have questions or worries. I’ll see you Monday. We can talk about next steps then, answer more of your questions.” It was the last I saw her. In seventy two hours, she was found dead by her apartment super, the cause never revealing itself, at least to my satisfaction. Possibly an overdose, though the toxicology report was ambivalent. Possibly the unpronounceable but deadly Takotsubo Cardiomyopathy, the ‘broken heart’ syndrome we read about. Possibly an arrhythmia. My own hunch? More than the cancer, more than her chronic bronchitis and awful pack-year smoking history, more than her widowhood, loneliness killed her.
There’s evidence to back my argument that isolation is like a disease, an invisible and deadly one at that. There was, for example, a recent article in the New York Times International Weekly about the subject — about new research, about its increased risk for cardiovascular disease, about social programs, about recognizing its deadliness. We are, it appears, hard wired to be social. The effort that it takes to block that activity must take a toll on the body; it certainly takes a toll on the person.
What can we do? As a society, we can become more aware of its consequences. As communities, we can offer programs, reach out, develop networks. There are dozens, hundreds, maybe thousands of Missys in every village, town and city of Canada — in Kitchener for example — on your block or in your apartment building. And as individuals, we can use the word, the random act, the invitation to lunch or coffee at Timmy’s, overcoming misperceived social clues.
At the very least, we can, like I do, remember Missy.