before i die Jenny Downham

nine

I dont know why theyve sent you here, the receptionist says.
We were asked to come, Dad tells her. Dr Ryans secretary phoned and asked us to come.
Not here, she says. Not today.
Yes, here, he tells her. Yes, today.
She huffs at him, turns to her computer and scrolls down. Is it for a lumbar puncture?
No, its not. Dad sounds increasingly pissed off. Is Dr Ryan even running a clinic today?
I sit down in the waiting area and let them get on with it. The usual suspects are here – the hat gang in the corner plugged into their portable chemo and talking about diarrhoea and vomiting; a boy clutching his mums hand, his fragile new hair at the same stage as mine; and a girl with no eyebrows pretending to read a book. Shes pencilled fake eyebrows in above the line of her glasses. She sees me staring and smiles, but Im not having any of that. Its a rule of mine not to get involved with dying people. Theyre bad news. I made friends with a girl here once. Her name was Angela and we e-mailed each other every day, then one day she stopped. Eventually her mum phoned my dad and told him Angela had died. Dead. Just like that, without even telling me. I decided not to bother with anyone else.
I pick up a magazine, but dont even have time to open it before Dad taps me on the shoulder. Vindicated! he says.
What?
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We were right, she was wrong. He waves cheerily at the receptionist as he helps me stand up. Stupid woman doesnt know her arse from her elbow. Apparently were now allowed straight through to the great mans office!
Dr Ryan has a splash of something red on his chin. I cant help staring at it as we sit opposite him at his desk. I wonder – is it pasta sauce, or soup? Did he just finish an operation? Maybe its raw meat.
Thank you for coming, he says, and he shuffles his hands on his lap.
Dad edges his chair closer to me and presses his knee against mine. I swallow hard, fight the impulse to get up and walk out. If I dont listen, then I wont know what hes going to say, and maybe then it wont be true.
But Dr Ryan doesnt hesitate, and his voice is very firm. Tessa, he says, its not good news, Im afraid. Your recent lumbar puncture shows us that your cancer has spread to your spinal fluid.
Is that bad? I ask, making a little joke.
He doesnt laugh. Its very bad, Tessa. It means youve relapsed in your central nervous system. I know this is very difficult to hear, but things are progressing more quickly than we first thought.
I look at him. Things?
He shifts on his chair. Youve moved further along the line, Tessa.
Theres a big window behind his desk, and out of it I can see the tops of two trees. I can see their branches, their drying leaves, and a bit of sky.
How much further along the line have I moved?
I can only ask you how youre feeling, Tessa. Are you more tired, or nauseous? Do you have any leg pain?
A bit.
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I cant judge it, but Id encourage you to do the things you want to do.
He has some slides with him to prove the point, passes them round like holiday snaps, pointing out little splashes of darkness, lesions, sticky blasts floating loose. Its as if a child with a brush and too much enthusiasm has been set free with a tin of black paint inside me.
Dads trying unsuccessfully not to cry. What happens now? he asks, and big silent tears fall out of his eyes and plonk onto his lap. The doctor hands him a tissue.
Outside the window, the first rain of the day spatters against the glass. A leaf caught by a gust of wind rips, then flares red and gold as it falls.
The doctor says, Tessa may respond to intensive intrathecal medication. I would suggest methotrexate and hydrocortisone for four weeks. If its successful, her symptoms should improve and we can continue with a maintenance programme.
The doctor keeps talking and Dad keeps listening, but I stop hearing any of it.
Its really going to happen. They said it would, but this is quicker than anyone thought. I really wont ever go back to school. Not ever. Ill never be famous or leave anything worthwhile behind. Ill never go to college or have a job. I wont see my brother grow up. I wont travel, never earn money, never drive, never fall in love or leave home or get my own house.
Its really, really true.
A thought stabs up, growing from my toes and ripping through me, until it stifles everything else and becomes the only thing Im thinking. It fills me up, like a silent scream. Ive been ill for so long, puffed up and sick, with patchy skin, flaky fingernails, disappearing hair and a feeling of nausea that permeates to my bones. Its not fair. I dont want to die like this, not
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before Ive even lived properly. It seems so clear to me. I feel almost hopeful, which is mad. I want to live before I die. Its the only thing that makes sense.
Thats when the room comes sharply back into focus.
The doctors going on about drug trials now, how they probably wont help me, but might help others. Dads still quietly crying, and I stare out the window and wonder why the light seems to be fading so quickly. How late is it? How long have we been sitting here? I look at my watch – three thirty and the day is almost ending. Its October. All those kids recently returned to classrooms with new bags and pencil cases will be looking forward to half term already. How quickly it goes. Halloween soon, then firework night. Christmas. Spring. Easter. Then theres my birthday in May. Ill be seventeen.
How long can I stave it off? I dont know. All I know is that I have two choices – stay wrapped in blankets and get on with dying, or get the list back together and get on with living.
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