My sister Vikki, died in the Bahamas on May 25, 2007, after a 15 month battle with ovarian cancer. She was only 44, one of the numerous women in the world who fall prey to what has become known as the ‘silent killer’.
Vikki had always had a phobia of doctors. In February 2006, after several weeks of feeling her stomach bloated and a severe pain in her right side, my mother finally coerced her into seeing a doctor. The first doctor she consulted thought she might have had a gastro-intestinal infection. She was given medicine. If after one week, the bloating and pain persisted, she would need further tests. One week later, the pain was worse.
At the private Doctor’s Hospital in Nassau, staff thought she was pregnant when first admitted. Blood tests and scans discovered the cancer. The gynaecological doctor on duty at the time diagnosed her with stage III ovarian cancer. The cancer was already progressing to other organs. His first action was to drain Vikki’s stomach, to reduce the bloating and relieve the pain. The next step was to be a complete hysterectomy.
I was living in Belgium, recently pregnant, when the news reached me in late February. I did not know how to react other than with concern. I did not understand the gravity of ovarian cancer until I spoke to my gynaecologist that March. When I told her Vikki’s symptoms, it was apparent she was disturbed by my words. She was sympathetic, yet direct — Vikki probably had 1 year left to live; she had seen this before. I do not damn her for what some feel was a negative or too harsh point of view. She wanted me to understand the seriousness of this illness, to prepare myself for what was to come, to make use of the time I had potentially left with my sister. And, years ago, when I lived in Atlanta, I had dreamt of my sister’s death. Everything seemed too real; too many similarities. I was devastated, but I could never tell my sister of my doctor’s words or of my dream, at least not until 3 days before she died.
Vikki refused the proposed hysterectomy for several months. She did not want the symbol of her femininity taken away from her nor an ugly scar down her stomach. Instead, she started regular sessions of stomach drainage every time the bloating returned. Dr. B, the gynaecologist who diagnosed her cancer, became her doctor. He recommended chemo treatments in an effort to control the cancer, to stop it from spreading further.
My sister had been working part time at a bar/restaurant on the waterfront and living with my mother for the past several years. She did not have any insurance. Because of this, and the fact that treatments would have been too expensive for my mother to afford, Vikki could not be treated in the private hospital. An arrangement was made with Dr. B to treat her as an outpatient at the public Princess Margaret Hospital, where he also worked.
Her first chemo treatment was at the chemo clinic attached to this hospital. It was scheduled to last 2-3 hours. About 45 minutes into the treatment, Vikki started to hyperventilate. It was determined she was having an allergic reaction, the drugs were being introduced to fast into her system, it was rebelling. She was rushed to the emergency room of the main hospital, stabilised and placed in the women’s gynaecological public ward where she could be under constant monitoring. The chemo treatment was modified to one where she would have to stay the night in the hospital. She spent the next three days recuperating from the treatment, closely monitored for any other unusual reactions.
The public ward was where women too poor to afford private or semi-private rooms stayed or where women were placed in an emergency when none of these rooms were available. It was not the most pleasant place - the smell, the dourness, the lack of privacy. Her nausea and the experience of her allergic reaction lent themselves to her horror/fear of the public ward. She swore she would never go back for another chemo unless in a semi-private or private room.
In June 2006, I returned to Nassau to see Vikki. She still had not agreed to the hysterectomy. Her hair was already thinning, she wore colourful scarves all the time to hide it. We spoke some of her illness. She wanted to understand why, when she felt her life had just started to get better, when she was beginning to be happy, that this cancer should arrive. We talked about Louisa Hay, and her belief that we create our own illnesses. We alluded, without outright words, to her sexual abuse as a child/teenager by my father. Could this be the reason? Because she had never dealt with how it affected her? She would never admit this.
We also discussed how the Louisa Hays of the world believe we could heal ourselves of illnesses using positive affirmations. I discovered in her journals, after her death, that Vikki had tried affirmations.
During this trip I went with Vikki and my mother to Dr B. to discuss her cancer and to encourage Vikki to have the hysterectomy. I never fully comprehended or was aware then, of the magnitude to which ovarian cancer could ravage a woman, until I saw Vikki in the last days of her life. I understand it even more now since I started to write a blog about my sister’s life and death. Dr. B told us to ‘read on the internet everything about ovarian cancer’ without giving what I felt was an adequate understanding of the situation from his point of view. He had no real literature to give us; perhaps none existed in the Bahamas. In truth, I was never at ease with his abilities to treat my sister, although she and my mother were. I offered for Vikki to come to Belgium with me where I thought she would receive better, more advanced treatment. But Vikki refused my offer. She did not want to intrude on my pregnancy or leave behind her beloved dog, Gucci. For the hysterectomy she feared the scar down her stomach, no matter how much the doctor assured her it would be a bikini line cut. Exasperated, Dr B gave her an ultimatum.... “If you don’t want to live, I’m finished with you.”
Finally, around August, Vikki had the hysterectomy. In the meantime, she had more overnight chemo treatments at the public hospital, this time in a private room. A plethora of drugs that included painkillers, stool softeners and anti-anxiety pills became her daily diet. Because she was so weak, she ended up staying in the public ward. The doctors and nurses were afraid to leave her alone in case something happened and no-one found her in time. She learned to deal with the conditions of the ward and grew to be friendly with the nurses and with the older poor patients, whom she made laugh, lifting their spirits. Vikki was good at making people feel comfortable, that she understood them, and she made them laugh. It was something I witnessed all my life, something others even during her illness often remarked on.
After her hysterectomy, Vikki was never able to defecate without pain and the stool softeners became a way of life. Eventually a port had to be put in her neck to facilitate the chemo and any other drugs necessary when she stayed in the hospital. Her veins were collapsing, her tolerance for pain low.
Her situation became more intense on Christmas Eve 2006. She had been overnight at the hospital for a chemo treatment and released to return home for the holidays. She had made such an effort to decorate the house, buy presents for everyone, even sending flowers to us in Belgium.... she knew it might be her last Christmas. Christmas Eve arrived. Vikki was vomiting until only bile came out. Dr B was out of town, and the replacement doctor at first suggested she drink ginger ale to ease the vomiting. If that didn’t work, my mother would have to go to the private hospital to get a medicine that would stop the vomiting. It didn’t.
Vikki was admitted once again to the Women’s Gynaecological Public Ward. She passed Christmas and New Year’s there, drugs and liquid food pumped through the new port in her neck. She was not released from the hospital until I came again in February 2007 with my husband and my son of 5 months. We brought Gabby to the hospital. Vikki forced herself into a wheelchair so she could hold the child she had loved since she knew of his inception. The doctor thought it was what she needed. She was released from the hospital for a few days to return home to spend time with us and her beloved Gucci.
She was tired and in pain but she insisted to come out to restaurants with us, though she ate little. She walked slowly and tired easily, any jolts from the road as we travelled in the car caused her discomfort. Only once did I see Vikki lose her composure. She had been in the bathroom trying to take a wipe off. Suddenly she cried out, in danger of passing out. I rushed to grab her, and with my husband, carried her to her bed. She lay there with me at her side and started to cry, saying “Why me, why me?” Quickly she gathered herself, apologised for a moment of weakness.
Between February and May 2007, my brothers and nephew came to visit. Vikki was released from the hospital a few times for a few hours to spend time with them. The rest of the days she remained in the hospital.
My mother was 79 years old at the time Vikki became ill. She was Vikki’s nurse, friend and companion during her illness. With the love and support of neighbours, her priest, friends from the church and workplace, she took Vikki to her doctor’s visits, to the chemo treatments where she would be seated next to Vikki when she awoke. At home, she would hold Vikki’s hand at night until she fell asleep and at really bad times, sleep next to her. She bore the brunt of it as the rest of our family was scattered in Europe and the USA. I called at least once a week, often twice to get news and speak to Vikki, if she was not too tired to talk. She never outright spoke of how much pain she was in.
In May 2007 I went back to Nassau. The doctor had been trying some other form of treatment, an injection directly into the stomach. It didn’t work. Vikki’s organs were starting to shut down, to stop functioning. She couldn’t eat hardly anything without vomiting it back up and had to be fed through an IV. She needed a catheter to help her urinate, she could not pass stool. They did not know how much longer she would survive in this condition. There wasn’t anything they could do for her except try to make her as comfortable as possible.
Ten days after I arrived in Nassau, Vikki died. During my 10 days with her I took turns with my mother sitting by her side. Friends came and went. The last time Vikki rose from her bed was in an enormous effort to hold my son in her lap in a wheelchair in the corridor outside the ward, an oxygen mask on her face. I thought my heart would tear out as I watched Gabby look at her, touch her face gently, then look back at me. He was so quiet, so calm, as if he understood the need to keep still, to give her these cherished moments. Moments I will never forget. I saw the struggle for her to return to her bed as three nurses pulled, pushed and lifted her from the wheelchair back onto the bed. She had no strength; she could not move her swollen legs and feet voluntarily.
In her final 2 days of life, Vikki was placed in a drug induced sleep. She had been unable to breathe, panicking, tearing at the oxygen mask on her face. She slipped into this ‘sleep’, moaning from time to time. It was as if even under the heavy drugs, she experienced some kind of torture. And, finally, with three rattled breaths, Vikki’s life was over. The ovarian cancer had won its victim.
I had expected it but when the end came and it was me there to see it, it affected me profusely. I felt for her pulse in those last moments and called for the nurses. I watched my mother holding her daughter with such grief I can never forget. I removed Vikki’s jewellery from her still warm body and called for the priest and the undertaker. I guided my mother through all the arrangements for my sister’s funeral, picking out the casket, the flowers, the clothing. I went to the morgue to put makeup on the face of my sister for the last viewing before the funeral. I did it because I remembered when my grandmother had died, how I hated her face, what they had done to it, it didn’t look like her. I wanted to recapture my sister’s beauty, in death, just one last time. I did it with the help of the mortician, to whom I am grateful for helping me maintain my sanity. Carefully, I painted her fingernails, her face. I placed her jewellery on her and wrapped a black lace scarf around her battered head. My mother told me she looked beautiful. It mattered.
In the next 5 weeks I cleared through the meagre belongings of my sister, giving away most of her clothes to the cancer society. I did not want my wounded and exhausted mother to suffer through doing this. I found a new home for Vikki’s beloved dog; as much as she wished to keep this memory of Vikki near her, my mother was not capable of handling the dog. I insisted my mother come with me back to Belgium. Vikki’s illness had affected her emotionally and physically, I could not leave her alone in that house to dwell on the death of her daughter. She agreed and spent the next 3 months with us.
According to her journals, Vikki kept most of her pain to herself. She never wanted to burden her partner, me, her brothers, her friends and in particular, my mother, any more than she thought she already was with her illness. She went through ups and downs but she seemed to always keep hope up until three days before she died. I was alone with her and she half asked/half told me that she was dying. I couldn’t lie any longer to her, holding her hand, I nodded my head. She told me she always knew she would die young. It was then that I told her about my dream so long ago. It was then she told me to always tell my son I loved him, no matter what and that she would be there for him, some kind of guardian angel. It was then she made me promise to tell my mother how much she loved her. And then she made me go home.
She never spoke to anyone, except maybe the priest, of dying, of how she really felt. She only spoke to our neighbour about how she wanted to be clothed for her funeral. She was often admired during her illness because she never indicated any anger at her burden, any real sadness. Through it all, she showed humour and concern for those around her including the other sick women in the public ward.
The reality is that Vikki was never in very good health all her life. Whether this stemmed from the long years of sexual abuse, I cannot say for sure. Certainly it played an important role in her emotional life. When she finally escaped my father at the age of 18, she turned to drugs and alcohol, at one point even trying to commit suicide. It took years for her to come to a point in her life where she was not so self-destructive. She always had problems with her menstruation, it was often and painful. At one point she had ovarian cysts. But Vikki refused to go to doctors. She saw a gynaecologist no more than three or four times in her life prior to her illness. Ovarian cancer had a willing victim. It was destructive and violent and never backed down. And Vikki waited too long to take action against it”¦ she never had a chance.
Regina Sayer lives in Singapore and writes a blog: http://myimmortalsister.com about the life, illness, and decline of her sister who lived and lost her battle with ovarian cancer in the Bahamas: at http://myimmortalsister.com. One of the websites Regina found comforting for people who have lost siblings is: http://www.counselingstlouis.net/page22.html
Regina wrote “I always think of those women suffering from this disease or any other cancer when I am writing as I know the imagery in my stories are not always uplifting. I hope if any of them or their loved ones, read my stories, that it is not destroying their hope for survival.” There is no “sanitizing” cancer or its impact on the human body and lives. And there is no “sanitizing” death and stories about it. Families with the love present in their stories and situations, that seems to be the gift to everyone involved.
Christine Vernon is the founder and editor of Women's International News.