Doctor diagnosed with terminal cancer leaves legacy for patients

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Kate Granger was just 29 when she was told she had terminal cancer. She has dedicated what time she has left to improving care. Sheron Boyle met her.

DRIVING in an open-top car to a romantic weekend in the Californian coastal resort of Monterey, Kate Granger wanted so much to be enjoying herself. But the niggling back pain she had suffered for several weeks had become so bad that instead of a candle-lit dinner by the water’s edge, Kate was writhing in pain on the hotel bed.

Her husband, Chris Pointon, insisted she go immediately to A&E. By now, Kate was too ill to disagree.

Over a weekend last July, Kate underwent tests and was given a provisional diagnosis of ovarian cancer. Having qualified as a doctor seven years prior and now working as a registrar in elderly medicine at Wakefield’s Pinderfields Hospital, she had already worked out that she probably had a tumour in her lower body.

Her diagnosis was confirmed on her return home when she was admitted to the Bexley Unit at St James Hospital, Leeds, where cancer patients are treated. And so the medic became a patient – an experience that was to open her eyes to the best and worst of the NHS. In the lonely, quiet nights of her hospital stay, Kate began to keep a diary.

“It helped clear my head, to get down my thoughts on how I felt about my illness,” says Kate today.

August 17 was a “day from hell”, Kate recalls in her diary: “I’m lying waiting for the results of an MRI scan determining how extensive my cancer is. The registrar asks me why I am so upset so I tell her: ‘Because I’m 29 years old and I’ve got cancer’.”

“Her astonishing reply is: ‘Don’t be silly, this won’t turn out to be cancer, you’re too young, it will be something benign’. I ask her to leave.

“My day gets even worse when a young gynaecology senior house officer (SHO) enters, clutching my scan report. I know he’s pulled the short straw and been sent to talk to me, the scary ‘med reg’ (medical registrar).

“He nervously sits down and declares, ‘Your MRI shows evidence of spread’. I’m so shocked by his lack of quality communication I ask to read the report myself: the cancer has spread to my liver and bones. As he leaves, I roll over with my back to the door and let myself go, the tears flowing.”

Having published her diary she now wants it available to all medical students in a bid to improve patient-doctor communication.

Tests revealed a huge mass in her abdomen and pelvis, some of which encased her ureters – the tubes connecting the kidneys and bladder.

Chris, 35, a manager for Asda in Leeds, visited a few hours later. “I break the bad news to him like I would a patient – that’s my way of getting through it. I tell him, quite simply, that things are not looking good at all. He is devastated. Lots more tears for both of us,” says Kate in her diary.

Further tests show Kate – then aged 29 – has a rare and aggressive terminal cancer known as a desmoplastic small round cell tumour, with a poor response to chemotherapy and dismal survival rates.

She tells her oncology consultant that should she suffer cardiac failure, she does not want to be resuscitated.

“That’s a big decision to make so early on,” he says. Kate is adamant she wants to control the manner of her dying as much as she can.

“Chris supported my decision – he knew I had seen many brutal undignified deaths in my job through attempted resuscitation,’ she explains.

“I think cancer doctors flog their patients, especially young ones, with horrendous treatments until the last possible moment despite incurability. I believe passionately that quality of life is much more important than quantity in this kind of situation.”

Kate spent her 30th birthday – October 31 – in hospital, as she pens: “I’ve been awake since 4am and feel an emotional mess. I can’t get out of my head that this is probably my last birthday. There’s been a lot of crying. But the nurses are fabulous – bringing me cards, gift. Chris visits with a deli buffet, a nice cake and presents.”

Despite her devastating prognosis the devoted doctor returned to work part-time in November but a series of chemotherapy sessions left her so ill that she made the momentous New Years Eve decision to stop treatment, Although recent news that her brother is getting married is making her reconsider.

She and Chris are working through her “bucket list” – they renewed their wedding vows in April, lunch at Claridges, and a weekend in Paris are ticked off.

Despite being in pain, Kate continues to work as well as giving talks about her own situation. “Death does not scare me. I’ve come to terms with it.

“If my patients ask, I tell them I have cancer, otherwise I never mention it.

“Having cancer has made me realise how important the little things are – holding a patient’s hand when talking to them, sitting down with them and not standing over them, communicating news in a compassionate way and explaining the impact it has on them to their families.”

Kate’s diaries are now a book – appropriately titled The Other Side. It will be her permanent and personal legacy to the medical profession that she dreamt of joining from the age of eight, as she grew up in Huddersfield.

“I hope students and experienced medics also read it and think about how they practise medicine. I love my job and want to make a difference.”

On a personal front, Kate lives life to the full every day.

“I am a control freak,’ she laughs, “so I’ve planned my funeral to the letter with music, poems, prayers and dress code. I’ve written letters and cards to Chris up to his 70th birthday.

“I am now writing letters to other close family. I am blessed with my life, work, husband and family – all of whom I love very much.”