New peace emerges as Covid lockdown ends my patient’s bucket-list dreams

Among her friends, Stephanie* was considered the ultimate Francophile. She loved France – the food, the fashion, and most importantly the music.

During her long chemotherapy infusions, she would blast Charlotte Gainsbourg and Natasha St-Pier though her AirPods, often to the chagrin of her neighbouring patients.

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As the chemotherapy drugs whirled their way through her body, hoping to find and attack the multiple cancers that had developed in her liver, lungs and lymph nodes, it was the infusion of music that kept Stephanie feeling safe and optimistic. The melodies beaming through her ears felt like the perfect antidote to the toxins being dripped into her veins.

After a time, the chemotherapy stopped working. Stephanie’s cancer grew, with new spots in her liver and lungs. We changed treatments, hoping that the new cocktail would slow things down. This time, it was Vanessa Paradis and Étienne Daho who soothed Stephanie through her increasingly difficult infusions. Her pain was getting worse now, but thoughts of future travel, and the soothing sounds of her most cherished musicians, propelled her on.

It was in June that I told Stephanie that her cancer had grown further. There were more spots in her organs, and new fluid in her abdomen. This, I explained to her, was why she had noticed her clothes getting tighter. Her liver was no longer working, and she was beginning to feel short of breath from the fluid in her lungs.

The cancer was no longer responding to our treatments, and despite her young age – Stephanie was only in her early 40s – I recommended that we stop her anti-cancer medicine. Our focus, I explained, would be on maximising the quality of the time that she had left. Stephanie was tired of chemotherapy, of the endless hours in the infusion suite, of the blood tests, of the anxiety following every scan. She was ready to make the most of the short time that she had left.

We thought of some ideas. A balloon ride over the desert. A visit to Byron Bay to be with her sister. A trip down the South Coast, where she could skinny dip in the brisk winter water to her heart’s content. Like many of my patients, Stephanie had a bucket list, and she’d been ticking things off since she was diagnosed with cancer. Now was her time to delight in those precious memories yet to be forged. We were excited.

And then, overnight, Sydney closed down. On 26 June, we were once again thrust into lockdown, a lockdown that has only tightened since this time. Suddenly, Stephanie’s bucket list, a source of joy and excitement, ceased to be relevant.

There were no more balloon rides, no more shows at the theatre. She couldn’t leave the city, couldn’t be with her sister, couldn’t swim gloriously under the waning sun, as she had planned. In the final short months of her life, Stephanie’s world has closed down, and the experiences that had once kept her enthusiasm alight were now inconceivable.

Ever the pragmatic optimist, she changed tack. Though she couldn’t host dinner parties, she could organise a virtual cocktail night, one that meant that she could spend special, if not distanced, time with her closest friends.

Walks with loved ones took on a holiness, a reverence, that she had never experienced – it was in these puffed interactions that she could express her love, fear and anger, that she could find meaning and sense in the tragedy of her cancer.

She cooked more, something she had always loved, but to which she had never devoted much time. Rather than travelling, she spoke for hours on the phone with her loved ones, telling them that she would miss them when she was gone.

She built connections with special people in her life, and cherished the moments that she could spend with her cat, with her mother, and with her niece. She sat in the silence of her intermittent solitude and thought about her death. She was comfortable knowing that it would be over soon.

Stephanie’s death preparations had changed. She would not be ticking things off her bucket list, as she had planned. But there was something comforting about this new version of dying.

Indeed, rather than spending time on new experiences, on new adventures, on a bucket list of events to tick off, it would be the closeness of family and friends that would sustain her. She found the precious closeness of connection, of loved ones, to be the true meaning of life before death.

For it was in these moments, in this mystic space between one human and another, that both life’s meaning and the meaning of death were found. She learned that a bucket list was not where peace resided. It thrived with those she cherished most.

Stephanie will not get to visit France before she dies. She may not even be able to leave Sydney. But today, lying in the park, drinking a glass of champagne, and listening to the fabulous French lyrics of Mylène Farmer, Stephanie smiled.

Dr Michael Krasovitsky is medical oncologist at the Kinghorn Cancer Centre at St Vincent’s hospital in Sydney

* name changed to protect identity

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