Hazel McHaffie

breast cancer

Peeling back the gilt of Christmas

Nativity carouselAt this time of year it somehow seems extra tragic when bad things happen to good people. Aside from the global crises afflicting our world and unravelling before our eyes in our living rooms, I personally have a number of friends currently facing serious illness, impending death, sudden bereavement, and yet it must seem like everyone around them is caught up in trivia and pleasure, festivities and excess – in reality of course, who knows how many others are only hiding stresses and problems from public consumption?

Mrs Santa straw figureIt’s in this spirit that my mind has been wandering over the huge dilemmas facing different families; what would I choose in their circumstances? how would I cope?

Metropolitan police officer Heidi Loughlin, 33, discovered she had an aggressive form of breast cancer the day after finding out she was pregnant with her third child. She decided not to have a termination of the pregnancy but to delay treatment until after the birth. Her condition became so serious however that her baby girl was delivered by Caesarean Section on Friday, 12 weeks early, and Heidi has been given a short time to recover from the operation before starting powerful chemotherapy next week. She faces a pretty gruelling Christmas, but is determinedly looking forward to March when she will get her baby girl home to her two brothers. She has risked her life to give her daughter a chance and says she has no regrets; it was all worth it. What would I have chosen in this situation, I wonder? What would you?

Then there’s fireman Patrick Hardison. He entered a burning house in Mississippi; the roof collapsed on him leaving him with severely disfiguring burns across his face, head, neck and upper torso. Think for a moment of the pain of a small burn from an oven shelf, a hot iron … Multiply that by ten trillion. Even after 70 operations he was still so terribly mutilated (see pictures here if you can cope with them) that he would only go out heavily disguised. What kind of Christmases has he endured, I wonder? He recently underwent the most extensive face transplant ever performed. Factor in not only the excruciating pain at every stage but the risks … would I have been courageous enough to want to go on living? Would you?Antique Santa candle holder

Within the last two months, two transgender women have been found dead in their cells in all-male prisons: 21 year old Vikki Thompson in November, and 38 year old Joanne Latham in December. No more Christmases for them. Many difficult questions present themselves where transgender people are concerned and there is generally much greater sensitivity to their issues, but what about when they commit crimes, serious offences that land them in prison? Not only their own welfare is at stake but that of their fellow prisoners. Where would you have housed these two? Nearly 150,000 people signed a petition to house a third person, 26 year old Tara Hudson, in a female institution even though she had been convicted of assault. Would you have signed it?

A 50 year old woman, mother of three, is so determined not to grow old and ‘lose her sparkle’ that she has refused to undergo kidney dialysis. Her kidneys were seriously damaged when she took an overdose following a diagnosis of breast cancer. For years her life style has been chaotic to say the least, and one wonders, what is Christmas like in that household? Whatever, the Hospital Trust responsible for her care appealed to the courts to have treatment imposed against her wishes. But a senior judge has upheld her right to an autonomous choice to die. Was he right to do so, do you think?

I’m merely scratching the surface by way of illustration. Remember all the cases we’ve heard about recently – various scandals around abortions carried out on the grounds of gender alone; teenagers killing themselves because they’re obsessed with losing weight; all the dire warnings about how to deal with declining fertility; the consequences of a simple blood test at 18 weeks pregnancy that allows screening for thousands of genetic conditions  … the list goes on and on. My files are bulging with clippings and articles.

Scandinavian figuresSo at this time of celebration and joy, let’s spare a thought for families caught up in tragic circumstances, and the courageous souls who try to support and guide them. May they find wisdom, courage and strength. And I wish all visitors to this blog peace as you prepare for the festive season whatever it means to you.

 

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Topical stuff

I know my antennae are always tuned to pick up the merest sniff of medical ethics but this week has been a veritable bonanza in the media. Would these headlines grab you too, I wonder? Do the questions trouble you?

Liverpool-pathwayThe controversial Liverpool Care Pathway, for example. Designed to ease the final hours or even days of a terminally ill person’s life: is it being abused? The son of an elderly woman who died in an Edinburgh hospital thinks so. He has accused her doctors of ‘murdering’ her, and the newspaper headlines certainly make the case sensational. At the moment the circumstances are being investigated by the Scottish Fatalities and Investigation Unit, and if anything suspicious is found, it will trigger a police investigation – the first relating to an individual death to be officially dealt with in this way. How do you feel about the LCPathway?

3-parent babiesThen there’s the major news that this country is set to become the first in the world to approve the creation of so-called three-parent babies – a way of allowing couples with major defects in their mitochondria (the bit around the nucleus that contains around 37 of the total 2,000 genes) to have healthy children who don’t die young. What a stooshie that’s causing! And that’s in spite of the fact that it’s the nucleus that carries all the genes for looks and behaviour. And you’re saving babies and parents terrible suffering and distress. Ah yes, BUT it’s genetic modification on human beings, with permanent results for generations to come. And the nucleus and mitochondria don’t operate in isolation; they talk to one another. And the mitochondrial cells control metabolic functions. Who knows what you might be unleashing … and unable to reverse. How say you?

Mandela decisionsThousands of miles away there’s another scenario playing out that currently has the media here in a frenzy. 94-year-old Nelson Mandela is on life-support machinery. The world reveres this man. His countrymen are fervently praying for his recovery. He has six children, 17 grandchildren, and 14 great-grandchildren, who are riven by disagreements and conflict at a time of private sorrow. Decisions about allowing life to end are notoriously difficult – in this case they are set against a nations’ wishes, cultural diktats, family feuding, in the full glare of the media’s eyes. Who should decide? What should they decide?

The joy of lifeRock guitarist, Wilko Johnson, (real name John Wilkinson) is dying of cancer but he’s been inspiring millions with his up-beat approach to the life he has left and his sheer humanity. He had no idea apparently until he saw so much emotion at his farewell concert, that people felt a real personal affection for him. He knows cancer intimately – his wife, his mother, and co-founding member of Dr Feelgood all died of it; he has no faith to sustain him; and yet, in many ways he says, he feels more alive than ever, and a special joy in existing, because he knows every day is special.  How would you respond?

Gene copyrightSpeaking of cancer … should companies be allowed to put a copyright on the genes that cause the disease? Myriad Genetics patented the two major breast cancer genes, BRCA1 and BRCA2, even though the search for the genes was a collaborative effort by thousands of scientists, many of whom were publicly funded. The firm also holds European patents on tests for the disease. In practical terms this means that the UK might be at risk of infringing copyright laws (with all the consequent lawsuits and outstanding royalties) with their own tests using publicly available genetic data. When Angelina Jolie revealed her double mastectomy, she drew attention to the cost of genetic testing (in the region of $3,500). What do we in the UK with our free-at-the-point-of-need NHS make of all this? What do you think?

Phoned decisionsI could go on, with this week’s tales of and life-and-death decisions being made over the phone;

Opt-out donationand Wales approving a system of presumed consent for organ donation, oh and altruistic organ donation (in journals and weekend supplements); and … but I won’t. Your brains are probably crying out for rest after the questions I’ve already thrown into your court.

By way of light relief, in between all this heavy-duty thinking, and working on the publication of Over my Dead Body, I’ve been reading Melisa Hill’s Before I Forget. It’s about a girl whose memory is destroyed in an accident. From the blurb it sounded to be close to my interests, so I picked it up in a supermarket. But … oh dear. Not my kind of thing at all. Style of writing, plotting, characters – I wanted to edit everything. And yet she has THE NUMBER ONE BESTSELLER plastered over the cover.  She’s published by one of the big firms: Hodder. Ho hum!

 

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