But, still, Maggie Rose was apprehensive, as she had been from the moment that she had seen Fine waiting for her in the reception area. She was strong-willed and had been able, if not to banish her fears, then at least to pack them away in a box at the back of her mind, but his presence. . not routine, whatever he said. . coupled with the disturbing family history that Sylvia Thorpe’s research had uncovered, had unlocked it and set them free to push everything else aside.
She frowned as she dressed, rubbing her hand idly over her bump as she fastened the elasticated uniform trousers that had been made specially for her. She was still frowning as she returned to the waiting area. A nurse offered her a cup of tea and a biscuit, and she accepted, then left them untouched on the table beside her. She was so preoccupied that she failed to see Mr Fine until he was standing in front of her, hair slicked back, pencil moustache as neat as ever, round spectacles perched on the bridge of his nose.
‘Would you like to come with me, please, Mrs Steele?’ he said, in a voice that sounded reassuring, but was in total contrast to the signals that all his years of professional practice could not prevent from showing in his eyes. She followed him without a word, along the corridor and into a small narrow room with a curtained window, an examination table, a backlit display screen and three chairs, one of which was behind a desk.
Several transparencies were attached to the board, brightly coloured cross-sections of a human body that she knew to be hers. She stared at them, almost slipping as she lowered herself on to one of the two patient chairs. Fine put out a hand to steady her, then took the other himself, beside the board.
He pointed at the images. ‘I could spend a while going through these in detail with you, Mrs Steele, as I’ve just done with my colleague Dr Goyle, our most senior consultant radiologist. I could point out to you what we’ve found, but it wouldn’t mean anything to you, since it takes a couple of years’ training and then several more years’ experience to be able to interpret these pictures. So I’ll just tell you what the position is.’
Maggie’s heart was hammering. She hugged her abdomen, as if she was protecting her child, as, subconsciously, she was.
The consultant read her mind; he waited, giving her time to control herself, then caught her eyes, holding her attention. ‘The scan,’ he continued slowly, ‘has detected abnormalities in both of your ovaries, and in your Fallopian tubes. There is also a shadow on your uterus. For one hundred per cent certainty we’d need to do a biopsy, but neither Dr Goyle nor I are in any real doubt. We believe that you are suffering from what is called an epithelial ovarian carcinoma. I’m very sorry, Mrs Steele, but that’s the long way of saying that you have ovarian cancer.’
Maggie felt all of the colour drain from her face. ‘Jesus,’ she whispered. She had known fear throughout her life, and violence on more than one occasion, as an adult and as a child, but she realised that before it had always been mixed with anger, and that until that moment she had never felt true terror.
‘Yes,’ said Fine.
‘The baby?’ Her voice trembled.
‘Your child is unaffected.’
Her breath exploded from her in a huge sigh, and she felt herself relax, a little. ‘Oh, thank you for that,’ she gasped.
Fine gazed at her kindly. ‘It’s not a matter for thanks.’
‘I wasn’t talking to you,’ she told him, with a very faint smile: it showed for only a second or two, before her frown returned. ‘That’s my diagnosis, but what’s my prognosis?’
‘It’s much more positive than it might have been,’ he replied. ‘Your condition has been detected fairly early, which isn’t usually the case with this type of disease. With immediate intervention and a subsequent course of treatment, still to be determined, you have an excellent chance of recovery.’
‘What do you mean by intervention?’
‘We’ll have to end your pregnancy now, and operate to remove your ovaries, tubes, womb and any other troublesome tissue that might have been hidden from the scan.’
‘Terminate my pregnancy?’ Maggie exclaimed. ‘But I have eleven weeks to go.’
‘Nonetheless, Mrs Steele, we have to act immediately.’
‘By killing my child?’
‘Your child has a fair chance of survival, even with such an early delivery.’
‘But you’ve just told me she’s small.’
‘Yes, but she’s viable.’
‘What does she weigh, right now?’
‘Maybe two and a half pounds. .’ he paused ‘. . but babies of that size regularly survive nowadays.’
‘Maybe, you’re saying to me. As in “maybe but she could be less”, right?’
‘True,’ Fine admitted. ‘She could weigh less than a kilo just now.’
‘And then what would her chances of survival be?’
‘To be honest, they’d be poor.’
‘And if I carry her full term?’
‘She would be six pounds at birth, possibly as much as seven; most of a baby’s weight is gained in the final stages. However, that could be affected by the development of your condition: she might grow more slowly than normal.’
‘Could my disease spread to her?’
‘Technically, yes.’
She stared at Fine. ‘And practically?’
‘Practically, the chances of that happening are minimal. Such an occurrence would be so rare that it would make the medical journals.’
‘Could you give me chemotherapy, or radiotherapy, without harming her?’
‘Absolutely not, I’m afraid.’
‘Yet we’re agreed that there is a far greater risk to my baby’s life by curtailing my pregnancy than by continuing it?’
‘That is true. But, Mrs Steele, the same applies to you in reverse. I’ve been comparing your ultrasounds, and while they’re not definitive, they do indicate that your cancer is developing swiftly, as I’d expect it to. The growths in your Fallopian tubes are metastases, secondary tumours. That’s not a good sign, but it’s manageable. However, if there is a spread beyond the pelvic region, that will not be.’
‘Manageable? Let’s be more specific than that. Given my present condition, what are my five-year survival chances? Quote me figures; I can look them up on the Internet, I’m sure.’
For the first time, Fine looked down, away from her. ‘Overall,’ he replied, ‘studies show less than fifty per cent. That’s allowing for all age groups, all stages of detection.’
‘In my case, if I follow your advice, what will the odds be?’
‘I’d love to say better than even, but I can’t.’
‘So what it comes down to is this. If I risk my daughter’s life, and somehow she overcomes the odds against her, survives and grows into a healthy child, I’m unlikely to be around to see her start primary school. Or, to put it another way, if I do what you say, the balance of probability is that my husband will lose both his wife and child.’
‘Maybe, but, Mrs Steele. .’
‘Forget the bloody maybes. Yes or no?’
‘Yes, but every case is different. These are statistics. Individual cases often throw up surprising outcomes.’
It was Maggie’s turn to draw his eyes back to hers. ‘With respect,’ she said, not unkindly, ‘you’re asking me to gamble my child’s life, and I will not, I cannot do that. I will carry her either full term or until you can put your hand on your heart and tell me that she can be delivered without risk above the norm. After that you can hollow me out, throw all the shit you like at me, and I will fight this disease with everything I have.’