In 2015/16, I lost nine people from my life, from my big brother to my good friend’s daughter, and many friends somewhere in between, some close. People asked how I coped. My answer probably came across as flippant but wasn’t meant that way: “Well, it wasn’t me that died”. Most of us cling to life, and while we never wish to lose those close to us, nor do we want to die ourselves.

Things were never quite that bad again in such a short space of time. Yet. In 2017, my elderly mother died, quite unexpectedly and peacefully, aged 89. She had longstanding dementia, so her death had been a gradual process.

In 2021, my Dad, 93, also died. He had also developed dementia (Alzheimer’s). Dementia means that a form of death happens sooner, and the grieving for what is lost joins it. It irks me still that dementia is rarely used as a cause of death on death certificates; usually, it comes down to pneumonia, frailty, diabetes, or cardiac arrest – whatever actually caused the moment of death, not the multitude of conditions leading up to it. My brother, who died when taken off his ventilator with severe brain damage, aged sixty-one, had hypertensive heart disease listed as the cause, not the multiple system atrophy he had endured for six years which stripped him of many functions. MSA simply was not mentioned.

In 2021, an old friend I’d rather lost frequent touch with contacted me to tell me she had bowel cancer. She was due chemotherapy and surgery. Obviously, I was upset for her and we communicated many times daily from that point. I was also upset for me, that we had renewed our vow of friendship only at a time when she was under immense stress; I regretted not keeping in regular touch after I moved away but life is often like that; she was also very busy with her career.

We had regular conversations about her dreading the hair loss that often accompanies chemo, and about other issues including pain and dying: some very real, authentic, conversations. She struggled with the effects of chemo, and rallied by the thought of the surgery that would excise the rectal cancer she had. She booked a holiday for the following autumn in a place she adored, Vancouver Island, and was looking forward to that. Not to be.

The surgery was long and complex but successful. However, she developed sepsis which meant a longer stay in hospital than expected. She was very ill indeed. Again, she rallied, realising that a stoma bag (another big fear) had become necessary. She looked forward to the day, some months later, that this ileostomy could be repaired and life could return to a new kind of normal.

That was also not to be. She discovered her cancer had metastasised (this is cutting a very long story short) and lesions were found in her lungs, her liver, but worst of all in her spine and sacrum. She now had painfully debilitating spinal cancer.

Radiotherapy was used to try to reduce the tumours in her sacrum and lower spine which were making sitting, and walking, increasingly difficult. She was on numerous pain medications. As she had paid into private health care, she had a liquid biopsy and genetic reports, in the hope of benefiting from immunotherapy. One of her genetic reports came back with a KRAS mutation, which explained why her cancer had proliferated and was so treatment resistant. She also discovered many other mutations. Suddenly, she went from hope to hopeless, with Stage 4 metastatic spinal cancer, for which there was no positive outcome.

Apart from sitting at my brother’s bedside for many days while he was ventilated, I have not been this close to death before for a prolonged period. As a student, I’d worked in a nursing home and helped to ‘lay out’ the lady I had fed ice cream to before she passed. I’d visited a friend weekly as her brain tumours took control of her body and finally saw her in the hospice where I had asked if she was ready to go. She nodded her head. She was fifty.

So, daily updates on the horrors of Pregabalin for nerve pain, and the array of medication my friend took for her terminal cancer was both sobering and grounding. My friend was a mightily intelligent, academic, professional and well-travelled woman who was also incredibly authentic in her dealings with everything and everyone. Therefore, her sharing of her cancer ‘journey’ (a journey no one wants to take) was exactly as honest as I would have expected.

It was my immense privilege to listen to and talk with my friend whose conversations touched on what really, really matters to us all when it comes to the life crunch. Home, and those we love most, ideally backed by a life well travelled.

My friend died on 2nd December, 2022, aged 57.