Watchful waiting


It’s four in the morning. I should be asleep. But two words tumble out of the darkness and play just out of my grasp. Watchful. And waiting. Watchful waiting. I didn’t know that expression before and now, in that way it happens, I just saw it twice in the same day.

I was at the clinic in hospital last week. I saw my breast surgeon for a check up. She went off clutching her copy of Being Sarah, and beamed at me telling me how proud of me she is. Big sigh. I do like her so much, but I would like my life not to contain sitting in cancer clinic waiting rooms. To not contain a medical file on me that is about four inches thick.

To not contain any of the admin of being a breast cancer patient. But it does, so I have to live with that.

At the end of our consultation I am given the usual yellow form. Alison, my surgeon, gives me one of these every time and she ticks some boxes and writes when my next appointment will be. I then hand it over to the reception staff, or if they have gone home – which they usually have as I’ve spent so long with Alison – I put it in the special red box in the waiting room. All the times I have done this in the last four years, and not once did I ever read the tick boxes. Alison has ticked the one that says, ‘Watchful waiting’. And I never thought of myself like that. That we are watching and waiting for something, or for nothing. As in breast cancer symptoms. 

When I get home I have an email giving me a link to the work of Sandra Steingraber, a ecologist and campaigner for cancer prevention. Her current book is called Living Downstream. These are the opening words:

Once there was a village overlooking a beautiful river. The people who lived there were very kind. These residents, according to the parable, began noticing increasing numbers of drowning people caught in the river’s swift current. And so they went to work devising ever more elaborate technologies to resuscitate them. So preoccupied were these heroic villagers with rescue and treatment that they never thought to look upstream to see why the victims were falling in. Living Downstream is a walk up that river. The river of human cancer.’

This is brilliant parable, an intriguing and clear way of expressing the way we view cancer now. We help cancer patients, but we don’t look at the causes. I continue reading. On the first page of the introduction, she explains that she had bladder cancer thirty years ago, but she is still regularly check for the disease returning. She describes receiving a telephone call from her medical team. Her last test results are abnormal. She has to give another test. After putting the phone down, she describes sitting in her home, her children’s crayons on the floor, the tomatoes are still on the stove, but the world has changed now. She gives another test, and then:

‘I began living within that period of time known as watchful waiting. This is a familiar place to me. Watch means screening test, imaging, blood work, self-advocacy, second opinions, and hours logged in hospital parking garages. Wait means you go back to your half-finished essay, to the tomatoes on the stove. You lay plans and carry on within the confines of ambiguity. You meet deadlines and make grocery lists. And sometimes you jump when the phone rings on a sunny afternoon. Bladder cancer recurs in 50-70 percent of patients. There are evidence-based reasons for feeling jumpy.’

Sandra Steingraber has perfectly described what this feels like. Watchful waiting.

And so what does that mean for me? I return back into my life. I go running. I knit. I plant bulbs in pots. Paperwhites and hyacinths. I plant garlic and onions, to harvest next year. I make quince jelly. I return to my screen printing, finish the latest images that I have been working on. And I am me. Watchfully waiting.

So in the night the words steal into my brain and wake me at four when I should be sleeping.

2 thoughts on “Watchful waiting

  1. >Watchful waiting. This is exactly what was on my mind yesterday. I was talking to my doctor about the next steps for me in terms of treatment. The best answer that I could get from her was that "there is no right answer" and that I shouldn't worry as I'm being watched. But in reality I'm also waiting as well aren't I? All I could think about, besides the screaming in my head, was how sad it is that this is the best advice we have to offer cancer patients. Despite the billions and billions of dollars being thrown at it. We just watch and wait.

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