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A heroic fight for life

His wife's early symptoms of cancer were put down to stress. Headteacher Roy Tebbutt looks back at her 16-month struggle and urges other teachers not to take a first diagnosis at face value

When my wife Ann died of bowel cancer at the age of 50 earlier this year she became one of the 18,000 killed by the disease every year in the UK. Earlier diagnosis may have prevented her death or at least prolonged her life.

All had seemed well in the summer of 1995. We'd had a good holiday and were looking forward to the new academic year: Ann as a head of year and of science in a middle school, and myself as a secondary headteacher in Bedfordshire. But her exhaustion and indigestion soon returned - to be dismissed again by her GP as stress. It was the duty doctor we called out one November Sunday morning who saw that there was more to her severe abdominal pains.

There was a history of bowel cancer in the family and two years earlier Ann had had surgery for an associated complaint. This, and other warning signs, were missed.

The surgery to remove the primary cancer was successful but the disease had spread to her liver. The prognosis was pessimistic and my wife's heroic battle for her life was to last another 16 months.

The first course of chemotherapy in the spring of 1996 seemed to arrest the cancer and, by the second treatment, Ann's liver cancer enzyme activity had declined. By her 50th birthday in July, we felt we had hope.

But just before our summer holiday, a dramatic oncology consultation revealed her liver cancer enzyme levels had started to increase again. Our last holiday together was in a village near Cahors, France, enjoying the simple pleasures of each other's company, beautiful countryside, good food and blissful sleep.

In September Ann insisted on returning to school while fitting in chemotherapy at weekends. Supported by staff, pupils and parents, her morale improved but by October half-term it was obvious her health was deteriorating. In November she had no energy to teach and another battle was lost.

Ann set herself targets - one of which was to join our three children in London just before last Christmas - for a celebration. Supported by a small battery-operated morphine syringe we saw Antony Newley in Scrooge and, for a few hours, ruled the world.

The recharging of the syringe driver was to become a daily ritual involving our new GP and district nurses who made a pact with Ann that she would die at home. Christmas and New Year were happy but intense affairs with Ann making midnight mass and my birthday on New Year's Eve.

The drug doses were increased almost daily as Ann fought on - but by March she could only go on shopping trips in a wheelchair. I was now working at home as much as possible but while in school in early March I was called home after Ann had another severe breathing panic attack.

My governors and staff allowed me to stay at home for that last month of her illness. On good days I was able to take Ann out in a wheelchair but she was visibly weakening. The stress on our children and Ann's parents grew. The district nurses and doctors visited daily to recharge the syringe driver life-line.

By Easter Ann needed 24-hour care. Early on Easter Tuesday morning, she had a serious panic attack and was heavily sedated and slipping in an out of consciousness. For the next 48 hours she held court. Family and friends were called home for her to give her last instructions. Her middle sister arrived from the US. Ann still recognised her and gave orders on how she should care for me. The doctors were amazed at the high level of morphine she required as the days slipped by until she developed bronchial pneumonia. I have no wish to see anyone die of untreated pneumonia and thank God for anti-secretory drugs.

She died on Monday, April 7, 28 years almost to the minute since we were married. I was on the telephone making preparations for the start of the summer term.

Face-to-face with death, my own dispensability took on a new perspective. Ann's work on key stage 2 and 3 science would not replace her dreams of seeing our children married, or the kisses for grandchildren yet to be.

Ann promised that some good would come of her illness. So I urge teachers not to accept all the diagnoses of stress-related illness at face value.

Many symptoms indicate other diseases, but make sure you have them checked. The only "if" for Ann became a lament. Caught early there is hope for cancer patients, but for Ann it was too much, too late.

Roy Tebbutt is headteacher of Lealands High School, Luton

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