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~Taboo Busting Journalists~
Recently I reviewed John Diamond's best seller 'C: Because Cowards Get Cancer Too' in which he wrote about his experience with cancer in his neck and tongue. In that book he mentions that whilst he was writing about his cancer in one newspaper, Ruth Picardie was writing about her terminal breast cancer in the Observer's 'Life' supplement. In a moment of extreme honesty, he reveals he had a teensy bit of jealousy that someone else was competing with him for the role of cancer columnist and that Ruth might actually be better than him. This prompt sent me off to track down a copy of Ruth Picardie's book 'Before I Say Goodbye'.
Between the two of them, Diamond and Picardie introduced a new approach to dealing with terminal illness. Quite possibly if just one of them had been active at the time the impact would have been much reduced but the sheer coincidence of timing increased the national awareness. Picardie's writing dates to 1997, a time when people still tended to think that cancer was the kind of thing to hush up. People got it, went behind closed doors and were expected to just shut up and get on with the quiet process of disease and death. The date will also trigger some people to recall that Picardie was sick and writing at the time of Princess Diana's death - another event which opened a vein of public emotion that had rarely been seen before.
With Diamond and Picardie baring their souls in the press, British behaviour began to change irreversibly. Suddenly writing about deep and personal experience became a new way of dealing with cancer and other terminal illness. These writers changed the national mindset in a way that neither of them could have expected. All they were doing was what seemed right to them at the time. Neither did it with a drive to help others or to achieve some philanthropic goal - in each case they were writers and communicators by training and by trade and writing was what they did - not some type of contrived therapy.
The full mail-bags arriving at the offices of their newspapers soon showed the power of their writing. Readers who had cancer, readers who'd lost loved ones to cancer and members of the public who had no personal experience of the disease all picked up their pens and wrote to tell someone that they had never met that their words had moved them.
~Ruth's Cancer Story~
In 1994 at the age of 30 Ruth found a lump in her breast and was told that it was benign. Two years later after having her twin children by IVF, she realised the lump was growing and in October 1996 she learned it was indeed cancerous and that the cancer had spread to her lymph glands. The lymph glands were only the start; the cancer spread very quickly, rampaging through her body and killing her in less than a year after her diagnosis. Given the speed of the disease, it's not a surprise that 'Before I say Goodbye' is a short book, running to just 116 pages of which the final twenty were written by her husband Matt Seaton. The brevity seems to contribute to the impact of Ruth's words in a 'less is more' kind of way. There's no prospect that the reader could get bored in such a fast-moving account.
The book starts in November 1996, just a month after diagnosis and ends in September 1997. Ruth is still writing up to just a couple of weeks before her death. We can see in the final weeks that the tumour in her brain has impacted on her writing - she's lost the use of capital letters and her sentences are short. Grammar pedants will love and admire that even near the end Ruth could still punctuate and use an apostrophe properly.
For a while Ruth tries every alternative therapy going until she realises that their promoters are a bunch of charlatans and con-merchants, preying on the fears and desperate search for results of the terminally ill. She tells us that chocolate and shopping are better therapy than all the caffeine enemas and herbal lotions and potions. Good friends are clearly the best therapy of all.
The structure is an interesting one with a mix of input and form. There are emails sent between Ruth and several of her friends interspersed with the five articles she wrote for Observer 'Life'. After the articles start the text interweaves some of the letters Ruth received from readers. Near the end we get copies of the two hand-written notes Ruth wrote to her children a month before her death (I defy anyone to read these and not get a bit weepy) and eventually we read the 'After Words' of Matt Seaton.
~How I felt as a reader~
I loved the email correspondence with her friends the best. With Jamie who has HIV and is 'in the closet' we learn that his T-cell count is pushing him ever closer to an official diagnosis of AIDS. Ruth discusses the nature of their illnesses, the taboos associated with them and the inevitable thoughts of death. With Carrie who lives in Hong Kong she reports the gradual evaporation of any hope of recovery as each hospital appointment and scan brings worse news of the spread of her disease. With writer India Knight, she cracks girlie jokes about getting fat, craving chocolate and spending far too much money on expensive face creams and treatments. There are other friends who pop up here and there but these three are the core of the correspondence. Many of the mails are funnier than you might expect given the circumstances though a lot of the humour is very black. She jokes about therapy sessions surrounded by old ladies in wigs, calls a therapist who wants to give her vitamins and oxygen treatment a "money grabbing wanker", gets crushes on doctors, and begs her friends to write about their problems and gripes because she's bored by going on about cancer.
Whilst I loved the emails with friends and was fascinated by the Observer articles, I felt some of the letters from readers were there to pad out this slim volume. It was important to include some to reflect the impact her articles had but perhaps there were a few too many. In many ways - sorry - I hated Matt Seaton's afterword. When I read a book like this I always want to know how it ended, what happened after the letters and emails stopped but in this case, his description of her last few weeks are too hard to read, not just for the descent into dementia but for the oddly cold and mechanical way in which he delivers his thoughts.
Sometimes it's better to end something like this with a moving and emotional post from the soon-to-be-dead person than to be confronted with the cold hard reality of the mental decline that dogged her last days. Seaton's apparent detachment in these final pages is quite possibly a very necessary coping mechanism but at times it seems rather cruel, cold and a great contrast to the open emotion of Ruth's own writing.
I was able to read this without any personal sense of connection to Ruth's disease because breast cancer has not really touched my life. I lost a cousin and an aunt 25 years ago but they were not people I really knew well. Most of the people I know who have had this - or whose relatives have been diagnosed - seem to have responded well to treatment. If I had breast cancer or if I had a friend or relative with it, I am pretty sure that this book would have really scared and upset me.
To anyone who does have breast cancer or is worrying about someone who does, I would suggest to think very carefully about buying this book. I'm sure that the vast majority of breast cancer sufferers do very well. In Ruth's case the apparent misdiagnosis of her lump in 1994 and her subsequent IVF treatment seem to have contributed to the spread of her disease and I believe the doctor who misdiagnosed her has recently been struck off. Nobody reading this should assume that what happend to Ruth is going to be representative of every terminal breast cancer experience. For example if you check my review of Jane and Mike Tomlinson's book 'How Good is that?', Jane lived 7 years beyond her expected time after her terminal diagnosis.
Read this as an inspirational book about the power of humour and positivity and recognise it as a book that changed our attitude to talking openly about disease but please don't assume that every woman with breast cancer will have the same experience.
Before I Say Goodbye
Second hand copies are widely available
After her death, Ruth's sister Justine Picardie set up a charity called the Lavender Trust which raises money to support younger women with breast cancer. you can find more information at http://www.breastcancercare.org.uk/about​-us/lavender-trust.
Reading all the 'My Favourite Things' ops to celebrate Jill's 4 years of being cancer-free got me thinking about life, love, death and all those 'big things', and I was drawn back to one of the most-thumbed books on my shelf, 'Before I Say Goodbye' by Ruth Picardie. I was stunned to discover that no-one had written an op on this, so thought I had better get to work, as it is a book I have cried over, laughed over, and returned to on many occasions when I need a little reminder that life and love are fragile, precious things, to be cherished always. Ruth Picardie was a journalist, wife and mother of twins, and was diagnosed with breast cancer in 1996. She had found a lump much earlier but it had been dismissed as a harmless cyst because she was so young, but it was malignant, and by the time cancer was diagnosed it was too late – she died a year later, in September 1997, still only in her early 30's. Her sister Justine was editor at the time of the Observer’s magazine supplement, and suggested to Ruth that she write a column about her experiences – when the first column was published, it was about the same time as John Diamond's column about life with cancer appeared in the Times, so there was some talk of bandwagon-jumping, but it soon became apparent that Ruth's columns were not going to continue for much longer. She had hoped they could be collected into a book after her death, but in the event there were only a handful of columns, because her decline had happened so tragically fast. So her family decided to include emails she exchanged with close friends, and a selection of the hundreds of letters sent by Observer readers who were moved by her writing. Added to this were a foreword by her sister and an account of her last days by her husband, Matt Seaton, and the book of 'Before I Say Goodbye' was created. I read a couple of the columns, and warmed to her firey determinat
ion to hang onto life even when the prognosis was so bleak, to laugh in the face of death even when the thought of letting go of her twin son and daughter was breaking her heart. One minute she rails against the NHS whose incompetence had led to her cancer going undiagnosed for years, the next she admits she fancies her oncologist because he looks like Dr Greene from ER. She wonders whether to splurge money on expensive face cream or designer clothes in the sales, because who will use them after she dies? She despairs at being too exhausted to clean the house – should she be spending 'quality time' with the children instead? – but is humiliated at the thought of a council-funded cleaner coming in a few times a week and seeing the washing up left in the sink. Interspersed with the columns are the emails she sent and received from friends, charting the progress of the disease as it moved from her breast to her bones, liver and finally brain, her own eventual acceptance contrasting with the friends who try to offer comfort but are still in a state of denial themselves, hoping that by some miracle she might be spared, as I would be too if I were faced with the prospect of losing a loved one. The reader's letters are a mixed bunch – some are fellow cancer patients sharing advice and offering support, some are from bereaved relatives of cancer patients who share their experiences of grieving, and some are simply expressions of sympathy from readers who felt they had been touched by her words. I didn't write a letter, feeling it would have been intrusive, and not sure I could put my feelings into words, but when I read that she had died, I felt that I had lost a friend – something that really conveys her skills as a journalist, the ability to make every reader feel that they know her intimately. The last few pages of the book are haunting, as her husband describes how her brain tumour induced dementia, le
ading to a temporary stay in a hospice, as she battled to keep control of her mind. Still she fought on, wanting to be alive for her twin's second birthday party, complaining about the state of the food in the hospice, having facials and getting her eyebrows plucked. The last few emails she sent to friends living abroad really illustrate the power of the Internet to bring people together – how else would these friends on the other side of the world have been able to say goodbye? The part of the book which always makes me cry are the two letters she wrote to her children, reproduced exactly as they were written, a month before her death when her handwriting had been reduced to a childlike scrawl. They are utterly heartbreaking in conveying the sense of loss, on letting go of her babies wanted and loved so desperately, but urging the children to be happy, be themselves, and to ask family and friends questions about her – Ruth was very aware from the reader's letters of the late parent becoming an 'unmentionable' topic, in the days when cancer was still a taboo subject. In the aftermath of her death, her family helped to set up The Lavender Trust, (lavender being one of Ruth's favourite plants, and colours) a division of Breast Cancer Care designed especially to support younger women diagnosed with breast cancer. A percentage of the book's profits go to the Lavender Trust, as do a percentage of profits from 'If the Spirit Moves You', a book recently written by Justine Picardie about the aftermath of her sister's death, and how she attempted to come to terms with her bereavement by investigating spiritualism and the supernatural. This is also a good read, and I might get round to reviewing it one day. I was drawn to this book because my maternal grandmother died of breast cancer at a relatively young age, so I have always been aware of the family history – and both my parents h
ave had cancer scares in recent years, both fortunately turned out to be benign. Although this book is often difficult to read because it is so intense and tragic – and might be overly distressing for a cancer patient or a recently bereaved person – it is also inspiring and uplifting, because Ruth was so determined to make the most of the life left to her, and her words of hope and despair, bleak humour and final acceptance of her mortality, will last forever. Amazon are selling 'Before I Say Goodbye' for £5.59, full price £6.99 Penguin Books, ISBN: 0140276300 Find out about The Lavender Trust from: http://www.breastcancercare.org.uk/
When Ruth Picardie died from complications following the misdiagnosis of breast cancer in September 1997, leaving a young husband and two-year-old twins, 1000s mourned who'd never met her. Ruth's column in The Observer recorded the progress of her illness and her feelings about living with terminal cancer. This text brings together these pieces, Ruth's e-mail correspondance with friends, selected letters from readers, and accounts of Ruth's last days by her sister, Justine, and husband Matt.