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When your husband is dying and simply refuses to talk about it: Widow Victoria describes the legacy of pain... and anger.

Wednesday, October 2, 2013

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Nigel Mossop was dying. After a seven-month battle with lung cancer, he was in hospital on oxygen and morphine, struggling to breathe and barely able to talk. His wife Victoria brought their three sons - Jamie, then 16, and 14-year-old twins Harry and Toby - to say goodbye.

But Nigel refused to believe he was terminally ill, and was genuinely puzzled by the boys' visit.  A few days later he died.

Eleven years later, his widow Victoria still feels heartbreaking sadness - and even, she admits, anger - that because Nigel was not willing to accept his cancer was terminal, they never discussed his feelings or the fact he was dying, in order that they could face it together.
Denying death: Nigel - with wife Victoria and their sons (from left) Harry, Jamie, and Toby
Denying death: Nigel - with wife Victoria and their sons (from left) Harry, Jamie, and Toby

It also meant their sons were not told their father had a terminal illness until those last  few days.

'I still feel intense sadness that we never talked about his illness being terminal and never even told the boys how bad it was until the bitter end,' says Victoria.

On a more practical level, Nigel's refusal to talk about his illness meant that Victoria knew very little about all the financial details involved in running the home.

'Nigel dealt with all that side of things,' she says. 'Having to deal with the mortgage, utility and car bills was all new to me, and more difficult to learn at such a distressing time.


'I find it hard to believe that now, as I've dealt with absolutely everything for the past 11 years. But if Nigel had just told me it would have been one less thing to worry about.'

It's not that she didn't try - it's just that Nigel, 54, a major in the Army, refused to talk about these things.

There is no doubt that Britons are uncomfortable discussing dying and death. As many as 45 per cent of people would never talk about their wishes if they didn't have long to live, according to the findings of the latest British Social Attitudes survey - which only adds  to the heartbreak of the bereaved, as Victoria discovered.

When Nigel first became ill, the couple were living in Wiltshire - their sons were at boarding school and Nigel's older sons (Victoria's stepsons) were living in the Channel Islands.
Fond memories: Nigel and Victoria the day before their wedding in 1983
Fond memories: Nigel and Victoria the day before their wedding in 1983

'Nigel was very fit, had never smoked and was extremely robust, but when he got flu in April 2001 he didn't recover as usual,' remembers Victoria. 'He suddenly needed to rest every afternoon and his nagging cough simply wouldn't go away, but we thought our holiday in Tuscany in June would help.

'But he didn't regain his usual energy, so when we came back he had a chest X-ray and was told he had excess fluid on his pleura, the fluid-filled space that surrounds the lungs.'

Doctors took a biopsy and drained the fluid off his chest. 'When that was done he instantly felt better but he was referred for a biopsy two weeks later,' recalls Victoria.

Alarm bells were still not ringing, even though his exhaustion persisted into August when the family went to the Isle of Wight for a few weeks.

'He rested every afternoon and had no energy to go sailing, which he loved,' says Victoria.  'While we were there the consultant rang to say that the biopsy didn't show anything.

'They were going to grow a culture to see if it could be tuberculosis, and when that proved negative Nigel was sent for a second biopsy in Southampton on September 11. He was feeling fine when we went back a week later for the results, but a young female doctor and a nurse drew the curtains round his bed before the doctor told him it was lung cancer.

 'Nigel was very fit, had never smoked and was extremely robust, but when he got flu in April 2001 he didn't recover as usual. He suddenly needed to rest every afternoon and his nagging cough simply wouldn't go away, but we thought our holiday in Tuscany in June would help.'
'I burst into tears but Nigel said: “Don't be silly, I'm not going to die.” I thought: “Yes, I think you are.”'

The lung cancer was secondary and had spread from a primary cancer that was never found. Nigel was offered chemotherapy.

'The first oncologist was simply dreadful, with no bedside manner at all, which made a terrible situation even worse - he was abrupt and aloof and volunteered very little information,' says Victoria.
'He certainly didn't encourage Nigel to ask questions.

'The day before Nigel was starting chemo he said: “I'm not going to do it - what's the point when I am not feeling ill? It will only make me feel ill and I know it isn't going to save my life.”
That was the only time he made any reference to his cancer being terminal, and he never mentioned it again. We were so relieved that we weren't going to have to face the gruelling effects of chemo that we went out to lunch to celebrate.

'I really respected him for making such a monumental decision. Before the next appointment with the oncologist, I asked if he wanted to ask “how long”, but he said he didn't want to know, and that was the end of the conversation.'

She adds: 'I think he was determined not to allow the cancer to rule our lives, and I said that we had to learn to live with it rather than die from it. For the sake of the boys I'm sure he wanted to keep a routine and normality as far as possible, and not let his cancer become a focal point that would haunt us all.
Fatally ill: Nigel, pictured in 1986, refused to undergo chemo as he knew it wouldn't save his life
Fatally ill: Nigel, pictured in 1986, refused to undergo chemo as he knew it wouldn't save his life

'He never wished to be seen by others as someone who was suffering from cancer and needed to be treated differently, and he certainly didn't want maudlin sympathy. He wanted to get on with living, doing his job and not discussing his cancer.

'That was his way of coping, but I wanted to talk about his feelings, what he was going through, the future, about telling the boys he was dying, so we could make the most of our last months all together.

'Sometimes I felt so helpless - especially since he dealt with all the household finances.

'I tried to get him to explain things, but talking about it simply wasn't on his agenda. He shrugged off the questions or walked away.'

In January 2002 - five months after his diagnosis - Nigel was posted with the Royal Gurkha Rifles from Wiltshire to Wales, and while the family were packing up the house for their move, he kept talking about 'coming back', says Victoria.

'All I could hear was this terrible pounding in my head saying, “You're not coming back, you're not  coming back.” '

At the welcome evening for him organised by his soldiers in Brecon, Victoria looked at her husband and remembers: 'He was so ill, so thin, but grinning happily with garlands round his neck as he sat with his soldiers and I thought: “He's in the  right place, he's back with his  beloved soldiers.”

Gurkhas, 1998: Victoria believes Nigel's Army training played a large part in his reluctance to talk about his feelings
Gurkhas, 1998: Victoria believes Nigel's Army training played a large part in his reluctance to talk about his feelings

'But being unable to share that thought with him was paralysing, and at one point I completely lost my voice for several days - I think as a result of the stress of being unable to talk about what was happening.'

The Army quarters in Crickhowell were lonely as they were the only occupants in a row of six houses.
But it was also very beautiful, and Victoria found great solace in walking her two dogs for hours beside the river, though Nigel was never fit enough to accompany her.

Nigel kept his illness from the Army until the very end as he thought - wrongly - he'd have to leave and would lose the boarding school allowance for his boys.

'He was desperate to keep the boys at their school,' says Victoria. 'Then someone rang me and said they knew and he mustn't worry as they would support him - too late, sadly.

'A few weeks later, the doctor suggested getting a Macmillan nurse, but Nigel said we weren't ready for that,' she says. 'He went into hospital in April 2002 and an abrasive nurse said to me: “You do know he hasn't got long, don't you?”

'It was probably the wake-up call I needed, as I had been bobbing along in the wake of the pretence that we were going to get through this, although he was struggling to breathe and was on oxygen and morphine  by now.

'When the boys - including Nigel's older sons, Peter, 29, and Anthony, 27 - arrived four days later he was completely lucid, had a bath, shaved and was talking coherently. It was like  a miracle.

'Anthony helped me to explain to the younger boys what was happening and I asked the palliative care team if they could tell Nigel that he was near the end of his life.

'Afterwards, he said to me: “The doctor says it's in my bones now. What does that mean?” - which was the closest we got to talking about it.

'We were both shocked and scared. I didn't have the words and it wasn't fair of me to force my agenda on him at that stage, so I said: “It's between God and you now.”

'Nigel died on April 21, 2002, with all six of us holding him and talking him through his journey. It was a beautiful blue-sky spring day, and although I felt numb that Nigel had gone it was also a relief that his suffering was finally over and we could now face  up to it.

'I wish we had talked more and had had a Macmillan nurse, as I felt  quite isolated while he was ill, despite the amazing support of friends  and family.

'He was the one person I needed to be able to talk to about the fact that he was dying, but I couldn't put my feelings above his and force him to talk, particularly if ignoring how serious his illness was made it easier for him to cope. But I also had no idea where to start with all the administrative details.
So I felt cross with him as well as grief stricken.'
Family gathering: The wedding of Nigel's son Peter less than a year before his death
Family gathering: The wedding of Nigel's son Peter less than a year before his death

Happier times: Victoria with sons (from left) Harry, Jamie and Toby in the summer of 2012
Happier times: Victoria with sons (from left) Harry, Jamie and Toby in the summer of 2012

It's a cliche, but no less true  that the one certainty in life is death. Refusing to acknowledge that and clinging to every hope  of life, even after being diagnosed  with a terminal illness,  is understandable.

But as Victoria's experience shows, it leaves too many unresolved questions.

'Every minute someone in Britain dies, but many of us still feel uncomfortable talking about  end-of-life issues or making our wishes known,' says Joe Levenson, of the Dying Matters Coalition, a national body of organisations including hospices and NHS support teams as well as individuals working to change public knowledge, attitudes and behaviour towards dying and bereavement.

'Talking more openly about dying is in everyone's interests, as it can help ensure that all of us get the care and support we want, where we want it, at the end of our lives, and can also make it less difficult to come to terms with bereavement.'

Six years after Nigel's death,  Victoria decided that she was ready to put her own difficult experiences 'to good use for others' in similar circumstances. She took a two-year counselling course, and then went on to more specialised bereavement and pre-bereavement support, starting work as a volunteer for Cruse, which provides counselling support for the terminally ill and the bereaved, in April 2011.

The work can be emotionally exhausting. 'One client was so angry over a bereavement four years earlier that she shouted at me for a full hour,' she says. 'I couldn't get a word in edgeways and was completely drained afterwards, but it served a purpose.

Six years later: Now, Victoria provides counselling support for the terminally ill and the bereaved
Six years later: Now, Victoria provides counselling support for the terminally ill and the bereaved

'It was the first time this young lady had expressed her anger over her father's death. It all came  bursting out.

'Many people don't realise that anger, denial, depression, bargaining and finally acceptance are very common, and so they feel further guilt when expressing their emotions, as I did over Nigel's refusal to acknowledge he  was dying.'
Looking back at that traumatic time, Victoria believes that Nigel's Army training probably played a large part in his reluctance to talk about his fears and feelings. Their sons have followed him into the Army, and last year all three were in Afghanistan at the same time.

When one son's close friend was killed by a roadside bomb three weeks after arriving in Afghanistan, Victoria was desperately shocked and it brought the reality of the dangers terrifyingly close to home.

'All soldiers are encouraged to write an “in the event of my death” letter, and although I've asked my boys if they've done that, they don't talk about it, although one told me his was inside his hat  box in his room in Germany,'  says Victoria.

Dealing with their mortality in such a practical way makes her sometimes wonders 'what if'.

'I recognise that many people simply don't want to face their own mortality, let alone anyone else's,' she says. 'But coping with death would be easier for all of us if there was more open discussion about it.
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