Do You Feel Lucky?

We talk a lot about luck in our house. At first, we couldn’t believe how unlucky we were when my partner – an otherwise healthy, non-smoking man in his fifties – developed a rare form of lung cancer. Our bad luck seemed to progress with his disease, as a combination of late presentation, misdiagnoses and delays in reporting meant that by the time it was diagnosed, his lung cancer was inoperable. Things went from bad to worse as blood tests revealed my partner had none of the bio markers that would make him eligible for some of the new immunotherapy drugs, and a needle biopsy failed to yield enough tissue to allow participation in a new genetics trial.

But then our luck seemed to turn. My partner underwent chemotherapy that only had a 1/5 chance of working – and against the odds, it did. The cancer was pushed right back until his lungs – once a cloudy fog of white – now looked almost normal. Alas, the cancer grew back, and four months later we were once again staring at a scan of white lungs, cursing our bad luck. The second line chemotherapy only had a 1/10 chance of working, but my partner seized on this slender chance, and luckily, amazingly, it worked. Once more, the cancer was pushed back, and despite a few hospital admissions, my partner survived one of the most gruelling chemotherapy regimes with his health largely intact.

But we both know it could come back, so after discussing the risks with his marvellous consultant, my partner agreed to undergo an open lung biopsy at New Year to see whether he has any of the genetic markers that might make him eligible for some of the new medicines currently being trialled.

This week, our luck seemed to take a catastrophic dive when my partner was admitted to hospital with chest sepsis and pneumonia. Sepsis is the body’s overwhelming and life-threatening response to infection which can lead to tissue damage, organ failure and in 30% of cases, death. It is fast, frightening and can be fatal. 44,000 people die of Sepsis in the UK each year. After a week of excellent treatment and hospital care, my partner came home last night, and we are still processing what happened. We started to talk about how lucky we were that I hadn’t travelled to London the day he developed symptoms. If the sepsis had developed 24 hours earlier or later, I wouldn’t have been with him, and my partner (who doesn’t like to ‘make a fuss’) might not still be with us.

But as we talked with the boys about how ‘lucky’ we were, I remembered something I heard Nick Robinson the BBC presenter, say about his lung cancer. He argued that it wasn’t ‘luck’ that meant his disease was diagnosed and treated early; it was due to the professionalism of the doctors who saw and referred him. His comments made me think back to that dreadful Thursday morning when things went so very wrong so very quickly.

It was lucky that I happened to have an appointment with our GP at 7.40am with my youngest son that day, so that I could mention I was a bit worried about my partner who had wakened at 4.30am with a sudden temperature and increase in coughing. I thought she was being kind when she told the receptionists to ensure we got an appointment with a doctor before 10.00am, but now I realise that this was her professional expertise.

By 10.00am, my partners oxygen was dangerously low, his temperature, pulse, and respiratory rate sky high. The young GP – who we had never met before – wasted no time in calling an ambulance for a suspected case of sepsis. We thought it was all a bit dramatic and unnecessary – particularly when the receptionists bought in oxygen canisters for my partner. I suggested in an oh-so-British way that we should sit outside so that the GP could see other patients whilst we waited for the ambulance. I thought she was just being kind when she insisted that my partner was her priority. I realise now that she was using her professional expertise and judgement and was making sure that my partner remained safe whilst waiting for the ambulance.

We half-expected the paramedics to dismiss us when they arrived, as surely the oxygen would have made him better. But again, they used their professional judgement as they wheeled him into the ambulance, insisting on hooking him up to some fluids before we even set off for the hospital. As the brilliant paramedic chatted to my partner about football and Scotland, I thought he was just trying to take his mind of the cannula going in, but now I realise he was using his expertise to stop my partner going into shock and me going into a full-blown panic. He then rang the hospital to alert them that a suspected sepsis case was on its way.

Because of the communication between the paramedic and hospital, my partner was admitted immediately to a place I later realised was the Resuscitation Ward. Horribly pale and breathless, he was hooked up to a lot of machines that again gave scarily high readings for his heart, pulse and respiratory rate. I clung to the fact his oxygen levels seemed to be improving, not realising that this was only because he was on an epic 15 litres of oxygen. Again, my partner was attended to by amazingly calm and excellent professionals who performed a series of tests and assessments with the grace and skill of a well-practiced ballet. X-ray machines appeared at his bedside, blood was taken, symptoms measured and all of it was reported and assessed within minutes.

It was quickly established that the cause of the sepsis was not some post-operative complication from the biopsy, but severe pneumonia in both lungs. After waiting for the super-strong IV antibiotics to hit his bloodstream and some of his symptoms to stabilise, my partner was admitted to a ward, whilst the A&E staff continued to use their expertise to save other lives.

I could go on forever about the excellent care my partner received during the week he was in hospital, but my point is that although we kept saying he was lucky to be alive, none of this was about luck. The GP and Consultants who treated him were the product of investments made over fourteen years ago that allowed them to train in their profession; likewise, the skilled nurses and physios who will have begun their courses perhaps over five years ago. The fact that my partner was seen and treated for sepsis so promptly also wasn’t down to luck – it was because the hospital and community health care system had worked together to develop and implement a ‘Sepsis Pathway’ which meant that a strict and urgent protocol was followed. The fact that we left the hospital after a week of super expensive care without a penny to pay was because seventy years ago Nye Bevan had the foresight to create the NHS, and that subsequent generations have continued to support it.

We often say we are ‘lucky’ to have the NHS, but it isn’t luck. It is an active choice we make as citizens about how we structure and fund the system of care in this country and as I said to my boys, we mustn’t obscure important decisions about (lack of) investment with the language of luck.

As my partner recuperates, there will be skilled histopathologists in a laboratory somewhere, analysing the tissue from his lung. In the next few weeks they will report their findings to our Consultant Oncologist, who will use his skill and expertise to assess whether he has any of the genetic markers that might make him eligible for some of the new stratified medicines currently being trialled.

Wish us luck.





I will be back at work tomorrow, and like everyone else, when asked how my holiday was, I will say it was lovely and quickly move the conversation on. I don’t have the time or words to explain that although it was indeed lovely, I wept my way through Christmas and held my breath through the first week of the year.
After an initial cancellation due to infection, my partner was finally admitted for a planned open lung biopsy shortly after New Year. As most of the world recovered from the seasonal pleasures of food, drink and late nights, a surgeon and his team cut out a wedge from my partner’s diseased lung. He then spent the rest of the week being cared for by an amazing team of clinicians as they made sure his lung didn’t collapse (it didn’t) or develop an infection (he did). Because of this, he stayed much longer than we’d hoped in a hospital far from home. But despite the obvious winter pressures, he received excellent care from the skilled, patient and kind people that make up the NHS and was finally discharged last night.
My partner is now on a lot of pain killers, because as the surgeon explained, the lung is not like an arm or leg that you can rest. We all need to breathe – up to twenty-two thousand times a day – so his wounded organ is constantly moving. He is tired, sore and won’t be able to lift a kettle let alone drive for several weeks, and yet, we are happy.
Because once again, we have hope.
The lung biopsy was not a diagnostic or curative procedure. We know that he has inoperable lung cancer and that although two lines of chemotherapy have temporarily (and amazingly) pushed it back, the list of options gets smaller each time the cancer grows. We are hoping that his wedge of lung tissue will provide enough information to participate in the National Lung Matrix Trial, which is looking at new drugs depending upon the changes to genes in cancer cells. The aim is to match treatments to particular genetic changes, a much more personalised and targeted approach known as stratified medicine, rather than the rather blunt hit-and-miss approach of chemotherapy.
All the risks were explained to my partner, but he readily agreed to the open lung biopsy, because for us it is an act of hope. And I am not going to lie: there is a perverse kind of comfort in having a wound to look after, medicines to administer, a regime to follow – something to do. The alternative is to passively wait and worry about the cancer growing back, hyper-alert to the coughs that echo throughout the house, wondering whether an increase in breathlessness is due to the cancer or a common cold.
Of course, the cruel thing about hope is that it can so easily be dashed. There is no guarantee that the biopsy will yield sufficient amounts of tissue (two needle biopsies have so far failed) and he may not have the ‘right’ genetic changes that will make him eligible for some of the new drugs on trial. But by participating in research, we know that even if he cannot personally benefit from the genetic knowledge his tissue provides, someone, somewhere might.
Our lungs are an amazing feat of biological engineering, drawing oxygen into our bodies and dispersing carbon dioxide into the world. With over six hundred million alveoli, if they were stretched out flat they would be the size of a tennis court. The biology text books will tell you that it is your diaphragm and rib cage that makes you breathe in and out.
But I am learning that those twenty-two thousand breaths a day are much easier to take if you have hope.

The next ‘big thing’ in books? Love, actually.

In recent weeks, our two sons have asked me what we would do in the event of a nuclear strike. We don’t have a cellar, so where would we go? Should we build a shelter? Clear out a cupboard? Their earnest questions brought home to me just how unstable our world feels right now and reminded me of how different my own teenage years were to theirs.

Back in the eighties we had the Cold War, the Falklands War, the threat of a Nuclear War and the actual fall out from Chernobyl. I assumed responsibility for studying the various pamphlets and articles on What To Do In The Event of a Nuclear Strike, choosing the cupboard under the stairs as our designated shelter (although my mum refused to paint the door white). I regularly stored water in pots and pans around the house and kept supplies of tinned food under review. I even had the foresight to purchase kelp tablets from Holland and Barratt for protection against radiation sickness (although sadly I was on a school trip to Wales when the Chernobyl fallout actually happened, sans kelp tablets). Some might have thought me an anxious child, but I was just WELL PREPARED. And if my brothers and parents mocked me, well they would be thanking me on their knees once disaster struck. (In fact, if disaster ever struck, we would all be on our knees, as the cupboard under the stairs was really quite small).

In what would become a life-long trait, I coped with the apparent threat of destruction by trying to control my immediate environment. But also, I read. Not just survival books (although the SAS Handbook was a firm favourite) but fiction: huge, sweeping family sagas that told inter-generational stories of love and loss against the back drop of war and disaster. Until recently, I thought it was just me. YA didn’t exist as a genre back then and I borrowed a lot of books from my mum and nan. But looking back at the charts from the eighties, it seems I was part of a bigger trend. Alongside horror (Stephen King) and spy novels (John Le Carre), the eighties charts were dominated by the likes of Danielle Steel, Barbara Taylor Bradford and Collen McCullogh. On Sunday nights (when I wasn’t collecting supplies for the shelter) our family would gather around the only screen in the house to watch The Thorn Birds, A Woman of Substance, Roots and Shogun: love stories, family sagas, call them what you will; huge, epic dramas with people at their heart. However, somewhere along the line, these books were dismissed as ‘women’s fiction’ or ‘romance’ and I’m sorry to say that I followed the implicit snobbery and sexism inherent in these views and dropped them like an embarrassing friend.

I was reminded of my love for this genre when I read Letters to the Lost by Iona Grey and more recently, Island in the East by Jenny Ashcroft, both moving love stories set against the back drop of war. I devoured both books as they filled a need in me that most crime and thrillers just cannot reach (although the very best thrillers such as Rattle by Fiona Cummins are ultimately about love). There is a lot of talk in the industry about ‘the next big thing’ and although I think there is no one answer, I suspect that as in the eighties, we may be about to see a resurgence in epic love stories and family sagas. Now as then, the world feels unstable, led by almost cartoon-like bad guys with the power to plunge us into war. At times like this, I feel an urge to read sagas not as a form of escapism, but as a reminder that people can and do survive terrible things, particularly the women. Decades later, I still recall the quiet strength and suffering of Fee Cleary, the fierce drive and determination of Emma Hart.

These books are not just ‘uplifting’, they are stories of hope, strength, rebellion and resilience. They are the stories of our mothers and grandmothers; they are the stories I believe we need now.

So when I build my nuclear fallout shelter, I will ensure we have a good supply of epic love stories and family sagas, alongside the water and kelp tablets. For as Larkin once wrote, in the end, ‘what will survive of us is love’.



Dear Doctor

Dear Doctor

I cannot imagine anything worse than being an Oncologist. All that bad news to break, bearing witness to such heartache whilst knowing that the medicine you give to heal can often do such harm and sometimes will not work at all. And it must be so hard to keep up: there are more and more patients coming through the door with a complex set of conditions; immunotherapy and genomics are transforming our understanding of the disease and everyday it seems there is a new research paper that you simply must read, (once you have finished reading the latest national guidance on what you are and are not allowed to prescribe). And in the midst of this whirlwind of knowledge, there are raw-faced patients and families queuing up outside your door waiting for you to tell them what is going to happen next. On every level – emotional, scientific, managerially – your job seems impossibly complex.

Except it’s not. Dear doctor, I want you to take a step back and remember that despite all the noise and activity that surrounds you, at its heart, your job is actually very, very simple. Your job is to make patients feel better. I don’t mean this in the curative sense. Going back to the roots of the word ‘disease’, it comes from old French and then Middle English and means ‘lack of ease’. When we sit in your room, yes we want ‘the results’ of that scan, those blood tests, but that is really a means to an end. Whatever that scan says, we want you to relieve our anxiety and dis-ease. In these dark days, we want you – we need you – to make us feel better.

I am writing this because my partner is fortunate enough to be cared for by an excellent team at a leading teaching hospital. There is no doubting their intellectual abilities or devotion to their patients. However, within a team there are different personalities and it is clear that some doctors seem to think it is their duty to tell us just how bad things are and how awful they are about to get. Perhaps twenty years ago, this would have been a terrible but necessary burden for the doctor alone to carry. But in 2017 we have the internet, so believe me, we know exactly how bad things are. The statistics could not be more bleak and there is no room for ambiguity or denial. What we need is for you to make us feel better, despite everything that is going on.

Every consultation with you is dissected and discussed: did you notice how he never smiled, the way he looked at you, not me? The Macmillan nurse was there (a bad sign) and he didn’t show us the scan (even worse). Everything is taken apart and discussed, weighing your words and the heavier silences between them, over and over again. Therefore, dear doctor, I am not asking you to ‘improve your communication skills’, but to be sensitive to what you are transmitting. Like a super hero, your every move is so powerful to us mere mortals.

This might sound like yet another complex request on your time but again, it is actually very simple. Before you call us into your room, ask yourself what is the key message that you want us to take home? Above all, how do you want to make us feel? Once you have decided that, be careful not to bury any positive messages in the debris of caveats and statistical probabilities. We can get that from the internet. What we want from you – the flesh and blood doctor – is a flesh and blood human being. What we need from you is to help us feel better. There is no such thing as ‘false hope’. Hope is a speculation on the future, just as misery is. But the anticipation of loss, of grief and pain has absolutely no value or purpose other than detracting from the life we have left to live.

So in conclusion, dear doctor, my key message that I want you to take home today is that it takes fourteen years to train as a consultant; a life time to develop into a fully-fledged human being and sometimes, just ten minutes to break our hearts.

Choose Hope

Three weeks ago, a well-meaning consultant gently asked my partner whether he was sure he wanted to continue with second line chemotherapy. Had he considered ‘going down the palliative care route’? It was, on paper, a reasonable question to ask. My partner had inoperable lung cancer, and despite a rare and surprising response to initial chemotherapy, it had returned with an alarming speed and aggression. He recently started second line chemotherapy, but after just one cycle, he was admitted for five days with a serious chest infection. The doctor we saw that day (not our lead consultant) explained that the risks of further chemotherapy might outweigh any benefits, as Docetaxel is very toxic yet only works in about 8-9% of cases.

We were shocked and upset to be having this discussion. We went round in circles, trying to untangle the cause and effects of cancer, chemotherapy and the chest infection, politely fighting against the undertow of the conversation. My partner is only 57, we have two young boys and so in the end he said that whilst he understood the risks, he also understood that no chemotherapy meant the cancer would definitely progress, whilst further treatment meant that it might not. For him it was a simple decision. He chose hope.

Just three weeks later, we sat with our lead consultant whilst he showed us the results of my partner’s CT scan. Once again, against all odds, the chemotherapy has had a significant and visible impact on my partner’s cancer. We stared at the (mostly) dark and clear spaces in the lungs where just four weeks earlier it had been a fog of white, unable to believe how lucky we were – again. I wrote before about how my partner had proved to be a ‘super responder’ to chemotherapy.

Tonight we are shaky with relief and joy, unable to process the impossible statistics and the near-miss consequences of not going ahead with this second line chemotherapy whilst carefully sipping the hope that this gives us. There are so many emotions. When our consultant showed us the scan, he leaned back in his chair and said, ‘to put it in perspective, you are the best news I will get to give all day.’ So our happiness is tempered by the knowledge that most of the people we sat beside in the waiting room will not have had our good fortune.

When we left the hospital three weeks ago, stunned and tearful, we bumped into an old friend I used to work with who was also suffering with late stage cancer. Despite being very sick herself, she and her lovely partner took the time to give us words of hope and encouragement and later sent us a video telling her story. When a doctor tried to tell her ‘how long she had left’, Jackie – a life-long campaigner for equality and the BME voice – held up her hand and silenced him. ‘It is not your prerogative,’ she said. It is a cliché and perhaps a burden to call someone ‘an inspiration’ but @jackielynton truly is and I urge you to follow and support this woman on her journey of hope.

I do not blame the doctors for sharing their frank opinions. Goodness only knows how they cope with seeing people like us day after day, how they sift facts from hunches and decide what to say and not say. My partner was given a choice and he chose hope. That choice will cost the NHS at least £39,000 and once again it will give us the priceless gift of more time. And for that we are profoundly, eternally thankful.


Two months ago, we were on holiday on the Isle of Skye. I remember watching my partner climb the hills of the Faerie Glen with my 16-year-old and 12-year-old boys. I took a photograph from where I followed behind, thankful for the miracle that had given us this second, precious chance.

Tonight, I took my boys to visit their dad in hospital. He had oxygen tubes in his nose, a nebuliser on his mouth and cancer back in his lungs.

I am still trying to understand why and how things could have changed so much in just ten short weeks. Still trying to process how this makes him, my boys and myself feel.

Actually, that’s not true. I am not processing it. I am denying it. And this ‘post’, this ‘blog’, is a belated attempt to try and make myself accept where we are.

And where am I? Alone at home for the second night running, my Other Half (truly, my other, better half) is in a bleeping, vigilant but strange room, unable to go to the toilet without reducing his poor, coughing body to a painful rubble.

We cling to hope. He responded well to chemotherapy before, so we hope that the second line chemotherapy he started on Monday will also be effective. Most of all we pray that the biopsy will reveal he has the right genetic markers for some of the new gene therapies that are becoming increasingly available as clinical trials.

We hope. We pray. We wait.

And to be honest, I get a bit angry. We knew there was no cure; that his extraordinary response to chemotherapy would not last. But we did hope for longer than three months. Next week my 16-year-old son will have his first work experience in London and my partner was supposed to go with him for a much-deserved holiday. My lovely, self-effacing partner who gave up his job and fragile self-esteem to look after our boys whilst I swanned off to his favourite capital city to garner praise and promotion whilst he did the thankless tasks of parenting. And now my excited and anxious 16-year-old son is trying to buy his first suit without the help of his dad.

I don’t know what to say other than it breaks my heart. All of it.

And before you tell me I am brave, truly I am not. I am terrified. I have become a parody of myself: the hard-working mum who keeps it all together right before she snaps, refusing to cry in front of her boys lest once she starts she will not stop.

I don’t think of this as a battle or a fight with cancer, more of an ungainly run from its clutches. I keep thinking of the apocalyptic scene from the film DEEP IMPACT: all those families gathering their loved ones to them as they try to out run the disaster and make it to higher, safer ground.

We are literally running for our lives. So tonight, as my partner of twenty-six years lies alone in a hospital room, I am playing one of our favourite songs: Run, by Snow Patrol.

You’ve been the only thing that’s right In all I’ve done’





The ‘cleavage sparing mastectomy’ that may have cost my mum her life.


Like everybody else, I was winding down on Friday and looking forward to a long Bank holiday weekend. I had prosecco in the fridge, plans to clean out the patio and maybe buy a new garden bench. But then the 5pm news came on. The lead story was that a surgeon called Mr. Paterson had been convicted of intentional harm.

And I was back in the hospice with my mum as she fought to take her last breath.

I have thought long and hard before writing this post. I cannot change what happened and I have no wish to be part of any media circus or witch hunt. But I do want people to learn lessons. And I want my mum’s death to matter.

My mum was first diagnosed with breast cancer early in 2006. We had a four-year-old son and a new-born baby, so she was staying over to babysit. Once the boys were in bed, she sat on our settee and told us about the lump she had found, and that the tests had shown it was cancer. I was shocked, she was scared and I promised to attend every single appointment with her.

The papers talk about how charismatic Mr. Paterson was. That was not my experience. When we met him – just the once – he seemed brusque and arrogant. He said my mum had a fast growing tumour in her breast and needed a mastectomy. I remember he spoke about the possibility of reconstructive surgery and my mum dismissing the very thought. She was 61. She had always been (in her own words) ‘flat chested’. She didn’t care about cosmetics, she just wanted the cancer gone.

Unfortunately for my mum, contrary to existing guidelines, Mr. Paterson carried out ‘cleavage sparing’ surgery. In effect, this meant that instead of a total mastectomy, some flesh was left behind in order to facilitate potential reconstructive breast surgery (which according to some reports, he potentially benefited from in his private practice). The pros and cons of this non-standard procedure were never explained or discussed. My mum was eager for the operation to commence and so consent forms were signed. She was, as Sir Ian Kennedy so astutely noted in his report, ‘consented’; she did not give consent.

My mum had the mastectomy and then went through the ordeal of chemotherapy and radiotherapy. I won’t go into the gory details. If you or a loved one have been there, then you will know what this means. If you haven’t, then I hope you never will. After that, it was an anxious vigil for us all as we waited for each scan, counting down the days for the five year ‘all clear’ milestone. My mum’s hair grew back, thicker and darker than before. She put on weight. She thrived. She was nearly there. In the spring of 2011, she had her five-year check up – with Mr. Paterson as it happens – and she was signed off. Five years, cancer free. My mum was so relieved. I remember that we went for a celebratory lunch and that she played Frisbee with her grandchildren in the garden.

But in the summer of that year, my mum was recalled by the hospital and told that the operation she’d had in 2006 had not been a full mastectomy and that she would need further surgery to remove potentially cancerous flesh. (It later turned out that my mum should have been recalled in 2009, but there had been an error and my mum was somehow missed off). Sometime after that operation, she visited the hospital for a check up where she complained of tiredness and pain. An alert doctor ran more tests and she was eventually diagnosed with bone cancer, secondary to breast cancer.

My mum then went through another round of chemotherapy, but as she said herself, this time her body was too weak to take it. It sapped her energy and confidence until she could no longer leave the house unless in a wheelchair equipped with oxygen tanks. Even writing this, all the memories I have blanked out – the sound of the oxygen tank in her bedroom, the tubes in her nose, the morphine by her bedside – it all comes flooding back.

I have read some but not all of the newspaper reports this weekend – even four years later, it is still too raw – but I am shocked at the sheer scale of the damage and hurt that Mr. Paterson has caused. He removed lumps and breasts when there was no clinical need. My heart goes out to those women and their families who went through unnecessary physical and mental trauma and I do not pretend to understand what they are going through.

I cannot speak for anyone else, but personally I do not feel any satisfaction or pleasure that Mr. Paterson is going to jail. As his colleague Dr. Budhoo said, I doubt if he accepts or understands what he has done wrong. For me, the big question is not what was wrong with Mr. Paterson, but what was wrong with the culture and practices at the Trust? Why did no one else stop him from practicing surgery that was so clearly outside of all guidelines? Why, when questions were finally raised (as early as 2003) was prompt action not taken to stop him from harming patients, and why, when he was under an active investigation and clearly conflicted, was he allowed to see my mum and sign her off? Some of these questions are answered in the excellent review carried out by Sir Ian Kennedy who wrote:

This is a tragic story. It is not a story about the whole of the NHS. It is about something that happened in one corner of one hospital Trust in one part of the NHS. But, it has lessons for the whole of the NHS. It is a story of women faced with a life threatening disease who have been harmed. It is a story of clinicians at their wits’ ends trying for years to get the Trust to address what was going on. It is a story of clinicians going along with what they knew to be poor performance. It is a story of weak and indecisive leadership from senior managers. It is a story of secrecy and containment. It is a story of a Board which did not carry out its responsibilities. It is a story of a surgeon who chose on occasions to operate on  women in a way unrecognised by his peers and thereby exposed them to harm.

It was also my mum’s story. My mum died in August 2013. She was just 68 years old and left behind a heart broken widow, three children and three young grandchildren. There was a hurried out of court settlement with the NHS Trust before she died based upon a clinical assessment of her case. Whilst it was accepted that having a ‘cleavage sparing mastectomy’ had increased her risk of cancer returning, it could not be proven beyond doubt that it had caused her secondary bone cancer. Her lawyers said that she could challenge this but my mum chose to accept the judgement. Partly because she didn’t have long left and wanted her affairs to be in order before she passed away, but mostly because she took some comfort from the clinical report into her case. My mum did not want to die and it would have caused her unspeakable agony to know that her death was both unnecessary and avoidable.

Like everyone else who has ever been affected by a clinical or managerial error, my mum’s main aim in persuing a court action was not to receive an apology or money, but to ensure that this could never happen again to anyone else. The best legacy for my mum and the other patients and relatives affected by Mr. Paterson would be for everyone in the NHS to read Sir Ian Kennedy’s review.

The lessons it sets out are very simple: always put the patient and their needs first. If you have concerns about a colleague, raise them and do not stop until they are addressed.

In short, always do the right thing.