“All the best”

I’ve been meaning to write this article for some time, and I’d like to dedicate it to the professionals- particularly Gary and his matron (whose name I think was Mavis)- who I not only had the pleasure of meeting and being comforted by during the journey of which you’re about to read, but who also brought comfort to my family personally also.

Some people sign off with, “Regards”, “Warmest Regards”, “Your Sincerely”, “Best” (which I assume is short for “Best Regards”, or “Best Wishes”), or more the more casual, “Cheers”. But for myself, I’ve been using “All the best” for some time now. I’m not sure exactly when I started using it, but I do know the reasons and the source of where my use of it came from.

In 1997, I had the misfortune, bordering between a scene from the Theatre of the Absurd and a Marx Brothers sketch, of having a wisdom tooth taken out whilst I was in a dental surgery chair, and with only a local anaesthetic. The dentist, who on a later occasion when he was examining my teeth let his nose dribble all over the front of my naval uniform, had to get his foot up onto the footrest to pull the wretched thing out. It had been growing at approximately 45 degrees to the vertical, and had started to cause me some pain. It was suggested during a later appointment that I consult a dental surgeon, to have more of my wisdom teeth removed. This started a journey that would go on for about five years, and a legacy that is still with me today.

To cut a long story short, I was sent off to get a CT scan, as there were some things coming up on the dental x-rays which were unusual. After a year or so, I was able to get a follow up consultation with the dental surgeon, which resulted in the possibility that what the CT scan had found was cancer. As you can guess, as a 25 year old living on their own and in another city to their immediate family, I went completely to pieces. Although the feeling of being completely lost was terrifying, I was one of the more fortunate, as it only lasted for about twenty hours (and not much sleep).

Luckily I was able to get in to see an oncologist the very next day. I had to travel, from Coogee in Sydney, out to Westmead in peak hour traffic: a two hour journey in a taxi- the first taxi that I had ever been in that had its own television on the dashboard. I can’t remember how much I handed over to the cabbie, but it was easily three figures.

Once out at the Westmead General Hospital Oncology Clinic, I was sat in the foyer for about an hour, before being directed into a small, cold and dimly lit consultation room, where for the next hour a different person would come in every twenty minutes, and examine me before closing the door behind them without any comment. This was, as I would say in my understated way, mildly harrowing.

Finally a man with a well-trimmed beard entered, wearing a hound’s-tooth single-breasted suit- the likes of which I’d never seen before or have never seen since. Such an ostentatious garment would not suit many, but on him it was killer (not that we would have said “killer” in the mid to late 90s- more likely “fully sick”, although this would have been a bit OTT). I’ll never forget his first relaxed, drawled words.

“G’day. Gary Morgan,” was uttered, as a hand was thrust out to me, which I grasped at desperately. Another drawl, accompanied by a slow shaking of the head: “It’s not cancer. In fact it’s rather more interesting. Come with me and I’ll show you.” I was then led into a room where, wall to wall, was my skull was lit up, with about half a dozen people peering at a variety of my head scans, prodding at the scans with the encased ends of biros as they intensely discussed the insides of my face. It was spellbinding and creepy all at the same time. And in the middle of this presided the ringmaster himself: Gary Morgan- Head and Neck Specialist. I’d never met a demi-god before- and not again until I met my polymath boss at the RNCM library. It was easily apparent how highly respected he was by those around him.

Gary turned out to be what I’ve been informed is an anomaly in his profession: a specialist with a personality. We got to know each other over the next five years. I would routinely make the pilgrimage out to Westmead (by train: the cheaper- although slower- alternative) every three or so months for a CT scan, followed up soon after with a consultation with Gary.

Those consultations would result in me spending roughly an hour or so each time in the oncology waiting room. I count myself lucky that I wasn’t there for reasons as severe as my fellow waiting room visitors, and although I’d have rather been somewhere more reassuring, I’m grateful for each time that I had to sit there, because it was impossible for your heart not to go out to these poor, and often helpless, people. I find myself shedding tears as I recall these moments. What saddens me is that many of them are most likely not with us anymore. However, there is some reassurance that if that is true, then the people that were entrusted to them could not have been any more sympathetic or caring than the staff that were in that ward.

To cut a long story short, my first operation, in August 1998, involved the removal of a tooth that wasn’t in my mouth, and the opening and emptying of a cyst- the largest that Gary had ever seen- in my right sinus, which was allowed to drain into my mouth over the next four years (it was too big to remove). If you had told me the year before that all of this was going to happen to me- someone who’d never been under a general anaesthetic- I would have looked at you sideways. Fate is a strange thing.

The second operation, three years later at the beginning of September, 2001, involved removing the rest of the cyst, and attempting to close the hole that was created between the right sinus and my mouth. Unfortunately that hole has never really closed (which, at times, can be an interesting party trick), and I’m left with a reminder of that time in my life, some fifteen years later.

My last consultation with Gary was in early 2002. By this stage I had moved back to Brisbane, and so I had to get a CT scan done in Brisbane before flying to Sydney, to see Gary for what we hoped would be my final consultation.
I saw Gary, who knew that I was keen to travel overseas, and that I needed to find out from him whether this was a safe thing to do. After giving me a clean bill of health- reassuring me that the oral-antral fistula would close- we shook hands one last time, before I walked out of Westmead General for the last time. I found a grassy patch of land outside and of course fell completely to bits: the relief that a tense time in my life was finally over. A chapter in my life had come to an end, and another one was about to start. My travels after this day are another story.

…but when I went, in Brisbane, to get that last CT scan done, I had to wait afterwards for the images to be developed and for the specialists to write their report. Eventually, one of the radiographers came out with the large envelope that contained my final scans, handed it over to me, and then held out their hand to shake mine. At that point I knew what was coming, and instinctively- as if reciting a familiar daily ritual- we both said the same closing comment to one another.

“All the best.”

It was at that point that I realised that this had been a common thread during my last five years as an outpatient. It had been the standard farewell from each medical professional that I had come into contact with. Using “good luck”, “have a nice day”, “take care”, or “have a good one” really weren’t appropriate in this environment: an environment where these people would have had to break heartbreaking news to less fortunate people than myself on a daily basis. In some ways it was the safest thing for them to say, yet at the same time the most sincere thing also.

When I use this in my signature block on emails, it never loses its lustre; it never loses for me its poignancy, its symbolic meaning, or its original context. Whenever I use it- and I use it daily- it reminds me of the people that I saw that were less fortunate than me, and how fragile life is. I have used it subconsciously as a quiet and private mark of respect to these people- both the professionals and their patients- without really knowing it. Because it has this sense of deep sincerity about it, it allows me to remind myself how important it is to wish everyone, everyday, the very best in their life.

All the best,