'For The Love Of Mariam': Narrative About Breast Cancer Death

The call came through while I was still at work poring over plans for the launch of a new hair care product. At the other end of the line was my friend Mariam’s husband. The connection was not very clear but I heard enough for my heart to sink into my stomach. Even though we’d hoped for a miracle, after several bouts of chemotherapy, a mastectomy, and a series of powerful drugs with distressing after-effects, Mariam had lost the battle against breast cancer. She was only thirty five years old.

The first time we met, about thirteen years ago, is still vivid in my mind. It was at work and I remember her long and healthy hair, and her glossy skin. What she lacked in height she made up for with her charm, her no-nonsense approach to business, and her impeccable English. The same Mariam with no trace of accent in her English could reel out Egba dialect without a hitch, and she spoke fluent Hausa, too. I remember an occasion when we needed her for an emergency ‘master of ceremony’. Mariam stepped       out onto the podium, spoke in her broadcasting voice, and then delighted the audience by switching to her local dialect. That was vintage Mariam.

We did not quite hit it off as pals at first because I thought she talked too much. It was a good deal later that I realised what I thought was lack of politeness was actually the definition of honesty. She was blunt to a fault. A spade was a spade to Mariam. She wouldn’t call it a spade today and call it a knife tomorrow. She was firm and direct. Some people loved her for this. A few felt she was too bossy or too aggressive.

The company I worked for at the time hired Mariam to supervise the launch of a new hair care brand. A seasoned hairdresser and cosmetologist, Marian rapidly made her presence and professionalism felt throughout the company. You could either love, hate, or tolerate her. Those who loved her saw a rare gem; her sincerity, loyalty, care and concern for her family and friends.

She called me Mama Kola. She was my confidante. When I was down, she was there for me through words of encouragement. I did same for her, even though looking back now it seems as if I didn’t give her enough time. Otherwise, how come I did not know she had cancer until it had progressed to a life-threatening situation? This is one question I’ve been asking myself since she passed away.

Mariam was an extended family advocate. She believed she was lucky to be in a privileged position. So helping her brothers, sisters, grandmother and all was no bother. From the modest salary she earned, she would give out money or buy food provisions for her family who came in droves for one favour or the other—school fees, rentals, food and so on.

Who was Mariam? I know her mother was an Egba from the western part of Nigeria who died when Mariam was still a little girl. Mariam ended up living with her grandmother. Her education was short-lived at higher secondary school level due to lack of funds, but this did not deter her from exhibiting brilliance in her chosen profession. She went to a hairdressing school where her skill was immediately identified. Her hard work quickly elevated her to the position of the Principal of the school. It was from there that she was recruited to run the company’s hair salon in preparation for an entry into the hair care business.

Mariam got married in her teens and had two daughters. Unfortunately she divorced the father of her daughters on the grounds that she was being gagged. She desired to make something of her gift, and her husband was against her working. She told me he had based his objection on cultural and societal norms, which stipulate the role of the wife as being to take care of the children and the home, while being docile in the process. Mariam rebelled against this tradition, and felt she was decaying by not working and putting her abilities to use. She got frustrated and opted out of the marriage. She later reunited with her first love, but continued to bear her first husband’s name. In her second marriage, she had a son who was still very young.

One day, she said to me, ‘Mama Kola, I found a small lump under my left armpit, and I want to go for a test.’

I was concerned but didn’t think it was anything serious. I was aware that most breast lumps are not cancerous but should still be checked by a doctor. I hoped Mariam’s lump would be benign. I supported her going to a doctor for a check-up. A biopsy was done, but somehow, out of negligence on our part, we did not go back for the results until she started complaining of aches in her joints, difficulty doing the normal things she was used to, extreme weakness—general unwellness.

It was then I asked, ‘Mariam, what about the result of that test?’

‘I will go back and check,’ she said and she did go to check.

It was cancerous. Surgery was suggested to remove visible tumours. Sadly, before she could go for the operation, she got really sick.

Mariam was now coming late to the office. Eventually she stopped altogether. One morning, she called me from the office reception. Before she could say anything, I said, ‘I’m worried about you. Are you okay? Why are you calling from the gate?’ I asked several questions without waiting for answers.

‘I’m sorry, Mama Kola,’ she said when eventually I allowed her to put in a word, ‘but I’m actually in a wheelchair.’

‘What are you doing in a wheelchair?’

‘I woke up this morning and I just couldn’t bring myself to stand up. I’m on my way to the hospital now. Just thought I should let you know.’

By then I was really worried. I asked her which hospital. ‘I’ll come and see you later this afternoon,’ I said after she told me.

When I finally got to the hospital, I was unprepared for what I saw and the news I got. Tears rolled down Mariam’s cheeks when she saw me. I was alarmed.

‘What seems to be the matter?’ I asked.

‘The test shows that the lump is cancerous. Not only that, it has spread to the other internal organs.’

‘How come?’ A stupid question to ask at that moment, but I just didn’t know what else to say.

‘I have no idea, but it is African cancer.’ Marian was despondent.

‘What do you mean African cancer?’

‘You know when things happen so fast that you cannot explain. Some people want to kill me.’

‘Why would anyone want to kill you?’ I was still confused.

‘I have been having these dreams... bad dreams.’

‘Calm down. Let me have a word with the doctor.’ I hugged her and left to get proper medical update.

The doctor said the cancer had spread to other parts of the body and did not look good. The treatments she needed were either to prolong the duration of her life or alleviate symptoms caused by the cancer to improve quality of life. None of the options were comforting. He mentioned chemotherapy - as one way of administering drugs to kill cancer cells wherever they may have spread.  Then he referred us to Lagos University Teaching Hospital (LUTH) for admission to continue her treatment.

The financial implication was going to run into millions of naira (hundreds of thousands of US dollars). Where were we going to get the money? My mind was in turmoil, but my brain went to work. Set up a Committee of Friends to raise the funds? How much could we possibly raise? Perhaps the Company would pick up the medical bills? That last option I decide to pursue. I went back to Mariam, consoled her that everything would be alright, but never mentioned anything about the fact that she might die. We were both emotional. She was worried, of course, about her two year old son.

‘Will you take him for me, Mama Kola?’

‘I think he should stay with his father,’ I replied.  ‘He would be better off with his father whom he is used to. He will be fine. Anyway you will be out soon.’

I went back to the office to inform the relevant people. To my delight and surprise, the Company was solidly behind Mariam. They provided for all her needs and never flinched over her gigantic medical bills. She also continued to receive her full salary throughout her stay in the hospital. All her friends were deeply touched. They rallied round her to support, encourage, and inspire her.

Mariam was moved immediately to LUTH where she stayed for several months. During the period of my visits to her, I learnt a lot about people, death, faith, greed, and grief. Some people simply amazed me positively, while others disappointed me.  Looking back now, I realise there are things I could have handled better. For instance, I did not give Mariam the full attention she truly deserved. I got tired mid-way from the visits. I hated the depression that overwhelmed me as I drove through the hospital gates. I detested the medicinal smell of the hospital after a while. Most importantly the despair, which enclosed me, was too much to bear. Particularly when I got to the hospital sometimes and saw an empty bed and I was told the occupant had died during the night. I avoided the gloomy faces that stared at me, ignored the groans, knowing I could not do much about it. It broke my heart to see Mariam in pain from one drug or the other. Terribly devastating were the side effects of Tamoxifen—vomiting, weakness, mouth sores. The most excruciating pain came from the bedsores—deep, ghastly, wounds—the likes of which I had never seen before and pray never to see again. It was difficult to even know which pain was worse. I can only imagine that it must have been hell for Mariam.

We had a few laughs sometime. In one particular instance, when her head was shaven after a session of chemo left her head in patches, I walked in and saw Mariam raised on the bed with her bald head.

‘Wow, this hair cut really suits you,’ I said and laughed.

‘You think so?’ she asked with a smile.

‘Yes o.’

‘I think I will keep this style when I get out of here,’ she replied humorously.

‘You will get out alright, and we can call it Mariam style.’

She laughed, but then went quiet.

‘Now what is the matter?’

‘Will you write about me Mama Kola? I know you are good with words. I want you to write about me. I want people to know about breast cancer. Look at me I am only thirty four. Here I am diagnosed with breast cancer. You know people should not take their health for granted. It is only when you are ill that you appreciate good health. Also I have been reading a lot about Jesus. Someone brought me all these Christian tracts. Reading them gives me peace. You have to write about me.’

‘No problem, Mariam. I will. One of these days, I will bring a voice recorder. All you have to do is just switch it on once in a while and pour your heart out. That will be a start. It will help a lot, when I am ready to write about you.’

‘By the way, Mama Kola, the doctor is suggesting mastectomy, because the side effects of the drugs are too much and the cancer is not decreasing.’

In medical terms, this means no remission.

‘What do you think Mariam? Do you want mastectomy?’

‘I don’t know yet, I will speak with my husband.’

‘I think the doctors know best. If mastectomy will eliminate and prevent a reoccurrence of cancer cells, in the future, then you should consider it.’

A few weeks later, my friend had one of her breasts surgically removed. Some weeks after that first surgery, the second breast went. When I visited her in hospital, she was no longer Mariam. The rigor and stress of having her breasts removed were just too much for her. For the first time, I saw what the scar of mastectomy really looked like. Although it was still bandaged, her chest was just so flat. It was difficult to believe that this woman once had the most envious breasts around.

This time I broke down. I was already tired myself, but I had to pretend I was strong. She looked dehydrated, so skinny and fragile. Her head had started sprouting some thin fluffy hair, like a baby’s. But she still had that smile, though it was weak by now. I apologised for not having come to see her for weeks. While it was half true that I’d been out of the country for one thing or the other, the reality was that my earlier enthusiasm to visit Mariam had waned. Seeing her day-in-day-out losing her strength was more than I could bear. The human element in me started to take over. I would visit all right, but wanted to escape as quickly as possible. The whole hospital environment was just unbearable.

Mariam accepted my excuse for having stayed away from her for weeks. She said it was alright, she understood. She asked that we take care of her son, who was by then staying with one of our female friends from the Company, temporarily, until Mariam got out of hospital. She never got out of the hospital. 

That was my last visit to Mariam, until I heard the news about a week later through the telephone. One of Mariam’s vital organs gave up one night soon after my last visit. The doctors tried to revive her but failed. I received the news with mixed feelings. First of all, I felt relief that at least she was free from pain; the chronic pain that was so intense, sometime it left her incoherent. On the other hand, I was sad that, after all that gallant battle, we had lost. I was upset that such a woman should have died—just like that.

I needed to see her again. I went to LUTH the next day. I met her husband who took me to see her body at the mortuary. The place was depressing. We walked up to where she was kept and the man in charge brought out her corpse. Even in death her face was still ravaged by pain. This was a woman who fought pain and death with the last breathe in her body. I walked away with a heavy heart.

Her epitaph should read ‘Mariam was a woman who had so much passion, but died with so much left to give.’

It took Mariam’s avoidable and unnecessary death to open my bottled-up passion for healthy living. All women are at risk for breast cancer, including those who have no family history of the disease. The good news, however, is that treatment has improved, so is survival rates for women diagnosed with early stage breast cancer. The chances of beating breast cancer is high when you start regular breast exams by your doctor and monthly self-exam at age twenty, and get annual mammograms beginning at the age of forty. Life is a gift; do not take it for granted.

Credit: Excerpt from Waving in the Wind by Bisi Abiola

 https://outskirtspress.com/WavingintheWind