Hannah’s Choice: A daughter's love for life. The mother who let her make the hardest decision of all.

The doctor looked at me as exasperation washed across his face.

‘You just need to give her some Calpol,’ he said.

‘I already have,’ I lied.

I didn’t want to be dismissed with paracetamol. I wasn’t simply another over-protective mother. Someone had to listen to me. Something was terribly wrong. I knew it.

‘I think you should take her home and see how she is in the morning,’ the doctor replied slowly. ‘You can always see the GP if she’s still not feeling well tomorrow.’

I stared at the man, wanting to fly at him and scream.

‘I want a second opinion,’ I said in a low voice, trying to keep my rage under control.

‘Well, I’m afraid there’s no paediatric consultant on duty tonight. You’ll have to take her to Birmingham or Hereford to be seen.’

‘In an ambulance?’

‘No.’

I didn’t have time to argue. Scooping up Hannah in my arms, I ran out of A&E towards the car. Putting her into her seat, I ran around the car, got in and started the engine. Hereford was closer – 45 minutes’ drive away.

‘My tummy hurts, Mummy,’ Hannah moaned.

‘I know, darling, and we’re going to make it better,’ I said softly.

Hannah shut her eyes as I started driving. The minutes slid by as I turned over everything again and again. Why wouldn’t the doctor listen to me? Why hadn’t I done something more before now? Hannah hadn’t been well for a few weeks but the GP had told me it was just a virus and I had listened as I told myself she was tired at the end of her first term at school. When she hadn’t perked up, I’d gone back to the GP again and was told the same thing – she had one of those unspecific childhood bugs that every under-five gets and she’d soon shake it off.

So when Hannah had refused to eat on a visit to see my great aunt Kitty, I’d told her off. When bruises had appeared on the tops of her feet, I’d explained them away by a bang she’d got when she opened a cupboard door. I told myself I was being over-indulgent – the kind of mother who won’t listen to good medical advice when she’s given it. The kind of mother I didn’t want to be. But what kind of mother was I now? I’d known deep down that something was wrong and hadn’t trusted my own judgement. Now I knew I must.

Fear turned inside me as I drove and pressed my accelerator foot closer to the floor. Hedges and trees rushed by in the blackness as we neared Hereford.

‘Nearly there, Han,’ I said in the singsong voice mothers use to calm fear, anger or anything in between.

But Hannah did not reply and I turned to glance at her beside me. She looked as if she was sleeping. Reaching across, I grabbed her leg and shook it.

‘Han?’ I said. ‘Han?’

She didn’t open her eyes. I pushed my foot down harder, trying to stave off a rush of panic. Was she breathing? Should I stop to check? No. I didn’t have time. I had to get her to hospital. They could do more for her there than I could.

Driving into the entrance of Hereford Hospital, I headed for the children’s ward. I’d done some nursing shifts there before so I knew where it was. It was quicker than trying to find A&E. Hannah was limp in my arms as I pulled her out of the car. Quick, quick. Hurry. Let me in.

I hit the doorbell to the unit but nothing happened and I stared around me, ready to start screaming. But suddenly the door opened and I dashed inside. Running along the corridor, I could feel Hannah lying in my arms. My baby. My precious girl.

Flying towards the children’s ward, I hit the bell on another door and waited for a voice to crackle out of the intercom. It seemed like for ever until it opened and I ran into a long corridor.

‘I need help,’ I pleaded as I reached the nursing station. ‘Please. My daughter is unconscious.’

Nurses burst into life in front of me and Hannah was taken out of my arms. I followed as she was carried into a room. Very pale, her breathing was fast and shallow as a doctor started examining her. Please, please let her be OK. Make her well again.

‘We’ll need to put a line up,’ the doctor said as the nurses peeled off the top of Hannah’s cream all-in-one sleep suit.

I stared in horror at her tiny body. It was covered in tiny red marks – more appearing with each second – livid spots popping under her skin as if an invisible person was pricking her. The doctor pressed a needle into her right arm to take some blood.

‘We’ll send this straight off to the lab,’ he said as he slipped the syringe into a plastic bag.

Hannah was still semi-conscious as she was put onto a saline drip. Now all we could do was wait for the blood test results. Time disappeared as I sat by her bed waiting. She looked so tiny – her blonde hair clinging to her head and her breathing still shallow and rapid. Her skin was so pale, it looked almost grey. I wanted to do something. Surely I could? I was her mother, the one person who would always protect her. But even as I tried telling myself this was some everyday, run-of-the-mill illness, I felt the spark of fear which lies inside every mother from the day their first child is born uncurl itself inside me.

‘Mrs Jones?’ a voice said. ‘The doctor wants to speak to you.’

I was taken into a room where the doctor was waiting with a nurse. She walked towards me as if to put her arm around my shoulders but stopped as I stared at her. I knew what this meant. I’d seen it a lot during twelve years of nursing. But I’d always been on the other side before – one of the people waiting to gently break bad news to a stunned relative.

I sat down opposite the doctor.

‘We’ve had the results back,’ he said. ‘I’m afraid Hannah is very poorly. Do you have any idea what is wrong with her?’

I looked at him. I’d been going over it in my mind and knew – the bruising, tiredness, loss of appetite. I should have realised before now.

‘I think so,’ I replied.

The doctor looked at me.

‘Hannah has tummy ache because she’s bleeding into her stomach and is now beginning to bleed everywhere. We need to work quickly to save her life now.’

I stayed silent as I listened.

‘This is very serious, Mrs Jones,’ the doctor continued softly. ‘Hannah is a very sick little girl. We think she has leukaemia.’

It was quiet on the ward, past midnight, as I opened my eyes and looked at Hannah. A small light above her bed threw soft beams and shadows across it. Standing up, I tucked her yellow knitted blanket around her. We’d brought it from home – something familiar in all that was so new.

Turning around, I stared at the plastic chair which I’d earlier folded out flat before wrapping a hospital sheet and blanket around it. This was my bed now, but I knew I wouldn’t be able to switch off as I lay down and heard the hushed sounds of the hospital at night – the clip of nurses’ footsteps, the rumble of trolley wheels and the soft beeps made by machines. I felt as I had in the first few weeks after becoming a mother – too scared to fall properly asleep as I listened to Hannah breathing. Like all new mothers, mine had been a waking sleep all those years ago until I’d learned to trust the fact that she was safe. Now such certainty was gone.

Hours after arriving at Hereford, we’d been transferred to Birmingham Children’s Hospital and already the map of our world was unrecognisable. Gone were pre-school and nursery pick-ups, bath times and stories before bed. Instead there were lumbar punctures and central lines, HB levels and platelets.

We’d been plunged into our new world during our first meeting with Hannah’s oncology consultant, Dr Williams. Young, smiling and comfortably rounded, he’d told us that she had probable acute myeloid leukaemia – an aggressive and rarer form of the blood cancer. From that moment on there was a flurry of activity, questions and tests. This morning Hannah had gone down to the operating rooms to be anaesthetised for a lumbar puncture to confirm the diagnosis and identify the specific type of leukaemia by drawing spinal fluid to test for cancer cells. A central line had also been inserted – an intravenous catheter which snaked through her chest wall and into her jugular vein ready to deliver chemotherapy drugs straight to her heart.

Andrew and I had sat quietly as Mr Williams explained AML to us. In healthy adults and children, bone marrow produces red blood cells to carry oxygen around the body, white blood cells to fight infection and platelets to knit blood together and control bleeding. But in Hannah this system had gone out of control, like a rollercoaster crashing off its tracks into the unknown. Deep within the core of her bones, her marrow was over-producing imperfect cells. It meant that healthy blood was not being made which was why Hannah had started bleeding internally. Without treatment she would certainly die. With it, she stood a chance.

For a moment fear had engulfed me as the doctor talked – a bitter, clenching terror that filled my gut. But I’d pushed it down as I listened to every word he said, knowing I must keep myself calm as we prepared to fight for Hannah’s life. Working for many years at the extreme end of nursing – intensive care and cardiac transplant wards, major injuries units and paediatric ICU transfer – had taught me how to do this. In the rush and panic of acute medicine I’d learned to keep still in the eye of a storm. Sick and infirm, young and fit, death was a random enemy which didn’t make allowances as it took lives. But it was only now as it tried to take my own child that I knew what fear really tasted like.

It had all felt unreal during those first anxious hours in Hereford Hospital as we waited to be transferred to Birmingham by blue-light ambulance. After the doctor had spoken to me, I’d phoned Andrew and he’d arrived desperate for news, tears wet on his cheeks as both of us tried to take in what was happening. Until then we’d had an ordinary life: Andrew working as an auditor and me doing twenty hours a week as a junior sister on a coronary care unit in Worcester, juggling my shifts around our three children, babysitters and nursery. We lived in a new house on a little estate and went on holiday once a year. It was a busy, run-of-the-mill life until we stepped out of the lift into the long corridor leading through Birmingham’s paediatric oncology unit for the first time and I knew nothing would ever be the same again.

Hannah was lying on a stretcher and I looked up to see a little girl walking towards us. She must have been about ten and was stick thin – a pair of shorts hanging from her hips and a white T-shirt dropping in folds around her body, her head completely bald. She looked like a ghost as she pushed a drip stand, and my breath caught as I stared at her. Just the day before I’d been planning for Christmas because it was only a week away. What toys to buy? What food to cook? Did I have enough to fill the children’s stockings? Did I have too much? But now this world had disappeared completely and it had taken just one word to shatter it. Four syllables. Leu-kae-mi-a.

As Mr Williams talked us through Hannah’s diagnosis and treatment, he’d shown us a red file containing pages of tiny typed words listing all the different forms of chemotherapy and their side effects. Hannah’s leukaemia would be treated by six rounds of chemo which would last about a month each and all follow the same pattern – after an initial burst of intensive drugs over several days, Hannah would continue on a lighter cocktail of medication for another ten before being given a ‘rest’ of about another ten days to allow her body to recover from the onslaught. It was like a war: a period of intense battle followed by a retreat and regrouping before the fighting began again. All we could do was wait to see if it would be enough to save Hannah’s life.

‘We hope Hannah will quickly go into remission,’ Mr Williams had told us. ‘But even if she does she will have to complete all six chemo courses to give her the best possible chance of long-term remission.’

Andrew and I had listened as Mr Williams warned us of the possible side effects the powerful chemo drugs could trigger because they would attack the healthy fast-growing cells in Hannah’s skin and digestive tract as well as the cancerous ones. The chemo might cause anything from hair loss and nausea to skin changes and tiredness. Hannah’s immune system would be so depleted by the highly toxic drugs that any tiny infection could be serious.