Nothing quite prepares you for the moment your words change someone’s life. You have cancer. Your wife is going to die. There aren’t any options left. It was a sunny afternoon in late September, the birds chirping outside the hospital window and the world alive with possibilities. The weather hadn’t turned yet, and you had no reason to think your dizziness was anything serious. A few too many drinks last night, perhaps. The excitement of a trip to The Lakes. Besides, the oncology team had pronounced your recent surgery as “curative”. A few months ago, the cancer in your oesophagus had terrified you. But it was gone now. Right?

It was the first time you’d visited The Lake District: Keswick, Grasmere, Cat Bells. You’d heard tales and seen photos – the glorious hills, the glistening lakes. What a dream! Besides, your wife and sister were keen to get you out and about again – to celebrate – now that the cancer was gone. Wondrous thing, that surgery. Curative. You clung to the word just as your wife’s hand clung to yours. And here I was, an F1 doctor, preparing myself for the words I knew would change your life: that the surgery wasn’t curative, after all. That the cancer had spread. Spread to your lungs. Spread to your brain.

The three of you stared at me for several moments: yourself, your wife, your sister. The news was too much, too big, too unexpected. We spent a long time talking through everything: the CT, the MRI. How it could have possibly spread. I gave you time to digest, to think, to vent – to ask questions, to air concerns. Tears glimmered in your wife’s eyes. Your sister tensed. And there was a new heaviness to you, now: something behind your eyes as the shape and the colour of this news took root.

We reached a natural break in the conversation, and The British in me took over. Tea. That’s what this situation needed: tea. Good old tea, and good old biscuits. I acknowledged that I’d dropped a bombshell; asked if you’d all like a cup of tea, water, coffee. Any biscuits? You all look up in unison and the same two words pour out: custard creams.

Well. Nothing quite prepares you for the moment your words change someone’s life. It’s a privilege and a burden – perhaps, some would say, a rite of passage. You were all very thankful, as I returned to the room with custard creams in hand. But alas, I think I’ll stick to the bourbons for now.