Overcoming the trauma of cancer
Margaret Nsubuga (R) with some of her children during her cancer treatment. Photo by Rachel Mabala
Margaret Nsubuga, 59, is a breast cancer survivor. She is a single mother of seven and a nursing officer who has been practicing for 29 years.
She attended Nyenga Senior School, Jinja for six years. She later joined Masaka Nursing School where she became an enrolled nurse and did a diploma at Mulago Nursing School.
As a registered nurse, she has worked in Mbarara, Arua and Mulago Hospital. She is now a member of the Uganda Women’s Cancer Support Organisation as a counsellor and ambassador.
We meet at the radiotherapy unit in Mulago. As she walks towards me, she is clad in a black skirt with a yellowish blouse that has blue collars.
Her hair is short and well kempt. She carries a white envelope labelled Uganda Heart Institute. She leads me to an office at the end of a corridor.
Our interview is more of a friendly conversation. In 2005, Nsubuga discovered a lump in her right breast. She had just returned from the UK after pursuing a course, Care of a patient during radiotherapy.
“I used to do regular breast checkups. As I was taking a shower, I discovered there was a swelling and I immediately went to see one of the doctors I was working with.”
She went for a core biopsy and they used a needle and extracted some flesh from her breast to test for cancer. They took pictures of her breast and told her to come back for the results after a while.
As we talk, she fiddles with a bunch of keys in her palms.
After a few weeks, the results were ready but she was scared of what the outcome would be. She was even hesitant to go and pick them up by herself.
She sent one of her daughters. They were sealed in an envelope. Being a nurse, I was terrified of reading the results because I always saw the agony our patients suffered.
Devastated, Nsubuga left home. “I was walking aimlessly around our residence in Old Mulago staff quarters. I walked but I had no idea of where I was going,” she recalls.
“I had reached somewhere past Kalerwe market. A doctor had told me that for the cancer to cure, my breast had to be cut off. At home, my children were worried and they had started searching for me.”
She later realised that no matter how many miles she walked, she would not take the cancer away.
She decided to go home and face the situation. As she tells me of her reactions, she brings in a light moment; “you see if a nurse like me reacted this way yet I have been dealing with such situations, how do you think another person feels, and they have not received any information about cancer?”
Accepting her fate
“I could not believe the results proved that I had cancer”. At this particular moment, she seems lost in thought and from that I notice that she is still affected by that day.
I appreciate her strength as she narrates her story . “I was sent home and I eventually accepted to undergo the first operation. I went into theatre twice; the first time, they just removed the lump in the breast.
This she refers to as lumpectomy. “After that, I was told that I needed to undergo another surgery in case the cancer recurred but this time round; the doctors were telling me that the breast had to be cut off.
I refused; I could not accept my breast to be removed.” she says that even at her age, she could not imagine herself with just one breast.
At this moment, she is only focusing on just one particular key as she tells me of how she cried endlessly. The keys are her focal point and she keeps them to herself as she narrates. I then start imagining myself with just one breast.
I glanced at her chest across the table but to me, she looks normal (two breasts on her chest) she smiles and tells me that one might not notice but she is wearing an artificial breast. She attempts to show me; I am not courageous to look at the scars. And the conversation continues.
“You can imagine, I was an old woman and my children were all grown up because they were all in secondary school. But I was refusing to cut off my breast,” she laughs. We laugh about it but it leaves me wondering on how life would be like with just one breast.
After sending for a friend of hers, Nsubuga was consoled and made to come to terms with the situation; she told me that there is nothing we can do about it but let us deal with the situation.
I had to come to terms with it. “I cursed and asked why of all people it had to be me. A single mother of seven children”, her imagination was taken to the future when she would be undergoing the cancer treatment.
“Cancer has three treatments and of the three, my major worry was the chemotherapy. Chemotherapy is the worst even when I am advising patients who come for treatment, I always tell them that chemotherapy is the worst of them because the medicine is different. “That medicine is not easy; all your systems change and you feel different.
You lose interest in each and everything; appetite goes, looking at yourself is painful. Eehh, it’s not easy! I think that medicine was made for animals and not people!” she says.
When I ask her what chemo is all about, she nods her head and places the bunch of keys aside.
I notice that it is serious and unless you have seen someone undergo it, only then can you fully understand it. I accepted and I was taken to theater and they cut off the breast. As she narrates, she has the keys in her hands and she unconsciously holds onto them.
I received very good care and treatment from my fellow nurses and the doctors who were treating me were extremely nice. Nsubuga was worried as she was admitted because she was worried on how she would care for her children. Amidst all the pain, her children were greatly cared for by her friends.
“It is great to have friends because as a single mother, I could not afford it all alone.” she adds.
“It is good to talk to friends because the support I got was from friends. The doctors here catered for me; there is Dr Kavuma, Dr Kigula, Matron Hilda.
They collected money for me” she says. “I was lucky because I was working in Mulago and by then, the operation was free.” Two months down the road, Nsubuga says she was recovering from the operation and had to embark on chemotherapy treatment. “There are six doses required and after every three weeks, you receive a dose.”
Chemotherapy
The first dose was a contribution from her colleagues although the other doses, she was able to come up with the necessary funding.
As she narrates the effects of chemotherapy; using her right hand, she passes her fingers through her hair and tells me of how her hair fell off.
“You think it falls off all at once, no!” passing her hands through her hair, she holds some hair in her hands and she tells me that the falling off was random like when bathing and as you pass your fingers through your hair, your fingers come back with large chunks of hair until she watched it all fall off.
I start imagining and I cannot help but imitate her but my braid strands are quite big to allow me the liberty. She continues narrating.
“I turned black and these nails (she places the keys on the table and starts illustrating while stretching the nails) my nails were almost falling off with puss oozing out of them.” This, she says, was a result of the chemotherapy treatment she was undergoing.
At the peak of it all, she was able to complete her six doses in 2007 with God’s grace and at the end of each dose, her body was checked to monitor the progress from the cancer and the effect it was causing on her other body parts like the liver, kidney and heart.
Two months after, she started her radiotherapy treatment and to her advantage, it was in the unit she was working with.
Radiotheraphy was not painful and she promises to take me in the room it is done to have a look at the machine.
As she was receiving radiotherapy, nurse Nsubuga resumed work. “I started coming to work with my bald head because I was bored at home. Besides, staying at home would only devastate me and I was refraining from self pity.
I was advised to stay home and rest but I kept coming anyway”. At the hospital, some patients would look at me and sympathise with the “musawo”.
I became firm, finished radiotherapy successfully and continued with hormonal treatment. “I took one tablet a day for five years till 2011,” she says.
What more did Nsubuga face?
Cost
Nsubuga did not spend much on her cancer treatment because surgery, radiotherapy and hormonal treatment were free. “I only spent on chemotherapy and at the time, a doze cost shs250, 000. I took six doses.”
Challenges
“I never wanted to tell my children about my illness because I did not want them to go through pain and uncertainty.” However , two of her daughters discovered on the day of her operation. Her friends were helpful in counselling the children and making them understand cancer.
One day, the patients she was counselling came in looking for her; “the young girl refused any other medical personnel to attend to her and requested for that nurse with one breast.
I was displeased and informed her never to refer to me that way again.” Stereotyping does not sit well with her.
On being ascertained that she had cancer, Nsubuga was discovered to have a heart problem; one of the valves does not work properly. But she says she is glad she receives her treatment free of charge.
Effects
Nsubuga is now the parachute for cancer patients at the radiotherapy unit. It is not easy to be told that you have to cut off your breast. We get young girls but I counsel them and use my experience to help them cope.
Nsubuga recommends that when detected early, cancer is preventable and treatable. She recalls some of the cancer cases she has dealt with; young couples who came to her for advice because the lady was supposed to lose her breast.
She says that patients relate better with her because of her experience and presents hope to cancer patients for a better life. As we conclude our interview, she stands up with arms akimbo and demonstrates how one can do a self-test examination for breast cancer.
