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A/N: The direct connection between lung cancer and cigarette smoking was proven in 1957 by the Medical Research Council, near the time of the terminal diagnosis (as per my head canon) of Patrick’s first wife. We now know that lung cancer can be the actual source of several other cancers, including brain, liver, and bone. For the purpose of my story, I have made medical understanding of the nature of lung cancer metastasis unclear at the time.

True to her word, Shelagh had not mentioned the subject of cigarettes since their last discussion. She knew she he needed time and could be patient, for now there was a sense of inevitability regarding the topic. Her concerns were out in the open, and as much as Patrick preferred to bury his own problems; he wouldn’t ignore her fears. Shelagh was willing to wait, and in the meantime, if the air was a bit awkward each time he lit up, neither mentioned it.

Settling on the sofa, she wrapped her cardigan closer and watched as Patrick paced in front of the mantle. Shelagh tried to tamp down a feeling of unease. Patrick was not comfortable with uncertainty, she knew, but she had only recently discovered her own dependence on his confidence.

He turned away, pacing to the window. “Marianne was a smoker, did you know?”

She nodded. “I remember.” While not a regular fixture at clinics, there had been occasions when the vibrant and healthy Marianne crossed her path. To the shy young nun, Marianne Turner had seemed confident and sure of her place in the world. Even as the cancer withered her, she was brave and strong for her family. Shelagh thought it had been no wonder Patrick and Timothy had been devastated by her loss.

He drew a shallow breath. “I think that’s what caused her illness.”

“Patrick, I helped nurse Marianne a few times. Her doctors diagnosed bone can-” Shelagh stopped, stunned. “It metastasized,” she whispered, the realization making her pale.

“Yes. We didn’t know then. All her symptoms were related to her back, so that was her doctor’s focus. The pain, the weakness in her spine; her symptoms all pointed toward bone cancer. We didn’t know then that it likely spread from the lungs first.

“After she…died…I needed to do something. I felt so useless.” He moved to the sofa, taking his place next to her. His eyes glittered as he met hers; the lines on his face had somehow deeper. She reached out and gripped his big hand in her small one.

Patrick’s lips twisted in a sad smile. “I convinced the doctors to let me see her files. I poured over them every night, trying to figure out what had happened, what we missed. She was so healthy, Shelagh. She never got sick. We used to joke that she couldn’t, that I had too many patients already.

“One night, I was reviewing her first set of x-rays again when I…I noticed something different. There was one film of her upper spine where a bit more of the lungs showed. I’m not sure why I even looked there.

“I could make out, just barely, a lesion on the lower left lobe. God, Shelagh,” he rasped. “I’d never thought-even after the MRC report. We never suspected that the cancer started in her lungs.”

His hand turned in hers, squeezing it, holding on tight. “I never saw it. Who knows how long the tumors were growing inside her before we noticed anything? Even the back pain, we just thought…her grandmother had a bad back. We thought, maybe it was just that. She didn’t tell me, but she must have had pain for months and never said.”

Gathering herself, Shelagh spoke gently. “She didn’t want you to worry, dearest. You, yourself said Marianne thought the pain was nothing out of the ordinary.” Her free hand slipped up to caress his cheek. “Patrick, you know lung cancer can go undetected for a very long time. Marianne had no symptoms; I remember. No cough, no breathing difficulties, nothing. There was nothing to point you in that direction. Even if you had guessed when the back pain started, it’s likely it would have been too late.”

Patrick pulled his hand away and rubbed at his forehead, struggling for words. He dropped his head in his hands, and silence grew loud in the room. Then his voice came to her, muffled. “I shouldn’t be telling you this. It’s not what I wanted to say. I don’t want you to think-” he stopped abruptly.

The sting of a hidden fear spread through Shelagh’s heart. She knew she wasn’t his first love. He had loved and lived with another before her, made a child with her. She feared Marianne would somehow always be between them.

Uncertainty froze her mind. She wanted to soothe him, to offer words of comfort, but couldn’t. Patrick was opening a part of his heart, but she wasn’t sure she was welcome there. Would his life with Marianne always be behind another barrier? Had she found the limits of his love? An unwilling tear slipped down her cheek.

He stood again, moving to the table as if this were a typical Sunday tea. She watched as he carried out the ordinary steps to pouring out. His back still towards her, he continued, “I didn’t tell you this. After I learned of the lung cancer, I tried to quit again. I did, actually, for three days. But there was Timothy to raise, and work, of course, was so… I had to smoke. It was the only thing that would help.

“Maybe I felt guilty. I was the one that survived. I was the one that would go on, watch Timothy grow up; I would continue my work. It didn’t seem fair that I could use her second chances, that I was given the opportunity to learn from our mistakes.” His shoulders slumped, weary from carrying so much.

“Shelagh, when you became ill… that whole terrible time when I thought I would lose you-” he turned finally, and she was devastated by the agony in his eyes. He crossed to her in two swift strides and knelt before her. “Marianne let me go. Before the end, when she was conscious so little of the time, she told me to keep living, not just for Timothy, but for me. She made me promise to join the world.

“It was hard, but I let her go, too. I didn’t set out to find someone else. When I finally realized what my feelings for you were, I let myself fall in love with you.” He smiled ruefully, a soft laugh escaping his lips. “I don’t think I could have stopped it. I…I just surrendered to it. I never imagined we would be together, not then. It was enough to know that even if I could never be with you, I could love you.” His hands gripped hers even tighter.

Shelagh felt a twinge of shame. She had no idea he had wrestled with his feelings for her. His letters, his confessions since that misty road, had described his acceptance of it, and his concern for her difficulties. She never thought that perhaps Patrick had fears of his own. How selfish she had been from the very start.

His grip tightened convulsively. “When you went to the sanitorium, your lungs could have… You came back to me, healthy; I had a fresh start. But then Timothy…” he stopped, remembering that unbearable pain, and his voice became derisive. “I kept smoking through it all. Oh, God, Shelagh, I kept lying to myself. How many signs will I ignore before I finally face the truth?”

Shelagh’s heart softened. This man had taught her so much of herself. His heart had such deep capacity for love. He was a brilliant doctor, with a great depth of medical knowledge, but it was his compassionate heart that made him a healer. She had to show him the way to accept his flaws and love himself. And love would give them strength to move forward.

She cradled his cheek, her fingers running through the black strands more silver than the year before. “You’re the strongest person I’ve ever known, Patrick. You feel things so deeply, you know of pain, yet you push on. I’m so very proud to be your wife. You’ve supported me through so many trials, and you never ask for anything. But I mustn’t be selfish anymore, Patrick. It can’t be all about me. You have to trust me, and I have to open my eyes to you.”

Patrick looked up at her shining face, stunned. This glorious creature accepted him, despite his weaknesses, perhaps in part because of them. He watched as her cheeks flushed with emotion. Her freshness of character and form reminded him that he was too old already. They already had too little time. There would never be enough time. How could he shorten their years together?

“Shelagh, what if I can’t? I’ve failed before.”

“You were alone before, dearest.” Her eyes gleamed with happiness.

He smiled as he felt fear lift from his heart. “Now I’m never alone. I’m married to you.”

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