Stuck in Bermuda for several months at the beginning of the pandemic, Charles Hayter used the time to complete a book.

Cancer Confidential: Backstage Dramas in the Radiation Clinic shares the stories of some of the patients he encountered in his 30 years as a radiation oncologist; mixed in with them is his “very personal story” of losing his father, Russell, to cancer early in his practice.

“What I focus on are the emotional reactions of both the patients that I'm dealing with and also my own reaction to their circumstances,” said Dr Hayter who returned home to Toronto, Canada, in May 2021.

“It covers the stuff that we as doctors don't get much training in in medical school — it doesn't get written about, it doesn't get talked about. We chose the title of Cancer Confidential because it's really the stuff that happens behind closed doors. And I hope by reading it people will find some points of connection with their own situations, their own experiences, the turmoil that a cancer diagnosis causes in their families.”

He studied English and earned a master’s degree in drama before going to medical school. He then taught drama for “a couple of years” at the Bermuda College.

“So I know Bermuda very well,” Dr Hayter said.

His love of the island brought him back here with his partner for a one-month holiday at the end of 2019.

“We kind of got stuck in Bermuda because things got really bad in Canada and, in terms of Covid, at that time Bermuda looked like the safest place in the world; you had all those entry requirements for PCR tests and whatnot.

“And so what happened was, there was a lockdown in Ontario and we decided not to come home. And then by the end of another month, Canada cancelled all the flights to places like Bermuda in an effort to dissuade international travel.”

Dr Hayter and his partner, Mark, stayed for “just over six months” as part of the Work from Bermuda Programme created by the Government in 2020 to entice people to reside here and work remotely.

“I worked on what was probably the third draft of the book while I was there and pretty well finished the book while I was in Bermuda.”

Cancer Confidential is the third book by the “award-winning writer” who is also a former associate professor of radiation oncology at Queen’s University and the University of Toronto. The first, Gilbert and Sullivan, was based on his master's thesis and “provides an evaluation of the comic operas” created by the Victorian-era dramatist and composer.

An Element of Hope, which was published in 2005, looks at the “history of radiation therapy and cancer treatment in Canada”.

Cancer Confidential was years in the making. To write it Dr Hayter drew on the notes he started taking while a medical student.

“One of those stories is in the book. It's a story from my last year of medical school when I was helping a young man with stomach cancer. I noticed that none of the doctors were using the word cancer with him. It was kind of eye opening to see doctors and other health professionals sort of pussyfoot around the cancer word; they often don't fully disclose and ultimately it was up to the patient [to say], ‘I've got cancer, haven't I?’”

Although he kept everything he jotted down, he didn’t start to organise the notes into potential stories for his book until he got close to retirement about five years ago.

As described by his publishers, University of Toronto Press: “Hayter shares 13 stories based on patients from all walks of life. Drawing upon his background in theatre, he gives each character a well-drawn emotional trajectory. Patients and their families transition from feelings of shock, anger and denial, for instance, towards a state of acceptance and hope. Moments of quiet courage and sardonic humour alleviate their spirits and strengthen their resolve to see the end of an often physically gruelling treatment regime.”

While he was in Bermuda, the book went through “a major rewrite” at the suggestion of his editor.

“Originally my father's story was just one chapter at the end. She encouraged me to take that story and weave it through the whole book and find points of connection between my own personal story of my father's cancer and what was happening with particular patients. And that's basically the draft I worked on when I was there.”

On his visit here in 2020, Dr Hayter fell in love with the island all over again and returned for another month last autumn. His hope is to revisit as soon as he can.

“Geographically, Bermuda is a pretty tiny place but I remember we had a running list of places that we wanted to go and see while we were there, and we never made it to all of them. And of course, it was fairly quiet during Covid time; the atmosphere was very conducive to thinking and writing and getting this draft of the book done. I loved it.”

The response to Cancer Confidential has been “fantastic” with praise coming from people invited to read it before publication as well as the friends and acquaintances who have read it since.

“They say these are the kinds of stories people living with cancer and their loved ones want to read to help them understand.

“When I was still working, generally the statistic that we played with was a 5 per cent increase per year in the number of people with cancer. It's largely related to the ageing of the population, because cancer tends to be an illness that people in their fifties, sixties and seventies develop so, as the population gets older, you're bound to see more cancer cases.”

There are, however, cancers that are rising outside of that such as melanoma, which “as you probably know, is connected to sun exposure”, Dr Hayter added.

His hope is that Cancer Confidential brings “comfort” to anyone who has been touched by the disease.

“I talk pretty openly about emotional reactions that are caused by a diagnosis of cancer and I think people who are going through the same kind of emotional turmoil will read these stories and might find themselves in the stories and also gain some insight into their own reactions.

“It's not a technical book on how to deal with cancer. It's more confronting and opening yourself to the emotional reactions. This is really the first book that takes people behind the scenes as it were of the speciality of radiation oncology. I know that radiation therapy is a kind of mysterious and sometimes very fearsome procedure that not many people know much about. And so one of the one of my secondary motivations in writing that book was to kind of demystify it, help people understand that it isn't quite as frightening as they might think.”

Cancer Confidential: Backstage Dramas in the Radiation Clinic is available on Amazon.com and other retail book sites. It can also be ordered directly from University of Toronto Press