Bride Sarah Foster’s joyous wedding in the face of cancer and COVID

A cancer diagnosis and COVID strict restrictions couldn’t stop Sarah Foster and Justin Tham from getting married.

Sarah Foster and Justin Tham’s wedding at St Vincent’s Hospital Melbourne. Picture: Befekir Kebede.

When Sarah Foster woke in her hospital bed she was stunned — her room was full of flowers and hanging in front of her was a sign which read “Happy Wedding Day”.

Cancer would soon rob the 35-year-old of the chance of a long life with her fiance, Justin Tham.

But there was no way the doctors and nurses who had fallen in love with Sarah were going to let COVID-19 deny her a dream wedding, nor a honeymoon more sacred than anyone could appreciate.

In the ultimate act of joyful defiance over cancer, a global pandemic and restrictions that had initially outlawed their wedding, Sarah, Justin and the staff of St Vincent’s Hospital in Melbourne triumphed.

“It felt a bit like a day of reclaiming some normalcy in our lives — we were just able to be Justin and Sarah, a couple in love who just wanted to get married,” Sarah said in the cherished weeks between her marriage and her death.

St Vincent’s nurse Laura Horgan helps Sarah with her veil. Picture: Befekir Kebede

Won over by Justin’s online dating profile and his dream of a house full of dogs, Sarah not only made it through the intensity of an interactive play as a first date on March 11, 2018, but came away from it telling friends she may have met “The One”.

After just three months dating, the couple decided they were serious.

“We put all our cards on the table from the get-go. There wasn’t any games, there wasn’t any secrets, there was no playing hard to get and seeing what happened,” Justin, 37, said. “It set the tone for the relationship.”

Then in August 2018 everything changed — except their attitude towards life.

By the time Sarah’s bowel cancer was discovered, it had already spread to her lymph nodes, liver and both lungs.

“We always knew that she had incurable cancer,” Justin said.

“It was something we acknowledged and we were just living in the present, cherishing every moment together because we knew there was going to be a shortened lifespan.

“She gave me the green light to leave her if I wanted to, because we were only six months in.

“But I was really, really falling head over heels for her by then, who she was and her outlook on life.

“She just loved life so much. She was a never-ending student of life and just had such a curious nature.”

Round after round of chemotherapy began at St Vincent’s to try to control the cancer. And for a while, it worked.

Sarah Foster and Justin Tham.

At just 33 and a fit non-smoker and a healthy eater, there was no sense to Sarah having bowel cancer. It was sheer bad luck.

From diagnosis, the speech pathologist rejected any cliches of “battling” cancer — she feared such a notion could imply anyone who died hadn’t fought hard enough.

Control of the disease was out of her hands, but she could certainly decide how she would live.

Determined to seize every moment, Sarah was driven to spread awareness of bowel cancer, starting “Cells Behaving Badly” with fellow patient Jody Horne to tell the world bowel cancer could hit young adults and reframe the way the disease is discussed.

With her health still strong in mid-2019, Sarah and Justin even risked a small break from Sarah’s treatment to visit Justin’s family in Malaysia.

Having often discussed how much they would love to get married, the ultimate defiance of their fate began on July 27, 2019, when Justin proposed.

“It wasn’t because ‘I know she’s dying, we have to get married now’. We wanted to get married already, we knew we wanted to get married,” he said. “We never asked, ‘How much time is left?’

“As much as it was a centrepiece of our lives, we didn’t allow cancer to take over or control our lives.”

Justin added: “There were tough times after chemotherapy, tough times after surgery.

“But they were also simpler times, simple things were of value to us and we didn’t need huge holidays because we appreciated the simple things, the time together.

“She taught me a lot about how to be present and just appreciate the small things in life,” he said.

Sarah Foster and Justin Tham with their dog Astrid.

Plans were soon set for an April 18 wedding this year. Celebrant Abbey Luckhurst was organised to oversee the nuptials, flights were booked for Justin’s family and a special collar had even been bought for Sarah and Justin’s dog Astrid to wear.

“It was to be at Heide (Museum of Modern Art), it was going to be intimate and not too big. Justin’s family were coming and there were these plans in place,” Abbey said. “We were so looking forward to it.”

Then, in early 2020, Sarah became worried by blood loss and booked into hospital.

Now in pain and distress, tests confirmed she had advanced cancer involving her pelvis, the lower part of her bowel and her abdominal wall.

“The decline started early this year when the tumour in her abdomen started growing and causing more problems, building resistance to the chemo treatment. We knew this is what was coming,” Justin said.

Rather than focusing on her dream wedding, Sarah had to undergo major surgery in March.

But she emerged from the operation feeling stronger physically and emotionally, more determined than ever to get married.

Then COVID-19 happened.

Cancer had failed to slow the couple, but there was no way to sidestep the effects of the pandemic.

Restrictions meant all weddings were suddenly banned — even though Sarah and Justin did not have the time to wait that almost every other couple did.

Their wedding scrapped and now isolated from their families, Sarah and Justin vowed to go to a registry office and at least get married on paper the moment Victoria’s lockdown was over.

“We knew time was short so we were gutted, but we had a lot of other stuff to deal with at the same time.,” Justin said.

“There was this sense that time was running out.”

Pictured to the left of Sarah Foster is Dr Rebecca Lendzion and to the right is Dr Lauren Cohen. Picture: Befekir Kebede

When Sarah arrived back in St Vincent’s seven west unit in August, the colorectal team realised she needed acute procedures to drain fluid from her lung and a stent put in her kidney to keep it functioning.

Over the next fortnight the chance of Sarah passing away moved from possible to probable, and upset staff began to talk about the tragedy of her missed wedding.

By August 21 they’d vowed to move heaven and earth to make the wedding happen, but it was left to Dr Rebecca Lendzion to run the idea past Sarah.

“It was pretty clear to us that at that time she was dying, this was as good as she was going to be,” Dr Lendzion said. “I asked her on a Friday night and instantly regretted it because I thought I was crossing some kind of therapeutic relationship.

“On the Sunday I came in and one of the nurses left a Post-It note on her folder saying, ‘She has agreed, she wants to do it.’

“It then just completely snowballed.

“It really pulled the hospital together. Sarah was able to connect people from departments that would never cross paths normally.”

In a twist of fate, Sarah and Justin’s celebrant Abbey was also a St Vincent’s staff member and would be able to marry them inside the Fitzroy hospital.

But first they would need special permission to take their vows during the restrictions.

The hospital brought in infectious disease specialists to plan a way to conduct a COVID-safe ceremony, before successfully lobbying the Department of Health and the Department of Justice for a legal exemption to stage a wedding on compassionate grounds.

Having cared for Sarah for two years — and grown close to a patient the same age as most of them — staff from across St Vincent’s rallied behind the wedding.

One nurse donated a wedding gown, and another made a matching face mask to complete the ensemble.

Others volunteered as caterers, organising a custom-made wedding cake and reception treats complete with the bride and groom’s names.

A week of frantic organisation was overseen by Sarah. “Even though my health was fluctuating, everyone made sure I still felt part of the preparations,” Sarah said shortly after her magical day.

“They had a whiteboard with a countdown, played wedding music every day in the lead-up, and I even got to try on a few dresses.”

With only five people allowed to attend the ceremony, IT staff stepped in to set up a live stream to beam the wedding to Justin’s family in Malaysia, to friends in Canada, and to other rooms of the hospital where family and close friends would be allowed to gather, socially distanced.

The wedding also offered Sarah an emotional isolation reunion with her parents Eric and Jane and her sister Becca.

Sarah Foster embraces her father Eric before he walker her down the aisle at St Vincent’s Hospital Melbourne. Picture: Befekir Kebede

With her father’s immune system compromised by a lung transplant, and Sarah’s by chemotherapy, the pair had not been able to see each other since February.

“It’s been so hard because this is a time in my life that I want to be spending as much quality time with them as possible, so being able to have this moment together was a huge gift for us,” Sarah said.

“Both my father and I have had very difficult health challenges over the past few years.

“Dad had a lung transplant in 2019 and we had both wondered if we would ever get the opportunity for him to walk me down the aisle.

“It was a bit of a miracle moment.”

When Sarah woke on August 31 she was overwhelmed to see staff had snuck into her room to decorate it as she slept.

Having been given an express COVID-19 check and a VIP entrance to the hospital, Justin was stunned to see St Vincent’s 11th-floor boardroom transformed into a chapel and receptions centre.

He said: “There were flower arrangements across the entire room; battery-operated candles arranged everywhere; there were flower petals everywhere; there was champagne; there was an actual wedding cake with ‘Justin and Sarah’ on it; there were cookies baked customised with ‘Justin and Sarah’ on them … I was just really, really touched and dumbstruck,” he said.

After proudly walking his daughter down the aisle, Eric had to hand her over at the doorway — the bride, the groom, the maid of honour Claire Nolan, celebrant Abbey and a wedding photographer had filled the five person limit — before rushing to a nearby room to watch the live stream.

“I wanted to cry … but you couldn’t not hold it together,” Abbey said.

“She was standing right in front of me with the biggest smile and Justin was just beaming.

“It was the most tragic of stories, but the happiness and smiles were just infectious.

“It was just so, so beautiful.”

As the big moment arrived and they were finally pronounced husband and wife, Justin and Sarah were briefly allowed to lower their masks and share a kiss.

“Cancer had really drilled into us that we should cherish the moments that we have together so, on the day as her father walking up to the aisle, I was just thinking, ‘We caught this moment, appreciate this moment’,” Justin said.

“We didn’t remember a single thing Abbey said because we were just looking at each other, looking in each others’ eyes the entire time and, with our masks on, we could only see each other’s eyes.

“It was amazing. It did not feel one bit as though it was a hospital-organised wedding. It was just beautiful.”

After a 15-minute ceremony the bride and groom were allowed to share a champagne and socially distanced celebration with family, before an exhausted Sarah needed to rest.

But St Vincent’s director of palliative care Mark Boughey said the joy of the moment spread throughout the entire hospital, lifting spirits in the middle of the pandemic.

“It was remarkable under any circumstances, but even more remarkable under the cloud I’ve been in the middle of a pandemic,” he said.

“There are things that stay in people’s minds long after the event, and this will be one of them.

“In the sadness of cancer, remarkable things can happen.

“I would say this in many ways was a triumph of their spirit.”

Two days after the wedding there was more good news for Sarah — she was able to leave hospital to be with her husband in their Preston home.

Sarah Foster and Justin Tham’s wedding at St Vincent’s Hospital Melbourne. Picture: Befekir Kebede

“There was this moment where we actually looked at each other as we stepped into the house as husband and wife and we did a bit of a ritual and hugged each other to soak in the moment,” Justin said.

With the aid of St Vincent's and Melbourne City Mission’s palliative care teams, Sarah was given the most sacred of all honeymoons – the chance to die in love and at home.

“In her final two weeks her pain and the nausea stopped.

“It was a good death in that sense. Her body had given way but her heart and her mind was still there.

“She was still laughing with us, talking with us and asking for Aperol Spritz because it brought her back to a time when she was visiting Italy.

“There were a lot of times where we were sort-of blessed to have the opportunity to say goodbye to her.

“We were so glad we got married. We were glad we seized that normalcy in life, glad we didn’t let it dictate us.”

Sarah Foster died on November 10, hoping her story would raise awareness of bowel cancer, honour those who supported her and teach everyone else the beauty of living in the moment.

“This is how she lived even pre-cancer — the cancer just amplified it.”