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How we die today

Submitted by on December 20, 2011 – 9:07 amNo Comment

By Eric NortheyPerson in hospital bed

Love is really an abuse by kindness. My father, 97, was frail and confused. Two weeks ago, after a bout of pneumonia, he was discharged early again from hospital, back into the local care home. Hospitals don’t want their mortality stats adversely affected. A dose of morphine – given from the very best of motives, to relieve the pain in his back – also gave him hideous hallucinations. Day and night they came. Sometimes singly, sometimes together. Long dead friends and relatives asked questions from the ‘Thirties and ‘Forties. They argued fiercely about the dole and the war and who said what to whom and when. And the more recently dead came too, like my mother. He sang Red Sails in the Sunset to her.

Sometimes the living, like my brother Dave, came. He stood and read the paper next to my dad’s bed. But of course, he didn’t come. Such spectres populated his room: gas men, bakers, his sister Mabel, the Prime Minister – all strode through, as and when they wished, and remained as fitful presences, till the morphine loosened its hold on his imagination and they slowly disappeared. The person left was by turns weak and tearful, or aggressive and rude. Neither was true to his real self. Standing was difficult. His legs gave way after a few minutes. His arms couldn’t push up to get off the chair or the toilet. All his muscles were weak, the muscles of the stomach and the bowel were no exception. Toileting was hard, patient work, both for the shitter himself and for those standing over him. He was often too exhausted and confused to wipe his backside properly. Sometimes he brought the paper round to examine it. It would catch on his pyjamas. Once, forgetfully, he very nearly wiped his brow with it. I’d squeeze the foam soap on his bum, clean him up, wash round his testicles and the tip of his penis, which was red and tender where the catheter slotted into the urethra. It was hard. No other word for it.

I’d taken to shaving him two or three times a week. The care home girls were reluctant to do it and he was frightened that they might nick him, which made them even more anxious. But for me, it was something I could do, that was appropriate to him and that restored, ever so fleetingly, his true self. It wasn’t a pleasure exactly, more of an honouring. It brought a rare and spontaneous smile whenever I showed him the results in the mirror.

- You look a bit more human now. Handsome almost.

- Champion!

I’d slept at my house, the last Friday night. He didn’t seem to be in any danger of slipping away and I was very tired from watching, sat in his armchair, for the previous two nights. If I was to be of any use, I needed at least to be rested. I strolled back over to the care home about half-past eight, Saturday morning, pressed the keypad, 8240, and let myself in. Even at breakfast, there was the lingering smell of boiled cabbage and piss. It wasn’t the best of places to die in, but we can seldom choose. I could hear his coarse, rasping breath as I climbed the stairs, but that, at least, was better than the shouting. He was exactly the same as I had left him the night before, propped up on several pillows, mouth wide open, fiercely breathing in deep gulps of air and, equally noisily, expelling them. As soon as he finished one breath, another was hastily grasped. If he was fighting for life, as I suppose he was, it was a pretty powerful struggle and, that morning, he actually seemed to be winning. I checked the morphine driver strapped to his upper arm with its pipe directly into his shoulder. It was empty, the rubber plunger right up against the bottom of the syringe. I went down the corridor and reported it to Bridget, the matron. She said she’d phone the District Nurses, the death squad. And three cheers for them, say I. When I went back, I looked at the bulging catheter bag on his spindly leg. It was the size and tautness of a small football and I couldn’t blame the girls for leaving it. You can’t imagine how much piss there is in any of us, let alone in someone who has had no fluids, of any kind, for six days. The practice now, is to let people die of thirst. I don’t know why. They show you how to ‘hydrate the oral area’ using a pink sponge on a lolly-stick. You dip it in water and rub around the lips and mouth. But the dying are so desperate in their thirst, that their lips seize it, clamp it between their gums. They almost swallow it, stick and all, in their yearning to draw down some liquid. Anyway, that’s how they do things today.

Sail boat at sunsetA fly was buzzing about and I was frightened it might be sucked in by the force of his breathing, so I swatted it away and started on the catheter bag. It can be an awkward job when it’s very full. I’m not surprised the girls leave it. It’s easy to spill. His plastic bed bottle was on the work surface over by the sink. I took it and placed the spigot of the ballooning catheter deep down into its wide neck and pushed the outlet valve to the other side. Out it poured, what seemed like a gallon or more; well, a couple of litres I suppose. But it was surprisingly heavy and had to be managed with care, as I tried to switch the valve to the off position with my right hand and hold the bottle with my left. And of course, I spilled some onto his socks. But, as he’d had neither food nor drink for six days, surely it couldn’t matter very much now. I teemed the yellow pee – good colour, considering – down the toilet, washed the bottle out in the flushing water and set it on the cistern top for next time. If there was one. I opened his window the few centimetres the catch would allow and turned the fan across his face to keep the busy fly away from his mouth. His breathing was still quite strong and very loud, his chest heaving up and down like a bellows of energised sucking and blowing. I smoothed the little tuft of hair that his nurse had made into a quiff and felt his stubble. Yes, he really needed a shave. There was a good couple of days’ growth there. He wouldn’t have liked that.

- I’m going to give you a little wash and brush up, OK dad?

There was no response. Just the rise and fall of his shoulders as he snatched each breath. I ran the water in the sink till it was as hot as possible and let the face flannel drift into the bowl so that it was really warm. I found his cheap Bic razor – double bladed, and better for it. You get a much closer shave. It was still pretty new, would last him out. The shaving foam I’d found in his bathroom at the old place. It hadn’t been used whilst he was in hospital so the can had rusted a little at the base and needed a good shaking to get a decent lather out. But it did the job.

- I’m just going to towel you up. OK pop?

Nothing. I spread the warm flannel round his cheeks and chin and tucked the home’s cheap towel round the collar of his blue pyjamas. And all the while, this powerhouse of breath, grinding away like a millrace turning some great, rusted crank. In and out. The shoulders heaving, the lips quivering as the air passed over them. In and out. In and out. I dipped the flannel in the hot water again so there was plenty of moisture on which to bind the foam to his skin. I shook the aerosol really vigorously, squeezed a couple of centimetres onto the palm of my hand. Soon, he was whitely smoothed all over his cheeks and chin. I held his skull in my left hand to steady the trembling of his head, then stretched across to start on his far sideburns. Down in one long smooth stroke to the line of his jaw, like the first cut strip at the start of a harvest. The next one down to the jaw line and after three, the whole cheek was clean. Still, that noisy, insistent percolation, as air was drawn deep into his lungs, followed by the soft whistle as it was blown out again. Wipe off the razor, dip it freshly into the hot water, turn his head away with the left hand and with three bold downward sweeps, the right cheek was clean. Now the neck. Upwards from the collar bone – god, did his hair conquer new territories towards the end up to the jaw bone in three or four strokes. Then his turkey wattle, which bobbled up and down with each surge and release of breath. Stretch over to the other side and three strokes clears it all. Finish with the top lip. Short strokes. Careful strokes. He said once that I’d missed a bit – which I hadn’t. But it must have felt so to him. I expect he was beyond feeling now. You do have to be careful though on the top lip. There isn’t much room and in his case, it was moving all the time, shivering a little with each breath. Equally carefully, under the bottom lip and then gently across the cleft of the chin till it was clean. And there. All done. No nicks. A wipe with a freshly dampened cloth and he looked great – except perhaps for that gaping dark tunnel of a mouth, with its rim of pink gums, hoovering up the air as if his life depended on it, which of course, it did.

- You look really good, dad. I wish I could show you. Best I’ve seen you in weeks.

No response. Just that sucking on vacancy.heart beat graph

I cleaned around the sink, wrung out the flannel, wiped the surfaces, put the towel on the radiator and turned to sit down in his chair. But as I rested my hand on the chair arm, it stopped. No stuttering. No rattle. Nothing over-dramatic. Just stopped. And I too paused, in mid-movement, my back bent away from him, now with both hands on the chair arms to steady myself. It was quiet. Not even the routine noise from the corridor. Just the soft hum of the fan. He was gone and ah, what mystery was there? I turned round to him and he was exactly the same, the large distended, mouth no, not quite the same. His eyes had opened and he was staring up at the ceiling. Except of course he wasn’t. And his legs were crossed. How had he done that? I waited for a minute or two, expecting to see the rise and fall of the chest again, hear that grating intake of breath. But there was nothing. His whole body remained exactly as it was. The silence endured for some time. When the routine noise from the corridor seeped back into the room, I stepped gently up to the foot of the bed and uncrossed his legs, feeling the damp patch on his socks. Of no consequence now. I sat on the bed at his side, quietly folded his arms across his chest, and with my two fingers, held down his eyelids for a few moments till they closed. I allowed my hands to lie on top of his for a while, then went to tell the matron he was dead.

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