> Quietly Among the Shadows (DIDMSNJ)

DIDMSNJDying In Dignity Mensa Sig News Journal Vol 2 Issue 2

Quietly Among the Shadows

Chris Hill

I became a volunteer worker at a hospice. I requested a ward job, and entered into the detailed induction. Even unpaid, and with a simple remit, we were required to be tutored in hospice philosophy and practice.

Following on from this, the physical training in tray-setting (standardized to the last posy and matching cruet) was scarcely demanding. I was, however, daunted by the prospect of presenting these oh-so-correct trays to the terminally ill in the small wards. There was really nothing to fear; for the first few workshifts I was accompanied by an experienced volunteer, who emphasized a list of "nots". Not if the privacy curtain was drawn; not if the medical director was at a bedside; not if the chinagraph list in our preparation kitchen said not. The few patients with whom I initially conversed were, accordingly, reasonably able and showed no special discomfort. The building, purpose-built, had an open layout and common areas were skylit and sunny. If death was the ultimate business of the hospice, it visited quietly among the shadows.

Preoccupied mainly with presenting the carefully researched menus in their dainty dishes, it was a few weeks into my stint before I discovered that one of my patients, John, with whom I had conversed on various subjects and habitually nipped in to see at spare moments, was getting worse.

It began one day when he refused his customary pre-lunch gin and tonic. The cocktail round was a joky interlude amongst all the participating patients, and I, as the holder of the drinks cupboard key, was the butt of many well-meant jokes about my own sobriety. John's refusal of a drink was followed by his barely touching his lunch.

During my next shift, I was distressed to see him still in bed, in his pyjamas, with a slack look about his face. He did, however, want lunch. How falsely reassured we are when a failing human requests nutrition! Again, though, he barely sampled each separately-served dish. When I collected his tray, he was dozing, with his legs, pyjamas and bedclothes akimbo. A urine tube extruded from his body. I noticed that his walking frame, with which he had previously managed to reach the bathroom, was missing. The proud man, who has dressed each day in shirt, tie, and pressed trousers, had, it seemed departed forever. Arriving for duty three days later, I signed in at our office, made my copy of the inpatients list, and noted with grief the red asterisk by John's name. I had seen such an asterisk before, but never really known the patient to whom it pertained. The red asterisk did not spare us from the dying room. It alerted us to the possible needs of "compassionate" visitors at the bedside.

John's daughter, who had given me flower-arranging tips and swapped house-moving stories, was sitting as still as the shadows. At her feet were carrier bags filled with his precious photo-albums and an assortment of bundled clothing. A smell of faeces hung in the air, and I asked her if she would like a tea-tray in the lounge, euphemistically whilst the nurses made sure her father was comfortable. She appeared dazed as she followed me into the corridor. "He's a smart man" she said, "and very intelligent." Not, her eyes said, someone to soil themselves and lie in the mess.

Mute with pity, I gripped her hand. She was chilled, and I wished I could wrap her in a blanket, or at least a cardigan. But in my designated role, tea and a shortbread finger were the best I could offer.

As the deterioration continued, I wished John dead. I wished his room unshaded, with a fresh flower posy on the locker and Ruth, the perky Catering Manager, offering selections from the menu to a new patient still dazzled by our range of services and courtesies. These were, it has to be said, far superior to the hospital which had arranged the transfer.

The red asterisk, and John's name, remained on the list for four more days. During that time the bedside company multiplied, alternated, slept on reclining chairs or in the lounge, ate exclusively from our snack menu, smoked outside on the terrace, but never, it seemed, showed much emotion. John, dehydrated, shrank to a bony huddle amongst the folds of the ripple bed. A nurse told me that scopalamine is given during the terminal stages, to dry secretions and quiet the death rattle. So, no opportunistic pneumonia for John.

He died a few minutes into one of my shifts, and it fell to me to take tea and coffee orders from the assembly in the visitors' room. And suddenly the grief was all around me; John's elderly brothers crying openly, a nephew recalled from abroad hugging everyone, three genteel ladies sitting red-eyed in a neat row. John's daughter, by contrast, showed composure. Her hanky was crumpled but dry. "I'm glad it's over", she said quietly.
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© 1996 Chris Docker.
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