In February, Leah had her 103 rd birthday. The whole family, including great-grandchildren, came over from Israel. The flat was so full of flowers you could hardly move.
Leah was determined to do more things for herself. She started by walking one hundred yards down the road and back, unaided. The next thing we knew she had been to Tesco, which was a quarter of a mile away. ‘I like to choose my own things. I don’t like people shopping for me – they always get it wrong,’ she said. In early March she said, ‘I’ve been up to the Town Hall today to get my bus pass. I will need it when the weather gets better.’
Then the ceiling fell in the bathroom. It sounded like an explosion. No one was hurt, but it broke the wash-hand basin into two pieces and cracked the lavatory pan. It would have been a shock to anyone, but Leah took it in her stride, and in the end my sympathies lay with the builders and the insurance men; the stick she gave them about repairs!
Her life force was incredible. She was absolutely determined to cope, and seemed to accept every difficulty as a challenge to be overcome – nothing was going to beat her. Nobody knew the mental and physical effort this cost her, no one saw the tears of frustration as muscular weakness took its toll, or the relief as she sank into bed at night. No one saw the effort it cost her to get up in the morning. She once said, ‘When I wake up, I can hardly move, my limbs feel so heavy and I ache all over. But I have to make the effort. Sometimes it takes me half an hour to get out of bed. Can you believe it? Half an hour just to get up!’ Then she would have a bath, which loosened her up, and, dressed, did her hair, creamed her face, and manoeuvred her Zimmer frame around several awkward corners to go to the kitchen for breakfast. It took her three hours. Many people twenty years younger would simply have stayed in bed and expected someone else to look after them. Not Leah – she would look after herself, thank you. Renewed pleas from her family to go to Israel were all rejected.
It must have been early June when Sandy from next door had cooked a meal for Leah and she said, ‘I don’t really feel like eating.’
‘Try it, dear, it’s nice.’
‘Yes, of course I will. It looks lovely. You’re very kind.’ But Leah couldn’t eat it.
Quite quickly after that, Leah suffered from nausea and vomiting, and became constipated. ‘If only I could open my bowels I would be all right,’ she said. ‘What I need is an enema and a good clear out.’
I was sitting beside her. She didn’t look herself. I asked her if she would like a game of Scrabble. ‘I don’t think I could concentrate,’ she said. She moved a little and winced. ‘I can’t seem to get comfortable. This pain jabs at me, here and here.’ She pointed to her stomach. I felt the area. It was a mass of hard lumps.
The district nurse came to give her an enema. I met her in the hallway as she was leaving.
‘I am going to get her doctor to come and see her as soon as possible,’ she said.
‘Are you thinking what I’m thinking?’
‘I don’t know what you are thinking.’
‘I think she has cancer of the stomach and abdominal organs.’
‘I am sure she has,’ replied the nurse.
The doctor came a couple of days later, and arranged for a hospital scan, which showed a massive cancerous growth in the abdomen.
Leah spent a few days in hospital at the time of the scan, then came home, then went back to hospital for more tests, then was sent home again. She was not eating, or at best she was taking only a tiny bit of food, and she lost weight rapidly. She began to look very ill. Her grandson came over from Israel and stayed with her for a week. He put pressure on her to go into a nursing home. ‘I will not return to Israel and leave you alone like this,’ he said, ‘and if I don’t go back I will probably lose my job.’
He searched widely, and found a home he thought she would like. She moved in.
I visited her there. It was a lovely day in June, and she was sitting in the garden in the sunshine – Leah always loved the sun. She seemed more relaxed, and therefore a little improved. This is often the way. The hospital or nursing home offers a feeling of security and freedom from the constant tension of struggling to cope with a battle one is going to lose. She was deeply engrossed in a crossword and saw my shadow on the grass before she saw me.
She looked up with a lovely smile. ‘You can’t stay beyond three o’clock,’ she announced. ‘It’s the finals of Countdown on television. I’ve been following it all through and must see these finalists.’ Her passion for word games and mental gymnastics was undiminished. She told me that she liked the new place, though she couldn’t eat the food, which she blamed on the cook, not on her digestive system. She felt she ought to stay there, because it was a worry to her family if she was alone at home, though she missed her home terribly.
I suggested again that she could have a live-in carer. Before the sentence was finished she butted in. ‘Never. I should hate having someone around me all the time.’ Most of us would think like that.
She told me that the previous day she had been taken to the anti-coagulant clinic at the hospital. Whilst I was with her, a carer came and said that the results had come through, and that she must have an increased dose of Warfarin. She handed Leah about six or eight tablets to swallow along with a glass of water. Leah sighed. ‘These pills! I’m sure it’s all these pills that are making me feel so sick.’ But she swallowed them nonetheless.
Suddenly she looked at her watch. ‘I’ve got to go. It’s time for Countdown.’ I tried to assist her indoors, but she resisted help, and in the end I gave up. I left her, paper and pencil in hand, eyes eager, sitting in front of the television, waiting for the first jumble of letters. On my way out I met another of her friends. ‘I’m just going to see Leah,’ she said brightly. I wondered what sort of dusty reception she would get!
I was bothered by the higher dose of Warfarin, and made a point of seeing the matron to discuss this before leaving. She was very guarded at first, as though I was accusing her or the nursing home of some impropriety.
‘It has nothing to do with me. We can only do as we are instructed. You will have to talk to the doctor.’
‘I’m not trying to cause trouble, honestly. I am merely puzzled.’ We swapped details on our training and experience. She was a woman in her fifties and was obviously dedicated to the care of the elderly. When I mentioned that I had been sister-in-charge of a cancer ward, she realised we were probably having similar thoughts.
‘If you look at her medical record you will see that since January the dosage has been going up after every visit to the Warfarin clinic,’ she said.
‘On what assessment?’
‘On the blood sample analysis.’
‘But she’s a hundred and three! What do they expect?’
‘I’m not sure that age comes into it.’
‘Apart from Warfarin, what other drugs does she have?’
‘Statins, cardio-vascular drugs and stimulants, anti-coagulants and diuretics, as well as regular analgesics.’
‘But that’s crazy. She has advanced cancer. It is better to die of heart failure than cancer.’
‘I know that. You know that. The doctors know it. But we cannot discontinue the drugs.’
‘Why? I don’t understand.’