Once again, though, Leah perked up. Perhaps being at home, which is where she had always wanted to be, stimulated her. Added to this was the knowledge that she had to cope, because she adamantly refused to return to the nursing home, and there was no alternative. So each morning she got up, bathed, dressed, and received her friends, with whom she talked intelligently and with humour. She played with Steve and Sandy’s baby, did her crossword puzzles and word games, and generally spread around her a love of life that was infectious.
Yet all the time she was growing weaker and losing weight. The weight loss accentuated the growth in her abdomen, and now she looked as if she were seven or eight months pregnant. Her pain was increasing, and the prescribed analgesics no longer relieved it. One night it became so unbearable that she rang her GP, who arranged for hospital admission immediately.
I visited her in hospital towards the end of July. When I walked in, I thought she was unconscious, but no, she smiled and took my hand.
‘They’ve given me something to relieve the pain,’ she said. ‘It feels easier. I wish they would give me an enema. I feel I need a good clear out.’ Her faith in enemas was touching. Had she still not been told, or had she, perhaps, guessed the truth?
Apparently not, because her next remark was, ‘I’m wondering if I’ve got shingles. It can be very painful you know, my cousin had it.’
She drifted off into sleep again and I sat stroking her hand. Then someone came round with a drinks trolley, and she had a little water. A nurse emerged with the evening drugs, but she passed Leah’s bed. ‘I’ve told them I’m not having any more pills,’ Leah said, ‘nothing.’ There was a pause, then, ‘I’m sure it was the pills that made me so sick. But no more, I’ve told them. And I don’t feel as sick, now. I feel better without them.’
Did she know that it was the pills keeping her heart and circulation going that had sustained life in her through the months since the accident? She was a highly intelligent woman, and it seems unlikely that she did not know. Perhaps she had discussed it with her granddaughter, the Israeli trained nurse.
Yet I had never discussed it with her, or the present fact of progressive cancer, or the inevitability of death. Mutual friends told me that she had never mentioned death to them, either, which is surprising because most old people – well short of one hundred and three – will say things like ‘I’ll be glad when it’s all over,’ or ‘I’ve had a good life. I’m tired now, and want it to end.’ My grandfather talked of the Angel of Death; others speak of going to meet their loved ones. The only time Leah had mentioned death was fourteen months earlier, when she had looked out of the hospital window at the blue sky and said, so wistfully, ‘I hope this is not the end. Life is so beautiful, so exciting, so interesting. I don’t want it to end.’
Her passion for life had sustained and driven her through all the months of coping alone. Yet now I felt her life force was waning. She could struggle no more, and she knew it. Was that why she had announced she would have no more pills? Had she known all along that it was the pills that had kept her going and that rejecting them would mean the end? Was this Leah’s way of closing the door?
A nurse came up to the bed and gave her an injection.
‘Is that morphine?’ I whispered. Our eyes met.
‘Yes,’ she said briefly.
‘I’m glad,’ I said softly. The nursed smiled and moved away.
It was high summer – long bright evenings with no wind. But the sun sinks eventually, though it seems it never could, and when I left Leah that evening I felt her light was going out, and that I would not see her again.
Leah died on 8th August, 2008. Her family were with her.
Cancer can sometimes lead to a hard and difficult death. It was so for Leah, and her daughter and granddaughters told me of this. They couldn’t understand how her body managed to sustain life for so long. I think I can. Her love of life had been her strength and driving force. She had led a privileged life, with a happy childhood and a happy marriage – who could ask for more? She had also enjoyed good health until the age of a hundred and two when she broke her leg. Three times – the break itself, the embolism, the hospital infection – she had nearly died, and each time it would have been a relatively quick and easy death. But three times modern medicine had pulled her through and kept her alive until cancer intervened. I wondered how Leah would have reacted if she had been able to see ahead.
If the Angel of Death had shown Leah the manner in which she would die, I am quite sure she would, like most of us, have said, ‘Oh no – not that. Isn’t there an easier way? Anything would be preferable.’ But if the Angel of Life had stepped in at that moment, and shown her fourteen months of increasing difficulty, but also of friendship and family love, I am quite sure she would have said to Death, ‘If yours is the price I must pay, so be it,’ and she would have turned and taken Life by the hand.
EUTHANASIA
It is surprising how many people are quite unable to talk about death, yet are happy to talk about euthanasia, and they do so with the assured confidence of one who knows all the answers. Consider the following conversation I had with a neighbour in 2008. He started:
‘I’ve got to go and see my mother in the local care home.’
‘I didn’t know she was there.’
‘Yes. She fell and broke her pelvis last year. She’s eighty-six. She’ll never walk again.’
‘That’s very sad, at that age.’
‘It was dreadful in the summer. That hospital’s a disgrace, you know. It ought to be closed down. She developed MRSA. We nearly lost her.’ He sighed. ‘They managed to pull her through, but her mind was gone; she doesn’t know where she is or who we are.’
‘It would have been better if she had died of MRSA, then?’
‘Oh no. I’m a great believer in euthanasia.’
‘But what’s the difference?’
‘She was suffering. It shouldn’t be allowed. But if they gave her an injection, a little prick, she wouldn’t know anything about it.’
‘She’s probably suffering now, in the care home.’
‘Yes, and it shouldn’t be allowed. Euthanasia’s the answer. I’m a firm believer in it. You want to read up about it on the web.’
I wrote this conversation down verbatim immediately, so that I would not forget it. He was obviously shocked when I suggested that she could have died of MRSA, but then immediately said that she should be ‘euthanised’.
In May of this year, I asked my neighbour’s permission for this story to be published, and I asked him about his mother’s present condition.
He said: ‘She is in a dementia care home. It costs us £500 a week. She is doubly incontinent, she can’t really walk, she has no real mental understanding. Does she have any quality of life? No.’
I asked him, ‘Is your opinion about euthanasia the same?’
He was very clear in his reply. ‘Oh yes, definitely. And my father had the same belief.’
‘And would you still say that she should have died three years ago when she broke her hip, which was the beginning of the end?’
He was thoughtful for a very long time, and then said, ‘Yes. Euthanasia is the best, but as it’s not legally possible, I think she should have been allowed to die of the MRSA infection.’
Later in the conversation he repeated his opinion about the hospital being a disgrace because of MRSA. This attitude is heard all too often. When I was a young nurse, old people in hospital frequently developed pneumonia and died. In the 1950s massive doses of antibiotics started to be given to kill pneumococcal organisms and every other infection. But micro-organisms are the basic life form, and, when attacked, they adapt and mutate in order to survive. This is the Darwinian law of life. So these simple cells have developed a resistance to antibiotics, and no hospital can be blamed. There have always been infections in hospitals, and always will be. These ‘super-bugs’ are no more than a variant of ‘the old man’s friend’.