Two Deaths: Nursing Home v Vets.

The bustle in a house

The bustle in a house
The morning after death
Is solemnest of industries
Enacted upon earth, –

The sweeping up the heart,
And putting love away
We shall not want to use again
Until eternity.

Emily Dickinson (1830–1886)

 

I witnessed two deaths in a year.

On Feb 14th, 2015, my Dad died in a nursing home in New Malden, and nearly a full year later on Feb 11th 2016, his dog Kerry died a few streets away at the vets.

Dad had spent three weeks at The Princess Alice Hospice, which he enjoyed immensely, having a great craic with the staff, and having made his peace with the fact that he would die soon. There is a question of funding: there are not enough hospice beds for all our dying: as Dad’s death was not imminent enough,  he was transferred to a nursing home. It seems a uniform feature of nursing homes that they are largely populated not with the physically ailing and the dying, but with the demented. I visited quite a few, and the one I chose for Dad was very good. I hoped Dad would be able to transfer back to the hospice to die, but was reassured by everyone that the nursing home was well-equipped for a good death.

And yet my Dad died in pain and fear. He was expected to last a few days and  I had pressed the bell for help when problems with his breathing unexpectedly escalated, and the arrhythmic sound of deep and desperate breaths sucked the atmosphere out of the room.

All the other inhabitants in their dreamlike dementia state were haunting the corridors, or in their rooms, ringing the bells. It was their bed-time. How do staff prioritise one bell ring over another? How could I leave my dying father on his own while I ran up and down the corridors to find a nurse to help? How could I not? I put my head out of the door and shouted, and went back to him, ringing the bell, in unison with all the other bell-ringers in the home. A campanology of desperation.

Pain distends time. I don’t know how long it took for him to die. Seconds of agony. Minutes of agony. A warped eternity.

I spoke to him, to reassure him, that it was ok to die, that we loved him, and that we knew he loved us, but my words were sucked into the vacuum in which the time passed. He didn’t hear me. He looked through me, sat bolt upright, staring. Death’s dark door stood open.

The nurse came: Dad’s life was just over. The staff, some of whom were very good, some not so, some very young, and very far from home, were upset and crying. In the week that he had been there, progressively more helpless and dying, with all the attendant degradations, Dad had shone with his humour and kindness. And so, just bereaved, I found myself comforting a young Eastern European economic migrant whose grandfather had died a couple of weeks ago. She couldn’t afford to go home.

Nearly a year later, Kerry, (Dad and Mum’s dog), was euthanised in front of me, after a discussion with the vet. It was Thursday at 6.30 in the evening. It was all happening very suddenly after Kerry had been horribly sick on Monday. He had been a healthy, active twelve year old dog till that point, (apart from his skin conditions). But now his organs were failing. It would be cruel and pointless to keep him going. He was already in a deep anaesthetised sleep, in a very different condition from the previous day, when he had been exhausted with sickness, but awake for my visit. He had been wretched, poor thing. Peaceful now. I watched his belly rise and fall.  I stroked his head, and spoke to him, encouraged by the vet, as she injected a solution of anaesthesia into a line which was already set up on his left front leg.

“Tell him what a good dog he’s been.”, said the vet.

She said it twice.

I struggled with this. He had had a good heart, and we were very fond of him, but he had undeniably been a badly behaved dog, and he was undeniably unconscious. Why must I tell Kerry he had been a good dog? I concluded I had to do this for the vet, who was administering death, which must be a hard job, even when it’s so easy. Even Albert Pierrepoint, by all accounts, didn’t relish the actual business end of his job.

So I obliged the vet.

“Kerry, you’ve been great with all the children, so patient, you’ve let them do whatever they wanted with you.” True.

“You’ve been a great guard dog, and given Mum a lot of security and confidence when Dad died.” True.

“You’ve been a loyal friend to mum and dad.” Although you drove Dad absolutely mad in the year he took to die. Dad was asked at Princess Alice, where he had a pleasant hospice stay of three weeks, if he would like his pet brought in to see him. I smilingly said I would oblige, as he grimaced and protested. “No fucking way.”.

“You’ve always greeted us like you’ve been pleased to see us.” You’ve nearly knocked us over several times by thumping us in the back of the thighs with your front paws, causing our knees to buckle. You’ve barked your welcomes to our total distraction.

“You’ve been very patient while I have showered you in the bath, cleaned your eyes, cleaned your sore-looking warty things, and cut your eyebrows.” And on occasion cut the shit from the fur round your bum.

“You have never bitten any human being, or even tried to, in all your twelve years.” True. It was just a few dogs.

“Good-bye Kerry, we loved you. We know you loved us. It’s ok to die.” True.

He was breathing, sleeping, and then slowly, he stopped.

I stayed with my Dad for hours after he died. My husband came to say goodbye to him, and went and took Dad’s clothes, leaving his cap and glasses with him. They were part of him. My youngest son came,  so wretched at losing his grandfather. They had been very close. The Doctor, a woman, fair and round, in motorbike leathers, came to sign the death certificate. She tipped up very late, after midnight, and was very kind to me.

The nurse, who was really a very good soul, had to ask me if I had a funeral director in mind? Dad’s body had to be removed immediately, to save distressing the residents in the daylight hours.

Dad died at about half nine, and I stayed with him till about one in the morning, when the Funeral Directors came. Watching him, I imagined I could see his chest move as the hours passed. Days later, in the Chapel of Rest, and I went a couple of times with my sons, I was sure his chest was rising and falling even though he was cold. He still looked very well, even a week after he died. The nurse told me this was normal, and the kind female doctor in motorbike leathers also assured me that Dad was indeed dead, as did the funeral directors. Well, I do hope so, because we cremated him.

Each time I left him, it felt like I was leaving a limb or an organ behind. Loss like this is physical pain.

I stayed about half an hour with Kerry after he died, stroking his head and belly. Poor thing. He had had a confusing couple of years, with Dad’s illness, and then that inexplicable absence, and then Mum’s hospital stays. I was thinking of Dad’s struggle and alarm as I watched Kerry’s breathing peacefully slow and imperceptibly stop. But Kerry’s body was still moving. His tail straightened. It was spooky.

The night the dog was euthanised I watched Simon Binner’s story on BBC2.

http://www.bbc.co.uk/iplayer/episode/b070jm26/how-to-die-simons-choice

Simon was my cousin Julie’s boss, and she makes a brief appearance in the film. At the age of 57, with a wonderful life, family, and golden retriever, Simon had been diagnosed with very aggressive motor neurone disease. It’s a beautiful, important film about an alpha male who needed to be in control of his body, as he had been of his life. Simon went to Dignitas, to Switzerland to die, while his body was still able.

Both Dad and Simon deserved as good a death as their own dogs. Simon got it.

Anyway, as my dear old grandad used to say, “It’s being so cheerful that keeps me going.”.

He died in Princess Alice Hospice in 1986.

I have been increasingly conscious, for the last 10 years or so, of deaths among my contemporaries. My generation is on the way out, and each death I have felt as an abruption, a tearing away of part of myself. There will be no one like us when we are gone, but then there is no one like anyone else, ever. When people die, they cannot be replaced. They leave holes that cannot be filled, for it is the fate — the genetic and neural fate — of every human being to be a unique individual, to find his own path, to live his own life, to die his own death. Oliver Sachs.

 

 

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