I should tell Julia, Monica and Wendy that Mum is in hospital. I never thought to tell anyone apart from Debbie until now. I need to phone the hospital after the doctor has done his morning rounds too; they’ll probably move Mum to a different ward… I’m glad the shop is quiet today. It is Monday and I am waiting for the doctor to have seen Mum.
Finally the hospital phoned. It was the consultant – doing his ‘morning round’ at 3pm. He said that Mum is not responding to the antibiotics and that we need to talk. He leaves at 5pm, so I’ll close the shop now and head up there. I have just phoned Julia, who is planning to see Mum after work, so hopefully she’ll be there when I am. I feel nervous now. Please God, let me hear and speak what is true and right.
I put a 24 hour ticket on the car and headed up to where they’ve put Mum on the top floor. Julia was there waiting. I think she last saw Mum a year ago with cousin Pauline. I let the ward staff know that I wanted to see the consultant before he left. Mum had no oxygen apparatus, no saline drip and nothing going into the needle in her hand. On the white-board behind her, the scribbled message read “Nil by mouth”. She was looking fairly peaceful though. I was not looking forward to hearing what they had to say. They had certainly not kept their word and given her 48 hours on antibiotics and saline – even if they started it the moment I left on Saturday and stopped as they phoned me today, even that would be maximum of 42 hours. I suspect that in reality she hadn’t had more than 30 hours.
The consultant who had phoned came in with another consultant. When he said “hello Avril” she shot him the cheekiest smile. She never could resist a man’s voice and Julia and I laughed. The consultant knelt down on the floor between Julia and I and told us that she had not responded as they had hoped and that it was her time to go. He said that they could delay death by keeping her hooked up to tubes, but that ultimately she was not going to live without them now. He explained that the kindest course was to let her die with dignity and free of pain now that her time had come.
“But you didn’t give her time to let the antibiotics work,” I argued meekly, to which he replied that it was not going to make any difference – that her brain and body were closing down and to prolong her dying would be unkind to her.
He seemed to make sense and Julia seemed content with his prognosis and verdict. He explained that she would be put on a morphine pump which would keep her pain-free, without the need for frequent injections. He said how we needed to look after ourselves now and be assured that the ward staff would look after Mum.
Julia left and I phoned Debbie. She was due to come down in a fortnight anyway, but that was obviously going to be too late to see Mum before she dies.
I guess that without food and water you get about three days? But no guarantees. Poor Debbie could leave Orkney that evening, but still not arrive until the following night, by which time, Mammy might be gone. She has to do what she can and I have to do what I said I would do – which is to stay with Mum from now until she dies, so that she does not die alone or afraid. I phoned home to let them all know my plans. I invited the boys to consider coming to say goodbye to Nana.
I talked to Mum and began to pray for us all, settling into this new space. I spoke as much hope and encouragement as came to me, then found a Gideon Bible in the side cupboard and began reading scripture too. I am beginning to feel a strong sense of peace. I know that Mum was, and therefore is, a Christian and that her future is God’s eternal Kingdom. She is finally going home.
Simon, Josh and Conor came over on the bus and the boys looked very solemn and awkward as they said their goodbyes. Josh seemed the most upset by it all and still couldn’t bring himself to give her a kiss. They were all supportive of me staying with Nana and, as I was so upbeat about it all, they seemed reassured.
I was set for my evening vigil and I knew that Simon would look after the boys during my absence. The shop will have to wait, although I have asked Hannah to work whatever hours she can. Debbie has decided to come over on the 6am ferry and will be with us tomorrow evening, so I can now relax and enjoy my time with Mammy. The hospital staff are good about me staying.
The nurses said they haven’t been trained to use the morphine pump prescribed by the consultant, so they said they would give morphine every hour or so. It hasn’t happened like that though and I find myself calling the nurses to give her a morphine top-up every few hours. Mammy becomes very distressed and uncomfortable, writhing about the bed and moaning, until the morphine calms her again. I thought about the long list of medication that she had been taking each day in the home – Haloperidol, Levetiracetam, Lorazepam, Procyclidine, Trazodone and 2 Senna tablets every night. Three of these cause drowsiness. Mammy has had none of those drugs at least since Friday night and it is now Monday night – no wonder her body is in distress.
The chair in the room was extremely uncomfortable and there was no heating on, which wouldn’t normally bother me under a quilt, but next to the huge top-floor window, tired and half an eye on Mammy…
Mum seemed warm enough, although she didn’t have a temperature, which surprised me as the first sign of an infection is always a high temperature. Mammy’s temperature, blood pressure and everything was normal even on the day she was brought into hospital. I found myself wondering why the staff at Sunny Meadows had suspected a UTI? When had she last had anything to eat or drink? Why had they not managed to get her to drink even some water? Why did they wait so long to call the paramedics? Silly questions no doubt and academic at this point, but doubts do begin to creep in, especially in the early watch of the night, when one is tired.
I was glad to see day breaking on Tuesday – the rare event of Dawn seeing the dawn. I replenished my large mocha, guiltily ate a sandwich in front of my starving mother and looked towards the day ahead with hope and peace. I remembered the consultant’s advice to look after myself and decided that rest, exercise and food were going to have to become a part of my vigil too.
When the day-nurse came on duty, she managed to hook Mum up to the morphine pump, which was very reassuring. The nurses must have washed and changed Mum a dozen times since I have been here and I have done none of those things for myself. I went down to the hospital shop and bought myself a clean shirt and came back to wash and change. I still need a shower though.
Wendy has been to say her goodbyes and to share her memories and a few tears. Pauline came too. Mammy seems very peaceful again today. I am looking forward to Debbie arriving. Julia came again and brought a favourite Everly Brothers’ CD which she played and sang along to. Apparently she and Mum used to sing duets to The Everly Brothers when they were growing up. Julia shared many beautiful memories with Mammy and I found myself very grateful to hear of those happy times that were before my life began.
I shed some happy tears today for the life, music and dancing that Avril had once enjoyed so much. I read aloud again from the Psalms, sang, prayed and drank countless cups of mocha, but forgot to eat again.
Debbie arrived about 7pm and was with Rachel and Rachel’s new baby, Skye. This was our first meeting, but baby Skye was not allowed in the ward. Debbie and I shared a few hours together before I reluctantly left Mammy to take Rachel and Skye home to eat and sleep. I was sure that Debbie needed a good sleep as much as I did after her long trip down from Orkney, but she insisted that she hadn’t come all that way for a good night’s sleep anyhow, so I didn’t argue and gratefully crept into my own bed, after accommodating Rachel and baby, enjoying a few words with my family and making sure that my mobile phone was on charge next to my bed.
Debbie had promised to call me if there was any sign of Mum deteriorating.
I slept uninterrupted, but was ready to leave for the hospital as soon as the boys were off to school. I left Rachel asleep.
Debbie had found the chair so uncomfortable that she had attempted to sleep on the window-sill, but she was in good form and had enjoyed her night with Mammy. Mammy was looking peaceful and more beautiful than ever.
Debbie and I are taking it in turns; the day times we spend together at Mum’s bedside and the evenings we split – one at my house and the other at the hospital. On Wednesday I felt desperate not to endure another sleepless night, so I asked and they found me a mattress which I sank into and slept like a baby.
Mammy seems to be getting progressively better and doesn’t look like she is going anywhere. I keep playing The Everley Brothers and an early Elvis album and holding Mum’s hand.
“Don’t be afraid, Mammy!”
Spring seems to have arrived since I’ve been in here – I am still in boots and leather coat whilst the world and her daughter are walking down University Boulevard in summer vests and sandals.
We have been discussing the next steps, which at first felt a bit strange, with Mum still alive and possibly hearing all we are saying, but on the other hand I hope that she is approving and reassured about the arrangements that we think she would like. Debbie feels sure that Mammy wants to be cremated and we knows that she wants to be lying next to Daddy’s little plot in the kirk on Graemsay.
Later Debbie showed me a photograph of Mammy lying on the grass next to Dad’s memorial stone and we smiled. I think it will be good to have Mum’s funeral here in Nottingham, where her mum and dad’s ashes are buried and where the inscribed vase is that Mum and I had done a few years ago. Her family and friends here will be able to say their farewells and then Debbie can arrange a memorial for her Graemsay friends later in the year and Mum’s ashes can be interred next to Dad’s.
It all feels surreal, but last night I went to ask the nurse what the procedure will be when she actually dies. She seemed a bit surprised, but gave us a booklet explaining everything, saying that she had never given one out before death. We need to discuss it together though and at the rate Mum is going, Debbie will be back in Orkney before Mum finally lets go.
I also remembered suddenly that Mum and I had talked about her donating her brain to Alzheimer’s research. We never did anything more about it, so I went to ask the nurse about that too. She didn’t seem to know, but has promised to look into it. I hope it is not too late.