But as I felt the Sunday morning feeling I remembered that Bo was dead. I grabbed his jumper – which is in fact in the bed still – and cried bitterly.
Subsequently, over the past two years, I have had dreams in which the opposite occurs: I discover that Bo is still alive, and that he never died. In January 2016, I had a dream of this kind:
In a town, in a house, with my sister, Síle, and some others. I go out – down winding stairs, as in a tower. Walk through the town, not a place I know. We pass a row of houses with green gardens in front. In each garden a man is cutting the grass. In one of the gardens, which is slightly different from the others because a space to park a car has been made in it, at the front, Bo is cutting the grass. We pass him and Síle says he looks tired. We discuss this and I remember that he never felt tired when he came to Kerry in the past (this is apparently in Kerry, although it has been defamiliarised, it doesn’t look at all like Dunquin, or even like Dingle). He always arrived after the long journey full of energy. We think the difference is that his friends are not here any more, all dead, and that’s why he’s tired. I go back to the garden. Bo is lying on the grass, having a rest. I joke with him that he’s lazy. We laugh. He looks very tall, very handsome, very much as he was when we were first together, and for most of the time. I am impressed by how handsome he looks. He’s wearing his beige summer trousers and a white shirt. He’s about fifty or sixty in this image. I think, but Bo, everyone thinks you are dead. We have had a funeral, with a coffin. There have been tributes and obituaries. Yet here you are alive, stretched out on the grass. I feel anxious about how we can reconcile these two narratives, that Bo is dead and that Bo is actually alive. I am a bit confused, but happy to be with him. We must have made a mistake, thinking he was dead.
And again, on 22 July 2017:
We – my children and I – are going to an event, a concert or performance of some kind. New shoes are needed. I try on the shoes in a shoe shop, telling the assistant that we only have twenty-three minutes to get them. The shoes are lovely – brown with cream spots. When I go to pay, the owner of the shop asks if I am the person who made the tapestry in the shop. Yes. Then you do not have to pay, he tells me.
We sit at the front of the hall or perhaps church where the event is to take place. All in a row. Bo arrives. He looks himself, aged about fifty or sixty. Cheerful, nicely dressed. He comes to our pew and hugs me for a long time. We are all delighted that he has come back, that he is not dead, or that he has resurrected.
The next day there is an article in the newspaper, written by a journalist who had apparently been sitting just behind us. ‘Family surprised when husband returns from the dead’ is the headline.
‘Our father goes early to bed, for he is an old man’
Anger is one of the Kübler-Ross stages. You can feel anger towards yourself, towards the dead person, or towards other people. I never felt angry at Bo. It was not his fault that he died. He was the victim of the fumbling of others, which is tragic, for Bo was above all painstaking and conscientious, in all his work and all that he did. He did not take shortcuts and had a deep sense of responsibility and duty. I felt angry towards myself, for my various bad decisions: not to read the instructions on the packet of pills; not to get him to a good hospital while there was still time; not to know about facilities such as private ambulances; and finally to agree to send him to Loughlinstown.
Anger at medical personnel is not uncommon, among the bereaved. I was furious with several doctors. I’ve read studies of grief, so I considered the possibility that this reaction was largely emotional, hysterical. But I am a rational person, and a person who has been trained – by Bo – to think clearly and to rely on evidence. I observed at first hand the way Bo was treated in the hospital, and kept notes even while I was there sitting at his bedside. Failures of care and attention occurred from the beginning, from the moment when the ambulance men had him walk down the drive – I saw the shock and surprise in the ambulance men’s faces when Bo almost collapsed from the effort and pain after the short walk. The confusion as to whether he was in the hospital or not when I arrived there on Monday evening did not inspire confidence in the standards of record-keeping. That the A&E staff did not begin the process of hydration as soon as he was admitted, but left him lying for hours without even a glass of water, was dismaying. The sloppiness about the intravenous drip; the unhelpfulness of individuals and the system in facilitating his transfer to another hospital early in that fateful week; and the horrendous last day when they could not get a bed for him in a hospital with dialysis facilities convinced me that my anger was not irrational. I suspected more and more that a lack of adequate care had been a factor leading to Bo’s death.
Minor administrative errors that I remembered or that came to my attention in the weeks following Bo’s death bolstered my suspicion that there was a general lack of attention to detail in the way the hospital was run. For instance, the unexpected request to cancel the post-mortem examination on Monday 11 November seemed strange, given that the consultant who had recommended the post-mortem had not been aware of this phone call. Who suggested it? Why? The right hand did not seem to know what the left hand was doing. And of course that request begged the question, was there something the hospital wished to hide?
Another cause for uneasiness occurred three weeks after the funeral. I received a bill for Bo’s nights in hospital – in Ireland public patients pay 75 euro per night for a hospital stay in a public hospital if they don’t have a medical. However, patients who are covered by private health insurance don’t pay – the bill is sent directly to the insurance company. Bo had full private insurance. When I telephoned the accounts department querying the bill the official said, ‘Oh, he is registered as a public patient. We didn’t know he was private.’ I recalled then that on the night of Monday, 4 November, when I was at the admissions counter outside A&E, I had said to the official at the desk that Bo had VHI cover (private health insurance). I was told, ‘Oh, that doesn’t matter here.’ If he had been correctly registered would a greater range of hospitals have been available to him, on the last day? Blackrock Clinic, for instance, was much closer than Beaumont. ‘Over to Beaumont in Friday afternoon traffic? It’d be chaos,’ the ambulance man had said to me. But they could not have contacted Blackrock since they believed Bo was not covered for it by insurance. He was incorrectly registered at the point of admission.
I detailed my questions in a long letter to the consultant, which I copied to our GP. The GP responded a month later, sympathetically. The consultant responded promptly and arranged a meeting to deal with my concerns. He was friendly and helpful.
‘I hate the words “What if?” he said. ‘If things had turned out differently, you would not be asking these questions.’
Well, obviously not. He explained Bo’s deterioration as a ‘cascade’. Once it started, with the ingestion of the three pills, it could not be stopped.
My solicitor, who recognised my distress and listened to my doubts, took advice from a barrister who specialises in medical negligence cases. The latter recommended that I commission a report from an expert. I did so – slowly, I must admit. Something held me back, and I did not want to incur large expenses. But on the other hand I wanted to get answers.
In October 2015 the detailed report arrived. I will not reproduce it here. The medical expert found that ‘there was failure to treat Professor Almqvist’. He was critical of the delay in giving fluid resuscitation. ‘A standard procedure would be to give intravenous fluids within one hour to restore his circulating fluid volume, restore his blood pressure, and hopefully restore a good urine output allowing correction of renal failure. His initial litre of fluid was not started until three hours after admission.’
The report found that Bo had suffered from sepsis, which was not identified until after his death. ‘I do not think the source of sepsis could have been identified at the point of admission, but should have been considered as soon as blood results were av
ailable. At that point a vigorous search for a source of sepsis should have been initiated and he should have been started on a suitable potent broad spectrum antibiotic pending results of investigations.’
Bo’s organ failure came about as a result of sepsis, which was neither identified nor treated in the hospital.
The broad conclusion was that ‘if optimally managed he on balance of probability would have survived at worst a 20–25% 30-day mortality and a 75%–80% chance of surviving’.
Bo was not ‘optimally managed’. Any fool could see that, and the expert opinion confirmed my impressions. Simple solutions – timely delivery of intravenous fluids, timely administering of an antibiotic – would in all probability have saved his life.
My solicitor said he had never seen such a clear-cut case. ‘It’s black and white. He had an 80 per cent chance of survival.’ He advised suing the hospital. In the event, I decided not to pursue the case. Although I knew my solicitor would only give good advice, I did not want the issue to drag on, and, more than that, I feared the consequences of losing the case. I had no idea how much the case would cost if I lost and had to pay my own legal costs as well as those of the HSE. The solicitor was certain I would win, and pointed out that it would be in the public interest to proceed with the case. But the health service continues to deteriorate, so I am not sure how useful that particular exercise really is.
The HSE could not give me what I want: my husband. Do I blame the hospital for his death? Bo was eighty-two – there seems to be a consensus in Ireland that once you pass eighty you belong to the category ‘old’, the subtext of which can be ‘dispensable’. (‘He is old,’ as one of the doctors I met in Loughlinstown said so ominously.) ‘Old’ is a moveable feast, however, and in Sweden eighty is certainly not considered ‘dispensable’. Of course he was going to die sometime, as we all are. Nothing is truer than the proverb which warns that nobody knows where the sod of his death is. But Bo had recovered from serious illnesses, he was cancer-free, he had a strong constitution, and hoped to live for several more years – he was working on two major books, which he wanted to finish, and he enjoyed life. He had renewed his passport – but he never got to use it. Bo did not have to die on 9 November 2013. He died as if he had been run over by a bus – and the bus was the Irish health system. Had he been in his own country, or in a competent hospital in Ireland, it is more than likely that he would have survived the episode that killed him – 70–80 per cent likely, according to the impartial medical report. As it was, Bo suffered an untimely, painful, and unnecessary death. It is difficult for me not to think of the Irish public health service – sloppy, careless, and ageist – as a murder machine.
In one of his essays Henning Mankell writes about the vak, a patch of thin ice on a frozen lake. If you step on to a vak while skating or walking on the ice, you will sink under the ice and drown in the freezing water. It is almost impossible to rescue a person who is unlucky enough to step on a vak.
Bo stepped on the weak spot in the health service. The thin ice gave way. He was pulled to the bottom, and I could not rescue him.
Hidden Pictures from the Middle Ages
My relationship with Bo had begun in the Middle Ages, in our shared love of literature, written and oral, old and new. It was a journey in time, and also in place. Our first holiday together was in Denmark, in Copenhagen and on Jutland, where we followed the footsteps of the great nineteenth-century folklore collector, Evald Tang Kristensen. Coincidentally, although we did not know it was the final trip, our last holiday abroad was also in Denmark – on the island of Bornholm and then for a few days in Copenhagen. In that sense, admittedly rather a trivial sense, a circle closed neatly.
I decided, in the year after Bo’s death, to visit Scandinavia. It would, of course, have been difficult to go to all the places I had been to with Bo, but in 2014 and 2015 I went to Iceland, Sweden, Norway, Denmark and Finland. In most of these places I was hosted by good friends who understood that I would want to maintain my contacts with the Nordic world. My friend Ulla in Uppsala raised my heart when she said, ‘You are always welcome to Sweden.’ My other good friends, Helena Wulff and Ulf Hannerz, Marianne Isaaksson in Stockholm, Marian Connolly Andersen in Frederikssund in Denmark, Sirri and Eggert Asgeirsson in Reykjavik, welcomed me to their homes and countries. My fear that without Bo I would lose Scandinavia, its culture and language, was assuaged.
One of the places I visited was Visby on the island of Gotland in the Baltic. I had never been there with Bo, and I went mainly because there is a writers’ centre in Visby – the Baltic Centre for Writers and Translators. Much of this memoir was written in the centre. I had not realised how delightful Gotland was, before my visit. I thought it the most beautiful place in the world. When I returned from the island, my sister, Síle, who had visited Visby with her husband when on a Baltic cruise a few years earlier, told me that after she’d been there Bo had said exactly the same thing. ‘It is the most beautiful place in the world.’ This confirmation that we had independently shared exactly the same opinion was very gratifying. Of course, it must be a common viewpoint.
I was happy in Visby, in the summer of 2015. As well as writing, I went for long walks along the seafront, I cycled to Högklint, where the beach is rich with fossils, with Helena Wulff, who came over from Stockholm to join me for a few days.
One of my happiest days in 2015, a year and a half after Bo’s death, was the day I cycled to Hejdeby to find Hejdeby Church.
I leave the medieval walled city of Visby by the eastern gate, cycle across the footbridge over the moat, and then through ordinary garden suburbs until I reach one of the roundabouts. The road to take is the 147, which leads eventually to somewhere called Slite.
There’s a cycle path for about two kilometres outside town. I smell the sweet perfume that often tinctures the air around Visby – a light floral bouquet is how it would be described on a perfume bottle. Chicory, cornflowers, chrysanthemums, poppies and meadowsweet flourish on the roadside, but I’m not sure where the smell comes from – from none of those perhaps? From all of them? From some shrub? Some mimosa or jasmine?
It’s delicious, this scent, and both more delicate and more definite than any manufactured perfume. Words like evanescent, airy, heady, come to mind. Ephemeral, fleeting, evasive. Numinous: it comes and goes like a fairy or a ghost.
After a few kilometres the real cycle lane stops. For another three or four kilometres there’s a hard shoulder, a narrow hard shoulder, and I cycle on this. The landscape becomes scrubby. I’m cycling through a forest of low pine trees. Cars speed along the two-lane road. From the perspective of someone on a bike, they seem to drive very fast. Most of the drivers are polite and give you a wide berth. Occasionally someone, seeing an oncoming car, and unaware that a driver is allowed to slow down, even stop and wait, skims too close for comfort. There’s not a lot of traffic but it’s fairly constant. Every minute or two a car passes.
Then the hard shoulder stops and I have to cycle on the road, share it with the cars. Just like in Ireland, where I don’t cycle. My hands grip the handlebars very tightly, as if this could protect me.
There’s nothing along this road for six or seven kilometres. Just the road, the cars, the trees and a sort of scrubland. Not a house or a farm to be seen. Or the cafe I’d been hoping for, somewhere ‘on the way’.
Hejdeby. Of course. ‘Röslein auf der Heiden.’ This is a heath. The name should warn you.
I wish I’d eaten lunch. I wish I’d brought something to eat in my bag. Luckily I had the sense to put in a bottle of water. And one square of chocolate. I don’t feel hungry but it’s almost three o’clock and I had breakfast at eight.
Am I on the right road?
The landscape changes. The woodland gives way to fields of corn, of wheat or rye. I see the roof of a house. And then, rising from cushions of fluffy trees, the slim black spire of a church.
Minutes later the sign ‘Hejdeby’ appears.
The church,
just down a little road to the right, is perfect. The snow-white walls, the black roof, the square tower with the black spire on top, the little vestry or altar place tacked on at the back like a kitchen extension. It’s set in a green lawn. The graveyard nestling around it, graves dotted like children on the grass. Behind, a field of golden corn.
One car in a parking spot. I cycle along a grass path and park the bike under an elm tree. There are black doors in the white wall and I fear the church may be closed. But it’s not.
It was worth the ten kilometre cycle.
Inside, the walls of the church are covered with pale pastel chalk paintings. The twelve apostles. The Virgin Mary. King Solomon riding to Jerusalem. Pale faded pinks, blues, yellows, drawn in two dimensions on the chalk walls.
The pews have painted red roses, framed in blue, on the little gates: you open the gate to gain access to your seat. The pulpit is similarly decorated, and painted blue and red and gold.
Hejdeby Church was built in 1281. After the Reformation, its murals were painted over: the word, not graven images, would hold sway from henceforth in the Lutheran church.
The church was built on sand. This was discovered or attended to in the early twentieth century, and various attempts were made to secure its foundations. In 1995 the floor was taken up. Underneath in the foundations a hoard of silver coins was found – coins that had been placed there, for good luck, when the church was built. More spectacularly, the thick chalky whitewash on the walls was removed, to reveal the most sensational set of murals in any church on Gotland. But many generations of Hejdeby people knew the paintings were there, hidden under the white chalk. They had caught a glimpse of them, through the veil of whitewash, when the sun was strong enough to X-ray the paint, to render it diaphanous. But in the late 19 90s they were uncovered, after five hundred years in hiding, sleeping like the princess in the fairy tale.
Twelve Thousand Days Page 20
