by Melvyn Bragg
Word was got to both her husband and her father. Wilson, her father, arrived first. He was almost sixty now but the five-mile walk had been rapid. He took both her hands and waited until she was calm and coherent and told her that if it came to it he and her mother would take on the children and they would be looked after. They would always be safe and well fed. Had she heard him? ‘Yes,’ she whispered. He then sat in a corner, and he folded his arms, and he waited.
When their father came, the children flew to him and clung about him so that for a while he could not move from the low doorway. The choke in his voice as he said his wife’s name made Mrs Harrison and the two other neighbours turn away, quelling their tears, wanting the couple to have some privacy.
And the new child gurgled and only occasionally cried as the women cradled her and held her close, shielding her, it seemed, protecting her from the fever of her dying mother.
It was when the candles were guttering in the first light breeze of dawn. It was even before the first birdsong, the fire almost dead. It was at the pitch of half-light that she shuddered out of life gently, as if not wanting to disturb anyone, with the same ease as had brought this sweet woman’s last child into the world.
She was a Tuesday’s child: ‘full of grace’, the rhyme said. Grace she would be.
CHAPTER THREE
Mary had been in the home for three years. Assessments were provided regularly. John also made his own.
As he lived so far away, he had been unaware of the slow degrees of the early decline. His visits north in those pre-dementia days were often rushed, robust affairs. Members of his family or himself, or all together, were bent on ‘taking Grandma out’. Out of her terraced cottage in a close near the town centre, out of her normal routine, out of herself – into the galloping warmth of their embrace, into outings, times for sensations and exclamations. Reflection and explanation were largely ignored. So, for two or three years, under the static of over-activity, the problem was unsuspected, the occasional misrememberings or splashes of forgetfulness rather fondly cherished. The stealthy erosion of her defenceless mind passed unnoticed, and the disease went about its business undisturbed, relentlessly, both the stalker and the reaper.
There were three incidents that significantly signalled the extent of the decline.
John had arrived a couple of days before Christmas. He registered at the last small hotel in the town that took in guests. He had a drink and then wandered through the fairy-lighted streets he could have navigated blindfold, enjoying the familiar seasonal temptations in the small shops. They were empty streets this early in the evening, pavements glittering still from the afternoon downpour. Down a slit of an alley, across a yard, on the path to her cottage and framed in the archway at the end of the path, he saw an agitated woman, looking all about her as if stranded in traffic.
As he walked towards this silhouette she resolved the agitation and walked quickly towards him, towards the fairy-lights of the town, no coat, no scarf, clopping heels on the wet cobblestones. It was his mother. She would have walked past him but he barred her way. Her hair, he could see in one of the few streetlights, was brushed violently to one side. But it was the lipstick, smeared around her mouth, and a high rouge powder coated on her cheeks that sank him.
It was the first time she had not recognised him. He took her back to the cottage, fire full on, every light lit, the dwarf Christmas tree ablaze, the table uncleared. She did not know where she had been going and he did not enquire. He stayed overnight in the spare bedroom.
There were cousins nearby who were devoted to her, and others about the close and in the town, and all of them said, ‘We’ve been noticing for some time but we didn’t want to worry you. She was just about managing. We didn’t want to bother you.’ And what could he say but tell me, worry me, bother me, but that would be a criticism of those who kept a lookout day after day while he turned up only occasionally and rarely for long. So they assured him they would keep a closer eye and tell him everything. It had been a ‘one-off’ they said, and he let himself be reassured.
But the next night, in the hotel bar, when he left her for half an hour for a cigarette and a Scotch, he could not let it go. Where would she have gone? To a friend? It was not her way to ‘drop in’ and she was too confused for such a coherent plan. To a pub? She did not drink but what other doors would be open at that time, what lights and fires on, what warmth anywhere else? There would be those who would know her but what would even they make of this old lady blotched for a night out? Who would have taken her home? What would they have made of her, vulnerable, needy, utterly adrift with no self in sight? How had she got into that state of mind and appearance?
He was shaken by her appearance. She was always neat about herself. Yet something of the Dickensian lamplit street, something of the darkness of sordid back alleys, the faintest trace of the gutter courtesan, had transformed her. And there was something, too, of the innocent, an old doll unexpectedly wound up and sent out in unsuitable finery to take her place in a world she would no longer recognise. Who would have taken her home? The town was no longer the intimate network and nest it had been in her childhood and his.
But calm, calm. The town, though gutted since her day, the medieval heart and intense slum cohabitation ripped out of it so that many of Mary’s lifelong friends had decamped beyond the boundaries of the old small settlement, would surely still recognise one of its own. Surely, he thought. ‘It’s Mary,’ someone would have said. Somebody who had known her at school or at church. ‘Mary. You look a bit lost . . . You look . . .’ He wished he could forget that look but he never did. What if the old codes of recognition had broken down as some lamented? He was being over-dramatic. She would have been recognised by friends and returned home. Or she would have met with the kindness of strangers. He had got there first and that was all, that was the blessing of it. But his fear was real and the beginning of an ending rose up from the horizon.
Over the next few months the reports were not encouraging. He cut corners and went north more often.
She liked to go to church for the nine-thirty service on Sunday morning. It was the best attended. A century ago a town of twelve thriving churches, chapels and meeting houses, now four but even so it was an encouragement to the vicar that they could raise more than sixty in the congregation at nine thirty still and put out a choir. Mary liked it that children came and she was disappointed that after the first hymn they disappeared into the vestry for what was no longer called Sunday school. She liked the tea and chat afterwards. She liked to sing. Whether or not she believed as she scanned and sometimes mumbled the Creed, her son did not know and never would: it was too late and it would be too tactless to ask. She liked to be in that place with these people. That was the meaning of it to her. And she liked him to be with her, although there was no clinginess about her, there never had been, not even when she had gone into the home. She was a stoic. ‘No complaints,’ was her answer whenever anyone at any time asked her how she was. ‘No complaints.’
On that morning they walked to the church through the back alleys both of them liked. The new Millennium bells pealed out, though not as loudly as they would have liked because of a handful of objections to ‘Sunday noise’. It was not especially cold: Mary was finding it harder to stand the cold. ‘Starvation’ was her word for cold. ‘It’s starvation.’
In the nine-thirty choral Eucharist in a High Anglican church there is a deal of standing, then sitting, kneeling, then standing, then sitting . . . He saw she was a little tired and whispered that she need not stand up to sing the next hymn. But the organ’s introduction was a call to arms and she was on her feet, the well-worn words decanting steadily into the elegant Georgian church. Suddenly she sat down. Her head fell over the back of the pew, her eyes wide open, staring at the ceiling. The singing went on.
John never forgot his inadequacy. He sat down beside her and put his arm around her, lifting her head. He saw no sign of her breathing. He sought the p
ulse on her wrist and could not find it. There was no pulse? He murmured quietly into her ear – ‘Wake up, wake up, it’ll be fine’ – but there was no response from any part of the face set in its expression of staring.
He did not panic. But ought he to have done? He remembered feeling very awkward, twisted in his seat, the cumbersome black winter coat an impediment as he tried to cradle her head. Was she dead? The church service had petered into silence, the congregation as frozen as his mother.
A young woman clambered over the pews. ‘Feel her throat,’ she said. She touched it quite firmly and intently. ‘There’s an ambulance on its way. It was just going out of the town. You’re in luck.’ His mother had not moved and, as far as he could tell, she had not breathed. Where was the luck? And shouldn’t it be more than just ‘luck’ in a church, in a place on holy ground? Meanwhile, save for the young woman, no one in the church moved. The vicar stood near the altar, still as the cross beside him; the choir, having peeped enough, bent their heads; the congregation, mostly behind him, were as quiet as the valley of death. But some were praying, they told him later. Prayers were being said; it was only right that he should know that.
The paramedics came down the nave with a wheelchair. The ambulance was at the church gate. Emergency procedure was followed. Mary came to, a little, and said, ‘Is John here?’
‘Yes,’ he answered, as they sped through to the infirmary, and he took her hand.
The next morning she was like a little girl in her white hospital nightgown, her hair braided fine, her eyes alight, wanting to know when she could go home, praising the nurses.
What did he really feel about her seeming death there beside him? It had been a little death; at the very least, an intimation. Why was there only a blankness in him? Not even tears. A nothingness? But how can a nothingness happen? There must have been something. He could not fathom it. Perhaps shock could be quiet and silent. And was his reaction governed by the belief that in a church, with music, with no apparent pain, death for a Christian, a prepared death, was one to be wished for? But who on earth would wish for the death of someone they loved?
The third and deciding event was when she fell and fractured a leg. The mend was reasonably successful but even her slight frame found difficulty putting much weight on it. For her first convalescence she went into the crowded local hospital. The wild night cries of distress and the constant klaxoning of emergency calls to an understrength staff frightened her. She was declared fit to leave, and then what? Or then where? How did you make decisions about the end of a life? Now he had to act. He was told that it was impossible to leave her in her own house. The social services declared it not fit for the provision of home care – so she had to move.
There were careful consultations yet when the decision was reached John felt that he had failed. But the chosen nursing home was the best place, everybody said that. John liked it the moment he saw its strange, rather comforting, single-storey solidity. So did his mother as her wheelchair crossed the broad threshold. She had always liked grand houses. She had admired them in magazines and at the cinema; she had fallen on articles about them and smiled at the photographs of the great rooms, the grand furniture, the paintings, the objects and the gardens and the people so well dressed, the men so tall, the women so slim, so smart.
She was quite excited that first time and said, ‘Who lives here?’
‘You will.’ He contemplated her alarm and the lies began. ‘Until you can walk properly.’
‘And then I’ll be back to my own house?’
‘Yes.’ For an urgent moment he knew he ought to move from London and bring his family to her, to see her through. It was impractical, but what did her remaining life weigh in the scheme of his own needs? What did ‘practicality’ add up to? Yet he knew he would surrender to it. He had, he thought, joined the new tribe that left the weakest behind.
John felt the other unasked question often on the tip of others’ tongues – why did he not bring her to his house in London? It was big enough. He could see her every day there and, much more importantly, she could see him and his family every day. So why not? Why don’t you? Why didn’t you? The little strokes and stabs of guilt that had crept up throughout the last few years intensified now and he could see himself in the dock. The prosecuting counsel or counsels, surely many of them, waving his past at him and in chorus saying, ‘Why don’t you take her to your house in London? It’s big enough.’ Hornets in his head, an incubus on the heart. And no answer but a ledger of sensible calculations where sense and calculation ought to have been thrown out of the window.
But it’s true, he would say in the courtroom of the conscience. We as a family are so rarely there in our house. The children are no longer children; they upped and offed years ago. My wife and I skid around London independently and interminably, committees, commitments, entertainment, engagements . . . The house is empty most of the time and usually only occupied when it’s late and dark. It would have to be redesigned as a mini-hospital, because now there are complications not only with the leg but also with her heart and a lump, benign as yet but unmistakable on her breast. And how could her relatives and local friends ever see her, three hundred miles south? And how could London nurses know the local gossip or even where Wigton was or had ever been? Bring her to the isolation of my home? Even this home in Silloth, ten miles from her birthplace, could sometimes seem too far away from her own home.
She would say, not insistently, but often enough, ‘When am I going back to Wigton? When am I going to my home?’ And the seaside place in which she had her room was a place she had come to on flat carts and in buses, on trips and mystery tours all her life: it had been her spa, her escape from reality and work, her holiday. It was a place of pleasure. Was that nothing? When told she was in Silloth she would smile and say, ‘I like Silloth.’
The doctors agreed. His relatives agreed. Everybody agreed with John except John. Three years ago now, and most days it worked for her and the decision had been the right decision. Until she said, ‘When am I going home?’
He had looked at some of the research on Alzheimer’s disease, although it seemed that his mother’s case was nearer vascular dementia than Alzheimer’s.
Yet [he read] vascular dementia and Alzheimer’s disease often co-exist, especially in older patients with dementia.
The term refers to a group of syndromes caused by different mechanisms all resulting in vascular lesions in the brain . . . Vascular lesions can be the result of diffuse cerebrovascular disease or focal lesions or a combination of both. Mind dementia is diagnosed when patients have evidence of Alzheimer’s disease and cerebrovascular disease, either clinically or based on neuroimaging evidence of ischemic lesions . . .
She had in some degree, although the intensity fluctuated, most symptoms listed in Wikipedia. Problems with recent memory, getting lost in familiar places, walking with rapid or shuffling steps (though she rarely walked more than half a dozen steps at a time and then always assisted), loss of bladder and bowel control, emotional lability, some difficulty following instructions, problems handling money.
But as Eileen, one of the nurses, was fond of saying, there were ‘differences of days’. Sometimes there was incessant repetition in her talk but with better drugs that had lessened over the past months. At the same time she slept much more than she had done. Yet when she was awake she could be alert and engaged and funny still, especially when her grandchildren charged in. At times, even, there seemed evidence of some improvement and repair.
John believed that there was a better way for him to help than this mere visiting. At the moment, he would arrive with magazines and biscuits and chocolates and, if she was in her room – and the nurses usually put her there when they knew he was coming – he would read to her from the newspapers. The property prices in the Cumberland News alarmed her. ‘You have to be a millionaire! That’s just terrible!’ Or she would catch sight of a headline, once of the violent abuse of a girl-child by her parent
s: she read it – her eyesight was intact – and pushed the paper aside. ‘How can people do that? How can anybody do that? I’m not reading any more.’ In her world the bad had to be rejected in order to be lived with. And her own sensitivity to pain, heightened by her childhood, made her raw when presented with the pain of others, especially of children. She was near weeping over that headline and would not be comforted for some time.
But time did pass and new starts were forever being made and he censored her reading from then on.
She wanted the past, he knew that. She wanted to sing. She wanted reminding of names and people and events she had known back then. She wanted detail. It was the detail that brought her most fully to life.
This disease had to be attacked on all fronts, he thought. Neuro-scientists and researchers the world over were working to find out how to meet this invasion. It was as if it had been sent up from the deep to punish the audacity of the human race in so steadily and cleverly increasing its life span. It did seem, to John, akin to the monsters of mythology that appeared from outer darkness to destroy all the men and women they could discover.
There were many ways to fight such monsters. The old way was to take a sword to the dragon’s head, or bind it with a spell, or fell it with a magic word. Science now was the magic word and was marshalling its intelligence to tackle this creeping undergrowth, which strangled the roots of thought.
But there were other approaches, he thought, however modest they could seem. There always had been. In myths and stories that still resonated there were always other paths up the fearful mountain.
He would take her back to halt the forward decline. He would try to work out what might absorb her so that she could be immersed in it. Perhaps in these simple ways the unravelled mind could connect again, the disintegrated could reintegrate, the parts could be made whole, the past could restore the present.
