by David Lodge
Dr Kannangara was very elusive that week, and to my annoyance I missed his ward visit on the Thursday. I did however see the young houseman, Wilson by name. He took me aside and led me into a store room off the end of the ward, and spoke in a quiet confidential tone. He told me that the specialist would make another assessment of Dad’s condition on the following Monday and see me afterwards. ‘He’ll probably suggest inserting a PEG tube,’ he said, and explained that this was a device which fed sustenance directly into the stomach. ‘Your dad’s had an extension of his stroke, which has further reduced his ability to swallow. If he doesn’t get more nourishment he’ll gradually get weaker and weaker.’ ‘And with this tube he’ll get stronger?’ I asked. ‘Let’s say he’ll remain in a stable condition. The same as he is now - unless he has another serious stroke, of course.’ He looked at me speculatively. ‘Your father’s achieved a good age, nearly ninety. In cases like this we like to be guided by the family. We can keep him alive, but without much quality of life. Or we can make him as comfortable as we can and let nature take its course. It’s really up to you.’
I didn’t like being presented with this choice. I didn’t like it at all. When I told Fred about it that evening, she could hear the stress in my voice, and decided I needed moral support. ‘I’ll come down to London tomorrow, and stay for a few days,’ she said. ‘Jakki can look after the shop. Ron will help out.’ I didn’t try to dissuade her, though I did warn her the house was a tip.
I met her the next morning at King’s Cross, and we took an extravagant cab all the way to the hospital. Dad didn’t look too good. Somebody had tried to shave him earlier and I guessed he had made the operation difficult, because he had a couple of cuts, and patches of his stubble were untouched. He didn’t seem to recognise Fred, though when she began to speak to him he looked sharply at her as if the sound of her voice triggered some faint memory. I wasn’t sure that he recognised me any more.While Fred and I went through a pantomime of hospital visitors chatting away to a responsive patient his eyes were following the uniformed nurses and ancillaries who went to and fro past the end of his bed with a kind of feral attention, as if he knew that these were the people on whom he depended for food, drink, and other physical needs. It seemed to me that he had regressed even past human infancy on the evolutionary scale and that his reflexes were disturbingly like those of an animal in captivity.
Fred was shocked and dismayed by what she saw. Afterwards, when we were back in Lime Avenue, sitting in front of the electric fire in the dingy dining room with cups of tea, we discussed the issue of the PEG tube. She said she didn’t see the point of keeping anyone in Dad’s condition alive by such an intrusive and artificial procedure. ‘Of course the doctors have to offer to do it, since it’s available, but the houseman gave you a heavy hint that they think nature should take its course now.’
‘But that puts all the onus on me,’ I said.‘I have to decide whether he lives or dies.’
‘We’re all going to die sooner or later, darling,’ she said, and her ‘darling’ was gentle and sympathetic. ‘Do you really want him to be lying in a hospital bed for perhaps months, unable to speak, unable to recognise anyone, looked after like a baby, fed through a hole in his stomach? It would be kinder to let him go.’ I nodded agreement, but I must have looked unconvinced, because she added:‘What would you want me to do, if you were in the same condition?’
‘Oh God, let me go!’ I said. ‘No PEG tubes, no life-support machines, please.’
‘Well, then,’ she said, as if resting her case.
‘I suppose the reason I find this so hard,’ I said, ‘is that it’s the second time in my life I have held another person’s life in my hands.’ And then I told her what I have told no other person, that I helped Maisie to die.
That last Christmas she was very ill, very weak, and in pain, though she bravely concealed the severity of it from the children. The cancer had metastasised all over her body and she knew there would be no remission. When I arranged for the kids to go on the skiing holiday, she saw a window of opportunity, to leave without fuss a life that promised nothing but more suffering, physical and emotional. She didn’t want to die in a hospital, or a hospice, looked after by strangers, however kind. ‘I’ve had enough, Des,’ she said. ‘I’m not sure how much longer I can stay in control. I’m tired. It’s time to go, and you’ve got to help me.’ I think our GP guessed her intention and decided tacitly to cooperate. Her principal means of pain relief was a battery-operated syringe driver - a fairly new device in those days - which administered a continuous supply of diamorphine subcutaneously, refilled by the visiting nurse as required. Maisie was able to increase the supply herself according to need, but only up to a safe level. She also used Distalgesic tablets when the pain was very bad. Towards the end of Christmas week our GP wrote a prescription for a larger than usual quantity, ‘to see you through the New Year holiday’, and as he handed it over he looked me in the eye and said: ‘Too many of these combined with alcohol can be dangerous.’ On the last night of the year I crushed twenty Distalgesic tablets and helped Maisie swallow them in a mixture of warm milk and brandy. She turned up the syringe driver to maximum. I kissed her, lit a night-light candle beside the bed, and lay down beside her, holding her hand, until she fell into a deep sleep. Then I sat in an armchair and watched her breathing until I fell asleep myself. When I woke at 4 a.m., the candle was out, and she was dead, her face quite peaceful, her limbs relaxed. I called the doctor at six and he came round. He didn’t ask any questions, and in due course he signed the death certificate. Later that morning I phoned the ski resort in Austria to tell Anne and Richard.
‘You poor darling,’ Fred said, when I had finished my story.While we had been talking daylight had faded outside the windows and the red glow of the electric fire was the only illumination in the room. She came across and knelt on the floor and took my hands in hers. ‘How awful for you. And how brave you were.’
‘Not as brave as Maisie,’ I said.‘But would you do the same for me?’
‘I don’t know,’ she said hesitantly. ‘Catholics aren’t supposed to, of course . . . but if it came to the point, and you asked, I probably would. What you did for Maisie was an act of love.’
‘I’d like to think so,’ I said. ‘But the trouble is, I wanted her to die. I wanted the whole miserable business to be over - almost as much, I believe, as she did. I had to struggle to conceal my relief afterwards, disguising it under grief. It left me with a residual sense of guilt that I think I’ve never entirely got rid of. And now it’s all happening again. Of course I don’t want Dad’s life to drag on pointlessly - but not just because it would be horrible for him. Because it would be horrible for me.’
We talked for a long time, and Fred did her best to convince me that I had no reason to reproach myself over the death of Maisie, nor would I if I decided against the PEG procedure for Dad. She invoked some abstruse Catholic casuistry about ‘double effect’ - if you did something with a good reason but a bad side effect then it wasn’t a sin, something like that. I wasn’t sure how it fitted my case, but I was grateful for her support. In the event I was spared the decision. Dad developed a chest infection over the weekend and by the time I had the interview with Kannangara it was obvious that he was in rapid and irreversible decline. Meanwhile Fred and I camped out in the house in Lime Avenue. Neither of us felt like sleeping in Dad’s bed, or sleeping apart, so we took the mattresses off both beds and made up one for ourselves on the floor of the lounge, the one room in the house that still looked in any way inviting. We did not attempt to make love, but we caressed each other and drifted off to sleep in a comfortable embrace, my hand between her warm thighs. Sooner or later that is what our sexual life will dwindle to, I suppose, if we live long enough - a tender intimate touching; and one might as well accept that prospect as infinitely preferable to nothing at all (while hoping it will happen later rather than sooner, of course).
Between hospital visits Fred bough
t cleaning materials and we set about scouring the kitchen of its coating of grease, and the rest of the house of its coating of dust, just to have something to do; and within a few days living there was no longer the queasy ordeal it had been. I visited Dad every day, sometimes with Fred, sometimes alone. Eventually she decided she would have to go back home and relieve Jakki, who had been running the shop largely on her own. Richard came to the hospital one day, and when he spoke to Dad and held his hand I saw the last gleam of recognition in Dad’s eyes, perhaps sparked by a dim memory of how Richard had found him and accompanied him to hospital. By the end of the week he was a pitiful sight. His left wrist was bruised and bloody from the repeated insertion and displacement of the IV tube, which was now attached to his stomach. He was too weak to sit in his chair, and lay in bed in the same position until the nurses moved him, breathing noisily with the aid of a mask which supplied his lungs with humidified oxygen. He seemed to find the mask, attached to the back of his head by an elastic band, irritating, and made periodic attempts to pull it off, sometimes successfully. If I was there I would hold the mask to his nose and mouth and grasp his hand at the same time, and he became more peaceful. But one afternoon when I tried to do this he brushed the mask away again and again until he was exhausted, then closed his eyes and submitted to the mask being replaced with the elastic band. That evening back at the house I had a call from the ward nurse that he was sinking rapidly and I had better come. I called a minicab and was at the hospital in under half an hour, but the ward sister told me he had passed away five minutes after we spoke on the phone. She left me with him behind the curtains drawn round his bed. He looked stern, almost noble, in death and I was not sorry that I had missed his last laboured breaths. I wondered whether his stubborn resistance to wearing the mask that afternoon had been a sign that somewhere in his ruined consciousness he had decided to give up the fight for life, and let go.
19
22nd February. Dad made the long journey north after all, not in an ambulance, but in a hearse. Tonight his body reposes just up the road in the mortuary of B.H. Gilbert & Sons, Funeral Directors, whose men fetched it from Tideway Hospital today.The local cemetery for Brickley, where Mum was cremated, is a dreary place, hemmed in by a council estate and a railway line where trains rattle noisily past every few minutes. I remember her funeral as a profoundly depressing occasion. There was a municipal strike on at the time, and a lot of uncollected garbage was blowing about the site in the strong March wind, and there were heaps of flowers all over the place, rotting inside their cellophane wrappings.There weren’t many mourners, and I knew there would be even fewer for Dad’s funeral if it were held in London. His two cousins, to whom I have written about his death, are both too old and infirm to travel from their seaside homes, and I can’t think of anyone in Brickley who would have come except perhaps the Barkers. When I drew up a list it mostly consisted of Fred’s family and mine, and the thought of inviting them back after the service to the house in Lime Avenue, even in its cleaned-up state, or hiring some place in Brickley, a district not noted for elegant licensed premises, was dispiriting. So we decided to have the funeral up here, and the reception at home. It’s been arranged for next Monday at twelve. It will be a cremation, and in due course I’ll take the ashes back to Brickley Cemetery where Mum was cremated and scatter them in the Garden of Remembrance where Dad scattered Mum’s. He left no instructions about his funeral, needless to say, but I think that’s what he would have wanted.
I saw his body once more after he died, next day in the hospital’s chapel of rest, but I rather wish I hadn’t. There must have been some delay before his body was laid out, by which time rigor mortis had set in, and they obviously had trouble fitting his false teeth, because his mouth was open and his teeth bared in a ghastly grimace. I found it uncomfortable to look at him, and sat behind his head as I thought about his long life. I had spent the previous evening going through old photographs I found in his chaotic desk, and it was pleasanter to fill one’s mind with those creased and dog-eared images in sepia or black-and-white: youthful Dad with his tenor sax slung round his neck, posing with the other members of a five-piece band, the Dulwich Dixies, its name emblazoned on the bass drum; Dad and Mum together, young and good-looking, on holiday somewhere flat and sandy in Thirties beachwear; Dad in the back garden at Lime Avenue, with me aged three straddling his shoulders and holding on tightly to his upstretched hands; a studio portrait of Dad looking deceptively heroic in his RAF uniform and angled forage cap; Dad and Arthur Lane in their tropical shorts, sunburned and grinning into the camera; Dad’s agency photos for modelling and TV work, wearing various costumes and expressions - here a comic Cockney in a flat cap, there a sober businessman in a chalk-striped suit . . .
Afterwards I registered the death at the local registry office, a tedious process because the staff were in a tizzy about a new computerised system (I glimpsed ‘DEATH MENU’ on a monitor screen); then I locked up the house and came home to make arrangements for the funeral. Fred has got her parish priest to officiate at the service, which is nice of her - and of him, considering that Dad was barely a Christian, let alone a Catholic. But it seems that the Catholic clergy are fairly easy-going about such matters now, accepting, I presume, that their main function is to bring comfort to the bereaved, and if that involves a little prevarication about the beliefs of the departed, so be it. It will be a short service, since there are funerals every half-hour at the crematorium. Fr Michael has given us a free hand in filling in the basic Catholic template. Anne and Richard will do readings. I’m going to say a few words - eulogy seems too pompous a word - about Dad, and I’ve tape-recorded some of his favourite classical music for the service. I thought of playing a few bars of ‘The Night, the Stars and the Music’ too, but Fred vetoed that.
I have given very little thought to Alex Loom in the past few weeks, having other things on my mind. Fred told me she had left messages on the answerphone a couple of times when I was in London, wanting to speak to me, which I didn’t bother to follow up, and when I came back to Rectory Road I found several emails from her in my inbox, saying she was very sorry to hear that my father was ill, but she urgently needed to see me as soon as I could manage it, and was willing to travel down to London if necessary.Today when I came in from delivering the music tapes to the undertakers Fred said that Alex had called again, and she had told her of Dad’s death. ‘She said she was very sorry to hear it, and she’d like to come to the funeral.’
The information disturbed me. If she came to the funeral we could hardly avoid asking her back to the house afterwards. ‘I hope you didn’t invite her,’ I said. ‘It would be quite inappropriate. She never even met Dad - he was upstairs sleeping off the booze when she turned up on Boxing Day.’
‘No, I pretended the arrangements weren’t settled yet. I should put her off, if I were you. And while you’re about it, darling, you might tactfully remind her that she still owes us for her curtains.’
‘You mean the ones she bought from Décor?’ I said, surprised. ‘That was quite a long time ago.’
‘Exactly,’ Fred said. ‘She paid a small deposit, and the balance was due when Ron fitted them for her in mid-January. She’s had a reminder.’
I asked how much was outstanding and Fred said it was four hundred pounds - ‘As I remarked at the time, she has very good taste.’
I went to my study to send an email to Alex and found a new one from her in my inbox, commiserating with me over Dad’s death and reiterating her wish to attend the funeral. I replied, thanking her for her condolences, and said that the funeral was to be a small private affair for the family only. I decided it would compromise the formal and distant tone of my message to mention the matter of the curtains.
23rd February. Alex called me this morning, after Fred had gone into the city centre. She said she understood about the funeral, but she was very anxious to meet me to discuss something. I said I was far too busy, and would be for some time, sorting out
my father’s probate, and disposing of his possessions and the house. I asked her what it was about, and she said she would rather explain in person, at her flat. When I said that wasn’t possible, she suggested Pam’s Pantry, and when I rejected that proposal too she reluctantly told me over the phone why she had been trying to reach me ever since my return from Poland.
‘I can’t go on being supervised by Colin Butterworth,’ she said. ‘It’s impossible, for obvious reasons. It’s the only thing we agree on. He asked me if there was anyone else in the Department I would like to transfer to, and I said no, there isn’t, but I would love to be supervised by you. He thinks it’s a brilliant idea, and he’s sure there won’t be any problem getting the University to approve it. You’d get some kind of payment, not a lot I guess, but something. And I don’t need to tell you I’d be absolutely thrilled.’
‘No, Alex,’ I said when she had finished her pitch.
‘Why?’ she wailed. ‘When I asked you before, you said it would be an insult to Colin, but that doesn’t apply any more.’
‘I just don’t want to,’ I said.
‘But why?’ she persisted.
‘If you really want to know, it’s because I don’t understand you, I don’t trust you, and I seriously doubt whether you are capable of writing a PhD thesis. I’m afraid I would end up writing it for you.’
