In the Midst of Life

though Mum had a known heart condition, and had had a previous severe heart attack, a postmortem had to be done because she had not seen a doctor for about six months.’ Apparently, if you have not seen a doctor for a fortnight before death, the law is that a post mortem must be carried out to discover the cause of death. In fact, it is very rare for any sudden death at home not to be referred to the coroner for postmortem examination.
    ‘We were asked if we wanted to see her after the postmortem when she was back in the undertaker’s parlour. But I didn’t want to. I knew all the time I would be looking for the incision marks of what they had done to her. I saw the postmortem report – every part of her had been opened up and examined. I didn’t want to see what they had done.
    ‘The coroner reported the findings on autopsy:
    1. Ischaemic heart disease
    2. Old myocardial infarction
    3. Acute myocardial ischaemia.
    ‘The coroner said that establishing the exact time of death was always difficult, but it could reasonably be stated that death hadoccurred before 9 a.m. – that was one and a half hours before I found her, and before resuscitation was started.’
    We talked a little about the sadness of it all, and Kelly said:
    ‘I think she had a peaceful death – there was no sign of a struggle, or anything like that, and her face looked comfortable and happy, not anguished, as though she had been in pain or distress. By the time all that resuscitation was started she wouldn’t have known, or felt the pain of those electric shocks, the tube being pushed down her throat, or the injections. In spite of what they called “an atrial response” I don’t think she would have known anything about it, and felt no pain or shock.’
    Then Kelly told me something that interested me greatly. She said:
    ‘I was talking about this with an acquaintance, and she told me that her mother had died one Christmas lunchtime, and that the family called no one. The men of the family simply carried her to her room, and laid her on her bed. They did nothing, because four years previously she had suffered a heart attack and had been successfully resuscitated. After that, she was so brain-damaged that she had to be looked after constantly. The family didn’t want it to happen a second time.’
    I don’t call it ‘doing nothing’. I call it respecting the dead in an appropriate and humane way, and enabling the family to say goodbye to their mother.
    I am grateful to Beatrice and her sister Kelly for their kindness in giving me this information, knowing that it was for publication. My sympathies go to them both for the troubled memories they retain. But I am sure that Kelly was right when she said that her mother died peacefully – she died quietly in her own home, in her own armchair, which is what we all hope for. It was what happened afterwards – events for which they were not responsible – that was grossly disturbing.
    Beatrice’s words to me, when she told me what had happened, stick in my mind. She’d said, ‘The trouble was, we’d never discussed it. We didn’t ask her what we should do if she had another attack.
    Weshould have done, because we knew she had a weak heart, and it could happen any time. But we didn’t. I think everyone should talk about these things.’
    Beatrice is right – everyone
should
discuss these matters, and make their wishes known. But accurate knowledge of the reality of events is in short supply. Most people get their information from the media, especially television hospital dramas, which portray a fantasy world in which resuscitation is usually successful and has no side-effects. There is a lot of debate amongst medical ethics committees, which is valuable, but their efforts are hampered unless the general public knows what the real issues are.
Everyone
should have proper information about what resuscitation involves; what the initial success rate, the long-term success rate, and the possible side effects are.
    Cardio-Pulmonary Resuscitation may be more carefully monitored and restrained in hospitals today, but the incidents in the community are increasing. For example, in 2010 St John’s Ambulance started a national fund-raising campaign to raise money to purchase thousands of Automatic External Defibrillation (AED) machines. This is just one of the many initiatives in the community.
    Anyone involved in healthcare, however loosely – police, ambulance crews, clinicians, social