In the Midst of Life

The electricity was switched on and the woman’s heart jerked back into some sort of beat.
    Why? The answer is nearly always fear. Fear of litigation haunts the medical world from top to bottom, from the most exalted professor of medicine to the humblest paramedic or care assistant. ‘Cover yourself,’ is the first rule of practice, ‘and if in doubt, resuscitate.’
    Todayresuscitation in the community is burgeoning, with a 5–8 per cent success rate. However, this figure includes young patients and success in the resuscitation of older people is not evaluated separately. The latter is predicted to be 0–2 per cent in the very short term, and even when resuscitation is successful brain damage may occur. Automatic External Defibrillators (AEDs) can now be obtained on the open market, anyone can use one, and this is causing great excitement. Soon every public place will be required to have an AED, and once they are available, they will be used. The force, violence and pain inflicted never seems to be considered.
    I was talking on BBC Radio South on Sunday, 6 February 2011 – it was a phone-in. A lady who said she was sixty rang to say she had died fifteen years earlier and had been resuscitated. She told listeners she had experienced an exquisite sense of beauty and peace and then ‘suddenly there was pain. I could never tell you how dreadful it was, like a great wooden stake being rammed through my chest.’ That must have been the CPR – entirely justified on an otherwise healthy woman of forty-five, but not justified on a failing old body for whom there is no chance of return to a meaningful life.
    Five per cent of the population die in an ambulance, but this statistic can be misleading. Ambulance paramedics are required to get a patient to hospital alive, so they use every means available to keep the heart going for the duration of the journey. Something must be done to protect the elderly who, like me, want to be able to die quietly without first being subjected to well meant, but intrusive attempts to resurrect us.
    A Commission of Enquiry is needed. I have approached all members of parliament and many members of the House of Lords. I have approached DEMOS, the government think tank that acts as a secretariat for commissions concerning social and medical issues. In this age of electronic tags and instant access to personal data surely it should be possible to prevent inappropriate resuscitation attempts.

TIME TO GO
     
    The Appalachian Mountains in 1896, the year Harry Randolph Truman was born, was a wild, rough place and it was hard to scratch a living out of the rocky soil. In a land of rolling valleys of oak and sycamore, beech and birch, it was natural for generations of Trumans to be woodsmen or loggers, and in later years Harry used the skills learned as a boy to construct the lodge, log cabins, boats and boathouse for the visitors’ centre he built on the edge of Spirit Lake beneath the brooding presence of Mount St Helens, in Washington State, USA.
    Truman possessed a daredevil streak and in 1917, lured into the war in Europe by dreams of adventure, he enlisted in the 100-Aero Squadron of the American Expeditionary Force. He learned to drive and to fly, and trained as an aero-mechanic and electrician – all skills that he would use in later life. Under a veil of secrecy the squadron was sent to Halifax, Nova Scotia, one of the Canadian ports shipping troops to France during the First World War. The boat on which he sailed was hit by a torpedo, and although many died, Truman was one of the survivors. His dreams of adventure were replaced by the cruel reality of war.
    In France, he worked first as a mechanic and then as a combat pilot. In later years, at St Helens Lodge, he would tell of flying the French biplanes in an open cockpit, ‘a leather cap on my head, a silk scarf round my neck flapping in the wind’. Like many such tales, they improved with each telling.
    But war changed Truman, as it did many young men. A friend said, ‘He became a kind of loner, I think. He never discussed the war, he wanted to forget it.’
    Truman was demobilised in 1919 and he returned to a very different America. He worked as a mechanic for a Ford dealer, butalthough always polite and courteous, he kept to himself, and seldom confided in or even mixed with his fellow workers. He seldom revealed his deepest feelings to anyone. It was not until later that they learned that he had married a girl called Helen