In the Midst of Life

nurse must obey medical orders.’
    ‘She does refuse drugs, all the time, so we hold her down and inject them. Isn’t that assault? And who commits the assault? The doctor who orders it, or the nurse who does it?’
    ‘I cannot answer these questions. Perhaps a lawyer could, but I doubt it. If life-saving drugs are to be given, they
must
be given, and any court of law would uphold the medical necessity to save life.’
    ‘Well, I don’t agree with the law!’
    ‘Nurse, you are young and passionate. You are trying to understand a subject too deep for understanding. Death used to be asyou have described it – your grandmother had a heart attack and just died in her husband’s arms. That is how it used to be for the vast majority, but not any more. Medical science has found hundreds of death-defying tactics, and, as this century unfolds, thousands more will be available to us. We do not know where it will end. Perhaps we will come to a point when human beings are unable to die.’
    ‘That is a frightening thought, Matron.’
    ‘Yes, it is.’ Matron stood up, all four feet eleven inches of her, indicating that the interview was over.
    ‘I advise you, Nurse, not to talk too freely with other people on this subject. You will not be understood. In fact you may be positively
mis
understood. All sorts of sinister interpretations could be drawn from your remarks. It is a dangeroussubject.’

MUNABLE TO DIE
     
    Hospitals in the early in 1950s were small, enclosed worlds, especially for nurses. We lived communally in the nurses’ home, and all our meals were taken together. Consequently, we exchanged news of hospital life all the time, so whilst I did not directly look after Mrs Ratski after the first five or six weeks, I was able to keep up with her progress, and made a point of doing so.
    Mrs Ratski recovered sufficiently to go to the convalescent home attached to the hospital. It was a lovely house, with gardens sloping down to the Thames, which she seemed to enjoy.
    The nursing staff tried to teach her how to manage her colostomy, but she did not understand, and seemed incapable of learning. She just muttered to herself, and poked it (the gut has no nerve endings, so can be touched without causing pain). She seemed intrigued, but quite incapable of understanding how to cope with it. After three weeks in the convalescent home, it was decided that she could return home under the care of a district nurse.
    A hospital car brought Mrs Ratski home. Her daughter-in-law, Karen, watched with dismay as the driver helped the old lady out of the car, up the garden path and into the sitting room. She went straight to the sofa, muttering to herself, and pulling her shawls round her shoulders.
    The district nurse arrived, kindly and helpful.
    ‘Where is she going to sleep?’ she enquired.
    ‘I don’t know. She slept on the sofa before.’
    ‘She can’t do that now – this sofa is not suitable. I can arrange to have a bed sent from the social services. It’s wonderful what this new National Health Service can provide, isn’t it? I’ll go now, and come back this afternoon.’
    A hospital-style bed arrived and the men put it up; the sofa wasput in the garden shed. Karen watched the whole proceedings, and bit her lip. Her nice sitting room was ruined.
    The district nurse returned in the afternoon.
    ‘I’ve got sheets and pillowcases, and cotton blankets that can easily be washed, and all free from the NHS. Isn’t it wonderful?’
    Karen was not so enthusiastic. Washing blankets was not something she had anticipated.
    Mrs Ratski sat on the edge of the bed looking uneasy, and still muttering.
    ‘I don’t know what you are saying, dearie, but let’s get these clothes off you, and into bed, shall we?’ The nurse turned to Karen. ‘I’ve got to show you how to clean a colostomy.’
    ‘What’s a colostomy?’
    ‘Oh, dear. Didn’t anyone tell you she’s got a colostomy? Well, briefly, the rectum has had to be sealed, and the colon is opened on to the skin surface and the body’s waste product goes into a bag. I’ve brought a supply of colostomy bags with me to leave with you.’
    Karen didn’t fully understand until she saw her mother-in-law’s abdomen. Two huge and angry-looking scars ran the length of the wrinkly old skin, and on the left hand side a pink, protruding thing burst on to the surface. It was covered with a plastic bag containing brown liquid and had sticky stuff around the edges. Mrs Ratski