In the Midst of Life

examined me all over, eyes and throat, and heart and lungs and I don’t know what, then she looked at my leg and said, “This is a very long plaster for a fracture in the foot.”
    ‘“No, it was the tibia and fibula, a compound fracture.”
    ‘“It says here, the fourth metatarsal.”
    ‘“Well that’s wrong, it was the tibia and fibula.”
    ‘“I’ve got X-rays here, Mrs Wilson, and—”
    ‘“But I’m not Mrs Wilson!”
    And then it all came out. No one knew quite how it had happened, but the ambulance men had been given the wrong instructions. The hospital was expecting a patient, and a bed was ready, so I was put into it, no questions asked.’
    She had to cough again, she was laughing so much.
    ‘So I had to be transferred again. I didn’t get here until yesterdayevening. I’ve been wondering about Mrs Wilson and what sort of a day
she
had. Mine was highly entertaining.’
    In all the weary months that followed, Leah’s sense of humour never deserted her, and her interest in life never flagged.
    From the beginning, Leah had been on continuous urinary drainage, because it would have been impossible for her to use a bedpan regularly. A catheter into the bladder for weeks on end can cause friction and general discomfort, but she did not complain. I presumed that she was having diuretics to keep the kidneys functioning efficiently, and also some kind of anti-bacterial drug to avoid infection.
    I do not know what happened to her bowels. From experience I can say that bowel movements can be one of the biggest problems for geriatric nurses to have to deal with. Constipation usually sets in, and faeces become impacted, leading to nausea, headaches, lethargy, confusion and other nasty conditions for the unfortunate patient. Enemas help, but Leah could not have been turned on her side to receive an enema. Aperients often add to the abdominal pain, or can sometimes cause uncontrollable defecation into the bed, causing a nightmare of shame and humiliation for a sensitive person. How the nurses and carers handle this is one of the greatest challenges of good practice; a bad experience can leave a scar, slow to heal, on the mind of the unfortunate patient.
    Weeks passed, and the leg did not heal. I don’t know how Leah endured the boredom of those long summer months, trussed up in a massive plaster that was impossible to move. Sometimes she complained of aching and stiffness in other parts of the body, so I massaged her other leg and her back and shoulders, which she said helped. Thank God for those new air beds, I thought, which continuously shift pressure from one part to another. In my nursing days massive pressure sores would have developed.
    About six weeks after admission, Leah complained of a slight cough, which she could not shift. The next time I saw her she looked dreadful. It was an embolism in the lungs, I was told. Shewas on high doses of antibiotics and continuous oxygen and an intravenous drip for fluids. She could scarcely open her eyes or move a hand. Her breathing was laboured, yet she had the courtesy to mouth the words: ‘I can’t talk. Forgive me.’ I sat quietly massaging her upper chest for about an hour. ‘This is it,’ I thought, ‘she won’t survive this one.’
    From the beginning, when the fracture first occurred, she had been on cardio-vascular drugs and other drugs to maintain circulatory function, as well as diuretics to stimulate the kidneys. When the embolus lodged itself in the lungs, massive doses of clot-busters were added, and all the other drugs were modified or intensified. Daily blood samples were taken for analysis until, she said, she felt like a pincushion.
    Leah was on the ‘not for resuscitation’ list, which meant that, if she actually died, no attempt at resuscitation should be made. In my days of nursing, an embolus on the lungs would almost invariably have been fatal for an old person, and I felt reassured to see that notice at the end of her bed. I was glad to see that she would be left to die in peace.
    I was not the only one to expect her death from an embolus. Her granddaughter, who was a practising nurse in Israel, came over to England and stayed in Leah’s flat, spending most of each day at the hospital with her grandmother. But the antibiotics, the oxygen, the clot-busters and the drip, combined with the cardio-vascular drugs, did their work. Leah was tougher than anyone had imagined and confounded us all. Two or three weeks later she was