In the Midst of Life

‘Please come to the office with me. Your mother has been angry and aggressive ever since she was admitted.’
    We sat down.
    ‘Now what was said? Why this outburst?’ I enquired.
    ‘I simply told her that I thought she should not have any more treatment, and that the time had come when she should accept the inevitable, and die with dignity.’
    Oh dear, I thought, so was this the origin of the fear and anger? ‘Please go on,’ I said.
    ‘Well, it’s perfectly obvious that she is dying. The cancer is spreading. She doesn’t need more treatment. She just wants an easy way out. We all do.’
    ‘Yes, I know. You are quite right,’ I said, encouraging himto go on.
    ‘I reminded her that she had signed an advance directive years ago, and had renewed it annually.’
    ‘That’s interesting. Please tell me more.’
    ‘She has been an active member of the British Humanist Society – we are all members, the whole family – and voluntary euthanasia is high on their agenda.’
    ‘Euthanasia is illegal,’ I reminded him.
    ‘Yes, I know, but an advance directive saying that no more medical treatment should be given after a certain point, is not. It is perfectly within her legal rights to refuse further treatment.’
    ‘It is. But at what point do we begin withholding medical treatment?’
    ‘Now, of course. She is not going to get better. Anyone can see that. She’s had a good life, and she’s a good old age. The time has come to lay it down.’
    ‘But your mother does not see herself as being at the end of life.’
    ‘I can’t understand it. She was always so clear-sighted, so positive in her convictions. She knows quite well that treatment beyond the point of no return can frequently cause more suffering than the original disease. But now, she won’t accept it, and gets furious with me and humiliates me in public. She had a blazing row with Evelyn on this subject a few weeks ago. Evie told me about it, but I thought it was just another mother and daughter row. They’re always getting at each other, you know. Well, I’m damned sure I’m not coming in to visit her again, only to be shouted at.’
    He spoke in an aggrieved tone, and stood up to go.
    I told him that his mother was angry because she was afraid, and that she would probably get over it. I expressed the hope that he and Evelyn would both visit, because everyone needs the family to be there at the end of life.
    Immediately after visiting hour had finished, Mrs Cunningham called me over.
    ‘Get the consultant,’ she demanded, ‘I must speak to him. Get him at once.’
    I explained that a consultant is not on call at a moment’s notice,but that I would ask him to come as soon as he was free.
    She exploded with rage, and was very insulting to me, and to the medical hierarchy in general. She was creating a scene, and this was having a bad effect on the other women in the ward. I began to think that we might have to put her in a side ward after all.
    ‘Well, don’t let my son or daughter in. That’s an order,’ she shouted.
    The Chief came after supper, and I told him of the afternoon’s events. He sat, tapping his watch, before he spoke.
    ‘The Euthanasia Society has gained in influence as medical knowledge has been able to prolong life which, it must be said, is not always a good life. I will speak to her, and I would like you to be with me, as a witness, if nothing else. We cannot have this conversation in the middle of the ward, so ask her to come here, please.’
    Mrs Cunningham came to the office. I could see as she walked that her son was absolutely right, and that she was a dying woman.
    She confronted the Chief even before she sat down.
    ‘Don’t you listen to my son or my daughter. They’ll tell you not to let me have any more treatment. They hate me. They want to get rid of me, especially Evelyn.’
    She blurted it out, hardly pausing for breath.
    ‘There’s nothing wrong with me. I’m as strong as I ever was, but they want me out of the way. Don’t you listen to them.’
    She jabbed her stick in the air to emphasise her words.
    The Chief said that he would always listen first to the wishes of a patient.
    ‘But what if I can’t express myself? Then they will sneak in and twist your mind. They are very persuasive, and not to be trusted. I don’t trust doctors; they are all as bad as each other. I’ve signed up. They will use it. That’s what you want, the whole damned lot of you. I know what you’re up to. You