In the Midst of Life

can’t fool me.’
    She was becoming irrational. Evidently this business of an advance directive had been playing on her mind to such an extent that she couldn’t thinkstraight.
    The Chief explained that an advance directive had no legal validity whatsoever, and was certainly not binding on the medical profession; but either she did not hear him, or could not take it in.
    ‘The best treatment is what I demand. Forget James and Evelyn. They are ignorant, prejudiced, stupid …’ She rambled on, repeating herself, contradicting herself. We listened to her tirade, and the Chief again told her that she would have the best treatment available. Unconvinced, but unable to say more, she returned to her bed.
    From then on, Mrs Cunningham’s whole existence became paralysed by fear. Her fear of death amounted almost to madness, and an overwhelming feeling of helplessness rushed in upon her. She was lost; she panicked; she prayed to a God she did not believe in; she lost control; she screamed for advanced medical treatment, and railed that treatment was being withheld because James and Evelyn had influenced the doctors. Craven fear had roused her whole mental machinery to a state of agitation that had taken away all fatigue, all possibility of sleep, all sense of self-respect. It was a distress impossible to soothe. Drugs could have helped her, but if we went near her with a syringe she screamed uncontrollably that it was all part of the plan to do her in. She was beside herself with terror, and this reduced her to a jabbering wreck, devoid of all self-control and dignity.
    We had to move her to a side ward, because of the effect she was having on other patients. She shouted that she knew why we had put her there; it was because of hospital secrecy. She knew what we were up to; all doctors were rogues and nurses were hand in glove with them. She demanded to see her lawyer, the police, her Member of Parliament. Her mind was obsessed, and nothing could divert it.
    The laboratory report on the blood tests returned. Widespread metastases of the cancer were evident. The radium treatment should be started, but the Chief hesitated, because with the malignancy circulating through her entire body via the venous and lymphatic systems, it would probably be ineffective and would bedistressing to her for no benefit gained. But she became hysterical and screamed that we were
deliberately
withholding the treatment she had been promised, and which it was her right to receive. So the Chief ordered a low dose, by way of a placebo. But when she was wheeled on a trolley to the treatment rooms, her fear became uncontrollable. In those days the radium treatment was carried out in a huge machine, into which the patient was wheeled, and the machine closed. She got halfway in, and then panicked. She shouted that we were putting her into a coffin to dispatch her while she was still alive. She thrashed about, and beat the sides, screaming for release. All the radiographers could do was return her to the ward.
    Poor lady. She was so weak, and she was dying, but fear possessed her and filled her failing body with an agitation that allowed her no rest, day or night. She was suspicious of everyone, and the room seemed reduced in size by her wakeful, watchful eyes. It was pitiful to see, and impossible to calm. She would take no drugs, not even sleeping pills, and then she accused us of withholding essential treatment.
    Illness is a revelation; one sees things one has never seen before. We saw, in Mrs Cunningham, a manic fear of death, which was not fear of cancer, because she did not believe she had it. Her fear was that death would be forced upon her because that was what she had always said she wanted. Day by day, hour by hour, she anticipated it, and the waiting nearly drove her mad. In fact, I think it
did
drive her mad.
    Illness can also bring a flowering of love between people. That is one of the reasons why nursing is such a wonderful profession – we see these things. But for poor Mrs Cunningham, love was denied her at the end. She was convinced that her son and daughter were going to implement the advance directive that she had signed and re-signed. The idea was nonsense, of course, everyone knew that, but you cannot reason with obsession.
    Evelyn came to the hospital several times, but her mother would not see her, and told the staff to ‘drive her away’. True to his word, James did not come again, but I have memories of Evelyn’s sadface