In the Midst of Life

as I took her final gifts of flowers and a bed jacket, and told her that she could not be admitted. The reconciliation between mother and daughter, which would have eased Mrs Cunningham’s last days and consoled Evelyn in her bereavement, was denied them both.
    Mrs Cunningham’s mind and body could not withstand so much tension. The frenzied activity wore her out. She could no longer shout and scream, but she sobbed out of a sense of injury and injustice. She called upon God and wailed for mercy. Her terrified state of mind pursued her into her sleep and dreams, for the night nurse reported that she often woke in the night with a dreadful start and wept convulsively.
    Mercifully, it did not last too long. Gradually, her mind became clouded, as it usually does as death approaches. Movement, speech, perhaps even thought, required more effort than she could command. Her breathing, circulation, and metabolism slowed down. Death overtook her, and calmed her, and, at the end, she learned that there was nothing tofear.

 
     
    ‘Hope is not the conviction that something will turn out well, but the certainty that something makes sense, regardless of how it turns out.’
     
    —
Vaclav Havel, playwright and
    President of the Czech Republic,1993—2003

THE BROOM CUPBOARD
     
    The greater one’s experience of death, the more cautious one becomes in making a pronouncement. The ways in which people face death are as different as the ways in which we all live.
    Perhaps I should qualify this statement. The last ten to thirty hours before death are very much the same; a semi-awareness of space and time and people takes over, leading into a different level of existence, accompanied by peace and tranquillity. If left undisturbed, death is not an agony. It is the earlier period, the weeks or months, or even years of illness or ageing that are so different.
    Mr Anderson was consultant to a firm of international financiers. He was a very successful man, confident, self-contained, a person who needed very little amusement or even warmth – his work was enough, and filled most of his time and his thoughts. For relaxation he liked to go long-distance trekking in mountain ranges, sleeping in wooden huts and scrambling over rocks and riverbeds. It was a total change from his business life, and kept him fit. His private life was less successful. He had married a pretty girl whom he thought he loved, mainly because it seemed the right thing to do, but he had no idea how to handle women, and his wife soon left him for another man. He was not particularly upset, and enjoyed the freedom of a bachelor’s life.
    He had never had a day’s illness, and prided himself on keeping fit through his walking, a sensible diet, no smoking and moderate alcohol intake. He had no time for some of his business colleagues who ate and drank too much, smoked like chimneys, went everywhere by car or taxi and then complained about feeling out of shape. ‘What do they expect?’ he said to himself.
    When he developed stomach pains and felt sick, he was slightlyoffended – it shouldn’t be happening, he thought, so for a week he cut out rich meats and fats from his diet and ate only salads. Things seemed to improve, and he was satisfied that he had nipped the problem in the bud. But a week or two later the nausea returned, along with heartburn. He had heard of something called a hiatus hernia, but lots of people get hernias of one sort or another, so he was not particularly worried. He felt well in other ways, work was busy and he was planning his first trek in the foothills of the Himalayas. Life was too full and too interesting to bother about a little heartburn.
    But things did not improve, and so, a month later, he went to see his doctor, who examined him, and found an unexplained lump in the upper abdomen. He said that another medical opinion should be obtained, and advised a gastro-enterologist at the Royal Free Hospital.
    Mr Anderson was indignant.
    ‘But I’m busy! There’s a lot of work on, and I’m going to the Himalayas trekking in ten weeks’ time.’
    The doctor replied that they must get him into good shape for the trip, and wrote his referral letter.
    At the Royal Free, Mr Anderson was taken to theatre for a routine laparotomy with exploration, and possibly a partial gastrectomy (there were no electronic scans in those days). In theatre, the surgeon opened him up, took one horrified look at an intractable growth of carcinogenic material,