In the Midst of Life

her die quietly. However, I must do a lumbar puncture to diagnose the cause.’ This she did, revealing abundant blood in the spinal fluid, which was diagnostic of a cerebral haemorrhage.
    We contacted the next of kin. Jamie left work at once and came to the hospital, but Priscilla was in Durham, and Maggie was on an assignment. The consultant surgeon, Miss Jenner, explained to Jamie that the prognosis was uncertain, but that a craniotomy could be performed to open the skull and suck out the blood and fluids that had collected and would be causing pressure inside the cranium. It might also be possible, she said, to locate the origin of the bleeding and tie it off.
    Jamie looked alarmed, and Miss Jenner explained that opening the cranium is not all that difficult, and trephining the skull had been performed since pre-Roman days, and that sucking out the blood is not a lengthy business and would certainly relieve pressure on the brain, which was essential if Mrs Doherty was to stand any chance of recovery. (Miss Jenner was a general surgeon. What shesuggested was not brain surgery, for which a specialist brain surgeon would have been required. Also, a general surgeon in the 1960s had a far wider role than today.)
    Jamie was asked to give consent for the operation. He hesitated. ‘I am not sure that she would want it. She wouldn’t want to be debilitated, I am quite sure of that. She is eighty-two, she has had a full and active life, and to go, while she is still getting about and enjoying herself, is what she would want.’
    His words raised an element of doubt in Miss Jenner’s mind. ‘This is always a difficult moment, probably the hardest you will ever have to face. To treat or not to treat. To leave well alone, or to intervene. But I assure you, that if we do not operate quickly your mother will die later today.’
    Poor Jamie. What a situation! And the decision was on his shoulders. His instinct said ‘leave well alone’, but he couldn’t bring himself to say it. He needed help. ‘I must speak to my sister. I will ring her office; please God let her be there.’
    He went and telephoned Priscilla, who was at her desk. He explained what had happened, and what the consultant had said. Priscilla was unequivocal and immediate in her response. ‘She must be operated upon. You must sign the consent form. We cannot morally, or even lawfully, as far as I know, withhold from her the chance to survive.’
    Jamie did not hesitate to give his consent for operation.
    He remained in the hospital, and spoke again at length to Priscilla, who said that she could not come to London until the work she was engaged in had been concluded. She did not want to pass it to her junior, and, as there was nothing she could usefully do in London, she would remain. Jamie contacted his other sister, who sobbed uncontrollably when she heard the news. ‘Darling Mummy, my poor darling. I’ll come at once.’
    The day dragged on, and the hours hung heavily for Jamie. His mother had looked ghastly when he saw her. She had appeared to be dead, but obviously was not, because she was taking in great noisy, sucking breaths, horrible to listen to. At the same time, the competent matter-of-fact attitude of the hospital staff had reassuredhim. She would be all right; she was a tough old bird, he told himself.
    The operation was done under general anaesthetic. The cranium was opened, and blood and serum sucked out, but the source of the bleed could not be found. X-rays were taken from every angle, but were inconclusive. Clinical signs suggested that the bleed was in the left side of the brain, but natural clotting had halted the flow. No further probing would have been appropriate, and so the piece of skull bone was replaced, and the wound sutured. Mrs Doherty was returned to the ward.
    We had prepared a side ward to receive her and she was lifted on to the bed. Her breathing was quieter, but very slow, and in other ways she looked worse than before, because her head had been shaved. The bandages on her skull were deeply bloodstained, because there are numerous small vessels on the scalp, and they bleed profusely. Two draining filaments had been left
in situ,
and were sticking out. She was attached to two drips, one blood, one saline, and a laryngeal airway for continuous oxygen. Frankly, she looked barely human.
    Nurses are accustomed to these things, and we were neither surprised nor alarmed, but Jamie was still in the hospital, and wanted to see