In the Midst of Life

like him, too, and see him as a grandfather; this would be a source of happiness to him in his old age. All these plans – and now it was not to be.
    A nurse was taking his pulse and blood pressure when I went into the ward. I told her to stay with him, and that I would return when I had completed my first night round in order to sit with him.
    I completed the night round and returned to Dr Hyem, takingwith me all the hospital notes and records from my office, so that I could write them up while I was sitting there. I told each of the nurses and the night porter where I would be, if needed.
    I sat behind the curtains in the dim, green-shaded light. I listened to the hushed sounds of the ward. Dr Hyem was no longer in pain. He was unconscious, or perhaps semi-conscious, and breathing slowly but deeply. His pulse was not perceptible at his wrist, but I could feel the carotid beat, very faint and irregular. His eyes were closed, and his expression peaceful.
    At ten o’clock we turned him, a nurse and I, and he seemed to be faintly aware of the movement. I leaned over him and said slowly and clearly, ‘Hello, Dr Hyem. It’s Jenny Lee. I am here with you, and I won’t go away.’ He made the faintest sound to indicate that he had heard and understood. I took his hand, and his fingers moved in response. Then he sighed and drifted into sleep again, or was it unconsciousness? Where are the boundaries in these states? Later, he was beginning to feel hot, so I took a cold flannel and wiped his face, neck and chest. Again a faint sound, a sort of appreciative ‘Mmm …’ on the outward breath told me that he knew I was there, and that he wanted me there.
    I have always been convinced that unconsciousness, in a dying patient, is not wholly without perception or feeling, or even thought. The dying, even to the last breath, know who is with them. Perhaps they drift in and out of awareness of this world and indifference to it. Perhaps they are entering, or perceiving, another world that we cannot see. Where does life begin, and life end? Where do two worlds meet, or is it an illusion? We will never know. Birth, life, and death are mysteries and it is fitting that we should never know.
    I sat with Dr Hyem for an hour or more. A telephone call came through, and briefly I went to another ward to answer a nurse’s request to check a drug, but returned to my friend’s bedside. He looked very peaceful, and I felt sure he would slip away before morning. The darkest hour before dawn is the time when the forces of life leave the body most frequently. After the tragediesand traumas of his life, I was glad that Dr Hyem was dying peacefully and painlessly.
    At about midnight, an urgent call came from the children’s ward. A baby who had been operated on for repair of a cleft palate was having breathing difficulties. I said I would come and asked a nurse to stay with Dr Hyem.
    The baby was choking and turning slightly blue. The night nurse had been feeding him water, but a little must have been regurgitated into the nasal cavities, making him choke. It was alarming, but not terribly serious. Holding him head down, patting his back to encourage coughing, and sucking out the fluid, restored normal breathing fairly quickly. The baby took no harm. However, one look at the nurse told me that she was in a far worse state than the baby. She was deadly white, shaking and sobbing uncontrollably. Not long before that incident a baby had died in a nurse’s arms, and the whole ward had been sad and subdued. No doubt the girl was thinking of that. She kept saying, ‘I don’t know what happened, Sister. I don’t think I did anything wrong. Was it my fault?’ I had to reassure her and told her it could have happened to anyone. I suggested she should sit quietly, cuddling the baby, for a while, and asked another nurse to bring her a cup of cocoa.
    With one thing and another, I was away from the medical ward for longer than was originally expected.

OPEN HEART RESUSCITATION
     
    (also known as Direct Manual Compression)
     
    I returned to the male medical ward to resume my vigil with Dr Conrad Hyem.
    Tread softly as you draw near to the bedside of a dying man, for the space around him is holy ground. Speak in hushed tones, with awe and reverence, as you would in a cathedral. Let not the mind engage in trivial thoughts. The awesome majesty of Death can only be met in silence.
    As I approached the ward, I was aware of light and commotion coming