‘Because I can’t understand how you, any of you, can do it.’
‘Because we are trained to.’
‘But why start the training in the first place? From what I can see, nursing is such a filthy, disgusting job. Why should anyone want to do it, especially a pretty young girl – and some of your nurses are very young and very pretty.’
Such a statement gave me a bit of a jolt. I had never thought of nursing the sick as filthy or disgusting.
‘I can’t agree with you. Admittedly we deal with the clinical indignities and intimacies that sickness entails but—’
‘That’s what I mean. Some of these old men …’ he glanced around him fastidiously ‘… are in such a revolting state that I wonder how anyone can go near them, let alone do the work that you girls have to do.’
I tried to explain that each man was a person with a life, loves, dreams, hopes and beliefs, and that the illness imposed on them did not alter that in any way; in fact, illness intensified it.
‘I’ve never seen anything like it,’ he said thoughtfully.
‘No. Few people even think of what illness can lead to.’
As soon as I had said the words, I wished I had not done so. I did not want him to identify himself with the ‘revolting state’, as he had put it, of some of the men around him. People never see themselves reaching the terminal stage of illness.
‘I’m damned sure I couldn’t do it,’ Mr Anderson said emphatically.
An incident occurred in the hospital, and, for a while, everyone in our small, enclosed world was talking about it. Matron was a sweet, trusting soul who saw no harm in anyone. When a gentleman called at the hospital and announced that he was a representative of the British Patients’ Benevolent Fund and that the society wanted to offer the Marie Curie Hospital a television for the benefit of the patients, she fell for it. A charming conversation over coffee and biscuits followed and the gentleman was shown around the hospital, which he assured her was a most heart-warming experience. A suitable location for the television was selected, and the gentleman said that the cost of installation would be ten pounds – a very large sum of money in those days, far more than an average week’s pay.
Matron wrote out a cheque to the Patients’ Benevolent Fund, but the gentleman requested cash, because he said he would have to pay the electricians in cash. She swallowed that one also, and went to her petty cash box and handed over ten pound notes. They parted with great goodwill on both sides, and the television and electricians were promised to arrive that same afternoon. One need say no more. Matron had many fine qualities, but spotting a con man at three paces was not one of them.
The patients had all been told of the kind offer and those that were well enough were very excited. Televisions were expensive items in the 1960s, and few of our patients had even seen one. The afternoon wore on. Several patients and nurses eagerly looked out of the front windows, and Matron was a-twitter with expectation. But the minutes ticked by, then the hours, and no electricians or television set arrived. Five o’clock came, then five thirty, and still nothing.
‘Perhaps they will come tomorrow,’ said a hopeful voice.
‘Not a chance. He’s got his ten pounds. We won’t be seeing him again,’ said a realist.
‘It is disgusting,’ said Mr Anderson, ‘I despise such a man. Tell Matron that I will buy a television for the hospital, and pay for the aerial to be installed. I can enjoy it for a while, and when I am gone it will remain for the enjoyment of others.’
This was a very unexpected and generous offer, but I wondered about his use of the words ‘when I am gone’. It sounded as though he knew he was going to die.
Cancer can overwhelm the body with frightening speed. Although the radium treatment was probably reducing the growth in the abdomen, we could not tell to what extent without performing another laparotomy exploration. Mr Anderson was losing weight rapidly. He was a spare man, with strong musculature, but within a few weeks he became pathetically thin. He found swallowing more difficult, and waves of nausea frequently beset him after a meal. We gave him anti-emetics, which helped a little, but one day, as he drank the mixture, he said to the nurse, ‘This is not going to improve me, is it?’
‘Oh yes,’ she said brightly, ‘we wouldn’t give it to you if it wasn’t.’
‘There is only one thing that is going to help me,’ he said, ‘and that is work. My secretary is coming at two o’clock and I must go to my broom cupboard.’ He grinned at the girl.
Mr Anderson always dressed in a suit to go to his office. We thought at first it was an affectation to assert his superiority over the other patients, who usually wore dressing gowns, but as time went on we realised that it was to preserve his self-respect and sense of dignity. As he lost weight, the jacket hung loosely on his thin shoulders, and he had to make new holes in his belt to keep his trousers up.
Excepting the days when he had radium therapy, Mr Anderson went to work. He even went on the day following treatment, when we usually advised patients to stay in bed because they often felt very ill. He would struggle out of bed, and one could see him trying to control the nausea and dizziness flooding his head, as he shaved and dressed. He usually returned to the ward about lunch-time, looking somewhat better. Obviously, the work was doing him good.
Pain is associated with cancer, and as the growth encroached further into the stomach and duodenum, Mr Anderson’s discomfort increased. Pain is something we cannot measure. No one can tell when the level passes from inconvenient to severe, to unbearable, and we all have different pain thresholds. Mr Anderson’s was probably getting to the severe stage – we could tell by the look in his eye, by the intake of breath and biting of his lip, by a slight moan that escaped as he bent over to try to ease the abdomen. But he would not take any painkillers. He had tried the Brompton Cocktail on a couple of occasions, but it had made him so sick he would not take it again, and he adamantly refused any injections.
Putting on his suit was such a struggle that particular morning.
I could see the effort it was costing him and he gave a little gasp as he leaned over to tie his shoelaces. He remained bent in that position for some time, and when he sat up, his face was grey.
‘You really must have some analgesics,’ I said to him.
‘No, I can’t. I’ve got to keep my head clear.’
‘Then why not stay in bed for the day?’
‘I am expecting some important telephone calls this morning.’
‘Your secretary will be coming. Can’t he take them?’
‘No. I have to make crucial decisions. No one else can do it. And then there will be a lot of follow-up work.’
‘Surely it cannot be so important that it can’t wait until tomorrow?’
‘It cannot wait. A great deal of money is at stake.’
I gasped, almost unable to believe what I had heard. Money, of all things! What on earth would he do with more money on the brink of eternity? A man obsessed with money has never appealed to me, but because I saw him wince in pain I said gently: ‘You might be feeling better tomorrow.’
‘I will not be feeling better tomorrow, Sister, and you know that as well as I do.’
Our eyes met, and, for the first time, I knew that he knew he was dying. The game of ‘let’s pretend’ was over. I was greatly relieved.
‘So you know, then?’
‘Of course I know!’ he said savagely. ‘Radium is given for cancer. Do you think I’m a fool?’
‘Do you want to talk about it?’
‘Yes, but not now. I have work to do. We can talk later. The only question I really want answered is, how long have I got?’
‘That is impossible to answer. Accuracy can never be assured.’