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‘“No, I wanted to be alone with him, quietly, lovingly, giving him time for his soul to leave his body.”

‘“This is most unusual,” remarked the nurse, and gave me a very funny look. But I didn’t care what anyone thought. I knew that he was safely on his way to wherever we go after we die, and I left the hospital, happy.’

Counsellors tell me that, increasingly, they encounter guilt associated with grief in bereavement. This is often because most people die in hospitals and not at home, and those left behind feel they have let the loved one down. They feel a sense of shame that he or she died alone, in the care of strangers. In my own life, I know that I still feel guilty, after thirty years, that my poor mother died alone, even though I also know that I was forcibly prevented by a couple of strong orderlies from entering the resuscitation room in which she died. In contrast, in 1996, my mother-in-law died at home in her daughter’s arms, and she described this as a beautiful, peaceful death. My sister-in-law was very close to her mother, but her bereavement has been eased by the knowledge that she did her duty, with love, right to the end. When talking about it, she repeatedly uses the word ‘beautiful’.

Many hospitals, and all hospices, now try to offer support to enable people to die at home. Support for the relatives, I mean, because it is not always easy, especially if the last stages of illness are prolonged. To be able to die at home is what most people want and, if it is possible, close relatives want it also. There have been many attempts to reverse the national trend towards a hospitalised death in recent years, such as the National End of Life Care Programme, the Liverpool Care Pathway, the Gold Standard for the Care of the Dying. Every hospital trust now has such a policy in place.

Charles, an old friend of mine, died at home in December 2005. His wife, Dorothy, was with him.

Talking with a widow shortly after her husband’s death can be a moving experience. There is no pretence, no effort to make an impression, just the loss and the depth of memories. Sentences are broken, disjointed, started and not finished. Thoughts are random. I will use Dorothy’s own words as I wrote them down:

‘He had prostate cancer twelve years ago, but recovered, and was active till nearly the end … but in July I could see that he was going down in health … he had no pain … it was a big effort for him to do anything … no pain … just weariness … he didn’t realise at the time that he was dying … the pain only started on Sunday … perhaps the cancer had come back … I don’t know … the Macmillan nurses came and he had morphine patches… slow release, you know … very good, very effective … on Thursday he was worse, and he said “I think I am dying” … I said, “Don’t worry, I am with you and will stay with you” … but on Friday he was bright and breezy … until the last day he went to the lavatory by himself, with a Zimmer frame, you know … and he shaved himself… his hand was steady … the weather was beautiful, really beautiful… he went to the window and looked at the sun on the garden and said, “The world has never seemed more beautiful … I want to take a photograph, and you can remember our last days” … I fetched his camera, and he took five pictures… I have them here … they are beautiful … then he went back to bed … he never got up again … he knew he was dying … he had said many times, “If I have to go into hospital I will find a way of killing myself” … I had already promised him that he would not, because I would look after him … the doctor came that day and said he would probably live another two or three weeks but I said no, he is dying … I can see it in his eyes … Friday night he wanted no supper, and he wouldn’t drink, either … it was a terrible struggle to get him to take even a few sips of water … I could see by his eyes he was going, and I called the children … I have a son, three daughters and six grandchildren … One of them said she would stay with him during the night, whilst I got some sleep … at three o’clock she woke me up and said, “He is dying, you are right, his breathing is very slow, he is going” … I held him, saying over and over again, “Go in peace, don’t worry, you are safe, go in peace” … I kept saying these things all the time … he heard me and understood … he knew he was dying … his breathing was getting slower … slowly, slowly, he went away … After that I didn’t leave him … he was not conscious, but I kept saying, “Go in peace, my love, don’t worry, everything is all right, go in peace” … and slowly, slowly, he went away … and his breathing stopped at eleven thirty in the morning … it was a beautiful day, the sun was streaming through the window … it was a beautiful death, too … we laid him out… a day or two later I found a note in the drawer of the cupboard beside his bed … it read, “I hope the love I have for you will linger on and support you through the last years which I had so longed to share with you …” (She showed me the note, written in spindly, shaking handwriting.) … he must have written that for me a few days before he died … so you see, he knew he was dying … we were married fifty-two years … it was a perfect ending … I am not sad … lonely, yes, but not sad.’

Then Dorothy told me that one of her daughters arrived with her son, a boy of thirteen, after the death had occurred. The boy said, ‘I want to go into the bedroom to be with Grandfather for a while. Don’t come in, any of you. I just want to be by myself, alone with him.’ He shut the door, and ten minutes later, quietly and solemnly, came out. But he never said a word about his thoughts and feelings.

That boy showed a maturity and wisdom beyond his years. He faced up to death in the only way that is meaningful – by being close to it. It was an act of love, but also an act of sound common sense, which some instinct told him was necessary. He voluntarily drew close to death, and was not afraid, an experience that will stay with him as he grows and matures.

The last words of the last monastic office of the day are, ‘Lord, grant us a quiet night and a perfect end.’ It is something that we can all pray for, but it is something that we can in no way command, because, at the end we are entirely dependent on the love and goodness of others.

The turning point in many lives is bereavement. Many have channelled their grief into activities for public benefit, and this has helped them transform bad into good. For example: Philip Lawrence, headmaster, was murdered outside his school in 1995, while trying to defend one of his pupils from an attack by a gang from another school. His widow set up an award scheme for good citizenship by young people, and works towards this aim.

In 1863, after her four-year-old daughter fell downstairs and broke her neck, Josephine Butler started working with young girls dragged into prostitution, and her lifelong work led to the repeal of the Contagious Diseases Act in 1886. There have been many examples of courageous and life-changing activities of lasting value inspired by the trauma of bereavement.

Facing death induces us to see life through new eyes; our perspective is altered, sometimes profoundly. Most of us live a headlong existence, so we are too busy to question the meaning of life. Suddenly all is changed, all our values are open to question and doubt. Even those who are non-believers begin to search for answers to questions like, ‘What is the meaning of life?’ ‘Why are we here?’ ‘What is life?’ ‘What is death?’ Bereavement leads some of us to think that there must be more to life than that which is concrete and visible, and we find there is a larger, deeper purpose than we had ever suspected. For some, asking these questions, even though there can be no positive answers, can transform their whole way of living.

1965

STROKE