I led her to the side ward. Two nurses were there. They had washed Mrs Doherty and changed her nightie and managed to get her out of bed to sit her in a chair. One of them was on her knees on the floor, adjusting Mrs Doherty’s feet to rest on a footstool; the other was tying a bib round her neck to catch the saliva as and when it dripped. Her body slumped to the right, in spite of the pillows they had placed to try to keep her upright, and she looked up as best she could by moving her head and raising her left eye a fraction. She obviously recognised her daughter, because a gurgling sound came from her throat and she moved her left arm in greeting.
Priscilla did not say a word. I opened the window a little, and one of the nurses looked at me questioningly. Should they attempt to give Mrs Doherty her morning drink? We understood each other without a word being said – this woman was undoubtedly intimidating, and would probably be critical. To attempt to give a drink to her mother, even from a feeding cup, would probably be repellent to her. No morning drink. Not yet, anyway.
One of the nurses placed a chair beside Mrs Doherty. I asked Priscilla if she would like a cup of coffee, but she shook her head. She still had not spoken. We left the room and shut the door.
Five minutes later she came out and asked to see me. The confidence, the assumption of superiority, had been knocked out of her.
‘This is a bad business, Sister.’
‘Your mother has had a severe stroke, which is always distressing to see.’
‘I was not aware it would be as bad as this.’
I refrained from saying that she did not look nearly as bad as she had a fortnight earlier. Instead, I said, ‘Your mother is making progress as well as can be expected.’
She turned suddenly, almost angrily. ‘But she cannot speak!’
‘No.’
‘She can only make gurgling noises.’
‘The side of her brain controlling speech has been affected.’
‘Well, what are you going to do about it?’ she demanded.
‘There is very little we can do, apart from physiotherapy, to encourage the healing powers of nature.’
‘Healing powers of nature! Is that all you are doing? There must be some drugs she can have. What about all the miracles of modern medicine we hear so much about?’
I thought how the miracles of modern medicine can prevent someone dying from a stroke, but cannot restore the loss of speech nor the loss of muscular control that are its legacy.
‘I must see the consultant. I must discuss what can be done about this distressing situation.’
I was explaining again that Miss Jenner was not expected on the ward until the following day, when I heard a familiar voice in the corridor. ‘Excuse me a moment,’ I said, and went out. It was Miss Jenner.
‘Hello, Sister. We closed theatre earlier than expected, so I thought I would just pop down to see how Miss Patterson is getting on. Perhaps that drain can come out. And if you can find a cup of coffee, that would be nice.’
I told her that Priscilla, Mrs Doherty’s eldest daughter, was in the office and wanted to speak to her.
‘I’ll see Miss Patterson first, then have a chat with her.’
A little later, before we parted for lunch, I caught up with Miss Jenner, and she told me what Priscilla had said. ‘She seems to think that we can restore her mother’s speech and movement by drugs. It astonishes me, the ignorance of the most fundamental medical facts that intelligent, well-informed people sometimes display.’
‘Very true,’ I laughed.
‘She seems to think that because we have not already done so, we are being negligent, and have missed an obvious point.’ She shrugged her shoulders despairingly. ‘I don’t know what she thinks we should be doing, but she is demanding another medical opinion.’
‘And will you get one?’
‘Well, I shall have to get a geriatrician’s assessment for her mother. She can’t stay here indefinitely. This is an acute surgical ward. She will have to go to the geriatric ward. That will give her daughter the second opinion she requires.’
Miss Jenner sighed deeply. She was a lady in her fifties, about twenty years older than I was.
‘It used to be so much easier in the old days. When I was a medical student it was not expected that anyone would survive a massive cerebral haemorrhage. All the medical textbooks, all the lecturers, informed us that death would result within a few hours, or at most a few days.’
‘I doubt if anyone would say that now.’
‘Oh no!’ Miss Jenner said emphatically. ‘No one would dare to say such a thing. They would be in serious trouble. It is a very dangerous subject.’
Miss Jenner left, and I sat very still at my desk, my mind going back about twelve years. Miss Jenner had used exactly the same words that Matron Aldwinkle had used when I was a student nurse – ‘This is a dangerous subject.’
A FAMILY DIVIDED
The geriatrician came to assess Mrs Doherty and advised a rehabilitation centre. Miss Jenner said that the patient could not remain for long on the acute ward, and asked if a bed could be found on the geriatric ward until rehabilitation. It was not easy – there were too many patients and too few beds available. The consultants both knew the difficulties. ‘We’ll ask the medics. They have more of a turnover than we do.’ The medical registrar came to see Mrs Doherty and said that a patient with colitis would be discharged at the end of the week and a bed could be available.
Miss Jenner saw Priscilla and told her that two specialist opinions had been sought and that her mother would be transferred to a medical ward for treatment for the aftermath of a stroke. Following on from this, her mother would go to a rehabilitation centre. The woman seemed satisfied with this and said, ‘I will reside in London until next week, and then I must return to Durham.’ Then she said, very formally: ‘On behalf of my family I would like to thank you, Miss Jenner, for saving my mother’s life. You obviously acted with great skill.’
She turned to leave and had to pass her mother’s door. She put her hand on the handle, and paused. One could almost feel the indecision going on in her mind, her sense of duty telling her she should go in, yet opposing that, her fear of seeing her mother, of not knowing what to do or say. She half turned the handle, then released it, and started to walk away. At that moment Maggie came round the corner with an armful of flowers.
‘Priscilla! You old stick! You didn’t tell us you were coming in this morning. How is she?’
Priscilla hesitated before answering. She looked exceedingly discomfited, and then said truthfully, ‘There is no change.’
‘But is she awake? Was she glad to see you?’
Priscilla could not answer. Her nostrils closed to narrow slits and her shoulders tensed.
‘Priscilla!’ Maggie was furious. ‘You are impossible. You came here to see the doctor, not to see Mummy. How could you?’
‘Don’t make a scene here in the corridor, with everyone listening.’
‘I don’t care if the whole world can hear me! Dear Mummy, lying there ill, and you don’t want to see her.’
‘Stop this behaviour. We will go in together.’
She opened the door, and they entered. The staff nurse and I looked at each other.
‘Wow, that was a near thing!’ she said. ‘We don’t want them fighting here in the corridor. You see it all in this life, don’t you, Sister?’
I could only agree.
We had a busy morning. There were five cases for theatre. That meant preps and pre-meds, calling the porters, arranging for nurses to escort patients to theatre and, afterwards, back to the ward, post-ops to be received and cared for, and student nurses to be taught the details of post-operative nursing. I was thankful to have a very good staff nurse, who was highly experienced and loved the drama and excitement of an acute surgical ward. She was indispensable on such a morning.