Growing Into Medicine (26 page)

On the second occasion Ralph took Cassie for a walk he sprained his knee and the excursions never resumed – but he could walk into the town to buy tobacco for a variety of pipes. He stopped smoking at frequent intervals but was always so miserable that I had difficulty waiting in silence during the few days before he restarted. Although I hate the smell of tobacco now, at that time I trained myself not to notice. After he died I buried my head in his tweed jacket, straining to reach a whiff of memory, with as much effort as Cassie strained for her stolen food.

Thus I have come to the moment I can no longer avoid – the plunge into the well of memory that leads to widowhood. 1990 was my
annus horribilis
, despite the fact that it started so well with the safe birth of Alec, my first grandson. Six weeks later Jimmy Matthews died suddenly of a ruptured aortic aneurysm. In November Ralph had a heart attack. He had spent a restless night, feeling sick and uncomfortable but not complaining of severe pain. As soon as it was time for our doctor’s surgery to open I phoned and asked for a visit. ‘If he says it is just indigestion I will smash his face in,’ said my husband who, since his discharge from the army, had never raised his hand to anyone, and who could not kill a wasp.

Our GP had just come in from another urgent visit and was about to start morning surgery. I had an image of his waiting room filling up with restless patients. ‘Do you want to see a few before you come?’ I suggested, identifying with his predicament. ‘I could give Ralph an aspirin in case it is a heart attack.’

Luckily he heard the panic behind my words and was on the doorstep within a few minutes with his ECG machine in his hand. The tracing confirmed our fears. Dr King stayed with me until the ambulance arrived to take Ralph to the Intensive Care Unit at the Royal United Hospital.

The treatment he received was meticulous. He was quite poorly for several days. I remember sitting with Helen in the small relatives’ waiting room, unable to let go of her hand as she tried to comfort the mother of a boy who had crashed his motorbike and suffered a
severe head injury. Corralled in the bubble of my own pain and anxiety, I could not utter a word.

During his time in hospital Ralph turned to Helen for comfort and reassurance. He relied on her medical knowledge and trusted her in a way he never trusted me. She was wonderful, bringing small offerings each day but more importantly just the reassurance of her presence.

After about three days the various tubes were removed from his body. I was sitting by his bed when the nurse in charge (she was probably no longer called a Sister) asked if anyone had washed his feet. When he said no she fetched a basin of water and descended to the floor.

‘Surely you must have a minion who could do this?’ Ralph asked. ‘You are much too senior for such a lowly task.’

‘Good enough for Jesus, good enough for me,’ came the reply, as she soaped between his toes.

When he was eventually moved onto a general ward the contrast was harsh. Here, we could have entered a third world country. The floor was not very clean with the beds close together, the room crowded with visitors who arrived early and stayed all day bringing food, flowers and titbits of gossip to entertain their relatives. The ward was for diabetics and the ever-changing staff had no idea how his exercise level should be graded after a heart attack. I tried to work it out with Ralph, not sure if I should allow him to walk to the toilet or fetch a wheelchair, uncertain when he should be encouraged to try a few stairs.

One kind act stays in my mind. A bed next to the window became vacant and a nurse suggested he might like to move into that privileged place. The change made an enormous difference to his comfort. Now he could turn away from the people and the noise and let his eyes travel up to the skyline where clouds moved, fast or slowly depending on the wind, in ever-changing patterns.

I never wrote the letters of thanks that I planned to the intensive care staff or to that nurse who had noticed that he was suffering, perhaps more than some of the others, a hermit confined in close proximity to a sample of seething humanity.

His stay was made worse by the fact that it was a mixed-sex ward. A few years before he had been admitted to a male ward for an operation on his Dupuytren’s contracture, a thickening of the tissue in the palm that pulls the fingers into a claw. I had been afraid he would find a general ward difficult but when I visited a few hours later he was in charge of the tea trolley. ‘Over here, Gov,’ the men were calling. ‘Two sugars for me, Gov.’ He was back in an all-male society that he understood, and had instinctively taken the role of the officer caring for his men.

A couple of days before he came home after his heart attack, I was standing at the sink thinking that the one person I would like to see was my sister. The idea startled me for we had never been very close. In my despair I was searching for some contact, any contact, with the world of my childhood where I had been safe and where it never occurred to me that any tragedy could touch my family.

I turned from the dishes – and there was Biz walking in at the front gate. Her husband Jim had insisted she came to support me and she had leapt onto a plane in Virginia and come. Surprise and gratitude overwhelmed me.

Where Americans are able to show their sympathy, our British reserve makes it difficult. I am ashamed of the time when I did not visit a relative whose husband was dying of dementia at an early age. I had told myself that there was nothing I could do. Now I know that just being there is something – only cowards are paralysed by their own inadequacy.

Biz stayed for a few days making welcome-home posters for Ralph. After his return home she peeled vegetables and disappeared to her room at appropriate intervals. When she left I was torn between the wish to spend time with him and my duty to return to work. Helen insisted I stay off for at least six weeks and ever since I’ve been grateful to her for helping to solve that dilemma. Those six weeks were very important for us a family. We had the baby Alec to stay while his parents had a night away. Ralph was afraid to pick him up, as he had been all those years ago with Helen. He had not met a baby since that time, thirty years before. But he would kneel down
and make faces and baby noises to entertain his grandson whenever I left them together. One picture remains vividly in my mind. After taking Alec into our bed in the morning, I had gone downstairs to make a cup of tea. When I returned the two chaps were lying in our big bed, their heads side by side on the pillow.

Supported by Helen, we grew very close. Ralph read poetry, sometimes aloud. He took short walks in the garden, a place he had seldom ventured when he was well. Until that time he had declared that he would be happy with green concrete. After six weeks he died suddenly, sitting in his chair. Again, I planned to write to the hospital to explain that, although they might feel his death so soon after discharge from hospital had meant their efforts had been in vain, the importance of the time they gave us could never be explained in words. Perhaps this was the reason the letter was never sent.

Much has been written about bereavement, yet my experience suggests that the advice is often misplaced. ‘Stages of grief’ have been described, with rules for the time each stage should take. My sense is that there are no rules, every person survives, or does not survive, in their own way. Talking to friends who have lost their partners we agree that the complete process can take up to six years, perhaps even longer for some. Until the end of that time I felt that part of me was still buried with his ashes in the crematorium. I would sit up in bed after I woke, my favourite place and time for remembering, weeping and putting some thoughts onto paper. On the sixth anniversary of his death I wrote a poem and when it was finished I knew I had dragged myself out of his grave and was now a whole person again.

Looking back from my vantage point twenty-one years later I wonder if the poem was the result – or the cause – of the healing. At the time I had been in analysis for four years. I had cried during much of my time in that room, without being clear what I was crying about. In the rare sessions when I did not cry I was left parched, as if the day held no possibility of new life, like the dry, infertile days of the menstrual cycle. As far as I can understand it now, much of the
work had been concerned with differentiation from my mother, a necessary step in the process of separation from my husband. Writing this memoir and reliving some of the past has extended that process. . . I am free to love him with even more of myself.

During this period there were of course times when I forgot and could enjoy immediate activities. These intermissions became more frequent and the time between patches of hopelessness grew longer. I was only sixty-two when he died and still had enough energy left over from grieving to devote to the struggle back to a new life. Very old people with reduced energy levels find the effort doubly hard and I am not surprised that many die within a short time of their loved one.

I had dealt with day-to-day family finances all our married life so the practical tasks of paying bills and running the house were no burden. More difficult was deciding what bread I wanted to buy. As with all food, Ralph had been fussy: square, processed white or nothing. I wandered round the supermarkets with no idea what I wanted to buy. In the end I closed my eyes, walked a few paces and reached for the first loaf I touched, only putting it back if it was square and white.

With little understanding of my motives I found myself making a collage of four women and their babies from sixty years of photos kept jumbled in a suitcase. In the top left-hand corner all generations are shown together. My grandmother sits on a garden seat holding Helen, a few weeks old. I stand behind in a floral summer dress, inherited ivory beads round my neck, which I seldom dare to wear in public. The killing of elephants for their tusks is quite unacceptable but this material was culled many years ago and I can’t put it back. Luckily it never occurs to people to consider that it is anything but synthetic. The line of my gaze blends with that of my grandmother, both of us besotted with the baby. My mother also sits on the seat, looking straight ahead with a stern expression.

Below this generational group are pictures of each woman with her offspring. My mother at about two years already looks rebellious. Where she is holding me I can just make out an arm round my
waist, she would not actually wish to drop me, but the more obvious hand is reaching down to her beloved dog Jimmy by her side. In other pictures two toddlers sit on different doorsteps. One is myself with curly hair, looking happy. Once, on being shown a picture taken by one of my mother’s friends, I had burst out, ‘But I was a pretty child.’

‘Of course you were,’ my mother snapped, ‘but we would
never
have said so to you or anyone else.’

Helen, on her doorstep, has very short hair and could be mistaken for a boy. Her expression is searching and not easy to read. Next to that image she is smiling as she holds her own baby aloft, the most joyous mother of us all. The men are all present but mostly in the background. The only way I can understand my obsession at the time is to notice the emphasis on babies, as if in the presence of death I needed to remind myself of the cycle of life and the possibility of new beginnings.

My career did much to help me through those years. Most evenings when I returned from a family planning or psychosexual clinic I found a message asking me to lecture, not only to doctors on family planning courses but to a variety of nurses and other health professionals. The first talk I had ever given was to a group of officers’ wives at Pollington when we were first married. I had been ridiculously nervous. The pill was not yet freely available so I dealt with barrier methods and periodic abstinence. I used to blush furiously and had none of the ease that developed as I became more familiar with the subject.

Once I moved onto subjects related to the emotional aspects of sex I began to enjoy the discipline of preparation. First, I would write the lecture out in full and read it through several times to memorise as much as possible. Then I summarised the themes onto cards, highlighting particular phrases to remind me what came next. I was determined not to read any presentation. The task of holding the attention of an audience is easier with eye contact. Although sex is a fascinating topic there were often two or three listeners who
thought all this ‘psych’ nonsense was a waste of time. They would do their utmost to rubbish whatever I was saying and I had to use the more sympathetic members of the audience to argue my case for me.

During the time I was adjusting to a solitary life I was busy looking for a publisher to take on two more books that Jimmy and I had been planning. We had asked Rosemary Lincoln, a psychosexual colleague of mine, to edit another multi-author book. She selected a wider range of contributors than I had used and I felt the book was an important addition to the scant literature on psychosexual medicine. Both Rosemary and I had the advantage of hearing papers given at IPM clinical meetings and drawing on the expertise of the best speakers. (I have already quoted from Judy Gilley’s chapter on intimacy and terminal care.)

The second book in the planning stage was called
Sexual Abuse and the Primary Care Doctor
by Gill Wakley. She points out that within the population of any one practice there are likely to be a handful of children currently being abused, but large numbers whose lives have been blighted by past experiences. She covers many aspects of relevance to the work of a general practitioner.

Jimmy had died before he published either of these books. After hawking them to a number of other publishers I found an editor at Chapman and Hall who showed some interest. She was a retired nurse. I would have preferred to see it promoted especially for doctors but had to make do with a list designed to appeal to a wider medical audience. At least I now had a professional publisher interested in the subject. Alas, they did not sell particularly well. Like others in the series they barely covered their costs, which saddened me for I considered them important – but I was biased.