In the Midst of Life (41 page)

At some point during the summer months she developed an infection of the lungs. ‘It’s an MRSA bug,’ I thought, ‘this will be the end.’ But it was not the dreaded MRSA. It was a treatable infection, and another course of antibiotics drove it away. Leah was back on form – on form for her visitors, that is. None of us knew what she really endured as the weeks dragged on into months.

A
long-stay geriatric hospital is not a place where any of us would like to end up. Leah was in a smallish ward of fifteen beds that were not too close to each other, but close enough for there to be no privacy. Most of her neighbours were confused in one way or another. Yet Leah never complained, not to me, at any rate. She did not become morose, in-turned or whiny – least of all did she succumb to self-pity. Her thoughts were always focused on those around her. ‘Look at that poor old soul over there. She cries all the time, poor soul.’ Or, ‘That woman over there came in last night. Her son came with her, a man of about fifty. He stayed all night, but he went after breakfast, had to go to work. It was good of him to stay for so long, don’t you think?’

The ward was chronically understaffed, and the nurses and care assistants were under great pressure, but they were cheerful and tried to maintain a happy atmosphere. Leah liked them, and knew all about their boyfriends, their children and their holidays. She was obviously popular. The worst thing for her was the boredom – ‘There’s nothing to do. The day is punctuated only by meal times, nothing else.’ Leah continued with her crosswords and books and knitting, which she adored, and I often took her a new commission to be knitted for someone else. Another friend, Suzy, had seen the same need, and also presented her with things to be knitted, until Leah had to draw a line – ‘Nothing more till after Christmas. I can’t cope.’

Leah’s reading would have been impressive for a woman half her age, but for someone of one hundred and two it was formidable. Moreover, she read without the use of spectacles. I saw her reading in hospital a history of Afghanistan in the twentieth century, upon which she commented knowledgeably; a biography of Charlotte Bronte, with a second for comparison; she read novels, biography, social history, poetry and occasionally a newspaper, but never a magazine. ‘I can’t waste my time on those things,’ she said.

She made the best of things with heroic goodwill, but it was not easy. ‘Nights are the worst,’ she said to me once. ‘I hardly sleep. Nights are very long.’

I am sure they were. To be awake, uncomfortable, and scarcely
able to move for hours on end must have been a torment. I asked her about getting a nurse to shift her position.

‘There aren’t any nurses overnight,’ she said. ‘Well, not what I would call a nurse. There are all these different women who come from an agency. You never see the same one twice, and they are so slow. I don’t know what they are supposed to do. They amble around, or sit chatting, but you can’t ask them to do anything, because they won’t.’

I thought of my own months of night duty as a student nurse, when we were constantly on the move in a ward of thirty beds.

‘But what about the night sister?’ I said. ‘You could ask her to get the nurses to move you.’

‘I haven’t seen a night sister since I’ve been here,’ she said simply.

The ward was hot and claustrophobic, but the summer wore itself away and autumn brought with it cooler weather, which was a relief. Many times X-rays had been taken, but, to Leah’s disappointment, each time they showed that the leg had not healed and the huge plaster could not be removed. She would have to stick it out.

In November, after five months of discomfort and immobility, it was finally taken off and a knee-to-ankle plaster was fitted. She was overjoyed, and when the nurses brought her a Zimmer frame, she practised walking with the zeal of a young athlete training for the Olympics. Finally, she went to a rehabilitation centre where, to her delight, she had a room of her own. There was a high staff/patient ratio there, and she had a lot of physiotherapy. At last, the short plaster was removed, and life skills were introduced, such as walking up and down stairs, taking a bath and shower, using the kitchen, cooking a meal. She was determined to succeed, and within a fortnight, after six weary months in hospital, Leah was ready to go home.

Leah was treated entirely by the National Health Service, and from my observation as a visitor, I would say that she received good treatment throughout. The ambulance emergency treatment on
the night of the break was impeccable, and the fact that she survived was little short of a miracle, and due entirely to her hospital care. Having been trained in the old school of nursing, when discipline was rigid, I was a bit shaken by the free-and-easy attitude of the nurses, but I think that is just my age – everything has loosened up in the last fifty years, and no one today would put up with the sort of nonsense that manacled us young nurses. There was, undoubtedly, a relaxed and cheerful atmosphere generated by the nurses. They sat on beds, chatted and laughed with the patients – things we would never have dared to do. I had the uneasy feeling, though, that no one seemed to be in charge, and I discussed this with Leah.

Leah agreed. ‘I’ve been in several different wards, both here and in the main hospital, and I could never have told you who was in charge.’

The main hospital was superior in every way to the long-stay geriatric hospital. But this has always been the situation. There is no point in looking back sentimentally and moaning, ‘It was better in my day.’ because it was not. The drama and excitement of surgery, acute medicine, emergency care, have always been the aspects of medicine that have attracted staff, and the career structure of the professions reflects this. An ambitious young doctor or nurse will rarely go into geriatrics if he or she wants to get on in the profession.

On the whole, I would say that things are probably better today than they were half a century ago. Staff shortage is no less acute, but at least Leah was in a ward with only fifteen other patients, and there was a reasonable distance between each bed. In my day, wards contained between thirty and forty beds, with about two foot of space between them.

Leah spent about four months in the geriatric hospital. In general, she was treated with kindness, courtesy and professionalism. The weariness and boredom of her situation she coped with in her own way, through mental activity and engaging with staff, who seemed to go out of their way to keep her spirits up. Quite simply, they were good to her.

Leah was discharged in December under the care of her GP, a district nurse and a home help. She occupied a beautiful ground floor flat in a large Victorian house that was divided into twelve. She was the oldest resident and everyone knew and liked her. Something akin to a reception committee was waiting in the hall to greet her when the ambulance brought her home. She was thrilled, and not a little touched, by all the attention.

However, she was basically alone, and had to manage. Indeed, it was what she wanted, as she was fiercely, almost aggressively, independent. Her grandson begged her to come and live with them in Israel, but she refused. It was pointed out that she could afford to pay a carer to live in for a while. ‘I should hate it,’ she replied. ‘I have to learn to manage by myself.’ And slowly and surely she did. Every step with the Zimmer frame was tortuous, every turn to get something from a cupboard or the fridge was frightening to watch, but she wouldn’t let anyone do it for her – ‘I’ve got to do it myself,’ she said. The neighbours, Suzy and Sandy, and her cousin, Carmela, did the shopping for her, and brought in cooked meals.

Predictably, the home help didn’t come up to scratch. ‘She just flicks a duster around the place, doesn’t do anything properly, but I suppose I will have to put up with her until.’ I can do it myself And once, ‘I was disgusted! I gave her my sheets to iron. I had washed them’ – and she had, God only knows how – ‘and she only had to iron them, and put them on the bed. When I went to bed that night, would you believe it, I found that she had only ironed the top and bottom of a folded sheet, and not opened it out to iron the middle. I have never been so disgusted in all my life! I had to get up at
11
o’clock, take the sheets off the bed and iron them
myself. I will never give her sheets to iron again – never.’ The thought of Leah stripping a bed, manipulating an iron and ironing board whilst clinging to a Zimmer frame, then making the bed in the middle of the night, sent a shiver down my spine. But I kept very quiet on that one. I have never ironed a sheet, to my recollection. My attitude is – if you can’t give a thing a shake and put it on the bed it’s not worth keeping! But I could hardly say that, could I? I didn’t want to end up in her ‘disgusted’ book.

Her social life intensified. She couldn’t get out, so people came to her. She revived her former bridge parties, and played with ferocious zeal, I was told. Bridge is a very difficult game, requiring a quick mind and memory skills. I resigned myself to being wiped off the Scrabble board, although she had the kindness to tell me my game was improving. I found, to my surprise, that I was concentrating fiercely, working out all sorts of sly strategies to outmanoeuvre her, but I never did, she was too quick for me. Then I realised, not at all to my credit, that I was getting irritated, and was determined to beat her. But the craftier I became, the more did she, and she was always one step ahead. Incidentally, she also kept the score, adding it up in her head as we went along. I tried score keeping once and got into such a muddle that she took the task from me without a word.

Steve and Sandy were very good to her, coming in each day to see if she was all right and if she needed anything. They had a baby who was between a year and eighteen months old at that time, and they brought him in to visit her every evening when he’d been bathed and was in his pyjamas ready for bed. Some toys were kept in Leah’s flat so that he could play. The two seemed to love their time together, and I have seen that little boy in the hallway, crawling towards her flat and lifting his hands up towards the door. Even after she had gone, he continued to do this for several months.

In February, Leah had her 103 rd birthday. The whole family, including great-grandchildren, came over from Israel. The flat was so full of flowers you could hardly move.

Leah was determined to do more things for herself. She started
by walking one hundred yards down the road and back, unaided. The next thing we knew she had been to Tesco, which was a quarter of a mile away. ‘I like to choose my own things. I don’t like people shopping for me – they always get it wrong,’ she said. In early March she said, ‘I’ve been up to the Town Hall today to get my bus pass. I will need it when the weather gets better.’

Then the ceiling fell in the bathroom. It sounded like an explosion. No one was hurt, but it broke the wash-hand basin into two pieces and cracked the lavatory pan. It would have been a shock to anyone, but Leah took it in her stride, and in the end my sympathies lay with the builders and the insurance men; the stick she gave them about repairs!

Her life force was incredible. She was absolutely determined to cope, and seemed to accept every difficulty as a challenge to be overcome –
nothing
was going to beat her. Nobody knew the mental and physical effort this cost her, no one saw the tears of frustration as muscular weakness took its toll, or the relief as she sank into bed at night. No one saw the effort it cost her to get up in the morning. She once said, ‘When I wake up, I can hardly move, my limbs feel so heavy and I ache all over. But I have to make the effort. Sometimes it takes me half an hour to get out of bed. Can you believe it? Half an hour just to get up!’ Then she would have a bath, which loosened her up, and, dressed, did her hair, creamed her face, and manoeuvred her Zimmer frame around several awkward corners to go to the kitchen for breakfast. It took her three hours. Many people twenty years younger would simply have stayed in bed and expected someone else to look after them. Not Leah – she would look after herself, thank you. Renewed pleas from her family to go to Israel were all rejected.

It must have been early June when Sandy from next door had cooked a meal for Leah and she said, ‘I don’t really feel like eating.’

‘Try it, dear, it’s nice.’

‘Yes, of course I will. It looks lovely. You’re very kind.’ But Leah couldn’t eat it.

Quite quickly after that, Leah suffered from nausea and
vomiting, and became constipated. ‘If only I could open my bowels I would be all right,’ she said. ‘What I need is an enema and a good clear out.’

I was sitting beside her. She didn’t look herself. I asked her if she would like a game of Scrabble. ‘I don’t think I could concentrate,’ she said. She moved a little and winced. ‘I can’t seem to get comfortable. This pain jabs at me, here and here.’ She pointed to her stomach. I felt the area. It was a mass of hard lumps.

The district nurse came to give her an enema. I met her in the hallway as she was leaving.

‘I am going to get her doctor to come and see her as soon as possible,’ she said.

‘Are you thinking what I’m thinking?’

‘I don’t know what you are thinking.’

‘I think she has cancer of the stomach and abdominal organs.’

‘I am sure she has,’ replied the nurse.

The doctor came a couple of days later, and arranged for a hospital scan, which showed a massive cancerous growth in the abdomen.

Leah spent a few days in hospital at the time of the scan, then came home, then went back to hospital for more tests, then was sent home again. She was not eating, or at best she was taking only a tiny bit of food, and she lost weight rapidly. She began to look very ill. Her grandson came over from Israel and stayed with her for a week. He put pressure on her to go into a nursing home. ‘I will not return to Israel and leave you alone like this,’ he said, ‘and if I don’t go back I will probably lose my job.’