Finally a consensus was reached demanding that Mr Fox call a referendum and allow the elders of Serenity House to register their feelings whether for or against the Anschluss he proposed.
Mr Fox objected to the word Anschluss because of its regrettable historical associations. ‘As the end of the century approaches,’ said Mr Fox, ‘we have the chance of going forward towards the year two thousand, enriched by our association with a chain of like-minded eventide refuges reaching across the continent of Europe. Or going it alone. The train is about to leave the station. Will we be on it? Or will it leave us behind? I am determined that the elders of Serenity House will not only be on that train bound for the future, they will be in the driving seat!
‘Let me give you some idea of the problems we face if we listen to siren voices urging us to miss that train. Between nineteen eighty-seven and two thousand and twenty-seven, the numbers of those aged sixty to seventy-four will rise to ten and a half million. There will be another five and a half million people over seventy-five. And elders over eighty-five will climb in number to well over a million. On retirement, according to recent studies, a man can expect to live to 78.4 and a female elder to 81.2.
‘How are we to care for our seniors? The Government already faces diminishing resources. More and more elders scrabbling for crumbs from an ever-smaller cake. If life expectancies continue to rise, and I’m afraid they show every indication of doing so, then elders across Britain face a bleak time of it. I dread to think of Serenity House early in the next millennium.
‘As to the question of a referendum, I have to tell you that I see no need. Management has gone into the question of joining Age Without Frontiers. Management has a duty to manage and I have decided that this is a purely administrative decision.’
They heard him in silence broken only by the Reverend Alistair’s soft snores and the occasional liquid spatter as one of the Incontinents lost a catheter and Imelda had to rush to the rescue.
*
In fact Mr Fox was not entirely sanguine in his expectations of the coming association with Age Without Frontiers. His conversations in Cologne had alerted him to the rather disagreeable realisation that Serenity House had some way still to go if it was to compete with the facilities offered by some of the continental eventide refuges. Serenity House suffered from a shortage of skilled staff. A legacy perhaps of Cledwyn Fox’s unwillingness to invest in training programmes. The fabric was old and infested with vermin, cockroaches and mice being especially troublesome; repairs to the roof were long overdue. Profit generated consistently fell short of running costs.
The elders, too (fond of them though he was), left a lot to be desired. Although fees at Serenity House kept pace with inflation (close to £500 a week and rising) several guests had failed to meet that pace, fallen behind with their payments and showed little sign of catching up. Serenity House could no longer carry passengers. If only the human dimension of Serenity House could be made to measure up, the other things could be adjusted.
What was needed was a totally new regime. Many of the unprofitable elders would have to give way to a new breed of guests. Higher fees and a reasonable rate of turnover was essential. Elders would have to understand that Serenity House did not owe them a living.
It was a real problem and one to which Mr Fox did not see any speedy solution. Though he did mention it to Night Matron and she promised to give the matter some thought. She also promised to speak to Dr Tonks. Dr Tonks was full of modern ideas.
Night Matron, as people later came to realise – even if the realisation came to some too late for them to appreciate it – made a significant contribution to solving the problems facing Serenity House. She introduced the concept of the Living Will.
She will always be remembered for it. (Indeed, as things turned out, she was also very likely to be charged for it, indicted and tried for it. But that all came later. When many of the eye witnesses were deceased. When the survivors either had a hundred stories of what had happened and who did what to whom – or they couldn’t remember.)
But let it not be thought that Night Matron came easily to the concept of the Living Will. She told Jack: ‘We are all potentially immortal, but you have to earn immortality. Not all of us are up to it. Sadly. Christ came to bring life more abundantly. It says so in the Bible. All we need is to be in touch with our cells. Immortality. Not in the next world, but now.’
Matron, however, was a realist and there were clearly many people in the world not in touch with their cells. Such cells were, as Matron explained, ‘in fact already dead’. What was one to do then with these lost souls? Her answer was the Living Will. ‘It’s a wonderful idea, Jack. I think it comes from your wonderful country. The clear recognition that nothing is gained by prolonging a life no longer worth living. I think everybody should have one.’
And by the time she’d finished everybody did.
She began by designing her forms, set out in plain, clear English, and big bold text for those with failing eyesight. Eventually, she hoped, braille copies would be available upon request. She composed her Will on the office word-processor. The heading was in confident bold capitals: ‘My Medical Testament’. The preamble in definitive bold lower case: ‘My Medical Testament sets out and directs my desires regarding medical treatment should sickness prevent me from speaking for myself. I sign this testament, being over the age of eighteen and of sound mind, and with a full and healthy understanding of the consequences of my wishes.’
Matron’s Living Will specified the elder’s wishes in the event of serious brain damage, or facing a variety of incurable conditions, examples highlighted in discreet italics. Terminal cancer to emphysema. Advanced Alzheimer’s to Parkinson’s. And/or – here was the skill of the thing –
any such life-threatening diseases which in the opinion of my GP and several qualified consultants is diagnosed as a threat to life and irreversible, then I solemnly declare that I wish for:
1.
Heart shock machine
2.
Breathing machine (ventilator)
3.
Chemotherapy
4.
Major surgery
5.
Pain control
(Delete whichever is inapplicable)
In the event of irreversible coma I wish/do not wish that attempts be made to resuscitate me.
‘I’ve kept the language dead simple. No jargon about cardiopulmonary resuscitation. The elders know what a heart shock machine is. They understand a breathing machine. So make your choice and Bob’s your uncle,’ said Night Matron. ‘A child with a Biro could do it. The beauty of my form is that it isn’t a legally binding document. No need to bother with lawyers.’
Matron’s Living Will looked like being ‘Flavour of the month’, said Mr Fox. Everybody wanted to try it. She assembled half a dozen interested elders in the television room and did a trial run with pencils and paper. Several key workers helped to assist elders whose arthritis prevented them from scoring through the various forms of treatment they did not want.
From this little test group, it became clear that some minor adjustments to the form were in order because, faced with a clear either/or choice for, say, ventilation, guests like young Agnes and the Reverend Alistair simply could not make up their minds but sat there with their pencils in their hands, squabbled over the pencil sharpener, or doodled aimlessly all over the forms. Or they put their hands up and asked to leave the room. Some, like old Beryl the Beard, burst into tears and wouldn’t say why she was crying. Young Agnes asked impossible questions: ‘Excuse me, Matron, but can I have the – you know – heart resuscitation one – but without ventilation? Or if you have the heart machine without ventilation does that mean you’re disqualified?’
To which Matron replied, rather curtly perhaps: ‘For heaven’s sake, Agnes. We’re talking about the last hours of a human life. This is not a game of bingo!’
In the end she had to redesign the forms for those amongst the elder
s whom she called, privately, but with some heat, ‘the dodos, the ditherers and the defunct. Got to give them some leeway.’ On the new forms, after each of the terminal options on offer, instead of a straight deletion for terminal services not required, Night Matron allowed a straight choice: ‘Yes/No/Don’t Know … Circle as required’.
Dr Tonks was exceptionally pleased with the Living Will. He came along to talk to the elders. In fact the geriatrician made a little speech: ‘I’m jolly pleased and proud to see how you chaps are all facing up to your responsibilities. You know, we doctors can only do so much. We’re not infallible and when one of you is wheeled in, after a fairly testing stroke, or an especially tricky heart arrest, we look down at you and wonder. You can’t tell us what it is you want. How very useful then – no, I lie – how positively liberating it is for chaps like us to be able to call up your Testament on the VCR, right there in the theatre, and know in a flash just how you feel about the whole matter. Yes or no? Stay or go? What we’re after is not just life for the sake of it but a longer life lived well.’
In conclusion, Dr Tonks told them all about the Nirvanatron.
‘A state of the art instrument progressive patients facing departure might find really interesting. I hope so. It comes, of course, from the great US of A … ’ This was accompanied by a smile and a wave at Jack who stood at the back of the room. Jack smiled and waved back, showing that he did indeed body forth in his compact person all that was best in America.
‘Now we get a lot of understandable questions about the Nirvanatron. People ask: “Does it hurt?” and “Does it take long?” and “Is it expensive?” To all these queries I can give a definite “no!” If the Government were not so shortsighted as to have forbidden import of the Nirvanatron, people would be able to try it for themselves and many ridiculous rumours would be scotched.
‘The Nirvanatron is a box with tubes, valves and a couple of bottles. Simply lie down. Or sit, or kneel, if you prefer. One tube feeds in the soother, sodium pentathol. A few minutes later you’re feeling good and happy and high as a kite. The other tube does the rest. A solution of potassium chloride slips into the bloodstream and shuts down your heart. You do need a trained person in attendance to ensure proper intravenous connection. But then it’s over to you.
‘We can truly say that the Nirvanatron is partially patient-driven. But I’m certainly not saying it’s the only way. I sometimes think we specialists concentrate too much on technologies of departure and not enough on the leaver’s own cocktail of desires. So I’m making myself available to anyone who wants it, my personal copy of the latest how-to book from the States. In my humble opinion, the best departure-zone guide yet. The Joy of Passing has been on the best-seller lists for months; it canvasses the best methods, equipment, ingredients for patients about to enter the DZ, lavishly illustrated.
‘Mr Fox will have my copy of The Joy of Passing in his office whenever anyone feels like consulting it. Thank you and good luck.’
Mr Fox held up a hand as the elders mulled about the exit in a clashing traffic jam of wheelchairs, sticks and Zimmer frames.
‘Remember, my door is always open.’
Matron said in a mood of fine enthusiasm, ‘If any eventide refuge is the first to use the Nirvanatron, you can be sure it will be Serenity House!’
‘Bless you, Matron,’ Mr Fox said gratefully, ‘perhaps elders will understand a little better why I’m so passionate about this link with Age Without Frontiers. Serenity House must face the next century with the latest and best for all our elders. Those arriving, staying and departing.’
‘Bless you, Mr Fox,’ said Night Matron.
The very next day the Reverend Alistair awoke briefly, went into the laundry cupboard and pulled a plastic bag over his head.
‘It’s a surprisingly pleasant way to go,’ said Dr Tonks, ‘despite a lot of fearful imaginings. I think The Joy of Passing is going to prove a wonderful boon.’
CHAPTER EIGHTEEN
The Great Escape
Early one misty morning, Max could be seen in the garden of Serenity House. His left leg was thrown out before him, his right arm behind him. He was hoping to remember something of great importance. He was wishful to learn. (‘Wishful’ says Fowler, ‘is a word used as a way of avoiding the synonym “anxious to”.’) Max refused to regard himself as feeling particularly anxious. He was jolly well going to learn, that was all. Though exactly what it was he was learning he could not quite remember. He’d been out in the garden every morning since Innocenta had called in tears.
The news was grim.
Albert and Elizabeth had been shrieking about a certain Superintendent Slack. (Was that shrieking or freaking? He always had trouble understanding Innocenta when she lapsed into the jargon of the young.) ‘You know, the policeman in charge of the hunt, Grandpa.’
‘I’ll be ready,’ said Max. ‘I am in training. Come and see me, my darling. It’s time we went rat-catching.’
When Max decided to move on Jack, Innocenta came to his rescue. She thought the success of their plan turned entirely on her. This was true up to a point. Beyond that point Max did not enlighten her.
A petrol-blue beret, apricot silk scarf, blood-red suede boots. To Max, Innocenta looked very beautiful when she called with the news, though she did look rather shaken up. It was quite impossible, as she sat opposite him, for him to do anything but love her.
‘Well, what do you have to give me?’
‘By about eleven, Jack was the best pickpocket on the Eastern seaboard. I still find it hard to believe. By twelve he was carrying a gun and holding up shopkeepers. The following year and he was in a detention centre. Two years later the Juvenile Court was told he had been arrested thirty-five times. He escaped from the detention centre and robbed an old lady in a lift.’
‘Knocked her down,’ said Max. ‘Ripped the rings off her fingers. Took her purse. Sexually molested her.’
‘Raped?’ Innocenta asked. Max’s weak eyes could make out tears on her cheeks. She sniffed loudly.
‘It seems not,’ said Max. ‘But only because there probably wasn’t time. He was sent to a corrective centre in Florida. That’s where Marta got to know him. She has a good heart, Marta. She took him home. Tried to sort the boy out. Innocenta – there’s something you’ve not told me.’
Innocenta blew her nose. ‘I’ve been keeping an eye on him, Grandpa. Staying close, like you said I should.’
‘Does he know you’re here?’
‘Daddy and Mummy took him out. They went off in the car. Something’s brewing there, for sure. I took him home, you see. Back to your place. I told them that you’d agreed. Stay close, you said. Didn’t you? And they’d thrown you out of your home. So I was taking what was yours, anyway.’
Max leaned back. ‘Bravo!’ Innocenta got up and walked to and fro, from his cupboard to the door where his dressing gown and pixie cap hung. ‘When he was at work one night, I found things in his room. Syringes. At first I thought, oh yes, he does serious drugs. Except they looked pretty tatty, those syringes. I also found a pair of pincers.’
Max touched thumb and forefinger to his temples. ‘Like this?’
‘Just like that.’
Max leaned further back in his chair and flexed his leg muscles. Things were improving. His incontinence exercises were beginning to pay off, and so were his limbering-up routines. He could turn much more quickly now. Turn and thrust. In fact, Night Matron, coming upon him in the corridor, wheeling, thrusting, feinting, had turned quite pale and it was only when he clutched his knee and fell over and she had him safely belted into a wheelchair that she calmed down enough to tell him he’d scared her half to death. ‘We’re not as spry as we used to be, Mr M.’ And Max had looked properly contrite, thinking to himself that as long as he was a tenth as spry as he used to be then someone was in for a big surprise.
If Innocenta had not been so self-absorbed she would have noticed how her grandfather, usually so very slow, so rickety, now left his c
hair with a sudden graceful movement, like a fallen tree rising in slow-motion. He crossed to her as she leaned on his blue table, close enough now to see the bruises on her neck which the apricot silk scarf did not entirely hide.
‘Those parcels, my dear. They’re mine. And there is something else. A blue carpet bag. Find them, Innocenta, bring them to me.’
‘I’m scared, Grandpa. He’ll hurt me.’ She touched the bruises on her neck. ‘He found me in his room yesterday and took hold of my neck. I couldn’t breathe. I think he’d kill me.’
‘Both of us,’ said Max, ‘without hesitation. Unless we get him first. Get my things. The parcels, my carpet bag. And I promise you we’ll escape. To another place.’
‘And then? Do I bring them to you?’
Max smiled. ‘That would be fatal. When you have them, get out of the house. Find a phone and ring me. 1’11 tell you where to go.’
‘Somewhere we’ll live happily ever after?’ Innocenta wiped away her tears. ‘Like in the fairytales?’
‘Something like that,’ said Max.
Seated in his wheelchair, unmoving beneath his Kumfee Thermalux cover, Max waited – the frozen man. He was waiting for Innocenta’s call.
When it came it was as bad as anything he might have expected. Innocenta’s voice was curiously calm, deliberate. Thick with sleep or pain. The parcels had been where she’d last seen them. The carpet bag had given her slightly more trouble. She’d located it at last, beneath Jack’s bed.
‘I was just reaching for it, Grandpa, when he hit me. I know it was him, though I never saw his face. He wore his Mouse head, all the time.’
He had taken the carpet bag, placed it on the bed and forced her to kneel above it. He had drawn her legs apart. He had roped her hands together, using, she said, a large roll of waxed string from the kitchen. Max thought he recognised the string. He had torn her orange robe. He had ripped and scattered the beads of her mala across the room. Then without bothering to do more than loosen his belt and lower his jeans he had rammed himself home into her.
Serenity House Page 21