Walking Forward, Looking Back

by Dinah Latham

  Is it this depth of encounter that programmed me and so bound me to each of my children that the struggle to recover their happiness after the divorce was fundamental to my very existence? Perhaps the strength of this bond was what made it impossible for me to grasp how their father was able to move forward and develop a life that included no meaningful contact with his progeny.

  Birthing was at the heart of many a meaningful relationship for me as I undertook my work as a district midwife. Childbirth brings together both the heights of joy and the depths of anguish, with the midwife working with and through this gamut of restless emotion.

  * * *

  For some reason, I can’t manage to sleep in this morning. Harriet has decided that, as it is beginning to get light, it’s time to be up and out. I’m not even managing to doze and can’t block out her incessant whining, so I give up and we are out by 5.45am; Harriet looking around, not quite able to believe that all the other early dogs aren’t out, raring to go, tails a-wagging. It is raining drizzling rain; the sort that you think isn’t really rain and will stop any minute, but you’re soaked in seconds and it continues relentlessly… threatening always to stop, but never managing it. The rain rate increases to a proper downfall now and I consider taking shelter in a lean-to cattle barn as we pass. It’s an open-fronted barn, so we slip in. We are both soaked and I’m just thinking that maybe to stop was a bad idea and we’d be better to push on home, when the downpour increases and the noise of the rain on the tin roof of the cattle barn intensifies.

  * * *

  Marion and Jerry

  I remember weather like this at an even earlier hour, travelling with my midwifery bag and bedpan on the back of my ‘sit up and beg’ bicycle through the country lanes in Sussex with my dynamo light fading dismally if I didn’t pedal fast enough. I arrived at a caravan in a soggy corner of a farm field and was welcomed aboard. This was an urgent call. I had not met the labouring mother previously… indeed I was soon to discover she had received no antenatal care at all. I was greeted by an anxious husband hurriedly motioning me up the steps and over the greyhound sprawled across the doorway at the top. The caravan was poorly lit by an oil lamp at one end as I made my way to the moaning sound coming from my right, mentally wondering how long it would be before daylight. The labour seemed to be well underway with only short breaks between contractions, during which I found I was unable to locate the baby’s head in the pelvis and could only detect the heartbeat with the foetal stethoscope placed rather high on the abdomen. To be sure, and to determine exactly what labouring stage we were at, I needed to do a vaginal examination. I asked Marion’s husband to please bring me the gas and air machine from the back of my bike. During my assessment, with husband hovering at a distance, I was not surprised to find that the labour was well advanced; the cervix was almost fully dilated. But I was concerned to learn that the breech was presenting through the neck of the womb at the top of the birth canal. (Babies usually deliver head first, this one was arriving bottom first.) While as midwives we did deliver breech births vaginally at that time, and it was not unknown for these deliveries to be carried out at home, it was seldom by design and certainly not without an antenatal history to depend upon. I swallowed hard, feeling thankful that at least it was a frank breech presentation – a bottom rather than a foot or knee. While determinably presenting an aura of calm reassurance, my stomach turned somersaults and sank to my boots as I tried desperately to ascertain exactly how many weeks pregnant she was while encouraging her to turn sideways on the makeshift bed adapted from the day-time window seat.

  The rain was drumming loudly on the roof as the groaning escalated and I felt sure that that was the beginnings of a grunt I heard, indicating her need to bear down with the contractions. I needed to position her sideways on this bed and support both legs – one on the upended gas and air case, the other on a stool – so that I could have room and depth to suspend the baby’s body below the level of the birth canal and wait patiently for precisely the right time to elevate the baby’s legs and feet, allowing the baby’s face to emerge, while controlling the slow delivery of the head. Struggling with lack of space and light, on my knees and trying to sound really calm, muttering what I hoped were reassuring words, something caught my eye just over my left shoulder, at the far end of the caravan. I momentarily pulled my attention away from my gloved hands and this slippery body to glance in the direction of the distraction. I was horrified to realise that the oil lamp had toppled over and the curtains were alight, with the husband seemingly totally unaware, transfixed by my activities.

  “Excuse me… Mr Watts… I wonder if…” My voice came out at least an octave higher than I expected; all shrill and squeaky as though in need of WD40. Mr Watts was focussed on my every word; the problem being that the right words weren’t flowing quite as they should. I suppressed a screech as I nodded in the direction of the flames… still no response. He clung to his wife’s hand over the tumultuous contraction, for all the world wanting to help her through it. As her effort diminished, and the blessed peace of relief returned, the voice that broke the silence was Marion’s. “Put the fire out, Jerry, there’s a luv.”

  Thanks to Jerry and the rain, the flames were extinguished and the baby was born. As I laid him on Marion’s tummy, he was still, quiet and very blue. I rubbed his chest vigorously and cleared the mucous from his mouth. I blew on his face and flicked the soles of his feet with my fingers. He and I took our first breath in unison, his loud scream followed, and in seconds his whole body flushed pink… all was well. I delivered the placenta (afterbirth) with some difficulty by torch light. And the downpour continued.

  The beating of rain on a roof today brings the very taste of that experience flooding back…

  The story didn’t quite finish there I recall: the greyhound dog, who had seemed oblivious to all the goings on, came to life at this moment, pushing himself past me to streak off up the field in the rain with his jaws firmly clamped on the afterbirth.

  7

  THE STUFF OF LIFE: THE STORIES

  We are so wet by now that I decide to push on home, doing my best to ignore the rain. I remove my glasses and hide them in my pocket… if only someone would invent windscreen wipers for spectacles. Harriet is looking very skinny; her soaking wet coat clinging to her body rather than it fluffing out all over as usual.

  We hit the town and I momentarily consider hopping on the bus as it halts at the crossroads, but think better of it. Harriet is pulling away from it anyway, just in case it makes that awful noise with its airbrakes that frightens her so much that she hides behind my legs, tying my ankles up with her lead. We walk that last mile home with my mind returning to another time and another bus. It’s thinking about that dog running off with the placenta that has triggered it…

  * * *

  “Is it true that once you left a placenta on a bus?”

  It was to be a phrase that would haunt me throughout my career and was still reaching my ears right up to the time I retired. It was a story that refused to go away. Nurses I’d never met would greet me with it and always wanted confirmation of the rumour.

  When, as a rural community midwife in the ‘60s, there was a need to go beyond your own borders to cover for a midwife in another area, it was sometimes necessary to get over there by bus. That ride had been necessary on this occasion. The labour had gone according to plan and now the delivery was complete, all except the task of dealing with the placenta. Once it had been checked and found to be complete (ensuring that uterine haemorrhage was now unlikely), it was the practice to burn it on an open fire. Failing that, it had to be buried in the garden. Neither of these strategies was possible on this occasion; there was no open fire, only a three bar electric heater, and being a very cold winter the garden was frozen hard and impenetrable for any spade. In these instances, the offending article had to be taken back by the midwife to be deposited in the cottage hospital incinerator.

  All was going to plan until the compar
ative warmth of the homeward bound bus met with my fatigue and I fell asleep. Waking with a start at my bus stop, I hastily collected my delivery bag and gas and air case and leapt off the bus just in time. I was, at that moment, totally unaware of my faux pas and the placenta travelled on to the bus station depot. Little did I know then that the story was to travel much further…

  That sinking feeling deep in the pit of my stomach returns as I remember sensing my career hanging in the balance when I was summoned to the midwifery superintendent’s office. Once again I managed to live on through the crisis and by ‘the skin of my teeth’ was allowed to continue on, to bicycle another day. So now it’s not only Harriet who shies away from buses; I’ve remained somewhat wary of them myself ever since.

  When the memory of that fateful day raises its ugly head now, I take a certain amount of comfort thinking about the entertainment value the story has provided at many a boring dinner party.

  I’ve been subjected to more than enough of those parties. The big disadvantage of attending such events on your own I’ve discovered, is that you are just bound to get backed into a corner by the most boring man in the room who wants you to see photographs of his cycling holiday in Norfolk. I’m learning to compete now with multiple pictures of Harriet walking nowhere in particular.

  * * *

  We go for an early evening wood walk today. Early enough to realise that the day isn’t lasting as long as it did; it’s late August. As soon as the longest day has passed, the mornings are slower to get going and the evenings begin not exactly to draw in yet, but hinting that they might soon. The lords and ladies (the wild arum) with their long straight stems and helmet heads of bright orange berries seem to know it too and are trying to shuffle into line either side of the footpath to brighten the almost gloom. The flower fairies poem about them jumps into my head…

  Fairies when you lose your way,

  From the dance returning,

  In the darkest undergrowth

  See my candles burning!

  These shall make the pathway plain,

  Homeward to your beds again.

  (Cecily Mary Baker, 1926, Flower Fairies of the Autumn)

  However, I’m not sure these lords and ladies haven’t been to the party themselves; they look a bit drunk and like soldiers desperately trying to get into line but not quite managing it, with a threesome over there gossiping together instead of following orders. Their berries are shaped like the furry helmets of those guardsmen outside Buckingham Palace, but red instead of black, and they look weary with all the standing.

  As we come up out of the wood heading for the common, there’s the sound of a muffled cheer and a loud round of applause. The batsman will definitely be making an appeal for poor light. I reach the edge of the ground in time to see the players drawing stumps and returning to the pavilion. Harriet tosses her head as if in protest that anybody should dare to invade her ball chasing territory. Cricket pitches and weekends loom quite large in my memory…

  * * *

  My father played village cricket. I grew up believing that this was what every family did with its weekends: go to watch cricket, make the teas, put the tin numbers up on the board, collect six stones for the umpire to move from pocket across to pocket to count the balls of each over and, in later years, to score. These tasks were also known to extend to persuading cows back to their pasture and foraging in the undergrowth for the lost ball – all at the Chalfont St. Giles cricket field.

  There is something so quintessentially English about village cricket and even now I can’t pass a match, with its white clad players and the sound of leather on willow, without stopping to watch an over or two, whilst remembering the smell of newly mown grass and the taste of my mum’s ham sandwiches, always prepared for the cricketers’ tea.

  * * *

  Ricky

  I sit on one of the benches surrounding the small common. It must surely be only just big enough for a cricket pitch; the boundary line is drawn directly in front of the seat. But since the game is now over we’re not in the firing line and no great six ball thwack is imminent. I love this common in Chesham Bois. It forms part of so many of our walks, either on the way out or on the way back, because it’s so near home. It is so much part of my life with Harriet. The cricketers begin to leave, with bats resting over their shoulders, chattering, laughing, dissecting the game, demonstrating the over arm googly that won them the match.

  As I wait for the ground to clear so that I can myself lob some well chewed tennis balls for Harriet, I think of Ricky.

  * * *

  During my first nursing visit to Ricky I could tell he was a lover of cricket; a suspicion validated by the numerous books about cricket on the bookshelf behind his bed. It was a makeshift bedroom, adapted from his study when the need had arisen to move the bed downstairs.

  Moving the bed downstairs is much more than a practical task when caring for people who are dying at home. When the patient can no longer manage the stairs, this expedient undertaking seems to take on a more sinister symbolism. It somehow compels patients and families to face the inevitable deterioration that’s occurring; a decline that can be ignored while continuing with an increasing struggle to make it up and down the stairs.

  On this occasion, the adaptation of the study into a makeshift bedroom seemed to be about something else as well. It was where the tragedy and Ricky could be shut away and forgotten for much of the time.

  Ricky had a malignant brain tumour, and the treatment he had received had inflicted brain damage while rendering him severely paralysed down one side. He was now unable to speak and had a distant look that demonstrated how little understanding there was behind his eyes.

  I tried but made little headway in developing anything of a connection with Sue, Ricky’s wife. I was informed early on in my visits that this was a marriage in name only now and I wasn’t to expect any hands-on help with Ricky’s nursing care from her. I’m sure the devastation of what had happened must surely have entered into Sue’s stance. I had hoped that, in time, I may have been able to gain a greater understanding of her position but, despite my efforts, it wasn’t to be.

  Meanwhile, Ricky lived a somewhat isolated existence in his adapted bedroom; always in bed, always, it seemed, alone, with the door closed. It seemed a drab, cheerless room. When I arrived in the mornings to prepare Ricky for the day, many times he hadn’t even been given a cup of tea, or if he had it sat cold and untouched on the small table next to the bed. He was unable to eat or drink unaided.

  The chatter from the young children getting ready to go to school never included a ‘cheerio’ or a wave to daddy as they dashed off. It was as if, having realised Ricky was not going to get better, he’d been written off; secreted into a corner like an unacceptable embarrassment to normal daily life. I’m sure it was Sue’s coping mechanism rather than an intended affront or cruelty but nevertheless, the lack of engagement with Ricky by the family felt like both a failure on my part and a punishment inflicted on this crippled, dying man.

  Daily visits with personal care tasks saw a relationship build between us. A professional relationship, yes, but caring brings in something else. Perhaps it’s just plain humanity; one human valuing another for no greater reason than he’s another human. I’m not sure what it is, but purely professional it is not.

  At times, I felt sure there was a flicker of recognition from Ricky when I arrived and he seemed increasingly to follow me with his eyes as I worked; sometimes I’d be talking, sometimes there was silence.

  It was a time when England was about to play Australia at the start of an Ashes test series and with an almost missionary zeal I decided Ricky was going to be up and dressed in his wheelchair, in the lounge, watching it. I hoped and thought he understood. I had learned to determine how and what he could comprehend and process and I felt, more than saw, his pleasure at my suggestion.

  Things started well: blanket bathed, shaved, shirt on, underpants and trousers resting above his knees with R
icky perched somewhat precariously on the side of the bed, with me standing in front, astride his legs. My cricket banter, a one-way conversation, had accompanied all preparations. The next part of the procedure would necessitate me bear-hugging Ricky around his waist, with his partially good arm around my neck, and then lifting him to the standing position, his legs held firm by my knees, while with one hand I would reach down behind him and pull up the underpants and trousers before lowering him down again on to the side of the bed. From here, I would tuck the shirt in, do up the trousers, and position the wheelchair at right angles alongside the bed with brakes applied prior to again raising Ricky up from the front, swivelling him round and lowering him into the chair – a move not allowed now as the dreaded ‘Health and Safety’ forbid it! It’s a tricky manoeuvre but one I’d performed many times in many situations over the years.

  My arms in position, I began to count as I rocked Ricky; one, two, with an extra rock on three to gain additional momentum to pull him to standing… and he did indeed rise… and he continued to rise… and went on rising. At just the point when I realised that Ricky was much taller than I had appreciated when seeing him prone, I recognised I had passed the point of no return. Still clinging to Ricky, my arms locked around his waist, I felt myself pitching backwards, and as I landed flat on my back with Ricky on top of me, his underpants and trousers still around his knees, I heard the slam of the door as Sue departed.