In the Midst of Life

by Jennifer Worth

  Another paper reported these words: ‘If the mountain does something, I’d rather go right here with it. If I was out of here and lost my home, I wouldn’t last a week at my age, I’d just die, and die miserable too. I’d have nothing to live for at all, and I’d just double up and die. My old heart would stop – if I’ve got one, an’ a lot of people have said I ain’t got no heart.’

  The press loved it, and the newspapers lapped it up, printing rows of dots when the language became too obscene. The public bought the papers and magazines in their millions. Truman was a star. The American people like to think of themselves as robustly independent, like the first settlers, and here was a grand old American backwoodsman, showing them all that the ‘spirit of America’ was alive and well.

  Meanwhile, in the courts and committee rooms of Washington State, debate was raging about Truman’s status as the only person remaining inside the Red Zone. Was it lawful? Was he trespassing? Could the evacuation order be enforced? Should he be forcibly removed for his own safety?

  The land still belonged to the Northern Pacific Railroad Company, so they enquired if the lease could be revoked in exceptional circumstances; the reply was so long in coming that it wasn’t worth waiting for. The Sheriff checked with local prosecutors about Truman’s legal rights. The lawyers conferred and came up with the conclusion that an independent court would have to decide, and that, in view of the publicity, it was doubtful they could find an impartial jury to hear the case. Therefore, they could not prosecute. Besides, there was no way of avoiding bad publicity, and the lawyer doubted if there was a law-enforcement official in the county who would arrest Truman, even if he was breaking the law.

  But was he? He was in his own home, doing no harm to anyone, except perhaps himself. Some bright spark came up with the question, was he sane? If not, he could be certified and removed. But the idea of getting in a couple of psychiatrists to examine him, which would undoubtedly reach the ears of the press, leading to a stream of derisive articles, was too much for the poor Sheriff and the idea was abandoned.

  The fact is, Truman was saner and a great deal more intelligent than anyone debating his case. He had always been a cute customer when he wanted something. He said once that ‘the press is more powerful than the law’. Had he foreseen what was likely to happen to him? It would have been no trouble for two hefty young forest rangers to manhandle an old-timer out of his home, into a car or a helicopter. But with the press reporting every move this would have caused a public outcry. Civil liberties, the rights of man, assault – all would have been evoked. Truman knew what he was doing all along. Not from altruism had he exhausted his stock of whisky and rotgut on the press boys. With public opinion on his side, he was safe.

  ‘Safe’ is an odd word to use if you live in the path of an erupting volcano, but his logic was impeccable. We all have to die, and, whatever the circumstances, it is better to die in your own home than in an unfamiliar place surrounded by strangers. He had said, ‘If I lost my home I wouldn’t last a week at my age. My old heart would stop.’ He was probably wrong, there. In modern America old hearts don’t just stop, and if they do, life will be forced back into them. For Truman, it would have been a nursing home, confined, confused, drugged and defeated. From that, he was ‘safe’.

  Truman stayed, and on 18th May, 1980, at 8.45 a.m. Mount St Helens blew and he went with it. A blast of hundreds of millions of tons of rock, ash and magma hurtled into the air at a speed of 900 miles per hour and a temperature of 700 degrees Celsius, then poured down the mountainside. Spirit Lake and the surrounding woodland vanished for ever.

  A memorial service was held for Truman a month later at the American Baptist Church in Longview, Washington State. The President of American Baptists took the service. In his commemorative speech he said these words: ‘No one lives his life amid the awesome beauty of Spirit Lake and Mount St Helens without a deep theism we could not readily define. Truman was a man of the seasons – he didn’t resist nature, he respected it – and he was a creature of the cycles nature brings. Wherever he is now, if he can see what is going on here today, he’s saying “don’t you dare cry for me! I did just what I wanted. Go have a good time.”’

  I am indebted to Shirley Rosen’s book ‘Truman of St Helens’, published by Madrona Publishers, Seattle, Washington State, 1981, for the information for this chapter.

  ‘I’m not afraid of dying, not at all, because I know what it’s like. I’ve been there. It was after the birth of my third son, and I had a massive haemorrhage. An artery in or near the vagina had ruptured and fresh arterial blood was literally bursting out of me, like a fountain or a water jet. I felt myself sinking slowly, slowly downward, like a slow spiral. This must have been the blood and the oxygen leaving my body. I couldn’t have moved if I had tried. But I didn’t want to. I was in a tunnel, a big tunnel and I was walking along it towards a beautiful opening or door or something at the end. It was so beautiful, I could never describe it; not an earthly beauty but peace and quiet and beauty, and I wanted to get to it. I was very near. Another few steps and I would have got to it, which is what I wanted. But then I heard a sound and I felt movement; that must have been when they checked the blood flow and started pumping blood into me. And I looked behind me and saw three little children, and I knew I couldn’t go. So I turned around and went back. But, oh, it was so lovely and I so much wanted to get to that beautiful place.’

  —Joanna Bruce, MBE

  (Jo is my mother’s first and favourite granddaughter)

  1986

  ACUTE HEART FAILURE

  To write about my own mother’s death is so painful that I wonder if I can do it at all. I have sat for hours at my desk with a pen and a blank page, and nothing comes but tears and regret. I have shut it out of my mind for twenty-five years, telling no one, unable to dwell on what happened, what might have happened, had I acted differently, what I could have done, should have done, what I did not do, did not know. For twenty-five years I have erased from my mind thoughts of the pain she must have suffered, her fear, her terror, and, worst of all, her anguish at being surrounded by strangers in the hour of her death, because I, her eldest daughter, was not there.

  Who can write about their parents objectively? Not me, for sure. The relationship is too personal to be objective. I will say only that my mother loved life and everyone she met. She was full of fun and vitality. It was life-enhancing just to be with her. She was also exceedingly pretty.

  In 1986 she was sixty-five and very popular. She had a host of friends, held constant luncheon, tea and dinner parties. She was a brilliant cook and a generous hostess. She swam regularly and enjoyed walking, gardening, and taking her grandchildren on outings. She enjoyed life, and appeared to be in excellent health.

  She had arranged to meet some friends for a coffee morning, but did not turn up. They telephoned the house, but there was no reply, so one of them came to the house and knocked on the front door. No reply. The woman looked through the window and saw my mother lying unconscious on the sitting room floor. She immediately called the local hospital, an ambulance came, and my mother was rushed to Accident and Emergency and put straight into intensive care.

  My sister and I were informed, and we both arrived as soon as we could. Our mother was attached to a defibrillator, an intravenous drip and other life-maintaining apparatus, with dials and monitors and flickering graphs and lights. The gentle hum of the machines was reassuring, in a way. My sister and I were both trained and qualified nurses, but no longer practising, and medicine had advanced so rapidly that neither of us had seen such hospital treatment, nor did we know what was going on. We were told that our mother had had an acute heart attack.

  ‘Acute’ is the word to understand, and acute heart failure is quite different from congestive heart failure, which is a slow and cumulative process of heart dysfunction, usually occurring in the elderly. Acute heart failure occurs in a second, with no warning, no history of ill health, and it often attacks relati
vely young people. There are many possible causes, but the most common is a sudden occlusion (obstruction) of one of the coronary arteries. It is usually, though not always, caused by blood clots, developing in an atheromatous section of a coronary artery. If a clot forms in one of the coronary arteries, the occluded area of heart muscle will die. This is known as an infarction. It is a major catastrophe. Whether the infarction is partial or total will depend on the size of the clot and the size of the artery occluded. Either way, the occurrence is commonly called a heart attack.

  Our mother must have had a partial infarction, because she was found on the floor, unconscious, and no one knew how long she had been there. Add to that the time taken for ambulance transfer to the hospital, and several hours must have elapsed. When my sister and I arrived, she was breathing without the aid of a ventilator, but did not appear to be conscious. We stayed with her all night, dozing intermittently in the chairs that the staff had provided for us.

  On the second morning she regained consciousness, glanced around her quite brightly, then looked at us in surprise. ‘What are you two doing here? What’s going on?’

  We stayed with her all day. She was very weak, and obviously ill, but she talked rationally and could remember everything up until the moment she had collapsed. She seemed very interested in what must have happened, and in all the medical paraphernalia around her. She remembered her mother, who had suffered a heart attack about thirty-five years previously and died.

  ‘If all this medical treatment had been available for my dear mother, she wouldn’t have died. I was there with my Dad. The doctor came, and said there was nothing he could do. I am very grateful to the doctors and nurses here,’ she said.

  The doctor told us that she was out of danger and that we could go home if we wanted to. As my sister had three children to look after, we agreed that she should go and that I would stay on at the hospital with our mother. I stayed with her all evening and dozed in the chair beside her during the night. The machines hummed and whirred, and nurses came at intervals to check a monitor and offer words of comfort and reassurance. It reminded me of my own years of night duty – the night-time holds a beauty and mystery that we do not know during the daylight hours – but I had to recognise that although I was an experienced nurse, the new machines were quite beyond me.

  It was Midsummer Day. Dawn was breaking, and soon brilliant sunshine was streaming in through the hospital window. My mother stirred and looked around her. ‘It’s going to be a lovely day,’ she said.

  A nurse came in and removed the drip from her arm. ‘You’ve had a good sleep,’ she said.

  ‘Yes, and I feel a lot better. A cup of tea would be nice,’ my mother replied. Then she turned to me and said, ‘Go and get yourself some breakfast, dear. I’m sure there must be a canteen open somewhere in the hospital. I’m all right. I feel much better.’

  The nurse agreed. ‘We want to change your mother’s bed and give her some breakfast, and we will probably get her up as well. I daresay she will be transferred to the ward when the doctors have seen her.’

  I made my way to the hospital canteen with a great sense of relief in my heart. She’s going to be all right, I thought. Modern medicine is wonderful. I remembered similar cases of acute heart failure that I had seen thirty years previously. when there was very little that we could do, and when many people died, or survived to be cardiac cripples.

  Breakfast was excellent – cornflakes, bacon and eggs, toast and marmalade, coffee – and it increased my sense of well-being. I had intended to go straight back to my mother, but … but … All those fatal ‘buts’ in life; they are as bad as the ‘if onlys’. If only I had followed my first intention. If only I had resisted the call of a midsummer morning, the lure of the rising sun casting long shadows over the hospital garden, the sight of small clouds floating in a clear blue sky, the sound of birds singing. If only I had shut my eyes and ears to the beauties of nature. But I didn’t. I went for a walk in the morning light.

  When I got back to the hospital, the door of the intensive care unit was locked. I could hear sounds from within but could not enter. I knocked on the door several times, my anxiety increasing. Eventually a nurse came out and said that an incident had occurred, and I could not be admitted.

  ‘What incident?’ I asked.

  ‘A cardiac incident. We are dealing with it.’

  ‘But I must come in,’ I said.

  ‘No, I’m sorry,’ was the firm reply.

  ‘But she is my mother. I must come in.’

  ‘No. You cannot be admitted. Go to the waiting room and you will be kept informed of progress.’

  ‘What are you doing? What’s happening?’

  The nurse did not reply, but turned back, shutting the door firmly in my face.

  I was trembling and crying. ‘Let me in, open the door. You can’t keep me out.’ That is what I intended to say, but it is more likely that I was inarticulate.

  Someone led me to the waiting room and brought me a cup of tea.

  I cannot remember my state of mind – confusion, panic, anger, self-reproach were all mixed up and churning around. Time passed. What were they doing? A ‘cardiac incident’? That could mean anything. When had it occurred? Why, oh why did I take that walk? I should never have done it. Never. I should have gone straight back after breakfast, and then I would have been there to protect her. I envisaged her, weak and helpless, wanting me, perhaps calling for me, and I wasn’t there. I had abandoned her.

  I ran back to intensive care, and banged on the door, calling out, ‘Let me in, let me in,’ but a man came out and told me: ‘No’. I tried to push past him, but he completely blocked my path and held me back. An indistinct picture of white-coated figures, and masses of black machines and wires around a naked body on a bed, was all I saw before the man shut the door. A nurse led me back to the waiting room. She saw my distress and was very sweet. My mother had suffered a second heart attack, she told me, and the resuscitation team were doing all that they could to save her. ‘Don’t worry,’ she said softly, ‘your mother is in good hands. They know what they are doing.’

  ‘But why can’t I go in?’

  ‘It really would be best if you stay here.’

  And so I did, as everyone has to. No one is permitted to see a full-scale hospital resuscitation taking place.

  I sat in numb grief for two hours. Self-reproach amounting to self-flagellation haunted me. If I had not taken that damned walk I would have been with her, and protected her from the violence of resuscitation. But would I? Could I? You never know in life, and it is always easy to be wise after the event. Could I have sat there and watched my mother suffer a heart attack, the symptoms of which I was well acquainted with, and done nothing? Could I have calmly observed her sudden pain, my mother clutching her chest with both hands, gasping, throwing her head back, mouth wide open in a frantic attempt to draw air into her lungs, her colour changing rapidly to a pallor that betokens death? Could I have witnessed this and done nothing? Of course not! In any case, my mother was still wired to cardiac monitoring equipment after the first heart attack, and red lights would have been flashing, warning signals screaming way beyond the confines of the intensive care unit in which she was being treated. The resuscitation team would have arrived anyway, and would have taken over. I would have been told to go to the waiting room, which is where I sat for two long, dreadful hours.

  Eventually, a doctor came and told me that my mother was dead. They had done all that they could, he told me gently, but she had not responded.

  ‘Since death (take my words literally) is the true goal of our lives, I have made myself so well acquainted during the last few years with this true and best friend of mankind that the idea of it no longer has any terrors for me, but rather much that is tranquil and comforting. And I thank God that he has granted me the good fortune to obtain the opportunity of regarding death as the key to our true happiness. I never lie down in my bed without considering that, young as I am, p
erhaps I may on the morrow be no more. Yet not one of those who know me could say that I am morose or melancholy, and for this I thank my Creator daily, and wish heartily that the same happiness may be given to my fellow men.’

  — the young Mozart in a letter to his father

  2004-06

  A GOOD DEATH

  There are many neuro-muscular degenerative disorders – motor neurone disease, Parkinson’s disease, multiple sclerosis, Huntingdon’s chorea, among many others. Each follows a similar, though slightly different, pattern. Basically, the nerve endings start to degenerate, and with it, muscular control starts to slip, and the condition is progressive over a number of years. Cognitive function is usually not involved, and there are many examples of a brilliant mind in the wreck of a body – Professor Stephen Hawking springs to mind. However, different areas of the brain can sometimes be affected. If the centres regulating speech are damaged, a misdiagnosis of dementia may be made, with tragic results for the patient. I can think of few conditions more heart-rending than to be trapped, unable to speak, in a degenerating body over which you have no control, yet retaining your full mental faculties, and hearing, on all sides, that you are demented. However, this is not always the fate of a person so afflicted.

  Carole and John had been married for ten years. He was a widower of sixty-five and she was a divorcee of fifty when they met. He was the love of her life. Ten years later he started to do strange and unexpected things, and to say things that made no sense. They consulted a doctor, who diagnosed frontal-temporal degeneration with primary progressive aphasia – that is, language mix-up and then loss of speech. John could understand exactly what was being said, and he and Carole listened carefully. They were told that it was not Alzheimer’s, but a degenerative disease in which the nervous and muscular system would break down. The ability to make any decisions would go, together with the ability to read and write, but understanding would remain for a long time. They were told that there was no known cure, but that certain drugs could relieve the symptoms and that death could be expected in two to five years. John said, ‘At my age, seventy-five, I can expect death in the next two to five years anyway, so what’s the big deal?’ and they all laughed. Carole was advised to keep a regular domestic routine going, and they were both told to enjoy life as much as possible – stimulation was the thing, physical, mental, emotional, visual, anything that makes you feel good.