In the Midst of Life

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by Jennifer Worth


  Jennifer Worth trained as a nurse at the Royal Berkshire Hospital, Reading, and was later ward sister at the Elizabeth Garrett Anderson Hospital in London, then the Marie Curie Hospital, also in London. Music had always been her passion, and in 1973 she left nursing in order to study music intensively, teaching piano and singing for about twenty-five years. Jennifer died in May 2011 after a short illness, leaving her husband Philip, two daughters and three grandchildren. Her books have all been bestsellers.

  By Jennifer Worth

  Eczema and Food Allergy

  Call the Midwife

  Shadows of the Workhouse

  Farewell to the East End

  In the Midst of Life

  Index

  abuse, 207

  acidosis, 217, 230, 232

  acute intestinal obstruction, 10—11, 15, 20, 42

  adrenaline, 340

  advance directives (advance decisions), 117, 122—5, 354

  advanced life support, 340

  age discrimination, 252, 258, 353

  ‘agonal gasp’, 241

  AIDS, 60—1

  airways, 339

  Aldershot Military Hospital, 239

  Aldwinkle, Matron, 24—9, 136—7, 179

  allbumen levels, 382

  Allow a Natural Death (AND) procedure, 348—9

  almoners, 62

  Alzheimer’s disease, 194—6, 258, 366

  see also dementia

  ambulance services, 251, 253—7, 338, 349, 350, 357—67

  amiodarone, 340

  amyl nitrite, 216—17

  amyotrophic lateral sclerosis, 279

  anaesthesia, and ventricular fibrillation, 337

  analgesics, provision of, 63—5

  Anderson, Mr, 128—44

  angina pectoris, 216

  anti-arrhythmic drugs, 340

  aortic aneurysm, 240

  aperients, 231, 290

  Aristotle, 326

  Army Medical Services Emergency Team (AMSET), 239—40

  artificial hydration, 382—3

  ascites, 230

  aspirin, 309

  assisted dying, 313—15, 323—8

  see also euthanasia; suicide

  atheism, 332

  atheroma, 216, 272

  atrial response, 248, 250

  atropine, 340

  Auschwitz, 116

  Automatic External Defibrillators (AEDs), 251, 255—6, 258, 338, 343

  Avon, Somerset and Wiltshire Cancer Services, 349

  back-pressure, 229—30

  Baden-Baden, 318—21

  Bass, Madeline, 257, 368—76

  Beckett, Samuel, 201

  bedsores, 21, 105, 196, 230—2

  Belfast, 337

  Belsen, 116

  benign growths, 120

  bereavement, 158—61, 163—4, 194

  Bible texts

  Ecclesiastes, 8

  St John, 214

  birth, 33, 148

  Blake, William, 154

  blindness, 195

  blood clots, 170, 272

  Boer War, 5

  Bonn, 345

  brain, 46—7

  and degenerative disorders, 278

  frontal lobe, 195

  hypothalamus, 107

  and oxygen starvation, 87—8

  and resuscitation, 230, 237, 246, 250, 254, 344—5

  speech centres, 278

  stem reflex, 345

  Briggs Report, 203

  British Humanist Association, 116—17, 122

  British Medical Association (BMA), 187—8, 211, 257, 373

  British Patients’ Benevolent Fund, 132—3

  Brompton Cocktail, 82—3, 89, 105, 134

  bronchitis, 196

  Bruce, Joanna, 270

  Buddhists, 56, 332

  Burnham, Dr Rodney, 199

  Butler, Josephine, 164

  Cairngorms, 144

  cancer, 81, 133—4, 300, 302, 306, 346

  abdominal, 298

  breast, 81—4, 318

  and hospice movement, 62—7

  lung, 160

  ovarian, 111

  prostate, 90—1, 162

  and resuscitation, 370—1

  sarcoma, 64, 102, 108

  and spontaneous recovery, 138

  cancer patients, 81—126, 128—44, 298—306, 318—28, 362—3

  Cancer Research Foundation, 144

  cannulation, 357

  cardiac arrests, 237, 240—1, 257, 339, 341—44, 352—3, 359, 369, 373—4

  cardiac stimulants, 21, 24, 238—9

  care homes, 38—9, 197—202

  and agency staff, 303

  and deaths, 197—9

  and force-feeding, 199—200

  nursing homes, 38—9, 190—1, 298—303

  and profit motive, 201—2

  and resuscitation, 254, 258, 348

  Care Quality Commission (CQC), 206—10

  catheters, and prostate cancer, 90—1

  cerebral haemorrhages, 170—1, 179, 182—3, 243

  Chamberlain, Professor

  Douglas, 359

  chemotherapy, 81, 318

  chest (lung) infections, 21, 41, 48

  see also pneumonia and ‘the old man’s friend’

  Cheyne Stokes breathing, 80

  children

  and death, 33, 147—53, 163

  funerals of, 156—7

  and grief, 152

  choking, 196, 281

  cholera, 168

  Christianity, 332

  chronic obstructive pulmonary disease (COPD), 363, 366

  Church of England, 280

  City and Guilds, 208

  cleft palate, 221

  codeine, 64

  colitis, 180

  colostomies, 15, 18, 20—22, 30—35

  comas, 344—5

  Community First Responders, 251,338

  concentration camps, 22—3, 28, 35, 52, 74, 116—17, 218

  confusion, 194

  constipation, 231, 290, 298, 303

  consultants

  remoteness of, 22

  and fear of litigation, 186—8

  see also doctors

  Contagious Diseases Act, 164

  corneal reflex, 345

  coronary arteries, occlusion of, 272,358

  coroners, 249

  Cotterill, Edith, 80

  counsellors, 159, 161

  Court of Protection, 374

  Cox, Mrs, 81—4

  crash teams, 238, 240—1

  cremations, 156

  Criminal Records Bureau, 206

  Critical Care Paramedics (CCPs), 358

  Cunningham, Mrs, 111—26

  Dartford, 357

  Darzi Report, 365

  deafness, 195

  death

  as active process, 99—100

  definition of, 197

  with dignity, 118, 312

  death—contd

  fear of, 124—6

  at home, 161—3

  and hospitals, 48—9, 146, 161, 244,312

  and the living, 15 9—61

  from old age, 5, 7, 45

  social attitudes to, 146—53

  verification of, 351—2

  violent, 146, 148—9

  ‘death agony’, 28

  death certificates, 7, 352

  death rituals, 56

  see also funerals

  decapitation, 253

  decomposition, 253

  defensive medicine, 48, 283

  see also litigation, fear of

  defibrillators portable, 252, 337

  see also Automatic External Defibrillators; Internal Cardiac Defibrillators

  dehydration, 383

  delirium, 382—3

  dementia, 35, 194—5, 278, 308, 371

  see also Alzheimer’s disease

  depression, 54, 158, 190, 194—5

  diabetes, 69, 71, 76—7, 216—17, 231—2

  diamorphine, 362

  diarrhoea, 231, 303, 309, 382

  digitali
s, 216—17

  Dignitas clinic, 313,3 24—5

  Dignity in Dying, 312, 349

  Do Not Attempt Resuscitation (DNAR) orders, 242—3, 251, 253—6, 258, 349, 346—8, 356, 360—1, 365—7, 372, 374, 376

  doctors

  and death, 54—6, 230—2

  and fear of litigation, 242

  and incurable conditions, 136—7

  and public expectations, 242

  see also consultants

  Doctrine of Double Effect, 383

  Doherty Mrs, 165—91

  Downes, Sir Edward and Lady, 313—14

  drowning, 253, 338, 354

  Dublin, 243

  duodenal ulcers, 309

  ECG interpretation, 357—8

  Edinburgh, 243

  electrocution, 337, 338, 354

  electrolyte balance, 230, 382—3

  Elizabeth Garrett Anderson Hospital, 171, 308

  embolism, 170

  End of Life Care, 210, 368—86

  endomorphs, 107

  endotracheal intubation, 339, 357

  enemas, 231, 290, 298, 304

  ether convulsion, 15

  ethics committees, 211, 251, 346

  euthanasia, 117, 122, 307—13

  Euthanasia Society, 118, 123

  evolution, 309

  faith, decline of, 332

  FASTrack stroke pathway, 359

  feed-pegs, 199, 282

  see also naso-gastric tubes

  films, 146, 148

  Final Lap, The, 197

  First World War, 26, 102—3, 153, 205, 218, 260

  flavine, 231

  flu epidemic, 153

  force-feeding, 98, 199—200

  forgiveness, 218

  frontal-temporal degeneration 278

  funerals, 153, 155—8

  gall bladder, 229

  gangrene, 21

  gastrectomy, 13, 129

  gastrostomy, 199—200

  General Medical Council, 350

  geriatrics, 294

  Germany, 51, 53, 316, 328

  Glasgow Coma Scale, 345

  glottis, 280

  Goteborg, 342

  Gravesend, 254

  Griffiths Report, 203—4

  Guedel airway, 339

  guilt, and bereavement, 161

  Hackett, David, 150

  also Appendix I 337—356

  Harlow, Wilson, 91

  Hart, David, 50, 145, 193

  Havel, Vaclav, 127

  Hawking, Professor Stephen, 278

  healthcare assistants, 137, 205—13

  salaries, 208—9, 213

  heart attacks, 4, 29, 46, 48, 157, 218—19, 234, 246—7, 250, 272—3, 275, 337, 346, 366

  heart block, 340

  heart disease, and mortality rates, 356

  heart failure, 196, 234, 300, 302

  acute heart failure, 272

  congestive heart failure, 216—17, 228—9

  heart surgery, 337

  heartburn, 129

  hemiplegia, 175—6

  heparin, 217

  hiatus hernias, 129

  high blood pressure, 170

  Hinduism, 56, 332

  Hippocratic oath, 309

  home defibrillation, 338

  home helps, 295

  hope, 139—40

  hospice movement, 63, 65—7

  hospices, 159, 161, 348

  hospital dramas, 251, 342, 369

  hospitals

  in 1950s, 30

  hospitals—contd

  and death, 48—9, 146, 161, 244,312

  geriatric, 292—4

  and hospital-acquired infections, 308

  and resuscitation, 340—2, 348, 351, 355—6

  How We Die, 196—7, 235—7

  Huntingdon’s chorea, 278

  Hyem, Dr Conrad, 68—79, 215—32,238

  hypercalcemia, 382

  hyperglycaemia, 217

  hypothermia, 344, 354

  hysterectomies, 111, 120

  immigrants, 210—11

  incineration, 253

  incontinence, 4, 196, 308

  Independent Mental Capacity Advisor, 374

  insulin, 73, 75, 217, 230

  Integrated Care Pathway, 283

  Intensive Care National

  Audit & Research Centre

  (ICNARC), 341

  intensive care units, 16, 238

  Internal Cardiac Defibrillators

  (ICDs), 343

  International Liaison

  Committee on

  Resuscitation, 344

  International Voluntary Service

  for Peace, 53

  intraosseous cannulation, 357

  intravenous cannulation, 357

  irritable bowel, 309

  Jehovah’s Witnesses, 209

  Jesus Christ, 326

  Jewish law, 332

  Jews, 51—2, 73—4, 217—18, 288

  Johns Hopkins Medical

  Research Faculty, 237

  Joint Royal Colleges

  Ambulance Liaison

  Committee (JRCALC)

  guidelines, 253—5, 360

  kidneys, 217, 229, 236

  dialysis, 200, 347

  failure, 196, 228, 232

  infections, 41, 48

  Korean War, 337

  Ku Klux Klan, 61

  Kubler-Ross, Dr Elisabeth, 51—61, 67

  laparotomy, 13, 129, 133

  Laryngeal Mask Airway

  (LMA), 339

  Latvia, 9, 13, 37

  Lawrence, Philip, 163—4

  laying-out, 160

  Leah, 285—306

  leukaemia, 56, 58

  Lewis, John, 278—84

  life after death, 110

  litigation, fear of, 186—8, 242, 258, 373

  liver, 217, 228—9

  Liverpool Care Pathway, 161, 283, 371, 376

  living wills, 251, 256, 258, 354

 

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