by Susan Duncan
‘Can you remember who it was? We’ll get him to take a look her in the morning?’
I gave them his name. Couldn’t resist adding: ‘He had the bedside manner of a Rottweiler.’
The staff grinned in unison. ‘You either hate him or love him. His style doesn’t suit everyone, but he’s very good at what he does.’
‘Yeah.’
I walked off, unable and unwilling to hang around while Esther’s clothes were removed, a catheter inserted.
‘All done,’ called one of the nurses. I returned to Esther’s bedside. ‘We managed to remove all her rings except one,’ the nurse said. ‘It may have to be cut off.’
‘No!’ screeched Esther.
‘Well, love, it could interfere badly with your circulation,’ she said reasonably
‘No,’ Esther repeated, quieter this time.
‘Let’s see how you go, then,’ said the nurse, kindly.
‘Ok,’ I said, ‘you’re all set. You’re in good hands. I’ll be back in the morning.’ I patted her shoulder. ‘The specialist will take a look at you. Tell us what to expect.’ I did not, for one millisecond, believe my mother would choose a noble death. She’d heard the word pacemaker. It was her trump card. All we had to do was wait for her to use it. At home, I slid into bed beside Bob. His hand reached for mine. Neither of us said a word.
A few moments before I climbed in the tinny to return to the hospital, my mobile rang. It was the specialist. ‘If you want your mother to survive,’ he said in his favoured tone that managed to sound accusatory, judgmental and hectoring at the same time, ‘she will need a pacemaker.’
‘Oh, for god’s sake, look at her. She’s ninety-two. Barely functioning. What’s the point?’ It was not one of my finer moments.
‘I see,’ he said, sounding tired and as though I’d whipped the hubris out of him. I suddenly felt sorry for him. He had an awful job.
‘Anyway, it’s up to her, isn’t it? I’m on my way to the hospital now. We can discuss all this in front of her. As I recall, that’s the way you prefer to do it.’ I phoned Bob from the dock: ‘Could you come with me? I think we might need a referee.’ Five minutes later, we cut across the water. It was a blazingly beautiful morning. As always, I thought that no one, given a choice, would give up the promise of an extra day.
There were three other patients in Esther’s room. The woman on her left was in a deep, drugged sleep or a coma. A man diagonally opposite, who appeared to be at least one hundred and ten years old, didn’t appear to be breathing. His eyes were closed. Mouth open. His legs were purple and blue, as though all the blood vessels under his skin were leaking. Directly opposite, an alert but aged man waved hello.
‘He served in the war, too,’ Esther said, sounding cheery.
‘How are you?’ I asked, standing back as usual while Bob gave her a kiss. She wheezed in reply, but I was immune to that wheeze. ‘You look pretty good.’
‘What? For someone who’s dying?’
‘Have you seen the specialist?’
She gave a limp-wristed little wave. ‘Oh, he’s been and gone.’
‘What did he say?’
‘Nothing much.’
I left her with Bob and went searching for him. Found him in the cluttered hallway further along the corridor next to a nurse holding a clipboard. ‘North Shore. The San. Manly,’ I heard him say. I guessed he was farming out the night’s intake to specialist hospitals. I waited politely. He eventually looked my way. ‘Esther Duncan,’ I said, meeting his eyes. ‘We’re ready when you are.’ He walked off, ignoring me. I returned to Esther’s room to wait.
An hour later he swept into the room like royalty. ‘Your mother,’ he said firmly and for the second time (which made me wonder if he had a set routine for every situation), ‘needs a pacemaker. Without it, she will die.’
My mother lay back, quite still except for her eyes, which darted from Bob to me. ‘What would you do?’ she asked. It struck me how young her voice sounded, even now, a day or two from death, three days at the most.
‘It’s not my decision, it’s yours,’ I said, refusing to be drawn in. If I understood anything about my mother, anyway, her mind was already made up. She was just playing the scene for all it was worth.
Esther gazed at the specialist standing at the foot of the bed. She gave off an air of submissiveness, a helpless little woman putting her life in his hands. But then, when she was young, doctors were gods. Early training, as I well know, is impossible to shake off. ‘I’m not afraid of dying,’ she said, sounding sensible. And then: ‘But what do you think I should do?’ The specialist turned away without answering. Over his shoulder he told us all to think about it, discuss it and let him know what we’d decided, but we didn’t have all day. He was getting the schedule sorted for transfers.
I followed and dragged him back into the room. ‘My mother needs to know the facts. What’s the upside, what’s the downside?’ I said, familiar with the system this time.
‘A pacemaker won’t fix anything else that’s wrong with her,’ he replied, looking at me as though she wasn’t there. ‘It will keep her alive. That’s all.’
‘What are the risks?’
‘She might die. She might come out of surgery with full-blown dementia. She might suffer a stroke during surgery. She’s in the very high risk category because of her age and the fact that her health issues are a long way along. If she’d come even a week ago, there might have been a better prognosis.’
‘And the outcome,’ I insisted on him repeating it, ‘the best possible outcome is …’
‘She’ll be alive, have all her faculties, but nothing else will change.’ In other words, the general crumbling would continue and escalate, but the head-on collision with death would be postponed for a month, two months, perhaps longer. Nobody could say.
This time, when he walked away, I let him go. Then I stood at the foot of my mother’s bed and looked directly at her. ‘Did you hear all that?’ She nodded. ‘Ok. You have all the information. It’s your decision.’
‘But what would you do?’ she asked again.
‘It’s not a decision I can make and it’s not fair to ask me.’ But I knew she wanted me to encourage her to struggle on, tell her she was the centre of my life, that I would wilt – even succumb – without her. I couldn’t do it. To offer affection, I knew from bitter experience, invited ruin. Exposed a weak point where the knife could plunge. I’d stopped taking the risk so long ago that I couldn’t play the loving daughter now. Not even if it meant her life. Whether it was deliberate or not, she brought out the shameful worst in me. The thin, complex wiring of mothers and daughters, or perhaps just this mother and daughter. Surely we were an aberration.
She settled her gaze on Bob then and asked the question once more. ‘I know what I would do in your circumstance,’ he said, ‘but I can’t tell you what you should do.’
Her eyes went flat and hard and her lips thinned. ‘In my circumstance,’ she said, enunciating each syllable very clearly, sarcastically, ‘tell me what you would do.’
Bob, a decent man, gave it to her straight: ‘I would say no. You’ve had a good run, Esther. Nothing is going to improve from now on. It’s going to get worse. But it’s your choice.’
She turned her face – pale, puffy and disappointed – towards a window filled with blue sky. ‘Tell them no,’ she whispered, scrunching, like a caterpillar, deeper into her bed.
I let out a breath I didn’t realise I’d been holding. ‘I’ll let them know,’ I said. ‘For what it’s worth, I hope I would have made the same call.’
She nodded. ‘I’d like to be buried in the dress your brother bought me. The one with the blue diamond pattern.’
‘Buried?’
‘Well, whatever. As long as I end up next to Wally. There’s still room for me there, isn’t there?’ And we switched, Duncan-style, into absurdity to cancel out despair.
‘Of course there is. Plenty of space. And you’ll have the chooks for comp
any. They’re great little yabberers. You’ve always loved chooks. There’s a brush turkey mound close by, too. We have chicks nearly every year. Cute little things.’ It didn’t occur to me until later how bizarre we must have sounded. Life. Death. The two most powerful driving forces in humanity, and there we were, once again discussing whether there would be enough room for my mother’s ashes next to her old Rottweiler. Later, I realised it was a clue: the seriousness of her situation hadn’t hit her. She’d shut away every grim detail in an airtight compartment while she focused on her deathbed performance.
‘I’ll find out where we go from here and be back shortly,’ I said. I glanced at the old bloke opposite. He gave me the thumbs up. Did the same for my mother.
I heard the scream as I stepped in the corridor: ‘Give me the pacemaker! Give me the pacemaker!’
29
ESTHER WAS TRANSFERRED TO ROYAL NORTH SHORE the same afternoon. The following morning she was quickly and slickly fitted with a small electronic device under the skin near her collarbone. It would keep her heart beating steadily, the blood flowing, for as long as she had the strength to keep breathing. For as long as her heart remained steadfast. I wondered at her iron will to survive.
The surgery went well, but Esther’s mind seemed to have short-circuited. She talked in riddles. Refused to get up. ‘The pain,’ she said, clutching her chest, ‘the pain.’
The overnight procedure stretched into one, then two, then three days. The head nurse, a young bloke, rushed off his feet and hard to pin down, said, ‘The pacemaker is working perfectly, her heart is beating strongly. She’s just not responding the way she should.’ He paused, looked at his feet. ‘She can’t stay here any longer. There’s nothing more to be done.’
I grappled to understand what was really going on: ‘She’s improving, though?’
‘She’s stable.’
‘So … not in any danger?’
‘No.’
‘Will she be able to go back to her old life in assisted care?’
‘We have a very good social worker who’ll come and talk to you. She’ll explain the options.’
My heart sank. When my first husband was beyond help, the hospital sent a social worker. I immediately understood that Esther had slipped a rung. ‘What happens now?’
‘We’ll move her to another ward.’
I sat in a chair in a corner of my mother’s room. ‘I wish I could tell you that when you get over this you’ll be seventy years old again, but I can’t,’ I said. I felt incredibly sad. The next step was a nursing home. Hadn’t my mother always told my brother and me, Whatever you do, never put me in a nursing home. Knock me on the head first. Her image was locked into an early-twentieth-century nightmare of filth, madness and cold, overcrowded cells, half insane asylum, half dumping ground for the near-dead. The kind of ugly, depressing place, I suspect, she and my father found for Uncle Ted after dementia blew his mind to bits and he tried to kill Esther. Choices were limited in Melbourne in the ’60s, and they’d done their heroic best before committing him, but I knew my mother was still haunted by the decision. Afraid, perhaps, the same fate awaited her if she dropped her guard.
To raise the bond money, I would have to sell my house. Or ask Bob to step in. But I wouldn’t do that. Family takes care of family. Blood dictates. My mother came first. If I believed she had failed me all those years ago, I could think of no valid reason to justify failing her now. I sat there for a while then crossed the room without another word.
‘I’m sorry,’ I heard her say in a very small voice. So not completely gaga, I thought. Post-anaesthetic confusion, maybe. Not necessarily dementia.
Outside in the corridor, the head nurse told me he’d made an appointment with the social worker for the following morning. I promptly burst into tears. ‘Oh god, sorry. It’s just she told us she wanted to die and then she changed her mind, and now a whole new existence needs to be sorted out. Which is fine. But where is the upside here? I mean, really, where-is-the-upside? Forgive me if I sound ungrateful, but my mother is ninety-two. It’s not as though she has a bright future waiting for her. Really. Was there a point to all this?’ I knew I sounded childish, selfish and even cruel. But to see my vain, witty, tough old mother slip unknowingly into an unlovely, empty-minded, demoralising living death was unthinkable.
The nurse was kind: ‘Will you do me a favour? Let me know how your mother’s going in a few weeks.’ Where do they find all that kindness?
‘Yeah, sure,’ I said, knowing even as I said it that I would not stick to the bargain.
The following day, Bob accompanied me to the hospital to meet the social worker. While we waited in Esther’s room, he went through the rituals. ‘You look great, Esther. More lives than a cat.’ And he leaned down to kiss her.
‘This is a very good hotel, you know,’ she said in a whispery, sly, confidential tone. ‘They even wash your bottom.’
‘You’re in a hospital,’ I said quickly, nervously, willing her to focus. Return to the feisty woman I knew. ‘You’d better not lose your marbles, Esther, because no one will want to know you.’ Hoping toughness would jolt her back to reality. She threw me a black look. Closed her eyes, shutting me out.
The social worker was a pretty woman with fair hair, a good figure and a soft voice. My mother warmed to her immediately. ‘You’re a natural blonde,’ she said, à propos of nothing. She added: ‘I used to be a blonde once. Blondes are always more fun.’
The social worker, whose name I can’t recall, smiled. ‘I was blonde a long time ago and now I have three young kids, so the fun part is debatable.’
‘I was a nurse like you,’ Esther said, sounding sly again.
‘I’m not a nurse. I’m the social worker, my job is to work out what’s best for you because you can’t stay here forever.’ There was a look of naked panic in Esther’s eyes.
‘You’ve been here nearly a week,’ I explained, ‘and it’s an overnight procedure. The system isn’t geared for longer stays. The thing is, Esther, you can’t go back to your old home – you’re not fit enough. We have to organise a halfway house until I can sort something out.’ She lost all interest in the conversation. Switched off. Her eyes seemed to empty of interest, emotion, life. ‘Do you understand, Esther?’ I asked, my voice louder than it had to be. She turned away from me.
The social worker said, ‘There’s a shocking shortage of hostel accommodation for someone like your mother, but I’ll get on the phone to see what we can find.’ Hostel accommodation? I had no idea what that meant. Like Bonegilla? Esther would have a fit.
The next day, the social worker told me my mother had asked to see her to explain that neither Bob nor I had her best interests at heart, that her son, my brother, was the only one who’d loved her. I was furious.
‘My brother has been dead for nearly twenty years. When he was alive, he banned her from his house. Even when he was dying he told his wife not to let her in. I have been looking after her ever since. I cannot remember a single word of thanks.’ I shook my head. ‘One day, I will turn my back and walk away. I will wash my hands of her and her name will never cross my lips again.’ I closed my mouth tightly. Took a deep breath. ‘Sorry. You don’t need to hear any of this.’
The social worker smiled with understanding. ‘You have no idea what we see in this ward. Women like your mother cling to their sons and are monstrous to their daughters. It’s unjust and irrational, but I’ve seen it over and over again. In my experience the boys don’t do much. It’s the daughters who end up with the dirty work. And, by the way, you won’t walk away. If you haven’t done it by now, you never will.’
‘No. Of course I won’t. But god, she goes too far. She goes way too far.’
‘Would you like a cup of tea,’ she asked kindly.
‘No, thank you. I’m fine. Over it now. Wanted you to know that I’m trying to find a bed for her in the country, near Taree. We spend most of our time on our farm there, so it makes sense.’
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�Sounds like a great idea. Let me know how you go.’
The following day Esther’s condition deteriorated for no obvious reason. I could have told them what was going on in that devious, manipulative mind of hers. Hospital was safe. There was always someone around if she felt threatened. She was plotting to stay as long as possible – preferably forever – and she wasn’t known as Sarah Bernhardt for nothing. Confused or not, her cunning instinct for self-preservation was as inviolable as ever.
I spent less than fifteen minutes with her. Both of us silent except for a polite word or two with the cleaner who mopped out the bathroom – a happy woman, or so it seemed as she hummed away under her breath. Thanking her lucky stars, perhaps, that she wasn’t lying in a hospital bed with a death sentence hanging over her. In the end, everything is a matter of degree and circumstance.
In a new ward, a geriatrician took charge of Esther’s wellbeing and called me each night with a report. ‘Very, very frail,’ she said. A few days later: ‘Her heart, her kidneys, are worn out.’ Another time: ‘Three weeks or three months, I cannot say.’ Finally: ‘She will need high care for the rest of her life.’
No way, I thought cynically, she’s conning the lot of them. But as always, doubts niggled. And nobody, not even my mother, lived forever. I decided to trust the experts and plan accordingly.
Beds in high-care nursing homes are hard to procure. Essentially, someone has to die before there’s a vacancy. I rang around the countryside on a daily basis, aware that snagging a bed boiled down to luck and timing. Or timing and luck. I was amazed to find, though, that in the country very few facilities demanded bonds. Fees were based on income and assets alone. It felt like someone had lifted a concrete hat off my head.
One evening, over a couple of drinks with a neighbour, she told me there’d been a cluster (three) of, er, check-outs, from the nursing home where she worked. Happened like that, she said, as though the Grim Reaper ordered in bulk to save a second trip. Called Alma Place, it was named after a nursing Sister who’d lived and worked at Bonegilla during my mother’s era. The connection, as flimsy as it was, might comfort her. I chose to see it as an omen. Shades of my mother, again and again.