by David Loftus
Then I must think about coming home, exhausted, thin and needing a comfy bed and a nice cup of tea. Some rain would even go down a treat as well. I’ll send a card from Turkey and Patmos though I expect I’ll be home before they arrive.
All my love, John xxx
Saturday 7 April
The Mews, with Ange working beside me
It’s funny that my father didn’t find love until he was fifty. You’d think that such a perfectly mannered, debonair chap would have been inundated with offers of love, but apparently not. His love of my mother was his ‘first love’. He waited, hopeful that one day he would fall in love at first sight, as he eventually did. His heart, like mine, was a big heart, full of love for his wife and then for his newborn identical twins, John and David. Later he suffered seven heart attacks, including a massive one from which my mother revived him on the operating table, after he’d been given up for dead. But I don’t believe his big, beautiful heart would have survived the death of John. I now understand the concept of dying from a broken heart. I certainly came close, and my father almost certainly would have done. Luckily the searing pain of a broken relationship is the greatest suffering that many of us will ever experience, particularly in our young lives. And ultimately time does heal most broken hearts.
But not all. There is a syndrome known as Takotsubo cardiomyopathy that affects many whose hearts are broken more violently or tragically. This little-known condition was first coined, as it sounds, in Japan, and named after the native word for an octopus cooking pot, which has a unique shape that resembles the broken left ventricle of a human heart. It’s provoked when the heart muscle is suddenly ‘stunned’, causing the left ventricle to change shape, and is typically prompted by intense emotional or physical stress. It causes some actual visual scarring, akin to a real physical break. When John died and I eventually lay down on my bedroom floor to rest, my heart was broken. Like many before me I willed myself to die. Ultimately what saved me was the sense of panic I felt when my body realized that I was bound for success in my quest for eternal sleep.
Note found on Mum’s desk:
Into your hands of love, Oh Lord, I command my dear John
Enfold him in your love and peace, now and forever more.
Amen
Sunday 8 April
Our wonderful nanny Molly Florence Wrigglesworth spent her life caring for other people, her parents, patients in local hospitals and, last but not least, the Loftus family, particularly us twins. When my mother called from hospital and Molly passed the phone to me, just the two of us at the breakfast table that was normally the centre of rowdy teas with all our friends, I knew that, other than Mother, she was the only person I could be with at that terrible moment. She had known John from the moment of his birth to the moment of his passing, and something broke inside her, inside us both, at that extraordinary moment in time that was shared between dear Molly and I.
Monday 9 April
I left the Mews early last night so that I could wander in a circumnavigation of Battersea Park before nightfall. It was the greyest of a fifty-shades-grey day, shadowless and dull. It’s rare to see, but no one was in the park, no dog walkers or joggers, the thick mist of impenetrable drizzle keeping them tucked up at home. What was extraordinary was the verdant vividness amidst the quiet stillness. I stopped occasionally to take photos; newly hatching catkins hanging lankly and sodden, patches of multi-coloured bark and moss peeling from the plane trees. I was struck by how much of the minutiae of the park was alive and bursting with colour and signs of new life.
It was a blissful hour of solitary silence, birdsong and observation of the colourful kaleidoscope of winter’s decay and new birth, new life. An uplifting, life-affirming hour, sealed with a perfect lingering hug upon meeting Pascale when I arrived home.
‘Drinking is a way of ending the day.’
—ERNEST HEMINGWAY
Tuesday 10 April
The Mews
Since I was unwell ten days ago I seem to have more of a wariness around wine. Not a bad thing, a drop in consumption levels; we’re talking five glasses down to three, not ultimately a drying out, more a subtle reduction in pace. Today, yet again, and I’m sure it won’t be the last time, I have begun my umpteenth attempt at stopping my constant plink plonk, fizz of the dreaded yet deliciously dissolvable Solps. Thirty years of averaging five a day may keep the headaches at bay but Lord knows what havoc they are playing with my inner workings. At least poor Johnny had a good excuse for his addiction, mine is the after-effects of my other addiction – rosé – even though three or four glasses of it are hardly rock and roll. Like all addictions, the partaking of the ritual begins to have its own beauty, the plink and fizz, delayed into extra time if you add ice, the rim of dried codeine around the lip of the glass that you can taste with a dunk and wipe of the finger, the salty, alkaline first sip, the mild fizzing in the nostrils, the hypnotic bubbling and chalky aftertaste.
When Johnny died my Solps consumption rose from one or two to five or six tablets a day, a soporific duller to the endless waking days. Somehow I found the strength not to drown myself in drink though the temptation was so strong.
I could too easily have gone off the rails but I was saved by the need to look after my mother. She needed me and I needed her, and our bond now is closer than ever. I yearn for her company. I’m very aware that she is in need of a lot of medication; a nasty little pill for her breast cancer, a tiny tipple of whisky for the blood vessels and circulation, some painkillers for the pain in her feet and legs, something to help her sleep, another to help her wake, a tonic here, some vitamins there. With me and my Solpadeine consumption, I recognize it as a sign of depressive behaviour, symbolic of my post-traumatic stress, so I’m trying to grab the issue by the horns and wrestle it away from my daily routine.
Wednesday 11 April
Another cutting, this one from British Medical Journal, 30 November 1991:
By Ian Loftus [then tumour doctor at Leicester Royal]:
Sir, the recent prosecution of two junior hospital doctors for manslaughter has attracted much publicity. It is the first time that such charges have arisen relating to the administration of intrathecal drugs, but it is not the first accident of its kind. My elder brother John died as a result of a junior doctor administering a massive intrathecal overdose of gentamicin while receiving treatment for meningitis after neurosurgery.
My family felt great bitterness and anger about the circumstances surrounding his death. We sought a full explanation from the staff and a reassurance that steps would be taken to prevent such a disaster happening again. However, the hospital was unhelpful, uncommunicative and, above all, unresponsive to our distress. Furthermore, the coroner and the General Medical Council appeared unwilling to address our questions about guidelines and procedures for administering potentially dangerous drugs.
It is with great distress that I hear of such accidents, including that in Peterborough (see previous BMA journal), occurring with disturbing regularity, and it seems to me that we should strive to reduce the risks of such events occurring. We must be aware of the terrible consequences that mistakes have on patients, their families and also often the hospital staff. So how can things be improved to reduce the risks of such accidents occurring?
I believe that there should be stricter guidelines and better education of junior staff with regards to administering drugs. More careful labelling of drugs, particularly those for intrathecal administration, and certainly checking of drugs with other members of staff should be standard practice and would certainly help to prevent similar accidents occurring. I am in no position to institute such changes but because of the loss suffered by my family, I feel they should be encouraged.
When accidents do happen, as occasionally they will, we must be able to admit that they are accidents, and not see this as a weakness on our part, for we are all human. We must be able to approach relatives sensitively to offer explanations and reassurances; failure to do so
can only add to the misery and despair caused by the loss of a loved one.
I. M. Loftus
Brother Ian is now Professor of Vascular Surgery at St George’s Hospital in Tooting. Following the Loftus tradition, my son Paros is now a second-year medical student at St George’s and spends his holidays on research projects for the vascular department. My mother retired from general practice a year after John’s death, a great loss to her patients who were devoted to her. Upon moving back to the shadow of Hadrian’s Wall she voluntarily helped the local hospice to administer injections in the palliative care of people with life-limiting illnesses.
Thursday 12 April
A 6a.m. start, a long day shooting the comings and goings of kitchen theatre at The Wolseley restaurant, followed by an interview with The Telegraph about the writing of this book. It was hard to talk to a stranger, journalist Peter, about the personal nature of the book, while being photographed by a sweet German photographer who, in a strange case of disconsolate chance, was born a triplet, a singleton girl with two identical twin brothers, who both died in childbirth.
Five great things to appreciate today:
Foxes on Albert Bridge.
Admiring Charlie Mackesy’s illustrations of a mole, boy and horse.
Pascale telling me she loves me more than I love her.
A jay plucking out weeds from my neighbour’s window boxes.
The beauty of photographing the egg of a goose.
Deep breath, tomorrow is another day.
Friday 13 April
John would refuse to leave his bed on Friday the thirteenth, believing that being there was the safest place on earth. Ultimately he was killed in bed, just not his own bed, on our birthday, Halloween, a day we had always felt laden with a fog of gloom and ominousness. So often in our youth we would huddle up as night began to fall, bedroom curtains drawn and overlapped so that no one could see in or out, believing without doubt, that witches would have their evil eye on us, identical twins born on Halloween. At least Friday the thirteenth would never fall on the 31st.
When I saw a clinical psychologist after John’s death, I would sit there gazing at the ceiling as she mentally prodded and probed her lone twin lab rat, handing her a cheque at the end, no better for the experience, with a new antidepressant prescription to be binned at the first street corner. What did I gain? A life dependency on Seroxat, the controversial ‘selective serotonin reuptake inhibitor’ that has so many unpleasant side effects when you’re coming off them. Life seems more dangerous than it would have been without them. I got a diagnosis of ‘post-traumatic stress disorder’ (PTSD) and a ‘ rare case of scenario syndrome’, something years later I can find little about other than its basic description which is ‘extreme catastrophic thinking’. In hindsight the diagnosis was wrong. Post-traumatic stress I take on the chin; what was happening with me was not catastrophic thinking but a symptom of extreme anxiety and slipping into depression.
Today the World Press Awards were announced, and, as usual, the pictures are extraordinary. Glimpses often of a terrible world that exists far away from our comfortable lives, images of tragic brutality or suffering. One image particularly moved me, reminding me of a pre-Raphaelite masterpiece. It’s an image of two sisters called Djeneta and Ibadeta, lying side by side in a hospital in Horndal in Sweden. Soft-focused and beautiful, the sisters sleep seemingly at peace, but for the tubes running from Djeneta’s nose. The sisters are Roma refuges from Kosova who suffer from resignation syndrome, which renders the patient immobile, mute and unable to respond to physical stimuli.
I just pray that the sisters dream beautiful and sweet dreams. The world can seem a vast and cruel world at times.
Saturday 14 April
An extract from Her, a memoir by Christa Parravani who, like me, found herself a lone identical twin:
I forgot who I was after Cara died. The power of her memory was so strong that I would see her instead of me. I gazed at myself in the mirror and there she was, her rusty brown eyes, frightened and curious as a doe. I’d smile at myself and see her grinning back.
I learned later that this heartbreaking delusion – that you are looking at your dead twin when really you are looking at yourself – is a common experience among identical twins when one dies. The surviving twin finds it impossible to differentiate their living body from that of their dead twin. They become a breathing memorial for their lost half.
Christa struggles as most of us lone twins do. She, like I, had read that 50 per cent – the equivalent of a toss of a coin – of bereaved identical twins die within two years of their twin’s death. Like me she rejected the help of psychiatrists and clinical psychologists and ultimately found help from a friend who had recently suffered the loss of her sister and mother. In my case, as I have already stated, it was my introduction to Tim Knatchbull, my lone twin soulmate.
Sunday 15 April
Flight from London to Stockholm and on to Mariefred
A day of headaches and coughs. My paranoia around headaches is, I think, an acceptable consequence of the events leading to John’s death. I can only assume that the headaches that John used to suffer in the years prior to his illness were far stronger than mine. I flew a hideously bumpy, overheated and overwrought flight to Stockholm today, a beautiful view of the curvature of the earth enhancing the sunset but otherwise an ill-tempered and uncomfortable flight.
Upon arrival in Mariefred I snuck a dose of Swedish cough medicine, I assume prescription rather than over the counter as the main ingredient seems to be morphine – for coughs! Still, it should thwack the headache into touch!
Monday 16 April
Mariefred, Sweden
Wasted days, like yesterday, frustrate me. I travelled from the Mews to Mariefred in Sweden, I saw the sun set in a purple sky, but I failed to find inspiration to write.
Today was different. My sleep followed the pattern of the day, frustrated, tetchy, irritable and overheated, but the dawn chorus at 6a.m. beckoned me outside into the chilled air. Mariefred is part of the archipelago, so on water, still partly iced-over, the air so still, bullrushes frozen to attention in the shallows. I walked to the water barefoot, and closed my eyes to the rising sun. Absolute silence and utter bliss, broken in a most welcome way by two Egyptian geese chuckling at me, their early-morning companion, equally barefoot. I so love the way they travel around Europe, almost unnoticed and incognito, beautifully exotic with red eyes and golden-brown tufty plumage, looking like they’ve just walked out of Tutankhamun’s tomb. I thought of Ange and her lists of ‘things to be thankful for’ and I thought how I’d been up for no more than half an hour and I already had:
A hawthorn bush full of sparrows chirping wildly.
The milky sunrise.
The frozen bulrushes and the freezing-cold water on my almost numb feet, reminding me it’s good to be alive.
The slight warmth on my face as I tilt my head towards the rising sun.
The bevy of swans wandering silently on the ice floe.
The quirky, Tim Burton-esque, knobble-ended apple trees, still bearing a few of last autumn’s fruit, curved over by the weight of their branches.
The Wes Anderson-esque architecture of the symmetrical yellow-painted timber-frame houses, like a scattering of oversized dolls’ houses, behind where I dangle my frozen toes in the brackish water.
And last but not least, Tweedledee and Tweedledum, my newly named Egyptian compadrés, making me wish that I’d brought my breakfast down with me so I could share it with them on the jetty.
Tuesday 17 April
Mariefred, Sweden
I started the day as I did yesterday, with a sole-spiking, pebble-hobbling wander down to the water, this time remembering some cinnamon buns for T-dum and T-dee. I was amazed to see the ice upon the lake had melted and disappeared completely, freeing the odd buckled and warped ghost boat from its icy clutches. I was tempted to board and conquer and claim but the biting cold on my bare feet sent me scuttling painfully ho
me to my studio for tea and knäckebröd.
Wandering with a hand-warming mug to sit under the apple tree in a small triangle of early-morning sunshine, I was catapulted back in time to a distant memory of me and John screaming and charging through the damson and plum trees at The Beeches. I’ve no idea how it started, but after dinner on balmy summer evenings, John and I would strip down to our little white M&S Y-fronts and tear outside and up the garden path, our corgi Sally in hot pursuit and full bark, screeching at the top of our unbroken voices ‘White pants men, white pants men!’ In and out of the trees, around the ‘shuggy boat’ swing and up and down the rockery we would career, ‘White pants men, white pants men!’
After a few high-octane minutes our brother Ian and cousin Edward would then tear out of the back door to a chorus of barks and screams, ‘White pants men, white pants men!’ John, David, Ian, Edward and corgi Sally, in close formation, arms aloft and at full tilt, streaming through the undergrowth, blissfully ignorant of rose-thorn scratches or nettle stings. And then, after a seemingly endless bliss of wheeling and whirling about the garden, we would all clatter into each other, grind to a halt and fall about with uncontrollable laughter as our sister, Jean-Marian, would nervously round the rockery corner, just in her underwear, to be met by four breathless chumps pointing at her and laughing our non-existent socks off, screaming at the top of our pre-pubescent voices, ‘Yellow pants woman, yellow pants woman!’ Tears before bedtime!
Wednesday 18 April
Last day shooting in Mariefred, a grey as grey day. I made my 6a.m. homage to visit my geese, but they were nowhere to be seen and the Mary Celeste had drifted back out to sea.