A Way to Die: Living to the End

    Unknown to Rosemary, the hospice staff worried about her
attitude. Adela had reported a seemingly casual remark of Rose-
mary's while the two of them were exercising Jane's legs to relax
her body: "Now that I know how, I'll be able to do this for you
when we go home, Jane." Adela was distressed. Didn't she realise
Jane was never going home again? There was a danger this might
influence Jane's attitude, too, so that she would be less ready to
accept her death when it came. The nurses decided to find out
what Rosemary's thoughts really were. It was Sarah who drew
her aside. "How do you feel about Jane's illness now?" she asked,
looking at her intently.

    Rosemary knew at once what she meant. "I've known for a
long time that Jane hadn't much longer to live," she replied with-
out hesitation. "She always seemed more ill than people thought.
I've watched her grow steadily weaker." Rosemary still half-
hoped Jane might die at home, but she had no doubt that her
death was very near.

    There was no need for either of them to say any more. Sud-
denly, Sarah smiled. "She is a smashing girl," she said. Rosemary
smiled back gratefully, deeply touched. They had communicated
far more than the mere words they used. This capacity for quick,
easy understanding was part of the hospice atmosphere, and Jane
had come to share in it, too. All her life she had been slow to get
to know people, wary of lowering her own defences, inclined to
keep strangers at a distance. Now she was on close terms with
everyone who came into her bedroom, responding rapidly to
the warmth of the hospice.

    Sometimes she was ready for serious conversations, but she
also enjoyed the small talk that can be so comforting to sick
people who need to communicate but aren't always up to more
intense discussions. The hospice staff knew that minor matters are
important to the bedridden.

    Jane had always been fastidious, relishing the sensation of clean-
liness; but a blanket bath, when she was washed in bed with the
minimum of movement, was the closest she could get to the joy
she used to derive from relaxing in a tub. She told Dorothy how
much she liked the soft feel of the sponge and asked her to take
her time over it. Sensitive to her mood, Dorothy lingered over the
task. She had never owned a natural sponge herself, and com-
mented with surprise on its light touch. This was enough for
Jane. As soon as Rosemary came in, Jane said: "Mum, when you
go shopping, could you take my money and get a proper sponge
for Dorothy? A really nice one—she's been so good to me. I'd
like her to have something she'll use every day." Jane was still
thinking of giving presents, and she asked Rosemary to make
pots for all the staff when she got back to her work.
On the other side of the wall an old man began to cough,
noisily and painfully. Jane stirred uneasily and finally said with
annoyance: "The pain's getting pretty bad. Could I have another
injection?"

    Sarah came immediately. "Of course you can have an injection
if you need it," she said. "But let's try and see if we can't make
you comfortable first. That would ease the pain a lot. It's some
time since we turned you. We'll move you onto your right side."
She asked Rosemary if she would help.

    "Of course, if you'll tell me what to do. I'm a bit afraid of
hurting her." It was very difficult for Rosemary to handle her
daughter's body now. In the past weeks, when her efforts to
wash or lift Jane had caused extra suffering, Rosemary had felt
an inept nurse. But hospice workers are trained to encourage
reluctant relatives to help.

    "Now," said Sarah, "I'll take her body. Just push your arms
right under the legs, as I'm doing with her back, and then we'll
gently ease her over in one. Right? Ready?"
Jane lay atop their four arms, quite helpless. Sarah had arranged
her legs so that they were slightly bent at the knees and hips
to reduce tension on the stomach muscles, for that was the area
of great pain. Her body's reactions to every movement had been
carefully noted and thoroughly discussed at the staff's daily con-
ference. Sarah knew where the cancer hurt most. As she turned
Jane over, she avoided provoking the additional pain that twisting
or stress on the spine would cause. Since the spine often aches
when one is lying in bed for long periods, Sarah packed pillows
against Jane's back to provide support and to give her confidence
that her body wouldn't slip to a less comfortable position. Help-
less patients can worry about slipping, and the hospice staff was
alert to these fears.

    But Jane wasn't comfortable yet. Sarah persisted in her efforts
to find a relaxed position, lowering first the head, then the foot,
of the bed, asking her at intervals if she felt more at ease. Jane
became embarrassed that she always answered No, but Sarah
waved the apologies aside. "It's no trouble," she said. "We've got
plenty of time."

    Rosemary helped to lift Jane over until she lay on her left side
again. Once more Sarah packed her body with cushions, easing
the pressure here, supporting it there, rearranging the limbs with
infinite patience.

    At last Jane smiled. "That's much better. I might get to sleep
now."

    But the pain returned, and Rosemary had to go looking for a
nurse again. Sarah came back promptly. The hospice was deter-
mined to control her suffering. She gave Jane an injection im-
mediately.

    When Patricia came on duty later, Rosemary was worried
Jane might get upset again. But the two were soon friends.
When Jane arrived at the hospice four days before, Patricia
had been well aware of her hostility. Now she found that Jane
was no longer a bundle of pain. A conversation started up when
Patricia commented on Jane's hair as she brushed it. It was still
thick and shining, she said, in spite of the treatments.
"I was scared of losing it all with chemotherapy," Jane re-
sponded. "I used to count the hairs in my comb every day. I
thought I was going to look like a scarecrow. I suppose it's silly,
 but I'd have been very embarrassed to have people see me like
that."

    It could have been something in Pat's manner—perhaps the very
directness and briskness that had irritated her the first day—that
I now made Jane think she could put the question, "I wonder how
long it will be before I die?" It came easily, naturally.

    "I don't expect it'll be long now," Pat said, in an equally mat-
ter-of-fact way. For the moment, that seemed to be all Jane
wanted. Pat was brushing the hair away from her face. "You
really do look very beautiful, you know."

    "That's hard to believe." Jane giggled, pleased in spite of her-
self. She had always done what she could to look as good as
possible.

    "No, you do look lovely. So serene. I thought so when you
first came in—how lovely you looked in spite of the pain."

    "Really?" She sounded sceptical. "I haven't seen myself for
ages, and then I looked pretty foul."

    It hadn't occurred to anyone at Dairy Cottage to offer her a
mirror. When Jane went to the bathroom, she didn't stop to look
at herself. The pain caused by the movement had made her want
to get back to bed as quickly as possible. But the hospice nurses
knew how much their looks mattered to the patients, old and
young, men and women. That was one reason why the list of
things a patient should bring to the hospice included a hand
mirror.

    "Where's your mirror, Jane? You must see for yourself."
Patricia rummaged in the locker beside the bed, then held the
glass up so she could look easily. "Can you see properly? It is
such a tiny mirror." 

    "Could you bring it closer? I can't see very well." Jane studied
her face silently, then she said thoughtfully, "I hope I die looking
like this. I don't want to end up looking hideous. Sounds silly,
doesn't it?" She made a face. "It shouldn't matter what you look
like."

    "I don't think it's silly at all, Jane. You'll be lovely, I promise
you." Jane took another look at the mirror and rested her head on
the pillow. She was smiling.

    Among the friends Jane had asked to see was Ann, whom she
had first met when they taught at the same school. Ann arrived
while Dr. Murray was with Jane and Rosemary was in the nurse's
kitchen making bread. It was one of Jane's favourite foods, and
she had taught Rosemary how to do it. The kitchen smelled
strongly of yeast. Ann spoke quickly, as if embarrassed.
"You know, when I got Richard's message that Jane would
like to see me I had no idea—1 hadn't heard anything at all about
her—1 was a bit shattered . . ." She paused, as if unsure how to
go on. "I was rather afraid to meet you, but it's a relief to see
you're managing. One never knows how people will be affected
and I didn't know you at all, only what Jane told me."

    "Yes, it has been hard." Rosemary kneaded the dough vigor-
ously. "But Jane's happy now, you'll see that, and everyone's
marvellous to us. We've been made to feel at home."

    "And the nurses don't mind you being here all the time?"
"Nobody says anything, no matter how many of Jane's friends
turn up. Today, Monday, is officially a non-visiting day, but it's
meant to give the patients' families a rest as much as the patients
themselves. Sometimes it's difficult for people to travel long dis-
tances every day. That way those who need a day to themselves
have an excuse, and there don't have to be hurt feelings."
"I can see they think of everything."

    "But if people want to visit, the nurses like it." She told Ann
about Arloc, and how the hospice staff had made him welcome.
"Everyone seems so—well, unbrisk, if one could use such a
word," Ann said. "I remember when my mother was dying a few
years ago, it was very different. They had such strict rules—she
was in the hospital, of course. She was much too ill to be looked
after at home. I wanted my daughter Judy, she was ten, to see her
grandmother before she died. But when I asked permission to
bring her into the ward, Sister said absolutely not. It would
damage the child to see someone she loved in such a state. So
I just said: 'Look. I'm sorry, but I'm going to bring my daughter
here to see her grandmother whatever you say.' And I did. Judy
told me afterwards that seeing someone dying wasn't nearly as
bad as she'd imagined it might be. She'd had all sorts of horrible
fears about it, and then everything was quite simple and easy
for her."

    They were interrupted by Dr. Murray's arrival. "Patricia said
I'd find you here . . ."

    Ann went off to see Jane. "Dr. Murray," Rosemary began, "I
wanted to ask you about something that's worrying Jane. She's
forcing herself to drink even though she doesn't want to." She
explained that Jane had been warned at the hospital that if she
didn't take enough liquid she would need another saline drip.

    "She really hated it."

    "That won't happen here. We don't feed intravenously," he
reassured her. "You remember our discussion about nerve blocks?
I've been talking to Jane about blocking off her nerves to deal
with the pain she still feels. But it's early days yet."

    "She does complain of pain sometimes."

    "She's moving more now and the movements produce pain. I
explained this, and she appeared to accept it. If we do block off her
nerves to deal with the pain, it's simply a matter of giving an
injection of a nerve poison like phenol. This would knock out the
nerve fibres for a time."

    "We were worried about her having to be moved. She still has
nightmares and asks: 'Where do we go when we have to leave?'
She needs to feel secure."

    "It can be done in her room," he reassured her.

    There was something else bothering Rosemary. "Richard has
to go back to America on Wednesday. He's spending tonight
with Jane, then Arloc will come over tomorrow to see her. It'll
be their last day here."

    "That will be very difficult for her," Dr. Murray agreed. "We'll
do what we can to help her through it."

    Rosemary thought of Arloc and his easy, natural manner with
Jane. The boy had never treated her as a being apart because she
had cancer; her illness had been no source of embarrassment to
him. "She'll miss Arloc as well as Richard," she said. "Yesterday
he just sat holding her hand and neither of them needed to say
anything."

    Meanwhile, Ann and Jane were chatting.

    "Shouldn't you be in school?" Jane asked.

    "I had a free afternoon. When the others heard I was coming
here, they helped me get off early. I didn't expect to see you look-
ing so bright."

    "They give me injections whenever I need them and I'm fine.
I still get nightmares, though. Last night I was in an Italian brothel
and furious that the Mafia were getting all the profits. Mum said
I tried hard to persuade her we should escape. I must've been
pretty scared." She yawned. "It was a tiring night. I'm sorry—
I do get very sleepy."

    "I have the whole afternoon, so if you want to drop off, feel
free," Ann assured her.

    "Did Richard tell you everything?"

    "Yes, he did."

    "He told you I was going to die?"

    "Yes," Ann answered without hesitation. "Are you frightened?"
The words came out naturally, but even as she spoke, she thought
this was a silly question. Jane's answer made her realise that it
hadn't been tactless after all.

    "I was frightened," Jane stressed. "I'm not now, not any more."
Ann felt that all the barriers were down. The restraints com-
mon in a conversation between people not entirely intimate no
longer existed. They were closer than ever before.

    "I seem to have slipped down in the bed. Would you mind
giving me a lift up? The nurses do so much, I hate to keep inter-
rupting them for little things."

    "Of course I'd like to help you," Ann said hesitantly, "but I'm
a bit scared of hurting you."

    Jane said she should try, so Ann put her arms beneath her
friend's shoulders and pulled her up in the bed. They both giggled
at Ann's clumsiness as she moved the limp body. How soft it was,
thought Ann. Soft and limp, as if she had no bones left, no
muscles, no strength.

    "Did you mind touching me?" Jane asked her. "Some people
find it embarrassing, especially when one is naked."

    "No, of course not."

    "That's one of the really great things about this place. They
don't get in a state over silly little things. Here they treat me like
a human being all the time, not just when they feel like it."

    Jane looked so virginal and good, Ann thought. Her expression
was almost elated. When she talked about dying, it seemed as if
she welcomed death, and not merely as an escape. But they spoke
easily of other things, too. "Do you get many birds coming to
the bird table?" Ann asked, peering out of the window.

    "It was there when we came and Arloc filled it with food. I
think they moved it nearer to the window, but I still can't see very
well."

    "There's a bird on it now. I think it's a greenfinch."

    "Mum says he keeps the other birds from feeding."

    Jane lay back and her attention drifted. Perhans she wanted
to sleep. Ann left soon. She decided she should share this experi-
ence with the class that Jane had taught. She would try to describe
Jane's feelings about dying.

    Ann's visit had made it possible for Rosemary to get away from the hospice for a short time. Sue. an old friend who lived  nearby, took her for a walk in the brilliant June sunshine.  Rosemary picked some poppies, remembering how Jane loved their deep scarlet colour. As the stalks broke, the familiar acrid scent rose up. This would be a far richer experience for Jane now that her
sight was failing. The smell would bring back memories of sights
and sounds, and enrich what time she had left.

    Together Sue and Rosemary walked round searching for smells,
and not just the sweet ones. Jane had never been a "sweet" person,
she had loved unusual tangy scents—that of dandelions, for exam-
ple. They could find no dandelion flowers, but the plant itself was
there and its leaves carried the strong pungent odour. Herb robert
grew nearby, too, the strong smell of its seeds surprising in such
a modest and fragile plant. They found other flowers and leaves
whose names they didn't know. They picked from every plant
in sight, then tested each for smell before adding it to the bunch
or rejecting it. Even strong, slightly unpleasant odours, like
that of the flower called stinking mayweed, would be worth ex-
periencing one more time. Clover flowers, sweet and slightly
dusty, would bring back the most typical scent of summer.
They carried their bunch of "smells" back to Jane and held
each flower, each leaf, in turn to her nose. She sniffed deeply, her
eyes shut, a smile of pleasure on her lips as she tried to identify
them one by one.

    Later in the evening Sue returned with a branch of orange
blossom, and the vivid smell filled the room. She also brought a
bunch of herbs. As she held them for Jane, she rubbed each herb,
releasing the aroma. Many of these were herbs that Jane had used
to flavour her cooking. Some of them grew in her own garden.
She sniffed slowly, taking a deep breath each time, and waiting
before going on to the next: lemon thyme, marjoram, bergamot,
tarragon, rosemary, mint . . . Each carried many memories. It
was as if she were saying goodbye to old friends with whom she
had shared good times.