We were getting anxious watching RS twitching her arms involuntarily as she lay unconscious in the hospice bed.
Black on Maroon Mark Rotkho 1959
She was a small woman, just turned eighty six and was finally succumbing to the non-stop intestinal punches of her cancer. Apparently it was painless, this so-called silent condition that turned her skin yellow in a swift morning swoop some ten weeks ago. Cancer was making the effect crystal clear ‘You stay still while I bring on pneumonia bruises, collapsed lung wheeze and whatever else makes your breathing look heavy and laboured.’
She lay on the bed, tiny and still. Her left arm raised, but bent at the elbow as if to shade her closed eyes from the beam of sun that stimulated the particles of human dust. I doubted she wanted to shade off the brightness because I knew she loved to discover the rays of light but as my father sat beside me he claimed to know her discomfort and the closing of the curtain supported his theory.
As the nurse walked in, she sensed the two-pronged assault: my father and I with questions and her bed-ridden patient’s silent needs. No pleading eyes and no question marked voices from the lady in the bed, just a stationary silence punctuated by those painful-to-hear breaths.
As one rehearsed voice we told the nurse that the patient appeared unhappy and off-comfort limits.
After looking at her eyes, temples, cheeks, throat and brow the nurse told us that all was in fact as well as can be.
She explained that palliative care differs from ‘mending nursing’ because the aims are different. A cure sits behind us, dismissed and irrelevant. What we are looking for here is a smooth journey to the end. Comfort, softness, toned down voices and muffled tears. Nothing is sharp or angled or abrupt.
She explained that RS was communicating involuntarily, through body language. Her lifting arm notwithstanding, she was without facial tension and free from frown. Her small neck remained loose. The cancer pain was emotional and psychological but this time; not physical.
This was the fifth death from cancer I’ve witnessed in the last 28 months and the one I’ve lived with the most. The visits to doctors, the blood tests, the hospital stays, the parking problems and the surgery. But above all this detritus the human efforts to deal with and chip away at unfair mortality have impressed me the most.
There are so many people who care. Some, like the doctors are well paid. Most others however are not, yet they still manage to offer time, soft vocal tones and shared tears.
This cancer seemed to create a stoic calmness. I saw other patients’ families sharing my bitten lip and inner cheek. I saw other patients walking through the specialist’s door with steady gait and defiant purpose. Fear always there, yet hidden.
Four weeks ago, while we were waiting in the hospital coffee shop for my father to return with her prescription steroids, I asked RS if she agreed with the oncologist that she was battling cancer bravely. ‘It’s not a battle’ she tells me ‘I’m too tired to call it a fight’.
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I have tried to remember other comments and quips that RS uttered in her last weeks, but cannot recall anything other than the silent sadness of (angry) resignation. The fighting bit was how she summoned up techniques from Tai-Chi and Yoga to exude a tranquil stance on her death bed. For whatever was going on in her mind and her heart, it remained hidden and muffled under the sheets of dignity.