Forty

‘Excuse me, but is that Dr Deerbon?’

‘It is, yes.’

She was settling down to read the latest choice for her book group, with a glass of wine.

‘I don’t suppose you’ll remember me – my name’s Jack Dacre, you only saw me a couple of times over the years but my mother was your patient …’

‘Yes – Elaine, is it? I do remember her. How is she?’

‘Not good, Doc, very poorly in fact, and it’s why I’ve rung you and I hope you don’t mind. We’ve been at our wits’ end knowing what to do for the best.’

‘Jack, you’re welcome to talk to me but I’m not your mother’s doctor now, so I can only give you general medical advice.’

‘But I think you are – I know you’ve done some sessions at her practice – Granham Road Surgery? She sees Dr Marriott, but she’s been away having a baby, so Mother hasn’t got attached to any other doctor in particular.’

‘That makes all the difference. I only do locum surgeries for Granham Road but as it happens I have done several in the past couple of months, some for Dr Marriott. So tell me what’s wrong.’

‘My mother has cancer. She’s at home – they sent her out of Bevham General because apparently they can’t do any more there, and in any case, she said all along that she wanted to come home to die. She knows she hasn’t got much time.’

‘I understand. I’m so sorry. How long has she been out of hospital?’

‘Four days. She doesn’t seem too bad in herself – she gets up when she can, even if it’s just to sit in a chair, and she comes down in the evening if she can make the stairs. The real problem is that she’s distressed in her mind. Then tonight, she suddenly said she wanted to talk to you. She said she’d have gone into the hospice only it’s closed …’

‘Not exactly – it has day-care patients.’

‘She’s past just going in and out for a day.’

‘I see. The nurses from the hospice would come out to see her – does she know that? It’s part of what’s done now there are no beds at Imogen House. It’s called hospice at home.’

‘My mother said you were the hospice doctor.’

‘I am – but I’m not working there so much at the moment.’

‘Oh. It’s all a bit complicated, isn’t it? I’m sorry to have bothered you then, Doctor.’

He sounded exhausted and flat, as if a final door had closed in his face.

‘No, no, it’s fine. Remind me where your mother lives – of course I’ll go and see her.’

‘Dr Deerbon, she said you would. I am so grateful to you, I’m so grateful.’ Now he was struggling to hold back tears.

It was mid-afternoon before she turned into St Luke’s Drive, remembering the road only vaguely – the GP practice she and Chris had run had been on the other side of Lafferton so not many patients had lived here.

‘I can’t tell you how grateful I am to you,’ Jack Dacre said, leading her into the quiet sitting room overlooking a long garden. ‘She hasn’t been sleeping well but when Angie went in to her last night, she said knowing that you would come was such a relief that she went out on a cloud and didn’t wake until after seven.’

‘Are you staying here?’

‘One of us sleeps here every night but we only live a dozen houses down so we come in and out … Angie works part-time so she can be here quite a bit, and our daughter Lou – she’s in the sixth form – she’s pretty capable.’

‘Lots of family support then. That’s so important and many people just don’t have it nowadays, for one reason or another. It’ll make a lot of difference to her.’

‘I hope so. We know they can’t cure her but I was afraid she was going to die in Bevham General – she went right down, didn’t eat, seemed to shrink into herself, if you follow me. It was as though she was giving up.’

‘She would have been very depressed … realising that you’re not going to get better and that you might end your days on a busy hospital ward is a pretty bleak prospect.’

‘That’s where the hospice should have come in … Well, anyway, she’s up and dressed and in the chair. She’s had some soup and toast – not a lot but as long as she eats something, we try not to fuss her.’

The wall between the second and third bedrooms of the house had been removed, making one light, spacious room, with a wardrobe and chests of drawers built in around and above the bed, and one end, also overlooking the garden, made into a sitting area. A bracket had been fitted outside the window with three bird feeders attached, and as they went into the room, there was a flurry of wings as blue tits, chaffinches and a robin scattered away in momentary fright.

The minute Cat looked at Elaine Dacre, she remembered her – a pretty woman with hair that had started to regrow after chemotherapy, and now formed a fluffy grey cap. It made her blue eyes look larger and more vivid. She was very thin now, and her skin had a tinge as if a suntan was wearing off. Her hand, as she held it out to Cat, had long fingers and Cat felt the bones moving beneath the flesh, like those of a bird. She was dressed in a silky blue shirt and loose trousers, wore make-up, including a bright lipstick, and a pair of shoes were beside the small armchair on which she sat with her legs up. The room was warm but a woollen shawl was beside her, two cushions at her back.

Cat sat on a stool which was drawn up close to the armchair, and took the fragile hand again between both of her own. Elaine Dacre gripped it tightly in response and her eyes filled with tears.

‘Shall I make you some tea?’ her son said, relief softening his anxious expression as he stood in the doorway.

‘I would love a cup of tea more than anything, I haven’t had one since breakfast, thank you.’

‘And there’s some lemon drizzle cake left, isn’t there?’ Elaine Dacre looked at her son with tenderness.

When the tea came, and the cake, cut in neat slices, Jack left to do the supermarket shopping. Cat listened to his mother’s lengthy praise of her family and how wonderfully well they were taking care of her, discussed the granddaughter’s future, and then Cat’s children and Lafferton events. The chat went on for twenty minutes or more and she knew better than to do anything other than take her cue from Elaine.

The house was quiet. The birds had returned to the feeders. A boy in the yard next door mended a bicycle wheel.

Elaine set down her cup. She had said twice how grateful she was that Cat had troubled to come. Now, she looked at her again.

‘Do you know what the worst is?’

‘The worst’ was different for every terminally sick patient, Cat had discovered years ago, though there were only so many variations – the pain, losing control of faculties, leaving partners and children or not seeing grandchildren grow up, loneliness, sense of disbelief, fear of the dying process …

‘Tell me.’

‘Nobody will talk about it. Or at least, they will, but only in a roundabout way, not really talk –’

‘About dying?’

‘Dying. Death … all of it. Jack and Angie won’t talk, they swerve away and ask if I couldn’t manage a bit more of this or that to eat. I can see the panic in their eyes. The doctors in oncology know what they’re doing but they would only talk about it in terms of prognosis and statistics.’

‘One of the points of the hospice movement has always been to provide a place where people can talk about everything to do with their situation. It’s what the staff are trained to do.’

Elaine shook her head, smiling.

‘Of course, nobody will start talking about death and dying if a patient clearly doesn’t want to … that would be intrusive and even unkind … though some things do have to be said – gone are the days when it was thought better not to mention the C-word, always to pretend someone was improving.’

‘I want to talk. I have had so many questions, so many thoughts whizzing round and round inside my head, a confusion of fears and feelings … and I want to say things, tell things. But it does seem to embarrass people – I find myself being very careful not to mention death and dying to visitors – and doctors and nurses – in case I embarrass or upset them.’ She laughed.

‘You’re going through and facing the most important time anyone faces, other than their own birth – only you had far less control over that and you don’t remember anything about it, and couldn’t prepare for it. Death is different. Or it can be. I really believe that. People say they’d like to die suddenly and not know anything about it but I’ve always thought that was a lost opportunity.’

‘Yes … oh yes!’ Elaine put her hand over Cat’s again. ‘I knew you were the one person I could be sure wouldn’t dodge and dissemble and change the subject.’

‘I hope not. Listen, I have to collect my son from school soon but I’ll come again with pleasure if you want to go on talking … if I dash off it isn’t that I’m trying to escape the D-word.’

Elaine rested her head back and closed her eyes for a moment. When she opened them again, they were brighter, more full of life, and the strain and anxiety in her expression had eased.

‘I want to tell you about something that happened – I’ve tried to tell other people but they’ve either looked embarrassed and changed the subject hastily – the usual – or they’ve been a bit scornful and disbelieving. I can’t mention it to Jack or Angie, they just say I was under powerful drugs and I should forget all about it.’

She had moved to look straight at Cat.

‘Tell me.’

‘My grandmother – that was my mother’s mother – lived with us for her last couple of years – she had heart problems and she couldn’t manage on her own. She was very special – warm, giving, loving, uncomplaining, always grateful for everything – she had lots of friends and they all came to see her even when she’d moved right away from her old home area. But when she was eighty-six, and I was fourteen, she was very ill – no one ever told me what was wrong. I know it was only partly her heart condition, but you know how it used to be – lips sealed or people whispering in corners. They thought I shouldn’t know anything. One evening, my mother had sent for the doctor and he came downstairs and said Nanoo – I always called her Nanoo – was, as he said it, “on her way”. My mother was upset and she said I shouldn’t go up and see her, but I can remember feeling I’d fight everyone rather than not be with Nanoo when she might need me. The district nurse came and she had oxygen. And then I did go to my bedroom, because it was after midnight, and I was falling asleep. I woke up at half past two. I looked at my bedside clock. And I had a very strange feeling … it was as if someone else was in the room and they were talking to me, but I couldn’t make out the words. I felt very calm and I felt something else too – it’s hard to describe it but it was just an extraordinary peacefulness. The house felt different. Everything felt different. The best way I can describe it is … it was as if something that had been difficult and hurtful and upsetting had been dealt with at last, and it was all right now. I also knew I had to go to Nanoo. It was such an urgent thing – the feeling that I couldn’t do anything else but go to her. I got out of bed and put on my dressing gown. I went to her bedroom – the bedside lamp was on very low, and the nurse was sitting beside Nanoo’s bed. When I opened the door she looked round and said, “It’s all right, you come in, Elaine. Your gran’s been talking about you. I think she wants to see you.”

‘She was one of the few nurses I’ve ever known who just accepted that my grandmother was dying and that I could see her, there was no problem about that. She didn’t think I should be kept away. She was a lovely woman, from West Africa, and I think they are often more open about death. The Irish are too, or they used to be. Anyway, she just talked to me about it so easily. I wished I could have her nursing me when I was in the hospital. I even dreamed about her once or twice. Anyway, Nanoo was looking very still and breathing quite slowly. Her face was so full of strain and worry and – I don’t know, as if everything in her life that had ever been a problem or gone wrong was piled on top of her now. I remember being very upset and touching her hand and holding it but she went on breathing slowly and I didn’t think she knew I was there. The nurse said she would call my mother soon. “Your gran’s not going to be with us much longer,” she whispered and she took my hand and held it. “You understand what’s happening, don’t you, Elaine?”

‘I did. I felt strange – as if I was there and not there, sad and not sad. It was very muddled and emotional. We just stayed like that for a while, me holding Nanoo’s left hand, the nurse holding her right, and then, as if she just knew now was the moment, the nurse got up and went out quickly, and a minute later, my mother was there with her, pulling her dressing gown on. It was November, it was quite cold – we didn’t have warm bedrooms then – but the nurse had a one-bar heater on. My mother looked at me, and I thought she was going to tell me to go back to bed, but she didn’t. We were waiting, and I knew my mother was standing a bit away from the bed because she was frightened – anything to do with death and dying really bothered her, she couldn’t deal with it. And then the most extraordinary thing happened – my grandmother started and her eyes opened wide … she was trying to sit upright but of course she was too weak. She didn’t look at any of us, she looked ahead – not blankly, she was looking at something. Then she gave a big sigh – as if everything was suddenly all right, everything was as it should be. And then she turned her head and looked straight at me with such a long, loving look, such a sweet, loving look …’

Elaine had tears running down her cheeks now but Cat did not stir or speak.

‘And then she just lay back and took one breath and that was it. No more breaths. The room was absolutely silent and still, and I felt that we were in a sort of bubble, a timeless bubble, not related to anything else … and then I heard my mother draw in a breath. Because there was a light – it hovered just over my grandmother, it reflected on the wall – it was a dim light, and blue, the most intense blue, and so beautiful. My grandmother’s face was beautiful too … it seemed to have changed in just those few seconds and she was a girl, or a young woman again, and every worry and pain line had gone – they were just smoothed out. We all three of us stayed still and I don’t know how long it was but it felt as if it was out of time and just going on and on. And then the light faded away very quickly and my grandmother was dead and my mother was making funny little sobbing sounds. And that was it. And it was as if, when I’d woken up in my bed earlier, I was going through what would happen … I remember lying in bed feeling so peaceful and so happy for Nanoo and somehow just accepting – and although I didn’t actually see it again, the light seemed to be still there somehow, all round me. It stayed with me for days – until her funeral. They were all for my not going to that but I was furious and I made such a fuss they let me … I said Nanoo especially wanted me to go, so in the end, they let me. The blue light was round me at her burial, but after that it seemed to dissolve away and I never had it round me again. And that is as true as the truth can ever be, Doctor, and if you think I’m mad and deranged or whatever, it doesn’t make a spot of difference. It never has. I’ve just lived with it for the rest of my life. I’ve never told anyone. I tried to tell Neil – my husband – and then Jack and Angie, but they didn’t want to know. My mother never referred to it. I didn’t try to talk to anyone about it, but I read some article in the paper about a woman who had had a similar experience – not the same, but like enough to make me know at once. The nurse prepared my grandmother, but then the doctor came to do the certification, and of course the undertaker, and all of that took over and I never saw that nurse again. I wanted to so much. I badly wanted to talk to her but I didn’t know how I could get in touch with her, so that was it. But it’s true, Doctor, whatever you think of me – as true as anything I know.’

‘Why would I “think” anything of you? Of course it’s true. I’ve known this – almost every doctor and nurse will have experienced something of this sort when they’ve been with dying patients, and there’s plenty of research about it done by highly regarded medics come to that. It is certainly not hallucination and not the result of overwrought imagination – these experiences are often dismissed as being nothing more than the result of high doses of morphine but in fact drug-induced hallucinations are quite different. So you’re certainly not alone, far from it. And thank you for telling me, Elaine. How do you feel now, after talking about it?’

‘Every time I remember it – actually, I don’t even have to do that, it’s with me all the time. It has always been there – part of me, if that doesn’t sound strange. When I do think of it deliberately, I feel – reassured? Helped? Yes. I’m not afraid of death though I don’t want to die in agony, of course I don’t, I don’t like to imagine the physical process. But I’m not afraid of dying because I was there with Nanoo and it was – good. A positive thing, even though I missed her so much because I loved her. But I always knew everything was all right.’

Elaine fell silent for a moment. ‘Why does everyone try to change the subject, do you think?’

‘Fear. The old embarrassment?’

‘I think there’s more to it. When people had a faith, they accepted death – it was part of the whole business, if you know what I mean. But now everyone is afraid to look stupid, gullible, they believe death is the end, so anyone who starts to talk about an afterlife, or anything spiritual, is automatically deluded or deranged, or indulging in fairy tales. And if you think death is a big black nothing, you probably prefer not to discuss it, I suppose. People have their own beliefs but it isn’t right to dismiss everyone who has other opinions, is it?’

‘No, absolutely not. Respect other people’s experiences and feelings and views, however different they are. My mother was a doctor, and not any sort of believer, but she always said it was her job to listen and not pass judgement, not dismiss anything. She was right. It’s arrogance to do otherwise.’

‘I’m very lucky to have you here to talk to.’

‘I so often wish I could go into med schools and hospitals and explain about listening. All doctors need to listen more. Lack of time the excuse of course, but people waste plenty of it on stuff that doesn’t matter a jot.’

‘The worst is when you’re treated like a child. “Now, now, let’s not talk about nasty things.”’

‘But don’t you think people try to change the subject and chivvy you into being bright and chirpy because it makes them feel better – never mind how you feel?’

‘You see, I keep wanting to talk to Jack about my will … it’s nothing complicated, there are just one or two things I’d like to be given to certain friends, you know, sentimental things – but he shuts me up, every single time, he goes all chirpy and makes jokes, anything to avoid facing the conversation. It’s made me very sad sometimes and then I’ve been angry – I shouldn’t be angry, I know, they can’t help it.’

‘Can’t they? What are they afraid of, do you think?’

Elaine sighed and rested her head back.

Cat got up. ‘I have to go. But I’ll pop in again soon. And thank you.’

‘What for?’

‘You’ve made me realise something I sort of knew but hadn’t quite worked out – how important all this is and what I want to try and do about it, even if it can only be in a limited way. So yes, thank you, Elaine.’

Cat bent down and hugged the woman gently, noticing how little there was of her body to grasp. She would come back, and soon. She had learned the lesson about putting things off and then to regretting it.

‘If there’s anything you need or if you want to have a word on the phone, please ring. I’m at home most evenings, other than Tuesdays which is my choir practice or you can leave a message for me at the surgery. I want to make sure everything’s covered so that you’re as comfortable as you can be and I’ll organise one of the hospice nurses to come in as well, if you think that would be a good idea. I know them all, I’ll make sure they’re properly briefed – no sing-along and no bingo.’

Elaine smiled. The colour was touching her cheeks again, and her eyes were lively. Something so simple, Cat thought as she left, and look at the difference it makes.

The end of St Luke’s Drive had been fitted with blocks to stop cars using it as a rat run, and as she unlocked her own car, Cat noticed another trying to negotiate an awkward three-point turn a few yards away. It was a fast, smart Mercedes coupé. She recognised it, and waved.

‘I thought satnav was supposed to know these things,’ Rachel called out of the car window. ‘Now look at the mess I’m in.’

‘Don’t worry, I’ll guide you down – but stop when you’re the right way round again, I haven’t seen you for ages.’

The turn was managed easily between the two of them.

‘What are you doing out here anyway?’

‘Delivering a parcel of books. Someone impatient for new things we didn’t have in stock, and they came in today so I thought I’d add the personal service element. And I was on my way home. You?’

‘Seeing a patient. Listen, I’ve got to collect Felix and then I’m heading home. Come to tea? Glass of wine?’

Rachel smiled with real pleasure. ‘Love to. I was only going to watch a film I downloaded weeks ago.’

‘Sad.’

‘Tragic.’

‘Right, here’s the front-door key to the farmhouse, go in and put the kettle on, I’ll follow with the boy. Unless Hannah is already back but I doubt she will be. Sam’s at cricket nets.’

Rachel caught the key, gave Cat a thumbs up, and sped sleekly off.