In the Midst of Life (40 page)

Leah had been my delightful neighbour for twenty-five years and I had always assumed that she was about ten years older than me. It was not until she broke her leg and went into hospital that I discovered she was thirty years older than me. Leah was a hundred and two.

Leah was a widow and lived alone in her flat, and she fell at about eleven o’clock at night. Somehow, God knows how, she managed to haul herself to the telephone and ring for an ambulance. Steve and Sandy, neighbours who held a key, were awakened by the noise of an ambulance team trying to get in to the building. Steve went with them into her flat and found Leah on the floor, covered in blood, with a trail leading across the carpet from where she had fallen. The break was a compound fracture of the tibia and fibula, about three inches above the ankle, and pieces of bone were sticking out of the flesh. Poor Steve, who is not used to that sort of thing, nearly collapsed, but he controlled himself and helped the men get Leah on to a stretcher. In hospital, the bones were realigned, the flesh wound sutured and the leg plastered from thigh to toe. No one expected her to live.

But Leah did live. When I first saw her in hospital, she was virtually immobile because of the weight of the plaster. She was uncomfortable, certainly, but not in pain. She had a corner bed by the window. This was in June 2007. She sighed wistfully. ‘I hope this is not the end. Life is so beautiful, so interesting, so exciting. I don’t want it to end.’ In the year that followed, that was the only time, as far as I know, that she mentioned the possibility of death.

I reflected that, if she had not managed to haul herself across the floor to the telephone, she would undoubtedly have died during the night. Numbness, caused by shock and blood loss, would have
engulfed her, and she would have drifted away before the morning light. I wondered what suffering lay ahead for her, what she could have spared herself within a night of fading consciousness. She knew her age; had she not anticipated death? But that is not the way our instincts work. Self-preservation is the first of the primary instincts, so Leah had made a superhuman effort to reach the telephone and seek medical help.

Leah’s husband, Alex, had been the artistic director for scores of major films between 1930 and 1975. He had worked all over the world with directors such as David Lean, Alexander Korda, Roman Polanski and Alfred Hitchcock. Leah had frequently accompanied him on location, and met many of the great film personalities of the period.

She told me that her biggest headache had been keeping Alex tidy and presentable, because he never cared a scrap about his appearance, and only wanted to wear old and comfortable clothes. ‘I knitted him a cardigan once, and after that he wouldn’t wear a jacket. The only things he wanted were these cardigans. I must have knitted dozens of them. They looked quite smart for a few days, but I don’t know what he did to them, because after a fortnight they looked dreadful – all out of shape, buttons pulled off, holes in the elbows – I could never understand how he managed it. The worst part was the carbon and charcoal from the sketches and drawings. If he wanted to smear something, or blend shades, he wouldn’t use a cloth like anyone else would. No, not him – he would grab the bottom of his cardigan and rub the drawing with that. No wonder his clothes were in such a state!’

She told me that they were asked to meet a new director. ‘We were told it was just an informal meeting one evening, so Alex went directly from work. I arrived from home and got there first. I saw at once that it was just about the smartest, most sophisticated cocktail party that film people can put on. Everyone was dressed to the nines, trying to outshine everyone else, the way they do, you know. It was all very pleasant. But when Alex arrived I nearly died of embarrassment. You’ve never seen such a sight – he looked worse than usual. One side of his cardigan was hanging down to
his knees, the other side was up around his waist and it was covered in carbon and charcoal. There was a hole in his trousers. I can’t imagine how he had managed to tear his trousers; they weren’t like that when he went out in the morning. But he didn’t seem to have the slightest idea of how he looked compared to all the other smart people. He went around greeting everyone, charming, affable, friendly. People always liked him. You couldn’t help liking him.’

She sighed, and a dreamy look came into her eyes.

‘I’ve been a widow for thirty-two years, but I would never marry again. I’ve had a couple of offers; but no, not after a man like Alex.’

Another time she said, ‘When your husband dies, life changes utterly – everything changes. No one wants to be bothered with a widow. Invitations stop. Friends melt away. It’s when you begin to know who your true friends are. I had to start all over again, with a new life and new friends.’

But Leah was not just the wife of a successful artistic director. She was a remarkable woman in her own right and had scores of friends. I was not the only one who enjoyed visiting her in hospital. She sat up in bed, or on a chair, knitting for anyone who wanted anything knitted – indeed, I have a jacket and my husband has two jumpers from this period! I looked around at the other old ladies in the ward and she seemed to be the youngest of them all. She was sitting upright, her back unsupported, her eyes bright, her skin clear, her hair nicely arranged – one would have thought she was a sprightly eighty-year-old. It was a joy to visit her, mainly because she was so interested in everything you were doing, and her memory was phenomenal. Most old people have short-term memory loss. Not Leah. She wanted to know the outcome of something I had told her during the last visit, of which she had remembered every detail. I told her I was going on a cycling holiday with my grandson, and when I next saw her, her first words were, ‘How did it go? Did you have fun? You were in the Cotswolds, weren’t you?’

Everything interested her, and she remembered things I had
forgotten myself. And as for Scrabble! It was humiliating. I played many games with her and she beat me every time. In fact, she didn’t simply win; she wiped the floor with me. My husband played a couple of games with her, but then announced that he wouldn’t play any more because he didn’t like Scrabble. Men are not very good losers …

Leah was a Jew, and the rest of her family was in Israel. She was obviously much loved because her daughter, who was seventy-eight, with a husband of eighty, and her grandchildren, in their forties and fifties, came to England regularly with their children, or phoned her every day from Israel. She was not one of those tragic figures, of whom I have seen so many, who are left entirely alone in their old age. Her family was very good to her, right until the end.

Leah spent three or four weeks in the orthopaedic unit of the main hospital. This is much longer than most people stay, but she could not remain indefinitely because the bed was needed for emergencies and she was transferred to what one would call a long-term geriatric hospital. My heart grieved for her when I heard where she was going, because I knew the hospital, and it did not have a good reputation locally. That was, I think, because the buildings had formerly been the old workhouse infirmary, and they had a bleak and forbidding aspect – ‘Abandon hope all ye who enter here.’ I approached the place with trepidation.

As I found my way to the ward, my attitude changed. A pleasant young nurse directed me to Leah’s bed and several others smiled at me as I passed. Leah was just finishing her lunch. I saw that her head was bent over and her shoulders were shaking. I thought she was crying. With great concern I touched her shoulder and said, ‘Whatever is the matter, Leah?’ She looked up and at once I saw that she was not crying, but laughing!

‘I was just thinking about yesterday’s lunch. Pass me those tissues, will you dear, and I’ll tell you what happened.’

She blew her nose and wiped her eyes.

‘The ambulance came to bring me here. Well, I was in the back
with a young man and we got talking. He was South African, so I told him that I had been there with my husband when he was working on the film
Gold
with Roger Moore and Susannah York. And would you believe it, it turned out that his father was a stunt man in
Gold.
Well, we had so much to talk about, swapping stories, and he was telling me about his family and how his father came to be in
Gold,
that we didn’t notice time passing. This hospital is only about a mile up the hill from the main one, but about half an hour had gone by. We had travelled fifteen or twenty miles, and neither of us noticed.’

She had to have a little cough and wiped her eyes again before continuing.

‘Well, we got to the hospital and they lifted me out and carried me up to the ward. A nurse showed them the bed that was ready for me, and they tucked me in. Another couple of nurses made a fuss of me, checking to see I was comfortable, and then the nice young South African boy said goodbye.

‘It was nearly lunchtime, so they brought me lunch, which I ate, then they cleared it away, and I was just settling down for a little doze when a young lady doctor came over with a bundle of notes in her hand. She said she wanted to examine me, and pulled the screens around the bed.

‘Well, she examined me all over, eyes and throat, and heart and lungs and I don’t know what, then she looked at my leg and said, “This is a very long plaster for a fracture in the foot.”

‘“No, it was the tibia and fibula, a compound fracture.”

‘“It says here, the fourth metatarsal.”

‘“Well that’s wrong, it was the tibia and fibula.”

‘“I’ve got X-rays here, Mrs Wilson, and—”

‘“But I’m not Mrs Wilson!”

And then it all came out. No one knew quite how it had happened, but the ambulance men had been given the wrong instructions. The hospital was expecting a patient, and a bed was ready, so I was put into it, no questions asked.’

She had to cough again, she was laughing so much.

‘So I had to be transferred again. I didn’t get here until yesterday
evening. I’ve been wondering about Mrs Wilson and what sort of a day
she
had. Mine was highly entertaining.’

In all the weary months that followed, Leah’s sense of humour never deserted her, and her interest in life never flagged.

From the beginning, Leah had been on continuous urinary drainage, because it would have been impossible for her to use a bedpan regularly. A catheter into the bladder for weeks on end can cause friction and general discomfort, but she did not complain. I presumed that she was having diuretics to keep the kidneys functioning efficiently, and also some kind of anti-bacterial drug to avoid infection.

I do not know what happened to her bowels. From experience I can say that bowel movements can be one of the biggest problems for geriatric nurses to have to deal with. Constipation usually sets in, and faeces become impacted, leading to nausea, headaches, lethargy, confusion and other nasty conditions for the unfortunate patient. Enemas help, but Leah could not have been turned on her side to receive an enema. Aperients often add to the abdominal pain, or can sometimes cause uncontrollable defecation into the bed, causing a nightmare of shame and humiliation for a sensitive person. How the nurses and carers handle this is one of the greatest challenges of good practice; a bad experience can leave a scar, slow to heal, on the mind of the unfortunate patient.

Weeks passed, and the leg did not heal. I don’t know how Leah endured the boredom of those long summer months, trussed up in a massive plaster that was impossible to move. Sometimes she complained of aching and stiffness in other parts of the body, so I massaged her other leg and her back and shoulders, which she said helped. Thank God for those new air beds, I thought, which continuously shift pressure from one part to another. In my nursing days massive pressure sores would have developed.

About six weeks after admission, Leah complained of a slight cough, which she could not shift. The next time I saw her she looked dreadful. It was an embolism in the lungs, I was told. She
was on high doses of antibiotics and continuous oxygen and an intravenous drip for fluids. She could scarcely open her eyes or move a hand. Her breathing was laboured, yet she had the courtesy to mouth the words: ‘I can’t talk. Forgive me.’ I sat quietly massaging her upper chest for about an hour. ‘This is it,’ I thought, ‘she won’t survive this one.’

From the beginning, when the fracture first occurred, she had been on cardio-vascular drugs and other drugs to maintain circulatory function, as well as diuretics to stimulate the kidneys. When the embolus lodged itself in the lungs, massive doses of clot-busters were added, and all the other drugs were modified or intensified. Daily blood samples were taken for analysis until, she said, she felt like a pincushion.

Leah was on the ‘not for resuscitation’ list, which meant that, if she actually died, no attempt at resuscitation should be made. In my days of nursing, an embolus on the lungs would almost invariably have been fatal for an old person, and I felt reassured to see that notice at the end of her bed. I was glad to see that she would be left to die in peace.

I was not the only one to expect her death from an embolus. Her granddaughter, who was a practising nurse in Israel, came over to England and stayed in Leah’s flat, spending most of each day at the hospital with her grandmother. But the antibiotics, the oxygen, the clot-busters and the drip, combined with the cardio-vascular drugs, did their work. Leah was tougher than anyone had imagined and confounded us all. Two or three weeks later she was as perky as ever, sitting up in bed knitting or sewing, doing the
Times
crossword puzzle, watching
Countdown, Mastermind
and
University Challenge
on TV, getting most of the answers right, and beating me at Scrabble.