‘Ella died this morning.’
The name sounds familiar. I flip back through my diary – and there she is, just a couple of days ago.
‘Ella! Of course! Oh no! She was pretty unwell, though…’
‘I know, but still. It’s a bit of a shock.’
To say Ella had been unwell was an understatement. An elderly palliative patient, in the closing stages of an aggressive cancer, she’d suffered a hypoxic collapse. After they’d stabilised her at hospital she’d been discharged home to die there. She’d been referred to us for bridging care whilst the palliative team struggled to find capacity. But as is often the case, things can go more quickly than anyone anticipates.
There’s not much time to dwell on it, though. We’re under the clock. It’s a question of grabbing what info you can, whatever supplies you need, and getting out on the road.
Poor Ella, though.
That day is particularly bright. I’m wearing sunglasses and I’ve left my jacket off. All the trees are starting to fill; daffodils and primroses blazing along the verges; everywhere a sense of the sun moving in, drawing up life and colour and warmth.
Ella’s daughter Rose answers the door.
‘You’ve just caught me washing my hair,’ she says, towelling it into a mad frizz and laughing. ‘Mum’s just through here. Mum! A visitor!’
The front room has been rearranged to accommodate Ella’s hospital bed, commode and a large oxygen dispenser that whirs and clicks in the corner.
Ella is sitting upright, clear plastic nasal specs looped round her ears and under her nose. She waves an emaciated hand in the air. Even that small movement exhausts her.
I introduce myself and explain what I’ve been sent to do.
‘I’m wearing two hats today,’ I say. ‘The first is clinical. They want me to run a set of obs, your blood pressure and the rest…’
Again, the waving hand.
‘Don’t bother,’ she says. ‘I can … save you … the trouble… they’re terrible.’
‘I won’t do them if you don’t want me to.’
‘The other is a carer’s hat. So depending what you’d like – a wash maybe? Help with the toilet? Something to eat?’
She shakes her head.
‘I can’t … eat,’ she gasps. ‘I feel too… sick. But a … flannel wash … might be nice.’
‘Let’s do that, then.’
I get together everything I might need, a bowl of soapy water, flannels and towels, then set up shop next to the bed. Ella wants to wash her own face.
‘I’m a … fussy so-and-so…’
She unhooks the nasal specs and puts the tubing down beside her. Her lips are a dusky blue, but she doesn’t have to be told.
‘Don’t worry,’ she says. ‘It won’t … take long.’
Half way through the wash she has a dreadful fit of nausea and can’t carry on. I help her through the worst of the retching. When it subsides, I do my best to make her comfortable again. She lays her head back on the pillow and closes her eyes, the skin in all the hollows of her cachectic frame sinking in with each snatched breath.
On a low shelf in her line of sight is a large, silver photo frame. In it, a black and white picture of a young man and woman lying under a tree, the woman with her head in the man’s lap, looking up and laughing as the man tickles her nose with a piece of straw.
‘What a beautiful photograph,’ I say to her.
‘That’s Ben,’ she says. ‘My husband. I’m glad… you like … that photo. I’m rather … attached to it … myself.’
By the time I’ve taken the bowl away, sluiced it, wrung out the flannels, hung them up to dry and come back into the room, Ella seems to have made something of a recovery. The duskiness has eased from her face, and she manages to talk a little more easily.
‘Ben was such a lovely man,’ she says. ‘Very determined.’
‘Like me! He had a stroke when he was fifty. Out of the blue. But he insisted on having… a handrail on a rope…. hung above the bed… so he could do pull-ups. What on earth… are you doing? I said to him. Getting fit he said. And a year later… there he was … hanging upside down from a helicopter… chasing the next shot.’
‘What was he? A hunter?’
She laughs, a low-down rattle.
‘Cameraman!’ she says. ‘But I tell you something…. between you and me… he may have been rough and tough… but he was actually as soft as butter…anytime there was something… you know, something silly… like a spider in the bath… guess who he came running to.’