‘They said there’s nothing more they can do for Jean. They said it’s terminal. Do you think that’s right? Do you think there’s anything more to be done?’
Stan’s eyes bore into me. There’s a slack and waxy look to his face, like he hasn’t slept for a week.
‘I don’t know, Stan,’ I tell him, and look down again at the discharge summary in my hands. The journey Jean has taken from ambulance admission to A and E and then back again is described in lean, jargonistic language, but no less damning for all that.
‘What did they say at the hospital?’
‘Not much. But then a doctor came round here the day after Jean came home and said that was it, basically.’
‘It’s so hard,’ I say. ‘How are you bearing up?’
He massages one fleshy hand with the other, working the thumb into the palm, like he only needed to get a little strength back there and he’d be able to do something, to make some change.
‘I’m used to sorting things out, getting things done,’ he says. ‘I’m the one they all came to. I even organised the skiing trips. But this? I just don’t know. I just don’t know.’
‘Do you have family around, Stan? Friends, neighbours?’
‘We didn’t have children,’ he says. ‘Not that it bothered us, after a while. We had Jean’s family, our friends, of course. They’re all elderly, now. Half of them are dead. I think I’m the only man left amongst the old lot. So – what do you think? What should I do?’
I lay the discharge summary gently on the table, beside the DNACPR and the scrip for the anticipatory meds.
‘You know – just reading what the medics have written here, it does look like Jean’s cancer is untreatable. So the thing is to take care of her at home now, if that’s what you both want. It’ll be about symptom control, making Jean comfortable. Have the palliative team been round yet?’
‘There’s been a lot of people in and out.’
‘It gets confusing. Whoever comes in should write in the folder here – who they are and what they’ve done – so there’s that. And there’s a list of the main numbers to ring if anything changes or you’ve got any questions. I’ll give the palliative team a call in a minute and ask where we are with visits and things. What to expect next.’
‘They left all these medicines. What am I supposed to do with them?’
‘Those are what they call the Just in Case meds. It’s things for pain relief, to help Jean’s breathing, anti-nausea meds, that sort of thing. You don’t have to worry about them, Stan. The District Nurses will be in to take care of all that. Is that okay?’
‘I suppose it’ll have to be.’
‘They’ve referred Jean to us for some urgent equipment and care support.’
‘Right. Got you.’
I wait a minute, then stand up.
‘What d’you think? Shall we go up and say hello to Jean?’
‘Yes. Sorry,’ he says. ‘It’s funny. She’s normally up with the lark, but she’s feeling pretty worn out so she’s staying in bed.’
‘I don’t blame her.’
He leads me up a narrow, carpeted staircase, worn to the thread in the middle, the boards sagging and creaking. The landing window is open and an unseasonably warm afternoon breeze nudges through the curtain.
‘Jean?’ says Stan, as we go into the bedroom where Jean is propped up on four pillows. She’s breathing quickly, her cheeks flushed and her lips pursed, with the rapt expression you sometimes see on patients who are riding their discomfort and don’t have room for anything else.
‘Hello, Jean!’ I say, waving. ‘Shall we sit you up a bit? It’ll help with your breathing.’
Once she’s more upright her breathing does ease a little, and her oxygen levels are surprisingly good. Despite her wasted condition, she still manages to tease me. Stan sits in the wicker chair beside the bed, and starts kneading his hands again.
‘I’ll need to make a quick call to the palliative team,’ I say to them. ‘Is that okay?’
Jean squeezes my hand.
‘You do what you have to do,’ says Stan.
I step away from the bed to make room for him, then make the call standing at the bottom of the bed, using the duvet as a desk for the open folder, which Jean moves with a cheeky nudge of her foot.
Luckily, Sandy answers the phone. Sandy’s a palliative nurse I’ve never met in real life but who always exudes great competence and compassion.
‘We’ll send a nurse out in an hour,’ she says. ‘Meanwhile, have a scootch around and see what you can do in the way of equipment. And start the care as soon as you can.’
‘I think you’ll really feel the benefit of a hospital bed,’ I tell Jean, putting the phone back in my pocket. ‘They’re fantastic, these beds. You can adjust the height, sit the back up – all sorts. All at the touch of a button. The pressure mattress is nice and comfortable, and means you’ll be less likely to get a pressure sore. We can get it installed pretty quick. All we need to decide is where it goes. We’ll need to clear space for it.’
‘I’ll show you the second bedroom,’ says Stan. He gives Jean a kiss then takes me next door.
The second bedroom is half the size of the first, with a single bed in the centre, a wardrobe in the corner and not much else. I’d guess it was the room Stan’s been sleeping in, although you’d hardly know it. There’s a shirt, a pair of trousers, a pair of pants and a pair of socks neatly laid out on the bed, side by side. They look exactly like the clothes he’s got on already.
‘This is great!’ I say, looking around, but not moving. ‘Plenty of room for the hospital bed once this one’s gone. A nice view of the garden. Lovely! What do you think you’ll do with this bed?’
‘I’ll just stand it on its end in the corner by the wardrobe. Maybe throw a sheet over it.’
‘Do you want a hand to do it?’
‘Me? No,’ he says. ‘That’s one thing I’m still good for.’
And we both stand there, side by side, staring at the clothes on the bed, like we fully expect them to magically jump up, throw themselves together and start flying round the room.
‘I’ll make the order,’ I say.
‘Stanley?’ cries Jean.
‘Yes, love…’ he says, and hurries back.