Archive for October, 2008

All you can eat

On Sunday i roasted a chicken for the (smaller than usual) family. Tonight I roasted a joint of beef and some roasties for a few mates. I’m currently baking bread (at 11.45pm…). I can see how this cooking thing gets kind of addictive. I have no idea why this satisfies me but it does.

I’ve been working

I’m back. I suppose. Whatever that means. I’m back in work. I’m back in my own house. I’m back, for the first time for two years, to what counts for stability and doing the same thing for perhaps slightly longer than a few months at a time. Not exactly the circumstances i would have wished for but it is what it is.

I’m now a fully paid up full-time, permanent contract member of staff in the chaos of the emergency department (as the kids are calling it these days…). It is chaos. It is horrible, it is wonderful. It is what i do.

I’ve made a list of about 20 or 30 things to change in the department, from knocking down walls to bits of equipment i’d like on order. The sisters told me to write a letter to Medical executive Satan Santa and see how i got on.

I’ve come up with a list of new rules i need to follow. I’m one of those people who likes rules. I like these little self-imposed commands that seem to represent some ethic or moral that goes with the conduct of each shift. I’m better at obeying some more than others.

– Be thorough in all aspects of history, examination, notation, treatment and disposal [though this would be supposed to be elementary, the temptation to be slack is constant…]

– Work slower [I work manically and far too quickly, i see a lot of patients. I’m not convinced this is a good thing]

– Fight for the patient [in the sense of annoying and if necessary pissing off other doctors if it’s in the patients interest – how not to make friends or influence them…]

– Always go and see the patient you’re asked about [when you’ve been woken at 4am for advice over the phone, you will almost inevitably say something stupid]

– Pee [15 hour shifts no problem…]

– Eat [easy to forget]

– Do not be afraid to follow up patients on the phone

– Keep a list of all the interesting patients

– Copy x-rays/CTs/ECGs [useful for teaching and remembering the interesting ones]

– Remember dual pathology on X-rays [just cause you’ve seen the broken clavicle on the x-ray doesn’t mean that’s the only break]

– Think laterally, always reconsider the differential despite what may seem obvious [just because the patient, GP and nursing staff are telling you they have appendicitis, does not always mean they have appendicitis]

– Ignore any pressure that is not in the patient’s best interests [4 hour target nonsense etc…]

All very noble and honourable ideals. We’ll see how long it lasts.

Grace under pressure

Eventually you have to get back in the boat and get on with life. Maybe that’s what happen when you grieve, you spend more and more time simply doing the business of life and then hopefully, after a while it doesn’t hurt so much. Not particularly profound but it seems to fit for now.

So I’ve moved back to my own house and spent a manic weak painting and cleaning and sorting. If in doubt clean. It’s what we do it seems.

My room is no longer this horrible shade of orange – the previous tenants having daubed the walls like a painting indian elephant. It is now tastefully (and boringly) white. This is oddly satisfying.

But then we thought we should literally get back in the boat and so we did. Now most of you think that the Blackwater is just a dingy little bit of water (stained black from the cow poo…) separating Tyrone from Armagh and stopping them from beating us in football. This may be true, (even the bit about cow poo) but it’s also quite pretty none the less.

Canoeing is almost the perfect Northern Irish sport, requiring large amounts of rainfall and a sport where you’re gonna end up wet anyhow so it may as well be raining. Though I describe it as a sport, it’s certainly not how we approach it. More of a way to get one from one place to the other with nice scenery that takes much more time and effort than simply driving would do.

It has reasonable support in NI with a number of new steps and trails being opened. The one on the Blackwater describes it as being accessible canoeists of all levels.

And while it started well despite the rain, we were soon avoiding discarded fishing tackle and spinners strung over the first bridge – i’m still not sure if they were lost or intentional in their placement.

There was a fair degree of flow on the river, with what could only be described as minor rapids to anyone with any degree of experience. To us this was grade 5 death rapids. Or so it seemed.

Our major mistake was the wrong turn. Some would have thought that making a wrong turn on a river is particularly difficulty if not nigh on impossible, but they would be wrong. Probably most easily seen on this map is the little island created by the diverging paths of the river. All of this came as a bit of a shock and so we did what any sensible person would do and chose to follow the narrow, overgrown river that left at an acute angle as opposed to following that wide, open stretch that lay straight ahead. Err… yes.

I suppose we got a little carried away, used to speeds of up to 2mph on the Bann we were a little dizzy with the adrenaline of 10mph, thinking we were back in the flumes in Portadown pool or something.

Till Simon hit the tree anyhow.

The nose of the canoe wedged under a submerged trunk and the full flow of the river behind meant it wasn’t long till the boat was flipped and wedged under the trunk – with Simon still inside. I’d love to say i paddled swiftly to the rescue but was busy trying to limbo under my own tree somewhat further up the river.

Now when you’re in a canoe, the most important thing is the paddle. With no paddle you’re just an idiot in a skirt in a plastic bathtub with no control.

So of course Simon, now underwater, tries his best to hold true to this idea, despite the lack of oxygen and the entrapment. Thankfully he lets go of canoe, paddle and finally tree and floats down the river. I, at this point a little late to rescue the brother make a sterling job of saving the paddle as Simon drags the canoe to field at the side.

This is all a little dramatic for a wet Tuesday afternoon two weeks after your Dad’s died. We both imagined what would have happened if Simon had actually met an ignominious end under a tree – we could picture Da saying “what the *&^% are you doing here?…”

In the end it was all a little less dramatic than it seemed at the time. We ended up carrying both canoes through a field of cows (sometimes I wonder what the cows make of it all…) to the junction of the river, had a nice cup of coffee from the thermos and paddled onward without further problem.

We haven’t quite got round to telling Liz yet, though she’ll find out eventually no doubt. She worries. Understandably it seems. The next purchase is helmets. Which says more about how much we enjoyed the drama and not so much about regard for safety…

Becoming more like Alfie

You seem to spend the first part of your life as a kid making yourself promises that you’ll never become like your parents. That when you have kids you’ll let them sit up till midnight snorting coke and eating skittles, cause you’d be a cool daddy.

Then you spend the rest of your life thinking that if you turn out near half as good a human and husband and parent as them then you’d be doing pretty damn well.

What happens when the heart just stops

30-09-08

So it goes.

I sit in the by window of the bedroom, listening to him breathe. Noisy, rattly breaths. He wakes only occasionally now. To pee. To take a few sips. He knows us. He knows what’s happening. He even makes the odd sarcastic one-worder (not having the energy for a full one liner).

But his voice is slurred and weak and he hasn’t even the energy to get the blankets off him on his own. This is what the sickness does to you. Leaves people the shell of what they used to be. I’ve seen it happen before. Just not to him.

So it goes.

Not like we didn’t know it was coming. Either from 4 months ago or even last year. We’ve thought about this. We’ve talked about this. We’ve planned for this. I don’t mean it makes it easier. I don’t know what it means. I’m not sure I have to.

Slowly (insidious as medics would say) he’s gone down hill. As the cancer grows and robs more of his energy and leaves him with more and more nausea and kinks and twists in his gut. As tiny blood clots lodge in the blood vessels in his lungs. As his poor starved liver stops making protein and all the fluid collects wherever gravity will draw it to. Week by week he could do a bit less.

There was of course the odd notable exception. Like the day they went to Newcastle and he ate a steak sandwich. Or the day the palliative care consultant came to see him and he was outside cleaning the drains. As mum said to the consultant: “this is gonna look bad…” I told dad they’d take his Graseby off him.

We’re grateful for what we had. He was glad to be here and we were glad to have him. I think that’s changed now.

I am remarkably calm. Though that’s not the right word. I’m not freaking out for some reason – I know I have done previously. The whole thing is a decidedly odd (and equisitely painful) experience.

4-10-08

And now he’s gone.

In the same way I’ve watched them all go before. We looked after him at home. We did everything. No nurse cared more than we did (and the nurses were great), rarely have I been so proud of my family, doing what they’ve had no training or experience to do before. I do this for a living in many ways, it is completely foreign to them.

I could watch all the signs that go with the event of dying. All the medicalised aspects of it. Knowing that there wasn’t enough blood and oxygen to his brain to deliver any kind of conscious awareness of what was going on. He was already gone. I knew this, but still… it’s my Da. He looked like all the other poor dying souls I’ve watched, but still… this was my Da.

Watching someone die is a strange and profound enough experience to start with, never mind watching it happen to someone you love dearly. I think this is part of why it has such a profound experience on people, and perhaps why it didn’t have such a big effect on me. His act of dying (the three or so hours form when he wouldn’t wake up until he was gone) wasn’t anything special. It was, as we’ve described it to people: “peaceful”. The bit that gets you is the sheer finality of it all. That the eyes won’t open again. That there’ll not be the sarcastic comments and the steely determination.

Amazing how quick something can go from being someone you have an intimate relationship to an odd looking body that bears little resemblance to the man you once knew.

I don’t understand emotion – I’m a man, none of us do apparently… But I mean on a physiological basis – the constriction at the back of your throat, such that you can’t even swallow, the pain, the sheer physical pain in your chest, the headaches, the inability to complete sentences, the way your face curls up like (to quote dear Ronnie…) “a bulldog chewing a wasp”. Why does loss affect us poor creatures so?

I wouldn’t want to have kept him here. At least not the last week or two, they’ve not been pretty. In some ways there’s this selfish desire just to keep them here, even if it’s only for a smile and a word. But you think about it and then you realise you wouldn’t want to keep them, not like this anyhow.

And then we were sitting there. With all that was left of Da. And what do you do. Where do you start? Simon phoned the doctor and all the important people, I sorted out Dad and all the medical stuff. Mum baked a pie. What else would you do? I was hungry. I don’t know why, but I was hungry. It was the best pie I’ve ever eaten.

The undertaker asked us would the house be “open” or “private” – Though according to Ruth ,when it says¬†“private” in the paper it actually means anyone can come to the house, but if it says “strictly private” then it’s private. That seems perverse. But it is Norn Iron I suppose.

People started to turn up at the house. And then more people, and more people. And here’s the difficult bit…

I am glad that so many people turned up to wish us well and grieve and tell stories. I am truly grateful for the hundreds of cups of tea and buns and sandwhiches. But there were frequent points when I was very close to standing up in the middle of the room swearing loudly “would you *&^%$¬£$% all go home and just leave us in peace…”

I didn’t.

Instead I went out to the garage to stroke the dog. The dog is therapeutic. Safer and cheaper than drugs and booze. The dog helps us cope. The dog has been walked and stroked within an inch of its life in the past few weeks. The dog is the single most happy and contented thing/creature I have ever met. Like colin the robot in the Hitchhiker’s guide to the galaxy after Ford has rewired its pleasure circuits (for those who’ve read Hitchhiker’s then you’re with me, if not please read it…) Dog’s are good listeners. We could learn a thing or two…

I am sorry for thinking about such thoughts about such dear people who would come only to “pay respects” and encourage. In one of those odd ways I am both glad that you were there while at the same time I wished you weren’t. I think i’m allowed such confusion.

We bury them quick in Ireland. Two days later. I like to think it’s on the third day and all that… I don’t know why we bury them two days later. Makes the whole thing a bit more intense, but I think it’s a good idea none the less. Though how should I know, it’s not like I do this a lot…

We had a short service in the house before the trip to the church. 25 of us – pretty much the whole family, well those of us old enough to know what was going on – packed into the living room. An unbreakable and terrible tension in the room. Me and Simon waited outside for the minister to come. Both of us in our suits, white shirts and ties, greeting mourners as they arrived. I remember thinking we looked like bouncers. Like a skinny, more weedy version of Max and Paddy.

And then we followed the hearse.

To the church, along the road that Dad walked every sunday afternoon when he was a kid, turning just before we passed the house he grew up in, up roads where he walked every sunday morning with the aging BB old boys.

To the church he’d gone to since he was a baby, that both his and mum’s parents had gone to for all the generations we can trace. [And all of a sudden I realise why roots are so important. Da always said, as if stuck on repeat, “who you are, where you are from, to whom you belong…”]

Carried under the flags of the BB he’d been a founding member of, where he’d served for 40 years. Carried down the same aisle that he’d watched mum walk down on their wedding day so many years before. [Funny how funerals are so like, and unlike, weddings…]

To lie in his coffin at the front of the church filled with the 500 or so people who came to say that they knew and loved him.

To listen to the hymns that neither, me, Simy or Liz could even begin to sing without choking up on tears. We just stood as if the sheer volume and meaning from the crowd behind us could hold us up. [“From life’s first cry to final breath..” is always a killer – i have watched lots of “life’s first cry” waiting to resuscitate babies as they come out. I have watched my own Fathers “final breath” – this is a lyric with depth and meaning…]

To listen and watch as Dad’s best friend gave a eulogy where we all got reminded who he was – someone who loved well and was first class when it came to taking the piss out of people. People got insulted – Da would’ve been happy, he wouldn’t have had it any other way…

And then carried. By those who knew and loved him best, by those who were his family, as we walked behind, careful to look only at the coffin and not side to side, knowing that if we made eye contact we’d come to pieces. Odd that – on the one day designed for mourning, you spend the whole day trying to keep it together for the sake of those around you.

Then taken. Out into the pissing rain (good day for a funeral…) And me and Simy take the coffin, down the path to where we’ve buried the rest of his family. And I just repeat over and over in my head “thank you for the life you gave me, thank you for the happiness, thank you for the discipline, thank you for what you made me, thank you for everything… I’m gonna miss you.”

This and the horrible practicality that if I have to walk much further on a slippy path in these shoes then I’m gonna drop the coffin.

I remember my Granda’s funeral, the same grave, 15 years before. When, as they lowered the coffin they struggled to fit the coffin into the hole and I remember it being remarked that it was just “Billy (Da’s Dad) – stubborn to the last…”

Dust to dust, just like every funeral.

[Liz is for being cremated- she says she’s scared of enclosed spaces and scared of being buried alive. I’m being cremated to save space. Or possibly cut up into tiny pieces by inept medical students with my stolen fingers being used in tasteless pranks… I fugure if GOD raises the dead, then the spread of my individual molecules, atoms, protons, electrons and Higgs Bosons throughout the diaspora shouldn’t pose too much of a challenge…]

As we walk away, the BB old boys gather round the grave to do what they always do, to do what I’ve done before, and “bury their own”.

In the hall, there is tea. Cups of tea like you’ve never seen before. Trolleys of buns and huge vats of tea, all arranged and moving with military precision. There is nothing quite like dear church folk doing catering at a funeral.

We took up a position in the corner and waited for the onslaught. Two hours of handshakes, embraces and tears we were still there as the queue slowly diminshed. Most of it was a bit of a blur. People I had never met, hugged me, good country men shook my hand till the bones cracked. Almost everyone called me Simon. I developed a layer of foundation on my shoulder from all the embraces. It was, in the strangest way, enjoyable. Listening to people tell me stories about Da, from long before I was born.

You see, this is what I didn’t get. I considere myself an authority on my own Da. I had reason to think so. But I forgot that Dad had this whole other life before I turned up. He had 20 years before he even met Liz. This life where he met and loved people and did all kinds of stuff that I knew nothing about. People knew Da in all kinds of ways that I didn’t even think were possible. I am humbled.

For most of the time I was OK. I smiled and laughed and joked and practised our “funeral soundbytes” – it is impossible to say something original every time someone asks you a question about it so you come up with a few choice truths which somehow lose their depth of meaning with repitition.

But every now and again someone would appear in the queue who I hadn’t quite expected or someone who didn’t even know Da and had come solely for my benefit – and then I’d begin to wobble a bit. It goes down as one of the strangest experiences yet.

Your wedding day is cool cause you know and love everyone there, your funeral is the same, except you don’t get to be there. Da would’ve enjoyed it. Just shame he wasn’t there.

We only seem to get this many together if someone gets born, married or dies. Odd that. Odd, the traditions we have.

That night we all got letters from him. We knew we were getting letters. And that wasn’t the easiest. To read his handwriting, with all the nice things and him taking the piss (“Andrew, you knew you were always meant to be a girl…” Cheers Da) and at the end he’s signed it and I can’t go downstairs and say thanks. That’s the tricky bit…

Cheers Da.

Ronnie Neill

Born 29-3-48

Died 2-10-08


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October 2008
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