myself, from anyone.
Dr Kannangara was very elusive that week, and to my annoyance I missed his ward visit on the Thursday. I did however see the young houseman, Wilson by name. He took me aside and led me into a store room off the end of the ward, and spoke in a quiet confidential tone. He told me that the specialist would make another assessment of Dad’s condition on the following Monday and see me afterwards. ‘He’ll probably suggest inserting a PEG tube,’ he said, and explained that this was a device which fed sustenance directly into the stomach. ‘Your dad’s had an extension of his stroke, which has further reduced his ability to swallow. If he doesn’t get more nourishment he’ll gradually get weaker and weaker.’ ‘And with this tube he’ll get stronger?’ I asked. ‘Let’s say he’ll remain in a stable condition. The same as he is now - unless he has another serious stroke, of course.’ He looked at me speculatively. ‘Your father’s achieved a good age, nearly ninety. In cases like this we like to be guided by the family. We can keep him alive, but without much quality of life. Or we can make him as comfortable as we can and let nature take its course. It’s really up to you.’
I didn’t like being presented with this choice. I didn’t like it at all. When I told Fred about it that evening, she could hear the stress in my voice, and decided I needed moral support. ‘I’ll come down to London tomorrow, and stay for a few days,’ she said. ‘Jakki can look after the shop. Ron will help out.’ I didn’t try to dissuade her, though I did warn her the house was a tip.
I met her the next morning at King’s Cross, and we took an extravagant cab all the way to the hospital. Dad didn’t look too good. Somebody had tried to shave him earlier and I guessed he had made the operation difficult, because he had a couple of cuts, and patches of his stubble were untouched. He didn’t seem to recognise Fred, though when she began to speak to him he looked sharply at her as if the sound of her voice triggered some faint memory. I wasn’t sure that he recognised me any more.While Fred and I went through a pantomime of hospital visitors chatting away to a responsive patient his eyes were following the uniformed nurses and ancillaries who went to and fro past the end of his bed with a kind of feral attention, as if he knew that these were the people on whom he depended for food, drink, and other physical needs. It seemed to me that he had regressed even past human infancy on the evolutionary scale and that his reflexes were disturbingly like those of an animal in captivity.
Fred was shocked and dismayed by what she saw. Afterwards, when we were back in Lime Avenue, sitting in front of the electric fire in the dingy dining room with cups of tea, we discussed the issue of the PEG tube. She said she didn’t see the point of keeping anyone in Dad’s condition alive by such an intrusive and artificial procedure. ‘Of course the doctors have to offer to do it, since it’s available, but the houseman gave you a heavy hint that they think nature should take its course now.’
‘But that puts all the onus on me,’ I said.‘I have to decide whether he lives or dies.’
‘We’re all going to die sooner or later, darling,’ she said, and her ‘darling’ was gentle and sympathetic. ‘Do you really want him to be lying in a hospital bed for perhaps months, unable to speak, unable to recognise anyone, looked after like a baby, fed through a hole in his stomach? It would be kinder to let him go.’ I nodded agreement, but I must have looked unconvinced, because she added:‘What would you want me to do, if you were in the same condition?’
‘Oh God, let me go!’ I said. ‘No PEG tubes, no life-support machines, please.’
‘Well, then,’ she said, as if resting her case.
‘I suppose the reason I find this so hard,’ I said, ‘is that it’s the second time in my life I have held another person’s life in my hands.’ And then I told her what I have told no other person, that I helped Maisie to die.
That last Christmas she was very ill, very weak, and in pain, though she bravely concealed