Not much blogging of late as I have been somewhat preoccupied with my ailing 87-year old Father, who finally died a couple of days ago. It was nearly 7 weeks since he had gone into hospital, so I had plenty of time to prepare myself for what eventually became an inevitability. Ultimately, what my Dad died from was really just old age; different parts of his body were wearing out at the same time and it was this ‘cocktail’ of bodily exhaustion that gradually ground down his resistance. However, this vaguely holistic view of his eventual demise cuts no ice with the bureaucrats who staff our National Health Service, as you will hear in due course….
Before I get into that, I want to digress sufficiently to tell you about my Father’s final day – in fact I should probably start at the beginning of his ‘final act’.
Briefly, he had languished in Northampton’s busy General Hospital for 5 weeks. He was admitted having vomited blood, something that was seemingly triggered by an oesophageal tear just above the stomach. That was fixed quite quickly and after a week he was moved from a High-Dependency Unit on to a General Surgical Ward and appeared to be getting better. However, he then suffered a major setback, contracting a ‘c.difficile’-type bug which created huge amounts of an infectious diarrhoea that triggered my gag reflex every time I went into his room. Knowing what I do now, I understand that he was actually ill with multiple ailments; swollen kidney due to a blocked urethra, progressive deterioration of his heart, to say nothing of the problems he was suffering throughout his alimentary tract. What the bug did was to weaken him appreciably, making it very difficult for a man of his advanced age to recover and making it more likely that any kind of innocuous ‘event’ could tip him over the edge.
According to the Consultant overseeing his case, he then entered a period where he neither improved or deteriorated – in the words of the doctors treating him, he had ‘plateaued’. The diarrhoea abated but never stopped and in searching for the cause, they duly discovered a raft of other problems, as mentioned. After 5 weeks, the staff in Northampton clearly felt that they had done all they could for him medically. He just lay there, day after day, usually lucid, occasionally confused but always weak. With the pressure on beds in NHS hospitals, they are clearly under greater pressure than ever to produce tangible results. Wheel ’em in, get ’em better and wheel ’em out would seem to be their modus operandi. My Dad’s case just didn’t fit their ‘template’ at all, but on the other hand, he was far too ill to go home.
What they did was to move him ‘sideways’ to Danetre Hospital in Daventry. It’s a bright, modern facility that was only built in 2006. Their real job is to rehab stroke victims and those recovering from serious surgery, ready for a return home. They also have a small ‘wing’ dedicated to palliative care for terminal cancer patients and it was to a room on this wing that my Dad made his last journey. I must pause long enough to pay tribute to the dedicated men and women in both hospitals who tried in vain to get my Father back to health. We are hugely lucky to have the NHS in this country, but the reality of my Dad’s situation was that no-one could really work out what to do about or with him.
The staff at Danetre were great and he certainly got better care there than in Northampton. He was warm, comfortable and well cared for. On the other hand, the Palliative Unit at Danetre is specifically designed to be an oasis of calm, whereas the wards at Northampton are much busier and the staff consequently more overworked. Despite the peaceful surroundings, my Dad didn’t fit Danetre’s ‘template’ either and one of the doctors there told me that they would review his case in a couple of weeks and that if there was no significant improvement, he would have to be ‘placed’ in a nursing home. I was loath to discuss this with him as I knew such a move would crush what was left of his spirit.
As mentioned in a previous piece, I was advised by the hospital to stay away from Danetre for most of the first week my Dad was in there as I was suffering from a heavy cold, which, had he picked it up, would in all probability have rapidly morphed into pneumonia or something far more serious. Having been ‘thus ‘quarantined’ for the best part of a week, I could immediately see, when I did get back to visiting, that he was now ‘sinking’ and that he didn’t have much time left.
And so to his final day. I got a phone call from the hospital in the late morning to say that his condition had deteriorated. They would give me no ‘hard information’ over the phone (as it transpired, they didn’t really have any) but did at least concede that this latest downturn was potentially life-threatening.
Fortuitously, the Princess was off work that day and equally fortuitously, the Partner managed to find a hole in her busy schedule, so we travelled to Danetre ‘en famille’, arriving in mid-afternoon. When we got up to the Inpatients Unit, the nurse met us and told us that his condition had improved since the morning and that he had both drunk and eaten a little and was quite lucid. When we went in, he was dozing but soon woke up and became as ‘engaged’ as I had seen him since his early days in Northampton General.
He seemed keen to check on a few tasks that he had asked me to carry out some weeks beforehand. He wanted to know about the state of his house. He wanted to tell the Partner that he wanted her to have his car. We assured him that everything was OK and that he shouldn’t worry. Looking back it now feels like he was checking off items on a final list. Looking back it seems like we were giving him permission to go.
The Princess even managed to persuade him to eat some mashed-up peaches and whilst she was feeding them to him, I slipped out to question the nurse about what had happened to him that was serious enough for her to call me. She told me (a sign of things to come) that she wasn’t sure, but that they thought it might have been ‘some kind of cardiac incident’. There would be a review in the morning she told me, after which someone would call me to let me know their thoughts.
We left shortly afterwards and stood in the corridor outside the room chatting with one of the staff. I looked back in and saw my Dad lying there peacefully with his eyes closed and still clutching the bottle of spring water I had left him with. Quite on impulse, I walked back into the room, kissed him on the forehead and told him I loved him, then left. At the time, I couldn’t have told you why I did it, but it seemed absolutely necessary to me then and I am so glad I trusted my instincts.
It had been a really positive visit and though I had no expectations of a Lazarus-type recovery, I was glad that we had all been there to catch him on what had seemed to be a good day. We drove home along the A45 through Coventry’s rush-hour traffic and finally got back here at about 6:20. At 6:30, the phone rang and the same nurse I’d spoken to about an hour beforehand told me that Dad had died about ten minutes earlier. My main sensation was astonishment that he had been chatting away to us quite animatedly only just over an hour previously and now he was gone for good. At that moment, my main feelings were relief that his travails were over and that he died with dignity in a caring environment where he felt comfortable with the staff and the place, rather than in some anonymous ‘Care Home’ where he knew no-one and could not expect the same degree of professionalism or competence from those looking after him.
In the light of what has happened since, the only ominous note was that the nurse could offer no insights about what it was that had finally killed him.
I rang the Funeral Directors that same evening and set the wheels rolling for the formalities. Danetre has no facility to store bodies so Dad was taken to an undertaker in the town and I was told that he would be collected and brought back to Northampton the following day.
The following morning (Friday), I rang the Registrar’s Office and booked an appointment to register the death on the following Monday as they couldn’t find me an appointment slot that day. I spoke to a woman in my Dad’s village with whom he served on the Church committee who promised to contact the local Rector with a view to officiating at my Dad’s funeral. I rang his few surviving friends and broke the news to them. I spoke with several of my own friends as well, who were quick to offer condolences and help. The most difficult call was to Dad’s sister who lives in the north-east of Scotland and with whom he had a major falling-out last year. They were never reconciled and she was devastated by the news. Still, as I pointed out to her, he was a churchgoer and so is she, so if what they profess to believe in is true, she would have a chance to patch things up with him in the Great Hereafter. Don’t think she was much consoled by my crude amateur metaphysics, somehow. Still, as I told her, they were both a couple of stubborn old curmudgeons and therefore equally to blame.
By mid-afternoon, things were coming together nicely. I had arranged to drop into Danetre, en route to Northampton, to collect Dad’s belongings and the Death Certificate, the Rector – an elderly, Runyonesque, old school Church of England windbag (to be quite honest) – was on board, Dad’s body had been retrieved from Daventry and a day and time had been tentatively set for the funeral. Sorting this out, followed by Dad’s ‘affairs’ and then, finally, his house is going to be a mammoth task and there’s only me to do it, but I was feeling quite pleased about how smoothly this first bit had gone. I should have known better.
About 3 pm, the phone went and it was one of the doctors who had been treating Dad at Danetre. I told him that I had spoken with the Ward Clerk earlier to arrange to pick up my Dad’s personal effects and the Death Certificate, at which point he informed me that there would be no such Certificate for me to collect. This was, he informed me, because he was not in a position to definitively identify the cause of my Dad’s death, which, under English law, automatically triggers a post-mortem, to be carried out, in this case, by doctors acting under the direction of the Office of the Coroner for Northamptonshire.
In immediate terms, this was a major irritation as any and all funeral arrangements have now had to be put on hold and I am currently in a limbo from which only the Coroner can release me. Until the body is released back to the Funeral Directors and a Death Certificate issued, I am unable to do anything at all and I have no legal right to challenge this decision. The various Coroners around the country are apparently answerable only to the Queen.
The man responsible for this wretched state of affairs is, of course, not the doctor at Danetre, but the late Harold Shipman who faked numerous death certificates he issued whilst practising as a G.P. in Todmorden and Hyde. The full extent of Shipman’s killing spree has never been fully revealed, but it is thought that he was probably responsible for the murder of around 250 people between 1971 and 1998. Since the Shipman case, the rules governing doctors issuing death certificates have been tightened up considerably and to set down ‘Old Age’ as a cause of death is no longer a viable option.
And so, my Dad, who spent 7 weeks in hospital being poked, prodded and pummelled, scanned, screened and scraped is now set to be sliced and diced in order to find out probably not very much at all. I know that some people would find it traumatic to think of their father’s body being treated in such a fashion, but I will confess to feeling fairly unsentimental about the empty shell that remains after my Dad’s essential spirit had departed. Even so, I think it only goes to show something that we all know full well; which is that the law is an ass at times and that sometimes a bit of common sense has to prevail. I have not quite abandoned all hope that this will be the case with my Dad and that over the weekend the Northamptonshire Coroner (in her infinite wisdom) will have an attack of the aforementioned common sense.
Dad was 87 years old after all and it’s not exactly rocket science to know that he was weak and suffering from a range of quite serious ailments (for a man of his age and medical history). His poor body was just worn out and I fail to see that the cause of medical science is going to be much advanced by this farcical piece of posthumous butchery. Aside from anything else, it places an unreasonable delay on the process by which myself, my family and my Dad’s friends have the opportunity to say a final goodbye to the old fella and achieve a little peace ourselves. No prizes for guessing who I’ll be calling first thing on Monday, though as is the case with bureaucrats all over the world, I doubt that the troubles of a handful of ordinary people will perturb their pressing need to get their paperwork in order.