Do The Right Thing 3/3 Dignity

He lies there gurgling, but not like the way we gargled with milk when we were kids. Back then we could easily swallow or spit it out if the notion arose, either onto each other or in any direction just to wind-up our mum. Yes, she would shout, at first, but her feigned anger never lasted and soon turned to laughter unless we’d stained the couch or carpet. Now he sounds like a drain bubbling just under the surface, wanting to overflow or explode in a geyser-like manner but devoid of the power.

A chest infection is causing the build up of mucus, which his weakened cough reflex cannot summon up the strength to dispose. He’s allowed injections every four hours to help dry up the mucus but the rattling sound is returning after two hours. All we can do is alternate between turning his head from side to side and raising him up quickly when it sounds as if he’s choking, which sometimes brings the putrid brown secretion out into the basin, easing the sound for a minute, maybe two. Three days he’s been like this.

It’s been nearly two weeks since I received the phone call during the night informing me he was in his last hours. The doctor who attended that night came to the conclusion that his vital organs were shutting down and it was only a matter of time. I sat for hours holding his cold hand, running my fingers through his hair and listening to his laboured shallow breaths. Sometimes he stopped altogether for a few seconds before resuming. The nurse told us this was called Cheyne Stoke breathing and was quite common among patients at that stage in the dying process.

I whispered stories in his ear about how he used to kick me in the shins when we were kids, and also some of his exploits in his teenage years, like flooding the policeman’s house after he’d broken into it. Eventually, he warmed up and woke up. The end, although closer, was delayed. Some in the extended family would have us believe the power of prayer persuaded God to let Tam stay with us a while longer. They may be right. Who really knows? The more rational mundane truth is Tam overdosed on morphine breakthrough pain-reliefs, became toxic and almost killed himself before the cancer could finish him off.

Not that he wants to kill himself. He has a low pain threshold and just wants the suffering to go away. After taking so much morphine for so long his tolerance level is higher than a junkie thus reducing the analgesic effect of the drug while increasing his dependence. It’s happened so often he told me:

“I don’t want to die. And some days when I feel okay I still hope the doctors have got it wrong and I’m not actually dying. I feel like a fraud on those days; like I’ve wasted all their time and effort just because I have a sore stomach. But when the pain’s at its worst and nothing helps alleviate it I wish I could just go to sleep and never wake up again. And although I’m not religious I still hope for a miracle, even though that’s ludicrous as God’s not going to waste any miracles on the likes of me. I know some believe anyone committing suicide won’t get into heaven. But if I die from taking too many Sevredol, it’ll be an accident, not suicide. Let’s face it, God won’t be letting me in anyway. I’ll have to take my chances with the big fire. As long as the pain’s away, that’s all I care about now. Well, that and having a lump when I get there.”

The last time I saw him on his feet was a week ago. I travelled over to find him opening the door for me looking like a meerkat dressed in smoking jacket and greeting me with a huge grin.

“Come in, young fellow. Very nice of you to come,” he said in his best Sherlock Holmes impersonation.

“What you doing up and about, Lazarus?” I asked, barely hiding my amazement as he attempted a little jig across the floor. “And what’s with the outfit, you’re not back on the pipe are you?”

“No pipe, young fellow. No pipe. Come into my kitchen, young chap and I’ll show you what delights I have on the menu today.”

He beckoned me forward, still attempting to walk with a spring in his step but I could see his knees buckling and feared he would fall at any moment.

I followed him like the Pied Piper and found his wife Rita cooking an aromatic casserole and pot of soup. Tam hadn’t been able to feed himself for almost a week due to double vision and loss of motor skills, so it was easier to feed him with a spoon.

“Mm, smells absolutely delicious,” I said.

“Never mind that,” he said. “Wait until you see this.”

I watched as he lifted a small medicine cup from the top of the microwave and emptied its contents onto the worktop.

“This is like the old stuff,” he said. “Much better than all that council muck that’s going around these days. Mind you, it’s £100 a gram…across the board. Across the board. Can you believe it? Bloody crooks so they are.”

He bent over and snorted a line almost as thick as his wrists, albeit in instalments as it took him several attempts to finish it. On completion he sprung up, turned around with a mischievous grin and kicked me on the shins.

“Elementary, my dear fellow. Elementary.”

“Ouch!” I cried in mock pain, fighting to keep the smile from my face. “At least you’re wearing slippers and not those old Frank Wright brogues from our school days. Now those buggers hurt. If you were wearing them tonight I’d have to kick you back. Just because you’re not well doesn’t mean I’ll let you away with murder, you know.”
He danced across the kitchen floor on his way to the fridge, singing, “Free-ee Nelson Mandela.”

“He’s been free for years,” I said. “But you should be locked up for that singing.”

“Oh, but I’ve paid my debts to society. Well, most of them anyway. And I got the last rites, or whatever they’re called these days, again the other night. I’m free of sin, you know.”

“Not after that singing you aren’t.”

“Think I might enter The X Factor next year.” He thought about bursting into song again but seemed to remember why he was at the fridge in the first place and turned his attention to Rita. “Anyway, what we got for eating, sweet one? Think I’m feeling a bit peckish tonight.”

She looked at me and smiled before asking him, “What’s that I’ve got on the hob?”

“Oh, that’s right, sweet one” he answered, still holding on to the fridge door for assurance as his legs attempted another jig. “You’re making soup. I forgot. I’ve been forgetting a lot of things recently.”

At the dinner table I watched in awe as he held his spoon and ate not only half the soup but also half the potatoes and casserole, then asked for a bit of cheesecake, which I polished off for him when he started to struggle.

After a couple of hours I left him as cheery as I’d seen him for many months and couldn’t stop laughing all the way home even though the heavy snowfall made driving conditions challenging to say the least. Little did we know at the time that was to be his last hurrah. When he went to bed much later that night no-one knew he was never getting back out of it.

The day before the gurgling began he was fully awake but very agitated. He kept trying to escape from the hospital bed that had been delivered to their spare room downstairs. His last attempt to climb upstairs to his own bed had resulted in a nasty fall from top to bottom and he suffered cuts and bruises which, in the grand scheme of things, really were only flesh wounds. The guard on the bed to stop him rolling out now looked like prison bars, especially as he tried to escape time and time again. I couldn’t help but wonder if he knew this was his death-bed and he was desperate to free himself. He was behind bars when my father died. And now, here he was behind a different set of bars for his own death; his biggest fear.

On that same day the various friends and relatives who came to see him – probably so they could say they were there right at the end, just like the ones gathered here today - witnessed his bout of delirium. He called out random names and statements, told the doctor to get out his house and asked me to do someone with a hammer, but I couldn’t quite make out who he meant. Although it was great to hear his voice again in what proved to be his last outward display of fight, it wasn’t really Tam lying there. Other days, when he just lay there with his eyes moving, some friends and family spoke to him the way they’d speak to a baby and showered him with kisses and cuddles. Last photographs were taken for posterity or whatever other reasons they harboured beneath the veneer of it all. If he was fully himself I’m sure he’d have told them where to go with the all diplomacy of an Israeli tank in Gaza. These scenes reminded me of a conversation we’d had days before our mum died as she lay there smiling up at her sons, albeit her mind on another planet.

“Where is her quality of life or dignity now?” he asked on one of his rare visits to her bedside.

“She’s awake and still knows who we are, maybe. And she’s not in any pain. That’s good enough for me.”

“But she’s just lying there in her own mess. I can smell it.”

“She’ll get cleaned up as soon as possible. Don’t worry. She’s not aware of it.”

“Well I’m aware of it. I can’t take anymore of this. I’m out of here. Let me know when something happens.”

I shook my head as he closed the door and left me to be the one to be there when it happened. So I sat watching her still hoping for the miracle to bring her back to us, even if just for another day. But the miracle never arrived and I left before the end.

His incessant gurgling is really doing my nut in now and I feel as if someone’s dragging my nails down a series of blackboards. The other family members and visitors are having a break and something to eat, giving me the opportunity to do something for him I know he would’ve wanted. He still has some top quality cocaine left from his last hurrah and it doesn’t take me long to find it sitting at the front in his bedside cabinet drawer. I lower the bars around the bed and rub a little on his lips watching all the while for any reaction, which doesn’t come. Next I put a small amount on his tongue, hoping that what little moisture is left will be enough to help dissolve the cocaine and help get it into his system. Still no reaction. Opening his bedside cabinet drawer again I find what I’m looking for: his little red straw; its inside coated with cocaine from daily use throughout the years. Also at the back of the drawer I find the photo of him and mum in The Caribbean and wonder how it got there. I take the photo out, sit it on top of the drawers and begin to feel better already, as if we’re all in this together. Turning around I study him closely again for signs of change; nothing. To make my task easier I remove one of his pillows so that his head rests lower, more horizontal. This doesn’t help him though. His gurgling worsens.

“Don’t choke on me now, boy,” I say in a school teacher manner before softening my tone. “We’re nearly there. You’ll soon be right as rain.”

Using his favourite Tesco Club Points card I chop a line from his lump and powder it as much as possible, trying not to make a sound in case one of the relatives comes in and doesn’t quite understand. Lifting Tam’s chin helps tilt his head backwards enough for me to push the straw up his left nostril as far as it’ll go. Constructing a makeshift scoop from a folded five pound note I use the card to transfer the powder to the note. Holding the straw with one hand I carefully ease the contents from the scoop into the straw, spilling only a little. Once complete I scrunch the note up and lean right over Tam. I can feel his breath on my face and taste the stench. On the count of three I blow into the straw until it is empty, massage his nose and sinuses, and work the drug into his passages. I hope for a smile, a twitch, a raised eyebrow, a cough or even a torrent of abuse followed by a kick on the shins. He gurgles and stinks.

Accepting his quality of life is definitely over this time, I wish he would just die. No more gurgling. No more photos. No more him being treated like a sick baby. No more everyone pretending we’re happy families. No more nothing. I cringe at his skeleton-like appearance with protruding cheek bones and dark sunken eyes blindly staring at the ceiling, wince at the foul smell of him and try again to block out the sound of his constant gurgling. Where is his dignity? Maybe there’s still a little something I can do for him. Remembering an old wives’ tale our mum told us I close his eyes, walk over to the window and quietly open it just a little, which also allows some much needed fresh air to circulate. Returning to his bedside I lift the pillow and do the right thing as mum watches me set his soul free. It’s what he would’ve wanted, I’m sure.