Hospital Corridors

hospital bed

Some people like airports and railway stations and shopping malls and art galleries.

Some people don’t like hospitals.

I do. I love them. All of them. Old ones, new ones, empty ones, full ones.

I see curing, healing, surviving. I see endless helping. When I visit a hospital I see people engaged in the pursuit of other people’s happiness. A selflessness. I know there is pain and death and lingering (inattentive staff and plain human error) but somehow the flip side still pushes through to me. It is what I feel.

In the corridor of Charlie’s art is secured to the wall. No one ponders it. It does its best to draw attention to itself. Large canvases. Orange vinyl chairs sit empty. The spaces are large and often vacant, like everyone is suddenly well. Once, new, the corridors were carpeted with a dark heavy-duty material but eventually that folly was replaced with linoleum roadways and I imagine orderlies pushing beds, two abreast, being able to race. Wide corridors. Being able to make donuts with hospital beds.

The hospital has old parts pretending to be closed. But then someone is seen in an office behind venetians. In the back-end there are old entrances, closed. Salmon brick and baby blue facade. Beside them sits an assortment of chairs, broken or bent and left out to rust or be stolen. No one does, because no one wants a disused hospital chair.

Do I love them because they are always ramped? Made for me. Even the old ones. Masonite ramps, too steep. Covered walkways that still let the weather in.

Once I visited a friend in Royal Perth and on leaving ran into a doctor I knew. He took me through emergency and out onto the roof top where the doctors hung out on their breaks. A few old chairs looked out over the railway line and the roof tops of old buildings. The sun shone there, and in secret, warmed their faces. In white coats they brought their coffee and took in the air. Some probably had a smoke. I felt lucky to have been up there with them. Like kids sneaking behind the bike shed at school.

At Fiona the staff don’t have their own canteen. So instead they eat with the public at the cafes strewn throughout the central courtyard. In their baggy green scrubs and forgotten paper shower caps. It makes life-saving seem so very ordinary, buying cappuccino, between laparotomies.

When I was little my mother took me to nursing homes and hospitals on the weekends visiting various decrepit members of the extended family. It captivated me. I liked to peer into spaces that seemed hidden. I liked the way strange and repugnant smells stung the inside of your nose. Methylated spirits. Why does all hospital food only smell of boiled broccoli? I wanted to know what happened behind the pulled curtain. My mother always went to the flower room to fill a vase and arrange the flowers she brought from her garden. She always knew where to go and get stuff and how to speak to nurses to get things done. Even then I knew this was a skill.

 

by Graham Miller
by Graham Miller

 

Talus

When G moved in many years ago, the wooden shelf above the old Metters cooker held a handful of my special objects. I am not sentimental and I don’t keep stuff. He took over the shelf and it became his place for his eclectic array of old toys and figures.

 

One of my special objects is the talus bone from the hock of a horse. It is sculptural. It is smooth and hard. It has a groove, so that when the bone is held in your hand like a ball, your finger lies snugly there. It has no smell. It is inert and unchanging. No hint of rock or wood. It is heavy and yellowed like aged parchment.

 

I am lying in hospital, only weeks since car collided with tree and my own spine snapped like a mere twig.

 

A bearded man comes to visit. Like many before him he brings a gift. Others have brought flowers and food. He is not like others. He still wears tweed jackets with leather patches at the elbows. He walks with a swagger like his trousers are too big, his feet unknown to him.

 

I am not able to sit up. I lie alternatively on one side and then the other and finally flat on my back. The bed has a special name. Every two hours it swings into action, operated by a single nurse. It is a spinal bed, designed to prevent pressure sores while the patient is immobilized. When finally I move to the spinal ward the bed will be replaced with three men whose job it is to turn people without twisting their spines. They are called the turning team. I grow to love them. To drink I use a sipper cup like a baby and am fed spoonfuls of mush as I lie on my side. I give up eating.

 

He enters the ward and stands looking at me. Everyone does this. Inspects me. I am a prisoner to their gaze, strapped into my bed. In his hand, held down by his side, is the bone. Perhaps he thinks twice before parting with it. He holds it like a bowler walking to his mark. Before he gives it to me he makes me name it. Talus? The most beautiful of bones. The man is an anatomist. Structure and function is his thing. He is giving me a treasure.

 

He pulls up a chair. Even someone as clunky as he can sit, can walk, can move. It irks me. He hands me the bone and my finger finds the groove too. Something to hold, he says.

 

I will never work with horses. I will never work with cattle. But I can admire the design of nature and together we talk about the magnificence of the horse. My fingers can feel the bone. They can find its curves, its waves, its hollows.

 

We talk of the stay apparatus of tendons in a horse’s legs that allow it to stand for hours without becoming tired, the chordae tendineae in the valves of the heart, the cleverness and delicateness of any spine. You are still a vet, he says to me.

 

My eyeballs are aching. Tears amass behind the globes. How many tears can you cry before you can make no more? Did you know the tears of sadness are not the same as those when you have grit in your eye? But I don’t really know the bearded man. He is a lecturer. He is kind. He understood that vet students were not always intrigued by the curves of the liver and the way the diaphragm shouldered it. He stood at the front of the lecture theatre and performed, all the while hitching up his trousers. He tried hard to get us to love anatomy as much as he did.

 

Seated at stainless steel tables we worked on the formaldehyde cadavers of greyhounds not fast enough to run the track. The smell attacked your nose and made your eyes sting. Tears of the unsad kind. We rushed through our labs to get away from the fumes. We didn’t draw neatly enough. We didn’t take enough care. We failed to see the beauty in the talus when it was shown to us.

 

Now I see it. I cherish it.

 

 

The Days before Day One of Dying

As I take my position by my mother’s nursing home bedside this is what I write in my journal; Day One of Dying.

I suspect I am thinking her death will be more drawn out than it is. How many days am I planning on?

She has spent the previous day in Fremantle Hospital. Like a scene from Hieronymus Bosch’s Hell. Full of vomiting, retching, gagging, coughing souls. Later I am told that the hospital has declared itself; Code Black. To the layman this is bursting at the seams. Patients are served up on skinny trolleys. Obtunded. Gurneys jam the space that is supposed to be a corridor. I see a man with a gourd-like belly just covered by a triangle of hospital linen. He is one of the many waiting. Patients, like cattle, stare out into the maelstrom of the central emergency area where the doctors, nurses and ancillary staff zig-zag back and forth before them. Buzzing like flies. Drawn to the smell of carcass. Maybe patients think if I stare long and hard enough someone will come. Then a scrub-suited someone places a stethscope on a chest, eyes to the ceiling, and then moves on. Someone might take a blood pressure. Find a pulse. Scribble it down. Order blood to be taken. Boot-faced nurses. Soft-shoed staff mesmerised by chest xrays on screens. Backs to patients. Speaking to relatives on the phone. Looking at the far corner of the wall, any place other than eye-contact with a patient or a pleading relative.

When I arrive in Emergency it is already late. People should be at home, in front of the telly, or in bed with hot cocoa. Instead they are wanna-be patients waiting to be called through. But their wait depends on the level of severity of their illness. Best be dying to get their attention. Some will still be sitting watching the screen when I leave many hours later. Go home I think. I see the triage nurse and say my mother is in Emergency and that they are expecting me. Indeed they are. A nurse has to show me where Mum is and I am met by a young doctor in scrubs. He seems reluctant to discuss her in the corridor and says perhaps we should go somewhere private. He leads me into a room that someone has tried to make nice, but has failed. I get the sense the room embarrasses him, but what can he do?  It has a painting of scenery on the wall. It is a little wonky. I can’t recall the scene. A lake bordered by forest? There is a vinyl couch (where I am supposed to sit) and a chair opposite it. It is where doctors deliver bad news. Bad news is thick in the room. It has made a home for itself here. I think how I prefer the corridor. I have already spoken to this doctor on the phone, so I know what he is about to say. Words like critical, sepsis and no white cells seemed to stick. Others, like the importance of her blood gas result, seem to fade. I remember his stethoscope necklace and the gentle grasp of his handshake. His face is Scandinavian, soft and sincere, as he delivers the poor prognosis and I think I like him. Mum would like him too.

Then I see her. Defrocked and in a hospital gown. Her bird-like chest is barely covered. Beneath her skin, by her collar bone, is her pacemaker. Her small bundle of clothes are in a blue plastic laundry bag at the foot of the bed. I remember Dad had a similar collection of belongings following him from ward to ward, from hospital to nursing home. She is a little bit confused, but knows it is me. I take her hand. She understands she is in the hospital and that she is pretty sick. But they will heal her. She is thirsty. No wonder. It has taken several hours to examine her and conclude she is dehydrated and get her on a drip.

They move her from a curtained cubicle in Emergency to a room in the corner, with a more comfortable bed. The corner room is normally reserved for women delivering a baby. It is a closet really.  As windowless as the rest of Emergency. A bunker. Do they imagine she will die here? She has multi-coloured cords recording her heart beat and its rhythm, as well as a baboon-making oxygen mask and an intravenous infusion.

I sit watching her. Listening to the electronic beeping of her machines. I watch the fluids running in, and hear the hiss of the oxygen being delivered. I think the amount of intravenous fluid they are giving her is what I might give a sick terrier. I check that urine is flowing out into the bag hanging by the bed. The urine is still more concentrated than it should be, but less cloudy than it was. It has looked worse. Infection is treatable. That is what antibiotics do. I see another doctor, a medicine registrar, this time. He is somewhat scathing of the nursing home and their level of care. He rolls his eyes when I describe her recent turn as TIA. He asks if brain scans were done. No, I answer. How was it decided that a stroke was the cause of her collapse then? It’s just what they suspected, I answer. Hmm. I see. I see. More hurling around of the word critical.

She does not look critical to me. I remember my mother doesn’t believe in death. I go home. I blurt it all out to Graham.

I sleep.

The hospital parking is worse in the morning and I have to park a few streets away. She is still in Emergency. Still in the closet room.

When I arrive I find her desperate for water. There are no cups by the sink used to wash your hands. I ask a nurse. They say she can’t have oral fluids. She is in danger of choking and getting an aspiration. She is on a drip. She won’t be dehydrated, they say. They leave. Still she asks me for water. I wet a paper towel and dribble water from it into her mouth. I can see how dry her tongue is. Her lips are cracked. She sucks up the little droplets. I feel good about doing this. I am mistakenly wetting her gown. I pat it with the paper towel. I keep giving her water. I stroke her forehead.

I stand out in the corridor and survey the emergency room for oncoming doctors or nurses. All that is out there are other sick people. They are searching too. Their faces are worried. Scared. They have had their clothes removed and are in hospital gowns. They haven’t their shoes on.  Some don’t have any underpants. They sit or lie on beds or trolleys. Some hold oxygen masks to their faces. Some hold kidney dishes to retch into under their chins. I am wondering how it is that I am normally so fond of hospitals.

The nurses come in to check her and to fiddle with the machine. They call her sweetheart and darling but the overused word is so devoid of compassion that they could replace it with any other noun; try pot plant. It might get more water. I am not sure what they think of her or me. I am not sure they care for us and that is what is crushing in on me and making my eyes fill up with tears. I don’t want to cry in front of people who don’t care that I am crying. I ask them to bring her a pan, because she is telling me she wants to use the toilet. They mistrust that I know, or she knows, what she wants, but I assure them she knows. She is not demented, I plead. But she can’t manage to use the pan and is still uncomfortable and I can’t settle her. I wonder if the nurse is thinking; See, I told you so.

We are setting up an adversarial relationship. I don’t want it to go this way. I want them to work for us. Like us. Help us. Mum is now begging me to get her to the toilet, but I can do anything. She might have sepsis, but all she really wants to do is to have a crap.

Then we are swooped in on by her team. They stand at the end of the bed, all six or so of them, while a young, nervous doctor gives the summary of her case. The consultant is the oldest in a tweed jacket. He is Irish with a lilting accent. Despite the chaos of Emergency he has not forgotten his manners. He addresses my mother and talks to me. He takes his time examining her. He listens to her chest. He looks at her neck and the bulging of the vessels pulsating in it. He points it out to his underlings. I tell him she is thirsty and he gets the bed head raised and hands her a plastic cup of water. She drinks from it. He wants to get rid of the wires and tubes and get her off the drip. He says yes she has sepsis. She is not mounting a good response. He thinks she should recover from this episode but sepsis will get her in the end. It’s not a bad way to go, he says. Make sure you have a blue form signed. He means make sure she has a DNR. You can go home to the nursing home and be treated there if that’s what you want.

 

To be continued…

Operating Theatre

I am in holding zone awaiting my surgical procedure. My surgeon comes past to tell me there is a slight delay. There is a back log in recovery. We women in our forties are lined up to be spread apart and peered into. There is a dairy cow feel to it. But no elbow length gloves. We pretend it is dignified, but really we are just another biological system that needs to be understood.

I watch the ceiling as I am wheeled in my bed and now I lie looking up. The white cotton blanket has the smell of a large commercial laundry. I am good at being in hospital. I know what will be done here. There is nothing to surprise me. The delay is not unwelcome. It is not unexpected. In hospital everything is wonderfully out of your control and to surrender to that feeling is strangely comforting.

The theatre is gleaming in every way. Spanking white white walls. The operating lights are a dark shiny blue. In the corner, on a stool, my surgeon waits while I shuffle across to the table. The operating table. He has his head in his phone. His down time between patients. Perhaps he is signalling his late arrival home. His legs are crossed and I notice his knee high white wellingtons. It gives him the look of an abattoir worker. Someone expecting to be splashed upon.

For now I am in the hands of the anaesthetist. Equally attired. Everyone is costumed up, including me, but, I suspect I am the only one without my undies. Like the courtroom with its wigs and robes, the operating theatre has its look too. Scrub tops and pants, hair caps and shoe covers. Even the word theatre; what role, what performance will be on today. How will we all play our parts?

Who is the villain, the hero? I have the bit part. Non speaking role. Who else converses with people as they lie on a slab. Leaning over. No wonder there is a power play between doctor and patient. No one else sees you like this. In a ridiculous gown that has no buttons. Splayed.

We only have a few moments, the anaesthetist and I. Soon I will be away from them all. In a space that is a void. He talks jovially about the Jackson Juice he is delivering. First he tells me there will be a short sharp pain. Indeed he is pushing hard as he delivers the anaesthetic. The theatre nurse is placing a mask across my face.

 

This Knife Ain’t Sharp Enough

My Dad is back in the hospital. His remaining penis is like a bloated poorly-cooked pork sausage.

I am reminded of a neighbour beyond the pickets whose favourite children’s party game was called pork sausage. The children would be in a line. No smiling, laughing, giggling allowed. He would go along the line and point and grope you on the body or the face and in a heavy Welsh accent say, What’s that there? And your answer had to be pork sausage but you weren’t allowed to laugh. Laugh and you were out. I was good at this game. It seemed the saying of pork sausage was hilarious to most small children. And when coupled with a big bellied man pointing and fondling your ear lobe, and asking you what it was, and having to say it was something it wasn’t, something as ridiculous as pork sausage, it was very nearly impossible. But I could do it every time. He could pinch my nose, my ears, grapple with a roll of tummy, fiddle my fingers and I could say it straight-faced. Pork sausage, Mr Elliot. Till I was the last kid standing. Grim-faced. Thinking, not funny Mr Elliot.

Winning this game did not endear you to adults. They wanted to see kids giggling uncontrollably. They loved to tickle you till tears were welling in your eyes. A kid that didn’t find pork sausage funny was a kid with no sense of humour.

This is what we are here for; to exam the pork sausage and decide its fate. No giggles. Not funny. The nursing home GP thinks an area of tumour recurrence can be seen near the urethral opening and he has organised Dad to go back to the private hospital to be seen by the surgeon who did the partial penectomy in the first place.

The ambulance is transporting him. I meet them at the doctor’s rooms but there has been a mix up. He is to be admitted and the consultant will see him on the ward when he has finished his appointments.

In the ward they have him down for 2pm. We have nine. But they find him a room. No 13. I sit talking to him but he has his head turned away and is not answering me. I go to the other side of the bed and then he realises it is me.

Oh Nicole, what a surprise. I explain he is in the hospital to have his penis looked at. Because it is sore isn’t it Dad? That’s why we are doing this.

He starts out just a little old man, a little confused. After six hours he no longer knows what he is, where he is and he’s as mad as a cut snake.

A nurse comes in and wants to take a peek downstairs. He is saying no more no more but she manages a look and with her ultrasound measures his bladder volume. It has 138mls in it and he has wet his pad in his pants. Reluctantly I call it a nappy.

He has bitten his lip or his tongue in the transport and has some blood in his mouth. I ask him about it but he doesn’t seem aware of it. I get him a choc milk and he drinks it with a straw.

He starts talking about leaving and all the things he must do to leave. He will need a bus on the highway. But where is he going to? What is his home address?

He is trying to swing his legs out of the bed and attempting to sit up. He is easy to push back down. And when I do he has to start his effort all over again. It weakens and tires him.

I wait till he is nearly up then down I push him. I think he probably doesn’t know I have done this to him half a dozen times. Each time I stop him getting up he is surprised I have stopped him.

When he is nearly upright I stop him again and he says, Oh no oh no. Exasperated. He leans back down in the bed. You have to stay Dad to see the doctor. Over and over again I say it.

I am driving myself nuts.

Oh I love you darling, but I have to go. I have so much to do at home.

He asks me why. Why must we stay for the doctor? I have him booked next week and he gives me a wink. That’s the way the cookie crumbles.

I have a lot to do at home. The dogs and cats need to be fed.

No time for yakkity yak.

He says I am trying to hoodwink him. He says the nurse is part of the secret service. Everyone is keeping stuff from him. Like information. Like addresses and where he is.

They move his bed from room 13 down the corridor close to the nurses’ station and he falls asleep. He has his glasses on. When I tried to take them off he objected. You want to hoodwink me. You know I can’t go without my glasses. Why have you taken my socks and shoes off? I can’t go without my socks.

When he wakes up he is gripping the side bar of the bed like he thinks he is moving or falling.

Dad. Dad you’re okay. I try and peel his fingers from the side bar. But he is hanging on.

No, he says. He has woken up different. More stubborn. Ready to fight.

He has woken up in another world. He starts talking about straw. You need to move the straw. Give me the pliers. You have to dig it there. When I try and move his fingers he gets  snarly with me.

Okay okay. But you don’t look comfortable.

Don’t take stuff without asking.

I can recognise the consultant’s voice outside. He’s on the ward. I feel relief to know Dad will be seen soon. He is slipping into further delusion and the longer it takes the harder it will be. I hear the consultant talking to nurses and then his voice fades as he heads into another room.

I poke my head out. Only nurses. A plate of cream cupcakes on their bench top.

I tell a nurse I am worried that I won’t see the urologist. Paranoia catching. Don’t let him skip us.

No no your Dad’s on the list.

The consultant’s voice wafts in and out of ear shot.

Dad is talking gibberish. Ellen on the TV.

The urologist enters the room smiling. He has beautiful teeth and a polished head.

Righto Alex. Do you remember me? I am your doctor who did your surgery. The nursing home wants me to have a look. They’re a bit worried about it. Despite Dad’s demented state the urologist talks to him like he is compose mentis.

I wonder why he bothers. Perhaps it is for my benefit. Maybe he thinks something might get through. When I tell him about the past month and how I am struggling with it all, he tells me how when his grandmother was dying he would gets calls from his mother all the time telling him today would be the day and how badly the grandmother was faring. In the end he said to his mother don’t call me till she’s dead. By the time she finally died he had done all his grieving, it was simply a relief. I think he is trying to empathise with me. But I am like his mother. I am the one who is doing it. I can’t say don’t tell me for there is no one else to do this.

Gloves snap on. He tries to move him in the bed; to get him to let go of the rails. But Dad is resistant and starts telling him to get off him.

You don’t ask, you just do.

Dad is shouting and the doctor pulls back. But Dad keeps on shouting. Swinging fists on skinny arms.

We might give him something to settle him before we look or else it’ll come to blows.

Two haloperidol, he tells the nurse.

I’ll be back. Gloves snap off.

Dad tells the nurse to go to. He is pointing at the door. Get out. Get out. You have no manners. Ask. You should ask.

Dad you need to take the tablets. She is proffering them close to his tongue and I am fearful she will get bitten. It’s feeling very veterinary. I am thinking of chemical restraint, muzzles. When faced with an aggressive dog we get the owner to help. Like the nurse is using me. Do you think you can get him to take them? I am like the client who stands back and drops the lead when the dog begins to growl. I don’t think I can do it, I say. But it is my dog. I am required to try.

When the owner gives up in the vet clinic the dog is put in a cage and the pole needle is used. As the dog is cornered the needle advances on it through the bars and a quick hard jab to the thigh muscles is attempted. Hopefully the needle doesn’t snap off. Hopefully the whole dose gets got. Victory is a dog that can’t curl its lip, can barely lift its head.

I suggest a needle for my Dad. The nurse thinks this might be just as hard. We persist with the little white tablets. Dad put your tongue out.

Don’t touch my nose, he shouts.

I try and give him the tablet so he can put it in his mouth himself. Perhaps it is control he wants. Trying to get him to take them from my fingers he is uncoordinated and we are not getting anywhere. Our fingers are like polar opposites on a magnet and he can’t take the tablet from me.

She gets a mini tub of ice-cream and I put the tablet in a teaspoon of vanilla. Here you go Dad. We get them down.

It has taken 30 minutes.

He is not very sedated when the doctor comes back. He is just as angry. He starts swearing. Fucking hell.

The nurse tells me not to worry. He’s not responsible. He’s not your Dad when he’s like this. Her being nice to me, tips me over and I am crying.

I am trying not to cry in front of Dad thinking this might upset him more but it doesn’t seems to effect him. He is oblivious of my noisy nose blows into paper towel. He has forgotten about me, who I am even. Why are you staring at me? he says.

The doctor tries to get him to pull down his pants but he can’t do it.

Okay Alex lift your bottom. Nothing. So in the end he yanks them. I am placating. Its Okay Dad.

You’re cruel to an old man.

Yes Dad I know.

He’s not that strong. You hold his wrists, can you? the doctor says to me. I am the client who digs in. Who says yes I can hold him, my writhing rabid dog, while you trim his nails.

Okay. I will. I grip them. They are thin. I push them down so the doctor can get a look. Dad is swearing and cursing me.

Get off me. Get off me. You brute.

The doctor is pawing down there.

He might as well be sawing it off for all the screaming Dad is doing. Is it really that sore I wonder? Is it just being restrained? Some dogs (think Cavalier King Charles Spaniel ) start to panic before a thing is done to them, screaming before anyone has touched them even. Is this Dad?

It’s thrombosed and woody but its not recurrence, the urologist says. I suspect the issue the staff is having is getting to it to clean him. But I don’t think there is benefit in doing more surgery. It might end up with a worse non-healing area. We could do some radiation for the pain. But he is still urinating. Actually if he stopped urinating it would be quick. It’s a good way to go. A potassium spike stops the heart.

We are talking about him across his woody penis while he rants and shouts. The urologist is pulling his nappy back up and we are telling him its over but he is still shouting abuse at us.

I want to hear the doctor Dad. Shh shh.

I think what we need to do is talk to the nursing home about what they see as the difficulties in managing the area. We can give him more pain relief but I think surgery is ill advised and he isn’t a good candidate. And he can’t have more clexane after the subdural bleed. We’re limited in what we can do.

I ask about a suprapubic catheter.

Hmm not necessary while he is urinating.

I just don’t want him to be in pain, I say. I don’t want him to have more intervention if it is likely to be bad for him. Tears are welling up again. I’ll be guided by you, I say. I am thinking what I want is for someone to take the responsibility out of my hands.

In my head I am thinking how crazy it is that we are talking about a urethral blockage causing a spike in blood potassium as a good way to go. Now we are imagining scenarios that are quick and painless. I think I know a quick and painless way – it’s called euthanasia and I do it to animals on a regular basis.

People don’t want to see their animals suffer and at the end of their lives they decide the time to bring them to the vet clinic. I give them a sedation that sinks their head to the table. They probably feel like they are floating. Then I clip a foreleg and put a tourniquet around the elbow. A vessel stands up. I slide the needle into the vein and a rush of blood comes into the hub, mixing with the green pentobarbitone, the red turns blue-black. I unclamp the rubber band and tell the owner I am going to inject now and they might sense their beloved pet slipping away. I inject slowly, as slowly as I can. By the time the ten mls is into the animal all breathing has stopped and the heart has slowed down. I change syringes for the next ten mls. By the end of this syringe the heart will have stopped. I say Nice and Peaceful like saying it will make it so and place a hand on the dog’s head or on the client’s hand if it is nearby. I check the heart. It is never beating but I take a minute to listen. Then I tell them their pet has passed away. Then they cry.

But my old Dad must hope for a quick and painless death some time in the future. We still don’t know how it’ll be. But this hospital business is not helping him.

We have been here six hours and the decision is made to do nothing. He can go home tomorrow. Endone might be a good thing. He’ll be more sedated.

The nurse brings me a cup of weak, luke-warm tea the colour of a muddy puddle. She had no teaspoon so she brings me a knife for which to stir. I am stirring my tea with a knife and Dad is asking me why I am staring at him.

I am thinking of how to kill you Dad, but this knife ain’t sharp enough.

 

 

 

 

Days with my Father

I had trouble with jobbies, he says. Even now as a woman in my late forties, my father using this word irks me. But there are no good words for it. Not my mother’s favoured expression inquiring about the opening of your bowels either. But definitely not jobbies.

So hard like a rock. I had to use my fingers and pull it out. He is showing me his hands, making an action like someone miming milking a cow.

Oh really.

Ooh yes. It was so hard.

A cleaner (she no doubt has a different title to this) tells me the toilet is blocked from too much paper. She keeps flushing despite this.

I relay the message. Dad don’t use too much paper.

Well of course I had to clean myself up after that. Maybe I used too much paper. I don’t know.

Well remember next time – use less paper. I think of saying “maybe not use your hand” but I don’t want to go there – to bring it up – to have to fully conjure the image.

Dignity is leaving him like fog lifting. Soon it’ll be gone completely.

I wander into the corridor to find a nurse. Two stand chatting beside a trolley. My dad, room 1226. I think he’s constipated. I don’t tell them how I know and they don’t ask. Normally, at the nursing home, he’d be given something for that.

She returns with a little plastic cup of vanilla syrup.

See Dad they have medication for that. You can ask the nurses.

I didn’t know that.

How’s the car? he says.

You don’t have a car anymore Dad. You can’t drive. I sold your car for you. Remember?

To be honest about it I don’t. I wouldn’t have a clue.

Where’s June? he says pointing to the ceiling with his thumb.

Lately he thinks she is upstairs in another part of the hospital, when he remembers he is in a hospital at all.

It’s a private hospital where nurses seem more akin to flight attendants than trained medical staff. You know it’s not vital that you get another gin and tonic, just be nice is all. But they’re busy. You can see that. Well that’s how it is here. Bells sounds. No one comes. Out of peanuts. Landing soon. Turbulence means we need to sit down and get our seatbelts on. They fuss with their charts, with their temperatures and blood pressure measurements making sure their pen marks are on the paper, the signature scrawled. But nursing, Nightingale-style takes time, takes talking. It means touching, using your senses; the real grit of nursing.

My father has had a partial penectomy. Perhaps you have to look that word up. Spell-check says there is no word but I know there is.

I’ll save you the trouble. It’s a penis amputation. Although he still has enough so that he can pee.

He needed this radical surgery because he had a squamous cell carcinoma on the head of his penis.

The cancer grew erosive and plaque like in a few weeks, shocking the staff at the nursing home with its rapid and seemingly malignant growth.

None of the staff at the nursing home had been faced with something like this before.

It was right before Christmas. My sister was in town with her daughter of five years old. Urologists, like most surgeons, take Christmas off. But we found one working through – not going the way of the Maldives. Infinitely practical, he saw little difficulty in the amputation surgery and excising the tumour.

We’ll leave enough length for you to hang on to he told Dad. So you can direct it down when you urinate. After all he just needs to be able to pee.

The doctor and my old dad are behind the curtain that does for privacy in the doctor’s rooms.

The receptionist has told me they have 7000 tracks on their i pod music selection. We’re all out of love, what am I without you … Air Supply takes me back to Countdown, Molly Meldrum. Dad loved ABBA, Blondie, Sheena Easton. If he heard a track now would it remind him? Would he remember being a Dad to teenage girls – hassling us at 5 o’clock on a Sunday night to clean up our rooms when Countdown was on and it was a matter of life and death to see who was Number one? .

I can’t see anything but I can hear my dad groaning. A pitiful sound. Unfamiliar. Animal. My sister and I wince together and raise eyebrows when we hear the doctor ask whether he is circumcised or not. We whisper to one another. Can’t he tell?

Why can’t he tell?

I have flash back of my father coming naked from the bathroom, sauntering down the hall to the laundry where he had his wardrobe. He never worried about modesty, till we were old enough to object strongly. He loved nudity, did my Dad. Maybe it’s a European thing, a Dutch thing. He cared little who saw him naked. He didn’t bother with the towel around the waist thing by the open car door at the beach. Just let it hang out. I remember the penis, elephant trunkish. Not circumcised.

The reason the surgeon can’t tell is because the tumour has pushed the foreskin back and the tumour has grown so that the prepuce can no longer move freely over the penis.

Dad can’t answer the question about circumcision. It’s equivalent to asking him the day of the week, the season of the year, what floor he is on.

I think back to the mini mental score chart. 13 out of 30 about six months ago. I wonder what he would get now.

Not circumcised, I pipe up.

Motherly.

The surgery went well. He seemed unaware that anything of such significance had happened to him. He said the nurses were taking his stuff and he was squirreling away sachets of jam and butter and mini boxes of cereal.

He started to talk of buying land at Leeman, a small fishing town north of Perth and somewhere I don’t think he has ever been. But the town name took hold.

But now after only two months back in the nursing home he is back in the ward again.

The remaining few centimetres of the penis has become woody the surgeon says. He thinks it is thrombosis after an ultrasound helps rule out recurrence of the tumour or infarction.

I can tell he’s not all that sure himself about why it has happened and what might happen from here. A hand rises to stroke the stubble on his shaven head. But he admits him for investigation and so I guess there is relief that something is being done or will be done or will be thought of being done.

I wonder how demystified the penis must be for this man who pokes and pulls and prods at them all day.

Because for a week before this the nursing staff at the old people’s home were wondering why the irritation, why the blood spots on the sheets and why the reluctance by him to let them clean up down there.

****************

I am sitting in his empty room. The bed has been made up but not with clean linen because I can see his breakfast stains, canary yellow egg and smeary cereal, on the white cotton blanket. Why do I think this means they don’t care about him?

Odd bits of clothing are about the room. I picture him getting them off and on unaided. Not really knowing what to put where. It’s not like the nursing home where the carers are really carers – deeply committed to his welfare. Cajoling and coaxing to get him to do it their way. Here the nurses are young, I sense they can’t be bothered with him. I hear my disdain for them in my writing. My contempt for their smooth skin. Give me an old nurse any day.

So I sit waiting. He shouldn’t be long I am told. Another ultrasound.

I’m new here, smooth skin says, I don’t know how long it takes.

The room is right by the desk, the nurses station they call it. Behind nurses gather, all chinking with their keys and badges and tags hanging off their belts and on bum bags about their waists. Beneath their Polly cotton tops and pants are detectable rolls of fat around their middles. Proof they don’t work hard enough I think or else is just everyone fat these days.

There’s lot of inane chatter. A nursing assistant says her husband thinks he deserves a medal for hanging up some washing. Another makes a phonecall to her own doctor requesting an appointment. Someone else is wanted but she’s at tea. Mrs So and So in room 14 has a temperature of 38.7 but is refusing Panadol.

A navy blue cardigan hangs over the back of a swivel chair like a cormorant hanging its wings out to dry on a pylon. But there’s no sea here. No wildlife. It’s decidedly hospitillian; low ceilings, the sounds of nurses moving – keys and tags rattling, trolleys, clanging pans, lift bells. There’s a whiff of meths, antiseptic, a chesty cough, old heart patient shuffles, a doctor’s voice – see you tomorrow.

In the end I leave without seeing him this day. There’s a limit to how long I can look at thin Venetians, count terracotta tiles on the roof opposite, read his chart.

But I still feel guilty leaving. If someone asks me I will say I have a school thing to do. And I have a life, or at least I want one.

It’s the time of the year that corellas come in large flocks. They hang from their toes on olive trees and harvest the fruit, staining their feathers with oil. They waddle on the grass with their seemingly over large heads and heavy beaks but then take to the air as a gang, squawking and marauding. Not a pretty bird song. A truly Australian sound. The Bikies of the bird world.

******************

He is going home. Back to the nursing home where he has lived for nearly a year. But he has no memory of it as a place he knows when I talk of it.

To be honest I haven’t the faintest clue, he says time after time when I ask him if he can picture the place.

When I arrive on the ward to take him home he is lying corpse like on his back, his mouth open, eyes closed. Lately his cheeks have begun to sag inwards and the shape of his skull is more noticeable. I think about the way old dogs lose their temporal muscles on their heads as they get really old, sometimes when they have cancer that seems to strip them of their meat. When you place a hand on their heads there is just bone beneath skin. Dad’s skin too seems draped over the bones, falling with gravity towards the hospital floor. Again I notice the stained bed linen.

He has his nightshirt on over his polo shirt, socks on, but no underwear. He doesn’t know whether he’s been to the toilet when questioned about his bowels.

There are little bits of dried blood on his face where he has nicked himself dry shaving.

You’re going home today Dad.

Is it a big place?

Your room is bigger than this.

It’s a nice place, Dad. Mum is there. She’s waiting for you.

Mum is having her hair done. Each time the in-house hairdresser is mentioned my mother tells me how she is a breast cancer survivor. Lost a bosie, Mum says. Another cringing word uttered by your mother.

My mother has a love hate relationship with the hairdresser. The hairdresser wants her to come more often but my mother doesn’t like to sit there while the set takes and the hair dries and the colour is put in. It is a test of patience that my mother fails. Waiting isn’t something she is good at.

The carers are putting Dad in the room and I go and find Mum to tell her he is back. She sits in a wheelchair, hair tightly set and teaky, waiting for someone to take her back to her room. She is happy to hear that he is back but worried too.

Last time he went to hospital he came back very confused, wanting to go to Leeman and convinced he was not staying in the home.

This time he shows he recognises some of the staff and their room.

But who knows really. He doesn’t want to disappoint either. Something somewhere tells him he ought to know. He ought to remember.

When Mum gets back to the room and she exclaims Darling you’re back he throws his arms in the air and says Ah Nicole. It is my name. But she doesn’t mind. She knows he recognises her. Just as he calls me June when he sees me in the hospital, he also calls her Nicole. We are the two lone moons circling his planet. The names are interchangeable.

From her wheelchair and him from his chair they reach for one another, tottering forward awkwardly and give each other a peck. The bony hands grasp each others.

It is lunch time in the home and together everyone decides to eat in the dining room. He hasn’t had much company in hospital and we all think it is a good idea. Using the frame and with Carol the carer beside him, gripping the back of his trackie pants, we head towards the dining room.

Other residents comment on Mum’s hair. She looks tidy.

Alex is struggling. He is stooping and might not make the table. Carol gets someone to bring a chair and he seems to collapse into it, almost passing out. He has gone a poor colour. The sagginess of the checks seems exaggerated. Three carers are about him as he closes his eyes. One has her hand on his pulse and Carol is behind him holding him into the chair that otherwise he might slip out of.

They keep asking him his name. And he says yes. Still here, he says.

A hoist is brought out to elevate him and get him from the armchair to the wheelchair. He is scooped up like a baby bird. His skin is like the unfeathered bird’s, showing the architecture beneath. A carer has a hand on his chest. Can she feel the baby bird’s heart beating within the thin rib cage?

Back in the room the hoist is used again, lifting him from the wheelchair and over towards the bed. I think of harnesses for Para gliders and kite surfers. I think of the daredevils whipping over the ocean at Leighton and then see Dad’s hands clinging to the metal as he hovers between chair and bed.

His blood pressure is low and the nurse thinks he has lost weight in hospital. She thinks maybe he didn’t eat. Maybe he didn’t. I ticked the boxes. I ordered the food, but I was not there at meals and I wouldn’t know if it sat untouched. Just as they ignored his bowels I wonder if they checked under the lid of the plate.

I leave him as he is falling asleep again, spittle snail-trailing down his chin. I exit through the dining room passing Mum on the way out while she works her way through meat and gravy. All of them at their plates like herd animals with their heads in a feed trough.

He’s okay I reassure her, just low blood pressure. Needs a rest.

When will you be back?

Tomorrow.