Twilight Sleep
So… this week is pretty hectic. I have four chapters to study, four or five International Court of Justice cases to study (at least they waffle less than US or UK judgements), three cases to solve, a load of research to do, a 1000 word assignment to write, and the house to clean, and a toilet to unblock – all by 6pm on Friday. Then I have four days of my family visiting, before a load more cases to study and more research to do and more assignments to write between Monday afternoon and noon on Tuesday. As you can imagine, I’m just about hanging on by the skin of my teeth.
I study far from home – well, fairly far anyway. I can get to my family with about a day’s travel. One particularly difficult thing about this is that I rarely get to see my Gran: she has severe dementia, and for a long time she didn’t recognise any of her family. A new care home, with better care, has meant that she’s much more aware, knows her family, recognises photographs of herself and my Grandad. She still can’t create any new memories, though; she reads the same book every day, because she’s no idea that she’s already read it.
Then a few hours ago, my Dad tells me that my Gran, who has been ill for about a week, will be having a biopsy some time in the next few days. The doctors have discovered a lump; they think she may have cancer.
If she does have cancer, she’s too old for treatment. They’ll “make her as comfortable as possible”. If she doesn’t have cancer – she still has an inoperable lump in her digestive system. It’s made her seriously ill twice so far. It’s not like she has years ahead of her, either way.
I know it’s not the fault of the doctors, or of the care home staff. What can they do? She is old – very old. She probably wouldn’t survive major surgery, let alone any kind of chemo or radiotherapy. But the idea of making her comfortable – it’s horrible. She has serious dementia; the only thing keeping her remotely in touch with the world is the care provided by the wonderful staff at the care home. What if she has to go into hospital long-term? She’ll forget everything – including her family. What if she can remain at the home, but is bedridden? The care she receives depends upon interaction, with the staff, the other residents, even just people on the TV. She can’t participate fully in that if she can’t sit in the lounge and read her book again, with all the comings and goings around her.
If she does have cancer, she’ll never know she has it. How could she? We’d tell her; and a few hours later she’d forget. Do we wake her up every morning, and say, as she eats her breakfast, “I’m sorry, Gran…” – or “I’m sorry, Mum…” – or “I’m sorry, Kath…” “…you have cancer. The doctors say – *check calendar, how long today?* – you have x months left”.
Or do we not tell her, let her spend her days wondering, more and more as time goes on, why she feels so grotty? Why she’s so ill? Why she’s so tired? With never an answer – a mere four months is already over a hundred days. Over a hundred days of wondering this; of such confusion and suffering. It’s like Twilight Sleep.
And when she dies – that will be truly desolate. Can we spend every moment by her bedside, telling her minute by minute that we love her? If not, the chances are good, if she’s been in hospital, or if her dementia gets worse, that she’ll die not knowing that she has a family who love her dearly. That she’ll die alone, not understanding how or why, not knowing that it’s coming, not knowing that anyone cares.
