I walk to work. It takes about 35 minutes. On Friday morning I could tell from the kitchen window that it was going to be a fantastic winter’s day. The light just behind the hills was gold, and the sky above turning like a bruise from black to purple. When I went out the air was still and cold, the windscreens on the cars iced over, and plumes of breath coming from the passers-by.
The walk to work is a good time for me to listen to podcasts and think. Sometimes I lose the thread of the podcasts and my thoughts wander, and at other times I find myself in the grip of some tremendous speech or exciting idea. Just recently I have been listening to podcasts from the BBC called The New Elizabethans. They are ten minute biographies of people who have influenced England for better or worse in the time of Elizabeth II. The presenter has the amazing knack of constructing quite moving and provoking stories about the people he covers. Though I have little interest in George Best or the doctor who pioneered test tube babies I have found both biographies fascinating.
Today I listened to the biography of Cicely Saunders. I had never heard of her. She “invented” the hospice. Until she invented it hospitals in the West had little notion of helping people to come to terms with dying. It strikes me that Cicely did a tremendous thing for people when she made palliative care come into the mainstream.
I realised that we needed not only better pain control, but better overall care. People needed the space to be themselves. I coined the term “total pain” from the understanding that dying people have physical, spiritual, psychological and social pain that must be treated.
What struck me was the idea that people who know they are dying must face not just the fact of the physical death, but all the other deaths described above. Coming to terms with the last three must almost be a greater burden than the physical.
Here is what she said about what she would like when she died.
I would like to have time. I think one needs time to say thank you. One needs time to say I’m sorry. And one needs time to sort out something of yourself, and what really matters until, perhaps, you can finally reach the place where, as it were, you can say, “well, I’m me, and it’s alright”.
Which struck me as very true and rather beautiful.
Of course, it is not how death works for many people. I rather hope that it worked like this for my father although I believe there was a lot of pain and difficult side effects of medication. I rather think it was not like this for my Gran who was unhappy in her final years, and thrown off course by the failing of her previously robust health and independence. And, of course, it was not at all like this for my friend Matt who had no time at all.
In the equations described above by Cicely Saunders there seems to me to be something missing, and that would be the people left behind. To some lesser extent those close to the dying must also face the physical loss, and the spiritual, psychological and social pain too. The death of someone close can certainly empty life, drain it.
Often I think of my friend when I walk in the morning. Particularly when it is a beautiful morning, and I have been watching the first blushing buds open on the magnolia in the back garden, and the smoke from the chimneys around our house is beating steadily into a clear, pinkish sky. Mornings are all about starting again, and possibility, and of course for my friend there is the sense of time torn of unused. The end of possibility.
And yet, you know, I am probably closer to him now than I ever was. I think of him more often, certainly. Just today, Monday, as I walked down the path away from school, the ground was freshly wet from the rain, and a bird was calling from the trees and bushes about me, and I thought of him, missing this, and everything which is wonderful but usually unnoticed about life, and the impossibility of telling him.
Because another friend reminded me of it, I have been rereading the poems of Larkin. Probably this says everything I have tried to say here, but better.