Mole intelligence: EPISODE 95

Completely irrelevant image of penguin from zoo

Completely irrelevant image of penguin from zoo

10 Forsythia Grove
Outer Hamlet

July 10 2000

My Dear Harriet

Thank you for your enthralling epistle on the subject of chicken care. I am relieved not to have any chickens – and especially cockerels – in my own life. And please don’t – ever – put yourself down. You are becoming exceptional, and that is life’s largest skill of all.

It is Sunday morning here in Outer Hamlet and I have risen early with the purpose of attending the swimming pool. As my feet – clad in white plimsolls – padded along the pavement, I became conscious of that rather sweet smell redolent of warmth and rain and the slow composting of organic material which has fallen to the ground. A faint mist of rain was falling and the world was as quiet as any human being could wish for.

As I trekked across the recreation ground – and all the beheaded white clovers – I thought of how different swimming pools have become since the war. If you recall, Harriet, I was but nine years old when the war ended and, by then, had only experienced the occasional immersion in freezing cold municipal baths (for they were baths then). It is only since the Great War – when male recruits were deemed to be lacking physical fitness – that the emphasis has shifted from keeping clean to keeping fit. And indeed, before then, swimming baths were thought to be positively dangerous places harbouring the organism thought to cause polio. My own experience, as a child aged eight or so, was that the swimming baths were likely to be closed owing to the impossibility of obtaining an essential part – customarily made by men then fighting in the navy, air force, or army.

This morning, however, I have pushed and pulled my way through heavy doors, decked myself out in a rather appealing-looking turquoise swimming costume, and headed for the water. I have enjoyed my recent experiences of kicking through the water on my back, kicking through the water on my front, and treading water. It has also been most wonderful to exhale air at the ‘deep’ end, exhaling bubbles, and kick back up to the surface from the bottom. But something has been lost, I feel, from the ambience of the modern day swimming pool compared with that of earlier times. Depth for a start. It now would seem virtually impossible to drown in a contemporary pool as the water is so shallow and the pool dimensions so short and narrow. And do you remember the time when it was possible to actually dive into – the really deep – end from a spring board or a gradually ascending height of boards? But most of all I think I miss the blue, or green, ceramic tiles which lined the pool itself and the walls of the great buildings which housed them.

With love as ever



We need to talk about Kevin . . . (episode 94)

rooster crowing (retro (circle) Image by 'vectorolie'

rooster crowing (retro circle)
Image by ‘vectorolie’

3A Hyde Park Terrace

July 6 2000

Hello Mum

I know I have been gone a bit quiet recently, I’m sorry. Sometimes it feels necessary to recoup one’s forces and try to regain a sense of Life’s direction. I seem to be meandering about somehow. Perhaps I have become one of the world’s many dilettantes? A woman of no particular skills . . .

The only recent event of slight note has been my acquaintance, Kimberley’s, request to look after her chickens while she went off on holiday. I met Kimberley while out walking Ferris in Hyde Park and she seemed like a splendidly capacious woman, adorned in any number of brightly-coloured scarves originating from countries all over the planet. I agreed, anyway, to the chicken care – despite knowing that I would have to trek over the park twice a day, owing to the squeeze of traffic pressing on her residence and the fact that her own garage would be locked. No parking of my own Triumph Spitfire Mk IV therefore!

It all seemed fairly straightforward (initially) Mum. Kimberley’s neighbour, Basil, would let the chickens out and all I had to do was feed/water both the chickens and the plethora of hanging baskets suspended above the decking out back. However, there was a slight mention of Kevin (the cockerel) before she departed. The slight mention alluded to the fact that Kevin could play up and that ‘playing up’ would take the form of flying at you – talons bared – and beak agape – in an attempt to drive you away. Barry, Kimberley’s husband, actually demonstrated the grabbing of Kevin – and the whirling about of him above his head – while clutching hold of his feet! And Kimberley informed me that, in the event of difficulty, a stick would be left inside the run for me to use. I certainly didn’t feel up to the whirling of Kevin above my head option . . .

I have to admit, Mum, that I arrived before dusk (at 2150) on the first night and, do you know, chickens do not want to go to bed until the last gasp of light. I stood there, and they stood there, and it was very clear who was in charge and it clearly was not me. Eventually, the lower status chickens cleared off up the ramp and I thankfully dropped a plank against the door of the coop. Kimberley had, of course, been most conscientious in her mention of The Fox. The fox, apparently, lingers – just out of sight – at dusk, waiting to tear apart any unwary chicken who has not gone to bed in time . . .

Guess where Kevin and the Big White Chicken were Mum? Still running around the run, or at least, they were running away from me. Also, Kevin seemed very intent on getting his ‘leg over’ so-to-speak and this caused somewhat of a pang in my own breast, for even a cockerel gets to have more carnal congress than a recently-divorced woman aged 41!

Eventually, however, they did retire to the larger shed at the end of the run and this set up a further set of questions in my mind. I had not been the person to let them out of the coop/s in the morning and so I didn’t have the faintest idea where Kevin and co. laid their beaks to rest at night. Were they usually in the shed? My unease increased when I realized that there appeared to be no means of locking the shed for the night. There wasn’t a bolt or padlock on the door! In the end Mum – and in somewhat of a panic – I wired the door shut and leaned a full watering can, a spade, and a plank against the door as further obstacles to the ingress of The Fox.

I didn’t sleep well at home that night! I had terrible visions of this magnificent cockerel – and the Big White Chicken – being torn to pieces in the jaws of the local chicken predator – and just finding feathers and the remnants of a few limbs and wings scattered around in the dust when I next appeared.

However, the good news Mum, is that I only have to keep them alive for another five days!

Best Love (as always)


Gazing into the abyss . . . (episode 93)


1A The Hole
Hope End Street

July 2 2000

What ho! Auntie

You sounded decidedly more chipper on the telephone the other night. So your plaster cast is finally off! How are the ‘kicking sets’ going down at the Outer Hamlet swimming pool?!

I am writing to report on my latest attempt to engage the attentions of Thule. Despite a certain amount of loitering around the corridors of Carpool District Hospital, I never seemed to bump into her. And, then, just before last weekend I observed her in the act of appending her name to a list on the ‘Outdoor Activities’ notice board. I naturally waited until she was out of sight, before sleuthing up to see what activity she had signed up for . . . It was a trip (that very weekend) to Sunless Pot in the shire responsible for the Kendal Mint Cake. Auntie, I added my name, before galloping back to my bedsit to see whether my wet suit was in sufficiently good repair for me to pack in a bag. It was. Only one or two holes in the rubber!

The following morning, along with quite some motley crew of around ten people, I arrived in the canteen car park, prior to climbing into the mini van. Thule was there but, disappointingly, she seemed to be hanging about the person of a character called Dan: the potholing team leader. Dan, as I’m sure you can imaging, resembled – to my jaundiced eye – the sort of chest-beating gorilla that you tend to see on episodes of Tarzan. AH – AH – AH – AH – AH goes that yell, doesn’t it? She did manage a rather cursory hello to Yours Truly, but that was it. I slumped into a seat and proceeded be harassed, rather irritatingly, by the only other female on the trip. I don’t want to appear unduly prejudiced on the subject of appearances Auntie, but she did have buck teeth and, every so often, she gave out a sound of loud slurping. Uncontrolled salivation I think – not necessarily of the lubricious kind – but more related to some physiological anomaly or other. It was only by dint of changing seats after every motorway service station that I managed to shake her off.

It was certainly a long haul up the slopes of Sunless Fell to the pot, particularly as I was assigned to the carrying of about 200′ of electron ladder. This is the sort of ladder, Auntie, that is metal, flexible, and narrow to the point of only accommodating one foot on each of its rungs. At this point, I was rather wondering what I was getting myself into – particularly as, by then, heavy lead acid cell batteries had been allocated to each person, in addition to helmets clad in a sizable light. I think I had been envisaging a little saunter along minor horizontal tunnels!

Sweating, and doubtless puce about the chops, I finally toiled over the rim of the fell and the opening of Sunless Pot yawned before me: vast and black and apparently descending into a void without bottom. Frankly Auntie, I was all for throwing in the towel – especially when I saw the ladder, all 200′ of it – being rolled over the edge, but I couldn’t as Thule would definitely have noticed my ignominious scampering back to the bus. There was also a loud growling sound to be heard and this – peering slightly further down into the chasm – appeared to be coming from a waterfall in full fall. Black and white water was frothing from a ledge.

‘Surely we aren’t climbing through that?’ I chirruped from my vantage point.

‘It’s no problem mate,’ said Dan, flexing his biceps. ‘You can take a breath from under the rim of your helmet. I’ll just rope you on.’

God only knows Auntie, how I didn’t turn and run – craven – back down the slope, but all I can say is, that terror had me rooted to the veritable spot.

I submitted to being roped on and gaped down at the ladder.

‘It’s easy mate,’ said the irrepressible Dan. ‘Just keep your body straight and close to the ladder. It might flex a bit above and below you.’ And then he gave me a bit of a thumbs up and a bit more of a push.

Well Auntie. What can I say? Down I went, foot after foot, breathing from the small interstice of air beneath my helmet rim, as the water roared down upon me. The beastly ladder certainly does flex about and it took all the strength I had to cling on as I descended through the zawn.

And if you are asking me if Thule was worth it, then I can only say ‘Yes,’ in a way, because she patted me on the back later on – in the ‘duck’ section – and before the ‘sump’ section – and actually said that she’d seen me about the wards from time to time.

I will tell you about the ‘duck’ section and the ‘sump’ section in future reminiscences!

Toodle pip

Your loving nephew


The other sort of swimmer . . . (episode 92)


10 Forsythia Grove
Outer Hamlet

June 25 2000

My Dear Ralph

I seem to be spending slightly more time repining at home than is my wont, and so it is far too tempting to dip my fountain pen into its green inkwell and pen epistles to yourself and Harriet. Do you like my note paper? It is of a weight and colour (deep lilac) designed to complement – and dignify – the ink. I have, further, invested it with a scent, the scent of lavender from my spray bottle, for I am an old-fashioned lady at heart. It is an opportunity, I feel dear, to also send some notion of my character and style.

And perhaps I have needed the uplift of the above, given the style of the correspondence received from the Bright Litton NHS hospital fracture clinic. I have been copied in to a letter that the medical personage at the clinic has sent to my GP. And quite apart from the factual inaccuracies scattered therein, there is one particularly offending sentence, which reads as follows: ‘Mrs Tankful is a self-employed gardener, who has “managed” to injure her wrist falling off a 2′ high stool.’ Beep beep dear. For a start, the medical personage is conflating two separate – and unrelated – facts. I may well be a self-employed gardener, but I sustained my injury indoors and not ‘out in the field’ so-to-speak. And, secondly, having done considerable damage to both my ribs and my shoulder – in addition to fracturing a wrist – it should be obvious to any thinking person that I did not just topple sideways into a flower bed while sitting on a stool (and wielding, for instance, garden shears). You would think – and you would hope – that this type of male would have become virtually extinct by the year 2000! The only plus point, as far as a communication of this quality goes, is that any, even slightly, decent recipient of it, would raise their eyebrows to the heavens (and give thanks that they had not been sent to see such a male themselves).

I was further dispirited by the telephone message I received from my GP surgery (that very same day) which went along the following lines: ‘Hello Mrs Tankful. This is the Empathy surgery here. We are just phoning to notify you that a letter inviting you to attend the Osteoporosis clinic will be arriving shortly.’ OSTEOPOROSIS CLINIC Ralph?! I have evidently had a slight fall indeed! At the age of only 64, I have entered the arena of OLD AGE!

The coup de gras (have I spelled that right pet?) was administered in an article written by a swimming coach that I came across in the Outer Hamlet public library. This rather excoriating piece stated that there were two types of swimmer who break their wrists. The first type, apparently, once clad in a plaster cast, never goes swimming again (perhaps this is because they are unaware that a waterproof cast is, theoretically, an option). But the other type of swimmer is undeterred! The other type of swimmer attends the pool and does ‘kicking sets’ – both above, and under, the surface of the water. So, guess what dear? I will be attending the pool, once I manage to get shot of the water-soluble plaster cast I am currently interred within. And I shall be attempting both ‘kicking sets’ and side-stroke.


Your loving Aunt

Evangeline Tankful (DBE)

Inhabitant of a plaster cast . . . (episode 91)

Garden snail.  Image by Simon Howden.

Garden snail. Image by Simon Howden.

10 Forsythia Grove
Outer Hamlet

June 17 2000

My Dear Ralph

I think I must be getting slightly better pet; I am able to summon the wherewithal to adopt my usual style of address. ‘Slightly’ is, however, the word. My plaster cast is weighing, literally, on my wrist and I have had to give up – among other things – swimming (plaster casts dissolve in water), cycling and driving. And while it is certainly – if eventually – possible to extract a full bag from the indoor bin; add/remove clothes to/from my person; get in and out of the bath; wash my hair, and deal with dirty crockery – none of these activities can be accomplished with my erstwhile ease and style.

And it is not just my left wrist (my writing wrist) which is out of action. Something is the matter with my ribs, which roll over each other when I climb into bed. Getting out of bed is only accomplished (without screaming) by pivoting myself on my right elbow. Yesterday, while out of doors and operating as a three-limbed gardener, I had to clear and re-plant (having removed the grass roots from the plants themselves) a whole bed of yellow irises. In the middle of all this turning and twisting, I was suddenly riven by an extremity of pain in my left-hand rib cage. It was lucky dear, that the garden owners were on holiday, for I myself had to stand – rooted – to the spot for quite some minutes waiting for the pain to abate. Furthermore, I am not sure that it is entirely svelte to be seen walking around town with my gardening kit stashed inside an elderly person’s trolley on which ‘Grunt with Bucket dot Com’ is printed. This, in days of yore – when I was in a relatively hale state of health – seemed to have rather an amusing ring to it. However, it is not so funny when one has to toil around town for miles and hang about at bus stops devoid of seating.

I have also made my first trip to the Bright Litton NHS hospital fracture clinic. This was an experience as dispiriting as one might imagine, for it looked like those citizens with any financial status whatsoever had hoofed it over to the private WOPA premises in Marl Street – which left the rest of us. The rather grim-looking waiting room was coated in a shiny-looking shade of magnolia and we all seem to be crowded round a series of floor to ceiling structural supports, which lended a bunker-like feel to the whole experience. I was eventually called in however and the doctor did at least show me the latest set of wrist X-rays. Apparently the radius bone is fractured from one side to the other and, at 90 degrees to the fracture (and running towards the small wrist bones), is a further crack. Sigh. Apparently I can get shot of the plaster cast in another 14 days. I did not think it politic to mention pet that healing might be delayed by my somewhat over-zealous used of hand shears while engaged in some topiary last week. I think, next week, and having viewed these X-rays, that I might be confining my activities to snipping through thin green stems only.

However – in mitigation to all the above – I have been attending one or two very beautiful garden borders, which I have had a hand(!) in creating. And walking up and down the paths of cat mint, Penstemon ‘Garnet’ and Lady’s Mantle – through the hundreds of bees pollinating the flowers – has been a soul-soothing experience, of which I never tire. And, further on, down into the garden, are the lavenders and roses and Knautias planted to surround a Sweet Bay trimmed into a geometric shape. If there is a greater joy in Life than tending to sights such as this, then I have yet to find it.


Aunt Evangeline

Mole intelligence: EPISODE 90


1A The Hole
Hope End Street

June 12 2000

Hello Auntie

It is raining here at Hope End Street; I can just about see it as I gaze through the dirty net curtains – and grimy glass windows – of my bedsit. But (unusually maybe) I am not one of those who see only darkness in the rain. I find the sight and sound of it – sloshing down upon the pavements – to be comforting. I imagine it to be enfolding me in a hug. A kind hug. And it acts as a silencer of the loud and shouting world. I seem to need this Auntie, this gentling of the spirit that occurs under a low sky.

Thank you for your telephone call by the way. Yes. I am more than happy to come round and cut off your T-shirt for you. You must be getting quite hot and sweaty if your plaster cast is stopping you from disrobing and getting into a bath. Still. Those freezer bags you mention sound very useful for the purposes of keeping the cast from getting plastered in mud while gardening. Do you get much trouble from condensation inside the bag?

Your remarks about the nature of heroism reminded me of a novel by Patrick White (he won the Nobel prize for literature in 1971) called ‘Riders in the Chariot.’ I don’t know if you are familiar with it Auntie? It has four main characters, all of whom might be identified as ugly in the view of the world. One is a deranged heiress; the second is a coarse-looking washerwoman; another is a professorial Jew, and the last is a syphilitic aborigine. They are: Mary Hare, Mrs Godbold, Professor Himmelfarb, and Alf Dubbo. The remarkable thing about them though is that they all exemplify the virtues of goodness, kindness, and compassion. They are riders in the chariot of God, otherwise known as the Zaddikim. It was one of those books that can change a human life and I have always kept it, albeit getting more and more battered – and caked with dust – with every passing year. I would take it to a desert island because I would never tire of the mortifying acts of casual cruelty described and these characters’ efforts to offset them. Perhaps I, too, was a child not set in a popular mould – made ugly by shyness – and who now aspires to reach out a hand to very ill people who lie in their hospital beds. People who need me.

On the nursing front, by the way, learning methods have taken a downhill turn owing to the introduction of ‘study modules’ on the library computer.  In my opinion, remote learning has an alienating effect on the learner for, once you have completed one set of multiple choice questions, the page vanishes forever from the tangible world into a digital realm from whence it is unlikely to reappear.  All such increases in technology seem to correlate, I feel, with a loss of humanity.  I really feel quite depressed by it Auntie; nursing care on hospital wards has similarly vanished down the computer toilet in this way.

Your loving nephew


The nature of heroism . . . (episode 89)

image by 'gameanna'

image by ‘gameanna’

3A Hyde Park Terrace

June 5 2000

Hello Mum

Thank you for your telephone call last night informing me of the radiological report on your wrist X-ray. A stress fracture of the distal ulna does, at least, sound less serious than a fracture of the distal radius. No wonder you were in such agony when changing gear in the Banger 0.9L Mk II! I was also interested to hear your remarks about the significance of the type of fall you sustained.

I remember slipping on the ice while out skiing in Val d’Isere with Austen one year. Of course, as my feet flew forwards, I fell backwards, putting my hand out to save me – and that is how I broke my own wrist. But, as you say, you fell sideways – describing what sounds like a parabola – from a standing position up on a chair. And that is how you probably landed on the ulnar side of the wrist. Why don’t they ask you these questions in a structured way when you turn up in A&E. Anyway. What happens now? Can you escape a plaster cast?

I myself have been cogitating over the nine Jesse Stone novels penned by the American writer, Robert Brown Parker. There is something terribly profound – and moving – about the characters of men (and women) who act to uphold the best interests of others, often at terrible risk to the quality of their own lives. We seem to see these acts of heroism – enacted over and over again – in the behaviour of fictional criminal detectives. But there must be people in real life who, every day, nerve themselves to act against a prevailing system, and in defence of the perceived best interests of another. How can they bear it? How can they bear the disapproval of – and indeed the invocation of punitive actions from – the system?

I also read that Robert Brown Parker had a particular penchant for dogs and so that must be how Reggie the red setter ended up featuring in the Jesse Stone novels. I think he must have had a special interest in heroism, as he has a PhD from Boston university whose subject is ‘The Violent Hero.’

I can’t quite describe the pain I feel when I read about the compassion and courage shown by such a man as Jesse Stone, in the interests of justice.

All love Mum


A broken wrist . . . (episode 88)


10 Forsythia Grove
Outer Hamlet

May 22 2000

Hello Pets

I have become hors de combat and it is painful even to cough or waggle a finger or two around. Honestly, after so many – injury-free – years as a horticulturalist, I fear I may have become blase even during manoeuvres around the house (which is where I managed to fall, stepping down from a table on to a chair).

I was up on the table, indeed I was up on a window ledge, during the course of siting something called a mobile wireless device as high up in the room as possible. But, as I stepped down on to the chair, I must have been a trifle incautious and the whole thing tipped to the left. I crashed to the ground dears, whacking my head and rib cage on the floor, and bearing a considerable amount of impact on my left wrist. I don’t think I was knocked out, but the word “concussion” has taken on a whole new meaning since that moment.

When I finally had the electromotive force to get up off the floor, I fortunately recalled the phone number of my chum Lord Sloth of Denbigh Dale (a.k.a. the Cosy Old Sock) and gave vent to some considerable importunings to come round forthwith. When he arrived, I said,

“Have you changed the registration plate on your car? It does not look quite the same as usual.”

Lord Sloth gave me a strange look and said, “What have you done to yourself Lady Beaver? You have a large bruise to the left of your eye.”

“Yes,” I said. I seem to have hit my head and the writing on my wall calendar looks a bit fuzzy.” I expect I will be alright in a minute.”

Round at Lord Sloth’s demesne, I said, “I’m sure I’m doing an afternoon shift for the care company this afternoon. The thing is, I can’t actually remember the name of the care company or the time I usually start it.”

“Oh,” said Lord Sloth, who started to turn the page of any number of old-fashioned paper directories and reading out the names of local care companies.

And finally we came across it or, eventually, I remembered it.

“Why don’t you give them a call?” said Lord Sloth. “You could ask them what time you usually start.”

“How can I phone up and ask them that?” I hissed. “It would look most odd.”

“Well, don’t you know Eloise’s number,” he said. “You could phone up and ask her.”

“Who?” I said. “Never heard of her. Who is she?”

“The person you normally work with,” rejoined Lord Sloth.

“Oh,” I said.

Eventually, and after one or two hours had elapsed, I decided that, actually, I probably shouldn’t go at all as my left arm, by then, was nearly-completely unusable and my rib cage felt like it had been crushed under a train.

“Why don’t you go to A&E and ask for an X-ray?” remarked the ever-reasonable Lord Sloth.

“Certainly not,” I rejoined. It is only a little strain. And, anyway, it is a trip on the bus, followed by a long walk up the hill to the hospital.”

“I will take you,” said Lord Sloth.

“Hmmph,” I replied.

Well, the long and the short of it pets, was that – two days later – on Saturday – I had a conversation with a citizen called Claude in the High street. Claude said that, when something similar had happened to him some years ago, he too had not thought he had broken anything.

“Oh?” I said. “What happened?”

“Well,” he said. “They X-rayed my wrist and said I’d broken it. They then informed me that they had to put a torniquet round my upper arm (to prevent the drug they were using ever reaching my heart and potentially stopping it). And when they did that my arm started to jump around uncontrollably. They then summoned an ‘ape’ to pull on the hand and get the bones back in the right position.”

I stared dubiously at Claude and said, “Perhaps times have moved on since then. Who knows.”

Anyway. This conversation had the effect of getting me to the bus stop. And at the bus stop (with shelter) was the local alcoholic with the long brown hair and strange white face. I wished I’d phoned Lord Sloth at this juncture. And then another unusual lady also turned up, followed up by somebody slightly more normal.

The bus arrived some 20 minutes later and I accelerated towards it, leaped on board, and asked for my ticket. The driver, however, was looking through the window in rather a distracted manner and then started to shout:

“HE’S NOT GETTING ON THE BUS. HE’S NOT GETTING ON THE BUS.” We all looked at the man with long brown hair. And then the driver started to shout, “GET ON THE BUS. GET ON THE BUS” to the other two ladies who were waiting. They, of course, froze before finally struggling in together and getting jammed in the door as it closed.

Phew pets. This whole thing was turning into a bit of a strain.

At the hospital – having spilled a cup of Mocha all over the waiting room floor – I was summoned by a nurse into the treatment room. She looked at my Michelin tyre-size hand, all blue and black, and said,

“Hmmm. It is the amount of bruising descending the inside of your wrist that I am worried about.”

And, indeed, the bruising did seem to have seeped for a whole 7.5cm down the inside of my wrist.

“However,” she went on. “It is Saturday and X-ray is closed. You will have to come back on Monday.”

And this, dears, is where matters have rested – apart from the unfortunate incident with the young men in baseball caps whom I encountered in the over-ground tunnel en route to the bus stop. Always be wary of young men clad in caps which read something like, “F . . . O . . . OR I’LL NUT YOU” when visibly incapacitated in an arm sling, toute seule and out of sight of the rest of the world.

Your loving relative

Evangeline Tankful (DBE)

Morpheus . . . (episode 87)


10 Forsythia Grove
Outer Hamlet

May 7 2000

My Dear Ralph and Harriet

My apologies, dears, for sending this to you via carbon copy. I know it is months since I last penned a missive – owing to prostrating endeavours on both the horticultural, and home care, fronts (albeit in different ways) – and so I have inserted an inked-blue ‘leaf’ beneath my writing page. I do feel faintly guilty about the duplicate method of correspondence, I must say, owing to feelings of boundless irritation when someone sends me a Christmas ’round robin.’ I myself always bin these . . .

It is some of my recent experiences with home care that I feel moved to discuss here. There are occasions when one is called upon to care for critically ill people in the community. These are not necessarily individuals with cancer; sometimes they are people with progressive, long-term, conditions who may experience a crisis in their conditions. They may spend time in hospital and then, for one reason or another, spend some months in bed. They may live or they may die. No-one knows and I feel that no-one should presume: either way.

There is still, to my mind, a far too hasty tendency to assign such people to the ‘palliative care’ mode of treatment and care. They may, after all, recover given time – and a chance! But, no, should a doctor attend and comment that the person has ‘end stage’ disease, a whole destructive steamroller of ‘care’ actions can be set into motion. The principal one is that community nurses may arrive and suggest that morphine – either as a liquid cordial or via syringe driver – be given “for the pain.” What pain? It is admittedly true that someone who has spent months in bed is going to be excruciatingly sore and stiff – when rolled from side to side – but this is an entirely different to the grinding, boring into you, sort of pain that accompanies toothache or bone cancer. Morphine – even at a dosage of 5mg/2.5ml – delivers a blow to consciousness equivalent to being hit over the head with a heavy lead cosh – and puts the unfortunate person into a state where they are simply unable to even ask for food and drink. And who can recover when food and drink is denied in this way?

I feel that insufficient thinking is going on in the heads of all concerned here. And I have recently felt prompted to make remonstrations on behalf of individuals in receipt of what appears to be ‘check list’ care. I hope that, in the future, a clause will be inserted into ‘end-of-life care’ regulations which protects such people and which states, in effect, that ‘where the outcome – life or death – is unknown, then all decisions should be made which follow the direction of Life.’

I have heard that the formation of a body called NICE (National Institute for Care Excellence) has been mooted. Maybe, by the end of 2015, they will have published new ‘end-of-life care’ regulations which will put such protection into place. But – even then – will the doctors, nurses, physios, OT’s, and care staff out in the community even read them?

In a way pets, this wasn’t even what I sat down to write about. I was going to talk about what a privilege it is to touch the skin – and perform the most intimate of tasks – for the person who is cared for in bed. And how one’s own skin sings with the compassion that such work requires. The work of a community health care assistant is skilled, responsible, and difficult. We not only perform the care of intact skin, we wash and feed and administer drinks and medicines. We handle all manner of excreted fluids. We regulate a person’s body temperature – opening windows/fitting bed socks. We occupy them with the radio and read them poems and stories. We act as advocates, representing what seem to be their needs and best interests to our employers.

And when, at night, they shout ‘help – help – help -‘ continuously, in their distress, we are the ones who soothe and distract them. We hold their hands and kiss their foreheads as we leave.

This work merits all our respect.

With Love


Press harder Sister . . . (episode 86)


February 20 2000

1A The Hole
Hope End Street

Hello Auntie

There has been somewhat of a lull in our correspondence recently? I hope you have not drowned in the pool? Or fallen off your bike on some steep descent or other?

My sojourn on ‘Buttercup’ ward is (thankfully) almost at an end and I am tired out. There have been one or two incidents and one, in particular, has played upon my mind.

It was an evening shift and the only staff on duty were myself, the ward Sister, and a young volunteer (clad in a pink shift). And in the side ward (invisible through swing doors) were two male patients recently admitted with cardiac symptoms. One of them, in my view, looked perfectly okay but the other had rather a grey-looking complexion and kept pacing about the floor.

I did say to the Sister, at this point, that I felt we could keep a better eye on him if he was moved into the main ward, but she said that – as it was an all-female main ward – we could not do this. I carried on with my work and all seemed quiet. And then the volunteer came up to me and asked if I could help Mister X off the commode. It did run through my mind to wonder why a man who was previously pacing about the room was now, suddenly, unable to get off a commode unaided – but it wasn’t until I got there that I realized what had happened.

Mister X had had a cardiac arrest. I shouted for help and the Sister (a very good and decent woman) phoned for the arrest team to come. The arrest trolley was, unfortunately, in a corner and pinned between two diagonally placed beds. But I got it out in the end and the Sister and I commenced resuscitation. I was breathing into the man’s throat at one end and the Sister was doing the cardiac compressions. Just before the arrival of the arrest team I was starting to feel that she was pressing too lightly on his chest . . . (You are supposed to depress the sternum to about one third of the depth of the chest, because the whole point of the exercise is to compress the heart between front bone and back bone in order for it to eject blood.)

The arrest team arrived and I could see the Doctor in charge looking thoughtfully at the Sister as she carried on with the chest compressions.

“Are you feeling tired Sister?” he said. “Perhaps you would like a rest?”

“Oh no,” she said. “I am feeling perfectly alright.”

And so she carried on and the patient died!

I was really quite affected by this Auntie, the moral of the story perhaps being: “Speak Up or else your Patient might be Dead!”

There is more to the nursing role than I perhaps first thought . . . Every so often it appears that one will be called upon to make a stand. And Auntie, I wonder if I will be up to it?

Your conscientious nephew