Friday, October 02, 2009

portrait of an amateur photographer

Dear Readers!

I hope you won’t mind if I include this next piece on the blog. Although it’s not about my life on the ambulance, it is about my life, so maybe it’ll fill in some of the blanks.

I’ve always tried in Siren Voices to keep myself in the background, to keep overt opinion out of the writing. There’s still plenty of bias, of course. I try to be even-handed, but it’s inevitable I’ll distort the truth of a situation by going after a particular feeling or effect.

I want to carry on doing that, but I thought now and again it might be interesting (and a bit of a change) to write some pieces with a more personal and personally revealing edge.

So here’s a piece I’ve written about the events surrounding my Dad’s death a few years ago. I have to say now – maybe more for my family than anyone else – that as personal recollection goes it’s as flawed as you’d expect. We all remember things differently, timings get changed around, and it’d be impossible to remember exactly what was said. The best I can do is honestly put down what seems to be the truest for me, my memory and my feelings about what happened.

I’d also like to include this piece as a respectful acknowledgement of the traumas and troubles of all those patients I’ve written about up till now. If I can write openly and honestly about their problems, I should expect to be able to do the same for my own.


Sometimes, an event happens in the life of a family of such consequence that like a syringe of dye dumped in a vein, the tangled network so long hidden is suddenly – dangerously - inked out for inspection, a thready network of kinks and loops, baggy thoroughfares, atrophied ends, tentative connections and recanalisations.

When what was hidden is laid open.

And then I suppose the challenge is not just how to read it all, but how to live with the consequences once you think you understand what is written there.


Dad had been suffering recurrent bouts of jaundice that left his face a screen print experiment in yellow. Even the rims of his eyes were golden. When the attacks came he would drag himself up the stairs to lie on his side in a darkened room, glittering beneath the covers, staring at the curtains, or throwing up in a bowl. The doctor was sent for, and a long road entered onto of hospital stays and investigations that led finally to an appointment with a Consultant Gastroenterologist and a biro sketch on the back of an envelope.

‘This is your stomach,’ the Consultant said, sitting on the edge of the hospital bed, smoothing the envelope out on his knee. He stretched his right arm out to ride his jacket sleeve up his arm, giving himself room to move, but looking like a magician proving he has nothing hidden there. Shirt cuffs a brilliant starched white.

Outside, through the sealed window of the eighth floor room, the sun lay across a patchwork of rape and wheat.

‘This is your duodenum, your bile duct, your pancreas, the rest of your small intestine here …’ He roughed out the pattern, his estimate for a difficult job.
‘Now, what we have in your case – what we’ve found – are a group of shadows here, here and here,’ scrawling a bunch of malign-looking dots. ‘They may be cancerous – the type of cancer that spreads, the bad sort – or they may be of a more benign pathogenesis. If they are the friendly sort, then they will only cause these intermittent bouts of jaundice and nothing much else. And there may be things we can do to make those bouts more tolerable. But if they are the cancerous sort, we would need to tackle them more positively.’
Dad cleared his throat.
‘So I’ve got cancer?’
‘Well – that may be. Our feeling is that you might well have cancer here. But we don’t know this for sure. We can only deal in percentage chances.’
‘What are the percentages?’
‘I would say maybe forty percent. That the shadows are cancerous.’
‘So there’s a sixty percent chance that if I do nothing, nothing will happen.’
‘But if they are cancerous?’
‘There’s a forty percent chance that if you did nothing your condition would deteriorate and you would die in six months or so. Cancers in this area tend to be quite aggressive in that respect.’

A sketch on an envelope. A spread bet on some dots.

Dad only ever bet on the football pools. A friend of his at work would drop by to collect the coupons and the money for the week. On Saturday at tea time he’d sit with his salmon and cress sandwiches on his lap, ticking off the results as they came rattling across the bottom of the TV screen. Methodically highlighting the score-draws, chewing over the results, looking for those vital games, the points that would change our lives, the golden points that would mean claims by telegram please, a huge cardboard cheque and a kiss on the cheek from some swim suited bird in a room filled with flashes and smiles and champagne showers, visions of big windows and bigger gardens, of space and light and freedom, an end to the eternal torment of the cycle ride to the office, an end to the double bed in the living room and territorial squabbles upstairs. But despite every new method he came up with – numbered sticks dropped in a heap, birthdays and high days, letting the children choose – the only telegram ever recorded in the family was from an aunt who couldn’t make the wedding.

It took a few days for Dad to reach a decision.

‘What would you do?’ he asked me, when the Consultant had left the room, and he sat there by the window, turning the envelope over and over in his hands.
‘It’s difficult. I don’t know. I think I probably would go ahead and have the operation.’
The Consultant had said that the chances of a full recovery from the operation were good. He’d done one the other week, the man would be going home soon. It sounded tough, though. There were risks.
‘So you think I should have the operation?’
‘He said chemo and radiotherapy wouldn’t work.’
‘So you’d have it?’
‘I’d want to do something.’

I was out of my depth. I didn’t understand the nature of the operation, other than it called for some radical re-plumbing, bits taken away, bits joined up in new and surprising ways.

Mum knew and I knew that my eldest brother Rich should have been sitting here. Rich, a GP, the one person in the family most qualified to be perched on a hospital bed trading percentage risks with a Consultant, translating envelope sketches into a family language of symbols we could better understand.

Of course, if what was really needed at that time was someone to come roaring up to the hospital on a motorbike, dump kit in the corner of the room, make stupid cracks, a cup of tea and whatever else it took, I was your very man. But these medical scripts? I was flailing around with my usual flair for the inappropriate, trying to imagine what I would do if I found myself with cancer of the bile duct, sitting there by the window, in that gown.

But what Rich thought or didn’t think was no longer available to us. When he left for medical school, no-one in the family realised, not my parents, not my four sisters, not my other brother, Craig (although he maintained later that it wasn’t a surprise to him, that the evidence had been there from the start), no-one realised that something more had happened than simply the freeing-up of a bed in the boys’ bedroom. Within a few years Rich had devolved almost completely from the family; after qualifying and moving up country, he was further away still, as inconspicuous as a satellite signalling from on an orbit at the coldest, furthest edge of things. He was absent from all family events and traumas. By the time of his second marriage, we saw nothing more of him. He had sloughed us all off like a skin.

What Dad made of it no-one could tell. He treated Rich’s absence with the same stoically dyspeptic face he turned to everything else, the same face he pulled when sometimes he would bite an apple and say: ‘This tastes like turnips’.

He had always thought Rich the least complicated, most effective, least troubled of all his children.

But then I learned that Rich had phoned home to find out what was happening, and had called the Consultant to discuss the case. None of us ever knew what he thought of the operation. Impressions of conversations with him only ever filtered back through Mum or Craig. But whatever he thought, the result stood nonetheless. Dad decided to go ahead.

Within a day or so he was in theatres, to ITU for recovery, then to a ward, then back to ITU with an infection, where he died the day after. All told, about a week.


How a life seemingly so settled and secure can suddenly fragment, burst apart and scatter not just into pieces, but into items of furniture, objects in a box, a scrap of paper covered with numbers or half a drawer of junk. How quickly we become the things we hardly thought of when we were alive. How quickly we move out of reach.

Like this overexposed photo of a Honda C90, the blue and white plastic scooter he’d ride up to the river to fish, or the shops on a Saturday morning to get the paper, or – astonishingly – two hundred and fifty miles to Exmouth, to stay with his elder sister Mae and her husband Frank. On the morning before each trip he would stand at the window, studying the sky.
‘I’ll leave it for a bit. Looks like rain.’

Or this metal detector, safely lain away like a shotgun at the back of a wardrobe.
Once I stood by with a trowel as he swept the disc back and forth across the clods of earth. There was a signal. I prodded around whilst he stood back, sniffing and watching.
‘It’s a washer.’
‘That’s not a washer. Pass it up here.’ Pressing off the dirt with the fatly gloved hands I grew into. ‘Yep. Thought so. That’s a dufer.’
‘A dufer?’
‘Take it to Brown’s. Slap it on the counter. Say “That’ll dufer a packet of fags.’

A neat stack of back issues of The Lady.
Dad was going to put in an advert, Situations Wanted: Hard working handyman / gardener seeks live-in position. Anything considered. He had worked in the estimates department of the local printers for thirty years. A strong man, practical and funny, somehow finding himself at the back end of thirty years staring out of an office window, making plans.

Thirty years too long at the printers. Quite an over-run. But too old and too tied up at the end to do much about it. I remember once he came home from work early, slamming upstairs, the only time I ever heard him cry – a series of awful, raging chokes from behind the door. But a week later he went back there. He knew, everyone knew, he would have to go back. Make his apologies to the manager, keep his job. What else could he do?

The Lady: England’s First & Finest Weekly.

But then blessed retirement was upon him, absolving him of the need for these petty negotiations, drawing him down into the softer, more padded territories of the slow afternoon bonfire, the strategic nap, the biro circles in the paper marking out the evening’s TV.

And now he lay with his eyes taped shut and a corrugated tube coming out of his mouth, the kind of pipe you might hang out of a washing machine. The intricate ITU mechanisms fussed and buzzed around him as we took it in turns to stand guard. He was sealed up along the centre of his abdomen by a brutal scar whose crimped ridge rode up like the edge of a pasty. When I saw the wound I imagined a surgeon up to his elbows in gore, periodically looking up to consult an envelope being held out by a nurse, riffling on impatiently until finally he straightened up, snapped the guts shut like a Gladstone bag and clipped smartly away down the corridor.

We lived for a couple of days in the relatives’ room. Slept on the chairs there. Made coffee in the kitchenette next door. Paced the room, took turns by his bed, read celebrity magazines, stared at them with paper eyes by the hard overhead strips and the blue light easing in through the window. It had been many years since we had slept under the same roof. But there were no revelations, no late night confessions.
‘These seats are so hard.’
‘What’s the time?’
‘I’m just going to the shop. Do you want anything?’
An assorted box of family members, like the pieces to an old game you come across unexpectedly and study closely, with a dislocated sense of time having moved on, and something significant left unchanged.

I know my answer to the question: What would you do if the world was going to end in five minutes?
‘I’m just going to the shop. Do you want anything?’

Dad carried on breathing for ten minutes or more when the machines were finally turned off. Stoking little gasps, without depth or hope, without end. My sisters, their families, a niece and nephew, Craig and me were all gathered around, touching his hands, forehead –a lacklustre crowd trying levitation by touch. Mum had her face pressed against his hand where it lay palm down by his side.
‘He’s still breathing. Can’t we do something?’
‘There’s nothing to be done. It’s a reflex action.’
‘But he’s still breathing. We must be able to do something.’
‘He’s a fighter. He won’t let go.’
‘Let go, Dad. Just let go.’
‘It’ll pass soon,’ said the nurse. ‘These are his last breaths now.’
‘But can’t we do something?’


Rich eventually phoned Mum to find out the time of the funeral. I guessed who it was through the hall door. I came through and asked if I could speak to him briefly. Reluctantly she handed me the phone.
‘Where were you?’
‘Excuse me?’
‘He was dying. He asked for you. He wanted to see you one last time. He was fucking dying, and you couldn’t even make that.’
‘You’re just mad because you told him to have the operation and he died.’
‘You’re a heartless bastard.’
A laugh. ‘And you? You’re mentally disturbed. You need help.’
‘I want nothing more to do with you.’
‘See a doctor, mate.’
I handed Mum back the phone.
‘Don’t,’ she said. ‘Don’t.’


A pause in the run of events. The coffin had been lowered into the grave, and time given over for the throwing in of a handful of earth, a bunch of flowers, a last glance before the ground was closed up again.

I had brought my camera but I’m pretty slack. The whole day I had only taken a few pictures of the garden back home coming into flower, and children chasing each other around the gravestones in the cemetery. I thought I needed something more substantial, so I went up to the edge to take a photo of the coffin in the grave, feeling self-conscious, wondering how it would look in an album but not wanting to miss the moment. I looked down and tried to imagine Dad lying there, the expression on his face close up against that lid, just about where the metal plate was screwed, reflecting the sun so I couldn’t see what was written on it. As I focused the lens I remembered a photo of Dad looking up from his deckchair in the garden, his favourite orange t-shirt riding up over his belly. The quizzical anger on his face, that frown, as he unlaced his hands from behind his head, as if he were going to get up, as if he were going to do something.

But I’m no photographer. When I got the pictures back, the three or four I took of the coffin all had my shadow lying across it.


Anonymous said...

A very challenging subject to write on when things get personal. A series of impressions that tell a tough story very well.

I hope some of the families wounds have healed even if others are beyond repair.

Best Wishes as always.
Louise x

lulu's missives said...

Oh Spence,
I'm sitting here, tears in my eyes, remembering.
Reading this, is like reading about my father, who had the same op, but survived another 2 years. His last breaths were the same.
Thank you for sharing.
I wrote a post in my old blog, called "Hold them close", so this is what I try to do.
x jo

Spence Kennedy said...

Thanks Louise

It is difficult writing about these things. But I wanted to be able to approach what happened with my Dad's death in the same way that I've been doing for all those ambulance jobs.

The family is fine, thanks, although my relationship with my eldest brother - weak to begin with - was pretty much destroyed in the aftermath of Dad's death. But even there I still think we could reconnect. He's my brother, after all. I'd never give up hope. x

Hi Jo
I remember you saying you'd lost your Dad, too, but I didn't realise it was through the same thing. The Whipple's Procedure is a horrendous op, pretty tough to get through (but still worth the risk, I think). It's fantastic that you got an extra 2 years with your Dad. I hope his recovery wasn't too awful at the beginning.

I know my post was a 'warts and all' treatment of Dad - a kind of rush through some of the memories I have of him, seen through the (very distorting) lens of his death. I hope you get a good sense of him, though. And of course, whilst I describe his 30 years at the printers as being something of an ordeal (which it was for him, mostly, I think), it's also true to say that he worked hard providing for his family for all that time, made friends there and won respect from his colleagues - and I'd be happy if anyone could say the same about me.

lots of love

cogidubnus said...

That must have been the most difficult (if not traumatic) subject you've tackled...not just "warts and all" re your dad, but about yourself and your own feelings too...

To be honest you've got me welling up with the simple honesty of your writing...

Thank you for sharing...

Hel said...

Spence... my mum was told this week that she has a sarcoma. I can't bear it. I can't bear what the next weeks will hold for us.

Anonymous said...

Moving post Spence...

Its nice to meet 'you' !


Spence Kennedy said...

Hey Cogi & medicblog999
Thanks for that. I did feel extremely anxious about posting this. It's a relief you like it!

Hel - So very sorry to hear about your Mum's recent diagnosis. But you know, cancer treatments have come on so amazingly far, even in the last few years. You can absolutely be assured your mum will get the very best treatment. Don't take this description of my Dad's experience as anything other than a story of someone who had some bad luck. That can happen to anyone, unfortunately. But even though he was unlucky, the treatment he got was fantastic, and gave him the very best chance.

I hope everything goes well for you.

Rach said...

Spence, while reading that as usual you took to me straight to the place, but my stupid cat tried to leap from one Settee to another and landed on the floor in between, which made me laugh but I was also cross with her for breaking my moment.

Beautiful and bravely written, thank you for sharing..xx

RapidResponseDoc said...

Very moving, Spence. I lost my Mum to cancer 10 years ago last February, and I can still relive those last few moments, the last two or three breaths, as if they were yesterday. Your writing is inspiring.

Conundrum said...

I've had your Blog on the Google Reader for some time now, I really like your stuff. I think this post is the best you've done for some time, as the comments show it resonates with a lot of people. My own father was diagnosed with lung cancer, had a lung removed within a fortnight then died of a stroke on the operating table. It's the sheer speed of it which is so bewildering.

Life is so seize the day, eh?

mumof4 said...

Amazing post. Glad you were able to share it. You captured your familiy's dynamics and some of your dad's history in those short paragraphs. I know it is a post I won't forget for a long time.

Sorry your dad didn't make it.

kathleen said...

A brave piece of writing Spence. I'm so sorry about your Dad.
But what made me saddest was your description of your brother leaving the family "He had sloughed us all off like a skin."
That must have been devastating for your parents and that's what made me cry.

Spence Kennedy said...

Hey Rach
How far away is one settee from the other? I'm guessing your cat is either very old or very ambitious. Our cat's getting a bit stiff these days. She can't make it up onto the table anymore (prob just as well). When she tries - and crashes spectacularly - she sits there licking her paws nonchalantly as if she meant to fall like that all along.

Thanks for the comment...

It's such a tough thing, seeing people you love fall ill and suffer like that. With Dad it was so strange to see him as vulnerable as that, as he'd never had anything serious wrong with him before. I thought he'd go on for ever.

Hi Conundrum
Thanks for the comment, and for following the blog. I really appreciate it.
You're right about the shocking speed of these things. Afterwards you're left regretting all the things you didn't say, all the questions you could've asked but didn't. I suppose the consolation is that with close family members, they're so much a part of you maybe it doesn't matter that somethings are never said out loud. And you carry them with you in your blood, you see them in your children, so that's another consolation.

Thanks again for the comment.

Hey Mo4
Thanks for that.
Any family dynamic is such a multi-faceted thing, it's almost impossible to put over what goes on. I think with this one, because I was concentrating on Dad's death (and my eldest brother's absence) the tenor of it was pretty tragic. But I could've taken another tack altogether and put out a different kind of story.

Maybe I'm getting too melancholy. Lighten up, Kennedy!

BTW - I wonder what Dad would've said had he read this post? Prob something along the lines of 'Well I didn't laugh once.' Or maybe: 'How much do I get paid for that, then?'

Hey Kathleen
Thanks very much.
I suppose Rich's departure from the family was as big a subject in the piece as Dad's death. I know for a fact Dad would've loved to have lived long enough to see a meaningful and lasting reconciliation. Maybe we'll make that happen sometime in the future. You never know.
Rich still has some contact with Mum. But it feels very much as if she's the last bridge.

Thanks again to everyone for all your lovely comments! xx

lulu's missives said...

Hey Spence,
me again.
Just to say, I wish I had your ability to help people. A friend collapsed last night and I didn't have a clue what to do, apart from ring 999.
So frustrating.
I'm so impressed you do what you do.
x jo

Spence Kennedy said...

Do you get to do any first aid on the social work course? It'd be a good idea. I bet social workers arrive on scene to an emergency sometimes!

Failing that, you could always do a short one day type course via St Johns or something. They'd give you the confidence to step up. And if not a course, then a simple book on the basics ( It doesn't take much, and it can make a fantastic difference...

I hope your friend was okay. xx

Marah said...

A friend of mine told how the distance between his siblings exploded with the death of one parent. I'm an only child, and I could never figure out how or why - but you've told the story of combined grief that paints a new picture for me. In my personal world, I guess grief has always been personal - untied to family closeness or distance..

Anonymous said...

It wasn't the Dad I knew & loved at the very end, just an empty shell.... my brain has a tendancy to lock unhappy memories far away, so your writing has unlocked more than a few doors. Dad's death did teach me one thing, you should always make the most of life as much as you can, cos you never know how long you have left. Certainly made me change one or two things in my life! Love, as always x

Spence Kennedy said...

Hi Marah
I suppose it's almost inevitable that major family traumas will exacerbate any weaknesses. It's a shame - you'd hope that adversity would bring you closer together (but then I suppose - I hope - that that must happen just as often).

Hi Anon
I agree about making the most of life whilst you can. It's good that out of difficult times can come positive change. I bet your Dad would've found some consolation in that.

Thanks for your comments! x

Merys said...

Hi Spence, I've lurked for ages (because I get RSS as a rule of thumb) but never commented. That has just brought back flashbacks to my first year of medical school when my grandmother died. I was the distant relative, told not to visit by my mother because 'grandma in hospital isn't the grandma you know'. And then she died, and I hadn't said goodbye; it broke me in two. Not helped greatly by my aunts raiding the house for jewellery while my father registered the death. Family is a strange thing, but you created the image so beautifully and emotively.

Hope everything is well.


Spence Kennedy said...

Hi Merys
Thanks v much for commenting (and lurking). Shame you didn't get to say goodbye to your Grandma - which doesn't make you a 'distant relative', so it's hard to understand the reasoning there. Do you think you would've been overly traumatised by the visit?

And those predatory aunts...

Reminded me of an episode from Steptoe & Son. Everyone descends on a dead relative's house after the funeral, and they've all got their eye on the one thing of value in the house - a little porcelain figurine on the mantelpiece (which Albert carries out hidden under his hat).

Hope your studies are going well. x

Gerry said...

Spence this may be the best thing you've published here on the blog. I encourage you to submit it for publication in print as well. It's time.

Merys said...

Ironically it was a ring that had been given to me as a child. Diamonds, amethysts plus my birthstone. A true family treasure. When the evils found out they asked for it back. I admire my mother's balls, she told them that my grandmother wanted me to have it since she gave it to me at the age of 6. I didn't even know any of this until she passed away. The ring is beautiful, though I doubt I will ever wear it, too many memories.

I'm not so much haunted as guilted. I work as an auxiliary nurse while I pay for my course, so my mother knows I would have played merry hell on the ward that left my grandmother without her glasses and bilateral hearing aids and then attributed her shouting to confusion. Neglect I call it...

Spence Kennedy said...

Thanks Gerry. Don't hold your breath about the publication thing, but I have been sending stuff off for a while. Maybe I'll get lucky one day...

Hi Merys
Lovely that your mum stuck up for you and you got to keep that ring. Those things are so precious (in the true sense of the word). Maybe you could keep the ring for some special occasion in the future...

Awful to think of your Grandma subject to those indignities on the ward. Makes you furious to think of it, whatever the extenuating circumstances might have been.

Coincidentally, I read in the paper yesterday that hospital and other nursing staff have been criticised for over-prescribing powerful anti-psychotics to make their elderly patients nice and compliant. shudder

Subz said...

Hello Spence x

That was moving. When my mum died, my brother wasn't there. We both live with guilt (amongst other emotions). It's a long process, eh?


Spence Kennedy said...

Hey Subz
Thanks for that.
Guilt is such a terribly corrosive emotion, so difficult to free yourself from. I hope things are okay now with you and your brother. xx