Once Again

She's in her late eighties, she has arthritis, sores covering her body and brain cancer.

Every movement causes her pain.

She's been moved from one hospital to another – all for her own benefit, but she only seems to stay in one place for a few weeks before going to somewhere more suitable.

She's getting good care, people are looking out for her, the place where we pick her up from is a nice unit – she's going back to the local hospital because of a new symptom that is causing her pain.

We put her on our trolley and wrap her up in our one remaining blanket, I 'borrow' a pillow from the unit. We don't have pillows, neither does A&E.

She worries that she has left something in one of the cupboards so, before we go, I make a point of opening all the doors and showing her that they are empty.

She's a little forgetful, but otherwise has insight into her condition. She's a 'proper' old East End girl. Good natured mild swearing, a little joke here, a little ribbing there.

I instantly like her.

We wheel her out into the cold but, once the ambulance doors are shut, she soon warms up.

I sit in the back of the ambulance and chat with her, she tells me about her son and how he works shifts, so he can't visit as often as she'd like.

She tells me that she really wants to go home but can't because there is no one there to look after her.

I'm holding her hand as she turns her head to me and looks at me with blue eyes.

'I'm eighty nine, I've had enough, I'm tired', she tells me.

I blink the moisture forming in my eyes away.

I know what she means.

She knows that I know what she means.

14 thoughts on “Once Again”

  1. Don't feel bad about that – it was the place she probably wanted to die in. I see so many patients who are barely cared for zombies in a nursing home, shuffled about between bingo and bland tasting food, swaddled in nappies and reeking of feces and urine. It's no way to die, and many patients in their later years fear that they'll end their days in one of these places, never to return home. I had a lovely chat with a 90 year old lady just the other day who was in this spot – all she wanted to do was to go back to the house she'd lived in with her late husband for 60 years and raise her plants in the greenhouse. I hope she gets there.

  2. Hi Tom, I found this article very moving and if I'm honest very scary. We are an aging nation with an increasing life expectancy but what is life without quality of life. I'm realistic enough to know that quality of life can be anything from watching the sun rise, reading a good book to traveling the world or walking up a mountain, but I think as well as quality I think that life should also have dignity.I live in Scotland and one of our independent MSP's Margo MacDonald is in the process of proposing a bill to allow terminally ill people the right to die at a time of their choosing. Whilst I know that the issue is not black & white I think that its good to debate the issue.

    Here is a link to the article for your info.


  3. We all have jobs that get to us in this way. What matters is that you accept that some jobs will get to you. I've seen paramedics crying with patients and their relatives. It's a release that everyone needs and it always means an incredible amount to the families involved.Every so often we all come across jobs that remind us why we do this work and they make all the rubbish worthwhile.

    There is an interesting statistical anomaly with ambulance work, the people who can not cope with the work do not apply.

    If your concern is about empathy then you are on the way to a good start.

  4. I'm a stroke rehab OT. Today my patient begged me to help her convince her family to take her to switzerland so she could die. I had to leave her before she saw i had tears in my eyes. Doesn't get any easier the more you here it.

  5. awwwww poor old girl.After my mum died of cancer (she collapsed and died on her own in her own home, still feel terrible about that) my uncle said that she said to him a few times that she was tired and had had enough, so I feel for you hearing that.

  6. Bless you and bless her.My mother was an old fashioned matron in south London – the former Tolworth Hospital. She always said that old people who had had enough knew – often had sorted their houses and papers out if they had time – and the phrase “I'm tired now” as you know is common.

    She herself died at 86. After having sorted her house and drawers and photos and papers out. With the phrase “I'm tired now”. and with the help of a little morphine which, as we all know, has the unfortunate side effect of depressing breathing a little but can quite legitimately be prescribed for pain relief.

    Keep on writing. You're seriously good.

  7. The feeling's mutual. I'm not even 60, yet I have an incurable and paralysing spine disease, take 196 pills a week (210 in a couple of weeks) and am due for my fourth heart op in two weeks time. I sleep about 14 hours a day and have to fight to get out of bed because there's no reason to get up and spend the whole day surfing the net, just for something to do. The diabetes is not controlled very well and the sleep apnea makes it hard to get any quality shut-eye. Along with the asthma which strikes at any time and gives little time to use the inhaler, what's the point of existing like this?

  8. i signed up to this blog yesterday after reading your books, which were amazing. i've applied to university to do the same job you do, and i've always wanted to do it but i'm a compassionate girl with a lot of empathy for people – i'm worried situations like this might get too much for me. i still am desperate to do this job though, theres nothing else in the world i'd rather do. i was involved in a car accident a few years ago and i will always admire the paramedics that treated me and i want to give something back. i just wanted you to know that i think you're an inspiration and i'm sure you have inspired many people in a similar situation to me 🙂 thank you.

  9. It's the pain of the elderly that finally drove me out of A & E nursing, I will never forget an elderly gent singing to me as I held his hand in the middle of the unit in the middle of the shift from hell. It broke my heart. I could deal with all the rest, even cot deaths, but the pain of seeing the tiredness of life in his face still haunts me after all these years. The day you stop feeling that pain is the day you stop being human. Thank God there are still people like you out there Tom, just hope it doesn't damage you in the long term. The caring ones have a shelf-life. Take care.

  10. @EmmaHave you considered trying the student paramedic path? They should still be accepting applications for the last available places.


    At least she looks to be cared for and, though she says her son can't visit her too often, she seems to imply that he does visit her when he can. As the Monty Pythons sang: always look at the brighter side of life.

  11. It really touching to meet such people that have lived full and long lives and that realize that their time is close to the end. They seem to accept that in a way that seems very strange to us but they have made their peace with themselves and seem to have a certain glare in their eyes that frightens some of us.movers

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