Tuesday, March 31, 2009

The End of the World

Arriving at ER, Cliff is whisked straight in for a CAT Scan and I stand in the hallway feeling useless, scared and alone. I don't care if the CAT Scan gives out dangerous rays or whatever it does - I don't want to be separated from him for one nanosecond. For me the CAT scan is superfluous and unnecessary, I already know, beyond doubt, that he is dying.

My emotions run amok and I can feel my heart thudding in my chest - the pain, horror and fear is too much. No, not this. God anything but this please. PLEASE. Surely my worst fear is not about to be realized? We still love each other, I still want him, I still need him. Outwardly I am quiet and focus on standing up.

I wait and wait and wait for an eternity, and keep asking to be told as soon as I can see him again. At last, I spot the Spanish doctor who first saw Cliff on arrival and he takes me to him, tutting that they have obviously forgotten about me.

I am relieved to be back together, and then the strangest thing happens. This power, this force of strength, love and protectiveness courses through my body, through my veins almost, and I know that I can be strong for my husband when he most needs me to be for him. Cliff has been strong for me for the past 15 years and let me live in my happy little world, oblivious to all cares and concerns of most adults. I need to do this for him now in his final hours. It becomes my only focus and it's all that exists in the whole world now. He can still open his eyes and see me and I am holding his good hand and he keeps squeezing it and I know that he is communicating with me, telling me that it's alright, that we can do this together. I keep telling him that I love him and that I won't leave him and that it's alright. When he squeezes my hand harder, I respond, "yes darling I love you too" and he gives my hand a double-squeeze so that I know that's what he's saying too. My heart is literally breaking, I can feel this physical pain in my heart as though it's in a vice, tightening slowly but surely, until it can't take anymore and then it will shatter into a million tiny pieces but I don't care. All that matters is him and the moment. What I feel doesn't matter and I feel this overwhelming love and protectiveness towards him. I tell him that I have to check that he's alright, that his "Achilles Heel" is intact and gently slide my hand over his chest and feel the bone in the centre of his chest that never quite melded together neatly after a long forgotten fight in this late teens or early 20's. As I'm touching it, I look down at his arm and all the hairs are standing up on end ... he knows and understands why I have to do this. We have both accepted that he is dying and we are going to do this together, and I know the vulnerable part of him - his Achilles Heel - is okay. I've got his back.

The Spanish doctor asks if he can have a word with me, and I'm looking at him like, I'm busy, is it important, and ask, "now?". Yes, he says, "Now."

Off we go into the Family Room and he says he's incredibly sorry for me but it's bad news and I tell him I already know that. He seems to feel it's important to explain that that means that Cliff will not survive this and I tell him again that I know. It's like I'm reassuring HIM. I'm calm and he tells me that he's sorry again, and I say, "he's my whole world" and break, the tears coming and I panic, really fear that I am not going to be able to stop them flowing, and that I might let Cliff down when he really needs me, that I might not be able to do this, that I can't do this ONE THING that he has ever REALLY needed from me. As we leave the room this lovely, kind and gentle doctor, suggests that I phone someone so that they can be with me and I tell him I will call someone when I have seen Cliff again.

Again I am so relieved when I can be with him again and touch him, reassure him that I will not leave him and how much I love him. "I'm here darling, I'm right here. I love you Cliffy. I'm not going to leave you." Over and over again. We get back to the hand-squeezing and he is my beautiful strong husband, calm and brave. That's no surprise to me - he is the strongest bravest person I have ever known. The surprise is that I can stand by him and be calm and brave too, and I wonder if he's surprised or if he always knew I had it in me. He probably knew. He knew me better than I know myself.

Then when there are no nurses around I lose my sanity and tell Cliff that I am going to try and heal him, and I stand up and move round to the other side of the bed and put my hands and arms on his head and try to absorb the damage that has been done by the massive stroke that he has suffered. I try and I try and every cell in my body, all my might, I will it to be absorbed by my body so that he will be alright again. Then I quietly regain lucidity and go back to my seat and he gives me a double-squeeze. He understands.

I tell him after a few minutes that I need to go to the loo, have a quick wee, smoke around half a Marlboro Lite in one drag almost and compose myself to make THE PHONE CALL. The decision is clear to me, I HAVE to phone Cliff's Dad first. It's the right thing to do. Hierarchal. My hands are shaking and my ears are ringing with the stress and the panic that I am keeping coiled up deep within me. I call Jenny, Cliff's youngest sister, because I know that she and Dad are in Holland visiting Cliff's other sister Jean. It rings and my legs start shaking. "Hello?" I blurt out in one fast sentence, "Jenny, it's Boo, it's Margo ... I'm sorry I've got bad news for you I'm afraid. It's Cliff, he's had a stroke and it's not looking good." She sounds like a wounded animal on the other end of the phone, "No, no, noooooooooooo," and I can hear Jean in the background saying, "for god's sake Jennifer, just calm down". I tell her that I've rung her because I had to let Dad know first and she manages to compose herself quickly and tells me that she is going to get Steve (Cliff's eldest brother) to call me back within the hour once I've told her which ER we are in. I light another Marlboro Lite and try not to sob as I leave Cliff's daughter Jayde a message to let her know that her Dad is critically ill and that one of Cliff's brothers or myself will pick her up in the morning so she can come to the hospital too. As I walk back to ER I expel the demons from my body and feel calmer as I touch him again.

He manages to tell me that the monitor's consistent beeping is annoying him by making a noise and moving his chin towards the offending source and tries to focus his eyes on it. I immediately interrupt a nurse and ask her to teach me how to turn off the noise. Every three minutes it will automatically start beeping again but I can cancel it by pressing one of the buttons which I do faithfully for the next few hours.

Time is meaningless. It goes fast, it goes slow. All that matters is the moment. I feel like we have been going through this forever and also for only a few seconds. Surreal. My worst nightmare come true. We are still doing the hand-squeezing thing and I only leave him for 3 minutes at a time if the nurses want to check his vitals, and use those breaks for two drags on a Marlboro Lite and a wee.

A lovely elderly lady is on a gurney awaiting treatment. She says, "Excuse me" and I go over to her as Cliff is still having his BP, pulse etc checked. She asks if I'm OK because I look so sad and I tell her the situation. This lady comes to speak to me before she leaves and tells me she feels compelled to check on me.

The Senior Registrar comes over to speak to me with the Spanish doctor and he basically says he's sorry and I'm wishing he'd hurry up so I can get back to Cliff. It's not about me. It's him that's dying, not me. Why can't everyone understand that I don't have time for anyone else today - all my seconds have to be spent wholely on him alone.

Five minutes later our hand-squeezing is interrupted again and this time it's the Spanish Doctor asking me if it's ok for Cliff's brothers to join me. Amazingly they have all left at the same time (from different places) and all arrived at exactly the same moment. I go to greet them at the door and hug each one of them. Their eyes are all on Cliff already and I speak to Steve and give him the details looking at him only - he's the eldest and I am only strong enough to say it once and to have eye contact with one of them. Graeme and John listen intently but they are aching to move to stand with their brother ... I can feel it instinctively.

I tell Steve that Cliff has had a massive bleed in the brain, and that he is still aware of everything but he's dying, that there is no hope and I don't know how long it will take. I don't share that when my Mom died of a massive stroke that it took three long days, that my father told me I had to say goodbye and I did, and then the next day he expected me to go back again and do it again, and I howled that I had done it and I could not do it again, but eventually I did, and that it broke me at the time.

I ask them to wait 30 seconds while I tell him that they are there. I tell Cliff and he protests, trying to speak and shake his head, opening his eyes. I know that he's saying no, but I understand that it's because he is worried that he will lose the calm feeling that we both have as a unit, that bringing in others, even brothers, may impact the strength that we are drawing from one another. I tell him that it's OK and that they love him and want to see him.

They all touch him and speak to him. He seems fine with it when he can sense that I am not losing it, and I am still in protectiveness mode. They are quiet with him and dignified. I leave the four brothers alone for 10 minutes to go to the loo, have a quick boo in the toilet and pray, really pray (why do we only really pray when the shit hits the fan?) and smoke my first whole Marlboro Lite.

I go back to Cliff and his brothers automatically make space for me so I can hold his hand and they listen to me speaking to him. I move Cliff's hand so it's resting on my belly, on the bare skin, while I juggle to retrieve something from my handbag. I think they are wondering how long I am going to hold up. They knew how badly I reacted to my dog dying so they are probably expecting hysteria to set it at any second, and they carry on watching me reassuring Cliff and probably notice that at no time do I break the contact between us, whether it is hand-squeezing or checking how hot is forehead is, or stroking his hair back so that it doesn't irritate him. I suddenly realize he is not opening his eyes anymore and cannot bear the thought that I will never see those clear blue expressive eyes ever again.

A nurse appears to put an IV into Cliff's hand and I tell her to get the needle in on first attempt because he is scared of needles. On reflection I shouldn't have said anything because I obviously made her nervous. She succeeds in getting the line in straight away but there's blood all over her sleeve and on his hand. I don't care. All that matters is that she isn't using him as a pin cushion because he really is needle-phobic.

Then a really kind elderly gentleman who I later discovered was a volunteer at the hospital comes up and quietly asks me if I'd like a cup of tea or coffee. He keeps us supplied in hot drinks and even finds some gauze and cold water so that I can use it to wipe Cliff's face as he is becoming quite hot to touch.

Steve tells me that they are going to speak to the Consultant and I don't really notice that they have gone until they come back. They have had a family discussion and agreed that John (Cliff's youngest brother) will stay with me, and Steve and Graeme are going to drive back to Surrey to wait for our phone call. We promise to call if there is any change, and Steve takes responsibility for keeping in touch with Holland.

ER decides to transfer Cliff to another ward in the evening, so while they move him onto a wheelable bed, John and I take a quick smoke break and John says that he thinks that Cliff might be improving because his breathing is a little easier, and they have taken all the wires and monitors off him and they are taking him to a different ward. I gently tell him that I don't think this is the case. I know that his breathing sounds better because they have administered diamorphine and that they are moving him because there is nothing else they can do for him.

John says, "If anyone can beat this, it's Cliff. He's always been so strong mentally and physically."

When we return I tell Cliff that we are moving to a different ward and John and I walk beside him all the way with the hospital porters.

I tell Cliff constantly how much I love him, and that I won't leave him. I remember my Mom telling me that when people are very, very ill, even unconscious, that they can hear you, that you can get through to them, and I believe this. I absolutely know that he knew I was there.

The new ward is quiet with dimmed lights and is managed by two Senior Sisters, who introduce themselves to me and I immediately warm to them. They speak to Cliff as though they have known him forever and tell him if they are going to take his pulse, blood pressure or anything. They make us cups of tea and tell me to tell them if I think he needs more diamorphine. I suddenly remember my sister telling a nurse in a different hospital that she thinks it's time for some TLC for my Mom, on the third day after her stroke and remember my sister gently explaining that it is common practice to administer extra diamorphine towards the end, that it helps them to go quicker and in no pain or distress.

I say to John that I need a 5 minute break and he accompanies me. He is my quiet faithful companion in these hours and I don't know if I could have managed to be so outwardly strong had he not been with me.

We go out for a cigarette for literally 3 minutes and return. I start wrestling with myself about the extra shot of diamorphine and look to the lovely Irish Senior Sister for some guidance and she says, "there is a chance that he could be uncomfortable" which is a euphemism for "in pain" if I ever heard one. I don't hesitate. In a heartbeat, I say, "yes, let him have it, please."

I tell Cliff that it's ok, that they are going to give him some dia-morphine just in case he is in pain, and that it's fine, that they don't need to inject him because there is already a line in his vein. I promise him that I won't let anyone do anything to him. Quietly, I thank him for being the best husband that anyone could ever have wished for and that I will never ever stop loving him. I promise him that I won't leave him now, not for one second. I'm still holding his hand, and moving the covers so that he can get a little cooler air - he is so hot, his arms are so hot to touch, as are both his hands. With my other hand, I'm wiping him with a damp cool cloth to try and help him be more comfortable.

Suddenly his breathing becomes a lot easier and I know intuitively that it won't be long. John says that he sounds like he is getting better and I look into his eyes and don't need to say anything because John has understood now.

Now I tell Cliff that it's ok, that he doesn't need to worry about anything anymore, that I'm fine and he can go to sleep. "It's alright darling, I'm right here with you, you can go to sleep now." This breaks my heart. If you truly love someone you can't be selfish ... you must let them go. It kills me but I have to do it.

For the past half hour I have been staring at his hands and his face, memorizing every contour of his face, not wanting to forget a thing. I keep looking at his hands. I have always loved his hands. Man's hands. Big, but beautifully formed, strong. When we held hands what that actually meant was that I wrapped my hand around his thumb because my hand was too small to hold his properly. Hands that worked so hard to earn money. Hands that worked so damn hard on our home and hands that could be so gentle too. Nimble and elegant ... strange considering they were big.

Now I'm standing and speaking quieter and quieter to him, almost whispering, stroking his hair and never letting go of his hand. John is the other side of the bed.

At 3 am, exactly 12 hours after he called me upstairs, my best friend, my soulmate, my guide, my compass, my lover, my only true love, my beautiful husband takes his last breath. Somehow ... on some primal level, as he took in that last breath, I knew it would be the last one. And I held my own. When my instinct or intuition was proved right ... I tried to keep holding my own (breath), wanting so badly to go with him. But my body would not let me.

I freeze and ask John to get one of the Sisters as my brain cannot accept this. They shake their heads discreetly at each other and I can see John looking at me, and can tell he is trying to figure out how he is going to grab me from where he is and physically get me out of there before I lose it - BIG STYLE.

"Come on, come on," he says gently, and his eyes are imploring me to take his hand and walk out of there.

"No, no, no, not my Cliffy, my baba," I can feel the shock and horror and pain and everything coming, bubbling to the surface now that it can. I have to say goodbye. I kiss both his hands and look at them for the last time to ensure that I have etched them into my memory. I place my hand on his chest and kiss him goodbye on his cheek.

Then John takes me outside so we can chain-smoke. We are both numb and in shock. I go very quiet but inside I am SCREAMING and feel terrified. I cry a little, but surprisingly the oceans of tears don't come. YET.

John tells me, "You are the bravest person I know in this whole world" and I ask him why. He says he couldn't do what I just did, not in a million years and I tell him he would. I tell him that if you love someone that much, you just do it, something takes over you and you have to do it if you love them.

It's not about me, it's about Cliff.


  1. This could almost be my story.....I can't write about it now, but I will later. I guess I was strong....

  2. Margo, this is so beautiful. I wasn't with Ken when he died. My little kids needed me and there was no one left around us who could take care of them and I had to keep leaving Ken in the hospital to be with them. He wasn't alone when he died, he was with a neighbor who sang to him and who I'm sure was very present for him, but how I wish I could have done what you did for Cliff, as you have described here. Will you understand when I say that you were lucky to get to be so strong for him when he died?

  3. Jill, I do understand completely.

    And what a wonderful neighbour you have. I'm so sorry that you didn't have the chance to do this ... a friend of mine who is a widower was in your position ... he also had to go home to be with his children ... that must have been incredibly tough for you Jill x

  4. Boo...after reading this, I just had to write something. It is almost identical for me and my Bee...he had a ruptured abdominal aneurysm. He was at work when he collapsed, but I was not far away so I got there quickly. He looked at me and said "I love you baby...but I am not going to make it". Those were the last words he said to me. They operated for nine hours and then, like you I would not leave his bedside. He collapsed on the Sunday and they told us he was not going to survive on the Thursday. He died on the Friday ....five months ago. When I first saw him after the first operation, he knew I was there and leant his face into my hand. He didnt speak again because of the ventilator, but his blue eyes said it all...they never left my face. They operated on Monday, Tuesday and again on Thursday...but they couldnt save him. He was my world. We had been together eight and a half years, married for four and a half. Every day we were so grateful that we had found each other - he was 45 and I was 48 when we met. He used to call me Pixie... We were in Abu Dhabi when he died and I had to sell our stuff, ship a load back to UK, and get out of the country in thirty days. I couldnt get back into our home in UK until March. I was so busy for those first three it is all done. But, like you, I would never have wanted him to go through this pain....this indescribable loneliness and longing for him.... You take care and I will be thinking of have survived over two years and have given me strength and hope that I can get through this too...thank you....xxxxx Jen

  5. Jenni thanks so much for writing a comment. Strange, as we should have been in Dubai, but things went awry, so we were here in the UK. That must have been so tough for you ... so you're home now? 5 mths I remember so so well ... please add me as a friend on Facebook (Margo Mayhew) and we can chat there easier, Ok? You near London?