Betty's Last Battle
The old woman was woken by the sound of someone’s very loud breathing. Betty lay there for a few minutes, listening, before it dawned on her that it was her own breathing she could hear. She opened her eyes, to discover that she was in a hospital bed, connected to an intravenous drip.
‘Finally!’ exclaimed the nurse, coming over. ‘You’ve been asleep for eighteen hours. How are you feeling?’
‘Do you need some pain relief?’
She slowly shook her head. She had neither the breath nor the energy to speak.
Soon her two middle-aged children appeared, jostling for the best bedside position when they saw that their mother was conscious.
‘Mum!’ cried Sarah. ‘We thought we’d lost you!’ She grabbed her mother’s hand and held it tightly.
‘Yes, we’ve been so worried,’ added Michael.
Her children clustered in closer, stroking her arms tenderly in order to reassure her, and themselves. Nobody spoke and the sound of the old woman’s laboured breathing was amplified against the silence.
During the entire eighty-eight years of her life, Betty had been admitted to hospital only three times – to give birth to her children and to have her appendix removed. She was hardly ever ill. This was actually a source of great annoyance to many of her friends, as it made her completely insensitive to anybody else’s ailments. Betty simply did not understand being sick. On the rare occasions when she had been struck down by a dose of the flu, she would take herself off to bed and sleep for two entire days and nights, only getting up for food and to use the toilet. On the third day, she would resume her life as normal, irritatingly healthy again and similarly none the wiser.
So when Betty had rung her son in Sydney to say that she was unwell, he’d immediately caught a plane. It was the third day in a row of over forty-degree heat in Melbourne and so Michael hadn’t been at all perturbed to find his mother stark naked, as this had always been her habit on a hot day. However, he was extremely alarmed by her shortness of breath and constant coughing.
‘I’m calling an ambulance,’ Michael had said, and was further shocked by his mother’s acquiescence.
After the phone call, he ran upstairs, found a nightie and managed to get his mother into it. By the time the ambulance officers arrived, Betty was almost unconscious. They reached the hospital quickly, and while the attending doctor was examining Betty, Michael rang his sister who was on a business trip in Indonesia. Sarah got a seat on the first flight out and arrived home within ten hours.
Betty sat up in her hospital bed.
‘Toilet,’ she announced breathlessly.
‘I’ll get the nurse to bring you a pan,’ Sarah said.
But her mother shook her head. ‘I want to . . . ,’ she began before a coughing fit interrupted her. Eventually she was able to continue, ‘I want to get out of bed.’
‘Mum, you can’t. You’re all hooked up.’
Betty pressed the buzzer and a nurse appeared.
‘Please?’ Betty panted, raising her hand.
Sarah explained, ‘My mother wants to go to the toilet and so she’s asking if you can remove the drip.’
‘No need to do that. She can take the whole thing with her as it’s on wheels,’ the nurse responded. ‘Now, dear, let’s get you on your feet.’
However, Betty imperiously waved her away. Yet when she tried to get out of bed on her own, Betty was surprised at how weak she had become and that she did in fact need help. Once upright, she was able to lean heavily on her daughter’s arm and shuffle, drip in tow, to the bathroom.
Betty sat disconsolately on the toilet. She was puffing hard from the exertion of walking. She stared at the reflection in the mirror of an old woman who could barely breathe, let alone walk, and noticed the profound terror in her eyes.
‘Are you okay?’ called Sarah.
‘Yes,’ she lied and was glad that her daughter could not see the expression on her face.
Betty’s husband had walked out on them shortly after Michael had turned four, leaving Betty completely devastated. She had suspected that he was having affairs but had turned a blind eye, assuming that they would not interfere with the sanctity of their family. She was wrong. Her husband was already in another relationship and consequently very little time elapsed before his previous family was replaced by a brand new one. By then he was far too busy to bother seeing his first lot of children and insisted that he couldn’t possibly provide any family maintenance. Betty decided that she didn’t need his money anyway and chose to believe that he was dead.
So Betty learnt to manage on her own. As she had no money for a car and there was no bus, she walked the kids three miles to the local primary school and then home again, twice a day. After a while, she returned to study at university and eventually got a job teaching maths. She repainted the entire inside of her house, regularly triumphed over the temperamental lawnmower and fiercely protected her children against any invading snake. She received such good refunds from her tax returns that neighbours began getting her to do theirs. Betty’s determination and strength carried her and her family through many disasters, helped along the way by cheap red wine, good female friends and a sense of humour. Betty had always coped, no matter what.
The nurse motioned again towards the small medicine cup she had placed on the tray.
‘I have pneumonia?’ Betty echoed, gasping for air.
‘Yes, that’s what I just said. Now hurry up and take your tablets,’ the nurse said.
Betty stared at her for a full minute, deep in thought, and then she shook her head.
‘No antibiotics,’ Betty wheezed.
‘But you have to take them.’
‘We’ll see about that!’ exclaimed the nurse and hurried out of the room.
A doctor soon appeared at Betty’s bedside to argue the case for the antibiotics, his fresh young face turning puce with suppressed anger. Betty continued to just shake her head in reply. He only lasted five minutes.
Over the years, Betty had witnessed many of her friends wither away as they got older and sicker. She had watched them give up driving, one by one, as each became incapable of concentrating and responding quickly enough to be safe on the road. In consequence, their social life soon vanished and before long they were confined to a lonely life within their own home. Betty saw with horror her friends’ advancing decrepitude and worse still, the decline of their mental acumen. She looked on as their intellect and passions were incrementally reduced, until they became spectres of their former selves, capable only of discussing the complexity of their current ailment. Eventually they relinquished their own lives completely, and moved into the home of a daughter or into some kind of institutionalised care. And then they died. Betty no longer bothered to go to funerals; there had been too many. It wasn’t death that upset her, but rather the unravelling of life and the humiliating, prolonged, debilitating, tortuous process of dying.
Betty did not want this to happen to her. So when she was told that she had pneumonia, she saw this as her opportunity to die quickly and easily. Over the last six months she had become aware that her body was increasingly starting to fail her. Sometimes the strength in her legs simply evaporated, causing her to collapse in an embarrassing heap; fortunately, the only injury she had sustained, so far, was to her dignity. She dreaded the next stage.
So when the shift changed and another lot of medical staff came onto the ward, Betty continued her battle.
‘Now tell me, what’s all this nonsense about?’ the new doctor asked, pulling a chair over to eyeball Betty. This one was older, more experienced.
‘Do you know what they say,’ puffed Betty, ‘about pneumonia and old people?’
The expression on the doctor’s face instantly altered. ‘No,’ he lied.
‘Pneumonia is considered to be an old person’s best friend . . .’ Betty wheezed, ‘because it mercifully ends life.’
‘But you’re just a spring chicken! I’m sure that you have twenty more years ahead of you!’
‘Why on earth would I want to live till I’m one hundred and eight?’
The doctor shifted uncomfortably on his chair. ‘Well, it’s my job to help you live as long as possible.’
‘Regardless of what I want? Or my quality of life?’
‘I know what’s best for my patients.’
‘And tell me,’ scoffed Betty, ‘do you enjoy playing God?’
Clearly offended, the doctor stood up. Betty managed to snort loudly before he left the room. It was her body, and her life, and she was determined to let nature take its course.
In the later years of her teaching career, many of her students had referred to her as a ‘sweet old lady’, which her colleagues found highly amusing. Certainly her exterior was ‘sweet’, with her cherubic face, silver hair and short stature; however, anybody who knew Betty was not fooled for an instant. She had a razor-sharp mind, and sometimes in staff meetings, would wield it against any slapdash idea or idiotic proposal. She particularly abhorred all kinds of pretentiousness, sexism or stupidity. At home, Betty swore constantly, drank heavily and argued long into the night about politics with anyone who could keep up. A supporter of euthanasia and the right to die with dignity, she was a woman of deeply held convictions and strong principles, who had always whole-heartedly lived by them. As an old woman, Betty was not about to change and become someone else.
Betty knew that her children would not approve of her stand against the antibiotics, or understand her reasoning. Sure enough, Sarah soon entered the fray.
‘Mum, you’ve got to take the bloody tablets! Don’t you want to see your third great grandchild? The baby will be born any day.’
‘I know you want me to live forever,’ Betty said, puffing, ‘but I do have to die one day. And quite frankly, if I’m not able to live the kind of life I want, then I don’t want to hang around.’
Sarah sighed with exasperation. ‘You’re being completely selfish!’
‘Listen, my body is rapidly falling apart and I’m already struggling to manage. I’ve become incontinent sometimes . . . Oh darling, please don’t cry.’ She gathered her daughter’s hands in hers. ‘I’ve had eighty-eight wonderful years and you, my beautiful girl, have given me such joy.’
‘But why haven’t you told me? I’ve had no idea.’
‘I didn’t want to worry you.’ Betty had a long drink of water to soothe her throat. When she turned back again, she knew by her daughter’s face that her next battle had begun.
‘Right. Then you must come and live with me, Mum. I’ll look after you,’ Sarah said.
Betty suppressed a scream. She’d been gloriously independent just about all of her life and that was how she liked to live. She knew that Sarah’s stance was primarily motivated by love, so she gently squeezed her daughter’s hand and smiled, but simultaneously shook her head firmly.
Michael too pressed her to go and live with him. Again she declined as tactfully as she could. But really, wondered Betty, why on earth would she consider giving up her friends, her home and her life in Melbourne, for a satellite existence around Michael and his family – someplace else? What sort of life would that be, for her?
So Betty fought it out, on numerous fronts. However, as each day passed, it became increasingly apparent that her health was steadily improving. Betty blamed the antibiotics that had been put into her intravenous drip those first few days, but whatever the reason, it was clear that she was not going to die, this time. Instead, she was to be discharged from hospital.
Betty sat on a chair in her room, waiting for her daughter to come and pick her up. She was going home. After extensive negotiations with both her children, she had agreed to the removal of her bedroom furniture from upstairs and to the arrangement of a complete bedsit downstairs. Aware that her body had been significantly weakened, she knew that she had to make a lot of adjustments and that there would be many more to come. This was not what she wanted, at all.
‘Shit,’ she whispered softly to herself and then resumed reading the newspaper spread out on her lap. She turned to tackle that morning’s Sudoku. As always, she rose to the challenge with relish.
But within six weeks Betty was back in hospital, with an even worse case of pneumonia. This time she was put on a ventilator to help her breathe, and again an intravenous drip was inserted into a vein. She watched a group of doctors congregate around her bedside to examine her chart and discuss her medical condition. At no stage did they address their patient and unable to speak, Betty was incapable of interrupting.
Just as they were beginning to move off, Betty managed to get their attention by tugging on one of their white coats. She mimed the act of writing and eventually a piece of paper and a pen were found. Although only one doctor bothered to remain, Betty wrote ‘no intervention’ in big letters and held it up for her to see.
The young doctor nodded, reassuring her that she already had a ‘do not resuscitate’ order marked on her chart, but Betty tapped her piece of paper again. The doctor clearly did not understand, so she began writing again.
‘No medication. It’s time to die.’
‘Please don’t try to keep me alive.’
‘You want me to do nothing? No treatment?’
‘Yes. I want to go off the ventilator. And no antibiotics.’
‘That’s absurd,’ responded the doctor, appalled.
‘And if I’m still alive after that, then I want to go to palliative care.’
‘But you don’t have a terminal illness!’
Betty would have laughed if she had been able.
‘I have a terminal condition,’ she wrote. ‘It’s called life.’
The doctor glared at the sign, and then at her patient.
But Betty was scribbling again. ‘Death is just a matter of when.’
She went to hold up the sign, only to discover that the doctor had already left the room.
Betty let the paper and pen drop to the floor. She sank back against her pillow, tears streaming down the crevices of her face. She knew that her worst fears were about to be realised. With all hope now gone, despair washed over her like a tsunami.
© Liezl Shnookal 2018