5 min read
What is Hampstead's best kept secret? Is it a coffee shop down a little alleyway? Is it a charity shop offering the cast-offs once worn by the Primrose Hill set? No. It is actually a place where people go to die.
One June afternoon 23 years ago, Mum returned from a trip to the hairdresser deeply distressed. Despite going there every week, she couldn’t remember which Tube line to take. This was before the days of Google maps and even Smartphones, but somehow, she had managed to get there – and back.
She was also starting to forget words. Mum, ever the practical one in the family, was no longer able to catch a train by herself. Mum, ever the chattiest member of the family, was no longer able to finish a conversation.
So, while physically, she looked immaculate, her funny, intelligent and compassionate mind was beginning to fall apart.
We booked a doctor’s appointment. Could it be early-onset Alzheimer’s? It wasn’t, but the news wasn’t any better. The breast cancer, which she had been diagnosed with 19 months earlier and seemed, recently, to have been held at bay, had metastasised to her brain. “How long have I got?” she asked. “Three months, at best,” said the doctor. She was 56.
Mum had already decided that further gruelling treatment wouldn’t be an option - it wouldn’t necessarily have been successful, and even if it had been, it wouldn’t have reversed the damage already done to her cognitive functioning.
She resolved not to die at home “so as not to be a burden”. Running on autopilot, I flipped through the phone book, looking for an alternative place for her to die.
I had heard about a hospice not far from us, only to be told: “Sorry love, you don’t live in the right borough.” It was a bit like someone saying your child can’t join a school as you don’t live in the right catchment area. (Maybe it’s a selling point estate agents should consider when writing their property blurbs: “Close to good schools, shops and places to die.”)
Fortunately, the very apologetic receptionist on the end of the line pointed me in the direction of another hospice - a modern red-brick building, discreetly nestled in a leafy residential street, only a 10-minute walk away. What luck.
I put in a call, described her condition and was told to get back to them “nearer the time”, and they would make sure there was a bed for her.
In the meantime, I learnt a new expression – “palliative care”. This isn’t about lengthening or shortening life but about making whatever time someone has left on this planet as comfortable and as comforting as possible.
They call themselves “palliative care doctors and nurses”, but I quickly realised they were actually angels who walk the earth dressed up in medical scrubs. As soon as Mum’s cancer was diagnosed as terminal, they put her on medication to ease the pain, coming to the house to increase the dose when it became unbearable. And when it was clear that her pain could no longer be managed at home, as promised, there was a bed waiting for her in the hospice.
I was apprehensive about what it would be like to witness a death. Would it be sudden? Would it be one big exhalation or a gradual slowing down?
She had her own room, which overlooked pretty gardens below. A friend’s father had died in the same room the year before, and I recall us joking later that although they had never met, they had likely died in the same bed.
Mum hung on for about a week after moving in – for us or for herself, I can’t be sure. During that time, there were good hours and bad hours, moments of calm and moments of distress - thankfully eased under the care and kindness of the palliative team.
I don’t know what Mum would have made of the End of Life Bill - which, on Friday, was narrowly passed in the House of Commons - but years before she got diagnosed with breast cancer, she did say that if she were ever to lose her mind, could we please just give her an injection. I am pleased that this was a decision she never had to make.
On day five in the hospice, Mum’s condition deteriorated. We called the doctor, who increased her pain relief, so when she died, it was without distress.
As she became sleepier, we each had time to say goodbye. I came out of her room and told my brother she’d said I was the “favourite” child. (Josh, if you are reading this op-ed, this did not happen. The reality was, I thanked her for everything she had given me and told her that her grandchildren would know what a wonderful person she was. She just listened with her eyes closed, a tear forming in the corner of one of them.)
I was apprehensive about what it would be like to witness a death. Would it be sudden? Would it be one big exhalation or a gradual slowing down? In the end, Mum spared us that trauma as she took her final breath in the early hours of a July morning, with just a kind-hearted nurse in the room.
Judaism has a wonderful way of providing a roadmap through the grief. There are the rituals of the levoyah, the Shiva and the period of mourning. There are also the things you say to one another. I have always found it rather strange – and possibly a little tactless when someone has died young – to wish the mourners “long life”. But this is the Jewish way. We accept death, but we don’t aspire to it. We will support someone through their bereavement, while reminding them that they need to remain in the world of the living.
I worry about the End of Life Bill, not only from a Jewish point of view, which chooses life above all. I worry about it because it runs counter to what doctors sign up to do - to save people and make death more tolerable. I worry about it because we already have wonderful palliative care in place to ensure that terminal illness and death are as pain-free as possible. If only there was more government funding for it, so people don’t have to consider self-administering a lethal drug and going through all the rigmarole of needing two doctors, a High Court judge, a lawyer and possibly a psychiatrist and social worker to give them the go-ahead to do so.
Mum died too young, victim of a cruel and indiscriminate disease, which sought to ravage her body and began to destroy her mind. But when the end came, it was thankfully peaceful, without prolonged suffering.
In the same way that there is no perfect life, there is no perfect death, and, for obvious reasons, I will never know if Mum had any complaints about the way she left this world. But as her daughter who was with her (almost) until the end, I can't imagine a better way to die.
