In the Midst of Life
Read In the Midst of Life Online
Authors: Jennifer Worth
In the Midst of Life
‘I never thought I’d care for a book about dying but this one is life-enhancing’ Matthew Parris,
The Times
‘Here she shares her experiences and observations from the front line of nursing . .. What makes the book bearable is Worth’s compassion and a burning mission to remind us that end-of-life care doesn’t have to be complex’
Lady
‘Jennifer Worth addresses head-on the taboos that surround death and dying . .. Her stories are often poignant and sometimes disturbing, but all show an understanding of the patient’s needs’
Nursing Standard
‘Perhaps her most thought-provoking book … Worth raises challenging questions that are sure to encourage the reader to develop a stronger, more profound view of death’
Church of England Newspaper
‘An honest, moving and sobering account which told me much I did not know – or possibly didn’t care to think about too deeply … I feel fortunate to have read this inspiring book’
The Woman Writer
Praise for
Call the Midwife
‘Worth is indeed a natural storyteller – in the best sense of the term, with apparent artlessness, in fact concealing high art – and her detailed account of being a midwife in London’s East End is gripping, moving and convincing from beginning to end … a powerful evocation of a long-gone world’ David Kynaston,
Literary Review
‘This uplifting story is about love, that of mothers for their children, and the love of God that compelled the nuns to dedicate their lives to the well-being of the poor’
Tablet
‘Funny disturbing and incredibly moving,
Call the Midwife
opens a window onto the fascinating and colourful world of the East End in the 1950s’
Mature Times
‘Worth’s portrait is subtle, skilfully describing a sense of community that no longer exists’
FT Magazine
‘Funny disturbing and incredibly moving’
Yorkshire Evening Post
Lydia, Daniel and Eleanor
and all of their generation
They are the future
Clinical Editor
David Hackett, MD, FRCP, FESC
Consultant Cardiologist
Praise for
In the Midst of Life
In The Midst of Life We Are in Death
1963-64: The Marie Curie Hospital
1968: Congestive Heart Failure
Cardio-Pulmonary Resuscitation (Cpr) In Hospital
In The Midst of Life We Are in Death
Appendix II The Paramedic’s Tale
Further Reading And Information
In my
beginning is my end;
In my end is my beginning.
— T.S. Eliot
This book assumes that death is sacred.
It is about the mystery, the beauty, the loneliness and the aspirations of death.
It is about the fear of death, and our inability to handle it.
It is about how we die. Perhaps few people have seen the Angel of Death approach and depart.
It is about the meaning, shape and purpose of life that will some day end.
It is about my own search to understand.
Since girlhood I have pondered these mysteries, reflecting on the deaths I have seen in hospitals and the hopes and fears of people who have come my way.
This book is about the need for peace in the hour of our death.
It suggests that death can sometimes be a friend, and is not always an enemy.
It raises the vexed issue of resuscitation, and the law.
It is about the need to rekindle reverence in the face of death.
It is about the humility of acceptance.
It is about the spiritual nature of death – God if you like, or Allah, or Krishna, or Jehovah, or Brahma, or one of a thousand names given to something we cannot understand.
Or just Evolution, Random Chance, or Biochemistry.
It really does not matter what you think or believe.
Death comes for us all.
How, when and where we die has always been a game of chance.
Our determination to control it has not loaded the dice in our favour.
Did anyone ever imagine that it would?
—
Jennifer Worth
Fifty years of thought, and four years of writing, have gone into the production of this book. The best wine and cheese, we are told, are slow to mature. Let us hope it is the same for books!
It has been written with a strong sense of vocation. ‘Modern medicine’ was just developing when I started nursing in the 1950s – they were exciting days. I was only eighteen, but could see quite clearly that with every new advance in pharmacology and surgery, the acceptance of death was being transformed into denial.
Only those who have seen death are able to talk about it meaningfully. I was privileged to be of that generation of nurses who were required to sit with the dying, and the insights gained from those experiences inform the whole book.
I left nursing in 1973, and although the earlier stories in the book are now medical history, the moral and ethical issues remain the same. But through the professional journals, friends and relatives, and observation, I have kept in touch with medicine and nursing, as the later stories illustrate. In order to bring this book clinically into the twenty-first century, I have asked three professionals who are currently working to write updates on modern medical practice: David Hackett, consultant cardiologist; Madeline Bass, palliative care nurse and teacher; Louise Massen, ambulance service paramedic and clinician. These papers are to be found in the appendices at the end of the book. Readers who are interested in a serious update on professional papers and government reports and directives can find an extensive reading list, but it must be remembered that these are changing all the time, and almost every month new material is added.
Jennifer Worth,
September
2010
My grandfather died in 1956 at the age of eighty-six. I loved him deeply and was very close to him. I saw very little of my father during the war, and in the years after. Every girl needs a man in her life, and my dear grandfather gladly filled that role. I treasure a Bible that he gave me for my twenty-first birthday, shortly before he died, with a loving message carefully penned by a shaking hand, unaccustomed to writing. He was barely literate, having left school at the age of eleven to work in a builder’s yard, and was the oldest of thirteen children, born in 1870, when every child in a working class family had to labour from an early age. At fifteen he lied about his age and joined the army, ‘So that one of my brothers could have my boots,’ he told me. He had about him a quiet simplicity and wisdom that greatly influenced my childhood, and therefore my whole life.
I remember his tenderness throughout my early years; going for long walks in the countryside, my grandfather pointing out and naming birds, trees and flowers. I remember going to his allotment to dig potatoes, him pushing me in the wheelbarrow and me shouting ‘Faster, faster!’ I remember helping him to polish shoes, clean the windows, clear out his garden shed, clean the grate and chop the wood and get the coal in. And I remember him growing old.
It was a gradual process. First it was the wheelbarrow. However much I shouted, he couldn’t go any faster.
‘I am getting old,’ he would say. ‘You get out and run. Your legs are younger than mine.’
As I grew older and stronger, he grew older and weaker, and, after a few years, I was the one pushing the wheelbarrow. Soon,
digging for potatoes became too much for him, so I dug up the golden white globes. I had always been told that Grandad was hard of hearing, but I had never noticed it when I was little. I prattled on and he always seemed to understand me. I noticed that his nose dripped.
‘Why is your nose dripping?’ I asked, pertly.
‘Don’t be saucy, little madam,’ he replied, taking out his handkerchief and wiping the offending organ. From an early age I remember pulling his skin and watching with interest as it settled slowly back into place. I pulled my own skin, and it bounced back.
‘That’s as it should be,’ Grandad said. ‘When you are as old as me your skin will be like mine.’
‘I’m never going to grow old!’ I shouted confidently as I raced down the garden path to his shed, which was always a place of wonder.