From the moment I met him, he smoked one cigarette after another, often lighting one of the untipped brand he favoured from the end of the previous one.
He had started as a teenager and was just about as committed as smokers get by his late teens. At 34, he quit. But of course the cigarettes left their damage which, 40 years later, resulted in poor health.
On the day he died, I was giving him a hand to get from one room to another when he collapsed. When he was lying down, I ran for a pillow and put it under his head. A medical groupie, I knew the long spaces between his breaths constituted “agonal breathing”, where the gaps are as long as 20 seconds between each breath, with the gaps increasing.
Nevertheless, I found my mobile phone and rang emergency services. Yes, the ambulance was on the way, the voice said, double -checking the details of our location. Once arrival times and access were sorted, the telephone voice changed tone. He introduced himself as Barry and asked if my husband was lying on a pillow.
“Yes.”
“Get rid of it. Lie him flat.”
“I’ve done that.”
“Right. Now you’re going to do chest compressions.”
“He’s gone,” I said. “There’s no point.”
“He may be,” Barry said. “But you have to give him every chance.”
He told me how to interlock my fingers, where to put my palm, how to press down two inches. Then he started to call out the rhythm: “One, two, three, four”. I did it and he demanded I count aloud in sequence with him and I did it, the phone tucked between shoulder and head.
Breaking bones
Together, this stranger and I went the “one, two, three, four and one, two, three, four” routine and I could feel my husband’s poor bones break beneath my pumping palms.
I wept protests at disembodied Barry (not his real name). While he was never for a moment rude, neither was he going to get sucked into the emotion. The message was: “We have a job to do...”
The paramedics arrived, one hauling me to my feet while another took over. I was led away from their punishing actions and shouted confirmations until they had the patient stabilised. He was loaded into the ambulance and a paramedic shared her car with me. En route to the hospital, the ambulance stopped. The paramedic driving me pulled out without hesitation to pass it and leave it there.
“This road is bumpy,” she said. “One of the tubes may have come loose.”
“No,” I said with the absolute certainty of the ignorant. “That’s to deal with cardiac arrest.”
She didn’t argue. Just drove. The ambulance arrived at the emergency department eight minutes after we did, and I was put in a room to wait. An hour later, the consultant in charge arrived with her team to share the worst and praise me for my part in it.
The paramedics had been able to establish a heartbeat, thanks to the constant chest compressions. It wasn’t a great heart beat, though, and he had arrested twice. If he arrested a third time . . .?
The three dots and the question mark hung in the air. Promise and threat. They would continue to work on him if I insisted. I shook my head and they went away. Another hour. Another cardiac arrest. It was over.
Held his hands
They took away the tubes and enveloped my husband in a simulacrum of bedclothes and left me with him. I held his hands and wept to see the age spots on them. He was low on vanity, my husband, but he truly hated the recurring blood bruises that had manifested themselves on his hands in recent years.
Then two gardaí came to do the State paper work. When it was done, I asked if anything else needed to happen before I called a taxi. “No need for a taxi,” one of the guards said. “We’ll take you home.”
They drove me to my empty house and made sure I had the door locked before they left. The paramedics had tidied up after themselves. Nothing was left to show what had happened, other than the pillow I had tossed away on Barry’s instructions.
Barry did a great job and I’m sure he would say I did a great job too. But he would be wrong. It would have been better to let my dying husband alone. Leave his head pillowed, not punished on a hard floor. Hold him in my arms until his life ebbed away. Instead, his dying was busy and brutal.
Today, questions are being asked about the merits of CPR for someone who is old and ailing. It is now suggested that it is counter-productive and that unconscious people in their 70s with cardiac arrest should be allowed to die under cover of coma, rather than being pummelled and intubated and chemically electrified into a response that is less than life.
In the case of my husband, my best efforts gave him half a heart beat for half an hour and left me with the final memory of his bones breaking beneath my hands.
