This is an abridged version of ‘Pastoral Who?’ written by Deb Wardle
I had the air punched from my lungs the day Rosemary rang to say that Mick had pancreatic cancer, inoperable, metastasised, not much time left. Her words chopped at me, nearly incomprehensible, until she asked again, ‘Paul, would you help us? He wants to die at home.’
‘Sure, of course,’ I took a deep breath, ‘when do we start?
‘Like, now.’ I could hear Rowie’s voice clouded with the weight of expectation, burdened by the unknown job ahead, rounded by her infinite love of Mick. Time went white blind for the next six weeks.
Mick was a drummer, we’d been friends since primary school, enjoyed a misspent youth and watched each other try to grow into men. We’d been best man at each other’s wedding. I’d been the first to offer cigars when each of his two girls was born, first Amy, then Chia. He chewed gum and drew deeply on the rolly he usually had hanging from his lip.
Since school I’d worked as a baker and was used to early mornings, days wasted. When my wife left me, I fell into the stupor of being a workaholic. I thought looking after dying people was for nurses, doctors, angels, not powdery bread makers like me, living out my forties in a swamp-quiet country town.
‘I don’t really know what’s happening, mate,’ Mick said, lying back on the couch, ‘only that I feel bugger tired most of the time, nauseous, like when we used to go out on the deep blue, fishing, only nothing to catch.’
‘What do we tell the girls?’ Rowie was starting to look tired even back then, at the start of the treatment. She strung her coppery hair in a loose bun, bits falling out, uncontrolled. ‘I feel so unprepared,’ she said.
‘So do I,’ Mick said.
That was a month ago and Mick could still wear his clothes. He refused to wear pyjamas to the end, lay on a fleecy lambswool in his jocks and singlet, his fading tats shrinking.
Once they realized that radiation and chemo was not going to work, they involved nurses, called palliative something, from the local hospital. They helped with medications, repositioning, sometimes with washing Mick. Later on they taught Rowie how to give an injection through the thing butterflied to his skin on his belly; ‘in case of breakthrough pain’ the nurse said, as if Mick wasn’t there.
‘Can you stay with Mick for a couple of hours tonight, while my mum and I go to the girls’ end of year concert?’ Ro phoned me on a stinking hot Friday in December. Before I could say anything, she continued, ‘Mum says I need a break. Mick’s fine about it.’ I’d noticed she was looking like me, pasty, but with even darker rims under her eyes.
‘Sure, I’ll come after school.’
‘Thanks, he just needs some company.’ Rowie assured.
They all looked really nice driving off to the school concert, instruments in the back. Mick was pretty proud of the girls playing trumpet and trombone at only ten and twelve years old.
‘I’ll record it for you, darl.’ Rowie said to Mick as they left. Mick was leaning out from his chair to wave them off, his scalp shiny with sweat.
I helped Mick into bed. They hadn’t been gone long when Mick rang his bell. He’d vomited down the side of the bed, onto the floor.
‘Tried to miss the bedding,’ he stammered.
‘No worries.’ I collected a bucket and rags from the laundry, scooped up the mess and wiped down the carpet. The stench made me gag. I gently removed the soiled singlet and talked about who was playing footy that weekend, how the Hawks creamed the Dogs last week. I wiped his chin and chest with a damp washer.
‘No worries. Did you want a beer?’
‘Not for the moment, mate.’ Mick lay back on the bed and groaned as a wave of pain rolled over him, squashing the smile from his lips.
‘Maybe I should’ve ordered that Nebutal from China,’ he hissed air through his teeth as the pain walked all over him in big boots. He was not connected to the morphine pump yet, like later, when he seemed a bit like a kite, fragile and far away, tugging on the end of a line.
‘Need anything for the pain?’ I asked, not really knowing what I could give.
‘Seems to be building up.’ Mick sucked in air and closed his eyes.
‘What do I do?’ I felt helpless as Mick grimaced, clenched the sheet.
‘Might need the morphine, poo’s blocked up like a bloody drainpipe full of cement,’ he gasped.
‘What do I do?’ I looked at his ashen face, his jaw grinding. ‘I’ll phone the nurse.’ Rowie had a list of phone numbers on the fridge. There was a recorded message saying they only worked office hours and to call the hospital in an emergency. My hands trembled as I tried to poke the numbers on my mobile; started to explain who I was, who Mick was, what was happening, asking for help.
‘I’ll put you through to emergency care,’ a voice was flat, sterile. I repeated it all again to someone else who said she’d check with the doctor on call.
‘Twenty minutes!’ I tried not to shriek. Then I remembered how busy emergency care could be on a Friday night.
Excruciating to see your mate in pain, but finally, after a couple more desperate phone calls, their doctor arrived and gave Mick an injection that seemed to settle him down. Mick slept and magpies sang out the end of the day. I tried to watch some tele. Flicked at the brochures on the coffee table that the nurses leave behind. Felt like waiting to be washed over a waterfall into an abyss of turbulence and tears.
‘How’d you go” Rowie asked as soon as she got home.
‘No worries, all’s good.’ I replied and helped her carry instruments while two tired girls clambered into bed. Later I told her about the doctor’s visit.
‘Thanks, Paul, good, he’s still sleeping. It’s all so expensive.’ I knew Rowie was getting worried about the costs of everything.
‘I’ll cover it.’ I offered, but still felt pounded by my helplessness.
The morphine pump meant the house was quieter. When Mick was asleep, Rowie and I would talk.
‘I’m scared I won’t be able to do what he wants, yet alone what he needs.’
‘You’re doing fine, Rowie.’
‘I’m not frightened about him dying, just the way he’ll die. Not sure if I can do this,’ Rowie continued, head in her hands, shuddering out a sigh.
‘Yeh, hope he’s calm,’ I hated the groans of his pain.
‘I don’t know how to talk with him, what he’s thinking,’ Rowie rocked in her chair for comfort.
‘Did you pick up that script?’
‘No. Not another medication?’
‘He is starting to look cachexic,’ the nurse said one day. It was like learning another language. I must have looked blank, because she added, ‘he has a marked loss of body tissue; his muscles and fats are breaking down. It’s called emaciation.’ Anyone could see he was becoming more wasted every day.
Rowie tried to feed him for a while, cooking fabulous meals, trying to make his favourites. He couldn’t touch much. She scraped away a lot of food.
The last two weeks I was camped in the back room, on the sofa. I started out visiting every second day or so, like it said on Rowie’s roster, along with a few others I hardly knew. I could see that Ro was not really hanging it together. She’d send the girls over to her mother’s place for a couple of nights, then they’d come home crying, wanting to see their Dad, even when he was skinny, yellow-grey and ugly. A few of us cleaned out his shed, fixed up the vege garden. Seemed to make him calm.
Then this person called a pastoral care something started visiting.
‘Pastoral who?’ Mick had never been religious, but this bloke Frank, let him talk. They’d met on one of the hospital visits, when Mick got the news that the metastases were rampant. The nurses were a bit busy it seemed so Frank turns up and says, ‘I’m here if you want a chat.’
At first Mick was pretty angry and told me how he went off at him, ‘Man, I don’t want to talk to bloody strangers, I’ve got cancer, not some disease that talking’s going to help.’
‘That’s OK, Mick. I’ll call again another time.’ Well Frank did keep turning up beside Mick’s hospital bed and he seemed to understand the type of emotional support that Mick and Rowie needed. One day Mick told me, when he was on his own with Frank, he just loosened up and let it all out. ‘Something just gave in me, mate. I told him how I was frightened about leaving the girls, not seeing them grow to be beautiful women like their mum, how I was worried about my mum, how I wouldn’t be there when she died now…’ He mentioned a whole lot of little things. His face crumpled, then he went to sleep.
Mick’s last week felt like I was watching a bolting horse, with Mick and Rowie clinging to the reins, nothing they could do to stop it. People coming and going from the house, meals turning up on the front door and Mick and Rowie and the girls hanging out together as much as possible. He slept a lot, but seemed to know when people were in his room. The nurses kept the morphine drip pretty well topped up and in the end he smiled and stopped breathing. Simple as that. I hadn’t known what to expect. It was three in the morning, and there were four of us in the room, Mick and Rowie and me and Mick’s sister, who made it back from the States in time. No one really knew whether it was a new day coming or the end of an old one. Time and life and death had stretched and distorted everything we knew. This kind of transparent calm settled, where there was no longer any uncertainty or doubt, or fears. Was the clearest moment I’d ever known to see him finally still and quiet, looking so peaceful. Even if his skin was stretched thin over the bones on his face, he looked gaunt and beautiful at the same time.
I helped with some of the phone calls the next day, to old mates, while Rowie called family members. Knowing that Rowie was telling the girls when they woke up sent me cold, shivered; my hands trembled as I buttoned my shirt. They had a good cry together in Mick’s room.
Later that day when the funeral director collected his body, I’d said my good byes, touched his cold hand, even kissed his brow. ‘See you on the dance floor, bro,’ was all I could say, but it seemed right. I played with the girls out the back, because Rowie didn’t want them haunted by memories of a hearse in the driveway right before Christmas. We all stared at the house when we heard the vehicle drive off on the gravel.
‘Uncle Paul, did you make more of those fruit buns yet?’ Chia just about bossed me as we walked hand in hand back to the house. The smell of baking bread softened the girls’ faces for a moment, then they ran to hold and be held by Rowie in one big embrace.
Thanks to the carers and professionals I spoke with and my readers of early drafts: Julie Hurley, Merrill Cole, Nic Aunger, Tess Fletcher, Felicity Wardle.
NB: The full, unabridged version of this story is available on the Palliative Care Australia website.