Interview 26

Age at interview: 70

Brief Outline: In 2006 her sister-in-law sadly died in ICU after having an accident in her car. She visited her daily and took care of all the practical matters.

Background: Retired GP, married with three adult children. Ethnic background/nationality: White British.

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In 2006 her sister-in-law sadly died after having an accident in her car. She last spoke to her in Accident & Emergency, before she had surgery. Following surgery her sister-in-law was admitted to ICU, where she deteriorated so much that doctors decided to withdraw treatment three weeks after the accident. 

Although she and her sister-in-law were not particularly close, she became her next-of-kin because her husband was working abroad at the time. She visited her sister-in-law every day and updated friends and family about her progress via email or telephone. She took care of all the practical matters during her sister-in-law's time in hospital and after her death, and helped organise a Jewish funeral which took place after a coroner's inquest. 

She felt that she learnt a lot about her sister-in-law during her time in hospital and after her death and regretted not knowing her better while she was still alive. From visiting her home, organizing practical matters and contacting her friends, she learnt that her sister-in-law had many interests and friends. She received a lot of support from her grown-up children and from her sister-in-law's friends.   
 

Although she and her sister-in-law had never been close she visited her for a short time every...

Anyway, during this time she was in hospital and I was the designated next of kin. And so I was the one, I visited every day, but I didn't spend a very long time with her. I think it's different when it's someone who you're very physically close to. But when it's someone who you're not very physically close to, you sit beside their bed and they're not there and they're looking awful and it's very horrifying. But it also, I didn't feel inclined to stay a very long time. 

I mean I made this trek up to the hospital once or twice every day. And it was quite easy. I could go, although it was rather expensive parking up there, I could park up there or I could even take the bus. So that it was something I did. And two of my children were at work and so, and I could only expect them to come with me when they weren't. And the other one, who wasn't, did come with me on several occasions. 

So during that time you were going into the hospital in the mornings, were you or'?

Not particularly just in the morning, but I sometimes went twice a day I think. 

And what was your routine like during that time, in those three weeks? 

I think I was, it was almost everything I did I stopped. I usually go to music about three times a week and I really gave up on that. And so that it was almost everything I did was to do with that. 

Her sister-in-law got better and worse so many times she felt embarrassed giving updates to...

There were days when my message to people would say, 'It looks absolutely desperate.' And then I'd feel rather embarrassed because the next day she'd be a bit better. And partly it was all about how difficult it was to keep her blood pressure up and how much of the drugs she needed and different drugs. Then later on there were infections. I think, I got the impression that everybody in ITU developed an infection at some point or other. And she did have MRSA in her pelvis, or in her perineum. And she had other things in her lungs, she had a bit of pneumonia. But these weren't very, very serious, although she did have to be transferred to an isolation room. And then she became very, very jaundiced and nobody quite knew why she was jaundiced. Whether something was blocking or whether it was an allergy to the drugs or whether it was haemolysis, whether it was to do with breaking down such a lot of blood, having bled into places and the blood having to be absorbed. And she got yellower and yellower. 

So there was a time when you thought things would improve, but then they deteriorated? 

Yes, yes. I mean several times. So that my emails were almost embarrassing. Because there would be one when I was saying, 'Things really do look as though it's getting a bit better' and then suddenly it was worse again. And then I think I felt even more embarrassed having said, 'Look, no, this is really, it's a write-off' and then they got, it got better again afterwards. But I think people were very understanding. At least they didn't blame me for doing that. 

She recorded music that her sister-in-law enjoyed and was very impressed when she saw one of her...

One of the things I haven't spoken about is music. I'd got an iPod, and she was very keen on music and one of the first things, well when I went to her flat I found that she'd got an enormous CD collection. I was amazed at how many CDs she had. And this was partly because she used to record things. She'd got a quite complicated system for being able to record things off the radio I think. And we took home a lot of these things and I put quite a few of them, she was particularly, for instance, had always been very keen on Vaughan Williams, and I put some of these on my iPod. And I went to the hospital and said, 'Would it be all right?' Because she was so covered in bits of wiring everywhere that I thought it might not be possible, and I was rather nervous of all this stuff and nervous of doing harm to her. But they were very nice about it and said, 'No, it's perfectly all right' and yes I should play to her. And so I did. 

And I didn't really have much evidence that she could hear it. But it felt quite nice to do this. And I was very moved one day coming to the hospital to find a friend of hers who was singing to her. And this was during the short period when they were slightly lightening the sedation and they were saying that she was taking some breaths on her own and it wasn't all assisted breathing. And he was singing and I felt that she was looking at him, or looked as though she was, her head was facing in his direction. And I was very moved. I was moved by his niceness in doing this. And I think he'd come all the way from Bristol and I was terribly impressed by this. And again feeling rather inadequate that my offerings of music hadn't ever been for very long. I was always rushing off. I hadn't left my iPod behind. 

She'd never been to her sister-in-law's home before but had to go there, find telephone numbers...

I suppose the main thing that I had to do that day, I think I probably came with one of my children, was to go to her flat because I had to inform various people. I had to inform the insurance people about her car and I had to go and find things. So I went to her flat. And this was a pretty weird experience. My husband and she weren't very close and so I'd barely ever seen this flat, in fact I'd never been inside it before. And I went in and there were signs of her recent meal that she'd just had. She hadn't washed it all up and so the sink was full of stuff. And her bed, it was February and she had an electric heater on the top of her bed and it was on, and this was very weird. And there were also, she had an answering phone and I listened to her messages. And there were one or two messages on it. And this was my first trail. 

I started to think, I'd already told my husband but he was in America. And I can't quite remember who, at that point, I talked to. But I certainly took the telephone numbers of the people who were on her answering machine. And I picked up from her house, I actually found she'd got masses of files, she'd got filing cabinets and other filing cabinets and things in drawers and things on her computer, and I managed to take away a list of email addresses and also a folder that had everything about her insurance and also stuff about her will I think I found. And I took all of these home and started making contact. And fortunately there was an email that I'd had from a relative that had been I think something that she had sent to several people including this relative and some other people, and I gradually began to build up a network of people who she knew. And this was a very amazing experience.

Many of the visitors she saw in the relatives' room were understandably wrapped up in their own...

I didn't say anything about the waiting room, which was a strange place. I mean very often when you get to the hospital, you ring at the bell and you say who you are at the door of the ward and they say, 'Well, could you wait. We're just doing something.' And so we would wait in the waiting room. And you kind of got to be familiar with the families who were in there, although again I didn't actually have many conversations with anyone. But everybody's situation was so different in a way, although we were all, everybody was focused in on really their own particular tragedy. But it was a kind of all-right place, although some people obviously spent long hours of the day there. I would learn to take a book and read in there. And there were facilities for making tea but I didn't actually do that, I don't think.

Although she didn't know many of her sister-in-law's friends, she emailed them with updates and...

So over the next three weeks I began to have a lot of support from the people who she [sister-in-law] knew. She belonged to a religious group called a Chavorah, which I didn't really know about and which was something that my husband hadn't really appreciated. And he used to rather come to blows about her religious convictions and involvement. But they clearly were a group of people who all linked up with each other and were very supportive of her and had been during the time when she was well and were being now. And there was, so that I would do a group email and the list of people who the email went to got bigger and bigger and I got more and more replies. And I found that very helpful and very nice. I felt all the time a bit guilty because I was told that I was doing such a wonderful job and I felt bad because we hadn't really been such tremendously good friends previously. And she would never know that I'd done this good job. 

She would have liked to have known her sister-in-law better when she'd been alive, and learnt...

I mean it had been, for me it had been a very important experience in getting to know her [sister-in-law], but it was a very bad way of doing it and a pity that it didn't happen when she was alive.

She was a great one for keeping up with friends. Which was something, I mean something I've always, I suppose if you said did it show me something that I've taken from it, is that actually, having been married all my life since I was 20, I've always been very self-sufficient. My family has provided me with everything I needed in a kind of way. And therefore I haven't gone out of my way to make a lot of friends and make friends with all the people who I come into contact with either at university or things I've done or my jobs. She's kept up with everyone. 

She's had rows with people, so there are some people who she dropped. But I was impressed by the way she handled being a single woman. One of the things I was absolutely amazed by, we were kind of nosing around, looking in a drawer beside her bed, I found hundreds of tickets for concerts going into the next few months. I was actually able to give these to someone. But I was, she'd kept going, she did things, she went to concerts, she went to plays, she went to lectures, she went to exhibitions. She, you know, she did a lot. She didn't sit, she was often very unhappy I think but she kept going and she worked hard at it. She had quite a lot of appointments for psychiatrists and alternative therapists and acupuncture or, you know, Chinese medicine people. I mean she felt a need to try to make herself feel better. So that there was a kind of, this paramedical side of it, but there was also this cultural side of it, which was very strong. 

Some doctors thought her sister-in-law had a chance of recovering when she was first admitted...

At some point in the first week or so, when I thought things were very bad, I thought that it would be important that the doctors both talked to my husband, who was still going to be in America for the next three weeks really, and that I was there to talk to them as well. And my son came up with me and what we actually thought at that point was that they were going to ask our permission to stop the treatment. And when we got there, I think they had already spoken to my husband. And they were very nice and they explained to us the situation. They explained there were, different people said different things at different times. Because sometimes people would say, 'Oh, it is possible you can get better from these things. Yes, she'll probably be very uncomfortable because of the hip business for a long time, but it will be possible, she'll be able to go back to her flat. There's all sorts of therapy that you can have.' And then there were other people who said, 'Really the outcome is not going to be good. We're having such trouble keeping her blood pressure up.' And later on of course she developed multi-organ failure. But to begin with that wasn't the situation. 

Occasionally she found it difficult to get information from nurses because, although she was her...

I did have a problem establishing that I was the person they should tell things to. So sometimes I would ring up early in the morning. Because my husband I think would probably have telephoned me just before he went to bed, and so I wanted to know before he telephoned me what the news was this morning. And sometimes the nurse would give me an answer that was meaningless. And I'd have to rather bully her and say, 'I am the person who is supposed to be told things.' And of course because that was the case that they only would tell one person, I was responsible for telling everybody else. And there were some nurses who would give a rather gloomy picture of what was happening, and others who would be very optimistic. And I wasn't really sure whether this was altogether to do with difference in her condition or whether it was to do with their own temperament in a way, their inclination to be one thing or the other. But they were all very nice. I mean I was very impressed by the idea that you have a nurse who is totally devoted to one patient for the whole time. 

She felt confused with the information she received from different doctors but, when her sister...

We were taken into a little room. We'd asked I think to speak to someone, but I don't know. I think probably what had happened is that we'd seen him in the room with her and he'd kind of maybe indicated that things were not going to be all right. And I think it was a weekend and so he was the same person who was on for the whole weekend, because other days you couldn't rely on it being the same person the next day. Anyway, so he took us in there and we talked about it. And I think one of the things that they were saying, they never absolutely said that it was impossible for her to recover, but he made it clear that, even if she recovered, she would have to be in ITU for at least a year and that she would be incredibly weak. But even three weeks on ITU is very debilitating. And that quite apart from the fact that her pelvis was going to have to be treated and might never be stable. 

And I can't quite remember whether he at any point said, 'You do have this choice. You could...'. I think he really must have said that it, there wasn't a choice. But because there were so many people who at various points implied that you could go on but it would take forever, I slightly blur in my mind what it, that moment. 

She was in this period of being slightly better, and then she was worse again. And within about three days they really said that it wasn't worth keeping going, and they did stop, I can't remember what, I think they stopped everything. And she died within about twenty minutes. And that was it.

She and her husband saw her sister-in-law after talking with doctors, who withdrew treatment and...

Finally, after about three weeks, my husband came back. And things were not really getting any better. Just about the time when he was coming back there was some suggestion that they might be in a position to slightly lighten her sedation. Which of course I looked forward to the possibility that I'd be able to speak to her. But it wasn't, but there was obviously the worry that it would be so painful for her and her hips would be so painful that actually it wasn't fair to consider bringing her round. But they did talk about giving her a tracheotomy so that she didn't any more have to have this thing going through her mouth. But it actually never happened, and her condition deteriorated.

But he [doctor] said I think, 'Do you want to be with her or not?' And we decided not to be. And then about twenty minutes later they came out and said she had actually died. And then we went in and saw her then. 

Her sister-in-law had left instructions and had wanted a Jewish funeral.

Then we had a funeral. And she'd left instructions. I think before she died we'd had a little time of, one of us had thought, 'Wouldn't it be nice to have a green funeral' and we'd investigated this. And the rabbi had said he couldn't see anything that suggested that it wasn't appropriate, that it, you know, that you could have a Jewish funeral and it be green. But actually when we got to arrange it, it turned out that the place where it was going to be, there wasn't anywhere for us to really congregate or, anyway, it was right outside London and I hadn't even seen it. And in the end we settled on a Jewish funeral that was run by these two friends of hers. And that was fine. And we had a party back here for her.

And what happened next, after her death, in terms of' 

I can't remember, and I can't actually remember because my notes actually stop. I could probably work it out from my emails, which I think I've probably still got, whether the funeral was the next day which it's supposed to be for Jewish funerals. But I think it wasn't. So we told everyone when it was going to be and we said, I think it wasn't, because I think I had a day or two. And we set up the funeral and ordered some food and that was it. There was going to have to be a coroner's inquest, and there had to be a post-mortem I think. But I'm not absolutely sure whether there had to be a post-mortem, probably. And that we'd been given the name of a kind of Jewish burial service. So that it was all taken care of, that side of it.

She had to clear out and sell her sister-in-law's flat and contents, which was very difficult at...

I gradually got used to going to her flat. It was actually really difficult deciding what to do with her stuff. To actually get rid of someone's life seems dreadful. And I think I've still got it, but she was, I think she was writing a biography of her parents and I think there were several copies of it and I think I have them. But towards the end, when I knew that it was the last moment for clearing out her flat, I became a bit ruthless and started taking home great masses of stuff and then taking them to the dump. And her clothes for instance, I didn't try to do anything other than, I mean I think a charity picked them up. But there was, for instance she had a whole lot of books that were prizes that were given to her mother's brother, who was a very, clearly took every prize in his school. And again this is about kind of how much you hang on to the past. And these books weren't books that anyone needed, they were rather kind of pretentiously covered, leather-covered books. And I took away three of them that were volumes of Proust. But the rest of them, I just got sick of carrying things and I didn't bring them back. There were some kind of Jewish things, candlesticks and things that somebody took. And there were the things that she used in her Chavorah. She had some cymbals and I think I've still got them, but I have promised to give them to her friends. But that is, part of you wants to be shot of the whole business and part of you, you can't bear to say their life counted for so little.