THE TEXT

The Life of Henry Fuckit
(1950 - 2015)

 

81   He serves a three year sentence


HENRY FUCKIT'S NURSING NOTES

Part 1 | Part 2 | Part 3 | Part 4

Up the long sloping tunnel that connects the main hospital buildings to the nurses' home. The lift to the basement and the linen bank. Low concrete beams and pipes overhead. So much piping, like veins and arteries and nerves and ducts. It is hot and humid.
They issue me with twelve uniforms that are anything but uniform. Ill-fitting white cotton trousers and jackets that have been donned by a succession of orderlies drifting through the big barn. The trousers are too baggy, or too tight, or too short in the leg. The jackets have high, collarless necks and button up at the side and give one the appearance of a chef, or an ice-cream vendor, or a barber.
In the sewing room I look at my reflection in the mirror and fight the compulsion to run. I have difficulty recognising myself. But is that not just what I want? Nothing can be done with this impersonal white uniform. Heavy white cloth to cover the body. This is my identity.


Sickness and excrement and the accompanying smells, sounds and sights.


The dawn walk starts with the click of the gate. Palmerston Road in lamplight and right at the public swimming baths. A man wrapped in a heavy coat leaves his idling car and closes a garage door, fumbling the cold lock in the dark. Across Queens Park playing field to the start of the path running along the cliff top of Brickfields quarry. Towards the mountain beyond the high mesh fence is Eastern Boulevarde arush with early traffic. The uneven grassy path winds up towards the top of Hospital Hill and ahead to the east the sky is lightening and brightening with sunrise colours. I pass the two skeletons on the cliff edge where they stand gnarled in silhouette. The wind is drawing out long streaks of smoke from the kiln chimney stacks and below and beyond them stretch the lights. Two at a time I climb the steps to the flyover bridge and descend on the freeway pavement past the nurses' home. At the stone cairn, memorial to the dead, I slip under the fence and cross the hospital road towards the canteen past the pool. Down the steps to the chapel and then around to the front entrance, passing the exhausted, inward faces of night staff shadows.


I am horrified and revolted by human sickness and old age. Sacks of flesh and bone dying messily in their own shit. Ugly, helpless and undignified. I am drawn to the idea of suicide. There is an argument that stresses the importance of man battling on till the last breath, never giving up hope: but I do not understand or accept it.
Mr Putney is in his seventies, a senile diabetic with pneumonia. He lies in a huddle, a catheter running down to a bag under the bed. He can do nothing for himself, not even turn on his side. He remains in an imbecilic daze, weakening, deteriorating. Why should he be kept alive? Why is this clinging to life so abject and cowardly?


The
Florence Nightingale
Pledge

I solemnly pledge myself before God and
in the presence of this assembly, to pass
my life in purity and to practice my profession
faithfully. I will abstain from whatever is
deleterious and mischievous, and will not take
or knowingly administer any harmful drug.
I will do all in my power to maintain and
elevate the standard of my profession, and will
hold in confidence all personal matters
committed to my keeping and all family affairs
coming to my knowledge in the practice of my
calling. With loyalty will I endeavour to aid the
physician in his work, and devote myself to
the welfare of those committed to my care.


How does it feel when you no longer wish to part your teeth, open your mouth? When opening your eyes is too much? Waiting to snuff it, tense and inward as more and more of the body and mind shuts down for the last time.


I swear by Apollo the physician, Hygeia and Panacea, and I take to witness all the gods, all the goddesses, to keep according to my ability and my judgement the following oath:
To consider dear to me as my parents him who taught me this art: to live in common with him and if necessary to share my goods with him; to look upon his children as my own brothers, to teach them this art if they so desire without fee or written promise: to impart to my sons and the sons of the master who taught me and the disciples who have enrolled themselves and have agreed to the rules of the profession, but to these alone, the precepts and the instruction. I will prescribe regimen for the good of my patients according to my ability and my judgement and never do harm to anyone. To please no one will I prescribe a deadly drug, nor give advice which may cause his death. Nor will I give a woman a pessary to procure abortion. But I will preserve the purity of my life and my art. I will not cut for stone, even for patients in whom the disease is manifest. I will leave this operation to be performed by practitioners (specialists in this art). In every house where I come I will enter only for the good of my patients, keeping myself far from all intentional ill-doing and all seduction, and especially from the pleasures of love with women or with men; be they free or slaves. All that may come to my knowledge in the exercise of my profession or outside of my profession or in daily commerce with men, which ought to be spread abroad, I will keep secret and never reveal. If I keep this oath faithfully, may I enjoy my life and practice my art, respected by all men and in all time; but if I swerve from it or violate it, may the reverse be my lot.


Mr Rubinstein is a miserable, whining little Jew. He said he was a good patient but he's not. He complains, whimpers and groans in his embarrassment and discomfort. He said he was prepared to pay for everything. He shakes violently with nervous tensions, makes sudden panic-stricken movements and repeatedly says he can't take any more. Yet I don't dislike him.
On the other hand I felt an immediate aversion towards that hugely revolting Afrikaans specimen, Lambrecht. A brutal, ravaged red face, vomiting and bellowing. A particularly disgusting heap of humanity.


'When I am at home, if I have difficulty, after a couple of days I just take a little soap on the end of my finger and massage the anus, gradually moving up. It helps a lot. Maybe I manage to remove a clod obstructing the passage. The only problem is causing some bleeding from a pile a little higher up.'


What a relief! My wash died in the night.


Returning from tea I was in time for my first 'laying out of a corpse.' He had a distinctly Goyaesque expression on his face - eyes open to slits, mouth agape in cadaverous leer, black tousled hair.
He looked better dead than alive. Not peaceful by any stretch of the word but at least no longer so explosively flushed. Also an improvement without the plastic airway.


I have noticed more than one patient taking a morbid interest in the obituary columns. They scan the names almost eagerly, searching for someone they have known, someone they have outlived. The greatest reward is to spot the name of a fellow patient who 'disappeared' yesterday. The perversity lies in their dependence on the printed word for death to become a reality.


Grobelaar: No, I don't want nothing.
                Here's your lunch.
                What must I do with this?
                Have you no appetite?
                Chris', man. I'll have to have a fuckin' big appetite to eat THAT.


Chronic airways disease complicated by pneumonia has brought Tom Grobelaar into the ward. He is a skinny little man in his seventies and, every breath being a battle, is distressed and irritable. He finds it difficult using the bottle. He prefers to get out and stand unsteadily beside the bed, wheezing and moaning and cursing as he pisses onto the floor. And the sputum mug is a fiddly little thing so he just spits over the edge of the bed.
'Chris' Jesus, man! Ohh, Christ. I tol' you, I don't want nothing. Just leave me alone. Hi, this bloody fucking thing! Christ, man. Oh Jesus, what is this?'
'Soup'
'Take it away'
'You must drink it.'
'No, Christ man. I tol' you, I don't want nothing.' He coughs a few times in his characteristic way, exhausting himself. Each cough is a shout of pain and dysphoria ending in the word 'Mimi,' his wife's name. As his condition deteriorates he calls for her more frequently.


Bluff, 63, is a confirmed alc in with the DT's. He has come from William Slater via Valkenberg and before being committed this time he had been living alone in a room in Tamboerskloof. A bachelor and a clerk. He has served several stints in William Slater and at Muldersvlei Farm.
After four days of the wildest delirium he is recovering fast and shows surprising resilience. His visual and motor problems have largely resolved themselves. On first regaining his senses he spoke openly and with considerable pity for himself, of his aloneness in the world, of his lack of support and encouragement. As he gains strength he becomes less open and begins erecting his façade of self-sufficiency and worldliness. When he has got it all more or less in place he will be released to follow a familiar pattern: rehabilitation and abstinence, return to society and a job, renewed acquaintance with loneliness and boredom, recourse to the bottle, unemployment, a binge grander than the rest. Maybe the next time will be the last time.


Rabkin: I am going to commit suicide.
What's that, Mr Rabkin?
I am going to commit suicide.
Don't do that Mr Rabkin. Rather have a cup of tea. Two sugar?


At the age of thirty-seven Hector Dodds is a fucked-out wreck.
Every night I always pray to God until I fall asleep that I can walk again and get a good job.


Rabkin in a thundering theatrical voice: Oh, the pain! The pain! God, God, God! Then, enquiringly: When is God going to come into the business?
Nurse: You think God would make a good partner, Mr Rabkin?


Dodds lying on his side between cot sides. vomiting into a kidney bowl and over the sheets. A dirty, tattooed, malodorous heap. Red-haired and phthisic, with long filth-caked fingernails. There is everything wrong with him: epilepsy, a broken femur, tuberculosis, alcoholism, impaired vision, hearing and speech. He has been an invalid for the past six years, cared for by his mother. Whilst in the City Hospital for TB and alcoholism he fell out of bed and broke a femur and knocked his head, developing epileptic seizures.
He curls up in bed, his long bony hands touching his face, shielding his eyes and nose. His filthy nails indicate some kind of anal exploration or stimulation. 'Cerebral atrophy' is one of the diagnostic terms used in his case. It's a toss-up between cerebral atrophy and Korsakoff's psychosis. Vague terms for 'fucked in the head.'


Busy with blood pressures, the five o'clock obs, my mind vacant but for a growing impatience as knocking-off time approached. I was suddenly confronted by an ugly incident with an ugly man. When I inflated the cuff of the Baumanometer stinking clammy Dodds violently wrenched his arm away, glaring at me with wild hate.
'Fuck off, you bastard! Fuck no, man! No fuck, man!'
Then he said later, when reassured and calmed.
'Take me to my mother's room, please, won't you?'
'You're in hospital, Hector.'
He looked blank, bewildered. Then frustration and rage filled his eyes.
'Fuck it, man! Fuck, fuck, fuck!' He pounded the palm of one hand with the other fist. 'Christ, man, I forgot! I'm sorry, hey. Fuck it, I'm sorry.' In his laboured and slurred Woodstock speech.


Prior was on the phone from Casualty. He was with an old A1 patient and they were on their way to the ward. The man's condition was 'basically hypertensive.' He arrived conscious, groaning with exhaustion and misery. As he was getting across from the trolley to the bed he seemed to lose his strength and rolled over onto his side, his face half buried in a pillow. He lay there and began to make a snoring, snorting sound. Lifted forward his eyes bulged glassily. I removed his spectacles and called Prior. We lifted him up and he lay there quiet, staring with blank dilated orbs, as if aghast at the emptiness of it all. His breathing had stopped. Prior felt for the carotid and in amazement said, 'Jesus, he's just died!' He called to Benny Lipschitz and said, 'Benny, this guy's just gone and died. There's no output. Nothing.' Lipschitz came over and gave an experimental shove on the chest. I fetched the cardiac massage board but they didn't want it. 'No point in calling Max. There's no output. What could it be?'
The consultant arrived and they puzzled over the body for ten minutes, tapping here and there, listening with stethoscopes, lifting eyelids, feeling and prodding. Then they walked off talking of CVA's and PM's, shaking their heads and scratching their arses.
After his wife had come we washed him and wrapped him up in plastic. There was the usual hush in the ward, broken by the crisp ripping sound of cellotape, each rip ending in a snap.


Now a disoriented patient who supposes himself to be travelling in a car and not lying stationary in a hospital bed. He holds on tight for corners.


Apart from the quietness I have noticed a stifling feeling of closeness behind the curtains with the corpse. The air seems warm and I experience a slightly feverish sensation. I have not discerned any characteristic odour, yet the air is certainly not bracing and I breathe it reluctantly.


The condition of the clothes of a patient on admission is noted with ruthless detachment. What might pass without notice in the street is exposed in all its shabbiness under the disinterested scrutiny of an orderly kitting in the items. A hole in a sock, worn-down shoes, a frayed collar, unpressed grimy trousers. And how demeaning toenails can be! A poor man with a genteel mind is filled with shame and humiliation.


I asked Meyer the time and in his excruciatingly slow bumbling way he showed me his fancy digital watch which, if you held a diploma in computer science, could be made to tell the exact time in Santiago or Peking. It took him some ten minutes to establish correct South African time.
Then he glared past me to the doorway.
'What's happened to him?' He indicated the empty bed.
I shrugged and he nodded comprehendingly.
'I see.' Behind me in the doorway he had glimpsed Mrs Beck. 'I've seen that before. A woman in dark glasses being embraced by another woman. I've seen those expressions.'


There is no conclusion to be drawn. There is no easy explanation. The evidence does not point to a facile homily. Anyway, why does every experience, every piece of evidence have to be disposed of, 'assimilated,' accounted for? Before one is content to let a matter drop why does one have to be didactic?


Stopel is a genially demented old man, unshaven and dressed and smelling like a vagrant. He was found wandering in the street with a graze on his forehead and some well-meaning citizen brought him to hospital. He has been admitted for observation.
He was brought in on a trolley and lifted onto a bed, much to his amazement. I have persuaded him to take off his shoes, which are lined with newspaper, and am trying to explain what is happening.
'This is a hospital.'
'Oh, yes? That's very nice. But I think I must go now, thank you.'
'They want you to stay here with us for a while. They want you to stay in bed.'
He sits up and begins to swing his feet off the bed when Dyer the registrar and Prior the houseman arrive. They spend ten minutes thoroughly examining him. Then the truth dawns on them. They ask him to stand, and he stands up in the bed, causing them some alarm. No, they meant down on the floor. He gets down and stands out of bed.
'This is very easy,' he says. 'Anybody can do it.'
'Can you walk?'
'Of course.'
He takes a few paces and looks back at them and smiles modestly. Then he heads off down the ward ready to go wherever the door leads. The doctors turn and walk away shrugging their shoulders and raising their hands, saying,
'There's nothing wrong with him.'
I stop Stopel next to Buchanan and suggest he put his shoes on before returning to the big wide world. Buchanan reaches over to his locker for the air freshener (Spring Breeze) and begins spraying Stopel and the air around him.


Nico Swart is a delicately stunted, cerebral palsied 'child' of twenty-three. He lies impassive, ignoring my attempt at communication. Then a flick of the black eyes - an inhuman child. At night he brightens up and utters a stream of obscenities like a parrot. Who could have taught him this? It is thought that he has lymphoma, a disease which should dispose of him within the next few months.


A turquoise swimming pool set with symmetry in clipped green lawn. Black stripes below the water, white railed steps in the corners. An upturned bench on the grass. Rain falls from a heavy sky and from the shelter of the veranda I watch the drops disturbing the surface of the pool. The air is clean and cold and does not smell of sickness.


Goodman: I'm a good psychologist. I can sum people up at a glance. I looked at that man and I could see he was swollen-headed. I took an instant dislike to him. What does he think? He thinks he is important, some kind of Very Important Person. You know, the Bible says all flesh is as grass, and all the glory of man as the flower of grass. The grass withereth and the flower thereof falleth away.
Suddenly I am very bored. How can I take this?
Goodman has lost a five-cent comb.
My comb has been stolen. Whilst I was asleep. Last time I was in here I was drugged and someone stole my teeth.
H is seventy-two and has a rare blood disorder called Von Willebrand's disease.
I am busy with research. I have been doing research into my condition for the past forty years.
I feel indisposed to receive any visitors today. I couldn't be bothered, they're too much trouble. I'm a very sick man. I'm not one to complain. I am very independent. And this after having got me to change his pyjamas for him merely because he likes to feel fresh and enjoys constant attention.
I would have committed suicide long ago if my religion permitted it.
What religion is that?
The Jewish religion. It forbids suicide, otherwise I would have done it long ago.


After a hard day, the last hour of which was spent helping with the restraint of a crazed cirrhotic whilst the houseman performed a lumbar puncture, I emerged from the hospital to be confronted, on rounding a corner, by the massive shape of Devil's Peak. It's dark enormity, blown with cloud and shadow, reared so impossibly high and overpowering that I was flooded with a sense of foreboding.


Was it the violence of the wind raging up there across the Devil's face that so filled me with fear?


DEMENTIA, according to Merck's gospel: a syndrome of progressive irreversible cerebral insufficiency caused by organic factors and characterised by predominant cognitive functional loss.
The clinical picture is of slow disintegration of personality and intellect because of impaired insight and judgement and loss of affect. The progression of the disease is more painful to the beholder than to the patient. Interests become restricted, outlook becomes rigid, conceptual thinking becomes more difficult, and some poverty of thought becomes apparent. Familiar tasks may be performed well, but acquiring new skills is difficult. Initiative is diminished, and the patient may become distractible. In addition, a global defect eventually develops, involving all aspects of higher cortical function. Along with the cognitive dysfunction, specific disturbances of speech (dysphasia), motor activity (dyspraxia), and recognition of perceptions (agnosia) may be discernible. Memory impairment increases, beginning with problems recalling recent events or finding names readily: the impairment varies greatly from time to time and often from moment to moment. It can be circumvented at first, but as the defect increases, remote memory is also progressively impaired. Characteristically, orientation becomes impaired at first for time, later for places, and finally for person.
In some patients, cognitive dysfunction is preceded by modifications in their usual behaviour and emotional responses. Typically, affect is blunted, but in early stages it may be excessive. Normal personality traits may become exaggerated or caricatured: an obsessive patient may be unbearably pedantic and rigid (organic orderliness), or a sociable extrovert may be facile and inappropriately jocular. The initial affective change may be dominated by irritability with periods of anger and violence. Depression is common. If the mood change (depression, anxiety, or elation) is sustained, the disorder may be misdiagnosed as a primary affective condition. Affect becomes more and more shallow and evanescent as the condition progresses and finally gives way to severe blunting, marked perhaps by a fatuous euphoria without depth.
The patient may embark on foolish and ill-judged, perhaps illegal, activities, but he cannot sustain them as his motivation and drive decline. Habits deteriorate, and the patient becomes slovenly, dirty, and eventually incontinent, culminating with the need for total nursing care in later stages of the illness.
Senile dementia: There is no treatment.


I am irritated by Archie Morgan's whining. He has a steadily swelling scrotum that is fast approaching the proportions of a soccer ball, he has the grotesque bloated belly of a starved child, skinny, stick-like arms and shoulders, and a suppurating anus.


Archie Morgan exudes the foul sweet smell of a septic wound. At twenty-eight he is a bearded, long-haired derelict with ascites, liver failure and perineal abscesses.


His stomach works frequently and it is a difficult, messy procedure. From the moment the curtains are drawn the trouble begins. He feels the pan:
'Hey, no Man! You want to freeze my arse off?'
This is a delaying tactic which must be ignored. If the pan is warmed he says:
'Hey, no Man! You want to burn my arse off?'
Two pairs of hands are needed, one to help him lift himself, the other to slide the pan under him. He is weak and in discomfort and does not like to move or even be moved.
'Now listen, be careful. Please, Man. Don't grab me there! Oh my fuck! No, don't. I can't take this pain. Nurse, what are you DOING? Hold it. Jesus no. Careful. Oh my God!'
He is such a wreck. Alcoholism to liver failure to ascites. Generally deteriorating health and unhygienic personal habits have encouraged the formation of anorectal abscesses: neglected, they have developed into a fistula. So each time his bowels move the wound must be cleaned and dressed. For this he has to be turned on his side - another process punctuated with yelps, oaths and groans.
The odoriferous combination of 'purulent discharge' and faeces - his especially - produces a strange effect. Once one has become better acquainted with this smell it loses its nauseating quality and assumes an esoteric fragrance, like opium and lust in an oriental brothel.


Archie Morgan employs flattery with such obsequiousness that I laugh openly.
'You're just the man I wanted to see. You're my friend, hey. I tell you, when I knew you was coming on duty, when I saw you come through the door into the ward, you know my heart started beating. You know, kind of fast. No, really. I'm not bullshitting you. You're my friend. Hey listen. Do us a favour, won't you? I don't like to ask but would you do us a favour? Just one little favour. I don't like to ask you.'
'What do you want?'
'You know. The usual. You KNOW.'
'You want another cigarette? They say you've got to cut down, Archie.'
'No, not that. For fuck's sake!' Whispers: 'Come here, Man.'
I bend close and he says, 'Won't you get me a pan?'

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