Twenty-Four

John had left the study door open and, through it, Mandy could hear him go down the hall and open the front door. She heard him greet the nurse, and then Evelyn, who must have been woken by the door chime, said something, although Mandy couldn’t hear what. Mandy sat on the edge of the bed, stroking Grandpa’s hand, talking, trying to reassure him. The nurse appeared in the study first, followed by John and then Evelyn, who switched on the main light. Mandy blinked against the sudden brightness after the red glow. She stood and moved away from the bed to allow the nurse access. He took Grandpa’s pulse and listened to his chest. Grandpa tried to cooperate by breathing in and out when told. But when the nurse asked if he could lie down Grandpa shook his head and remained bent forward. ‘We need to make you more comfortable,’ the nurse said, and looked to John for assistance. John went to the bed and, taking a shoulder each, they slowly eased Grandpa down. But as his head touched the pillow and his back straightened, losing the last of the C curve, he cried out in torment.

‘Oh Dad,’ Evelyn said, her hand shooting to her mouth. Mandy put her arm around her.

‘Soon have you asleep,’ the nurse said gently. He took two sterilized packages from his bag and, tearing them open, assembled the injection.

‘Can’t you increase the dose?’ John asked in desperation.

‘Unfortunately not. I can’t even give him all this.’ He held up the phial and tapped it. ‘On top of what he’s already had it could kill him.’

Mandy met John’s gaze and knew what he was thinking.

They watched as the nurse shot some of the morphine into a tissue before lowering the waistband on Grandpa’s pyjamas and injecting him in the only flesh he had left: at the top of his thigh. Mandy wondered if Grandpa was aware that some of the morphine had been withheld, which to a man who was begging for permanent release from pain would seem like an added torture. The morphine took immediate effect and Grandpa’s face relaxed and he drifted into sleep. The nurse disposed of the used syringe and morphine-soaked tissue in a small plastic box, which he returned to his bag. He then took out another sealed package, which Mandy saw held a clean pair of incontinence pants. As she had done previously she left the study while the nurse changed him.

She went into the kitchen, where she filled the kettle and set it to boil. What exactly had John been about to do to end Grandpa’s suffering when he’d removed the lid on the beaker? What would she have been an accomplice to had not the nurse arrived in time? In some ways it was a great pity Grandpa had been so opposed to staying in hospital where pain relief was presumably always on hand, and effective.

A few minutes later she heard John and Evelyn see the nurse out. Then they came into the kitchen and Mandy passed them a mug of tea each. They leant against the kitchen cabinets and sipped their drinks, none of them in any hurry to leave and return to the study. Grandpa would be deeply unconscious straight after the morphine so wouldn’t need anything for a while, and there was a cosiness and a sense of normality in standing in the kitchen having a hot drink.

‘Gran didn’t wake then?’ Mandy asked after a moment.

‘She wouldn’t have heard the bell,’ Evelyn said, ‘not without her hearing aid, poor dear.’

With her hair uncombed and no make-up, Evelyn looked much older than she did during the day. The strain of nursing Grandpa and all the accompanying worry and upset showed in the lines of her face. Mandy felt sorry for her: she seemed so fragile. She was pleased her father and Evelyn had made up their argument and were now comfortable in each other’s company. It was just a pity it had taken ten years, she thought, and Grandpa’s illness to do it. When Evelyn spoke again there was a finality in her voice that hadn’t been there before, as though she’d been considering something and had come to a conclusion. ‘God only knows why the nurse didn’t give Dad the full injection. In some countries they help people at the end.’

‘But not here,’ John said. ‘If the nurse had given Dad the extra morphine, aware it could kill him, he could have been prosecuted.’

‘And who’s going to tell? Us?’ she challenged. ‘Hardly. It would have been a relief for Dad. He can’t take any more and he doesn’t deserve this. He should be allowed a dignified and pain-free end.’

John glanced at Mandy. There was a small silence when Evelyn’s words hung in the air – as though she had just given them permission to do whatever might be necessary. ‘I know,’ John said quietly after a moment. ‘I completely agree. But we can’t ask the nurse.’

Evelyn nodded and looked away.

In that moment there was a tacit agreement, Mandy thought, that Grandpa wouldn’t be allowed to suffer any longer. But only they could be the ones to put a stop to it. It would be up to them.

After a few moments Evelyn crossed the kitchen and placed her empty mug in the dishwasher. ‘Mandy, are you all right to continue or do you want to go to bed?’

‘I’m all right,’ Mandy confirmed. John nodded.

An hour later John had closed his laptop and was trying to doze, while Mandy, her head resting on the chair-back, was again following the red bubbles of moving light. Although it was only an hour since the injection, Grandpa was already very restless; his limbs jumped beneath the sheets and he groaned in his sleep. Suddenly he was bolt upright again and crying out in torment. They both leapt out of their chairs. Mandy went to the bed as John grabbed the phone to call the nurse. ‘Perhaps he’ll change his mind about the injection now,’ he said bitterly. Mandy saw his anger and frustration and was a little afraid.

The nurse answered and said he would come straight away. ‘Twenty minutes,’ John said to Mandy as he put down the receiver and joined her at the bed.

Grandpa moaned in agony and, leaning forward, clutched his stomach. ‘The nurse is coming,’ Mandy reassured him.

‘Hold on there, Dad,’ John added, a tight edge to his voice.

John moved to the bed-head and tried massaging Grandpa’s neck and shoulders, while Mandy sat on the bed and held his hand as they had before. But Grandpa’s pain was so far past being soothed that their pathetic attempts seemed risible. Bent double, with his arms closed across his stomach, it was as though he was trying to contain the pain, stop it at its source. He cried out, dry-retched, called on God to help him, and then somehow found the strength to raise his voice at them: ‘You promised! You said you’d help me!’

‘I know, Dad,’ John cried, then: ‘For fuck’s sake, where the hell’s the nurse? It’s been twenty minutes.’ Storming from the bed he crossed to the desk to phone the nurse again. ‘It’s on fucking voicemail!’ he shouted and kicked the desk chair, sending it crashing to the floor. Grandpa started and then whimpered, upset and frightened.

‘That’s not going to help!’ Mandy snapped.

‘And what do you know?’ John yelled, rounding on her.

‘John?’ Grandpa asked weakly and tried to turn his head in the direction of the noise.

‘It’s all right,’ Mandy soothed. ‘The nurse won’t be long.’

She looked at John standing by the desk with the phone still in his hand. In the red glow of the lamp she could see his face set hard with fury and his eyes wide and staring. She saw his anger and knew at that moment he was out of control. Reason and rational thought had left him; he was capable of anything, and she needed to protect Grandpa.

A few seconds later the doorbell rang. ‘Thank God,’ she breathed.

John stormed out of the study, flicking on the main light as he went.

‘John?’ Grandpa asked again. He sounded frightened.

‘Don’t worry,’ she said soothingly. ‘John is upset.’

‘Because of me?’ Grandpa asked, his head still bent forward on his chest.

‘No, not because of you, love,’ Mandy said. And as she spoke the words she had the strangest feeling she’d heard them before. She could hear them being spoken, but when and by whom? John is upset…because of me?…No, not because of you, love…She couldn’t place them although she knew they were real. Like the other words and pictures that had come to haunt her they’d landed in her head without warning.

John reappeared with the nurse. Evelyn hadn’t come downstairs this time; whether the bell had woken her or not, Mandy didn’t know. The nurse took the sterilized packages from his bag and shot some of the morphine into a tissue before injecting him. Mandy thought it was just as well Evelyn wasn’t here to see it. ‘If you can’t give Dad all of it,’ John said tightly, his anger just under control. ‘Can’t you give him something stronger?’

‘I’m sorry, Mr Osborne, there really isn’t anything stronger. But I’ll come as often as required to top up the pain relief. I can be here in under half an hour if necessary.’ Mandy saw the look on John’s face and knew exactly what he was thinking: half an hour was an eternity when Grandpa was in acute pain.

‘I suggested a live-in nurse,’ John said quietly. ‘But Evelyn won’t hear of it. She promised her father she’d look after him.’

The nurse nodded and Mandy looked away as he checked Grandpa’s incontinence pad, which he said was dry. He said he’d visit again at 6 a.m. unless he heard from them sooner. The anger had completely left John now Grandpa was out of pain; he thanked the nurse for coming and then showed him out. Mandy switched off the main light and returned to the armchair. She took her mobile from her bag and checked the time. It was 2.23 a.m.

She was half expecting an apology from John, but when he returned to the study he went to the bed, checked on Grandpa, and then sat in the other armchair without speaking or even acknowledging her. Opening his laptop, he began scrolling and typing, so Mandy plugged in her iPod and closed her eyes.

When she woke it wasn’t from Grandpa’s cries – she still had her earpieces in – but from a hand on her arm, holding too tight and tugging. She opened her eyes, at the same time taking out her earpieces. John was trying to pull her out of the chair. Although startled and disorientated, she was awake enough to realize Grandpa was sitting up in bed in pain. ‘What? What time is it?’ she mumbled.

‘Three fifteen. I want you to leave the room,’ John said, and propelled her towards the door.

She resisted. ‘Why? Have you called the nurse?’

‘No, there’s no point. It’s only an hour since the last injection. He can’t do anything.’

She jerked her arm free and stared into John’s face. His pupils were dilated and she could hear his breath coming fast and shallow. Grandpa cried out again and dry-retched. ‘I’ll call the nurse,’ Mandy said.

‘No, you won’t,’ John hissed. ‘He can’t help any more. There is nothing he can do.’ He was standing in front of her, blocking her way to the bed and phone, his face too close to hers. ‘Look at him, Mandy!’ he demanded. ‘Do you want him to go on suffering? Look at him. It’s pathetic!’

Mandy looked towards the bed as Grandpa screamed again. He was doubled up, his scrawny neck bent forward and barely able to support the weight of his head. Tears welled in her eyes. ‘Do as I say, Mandy,’ John said. ‘Go into the kitchen and stay there until I tell you.’

She held his gaze and panic gripped her. ‘What are you going to do?’

‘Don’t ask, Mandy, just do as I say. Go into the kitchen and stay there. If Evelyn comes down, keep her there too.’ The study door suddenly opened in front of her and she felt his hand in the small of her back. With one small push she was in the hall and the door closed firmly behind her.