Today’s ABC Radio National Essay

Hospital is Another Country

My 83-year-old mother is in hospital. I sat in the front seat of the ambulance, Mum’s handbag and a pair of slippers in my lap. This is it, I thought. This is the day it will happen. This is the day my mother will die.

What did we talk about when I saw her yesterday? Did we argue? Oh yeah, she’d told me to make sure I wore a greeny-browny silk scarf to the gig I was doing that night, and I’d suggested back that she stop telling me how to dress given I was over fifty now. Then she’d said that at my age I should always wear a nice scarf because your neck will always give you away no matter how well you take care of yourself.

The ambulance driver tried making conversation with me but all I could hear was the other ambo in the back with Mum.

‘Can you hear me love?’ he asks her.

‘Does she speak English?’ he asks me.

‘Yes. Very well.’ I tell him. ‘Her English is better than mine. She corrects my grammar and she reads voraciously and she was an English teacher and she’s very smart and independent and…’

It must have been her Italian surname.

‘We’re taking you to the hospital now love. Your daughter’s here.’

‘Mum? I’ve got your bag.’ Like she cares about her bag.

I’d expected to sit in the back of the ambulance with her. You know, holding her hand reassuringly. But they don’t let you do that in real life apparently. So I’m sitting up front and the driver is asking me something again but I can’t make out what she’s saying.

This is one bumpy, noisy and fast ride. I realize I’ve brought the wrong slippers; these ones ‘have had it’ she reckons.

When I’d gone to Mum’s yesterday to pick her up for our daily walk in the Botanic Gardens she’d said she felt too tired to walk. I’d tried to cajole her into getting dressed. Sometimes one of us is too tired or too low so one usually convinces the other to snap out of it.

‘Everything always feels better after a walk,’ I’d said to her yesterday. ‘Come on, the blossoms out. Get off your bum.’

I spend the next 12 hours with Mum in the Emergency department of a large regional hospital. At one point, about 3 hours into the wait for triage, she and two other elderly lady-ducks are all lined up on their trolleys against the wall in the corridor like, well, ducks, all flying high with delirium.

Mum tells me to put a clean singlet on my sister who’d be in her late 40s, if she were still alive that is. I offer some water to another woman, who takes the paper cup in her paper-white hand and calls me Patrick.

My mother is staring up at me and I have never seen this expression in her eyes before; startled, unrecognizing, blazing.

‘Does she know who I am?’ I ask the ambo who’s been waiting with me all this time.

‘Love?’ he almost shouts at her. But then it’s so noisy in Emergency – all the beeping and buzzing, talking and dashing about that maybe she just couldn’t hear me earlier when I’d been holding her hand and stroking her feathery silver hair.

‘Love? Do you know who this is?’ he’s ushering to me to come closer now. Mum appears to nod and tries to speak but nothing comes out.

My friend is with me and she stays a long time. She must have followed the ambulance in the car but I hadn’t really noticed her until now.

Eventually we get moving. Mum is wheeled into a small area behind a blue curtain and it’s hard to stay close to her because so many people are around her now asking questions, speaking about things I don’t understand.

She has a temperature of 105 and is muttering all kinds of crazy stuff. Every so often she tries to leap off the trolley, so I hold her, steady her, cradle her in my arms to prevent her falling off the narrow wheelie bed and onto the hospital floor, ripping at all the tubes and leads.

During the course of the night I drink cups of tea and eat white bread sandwiches from those plastic triangle shaped boxes. I wander the ward and over-hear all sorts of things that ought be private. Sick people, exposed people, doctors, nurses, cleaners, families, friends, we are all here: compressed humanity up close and personal.

Hospital is another country and I have been living the hospital life for the past twenty-two days now. But although I am l beginning to learn the language and to eat the food of my new country, I will never be accepted as a local. I will always be that middle-aged daughter who comes to see her sick mum every day, asks too many questions and doesn’t stop tidying up and rearranging her bedding and flowers.

She’s like her mother isn’t she, I imagine the nursing staff saying, she really speaks her mind and is so bossy.

On good days Mum and I talk and gossip and on bad days she just lies there quietly furious and shocked with her recent and uncharacteristic decent into indignity and powerlessness. Handing over is not in Mum’s DNA, neither is being cared for.

This large regional public hospital never stops. It seethes and functions like one massive sighing, grieving, struggling, sucking, weeping, eating and purging single organism.

The hospital is under staffed, there are not enough beds, the food is awful, the air is too warm, the nurses are efficient, their use of language often more pre-school teacher than medical professional, the doctors are either inexperienced and tentative or less entertaining versions of Doc Martin. Although some are so wonderful and kind you can’t help falling in love with them just a little bit. Everyone is this place is run off their feet and working like dogs.

In her recent Quarterly Essay, ‘Dear Life: On caring for the elderly’, writer and Dr. Karen Hitchcock observes: ‘All general medical departments are under enormous pressure to treat and discharge patients as soon as possible. They have such a large number of patients that extending each patient’s stay by even a single day would cause emergency departments to choke up. However, elderly patients are complex and time is needed to offer them the care they need, to talk to them about their wishes, listen to their experiences of their illnesses, and together forge ways to make their lives bearable. To do well, patients need to eat, move and remain mentally active in hospital – three things the hospital environment specifically hinders’.

Mum is being discharged next week, they say, and will be able to go back to her home. But it remains unclear how will she be changed and how she will re-adapt. She is scared stiff. So am I.

Today she talked her head off about politics and our recent change of leadership.

‘You watch’, she said. ‘Shorten will step up now. You just wait and see.’

Then she demanded I take her credit card and go pay her rates, wash her nighties, and buy myself a decent set of saucepans and a new greeny-browny Italian silk scarf.