August 20, 2010: the unbreakable umbilical cord

By Duncan McLaren , Friday 20 August 2010

Alphabet T This week writer Duncan McLaren accompanies his mother to hospital, where she is to have an operation
Duncan and MabelDuncan and Mabel

I arrive at the care home sharp at 9am. I’m taking Mum to Perth Royal Infirmary where she is to undergo a minor procedure. So I’m expecting there to be an overnight bag and a letter from the manager of the home which explains that Mabel cannot move anywhere without supervision. The last thing we want is Mabel falling down on to the cold, hard floor of the hospital.

Mum is dressed, her bag is packed, the letter is there, but she doesn’t have a clue what’s happening. What is happening? When I Googled 'prolapsed womb' I learned that it mainly affects women who have had children. So this is all my fault, one could say. Ironic that Mabel gave birth to me (and my brother) at home, but in the end she is still going to have to put in an appearance at a maternity and gynaecological department.

As we drive along, I look back at the chain of events that have made this expedition necessary. For some years Mabel has had a pessary keeping her womb in place. Every few months the device needs replacing, and increasingly this has become a problem. First, the long trip into the main Dundee hospital became too much for Mabel. We got over this when it was discovered that a consultant ran a clinic in our small town’s cottage hospital once a week. However, at Mabel’s last appointment he found it wasn’t possible to remove the pessary without causing pain. I was there, on the other side of the curtain, and I heard Mum’s loud 'Oh, here, stop that!'. I was disappointed to hear the consultant immediately abandon his efforts. Surely he appreciated how much more traumatic a trip to the hospital, a general anaesthetic, and the boredom of lying in alien surroundings for the best part of two days would be for his elderly and demented patient?

Mum wants to know if she’ll be cut up inside. I reassure her that she won’t be. In fact, we have a fairly sensible exchange, at the end of which I feel she more or less knows what’s in store. Nothing much will happen today. Tomorrow she will be put to sleep and the doctor will do what he couldn’t do at the cottage hospital. If all goes to plan, Mabel will be back at the care home tomorrow afternoon. In response to my squeeze, she squeezes the fingers of my hand. While my other hand remains firmly on the steering wheel.

We check into the ward with the help of a nurse. After half an hour or so, a second nurse introduces herself and together we fill in a form. Date of birth, allergies, and so on. I could answer these questions on Mum’s behalf in my sleep. Mabel couldn’t answer them at all, except for her name. Address? Mum grimaces and remains silent. I intervene. 'Next of kin?' The question doesn’t come close to computing in Mum’s head. 'It’s Ian, isn’t it?' I prompt. 'Ian?' says Mabel. I turn to the nurse and give her my father’s details as well as my own.

After a charming anaesthetist pays us a visit, the second nurse takes Mabel’s blood pressure. The figure is a little high, but not high for Mabel. On two of her emergency admissions to hospital her reading’s been up past 200. Today she continues to treat what’s happening as a low-key event. Which bodes well.

There is no-one else in the ward. On her return, I ask the first nurse if the other three beds will fill up as the day goes on, but she says not. 'We’ve put Mabel in this quiet ward because we know she has special needs.' What’s more, they’ve put her in the bed nearest the toilet to minimise the distance she has to zimmer. The nurse asks me if I can hang around for another hour or so, as there is a consent form that the registrar will have to go through with us. So I sit on a chair and chat to Mum about the birth of my brother and me. Both deliveries were difficult as we were such big babies, apparently. Whereas Mum’s sister, Alice, was the lucky one, in that she had two 'slips of girls' to deliver.

The registrar arrives and apologises for keeping us waiting. The young doctor needs to establish if Mabel is fit to give her consent to the hospital procedure, so she needs to ask her a couple of questions, starting with: ‘Mabel, what did you have for breakfast this morning?’

Mabel looks at me. 'What did I have for breakfast this morning?' she asks.

Two can play at that game. 'Well, what did you have for breakfast?'

Silence.

So that’s that: question one, over and out.

'Mabel, how many grandchildren do you have?'

Again Mabel looks at me. 'Two?'

'Well you have two children,' I say. 'But that’s not how many grandchildren you have. Is it?'

'Isn’t it?'

Perhaps Mabel does better than I give her credit for in this general knowledge quiz. Because in the end it is she who is asked to sign the consent form, not me.

Shortly after this I get to leave the hospital. Before I know it, I’m back there again, collecting my post-op parent, who seems none the worse for having had her ring pessary removed and a state-of-the-art cube version inserted in its place. Apparently, from now on the device will be removed, cleaned and replaced on a weekly basis by a district nurse.

What do these last two days prove? That my elderly mother has a large team of well-meaning, well-educated people available to help her? I think so. But I think they also emphasise that I need to keep playing my part, by staying reconciled to being Mum’s mediator.

How does one stay motivated in such circumstances? I don’t know the whole answer to that. But I suspect it’s not as easy to cut the umbilical cord as they make out in medical textbooks. Indeed, I have a vision of a man in a white coat holding metal-handled scissors trying to come between Mabel and me in 1957. 'Oh, here, stop that!' cries the voice I recognise above all others.

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