Manslaughter - Guilty by Definition

By: Adam Shaw

After over 13 years working a nurse I had witnessed some weird and wonderful things. Occasionally, one of them stands out as significant. Back in '97-'98 I went to Australia with a one year working visa. During this time I worked for nurse agencies in Melbourne, Perth and Sydney. The experience was a good one as I was able to see how another health care system worked.

During this period a stack of interesting experiences occurred for me, though the most significant happened in Sydney. What happened here would alter my perception of life and what nursing was all about.

Working as an Agency nurse in a city usually means working at several different hospitals, in several different wards. This had been my experience after 11 months in Australia.

For some reason I'd been allocated several consecutive night shifts on a rehabilitation ward, in a private hospital. Since this ward was generally quiet for most of the night I usually brought a book along with me to pass the time.

To find my next book I went into a second-hand bookshop, went to the New Age section, stood back and waited for a book to grab my attention. One soon did - The Tibetan Book of Living and Dying. I picked it up and started to read it that night.

The opening chapters explain, amongst other things, that the main difference towards death in the East and the West is that in the East people are generally prepared for death from a very young age. The West has a general theme that we don't usually face up to death until it's staring us in the face.

This resonated with me. How true. I had seen it on numerous occasions - scared patients and hysterical families attempting to make sense of the impending demise of a loved one after being given a death sentence by a doctor.

I thought about this a lot during the next couple of nights.

During my time on this rehabilitation ward I got to know the patients quite well. Each night I would stop in and have a chat with each of them, handing out the assorted pharmaceutical delights, which they had become accustomed to.

One of my patients was a lady called Dorothy. She had fallen over at home several months ago. She had no medical history, just a case of bad luck. She had a lovely smile and a most pleasant demeanour.

After about eight shifts on this ward I went in one night to be informed that Dorothy would be going home the next day. I entered her room last that night so that I could have a longer chat with her, beyond the cursory 5 minutes that we usually spent together.

'Congratulations. You must be delighted,' I told Dorothy, as I walked into the room.
'Huh! Delighted? What possible reason would I have to be delighted?' Dorothy was unusually curt in her response.
'I don't understand. Are you not happy to be going home?' I asked.
'What have I got to be happy about. I live on my own and I can barely make it from the bed to the toilet. I'm dependant on someone else to do my washing, cleaning, shopping and cooking. I can't ask my daughter to look after me - she has enough on her plate. She has two young children and a very demanding job. I have absolutely nothing to look forward to.'

Upon hearing this from this sweet, usually smiling, old lady I found myself momentarily speechless. I had not expected that from her. My mind went blank.

After a prolonged pause I asked her, 'Do you believe in life after death?'
Then it was Dorothy who paused, before looking me in the eye and saying, 'Well, I'd like to but I just don't know.'

This prompted a discussion about life after death and some various perspectives that I'd come across at that stage. We talked for well over an hour and a half. I mentioned the Dalai Lama being reincarnated several times and that this was fact according to millions of Buddhists across the world. I'd also heard about a Native American Indian ritual whereby people knew they were about to die and sat around a fire and gave all of their worldly belongings away. This was their way of cutting the ties with this world and moving on to the next.

I had not thought about death too much before - but given the choice between life after death and no life after death - I knew which one I preferred the sound of. Despite this, I wasn't sure either way.

At the end of our chat Dorothy grabbed my arm and her face lit up. 'Thank you Adam, this has been the most useful conversation that I've ever had.'

Her words touched me, though I thought little of it at the time. She had been experiencing anxiety and I had said something to alleviate it. I'd done this numerous times before. I wasn't really sure about what I'd told her but she seemed happy enough, so my job was done.

I looked in her room before leaving the next morning but Dorothy was sound asleep, so I left the ward and went home.

That night I went back into the same ward. As I arrived, there were doctors running down the ward and into the room that Dorothy had been in. I wondered what was going on, as she should have been discharged. I slowly made my way to the room and Dorothy was flat on the floor and the crash team were attempting to resuscitate her.

I went numb at the door as I witnessed the futile attempts of the crash team to resuscitate her and the subsequent disbelief of the entire ward staff. Dorothy had no medical history - this was out of the blue. I'd been responsible for the death of Dorothy and I was the only one that knew it.

After I had watched the resuscitation team in action and gone numb, I felt a resounding peacefulness permeate my body. Had Dorothy waited for my return to die?

I'll never know this for sure. What I do know is that any doubts about whether there is life after death were eradicated for me that day. For all of the books that I had ever read on or around the subject, nothing had ever, or indeed has ever, come close to what happened on that ward during those two nights.

I dedicate this article to Dorothy and thank her for the gift of hope beyond doubt that she has given me.