Ghost town

I drive through the streets of my next door town, past the houses of former patients and perceive the ghosts.

Not actual ghouls, more their memory, the ripples in time and space left behind.

It’s weird.

My experience of that town is different to almost every other citizen.

I am a strange connection between disassociated souls.

Most are old, many had been living with dementia, severe frailty, or advanced old age before their passing, yet little beyond that commonality; Me, their doctor, they citizens. That is it.

I remember the house of A with his back door left open for Rover who would never return.

I remember B with her silken collie. Silk Cut and tidy front room.

C, headmistress, would perform Gilbert and Sullivan in her prime.

D coughing in bed, immobilised by motor neurone, or E, my other patient also with MND who, on our first meeting recited from memory verse after verse of Burns.

F old farmer, one of my first experiences of supporting a patient to die at home, in my early days, learning the relationships between family, the community nurses and me.

G who fell, broken hip and never left hospital.

H never stepped foot over the threshold of her door for a year of Covid, who on my advice went to hospital and did not return.

I and his tortoise. Who will tend to his hibernation now?

J, crooked neck, the remnants of Polio, organised garden and sailing awards.

K, ragged beard, depressed right up until the end.

L in her 90’s independent, overseeing an orderly home until it all fell apart.

M and the weekly flowers sent to her by late husband via intermediary long after he had passed.

N, I called round to head-off the police who had been called accidentally, allowing a dignified end.

O admitted to hospital against her wishes and all manner of treatments before death.

P, kind with a wonderful humour who was moved from care home A to hospital to care home B, then C, around the town like a chequerboard piece and then he went.

Q from Dumfries.

R and his tractor.

S and her cigarettes in the front porch.

T, her Geordie accent that made me feel good.

U, black Labrador at his feet.

V who said I was a ‘pussy’ embarrassing her family and making me laugh.

W former miner, man mountain whose final illness diminished his stature.

X nebulizer humming, wheezing away, asleep sitting up.

Y rake thin and feisty.

Z are all the rest, too many to count, all gone, all passed, and I think of the privilege of my work, meeting these people, with my burden of care and treatment, my plans for support all intermixed with their family’s fears and hopes. Here then gone. Dust to dust. I don’t attend the funerals. There would be too many and what would I say? ‘I remember when the doctor would…’ Says a patient, ‘Times have changed,’ I reply. I don’t feel sorrow so much as the absence, a lack of these souls. I wonder if they were all alive today what would be, how would they exist. Not a productive analysis. Most were at the end of long, painful disease or illness, they may not thank me for dragging them back from the other side. We are born and we die. We pass through this life with one chance to make a difference, to influence others, share hope and love and then, it is over, and we are dust or bones in the earth. I don’t pray as I have no belief. I hold them in memory which for me is a kind of remembrance. In my religion, yes, I am the solitary Jew, death is annually commemorated through Yahrzeit, a Yiddish word meaning year-time. In the week following the death of a parent or partner there is a special seven-day candle. My mum’s candle is still in my house, the Yahrzeit I never remember although each time I see such a candle in the shops I remember and that is perhaps adequate. Many of my patients in their last weeks see the end, perceive, as in the Book of Daniel, the writing on the wall. They know. Some resist. Refuse to accept the inevitable and I usually support them in this perception; no point in ending hope I suppose and no, I don’t know the future; ‘How long do they have left,’ I am asked. Last week I learned, an appropriate response, which is not the time left, it is ensuring that every day counts. Seeing that there will be an end, for me, for you, dear reader and assuring that time is not wasted, that the hope of a do-again is acknowledged as futility. Live your life.