"Get out of here Mary. It's no use coming in here unless you try to buck your ideas up." Mary would retreat from the little coffee annexe just off the Big Room with where the piano was. Mary was her sister. They were born, Lillian in 1901 and Mary in 1909, in Limerick, Ireland. Ireland in those days was fairly turbulent and their father and mother had friends already down here in the colonies. They had been following the gold trails. The family had decided to give it all away back home and come to New Zealand for a quieter and more peaceful way of life.
Gisborne was a pretty way out place, as it is today, being off the 'main drag' between Wellington and Auckland. It was something of a culture shock for all of the family, Lillian, Mary and their ten brothers and sisters. Their father had prospects of a good job in Gisborne, but they weren't quite prepared for the dark-skinned people living in the Gisborne area. The marae, with its huge pitched roof of elaborate wood carvings dominated the community. Its huge corner posts depicted warriors sticking their tongues out, grasping thick spears and what looked like curved rocks.
They all survived, thriving for some time there. Lillian grew up strong and capable and believed she could make the world run around after her. Bryan, owner of his "Living Futures" rest home regarded her as his 'ideal resident' even though he loved the old dears with alzheimers and their funny ways, too. They included Mary, little Mary, only four feet eleven inches and as thin as a pin.
Mary had lived a long and mostly productive life, bringing up her family in the depression times of the 1930's. Her husband Jack had lost his job as a farm manager and the family, including their two daughters later moved to Auckland.
"Lillian, please do not ram Mary's walker again with yours. It's not very nice, you sisters carrying on like that." said Bryan, a look of anguish on his face. "Don't you love her any more?"
"Course I do. Silly Mary. She's got to pull herself together, that's all I say. She should stop talking in monosyllables and about Jack coming to visit her all the time. He's dead. Died of cancer years ago. Why does she say he's still coming?"
"She can only remember the things of the past," said Bryan, weary of explaining all over again how alzheimers works, so to speak. "Can't you understand that?"
One of Mary's daughters, who lived nearby, was the reason Mary was placed in Living Futures rest home. It was to be near her family and her only surviving sister, Lillian. Mary's daughter told Brian about the onset of Mary's alzheimers. First of all it did not affect her sunny nature. Mary had always been loved by all. She had been a lovely child, even in those harrowing times in 1919 when the great influenza epidemic struck New Zealand. You would read the papers day by day for about six weeks and see the columns of deaths in the births, deaths and marriages section. For a start, the cause of someone's death was mentioned - '....of influenza at the hospital'. Then after week or more, no more mention of the cause of death, if it was influenza. It had been too distressing.
It was thought that troops coming back from the awful battles at the end of the war, where the Germans developed machine-gunnery to a fine art and mowed down tens of thousands of Empire soldiers in a last ditch stand against their opponents introduced this strain of influenza. Coming back to New Zealand in mild spring weather, conditions were perfect for breeding the deadly virus. It spread like wildfire.
Lillian and Mary's parents were early victims. Alive, bustling and well one week, dead, cold and buried the next. Both of them. Whole families had been wiped out, already decimated to the extent of some 10 percent of all deaths reported in the papers for the four year period of the war. Young men who had been "killed in action, died of wounds, died of illness, died of accident" in that vast European conflagration.
Lillian brought the rest of the family up; not being even twenty years old yet. She had plenty of help from friends, especially amongst the Gisborne Maori community. Their older brother Sean had begun seeing one of the local girls, a young Maori girl, and after a while decided it was time to take her home to meet the orphan family. All the children waited outside for them, eagerly awaiting their arrival and wanting to be first to spot the Maori girl. Upon seeing them they all ran back to the house to compose themselves and try to be the picture of a well behaved, good mannered family. You can imagine their surprise when on being introduced, the Maori girl kissed each one of them in turn. They met her family, accepting and liking the freedom and friendship of the Maori community. Eventually Sean married his young lady and they had many children themselves.
Mary was diagnosed as having alzheimers soon after her husband Jack died. She was still a young woman, in her late forties. It was noticed by friends and neighbours that Mary was becoming confused and forgetful. Going to the shop and forgetting what she wanted. Not cooking meals for herself, having thought she had already eaten.
Lillian recalled one instance that particularly disgusted her. "Bryan, do you know what my foolish sister did once?"
"No, but please don't tell me again." Bryan tried to joke. Being told the same stories over and over was part of life in a rest home, especially when the old dears gathered round the big rosewood piano in the Big Room on Sunday nights when their families usually came to visit.
"She got this little dog. Somebody must have given it to her. She lived on her own then, couldn't pull herself together to be of use to anyone...."
"Now now," cautioned Bryan, please be a little tolerant. "You might be like that yourself, one day."
"No I won't," Lillian shook her walker vigorously. "Mary still had this old coal range which she cooked on. Hadn't enough wit to buy one of the new cast iron electric ones. She would rake out the embers in the morning, opening the door to the oven on cold days so her little dog could climb inside to keep warm. On one of her 'silly' days Mary forgot her little dog was inside, shut the door, stoked up the fire and went to the shops no doubt forgetting what she went to buy. You know what she found when she came back?"
"I shudder to think," Bryan winced. This was the bit he always hated.
"One well roasted, flavoured pet!" Lillian shrieked with laughter.
It was a good job Bryan was an expert on alzheimers. He sighed. Lillian's response to her sister had given her meaning in her life, which was as tightly confined as the other old folk, in Living Futures. You were in a situation where everybody existed together and the 'infighting' was as part of the whole as anything else; the get-togethers over the piano and everything else.
Most of the ladies had alzheimers. Visitors, such as Bryan's cousin Terry from Dunedin, were approached by Jessie very enthusiastically, when they visited.
"Do you know - do you know....." Jessie, breathlessly would say, "my husband John is coming this afternoon, at three o'clock. I must away to my room and tidy up. He visits me nearly every day, you know." Jessie would hurry off and Bryan would sigh, explaining to Terry that Jessie's husband John died many years ago but she has forgotten about that as well as many of the others things in her life. She would be back in a few minutes to tell Terry the same story. For Jessie, John would be alive always. And so would she be.
Mary's main activity was to walk constantly day and night until she tired. Then she would curl up and go to sleep wherever she happened to be. Lillian would follow her, from a distance.
One day Bryan decided to follow Lillian who was following Mary, to see what was happening. He did this sort of thing from time to time, so that he wouldn't be caught out not knowing what to do if things got out of hand somewhat. He didn't want one of his dear old ladies to become distressed for no reason, or because he didn't know what to do.
Mary began walking and Lillian followed, being watched by Bryan. Mary found the first bed she came across, curled up and went to sleep. Lillian gave her a few minutes then went into the room. "Here, get up you silly old lady," Lillian said stridently, "You're not supposed to be here. Go back to your own room."
Mary got up and obediently moved on. "Bossy bitch," she muttered to Lillian's back, as she went down the passage.
"This is the place?" Ernie back the ambulance into the narrow driveway, stopping just short of the door. "Been here before, I think". Ernie had been on the job for a lot longer than Dave, who was just new to the job, really. Picking up old ladies from rest homes to take them to the hospital was routine. Lately though, with the health cuts by the Government, rest home owners were being encouraged to show more restraint at calling up the ambulance. Especially late at night, when special wage rates applied.
Dave flipped down the stretcher wheels and trundled it through the open door where Bryan was waiting. "She's in here, poor old thing." he said.
"And what's wrong with her," said Ernie importantly. He hoped this woman wouldn't snuff it on the way to emergency. That sort of thing was always upsetting for a medic. Too many questions to answer. He'd rather the interns deal with that end of the job.
"Heart," Bryan said. "Off colour all day and very grey and.... well, she doesn't mention pain much, but....."
"Well let's get her loaded up anyway." The trip to the hospital was uneventful and the woman seemed stable. After passing her on to hospital staff Ernie and Dave hung around, drinking coffee in case of another call before their shift finished at three in the morning.
"All seems to be stable to me with this one," the young doctor rostered that night said to his companion. There were only two doctors on duty that night. The big rugby match last weekend had resulted in the shifts getting gummed up and since leave was due to so many of the interns, only two doctors were rostered for this night. There had been a series of doctor strikes in the country for the last three weeks for better pay and conditions. The Government was trying to get health out of the public sector, like in America, so that they could make tax cuts and be re-elected.
After a few tests, little was found that the doctors could see as crucial or life-threatening. Usually, patients who arrived this late at night, or, rather, early in the morning were kept overnight, especially cardiac patients where anything at all could go suddenly wrong.
The young Pakistani doctor, who knew a little more than his colleague about cardiac things checked to see if Ernie and Dave were still rostered. There might be some trouble getting an ambulance organised after three o'clock. And the bed for overnight was out of the question. Wards were being closed; rationalised, some said even though it was feared that this process might affect 'patient outcomes.' Patients were regarded by the hospital authorities as 'Income Generating Units' , or IGU's these days and treatment had to be kept within the criteria of each illness description as far as cost went. Otherwise the hospital would lose 'operations' to make up that cost deficit. Generally, good patient outcomes were being edged towards younger people in the community. Too much treatment for the really old was not seen as cost effective in terms of the total health care budget allocated. Already, some old folk were being refused dialysis treatment because of their age.
"Okay, nothing we can do for this one here, and there's no bed available, so take her home please." Ernie's lip twitched when he heard that command from the doctor. He could see it as just another imposition on medics like him, increasing the risk for him if something went wrong.
"Righty-ho - here we go." They humped Mary up on to the stretcher, her tiny body nearly all bone and with bright staring blue eyes, wide with surprise.
"She doesn't know much about what's going on anyway," Ernie said to Dave in the cab as they sped back to Living Futures, "I've seen 'em before."
"You bloody fools....." Bryan yelled down the phone to the hospital registrar. "The media's on to me - you've really stuffed up this time. The whole country is buzzing over this." Bryan slammed the phone down and did the necessary deed, ringing the undertaker. A deed he had had to do many times before. They didn't call his home a twilight zone for nothing. The old folk came and they went. He loved them all the way. Then this happened. Somebody would pay.
Mary had a heart seizure not ten minutes after being delivered back to Living Futures. She was dead within seconds. The bright blue staring eyes had opaqued; become sightless.
"Fancy sending a poor old 87-year old lady back home from a hospital at three in the morning," Bryan told the television news show host over the phone. He refused to appear on the show. The tragedy would have been sensationalised. Anyway, it was big news for a whole week. The radio talk-backs buzzed with indignant people.
There had been an 18-bed ward adjacent to the A & E at the time, with nobody in it. It turned out the hospital would have had to have got emergency nursing staff for just one poor little old lady, to enable her to stay the night.
Lillian was inconsolable. "What am I going to do now? I've lost her - my only dear sister. What have they done to her." Bryan could not tell her. They gathered round the old piano the next Sunday night in the Big Room. They sang songs, sad ones, and told stories. Each story of a full long life and what it meant to them.