Since retiring from her career as a suburban solicitor, Kerry had been working one day a week for nearly five years as a volunteer driver for a community transport agency. It was a free service, intended for people either too sick, disabled or impoverished to travel to medical appointments by public or private transport. She had come to know a number of the regular patients while jockeying them to various clinic treatments, doctors and therapists.
One regular was Pam, who lived in a local nursing home. Despite severely compromised airways, she remained optimistic and loved to chat – her main chance given most of the other home residents had varying degrees of dementia. During their trips, Kerry and Pam talked about their histories and the news of the day, and marvelled at the behaviour of other drivers.
Pam never talked much about her family, and it seemed to Kerry intrusive to ask about her illness, but she learned over time that Pam’s husband had died at their home in Adelaide a little over two years before, from a lung disease similar to that from which Pam herself suffered. There was no effective treatment, and she faced a lingering decline.
Pam had a fractured relationship with her only child, a daughter, and had moved to Sydney in a bid to restore the bond. The daughter had responded by moving away to the mid-North Coast. She had not given her mother her new address, which deepened Pam’s sadness over the rift.
After a few months of their shared journeys, Pam answered Kerry’s knock one day in a mask attached to an oxygen bottle. Her breathing had become more difficult, and speaking was an ordeal. Together they worked out the mildly complex process required to get a frail lady, walking frame and air supply into a small sedan. Extracting them all at the destination was more of a challenge, and they shared a delicate “high five” when they accomplished it.
Communication was hard, and Kerry did most of the talking. Pam’s eyes were left to speak of her love for Kerry and their time together.
A couple of weeks later, Pam’s name was missing from Kerry’s Run List. Kerry asked the agency transport co-ordinator, Anna, if she knew any more, and discovered that Pam’s condition had worsened and she was in a hospice, receiving palliative care. A few weeks on, Anna rang Kerry at home, passing on a message to contact the nurse supervisor at the hospice.
Louise, the palliative care nurse, was a little apologetic about the contact, and said, “As you know, Pam’s condition is terminal, and she has weakened significantly over the last week. She is in no pain, but her breathing depends entirely on bottled oxygen. At the moment it seems unlikely she will last long.
“She is drifting in and out of consciousness, and asked me to reach out to you.
“There’s no easy way to say this, but Pam would like you to be with her when she passes. She has no family to speak of, her daughter has refused to come down, and she sees you as the best person she knows.
“I know it’s a big ask, but it would mean a lot to her, and to all of us who have come to know her.”
It took a little while for Kerry to take this in. Even though she adored Pam, their relationship had only been within the context of volunteer driver and patient. And yet, in the circumstances, how could she refuse Pam’s request? She told Louise she needed some time to think, and promised to call her back soon.
Kerry thought of her own family; close, warm and supportive, even if sometimes a little too outspoken in their opinions of the best path for her. How could she, an outsider, assume a role she thought properly belonged to a blood relative?
On the other hand, the reality of Pam dying alone, unsupported, was more than she could contemplate. So, she rang Louise to say she would be honoured to be there.
Louise was grateful, and told Kerry that they would slowly increase the morphine until Thursday afternoon, then reduce the oxygen to allow Pam a peaceful death.
When Kerry arrived, she needed to mask and gown up, which seemed excessive in the circumstances, but what did she know? She entered the room where Pam lay, a shadow of the vibrant woman she had been, grey and connected to machines, and took her hand. Pam’s eyes flickered open, and she gave a hint of a smile which told Kerry all would be well.
Kerry sat by the bedside, talking as they had done in the vehicle and recalling crazy drivers and politics and weather events while Pam gradually ebbed away. When Louise came in to turn off the oxygen, Kerry could not bear to watch her turn the controls. She began to sob as the monitors gave out the steady tone which indicated Pam’s life had ended.
Kerry sat with Pam for a long time afterwards, dwelling on their relationship. Finally, she rose and began to walk wearily back to her family, her life and her future, saddened but enriched by all she had encountered.
Editor’s note: Names have been changed to protect privacy.