Goodbye Jim

For over three and a half years I have been visiting Jim. COPD burdened his body, but it was his battles with anxiety and depression that impacted his life the most. We bonded over our love for the Classics, history and a generous dash of silliness. It took time to build a strong trusting relationship, I ensured that I was always consistent and reliable, as the slightest of shifts in routine would have severe impact on his resilience. Most important for Jim was to always respect his choices, to be un-judgmental and promote his independence – despite him often making decisions that it seemed so obviously went against his health and wellbeing. But he had the capacity to make such ‘unwise’ decisions.

I would spend hours chasing appointments - for vaccines, mental-health, specialist COPD check-ups, and getting his end of life wishes formally noted. Jim, who worried fiercely about everyone else being ok, quietly acknowledged one candid moment that he would never have taken these steps to fight for his own wellbeing… almost questioning his worthiness. He affectionately called me his ‘bulldog’ because I relentlessly pursed what I believed he deserved, and I hope and like to think that this advocacy for him conveyed that he was well worth it to me.

Towards the end of September Jim’s health took a turn for the worse, which prompted numerous follow ups with the local surgery. One day Jim texted me to ask if I could pop in and see him, somewhat unusually, on a Sunday, as he had been particularly struggling that week. I arrived to find him unable to speak – yet when I asked him if I could call 999, he shook his head. I proceeded to try and provide fluids, but he struggled. I asked if I could call 111 for advice and he thankfully agreed. The 111-agent wanted to call an ambulance as he deemed it an emergency and, eventually, Jim nodded in agreement.

As I ushered through the ambulance crew, the reality kicked in so quickly it made me gasp. I checked myself and put this to one side. Jim was extremely sensitive to others’ moods and at I knew I needed to stay sharp, calm and convey confidence during such an ordeal. I had pre-prepared a hospital bag, and quickly added his list of medications and DNAR form. I kept Jims’s light on, which he often anxiously reminded me to do should he ever go to hospital.

I travelled with Jim in the ambulance answering all the paramedics questions and reassuring Jim at the same time. It became evident that Jim was actively dying, gasping for air, but he was resolute in refusing treatment. This was upsetting for of one of the doctors, who was so desperate to help. But as badly as I wanted Jim to receive treatment, I knew that this is not what he wanted, he had made it clear to me and others, so many times in the past. He had simply had enough.

He looked at me in desperation, panicking that they would override his choice. Time for me to ‘bulldog up,’ and ensure that his wishes were honoured.

Fortunately, in the hospital a lovely Consultant came to talk to us. He told us that Jim was dying, and oxygen would only prolong his life for perhaps a few days. He gently agreed that there was no point in this if it was going to cause Jim upset, and instead asked permission to administer drugs to ensure that the end would be pain-free. Jim accepted and expressed his thanks through gasps and squeezing my hand very tight.

Jim’s next of kin arrived and I explained the situation. We stayed by his bedside until late in the night, telling each other stories of cherished memories with Jim, and he gave the odd chuckle as he listened in, now more peaceful thanks to the pain relief. She told me she needed to go home but would be back in the morning, so I decided to stay. The doctors did not feel that he would pass away that night, but I was not prepared to take the chance. The nurses were very kind and set me up a little bed beside Jim’s.

I listened sharply to his breathing throughout the night, and Jim would periodically indicate when he wanted me to wet his lips with water. In those solitary hours I allowed my thoughts to wander, reflecting on the path we had shared together. I felt it was a profound privilege for a Companion to be there right at the very end.

At around 4.30am his breathing changed subtly, I held his hand with a lump in my throat, and my heart sank. I knew the inevitable was imminent, yet was somehow still hoping for every breath to come. I even found myself holding my own breath at times, waiting for his. I consoled myself that Jim was ready to be free, and this was his final and only wish. A nurse came in and again suggested Jim take some oxygen, and again I informed her that this is not what Jim wanted. She looked a little confused but nodded and left. Jim looked at me in the dim light of the dawn, a little tear in the corner of his eye – I like to think it was a thankful tear.

When Jim finally passed later that afternoon, I hoped that he left with the feeling of being very well-loved, that he knew my care was genuine, and that I had did my very best to support him – preserving his wishes and dignity right up until the very end. Rest in peace Jim.