Medical vignettes, number 4

sandyThe House stood in its own seven acre grounds in an isolated spot in the valley. Originally built as a Hunting Lodge, it had changed hands at the end of the eighteenth century on the turn of a card.

The new owners set about transforming it into a spacious forty room family home complete with a south facing first floor balcony and a walled vegetable garden. Built on a sand fault that runs across the valley it was further enhanced by a large stand of tall and colourful rhododendron bushes.

The owners lived here with their two daughters. Early in the twentieth century one of them developed breathing difficulties. Her mother took her to London where in Harley Street she sought the advice of an eminent physician. The great man examined the child and then declared that what she needed was simply fresh air and lots of it. In fact he insisted that she should at all times sleep outside. She was then instructed to return for review in three months time.

As mentioned, the house included a large lead floored balcony leading off from two of the bedrooms and it was to here that the young woman was consigned and where she took up residence.

At the end of the three months she returned to London for her review appointment only to find that the physician had unfortunately passed away on the previous day. What to do? Her mother was sure and determined. Her daughter, who thought that her banishment to the balcony was for but a short time, was informed that henceforth, while she lived in the house and as her health had apparently improved she would continue with the current sleeping arrangement.

Until just before her death in her late eighties, she never left!

I appeared on the scene in her life in the late seventies. The house and grounds had deteriorated, the parents long since dead and the sister moved away. My patient lived on her own in one room, the kitchen, of the now largely unfurnished and somewhat eerie mansion. She had for many years kept a small herd of Jersey cows which she continued to hand milk into her eighties with the help of a neighbour. Her only companions were her two faithful collie dogs.

She was never ill or needing of my input so it was not until her middle eighties that our paths converged. A phone call at 2 am summoned me to the house as an emergency. On arrival, there was no one to meet me and no lights. With only a torch, I made my way through the back door and kitchen into the pitch black main body of the empty house. Boards creaked as I climbed the stairs and made my way along the landing. A bedroom door was open and a slight glow visible through the window. I entered and made my way through the French window onto the balcony.

In the middle was what appeared to be a large tent suspended by various hooks from the ceiling. A wheezing noise emanated from within this construction. Announcing my presence, I gingerly turned back one edge of what transpired to be a weather proof canvas tarpaulin and was met with what I can only describe as a biblical tableau.
The patient in the great respiratory distress of heart failure lay on a crude rough wooden bed construction. On this was a straw palliasse mattress, the scene illuminated by a single candle. On either side of her propped up body, both sitting bolt upright like sphinxs or Pharoah hounds at the head of the bed were her two collie dogs gazing with what I can only describe as a mixture of malevolent intent to me, but concern for their mistress.

Two intravenous injections administered with some trepidation under their watchful gaze happily returned matters to normal. Her breathing settled, she fell into a peaceful sleep and I snuffed out her candle and withdrew, still under intense scrutiny.

Unfortunately, twice more in the next few months I had to make a repeat of that journey in the middle of the night and on both occasions was met with the same scenario. Eventually, those with responsibility decided to move her into care where she died very shortly afterwards.

The memory of that first encounter though, has remained etched in my brain forever.

Sandy Scott

December 2019-January 2020