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Sep 22, 2013


Lacuna, defined in the Oxford Dictionary as a Hiatus, blank, missing portion, empty part, seemed to be the picture of the world to J, whom on the death of his exhausted mother, becomes the sole carer of his aged father who is in an advanced
state of Alzheimers, in a confused, agitated South London where mobile phones and iPods, both addictive and sedative, are background Muzak to more serious displays of road rage, street rage and drug activity.
Encountering a Health Service whose professionals find it as difficult as him to reach down into the heart of this unseen, ungraspable disease he is forced to seek innovative ways of dealing with the daily problems.
A chance meeting at his local pub provides him with an informal support group. Three men that he meets in the late evening several times a week become to him the Three Wise Men, affectionately abbreviated to TWM.
ln the third year when his father takes a serious fall they enter into a world of medicine which is advanced and competent but where 'nursing', has become clerical rather than physical, and where 'care' has been marginalised by pseudo
professionalism. Whilst grim duty never goes away what began as a five year retreat from Moscow becomes in part a rewarding internal Odyssey. A gradual retrospective view of his father's early imperceptible decline does bring a degree of understanding and the lifelong unbroken friendship between them is reconfirmed.
Sep 22, 2013

Informazioni sull'autore

Born of Irish parents, Sean Rian has lived in London most of his life. Now retired and divorced, after intensive involvement throughout the years in construction, property and travel, his main preoccupations are serious reading and extensive travel.

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Lacuna - Sean Rian


2013 by Sean Rian. All rights reserved.

No part of this book may be reproduced, stored in a retrieval system, or transmitted by any means without the written permission of the author.

Published by AuthorHouse 08/13/2013

ISBN: 978-1-4918-7544-5 (sc)

ISBN: 978-1-4918-7545-2 (e)

Any people depicted in stock imagery provided by Thinkstock are models,

and such images are being used for illustrative purposes only.

Certain stock imagery © Thinkstock.

Because of the dynamic nature of the Internet, any web addresses or links contained in this book may have changed since publication and may no longer be valid. The views expressed in this work are solely those of the author and do not necessarily reflect the views of the publisher, and the publisher hereby disclaims any responsibility for them.

John R. Ryan

37 Penrose Street

London SE17 3DW

TEL. 0207 703 3448


Chapter 1

Chapter 2

Chapter 3

Chapter 4

Chapter 5

Chapter 6

Chapter 7

Chapter 8

Chapter 9

Chapter 10

Chapter 11

Chapter 12

Chapter 13

Chapter 14

Chapter 15

Chapter 16

Chapter 17

Chapter 18

Chapter 19

Chapter 20

Chapter 21

Chapter 22

Chapter 23

Chapter 24

Chapter 25

Chapter 26

Chapter 27

Chapter 28

Chapter 29

Chapter 30


About the Author

To my Mother and Father

LACUNA—Hiatus, blank, missing portion, empty part; cavity in bone, tissue & C.

The Oxford Dictionary.

Chapter 1

The nurse told them, ‘Sit and talk with her, but please do not let her take off the mask.’

His mother’s hand was already rising to her face and quickly reaching out he gently took hold and reassured her that he would talk today and that she could do so tomorrow. His father sat within his silence, leaving his son to improvise a monologue that was beyond recall by even the following day.

It seemed all too brief before the nurse returned to remove the face mask and substitute a nose intake so that she could swab out his mothers mouth and give her some pills and fluid.

When the nurse finished the son said, ‘Let me give you a kiss before the mask goes back on.’ He stopped to do so and then signalled to his father to follow suit.

As the nurse went to replace the mask his mother’s mouth went into a distorted twist and the monitors went through the floor. The way the oxygen saturation reading plummeted was the most scary. His mother was dead within the minute. Two junior doctors came through a gap in the curtains that had been drawn around the bed. One of them switched off the monitors.

The nurse was most moved. ‘She waited for you. She waited for your kiss,’ she told the son. He was too numbed to respond.

On leaving the hospital they crossed the road to ‘The Miller of Mansfield’. It was Friday evening and although the pub was nearly empty the music was on full blast. ‘Let’s go home,’ he told his father. ‘We’ll have a large whisky back at the house.’

The drive home was free of traffic and they were back in the house in minutes. Having settled his father with a large tumbler of whisky he rang his uncle with the news.

‘Oh no!’ his uncle wailed back down the phone. ‘What happened? I spoke to Jack this afternoon and he told me your mother was fine and out shopping with you!’

‘Jim, Jim,’ he said gently. ‘You saw her two days ago. Flat out with oxygen, I.V’s. and monitors. Don’t you believe your own eyes?’

‘But Jack sounded so sure and so pleased and has never been a liar.’

‘He believed what he said. Can you let the others know in Ireland? I’ll take care of mother’s side.’

Women may not be running the world but they certainly keep the wheels turning. The Relative Liaison Officer was a pleasant mousey haired woman in her forties with an interesting face. Her hospital coat was clean but slightly creased. She checked through the list of effects in the plastic bag; night dresses, tissues, reading glasses, a rosary, a toilet bag with brush, comb and toiletries.

Provided the medical certificate of cause of death:-

A) Pulmonary Oddema.

B) Heart failure.

She also gave me the address and a map of the Register Office of Births, Marriages and Deaths in Peckham Road and an information sheet listing organisations that offer help and solace to the bereaved.

At the register office I was fast tracked directly to another woman, her face carefully made up, no hair out of place, in a smart jacket and dress who calmly entered the details into a large ledger before she issued the certificates.

My next door neighbours, who had buried her husband the previous year, told me where to go and who to ask for.

Another woman of course. In the funeral parlour Francis presented me with a menu. The range of coffins was sufficient but not to extensive enough to confuse me. I chose a Windsor, cheap but good enough for a cremation. The several pages of floral tributes were not overwhelming. My eye was drawn to the large floral White Cross that I knew would be to mothers taste. And of course I asked for a Requiem Mass which would have been high on her list.

I felt oddly becalmed, not sufficiently distressed. I wouldn’t have liked to openly explain it.

There had been plenty to get on with the two weeks mother had been in hospital. I had made personal changes. The fruit bowl had been banished from the dining room table to the larder. The toaster moved from a dining room side table to the kitchen alongside the tea tray.

The previous year I had moved my parents into this four bedroom house. Each of the rooms had generous cupboard space and mother filled them all too bursting point. Cupboard doors bulged and several drawer bottoms had popped out. An accumulation of the eighties and nineties, their autumn years. Shoes, winter coats, dresses, suits, cardigans and blouses; all impeccable cleaned and ironed. Stacks of towels and linen, some still in their packaging, and in the kitchen and larder boxes of incomplete cutlery and crockery.

When they returned to London in 1970 after an abortive year in Ireland, they carried in the two door Anglia only clothes and mementoes, leaving behind the furniture and moved back into our house in West London that was temporally occupied by me and bare except for a fitted kitchen with a dining table and chairs, a living room sparsely furnished with an arm chair, a coffee table and three large floor cushions and a double futon in each of the two bedrooms.

‘It makes it easy to clean,’ I assured my mother, when she gave me a look that other sons get for trashing a house with an out of control party.

She soon filled it up and over the years they did retrieve bits and pieces from the house in Ireland but only what could be carried in the Anglia.

In the week before the funeral I cleared seven full car loads. The Salvation Army shop volunteers greeted me in the street for months afterwards.

A four minute memory span can be a dubious advantage. ‘Is your mam out shopping?’ Or ‘Are we going to the hospital?’ Or ‘Did you leave your mam with Stephen?’ Her brother in Australia who had died two years ago.

Directly, brutally, I told him. ‘Father, she’s gone! Died in front of us Friday evening!’ I wanted an indelible fact to stay in his head.

‘Oh no!’ he would respond, brushing a hand across his face. But minutes later he would ask again.

If only weddings went as smooth. The funeral usher is probably the nearest experience that most of us will have to being taken care of by Bertie Wosters butler. At the Requiem Mass Father M. told us how my mother, who always took the sacrament of communion with obvious joy, on the morning that he had gone to the hospital in response to my request had asked him, ‘Who told you I was dying?’ He had reassured her that it was now the Sacrament of the Anointing of the Sick.

Getting everybody from the church to the Honor Oak Crematorium was the hardest part of the afternoon. Perhaps in retrospect everybody other than me had been there on some previous occasion. There was some wind and rain. My mother’s final joke was a friend’s comment, her first was getting him to Mass, an experience he had avoided even as a child in Barcelona. I still have a visual picture of father in his smart navy blue Combie overcoat in front of me, alone, looking down at the space that had just swallowed up mother’s coffin. The Combie was symbolic of mothers decline. The lining and tailored details were fantastic. But the coat itself was speckled with moth holes. When mother was fit with her wits intact the moths never had a chance.

Back at the house everybody got a cup of tea. Years before I had been best man at a wedding where we had all been given a cup of tea on arrival at the reception rooms. It had been so appreciated by all that I have done the same ever since. Then one of my cousins took charge of the pizza’s I had bought from Tesco, Safeway, Sainsbury and M & S whilst I got busy with the drinks dispensing cans of beer, cartons of fruit juice and bottles of wine, sherry, brandy and whisky. Father sat with his brother, sister-in-law, nieces and for a while Father M. And they talked easily for hours as I walked back and forwards filling glasses, talking to friends and relatives and then later to neighbours who dropped in.

I told one of my cousins about the final minutes. ‘It will be a long time before you kiss anyone again,’ she told me. At midnight, drinking champagne with three remaining friends I remarked that Irish gallows humour is the limit.

Chapter 2

‘After you left last night,’ his mother told him. ‘There were men walking up and down the ward in rabbit suits with long ears and white tails.’ His eyes looked up at the oxygen saturation monitor; 90 he noted. On the edge. The previous evening she had complained of an enormous party of at least a hundred people in the small pokey T.V. room at the end of the ward that had gone on late into the night. At the end of the visit, to satisfy his curiosity he went down to look at the room. It would have been a squeeze to fit in a dozen people. And the evening prior to that she had complained that across from her and a little way up that on the previous night four adults and eleven children had slept on three beds pushed together. The serious look on her face made it almost possible. He couldn’t say that his mother didn’t have a sense of humour but inventive fantasies had never been her line. This was a High Dependency Unit and only staff and visitors were standing or sitting and someone in the ward died every day.

The young staff nurse had asked him to see her before he left. Several minutes before the end of visiting time he left father at the bedside and went over to the desk.

‘I don’t want to alarm you,’ she told him. ‘But the new treatment to remove the fluid from your mother’s legs may cause problems. We would like your permission not to resuscitate.’

‘You have my permission,’ he responded.

‘I can call a doctor to explain more fully,’ she offered, a little taken back by his immediate compliance.

‘You don’t need to. Over the last two years I have watched my mother turning into a living wraith. Several times over the last months I have expected my hand to pass through her.’

‘Patients at your mothers stage do recover,’ she ventured.

‘Not often. I know what I’m looking at.’

The next morning he called in at the presbytery to alert Father M., who went directly to the hospital.

The morning after the funeral I unhurriedly but methodically cleared up. Stacked bottles in boxes for the dump, carefully vacuum cleaned, rearranged the furniture. Washed up, stacked, cleaned the kitchen surfaces and made the first coffee in weeks.

An aversion to coffee had kicked in the evening my mother died.

I didn’t wake father but sat in the armchair looking at the blank television screen. With the sharpened senses of the bereaved I began to think. The role of carer to my father had not been unanticipated. My mother’s strength of will and unwillingness to die had not deceived me. Father M. Told me that although she accepted the anointing she had assured him that she was going home the next weekend, but I knew her number was finally up long before they asked my permission not to resuscitate.

Months earlier, driving with the light replacement cast on my leg I remembered saying inwardly, ‘Please mother don’t die until I’m walking again.’ She obliged. The leg still aches, but I am able to walk.

Strange how things fall out. If I hadn’t split from Melissa I’d never have covered the Shostakovich season at the Barbican. And what would I have done with this helpless father of mine? Thanking God that he had given up smoking twenty years ago I decided to change the gas stove for an electric one and replace the wash taps in the bathroom with push down taps. How much help would be help? Mother would not have any. It seems every old lady has a fund of stories about erratic time-keeping and persistent petty thieving. Any outsider confuses father and how much of it would be avoidance on my part? Pandering to resentment?

Resentment is an energy killer and even kills carers. Caring for father I thought would certainly give me a real fix on reality. If I didn’t resist. It could be a time to retrench, to renovate the house either for sale or a long absence, to read avidly compensating for social distraction in the past and travelling in the future to come, and to be a tourist and explorer in London.

Most of the ready solutions and recipes offered to mother were a mixture of avoidance and bewilderment. Reaching down to the heart of the problem was never fully attempted. Senile dementia, Alzheimer’s, whatever my father disappeared into was what killed my mother.

It is troublesome dealing with the denial of a drug addict or alcoholic or anorexic or an obese man or woman. But those whose brains are entrapped in Alzheimer’s are beyond denial. They do not know that they are missing.

Oedema and heart failure were the written causes of death. Her lifelong habit of smoking had wasted her heart and lungs but exhaustion, stress and anger were the finishing strokes. It had not been pleasant watching my mother’s destruction.

I laid out the breakfast tray for father. The kettle and toaster now side by side, with two slices of bread in the toaster and a tray complete with a cup and tea bag, a small jug of milk and a plate with a large pot of butter and a knife and spoon. All together, on display, within a foot radius.

Upstairs in my room, reading and writing, my antenna was active and I registered the movements father made throughout the morning but when I came down I found him slumped forward on his armchair, his forearms resting on his knees, the back of his head uppermost, showing the smallest of bald patches.

‘Hey. What’s up?’ I asked.

Neither dead nor crying he looked up blankly.

‘Get your shoes and coat on,’ I told him. ‘We’ll do a John Major and have a greasy spoon breakfast and then a couple of pints.’

We each had a full house at the workman’s cafe on Walworth Road and then two rounds of bitter for him and a Guinness for me in a market pub. It revived father but it was something I could not do every day. Something else had to be worked out.

All had feared fathers deferred retirement. Unwilling to do so at sixty-five he had carried on working until he was seventy years of age. He confessed to me several years later that the last year was very arduous. His strength and energy had suddenly gone into decline and the work each night took longer and became more tiring. But he never got sloppy. Right up to the final day they queued out of the door and along the pavement to buy the bread.

I see now that my parents early years of retirement were golden years. Fond reunions were enjoyed with brothers and sisters in Canada, the USA and Australia. A routine was established. They shopped twice a week, on Tuesdays at the Sainsbury supermarket alongside Wandsworth Bridge and on Thursday at North End Road street market, each followed by a drink at nearby pubs. Sundays after mass, they would rendezvous with me at the White Horse on Parsons Green. After two rounds I’d return with them for Sunday lunch.

They were moderate drinkers and father was the rare Irishman who would not go to the pub alone. Which caused friction in these latter years when he would ask mother repeatedly, ‘Shall we go for a pinta?’ Countless, countless times throughout the day provoking an explosion.

‘Your good fortune has turned into misfortune mother,’ I unkindly reminded her. ‘Think of all the Irish women you never knew over the years who wished their husbands were like father.’

He treasured table talk. As I have always done. More so now I realise how lucky I was, having been in so many houses that do not have it. So often now there is an overhead television for the table to view; sometimes the sound is muted, sometimes not. My eyes are not the only pair involuntarily drawn to it. Cliché’s and running comments serve for conversation. I come away with the feeling that I’ve been fed, but hunger still.

Neither of my parents had watched television all day. They would watch the one o’clock news over a tea and sandwich and then switch off, he to read, mother to energetically clean, dust and re-arrange. After dinner, around about five o’clock they would wash up and then switch on the television for mothers evening soap operas.

Over the years I loaned him books. Such writers as Somerset Maugham, Ernest Hemmingway, Graham Green, Aldus Huxley, Hermann Hess, D.H.Lawrance, Thomas Mann, George Orwell, Nikos Kazantzakis, Jean Lateguy, Doris Lessing. Early abiding loves and lucky encounters. To the relief of all he avidly lapped them up. In fact the last books he read before the sudden loss of short term memory were the four volumes of Winston Churchills, ‘History of the English Speaking Peoples.’ He read them in three weeks which did rather impress me.

It was not easy for him to put into words his thoughts about the books he read. But several exceptions come to mind. After reading Solzhenitsyns, ‘First Circle,’ gently shaking his head, he told me, ‘I don’t know what can be done but the Russian people do not deserve this.’ Then on another occasion he asked me if he could borrow Marcus Aurelius, ‘Meditations,’ for a re-read and several years later at my parent’s fiftieth wedding anniversary party I overheard him recommend,’ Meditations’, to a bemused niece.

Now he cannot even get through the Sun. By the time he’s in the middle of a page he’s forgotten the beginning. So it was up to me to switch on the television. Fortunately, there was day long snooker, which immediately relaxed him.

It took my mother and I a long time to catch on to what was happening when father began to line up his spectacle cases; five in all current and past, to switch continuously from one to the other when reading or watching television, driving my mother up the wall. A visit to the opticians for an eye test gave no satisfaction. They assured him that his current pair were the right focus. The following day he persisted in using all five spec’s, with frequent asides to mother that he must have an eye test. The following day after a visit to the Wallace Collection at Manchester Square I took him to a nearby shop that specialised in magnifying glasses and other aids. We agreed on one. A week later he told mother that it was useless and a waste of money.

After a little more observation it clicked that it was his lack of memory and not his eyes that was causing the discomfort. He couldn’t read or view because he couldn’t hold the words or images in his mind; not because he couldn’t see them.

I suggested to mother that every couple of days she should spirit away and hide one of the spec cases until they were down to the current pair. But she would not and fumed nightly to boiling point. Over the last three weeks I belatedly carried out my suggestion and father never noticed.

The coming year would be a learning curve. Large. In a way the care of an invalid or a small child does simplify life. And caring for father certainly filled some of the emotional void in my life. I hardly had time for a single thought about Melissa.

Chapter 3

His father made use of the wall, table and chairs on his way through the kitchenette to get to the bathroom. On the way back he came to a stop and folded over by the table. ‘There’s something wrong with my leg,’ he told his son.

Earlier in the day they had examined the bruise on his father’s thigh. He had no recollection of a fall.

‘Your leg has stiffened up,’ his son told him. ‘I’ll drop you into A&E.’

He helped his father to get his shoes and anorak on and with great difficulty got him into the car. It was a wintery evening and the streets around the hospital were deserted. The forecourt to the hospital was devoid of the crush of cars and the admonishing security guards that prevailed throughout the day. Parking with ease he went into find a wheelchair.

Leaving the car on the front he wheeled his father into an almost empty A&E. At the triage desk was one of the nurses who had attended to his mother the week before. She was young, a little stout with a butch haircut.

‘This is my father,’ he told her. ‘He has a massive bruise on his left thigh and he can’t walk.’

‘Are you bringing all you family in?’

‘It looks like it doesn’t it. I’ll park the car and be

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