Stepping up and walking into the fires of loss

The epidemic that we have been living through these past two years seems to be slowing down, although professional opinion from epidemiologists from the beginning always was that this was going to take at least three years to fully play out.

Down here in Devon we were spared the worst of it in the first wave of the virus, our rural isolation placed us with the lowest rate of infection apart from the Shetland Isles, but we personally still went to some very sad and scary places to collect people who had died, nursing homes in which the virus had ripped through like a flash flood leaving so many old and vulnerable people needlessly dead, the nursing staff who had not succumbed exhausted and tear streaked.

But our geography, and our social demographic spared us much of what the rest of the country was going through. My colleagues in funerals who worked in more racially mixed communities, places which were more economically perilous, went through hell.

This is a socio economic disease, and the people who suffered the most were the poorest and the most tightly packed in terms of housing, people who’s jobs meant they couldn’t isolate at home, the NHS workers, and bus drivers and shop workers, people who lived in working class, urban communities suffered disproportionately, and those who’s existing medical conditions made them vulnerable suffered the most, both in terms of death rate and the need to maintain their social isolation long after the rest of us felt able to take some basic risks.

As I say, a socio economic disease, like most diseases. Deaths from heart problems and cancer are always higher amongst the poor, death generally tends to leave the rich and comfortable to the last.

And now we live in the beginning of the aftermath, and that sees us facing a whole raft of knock on effects; undiagnosed cancers from people too scared to go in to hospital, deaths from conditions that have had operations postponed, all tide up in the slow attritional decay of the NHS, an idea which we here in Totnes should feel particularly furious with, seeing that Dartington Hall was one of the main places where the very idea of the NHS and the Welfare State was conceived, part of a surge of post war social justice that was determined to prevent people from living short brutal lives of quiet desperation.

Yet amid all the horror and sadness, there have been some chinks of light.

In the past two years, more and more people have been dying at home. Whereas previously, most of our funerals would begin with a call from the hospital mortuary, now they often begin weeks before the person has died with a call from their partner telling us they are entering the end stage of their life at home.

This of course is how it always used to be, 100 years ago nearly everyone died at home, and this was both a blessing and a curse, with palliative care being in its infancy, and medication crude compared to today’s painkilling and anxiety reducing drugs.

Now, we have some incredible hospices, but sometimes only just, as funding is even more haphazard than the established NHS, and most hospices rely heavily on charitable donations, but the part of the palliative care world that exists outside of a hospice: MacMillan Nurses, and Hospice at Home, they have been doing some incredible work to ensure that those people who are dying at home, both out of choice and necessity, are doing so with their needs and the needs of their family taken care of in a way which has been both heroic, and entirely ordinary for the men and women who do this job.

These professionals, working at the edge of their exhaustion, physically and emotionally, have been providing the same level of cheery, competent reassurance to the families they are helping through this private calamity that they always did.

We all owe them a huge thanks. Walking into a house where these nurses have been holding a family through this everyday personal apocalypse that is any and every death, has been to feel the warmth of basic unconditional human love that turns strangers into angels.

So more and more, we start our journey with a family in that most intimate of family spaces, a bedroom. My job, while one that we have in some small way evolved professionally, remains the same as it was 200 years ago, just like that of those nurses, playing the part played by the women of the village before them.

And it all comes down to stepping up and walking into the fires of loss.