Arthur and Mildred

When I met Arthur, he was 92. His wife, Mildred, was 87 yet suffered with the worse health. They had aged together in a bungalow in Bridport. Over the course of 60 years, the paraphernalia of life had accumulated – most of it dated and out of place in the 21st Century: heavy mahogany furniture that seemed to suck the light out of the room, looming over the space. Arthur and Mildred were from a generation that still considered eating to be an activity requiring its own space and scheduling: dining took place in a dining room, undistracted from other activities. Their dining table was large enough to seat eight, yet it rarely did. It was now piled high with papers, signalling their loss in the fight to stay ahead of the tidal wave of detritus that swamps modern life.

As a result, in their waning years of tottering mobility, they continued to live in a home overrun with furniture they neither used nor needed and found the weeds of bills, paperwork and junk mail sprouting around them. Only a single track between the kitchen and living room was unblighted by furniture and only a single area of carpet between their easy chairs and the television was visible to the naked eye, revealing a high quality but highly aged beige Axminster carpet.

The day-to-day experience of life for both Arthur and Mildred was challenged by more than just their physical clutter – were it not for the ravages of time on their bodies, they might have navigated the house easily. Yet their desire to tame their surroundings was scuppered by the realities of old age. Arthur was a retired engineer, who used to stand at 6 ft. 2 but was now stooped in a question-mark shape short of 5 ft. 9. He was riddled with arthritis, which left his hands gnarled, his back and hips creaking and his knees with the tendency to give way underneath him. In spite of his relative loss of height, the stiffness in his limbs and joints meant that although he could see the physical continuity between his lower legs and the rest of his body, his inability to reach them meant that, to him, they were only philosophically part of him. With the equipment given to him by the occupational therapist, he was able to get by. The leg lifter, long shoehorn and sock tool were the lifesavers he never thought he would need. Who knew that one could reach a point in life when donning socks independently would be a triumph?

Arthur would never admit it, but it was looking after his wife that caused him the most anxiety. Their 62 years of marriage meant that he could never contemplate life without her. He would certainly miss her terribly if she were gone, but there would be benefits too. Mildred’s memory was not what it used to be, but that did not stop them reminiscing about the past. Indeed, there was a great deal to remember fondly.

They were a couple who had experienced great contentment and fun together. Arthur’s job had taken them, for a while, all over the world in his senior position at a petrochemical company. Their children had thrived and succeeded and gave them immense pride. But in the present, Mildred was less reliable. Arthur could cope with her memory lapses, but her physical limitations tested him more.

The second half of Mildred’s life had been if not defined then certainly influenced by her Type 2 diabetes. The management of one’s blood sugars is only half the challenge of living with diabetes in old age. The other half is dealing with the effects on the body of the long-term diabetes. Mildred in particular had been affected by poor eyesight from diabetic retinopathy, but more profound than even her partial blindness was the autonomic dysfunction, which meant that her body became less able to maintain a stable blood pressure when she changed posture. Thus, when she stood up, her blood pressure would often fall catastrophically, causing her to collapse. The lack of blood supply to her brain could be transiently significant, leading to loss of consciousness and even fitting.

Over the last few years, Arthur had learned to recognise these events and, rather than seeking medical help, would put a cushion under her head until she came round a few moments later and then gently help her back to her feet when she had recovered enough to give it a try. Latterly, however, Mildred had become unable to get up without help, and he had become unable to help her himself. He reasoned that there was little sense in them both ending up in a pile on the floor.

The week before I met the couple, Mildred had collapsed. Unfazed by this now familiar event, Arthur had considered his options. With Mildred lying with her head on the hearth, Arthur concluded too high a degree of hazard to help her up again. As many of us in his situation would, Arthur called 999, hoping to request the assistance of a paramedic to help him return Mildred to the upright position. However, he reckoned without the unthinking application of the ambulance service’s algorithm. Asked whether he could feel Mildred’s pulse, Arthur demurred. In the heat of an urgency that existed only in the logic of a computer program inadequately supervised by a thinking human, the call handler did not stop to enquire why Arthur could not feel a pulse (he could not bend down) and shouted at Arthur to start cardiopulmonary resuscitation (CPR).

Raised as he was to show good manners in all situations, Arthur did not correct the mistake and did as he was told. Creaking himself down to his knees, he began chest compressions on a woman he knew to have fainted, because a call handler who could not see what was actually occurring knew she had suffered a cardiac arrest.

By this time, matters had been taken out of Arthur’s hands: within