Kay
“Nature's first green is gold,
Her hardest hue to hold.
Her early leaf's a flower;
But only so an hour.
Then leaf subsides to leaf.
So Eden sank to grief,
So dawn goes down to day.
Nothing gold can stay.
Robert Frost - Nothing Gold Can Stay, 1923.
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Today, I attended a pauper's funeral and it was a pitiful site. A near empty chapel, no hymns nor meaningfully commemorative music, and funeral directors, who are probably used to attending any funerals of the fundamentally alone, but in truth, hoped that maybe one family member might show up with a fond word to say, or anecdote to tell. The person recently departed was a woman aged 65 whose life ended by multiple organ failure, in a hospital alone. All family members had turned away from her, refusing to help or support her down the years. Bar one. My son.
The reason? In life, she had paranoid schizophrenia with a backstory of violent behaviour.
My son was the one person who did not turn her aside. Most of the time he had known her, she had largely been under control - as a result of adequate meds and a better mental healthcare system. The combination tabs and interventions kept her mostly stable for a lot of the time. The last ten years, however, had been extremely hard. A switch of medication had been the wrong call and the worst of the struggles she had endured in the past had come back tenfold.
Supposedly being looked after remotely by a stripped-back mental health team, this 'care in the community' project did not work. She needed to be in a warden-controlled place on the right medication, with people that she could identify with - not left alone to rot in a damp flat. Her only contact were the team with her weekly med jabs and my son, who cared enough about his aunt to help.
He supervised her taxis so they could shop at the local supermarket. He obtained new furniture and white goods when hers had broken down or been smashed in rage. He was the one who answered phone calls from her neighbours at four in the morning, because she was outside their house screaming obscenities - again. Or when she had tried (unsuccessfully) to set fire to the bottom floor flat she lived in - and this was no isolated incident.
Countless times, my son had asked the mental health team to review her case, many times knocked back by excuses that her case worker was on leave, or had changed, or they'd have to start again, or palmed off with vague promises and care plans that weren't followed for long. At one point, they lost her case notes altogether and had to piece a 40 year jigsaw of information in regards to her long term psychological profile. They would come out once a week, give her a long-activating injection to temper her mood swings and would leave again, pronto. Sometimes, my son said, he wasn't sure what was so exasperating. Her behaviour, or the repeated wall of vagueness and/or negligence by an underfunded unit, who more often than not did too little too late. Alas woefully late, they'd had to bring the bigger guns in to section her for re-evaluation - something they should've done several years sgo.
In the last few months, my son had noticed that she had fallen into even a lower level of general health. Once in hospital, she physically declined even further and they put her on end-of-life treatment. She died a fortnight later.
I hadn't seen my former sister-in-law for many years. She had some monies tucked away, but the council paid her dues for the pauper's funeral. My son, my husband (son's stepfather) and I were the only ones who attended, the other family members either long gone or unwilling to return my son's calls. Just us three in a sparse chapel, a small coffin, a council-organised service and the last chance for anyone to say something vaguely fitting.
I was unprepared, but managed to say something. That...
Kay was a girl from a large Cornish family, daughter of Frank & Dorothy, the third youngest of fourteen children. Her family worked on the land and within local factory industries and that previous to me meeting her, she was a young woman working for Rank Toshiba in one of the nearby towns. One day in 1980, Kay's family were involved in a serious road collision, It was in the days before mandatory seatbelt wearing became law. Kay received a severe blow to the head by hitting the dashboard, and in addition, lost an eye. It was important to mention and briefly summarise the accident, because this signified the beginning of her gargantuan psychological struggles.
Her predicament was a product of the time. A layman's knowledge of mental disorders was both scant and taboo, doubly so in Cornwall. Her sudden erratic behaviour changes were in line with someone who had blunt trauma and possible brain damage as a result. But the family saw it as her being 'wayward' or 'troublemaking', and they tried to keep their charge quiet until eventually, her behaviour got out of hand and the authorities had to be called in.
I first met her a few years later, and although I had seen worrying mood swings and other such outbursts, I could see the person underneath it all. She was funny, if a bit stubborn. Occasionally wilful, but also bright. Charactful, a bit of a drama queen, but also generous and kind. But the confrontational behaviours drove countless people away. With a certain amount of justification. By the time her old medication had been reinstated, further psychological damage had been done. The medics were not sure why, other than sometimes, some drugs just don't work anymore. This continual out-of-control struggle led to extreme confrontational behaviour, whuch in turn, prevented people from getting her the help she eventually physically needed.
The mental health team skipped with the line of whether she did or did not lack psychological or intellectual capacity over her own physical and mental welfare (because she had lucid and informative conversations with medics - is this for real?? She tried to set fire to a whole block of flats ffs!!). While they argued semantics, she withered away.
Untouchable, unlovable Kay.
Obviously I didn't reveal her full mental health profile at the funeral, but I briefly hinted, using discrete, careful words. I ran with most of what I thought appropriate and shied away from uncomfortable truths, stopping short after the 'generous and kind' bit. Besides, I did not want to distress my son further. Maybe I just wanted to push late-stage mental advocacy a little, even if it was to address the four officiants at the back of the hall who up until that point, had no real clue as to who she was. I wanted other people to know that Kay had been a person and meant something to somebody. Anybody.
In the time I had available (very short notice, and I'd only just come out of hospital myself), we brought along supermarket flowers, but rewrapped them carefully in tissue paper - turning them from a half-assed afterthought into a discrete spray of palest purple and white roses, some white chrysanthemums, mixed in with fronds of fern and ivy. Embarrassingly cheap, but I think effective, borne from not knowing what the constraints of the council-run funeral were. We had no other choice but to make the best we could from basically nothing.
After I said my bit and the officiants played 'One Day Over The Rainbow', we each rested our hands on her tiny coffin and said our goodbyes.
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On reflection, at least she's free from the inner torment she suffered on this earthly plain, I just so wish she had a better, happier life. Because, even if psychological disorders are more keenly understood, the funding and the inclination to support the vulnerable members of society is now almost non-existstant. The term 'healthcare' is an oxymoron, a word now reduced to two distinct words and now 'health' and 'care' are two separate things. If things were run better with more funding, compassion and understanding, Kay and countless others like her might have been given them better quality of life with a far happier ending.