She had been restive all day and I had dropped in twice to check on her. By the afternoon however, the sedatives were taking control and her features assumed a more refined composure. Outside, the trees and shrubs in her garden were ravaged by a fierce north wind but behind heavy curtains, the house was silent. I located the thermostat for the heating system and raised the temperature a little more. She might as well be comfortable for her final hours.
Late in the evening I returned to the property and took her pulse. She was still sitting in the armchair, her tiny frame almost swallowed by the ample cushioning of its upholstery. The pulse was faint but regular, her breathing shallow and light.
Don't worry, Clara, I said to her. It's nearly over.
I boiled the kettle and made a cup of coffee for myself, then went to join her in the sitting room. She turned her head slightly and swallowed as I came in, her eyelids flickered momentarily. Then her head fell back, too heavy now to be raised to the world. I stroked the sallow skin on her wrist, so soft and warm to the touch. Then I gently raised her sleeve and fastened a tourniquet on her upper arm.
It's been a long life, I told her gently. You've lived a long life. You've made it to the end.
Her blood pressure was very low.
And here you are in your own home, my dear. Not for you the indignities of the hospital ward. For her to suffer in a cool, impersonal environment would be an injustice. How much better that she had retained her own dominion, the independence for which she had fought so vigorously in her younger years.
I opened my bag to make sure I had everything she might need. An insulin syringe, several ampoules of diapmorphine then I tapped her gently in the crook of her elbow to check the cephalitic vein and saw it pulsing silkily, the thin blue cord.
But not just yet. I sometimes despair at the impatience of my younger colleagues to rush straight to the brink. A moment like this should be treated with respect. It is not so much the end of life as its culmination. Clara had drunk deeply from the draughts of sorrow and joy and now in the final moments of existence, took on a luminous quality. Her body was preparing to journey on into that pathless land, with no earthly trappings, just the bare fact of her own soul.
She murmured slightly but although I bent close to her, the words were lost. I carried my bag through to the adjoining dining room where I set out the pad of death certificates and my fountain pen on the teak table-top. Then I contemplated her bookshelves. The eclecticism of her interests was apparent in the titles of philosophy and art history. Even a smattering of church history, and a two-volume edition of Gibbon, well thumbed and broken at its bindings.
I read some verses of Manley Hopkins and skimmed through a glossy new hardback on English cathedrals before my attention was captured by the framed photographs on her walls. The thread of her existence was traced through them. The young woman with dimpled smile embarking on an ocean voyage, posing with her fellow actors on a dusty stage or clasping the hand of some long-forgotten dignitary. In later shots, her posture limned in assurance and authority, she was captured beside ministers of state, royalty, conferring degrees on students.
The clock in the dining room was chiming midnight as I dealt a deck of cards onto the table and played a few hands of patience. I have always preferred games of chance. Some may revel in the skill of a knight's gambit or the athleticism of the sports field, but in the stillness of Clara's rooms, each turn of a card was singing with the probabilities of the universe. Later, I slid the purse from her handbag in the kitchen and was not surprised to find over a hundred pounds in cash. So many of my elderly patients seemed happy to carry around that kind of money. I left the cards of course and the car keys though she would have no further use for either but the notes I transferred to my own wallet. Tucked into the side pockets of her bag were other papers, a clutch of receipts and then, neatly folded, a brand new lottery ticket for the weekend's draw.
I was struck by a sudden irritation. I knew very well she had no children, no spouse and had designated a number of worthy charities the beneficiaries of her estate. The futility of this final gesture annoyed me.
You silly girl, I told her. What are you wasting your money on this for? The chances of winning are next to nothing!
I shook my head sadly and fumbled in the kitchen drawers for a box of matches before burning the square of paper over the sink, dropping its embers into the waste.
Some time later, as I was pushing the expended syringe into the clinical disposal can, she stirred and filled the sitting room once more with the tenor of her voice. There were no distinct words by this time, only the echo of some distant memory. It is often the way in these fading moments, as old footsteps are re-trodden for a final time. I seated myself on her elegant furniture, to wait. I could not consider leaving her to face the fading light alone.
She was well dressed, her expression calm, retaining the dignity which had been apparent throughout our acquaintance. At one thirty-five, I took up my pen and wrote out her final chapter.