My friend Robert Nedelkoff recommended this book to me after stumbling across a reference in a 1980 collection of Ronald Firbank’s prose titled Firbank: Memoirs and Critiques edited by Mervyn Horder. In Horder’s preface, he dismisses the notion of dramatic death scenes, writing, “We are assured by a competent technical observer of the subject that people tend to meet the moment of their death in the same manner as they live — the self effacing quietly in their sleep, the egocentric giving the maximum trouble to all concerned, the theatrical speechifying away con brio, the athletic with one foot out of bed, and so on.”
Horder’s competent technical observer, we learn from a footnote, was Pamela Bright, whose The Day’s End he describes as “a neglected book of 1956” — which of course caused Robert to reach for the Neglected Books phone. It sounded like the real deal, and I was delighted to find it awaiting patiently on the Internet Archive (link).
The Day’s End is a study in how we die. Set on the cancer ward of an unnamed women’s hospital on the western edge of London, the book takes us through two days on the ward as seen by its head nurse (Bright, though she never identifies herself in the book). There are old women and young, some there just for an exam or two, others doomed to spend their last days within its walls. Bright confirms Horder’s paraphrase above, but more from the perspective of a nurse:
The ways people die are as varied as the pictures on the wall ofa gallery, and each death remembered for a different reason: one for its setting; one for its atmosphere and whether there was summer in it or frost, or darkness and an oxygen cylinder; one for its human characters, for its peace, for its distress, and whether it was in the order of things or sudden in its unexpectedness.
At the time Bright wrote the book, she had been a practicing nurse for over 18 years. Earning her cap just after the outbreak of World War One, she served in military hospitals in Palestine and, after the D-Day invasion, trailing the British Army through northern Europe. The latter experience she described in her first book, Life in Our Hands (1955), and there are flashbacks to her time in Palestine throughout The Day’s End.
Also throughout the book are mentions of the stress of being responsible for a ward full of patients and a team of nurses and orderlies that almost seem like Bright’s reminders to herself: “it demanded constant wariness, the habit of keen observation, the noting of others’ moods and tempers, the habit of explaining, and the ability to learn the knack of not always depending on the advice or backing of others, but of believing in one’s own judgment and ability.” As she rides the bus home after her shift, her thoughts scroll through the patients — who’s improved, who’s failing, who may need to be shifted to one of the side rooms where a patient nearing death can have some hours of privacy and peace — and which nurses need to be encouraged or restrained the next day. She acknowledges, though, that she gains a form of comfort from that stress: “Although theoretically I abhor the business of being busy and in a hurry, yet I must confess that often it is in that condition I find myself happiest — it is a drug, and one can forget.”
Caring for a terminally ill patient proves among the most demanding of a nurse’s duties because it represents, in effect, a failure. So, on top of the inbred discretion of the English middle class there is a reluctance to draw attention to the obvious: “However acute a patient’s illness, we never admitted the signs of impending death.” Some of this reluctance stems from the difficulty of admitting how much about death remains unknown to medical professionals, but some also results from having seen the process repeated hundreds of times. “A dying man rarely looks death in the face,” Bright reports, “and who are we to tell him the truth? Why should he not go on building castles in the air when to some extent he has been doing it all his life?”
What makes The Day’s End memorable, however, are not such generalizations but Bright’s portraits of her patients. Mario, the dashingly handsome Italian soldier in her hospital in Palestine, who insisted on wearing a pink hairnet each night to keep his long, oiled black hair from getting mussed — until the night when he no longer called for it and Bright knew he would not last until morning. Or the lonely woman whose sad tale takes less than a sentence: “Miss Smart, for instance, who had had not a single friend and who couldn’t be forgotten when she died, for no one remembered her while she was alive….” And especially Mrs. Ferrett, possessed of a malevolent intensity worthy of a character in Balzac:
Her face seemed crudely sculptured, following the curves of a gargoyle on some cathedral front; and as one invariably gazes with delight upon such goblins and the workman’s freedom of expression, so one had to smile at Mrs. Ferrett. When she sat in bed she was coiled up in the smallest possible space, her chin almost resting on her knees, her hands close to her sides, like a child in embryo: when she was on her feet she moved softly and half inclined sideways like a crab: when her sharp eyes glistened, she pierced the ward from end to end and gleamed upon her neighbours, nurses, visitors, indeed everything. Mumbling, or munching peppermints; crabbed and cranky, she would gaze upwards at the plain corners and downwards at the dust, and in silent glee hug to herself some fearful secret.
She occupied the first place among the simplest. But she occupied it with such force, daring and calm that none of us would have thought of taking it away from her. This selfish, wicked woman bewitched even the people least susceptible to such influence: us nurses and the doctors.
Bright chronicled her career in a total of five books: Breakfast at Night (1956), about her training at an Edinburgh hospital; Life in Our Hands about her service in Europe during the war; The Day’s End, which found her in mid-career; A Poor Man’s Riches (1966), about her experiences caring for Palestinian refugees in the early 1960s; and Hospital at Night (1971), a fictionalized account based on her time as chief nurse of a busy metropolitan hospital. After retiring from service, she wrote a biography of her ancestor, Dr. Richard Bright, a pioneering surgeon who first described the ailment of the kidneys that now bears his name. She died in 2012 at the age of 98.