In contrast, not all the research participants wanted to think about death as the potential outcome of this hospitalisation. Some believed that by not
contemplating the possibility, death would not occur.
. . . there were a few times when I thought "oh what if she doesn 't make it ", but not very many. I was always confident the whole way through that she was going to get through ... A few times I did wonder what it would be like if she wasn 't, you know, if it were permanent. And I think it would have been different. To me it was always a temporary arrangement; it wasn 't going to last
forever (Paul, p.4, & p.7).
Although the research participants were in suspense, they were supported in
the knowledge that the disruption could be temporised. "To me it was always
a temporary arrangement .. . it [the hospitalisation out-of-town] wasn 't going
to last forever" (Paul, p.7). Furthermore, the prospect of dying was put into
the context of life's developmental stages. Owen pointed out during the interview that:
. . . twenty-eight years ago, [Fiona] had been diagnosed [with the
same problem] . I was more worried then, when I thought I was going to lose her. I think mainly because, and the kids were upset, because they were only young still. Her Mum and Dad were terribly upset, because they had already lost two sons. This
time round the kids are all married ... (PA).
The being of the world belongs to the relationship of Being of the whole. In
the case of the experiences under discussion, the illness that required a transfer to the non-local tertiary centre had to be considered in the context of the continuum of living. Although they did not think about it, each research participant contextualised the illness in order to make sense of the world. On reflecting over the interviews and listening to the tapes, I realised that I started off by asking much the same question . .. ("Tell me about the events leading up to [whoever) getting sick andfinding out that slhe was being transferred out
of-town"). The non-local tertiary hospitalisation was not a phenomenon that
occurred without the 'rules' of living with an illness.
In contrast, none of the research participants identified their spouses as 'being sick' , both during the time that they were transferred out-of-town, or now.
They may have been unwell, and in the case of Warren, had only just come out of hospital, but no-body talked about chronic illness and they were not sick in comparison to others or what they could have been. During the
interviews Don (the patient) was describing his first admission to hospital, and said "[It was a] massive heart attack ". However, Victoria interrupted by saying "It wasn 't massive, because you were still sitting up " (p. I ) . Victoria's previous understanding of heart attacks was founded on the time when her father had collapsed following his heart attack. Although Don was unwell, he was not as sick as her father had been, because he was still sitting. Another research participant talked about her husband "taking sic'" (Nancy, p.7) just days before he died. In disclosing the experience, research participants also disclosed their understanding of life. Until facing death, Da-sein takes the
ready-to-hand of living for granted.
Having received treatment, and now returned home, the state of being-in
suspense is not resolved; it has become part of the research participants' state
of living:
. . . she 's been having regular checks and everything seems to be fine. I just prefer not to think about it, you knOw. . . . As far as I am concerned she is well... and I'll keep thinking that until I know otherwise (Paul, p.7).
Although their spouses were not sick, the research participants were aware that the problem may resurface. Research participants were still being-in suspense knowing that while the treatment had been successful, most spouses of those who took part in the current study still had a medical condition that would eventually require further treatment. Some research participants were concerned that the disease would resurface after thinking that the problem had gone away, while others felt that the dis-ease was waiting to pounce at the earliest opportunity. In either situation, the research participants expect the dis-ease to resurface, but they acknowledge that the dis-ease is now part of living:
And [we were told during the consultation] ... they think it is alright, but they can 't be sure. We just sat there and said "God, you know, when the hell can you actually relax with this thing? "
now on, she says "she is a time bomb " . . . Daily life takes you away from that, but every so often something happens, and it brings you back to thefact thal . . . Really, what are your priorities here? And we do revisit that quite often (Edward, p.9).
As identified earlier, when I set out to explore the experiences of having one's spouse hospitalised in a non-local tertiary centre, I was taking this
hospitalisation out of the context of having a disease that required
hospitalisation in the first place. Almost all the research participants used the word "luck" when describing their experiences. Research participants felt fortunate that their spouses found the diagnosis early enough to have treatment, or that the condition was not so severe. For example, one spouse with coronary heart disease could be treated with an angioplasty, rather than open heart surgery. Others felt that it was luck that the cancer had been diagnosed in an early stage, or that the children had left home, and they did not have to juggle children, the home, and support the spouse having treatment. As two research participants explained:
I guess there are other people who don 't have that [future to hold
on to] . They are very unlucky when it comes to things like this.
We are grateful that we got onto it in time. That it was only a very small lump, very aggressive, it was one of the worst kinds. But we got it early, and touch wood, everything seems to have worked. So . . . it was, as I say it was something that we could have well done without, but I guess you learn from the experience (Paul, p.3).
We were unlucky that it happened . . . but lucky that we were older. Basically, if you look at it, we have done our working life,
come closer to the end than we were to the beginning (Y oland,
p. 1 5).
The state of uncertainty still remains in the potentiality-for-being as the research participants make sense of being in the world as it has become. Although the couples are focussing on living, they acknowledge that the dis ease remains in the background:
Nothing is guaranteed anymore. Before we probably felt a bit bulletproof Now we are a little bit more careful about what we do, and how we do it, what we have got going for each other. Because nothing else is going to happen . . . but you never know. Everything is fine at the moment, and we just keep praying, finding the philosophy that until we know anything else we will
In taking part in this study to explore the experiences of having one's spouse hospitalised in a non-local setting, the research participants disclosed their world that they had not deliberated about. As identified in Chapter Four, the research participants did not initially believe that they could contribute to others' understanding of having one's spouse hospitalised in non-local tertiary centres. In disclosing the experiences and associated anxieties, Da-sein
understands the impact of it on the possibilities, and resolves the anxiety itself. Once the research participants were able to make sense of the world,
Da-sein could flee back into the comfort of being-in-the-world. In other words, Da-sein can confront and disband the anxiety, because the immediate future no longer remains uncertain. "When the anxiety has subsided, then in our everyday of talking we are accustomed to say ' it was nothing'"
(Heidegger, 1 962, p .23 1 ) ; and Da-sein becomes resolute4 Because the worst possible fear (that of death) did not eventuate, the research participants' perceptions of the experiences were that they did become 'nothing' .
The onset of a life-threatening illness now presents a challenge for a couple to maintain the same pre-illness relationship. What was once routine has
become unpredictable as the couple adjust to the world, which for them has included non-local tertiary hospitalisation. In learning from the experience, research participants re-evaluated their lives as a result of the out-of-town hospitalisation. It was not only the non-local hospitalisation that caused this re-evaluation of living, but the medical diagnosis itself. For example, one of the participants talked of cancer. "It is such an awful word we would
probably try and hide it. Ignore it" (Alice, p.3). Therefore, the first process of evaluating lives is acknowledging time together, or celebrating small achievements.
You know we had a goal, and the goal was to have the treatment, and we would have a little celebration at that time, which is what we did, and that is what we werefocussed on really (Paul, p.8).
We are having a party this weekend, just people for dinner that have really supported us. And [my husband] said "it is a staying
alive party H. Yeah. He is making a bit of a joke about it. They
haven 't got me yet ... (Alice, p.3).
The second process that the research participants and their spouses underwent in coming to terms with the illness was to make the most of living as
examples from three research participants illustrate:
once the operation is over, you can relax a lot. You can, I think it is such a huge weight off your shoulder .. .It is like boy, I can do anything because there is life, so it didn 't really matter. I didn 't feel sorry for myself having to look after the children by myself or anything, because it had all gone so well that I thought we were really lucky (Alice, p.4) .
. . . now, since she got sick, and I keep saying it to her too, "in the morning, if the sun comes up, make the most of it, because tomorrow it mightn 't H. And that 's how I am now. And her getting sick has done that. I was always a little bit that way, but I am more so now. And I mean if the world falls over tomorrow, I am not going to be terribly concerned about it, because there is not a hell of a lot we can do about it (Owen, p.7).
And when you go through something like that it makes you re evaluate your whole life. It makes you think that a lot of things that you thought were huge are not important anymore. Like you don 't worry about things like you used to. You sort of think you know, it doesn 't matter, we are still alive, we are still breathing, we will carry on . . . we are inclined to slip back into "you should be doing this and that H, putting pressure on the person again. Then someone says something, and you think 'yes, that 's right. We 're not going there again H (Victoria, p.7).
5.7 Chapter Review.
Having a condition that causes an episode of non-local tertiary hospitalisation results in times of uncertainty and fear of the unknown. This period of time of
being-in-suspense occurred on the continuum of living. Research participants and their spouses experienced times of being-in-suspense at all stages, from being aware that their spouse was not well but not having a diagnosis, through to the time of having completed the treatment, and waiting for symptoms of the condition to become apparent again. Coupled with being-in-suspense
while awaiting treatment, is the fear of death. Research participants came to terms with their personal fears of death of their spouse, but they also felt surrounded by death, and walked alongside other spouses who faced death on a daily basis. Such experiences encouraged the research participants and their
spouses to re-evaluate life and celebrate the elements of luck that had emerged from this out-of-town hospitalisation.
In the next chapter I address Da-sein 's state of resolution, and the strategies that the research participants utilised to adjust to Being-in-the-world as it had become when their spouses were transferred out-of-town for treatment.
CHAPTER SIX
FITTING BEING OUT-OF-TOWN INTO BEING-IN-THE-WORLD. 6.1 Introduction.
When people are transferred to a non-local tertiary setting, the known and taken for-granted world rapidly changes. It was identified in the previous chapter that many research participants could not envisage what the future held for them and spent the time waiting for the worst, but at the same time hoping this worst would not happen. The previous chapter closed with the research participants
minimising their concerns, because they could make sense of the world again, and the dis-ease became part of their world. The couples oscillated between
being-in-suspense, to being-in-the world as they adjusted to living with the illness, until the next anxiety caused them to be-in-suspense again.
In this chapter the adjustments that the research participants made during the oscillation are explored. As the research participants adjusted to the being-in-the world of having a spouse with a medical condition, the necessity of the out-of town hospitalisation became part of everyday life.
The research participants had to make the decision whether to accompany their spouse to the non-local tertiary hospital or stay at home. Either decision required them to fill the long hours of waiting either by being by the bedside, or managing the house and home. It is intended that those reading this chapter will be able to conceptualise the research participants' experiences as they had times of
wondering who was caring for them and they juggled their priorities, leading to times of feeling tom in two. Finally, readers of the chapter are introduced to the assertions that despite the challenges the research participants faced, these participants contended that they coped mainly because they needed to cope.