Thinking back to the 1990s, my mind conjures up endless lives, numerous men and women who I still carry within. Being asked to look back, three images stand out for me. These all happened on nightshifts. Night was the time on most wards when the telephone rarely rang, there were fewer distractions and everything seemed more intense…. One was of a tall, glamorous Italian man who came out of his room one night in a blue ballgown and six-inch heels before six-inch heels were commonplace. He looked so gorgeous as he sashayed towards the nursing station. Then he began to cough up lung tissue, dark, bloody flecks staining that beautiful blue gown. 

 

Another is of a man close to the end of his life who was afraid of dying alone, rocking himself on his bed in pain because his back was covered with Kaposi’s sarcoma and he couldn’t lie down comfortably however tired he was. I sat with him, gently rubbing his back to ease it. He was so thin it felt as if I was touching a bird’s skeleton. 

 

A third was an African woman who was very religious. Every morning she asked the nurses to read to her from the Bible and prayer book by her bed. Then one day, she stopped asking. She was not far from death and, thinking it would comfort her, I asked her one night if she would like me to read from her Bible again. She said the illness was so terrible she had given up on God, since He had obviously given up on her. You can give someone pills for their pain, but how do you comfort someone who has lost their faith? I’m still troubled by that. 

 

All we wanted, as nurses, was to bring some sort of healing to our patients. We couldn’t cure them, but we felt our job was to offer at least an inner healing, so we did things we would never be able to do as nurses today. We didn’t like the idea of a patient being discharged to a cold, empty flat, so for one patient a colleague and I jumped on a bus and beat the ambulance to his home to put on the heating. We made him a hot water bottle and tucked it in his bed, then returned to work. Those were the things we could do that made a difference. Another was when the comet Hale-Bopp was in the sky in 1997: during one night shift, when there was a clear wintry sky, a nurse who was doing the shift with me and I put patients into wheelchairs, wrapped them in blankets and took turns to take them out into Regent’s Park to see the comet, a once-in-a-lifetime experience. We had such fun that night and the patients loved it. I could never do that now, and I would never again have the courage to be so carefree but, like our patients, we were young and brave then. 

 

There was an extraordinary amount of laughter on Broderip Ward, usually over the tiny things in life because, suddenly, those tiny things really mattered. A cameo comes to mind from those days when I wasn’t completely familiar with English idioms, so I remember giving a patient an intra-muscular injection, and instead of saying, as nurses usually do, you’ll feel a sharp scratch, I said: “I’m sorry, I’m going to give you a small prick”, and the entire ward erupted in laughter. I soon learned that wasn’t the way to put it. 

 

HIV/AIDS did change medical care in some respects. It had been quite paternalistic: the doctor had the answers and the patients did as they were told. But AIDS was new and totally different – nobody had the answers. Everyone was learning at the same time, and we all had to work in partnership, something that changed doctor–patient interactions for good. Patients have far more of a voice now than they did before HIV. It was also the advent of a real multi-disciplinary approach to care: all of a sudden dieticians, physios, social workers and others all became part of the patients’ inpatient stay and discharge planning. 

 

AIDS carried such a stigma that patients were often relieved when they received a cancer diagnosis. It meant they could admit they were ill: if they had cancer, people would pity them, but if they told the truth, that they had AIDS, they might be ostracised. The parents of one young man, who died of an AIDS-related chest infection, didn’t want the words HIV or AIDS on the death certificate, which caused no end of difficulty. In the end we changed it to ‘an antiretroviral complication’, which fudged it enough for the parents, though anyone with an iota of medical knowledge would have understood what it meant. For that matter, my own parents would never admit to their neighbours I worked with HIV patients. They said I was on a cancer ward. 

 

So many of those young men had kept their London life secret from their parents. One patient asked us to contact his parents and invite them to the ward, but to say he had cancer – not entirely a lie, as he had an AIDS-related cancer. But when they arrived, it was obvious to them it was an HIV ward. They were elderly, and didn’t understand anything about their son’s lifestyle or the disease. The father didn’t want to hold his son’s hand, because he thought he could catch HIV from it – and if he showed any closeness to the boy, people watching might conclude he was a closet homosexual himself. The mother sat at the bedside apparently totally composed, clutching her handbag, and 

didn’t say a word, didn’t touch him or speak to us, but she had the saddest eyes in the world. I will never forget her awful despair. 

 

Some patients came back so frequently we knew them well. Oscar Moore was a journalist who wrote a column called PWA – Person with AIDS – for The Guardian, a witty, handsome man in his thirties who brought laughter and brightness to the ward. He was allowed onto the ward as a ‘social’ admission – something you would never find nowadays because the NHS is too stretched – admitted for a few nights for respite because he was finding it hard to cope at home. The next time he was with us, he asked if I had brought my bicycle onto the ward. I couldn’t think what he meant until he pointed to the wheelchair by his bed. In just a few weeks, he had become so blind and confused he could no longer identify a wheelchair only a few feet away. His end was very quiet; he just slipped away on a whisper, breathed, then breathed no more. 

 

I kept a diary and noted every time a patient died. After three years, there were more than 150 names of men and women on the list, almost one death a week. 

 

One memory that sums up our approach to nursing in those years for me is Billy. He was older than most of our patients, 54, a tiny Scotsman who arrived on the ward with all his belongings in black bin liners, bags and bags of stuff, and a guitar. He loved music, and played his guitar all the time – we had to negotiate with other patients to let him play it. He’d found God at some point in what had been a difficult life, and religion was important to him but so was his music. As he became sicker, he played his guitar less and less. We moved him into a side room with all his bags and a radio, which another of the nurses, Lucy, would switch on for him, and he’d sit on his bed rocking and saying Jesus loves me, Jesus loves me, as if he needed to convince himself. 

 

One Sunday afternoon, I came onto the ward to find Lucy carting black bags out of his room, piling them up by the nurse’s station. Next, she pushed the bed out into the corridor, emptying Billy’s room completely. Then she tuned the radio to a programme of dance music. She and Billy started to dance in his empty room, the waltz, the cha cha, the foxtrot. They were perfectly in harmony, completely at peace dancing together. That embodied for me what nursing could and should be – meeting a patient’s needs in the most unexpected ways. The way we nursed those patients while they were dying is the best nursing the NHS has ever done, and I wish we could still do it that way. 

 

Around 1996, the first anti-retroviral drugs arrived, and slowly the death rate began to fall. Soon, everything in HIV was pharmaceutically-driven. We more often saw people who were ill because of side-effects caused by their treatment, not because of AIDS.A large part of our job was to motivate patients to remain on their medication. Western people with HIV were generally open to trying the drugs, whereas many African patients were much more reluctant, fatalistic about letting AIDS kill them. Eventually fewer beds were needed, so Broderip Ward closed and we were moved to another part of the hospital. I used to go up to Broderip to look into the empty ward and remember the patients I’d met. One day, a man had beaten me to it, peering through the doors, the partner of a patient who’d died, there to remember too. 

 

Nurses are important to patients, but the reverse is also true – we remember patients and are shaped by them. I’m a different person, and a better nurse, because of all the people I’ve nursed into death, and I still feel the loss of those young men and women. And if I feel like this all these years on, how must their family, friends and partners feel?