A CASE FOR SPECIAL TREATMENT 1982–2007
WITH THE DOCUMENTS OF PHILLIP
– OLIVER MEDHURST’S FATHER –
EDITED WITH PERMISSION BY
IN TWO PARTS
PART 1: LEICESTERSHIRE. 1982–1985
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printed for the OLIVER MEDHURST appeal fund at
8 Prophets Close
96 Withins Lane
© Phillip Medhurst
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PART 1: LEICESTERSHIRE
Journal. 26 September 1982 [Sunday]
It will be six weeks on Tuesday since Oliver was run down by a car on the dual
carriageway at the bottom of our street. He now appears to be growing stronger,
and in purely physical terms the worst seems to be over. But there is much
about Oliver's present state that is difficult to interpret, and this is one reason
why I have decided to make notes on his progress. The other reasons, I am
sure, will become apparent as this journal progresses.
The exact circumstances of my son's accident have not been ascertained and
probably never will be. Among the plethora of fickle testimonies painstakingly
compiled by the police, and which, in view of their superfluity in legal terms I
have declined to read, my wife and I have alighted on one. My wife could
probably recount the details of which shopkeeper or eagle-eyed neighbour
originally communicated this narrative, but whether observation or surmise, it
is the version which rings true to me.
According to this, Oliver, no doubt in his habitual state of athletic excitability
and boyish urgency, was at the pelican crossing having fulfilled his errand of
buying a cake. It being summer holiday time, Jackie, myself, grandpa and
Oliver had just shared a fish and chip lunch at my father's house. Having
improvised the first course, we agreed to improvise the second, and sent Oliver
on his five minute journey to the local shops. My last memory of him before the
catastrophe sees him seated at the dining-table, his peaked cap [a present from
Holland] pulled determinedly over his temples, methodically devouring the
rough-and-ready delicacy. He was clearly pleased to be part of this intimate and
exclusively adult family circle [his sister being elsewhere], gleefully tolerating
the turgidity of adult conversation in exchange for inclusion as we discussed
the logistics of conveying Rebekah to and from her new school.
What happened to him after he received his instructions and departed on his
errand [a chore so mundane that I hardly noticed his absence in my absorption
with the daily paper] is partly a matter of speculation. It seems that, while
waiting impatiently at the crossing, mission accomplished, a lady took her
chance, ignored the signals, and crossed. Oliver followed her example. He was
struck by a car. He broke both legs and sustained a serious head injury. A
shopkeeper called an ambulance.
Meanwhile, my wife, concerned as to his whereabouts, had made a brief foray.
Seeing the maelstrom of flashing lights, signalling uniforms and static
pedestrians it registered instantly as the mother's nightmare.
Still absorbed in tabloid trivia like a sunbather on the edge of a crumbling
precipice, I had no idea that the ring of the doorbell which drew me so
unwillingly from my complacent lethargy was a summons to Hell. The child,
Oliver's friend, said simply, "Oliver's been run over."
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I wanted to cry out. Instead, I ran. I did not run at my fastest because that was
to admit something unthinkable. The traffic had stopped on the opposite
carriageway. I reached the crossing. Someone said "Here's his father." Ironically,
I remember methodically pressing the signal button on the crossing and waiting
patiently for the traffic to stop. An official of indeterminate uniform stepped
forward to halt it. I crossed. Jackie stood weeping. Oliver was in the ambulance.
We got in. Then followed the tumble into the abyss: the ambulance rocking and
lurching as though tossed on the sea of Chaos; the gruesome rattle of the
suction-tube; the intense glances and cryptic murmurs of the ambulance-men;
the studied abandon of the driver. Oliver kicking, turning his head, rolling his
eyes. The smudge and smear of blood. The paleness and trembling and
uncomprehending stare of his mother. The clenching jaw . . . . . . . . . . . . . . . . .
Arriving at the Infirmary.
Journal. 3 October 1982 [Sunday]
Oliver was in intensive care for two weeks following an operation to deal with
internal bleeding in the skull. The problem was to control pressure on the brain
due to swelling. Treatment included heavy sedation and the use of a ventilator
inserted via tracheotomy. After I.T.U. and successful control and reduction of
pressure Oliver was passed on to a children's ward. Last week-end [ie. nearly
one month after I.T.U.] he seemed to be on the road to improvement. While not
"conscious" in the normal sense he was breathing for himself, he could move
his hands, arms, head, toes, eyes and make sounds. He reacted to sound. This
was encouraging even if he did not respond to verbal instructions. There
seemed to be no paralysis apart from his right pupil which did not [and still
does not] react to light. He was not "seeing" and "hearing" [as far as we can
understand] in the normal sense, but the fact that he "jumped" at a sudden
clatter encouraged us to play tapes. His increasing strength encouraged us to
sit him up in bed [as far as the leg-plasters allowed] using our own bodies as
support. While seated on the bed in this way it was difficult to see reaction
since we were facing the same way, but observing Jackie in this posture with
him last Sunday it seemed that he was reacting to affection. His arms were
relaxed, as were the muscles round his mouth. When Jackie kissed him on the
lips he opened his mouth as if for more; when I kissed him he curled his upper
lip, clearly preferring his mother's scented embrace to my grizzled overtures.
Things seemed to be moving.
Then, last Sunday night, we received a call from the hospital: Oliver was having
breathing difficulties; he seemed to have an obstruction in his throat. The
demon of anguished shock woke up with a vengeance; the ride to the hospital
was like a nightmare recall of the ambulance terror. It was probably a fit. We
had not anticipated setbacks. When the crisis passed, we were all left very low.
But that dreary train of events is still being lived through, and its telling
demands more energy than I have now . . . . . . . . . . . . . . . .
Journal. 4 October 1982 [Monday]
Now, as I write, Oliver is undergoing an operation. I have already mentioned the
setback of last week. On that difficult night a nurse called Fiona, who seems to
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have a special affection for Oliver, noticed that he was experiencing breathing
difficulties. The nearest doctor to hand, an anaesthetist, was called into the
ward. She knew nothing of him. He was given oxygen orally, his tracheotomy-
pipe having been removed just over a week before. Just after we arrived Dr. O'C.
came in, one of the doctors from I.T.U. He inserted an airway in his mouth. This
has remained since that time. He speculated, since there was no obstruction
and his chest was clear, that Oliver was having a fit, and prescribed an anti-
Gradually, the crisis subsided. I arranged for Jackie to be taken home and I
stayed at the hospital that night. Eventually Oliver passed into a deep and
tranquil sleep. Before this, however, I saw the tense spasmodic movement of the
arms which, according to the night staff, had not been uncommon at night. It
showed an aspect of Oliver's state which I had been completely unaware of. It
seemed to open a trapdoor into the darkness of another storey of his damaged
Throughout the following week he seemed very tired and his general level of
awareness appeared to be in decline. The paediatrician, Dr. M., seemed puzzled
and worried: Oliver's blood-pressure was high and was having to be controlled
by drugs. Clearly, something was wrong inside Oliver's head, although we were
pleased by his efforts to remove the nasal airway which had been inserted later
on the difficult night, and the nasal-gastric tube by means of which he was
being fed. This indicated, I believe, Oliver's basic problem. Under the impact of
the hurt and shock, Oliver's mind [if I may use a word whose meaning I am not
sure of] had retreated into some dark, closed void. Each new "therapeutic"
procedure, aimed at relieving his physical state, seemed a jarring re-iteration of
that first psychic shattering. Skull incisions, suctions, alien murmurs, arm
incisions, throat insertions, encased legs anaesthetic bludgeons, the throb of
swelling and cuts and sores and knitting, and the pain of the hurt that had
forced its way deep inside his body's citadel and crashed into the watchtower of
his being, all were the reiterated roars, jabs, and twists of the demon that was
Cradled in his mother's arm that Sunday the demon was, perhaps, slumbering,
and Oliver was stirring as if to creep to the mouth of the lair, into the light and
warmth which we longed to share with him. But something happened that night
to drive him back to huddle in a corner of the cave. Maybe a fit, another callous
blow from the demon's brutish arm, a warning cuff to stifle the lure of
sunshine. Or perhaps Oliver's nerve failed him. Dr. M. does not seem to believe
it was a fit, and appeared irritated by Dr. O'C.'s prescription of a perhaps top-
heavy dose of the epilepsy drug. The demon if stunned, had pinned down his
thrall beneath his dominant mass. No. Dr. M. thought that, venturing out,
Oliver had turned to the support of his breathing tube, to find it gone. It was a
momentary panic of the emerging psyche. Is it just a father's fancy to recall the
breathless panic that I too have been experiencing these nights in the face of a
deep and comfortless sleep, and to believe that this is just a shadow of the
darkness that now envelopes my son, whose soul is linked to mine by silken
threads that still twitch at the labyrinth's mouth?
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I know and love Oliver. This enigma, this unresolved wonder of our familial love,
deep down beyond the mere accidents of intelligence and perception, is: I know
him. We will not part. Nothing, not even death, can divide us. My soul hurls a
challenge to Chaos. Evil must vent its fury and spend itself; it knows it cannot
Throughout this time some continuing consultation had been going on with
neurologists at Derby Royal Infirmary. Oliver was not getting better and
something had to be done. No doubt on the evidence of the scans [no-one
seemed to make much sense of an E.E.G.] Derby diagnosed a build-up of fluid.
This could be relieved by inserting a tube internally to drain the fluid into some
comparable cavity in his abdomen; my knowledge of anatomy is vague. This
wondrous device may relieve his condition and lead to progress, or it might not.
We shall see. I am not over-optimistic. While not ungrateful for the surgical
techniques which have indeed saved Oliver's life and prevented God knows
what suffering, I believe that the Problem is far more deep and complex than
the surgeon's knife can solve, and it is not just Oliver's problem. It is a moral
problem: coping with handicap. It is an emotional problem: channelling feeling
into healing and creativity. It an intellectual problem: how does the brain
actually work? It is a problem of the re-ordering of priorities, the re-orientation
of values: not just of the little world of Jackie and myself, but of the whole
world, yes, even the cosmos. I dare to say that my own little family problem is
indeed earth-shattering or the dawn of a new age in that spiritual sphere where
human scale is unimportant. We shall see . . . . . . . . . . . . . . . . . . .
Despite further violent, if benign, assaults on Oliver's physical integrity [an
operation labelled with endearing simplicity as "the shunt"], surgery seems to
have had an almost instant effect. Sitting here beside his bed, I see that his
eyes are very slightly open with rapid to-and-fro movements. His hands are
relaxed and his arms [particularly his left] are moving gently, although
contracted at the elbow. His left leg moves spontaneously at intervals; earlier
this afternoon he was moaning insistently. He now looks more bewildered than
withdrawn. I guess that there is now some ground for cautious optimism.
Journal. 27 October 1982 [Wednesday]
On arrival [about 5.00 p.m.] I propped up Oliver against my chest with my left
hand flattened against my chest. For about four minutes he emitted a series of
moans including one load moan, almost a cry. [My father had clearly heard the
same sound. Last Friday he claims that he shouted "Oi" when father was
moving his head from side to side. On the same day nurses claim that he
"shouted" when taken out of the bath.] Conclusion: this may be in response to
unusual, though not necessarily unpleasant, sensations. It probably indicates
and articulates objection, and may be a positive progression from the
movements we witnessed before the ventricular-peritoneal shunt was inserted:
bringing his hands to his face in a "cringeing"-type action. I believe it indicates
a very basic attempt to relate to his environment through elementary
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We had not experienced any evidence of will or effort since his attempts at
Derby to nudge out his naso-gastric tube. These attempts have since subsided,
possibly because his nose is no longer sore after a clumsy insertion of an E.T.
tube during his "fit". Today I tried shaking his left hand loosely at the wrist.
After about six seconds on three consecutive tests he pulled his hand away. It
was a weak action, but unmistakable. I fail to see how this can be interpreted
simply as "reflex".
Journal. 3 November 1982 [Wednesday]
Having read a little about ontogeny, it appears that Oliver currently has the
responses of a one-month-old baby. It is still open to question whether or not
we could move him on towards the responses of a three-month-old child. It is
unclear at this stage whether the handicaps are neurological or psychological.
My body is yours;
my brain is yours;
your soul is entrusted to me.
If Oliver's "problem" is psychological, then we must provide him with the
comforts of the womb, while coaxing him towards birth. This is the prime aim of
his mother. If his "problem" is neurological, then we must extend his brain,
both as receptor and emitter, by means of electronics. This is the prime aim of
Journal. 2 December 1982 [Thursday]
Oliver has made some small but encouraging progress over the last couple of
weeks, the most rewarding of which is his new-found ability to smile. Although
this does little to overcome his physical problems, it is a tremendous boost to
morale. When it first happened [I was talking to him about his favourite foods]
Jackie and I were together. This was great. If either of us had reported the
"event" to the other, it would have been met with incredulity. As it was, it
happened three times "on the trot": chocolate . . . smile and "coo"; ice cream . . .
smile and "coo"; cake . . . smile and "coo". And yesterday, for the first time, he
smiled at what he heard on tape [no doubt recognising John Pertwee as
"Wurzel Gummidge"]. This is personality.
Much more important in medical terms is his growing ability to swallow. He
began to take baby-food about three weeks ago, and now has two liquidised
meals a day. Consequently, he is now physically a great deal more robust.
The physiotherapists continue to spend a great deal of time with him, and have
just started to take him out of the ward. They seem rather clandestine in their
behaviour. Whether this is because they are jealous of their "trade secrets", or
because they are trying something along the lines of "patterning" - establishing
the correlative mental circuits appropriate to his next stage of development. At
the moment it's difficult to establish a dialogue with the physio's: they operate
in the early afternoon when I don't normally visit. But since everyone is now
talking about a training or induction week for Jackie and myself at the hospital
after Christmas [an introduction to some of the problems we might meet in
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nursing Oliver at home], I guess there will be more fruitful contact with the
physiotherapists then. I see them as the hospital's major input at the moment.
Oliver is now not simply "not stiff": he is supple. It's good to see him tired in the
evening. It must be a great aid to real healing sleep and a creative antidote to
boredom and frustration.
We hope that we are on the threshold of some communication with Oliver. It
seems [Jackie is more convinced than I am] that he will both blink and widen
his eyes to instruction. Experimenting yesterday, he did seem to be doing this.
The telling point is that when congratulated on his clear response to
instructions, he smiled. This could be a major breakthrough. As far as we can
see, he has no comparable control over any other part of his body, although
there is a shade of co-operative movement in his arms. Dare we begin to think
of a system of codes? Our biggest worry now is our future domestic
arrangements. I hope the picture will become clearer in the next few days . . . . .
Letter. 15 December 1982. To: Head of Special Education Section, County
Hall, Leicester. [Mr. L.]
I am writing to you in connection with my son who is nominally a pupil at
Belgrave C. of E. Primary School, Leicester.
Oliver sustained a serious head injury resulting in brain damage as a result of a
road traffic accident last August. He is now undergoing treatment in Children's
Ward 11 at the Leicester Royal Infirmary under the supervision of Dr. M.
Domestic problems are being dealt with by Miss C. P., the Hospital Social
The competence and commitment of Mrs. V. P. [acting Headmistress] and her
staff at the L.R.I. School are above question. Nevertheless, Oliver undoubtedly
has special educational needs which they are not necessarily trained to meet. I
would be very glad to initiate some discussion and consultation regarding any
special provision which can or should be made for him both in the short- and
Without wishing to pre-empt any decisions which may be imminent, you will
appreciate my concern that there should be maximum co-operation with
medical and social-work staff even at this early stage in order to achieve the
optimal progress and quality of life in his present situation. I must stress again
that I am in no way questioning the L.R.I. School's ability to make excellent
provision for developmentally "normal" children. I would be delighted to discuss
the matter with you at any time during normal working hours in the next three
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Circular: Ten Discussion Points re. Special Educational Needs.
1. We feel that the question of educational provision for Oliver during the
summer term should be sorted out as soon as possible, since other, fairly
complex arrangements need to be structured around it. He will be returning
home on the 28th March.
2. On the basis of visits already made, we are not convinced that there is any
special school in the city which can adequately cater for Oliver's needs at this
precise moment in time. We recognise that it may be impossible to achieve a
perfect long-term solution given the accepted priorities in resource deployment,
but in order to avoid possible disruption at a later stage we feel that the utmost
care should be taken over deciding what is the most appropriate long-term
provision. In view of this, placement may best be deferred until the beginning of
the next academic year. Whatever the outcome of discussion, we may be eager
to take advantage of our statutory right to comment on the draft of the
statement of our son's needs together with other rights under the 1981
Education Act. We may also, if necessary wish to avail ourselves of the
opportunity to view and comment upon any personal records appertaining to
our child in accordance with the recent resolution of the Policy and Resources
3. Oliver's peak phase of alertness is during the morning session. Thereafter
fatigue sets in. We feel, therefore, that any specific educational input needs to
be concentrated in the morning. In view of this, school might not be the most
appropriate provision ay this stage. Pending further discussion we may be of
the opinion that a hone tutor should be made available for an adequate daily
session for the remainder of this current academic year. This provision could be
coupled with access for both tutor and tutee to the facilities of a "normal"
school in the home locality in order to provide for social and other stimulation.
This would be entirely appropriate to a post-Warnock situation.
4. While Oliver is now we feel certain, capable of sustained concentration
during an entire morning session, it may be difficult for a teacher to sustain
such a concentrated educational input on a one to one basis. Any one tutor
would be in need of the support and guidance which teachers enjoy in a normal
school situation. We feel, therefore, that the optimal provision would be two
tutors, each employed in the two two-hour sessions in the morning, with a half-
hour "cross-over"/liaison period in-between. During this half-hour period Oliver
would have a break between the hour-and-a-half lessons on either side while
the tutors were planning/conferring.
5. Any tutor should be guided by the Schools' Psychological Service in the
formulation and resourcing of an individualised learning programme which may
take into account the following factors:-
[a] Oliver's hearing and aural comprehension is excellent;
[b] There are problems with Oliver's vision. His perception of colour is
very good, but with unfamiliar visual stimuli there appears to be a delay of
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