A free spirit

By Cindy Hatchett | 01/20/2016

I had been transported back in time!

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I am a nurse practitioner. For two years, I worked for a nongovernmental organization (NGO) in Southern Africa. With referrals from hospitals, clinics, private doctors, lay care workers [carers], and other individuals, we visited people in their homes when they were ill. Every day was a challenge, because I never knew what I would have to deal with. The goal of our team was to provide palliative, holistic care to everyone we visited, which meant we tried to relieve suffering, whether psychosocial, environmental, physical, or spiritual.

Many of the people I visited did not have the wherewithal to write their own stories, so I will be their voice. These people and their families deeply touched me and remain etched in my mind. As a candle-lit Turkish lantern illuminated an uncertain pathway for Florence Nightingale, I offer these narratives to help light the way for others who have also chosen the noble profession of nursing.

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Referrals for admissions came from all quarters. Any patients in need of help or assistance could ask us to visit them in their homes, or we would receive a referral from the hospital, a doctor, or family member. At the first visit, a full physical examination, medical and family histories, as well as social and spiritual assessments were done.
 
Always be prepared, I was taught in the guides. In this job, that was not always possible. What a challenge! Every day was different, each patient teaching us something new and exposing us to diversity.
 
I thought I had led a varied life filled with exposure to all kinds of things. I was a mature nurse—somewhat disorganized, but experienced—or was I?
 
On this occasion, it was a family member who called to ask for assistance with an older gentleman. At the same time, another call came from the hospital about the same man. He needed immediate assistance. He had no fixed abode, but I managed to get his cellphone number from his daughter and called him.
 
Liam was very happy to receive my call and said he was looking forward to our meeting. He asked if I could stop by for some tea at 10h00 and gave me directions to where we could meet. After calling Marie, the carer in the area, and informing her I would stop by to pick her up, I started the 30-minute journey. En route, my head was filled with thoughts of my late father because this gentleman had the same condition: carcinoma of the colon, Stage IV.
 
Following my written directions carefully, we travelled on dirt roads and through forest, then came upon a lodge. I double-checked the directions, and yep, this was the place.
 
Milling about the lodge, which was situated amongst trees and flowers, were many young adults wearing kaftans, flowing skirts, beads, bangles, and sunglasses. (If this was a video, a soundtrack from The Doors, the Beatles, or Janis Joplin should be inserted here.) Somehow, it seemed, I had been transported back in time to the 1960s and a secret sect of hippies!
 
Some of the women wore bikinis, many of the men had long hair, and the majority of the people were barefoot. As Marie and I walked into the central area of the compound, everyone looked our way. We stuck out like sore thumbs. My scrubs, orange tool box, and stethoscope were alien in this place of flower children.
 
Liam approached and hugged and welcomed us warmly. In his 60s, he had a kind face and his long hair was tied up in a ponytail. I asked if there was somewhere private where I could examine him and ask him some questions. He smiled, said we were all made of the same stuff, and proceeded to lie down on a bench amongst the trees. A young lady gave me a flower to hold. Perhaps if I tucked it behind my ear, my uniform would disappear and I would fit in a little more?
 
I began by asking Liam questions about his history. I learned he had been diagnosed with cancer of the colon and had agreed to one operation to alleviate an obstruction, but had since refused all “normal” treatment, such as chemotherapy and radiation.
 
When I enquired about pain medication, he said he didn’t believe in taking anything manufactured synthetically and proceeded to pull out a small jar of dark green goo. Twisting off the lid, he scooped out a small amount and rubbed it on the inside of his cheek, then offered me the jar and asked if I would like to try some. I immediately stammered, “Er … no, thank you, sir, I’m on duty!” In retrospect, it wasn’t quite the right thing to say, and the carer chuckled.
 
I was then offered a cup of tea, which I said would be lovely. He took me over to a counter on which there were about 10 pots filled with a variety of tea leaves, herbs, and flowers, some with a mixture of all three. I politely asked for a cup of normal tea. Did they perhaps have a tea bag? The lady behind the counter with the huge grin on her face said, no worries, she would go and get one. Heavens! I was so out of my depth! What was the problem with asking for a normal, regular cup o’ tea? Liam, amused at my discomfort, said I needed to chill a bit and absorb the beautiful surroundings we were in—that life had led me to that place to meet with him for a reason.
 
When my tea arrived, I sniffed it and warily took a small sip. It tasted OK—normal—and I enjoyed it. Liam then removed his shirt, lay down on the bench again, and continued to answer my questions. When I started to draw a genogram of his family, he started calling me the genealogist, a name that would stick throughout our subsequent meetings.
 
There, under the trees, with birds chirping in the bushes and butterflies swirling around us, I examined Liam. He had a large, hard mass in his abdomen. Surely, he must be in some pain. He had stopped eating solid food and was liquidizing fruit and vegetables for each meal. He spoke of his family, how blessed his life had been, and the wonders of natural remedies. He said he didn’t stay in one place for too long, so didn’t know if we would meet again. Gently, I enquired about his condition. What had the doctors said? Brushing aside all my enquiries, he thanked me for coming out to share this time with him. He didn’t need help at the moment, and his family and friends were all just panicking. Everything was under control.
 
Many of Liam’s family members and friends were concerned about him and phoned me after that initial meeting, but he refused intervention of any kind and kept moving from place to place. He was a rolling stone that no one could pin down, but I kept up telephonic conversation with him at regular intervals to make sure he was alright.

It was late on a Saturday night when I received a call of distress from his daughter. She was sobbing and very anxious. She was a seven-hour journey away and would be leaving early the next morning to go and collect her father. Please, could I go and see him tomorrow morning? He was in pain, unable to take food orally anymore, and having difficulty walking. She gave me detailed instructions on how to get to a cabin in the forest where he was staying with a couple who lived “off the grid.” They were distressed because they didn’t know how to help him.
 
I phoned Liam, and he informed me that he just knew the genealogist was going to call. Please, could I help him? He wouldn’t go to hospital and did not want any drastic interventions, but, to relieve the pain, had started to drink that afternoon the oral morphine he had been given at the hospital on a previous visit. I advised him to continue taking it regularly, along with the antiemetic, at the dosage the doctor had prescribed. I would see him early the next day.
 
Sunday morning early, I drove for 45 minutes, first on paved road, then dirt road, then into the forest, where I came across a rickety gate and then a cabin surrounded by nature. There were enormous trees, shrubs, flowers, and lush, green grass. What a perfect place for Liam to be. A few horses roamed in nearby fields, oblivious to his suffering.
 
I met Liam’s friend, who was distraught, and followed him. Liam was sitting in a chair in the middle of nowhere, face turned up to the sun, soaking up all the bounty around him. He had lost a lot of weight and looked tired but peaceful. The morphine was working and had taken the pain away.
 
Liam greeted me warmly, thanked me for coming, and asked me to take a seat beside him and hold his hand. “Look around,” he said. I did, and then, a short while later, I looked at him and was surprised to see tears coursing down his face. He didn’t want to leave here, although he knew it was difficult for his friends. Soon, he would be collected by his daughter and be with his family. As a genealogist, I should understand, he said, and chuckled wickedly.
 
His friend offered me a cup of tea and asked how I took it. Uh oh, here we go again. One sugar and a little milk please, I replied. He shook his head and started talking rapidly about karma and taking milk from cows. Quickly, I assured him that black tea would be good, thanks. This was no time to get into heated debate.
 
Liam and I sat together in the middle of the forest, and he spoke of many things—things he loved, people he loved, things he should not have done, funny things, sad times, and, for the first time, the path in front of him. I listened mostly. We watched the birds, the grazing horses, the wind moving the branches of the trees. There were many silent moments, but they were comfortable.
 
After a couple of hours, he asked me to go to the cabin and fetch the white bucket that was just inside his door. I brought it to him, and he said it was a gift for me. For a time, he had been a beekeeper, and this was the last pot of honey he had harvested. All of a sudden, I felt emotional. We would never meet again.
 
The sound of an approaching car informed us that Liam’s daughter had arrived, and he stood up shakily and hugged me. “Thank you for being part of my life journey” he said. “Every meeting has a purpose. Nothing is a coincidence.”
 
We said goodbye, and I left with a sense of privilege that I was given a glimpse of this gentleman’s life. He had allowed me to be part of his journey. That Sunday morning, he taught me the importance of taking a little time to smell the roses and listen to the wind.
 
A free spirit, at one with nature.
 
Cindy Hatchett, MSc, RN, RM, was born in Liverpool, England and has also lived in Australia, Borneo, and South Africa. She has been a member of the Honor Society of Nursing, Sigma Theta Tau International since 2007.
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