Every year around December we drive through the Karoo, and once we cross over the Orange river I do two things. Firstly, something happens in my brain and I need to listen to Afrikaans music to my poor family’s utter disgust. It is as if the sight of the big skies and farmlands reminds me of my roots. I also start processing the year, that not unlike the Karoo, stretches out in the rearview mirror behind me.


Our year started with one of our most courageous guests dying just after midnight on New Year’s morning. Dr Ed Schutze left his New Year’s Eve party to be with Dave. Palliative care doctors are simply different from the rest. Dave had a melanoma that metastasised to his brain and his decline was rapid. In the months we cared for him, we got to love and care for him and his wife deeply. She stayed on in his room for a few days after his death,  and we nurtured  her and her broken heart with the same tenderness with which we’d cared for him. A year on, she comes to visit us often and we go for lunch. Every time I see her, she has healed a bit more, but I know that this first Christmas without him lies like a mountain ahead of her.


As the year draws to a close, we also lost one of our own this weekend. We had a sweet, precious young cleaner named Jessica. She started working for us around the beginning of the year when my friend Cathy phoned and said Jessica helped her part-time while her domestic worker was away, and she felt that she would be perfect for our business. She was educated, humble and incredibly kind. She had a ferocious desire to learn and to escape the cycle of poverty in which she grew up. She lived with her granddad who adored her and even though he was a gardener, he encouraged her to build a career. Jessica always smiled and she had a strange love of ridiculous hairstyles. More than once I had to ask her to change whatever was  happening on her head, and one of the funniest moments was during the Leadership Conference in October where I got stuck behind her and her hairstyle, which resembled something between a 60’s beehive and a Kruger-weaver’s nest. I remember that day well. It was the first time Jessica had ever gone to a conference and she was dressed so smartly and participated in everything enthusiastically, fully invested in this learning opportunity. Throughout her time with us I could see how she grew each day, getting more and more confident, making eye contact, voicing her opinion and even cracking a joke with me after being quite careful in the beginning. Just last week we had a staff outing to the Dreambox at Prison break market. It is a massive warehouse with nooks and crannies where you can take the funniest photos. There’s an upside down room, a room full of rubber bath ducks, a room where it looks like you are swinging on a beach and one full of bubbles. Jessica liked the room where she could pretend to be in a recording studio and lived out her fantasy of being a jazz singer to the fullest. We laughed and had such fun. Someone must have told her to calm herself down in the wig-department because whatever she had on her head that day was rather tame, even thoughit was still twice as big as other people’s hairdos. At least, the wig did not need its own identity document this time. I went back now to the photos of that day. I look at Jessica in the team photo of all of us throwing plastic balloons. She is laughing spontaneously, completely free and living in that moment. One can see she belongs in this team. She was the youngest staff member, our baby, and I can imagine how she must have been so proud of herself to have arrived here in a place of belonging where a group of people wanted to nurture and invest in her. She had an older sister and a cousin, both of whom are working for us too now. She went from a young, immature girl coming from a village in the middle of nowhere, to someone that mattered, had the power to help uplift people and have opportunities to create a better life for herself and hopefully, her children one day. Three days after we went to Dreambox Jessica was admitted to Helen Joseph hospital. We were not worried, as it was extremely hot and many people had a tummy bug. We thought she was just dehydrated. A few days later we were told she had meningitis and the next day, she died. The system failed her. Africa sold her out. Our disgusting greedy politicians killed her. I am devastated, not just for her, but because this is just one of many stories like this one, and there are countless more. Rest in peace, sweet young Jessica.


So, yes, there were brutal moments this year. We had about two or three deaths a month. I am delighted to say all were beautiful, gentle and graceful. We have kept in contact with all the families, and they visit us often. We had a huge variety of recoveries as well – many joint replacements as you can imagine, but then also an array of trauma’s like gunshots, horrendous motor vehicle accidents, adventure sport accidents and injuries obtained in combat! A large number of our guests were from overseas this year and I also love that our patients varied in ages: some from a few days old and many in their nineties. We celebrated the one year anniversary of Daphne, who was supposed to die within 24 hours when she first arrived, but 21 months later, Daphne is doing many things, but dying she is not. She has not been out of bed since Christmas day last year, and due to her tumours, she cannot change position. I am so proud of my staff that she has not had one bed sore, ever. They love her so passionately that they simply will not allow this to happen.


This year Storm got married and she looked gorgeous. Her husband Thornton is a very lucky guy, as Storm is everything anyone can ever desire in a wife (except if you like eating… she doesn’t cook). Felicia had a chubby healthy little baby, six staff members completed additional training at Red Cross. Both Olida and Dylan got new cars and Leonard has excelled in his online courses.


Some of our staff have left. Darling Tola went back to Nigeria (Side note: I foolishly paid her her full salary the other day by accident. Her bank account is now used by someone else from Lagos, but can you believe, that person graciously paid back the full salary to us. I never thought that would be the case!) Noreen who was with us for years left to pursue a career in the UK. She was also the first to send me an AI-written and composed resignation letter!  I had to dismiss a person who worked for me for over 26 years. Firing anybody is hard, but to dismiss someone you have loved so long is heart wrenching. I loved her kids, knew her extended family and attended many funerals and weddings with her. As much as I don’t like it, I am grateful for written procedures and codes of conduct which take the emotions out of decisions. When you get to just work with facts on black and white, arriving at conclusions is so much easier. I’m used to living in the nuanced greys but in this case, I could not afford it. I had to look at what procedure to follow and how to do it. I did what was right, but I hated myself for it.


I also lost my dear friend, Harriet, who was in ICU at Sunninghill Netcare Hospital and although she and I plotted daily while I brushed her hair that she would come and stay with me on discharge, it never happened. I wish she did not have to die in a sterile clinical environment where death is hard and brutal. She was the most glamorous of people and deserved more dignity.


I will finish on a happy note. We are beyond excited about our new collaboration with Zazen Respite Care. On 15 January we officially open our doors at our other lodge down the road where we will specialise in respite, palliative and end-of-life care. We are proud to have all the licenses and are registered with medical aid. The best part is that we have structured the business in such a way that for every three private patients, we commit to helping a non-paying patient free of charge. There is an incredible shortage of inpatient beds for palliative care and the government does not supply a single one. This means people are forced to die in homes that cannot cope with their needs, or in noisy graceless hospitals. I am forever grateful for the serendipitous meeting with Dr Jodi Wishnia and Dr Jesne Kistan who share our deep commitment to the frail and dying. We also share the vision that at the end of the road, you need community, dignity, proper pain management, beauty and comfort. Instead of being tired and run down at the moment, I am incredibly excited for the year that awaits us. It is as if everything we have done and worked for has led to this point, to creating this wonderful business which serves everyone: the staff, the patients (paying and non-paying), the community and of course, God.


I am afraid that this may sound contrived, but I have a sense that this new venture will be God’s place, and we just get to run it for Him. We will be in charge of the exit lounge before the people we care for move over to the next realm to be with Him. What a privilege this journey is.


And now, I want to thank you readers who always comment and encourage and allow me to share my stories, my pain and moments of total chaos. This blog is much cheaper than therapy (although I still need the therapy, but this helps a lot!) May your Christmas be filled with family and love and may you focus on what counts: your people and their presence around you. May your 2024 be gentle and may you know that you are loved.