On Tuesday morning I kept watching the little pathway leading up to the dining room. I knew that at any moment, Mr and Mrs Desai would be walking towards me, ready to have breakfast. Mr and Mrs Desai started coming to us in 1999 when they brought the, now-late, Mr and Mrs Desai Senior for check-ups. Fast forward 24 years, and the son that brought his parents to visit doctors is coming here himself for the same reason, seeing the same doctors and staying at the same lodge. They are from Zambia, the country where my husband was born and over the years, while we all navigated different challenges, we have grown extremely close, so close that they call me their daughter (they only have sons) and I call them my Zambian parents. Each time they come to SA they make sure to buy me my favourite red wine and chocolates at duty free, and I personally make the pressed veggie-fruit juices they like.
As Mr Desai was showing me photos on his phone this week, I spontaneously crept closer and closer to him wanting to crawl under his arm and feel his warmth. I miss my dad, and my uncle, who serves as a substitute, lives far away in the Western Cape. I just needed a bit of wisdom and love in a safe space from a father figure and I think, just maybe, Mr Desai wanted a bit of comfort too, as his biological kids are in the States. We have little in common on paper: different ethnicities, different religions, different generations, different home countries, and yet we have a deep connection built over years of continued interactions. I treasure these wonderful blessings in my life and never want to take for granted these rich relationships that offer such sanctuary.
I had a meeting with two incredible women this week. One is a passionate social worker who is so qualified that I reckon she could fix the NHS in a morning. The other, is an equally passionate doctor working in oncology focusing on head, neck and shoulder treatments. Together, the three of us were brainstorming around solutions for these patients while they undergo radiation treatment. Even though the clinical treatment has improved and modern medicine is achieving more spectacular miracles than ever, somehow the humanity-side of this was left behind. The focus, and rightly so, has been on the treatment of the cancer, but because of these invasive procedures, people’s dignity, self-esteem, mental health and comfort were unintentionally sacrificed.
As I write, I’m getting goosebumps thinking about how committed these pioneers are and how they are willing to fight for their patients; are willing to challenge the status quo to get the best for them. People love to say that doctors go into oncology for the money and their egos. This is not what I experienced with these two women. This is their calling and nothing but their patients’ best interests matter to them. We are trying to find reprieve and comfort for people who are often left with a trachea (an easy condition to manage, but quite degrading and traumatic in many ways) and are forced to spend weeks in institutions because of ongoing treatments. We want to offer them a soft landing and a bit of beauty on a brutal journey. Of course, the other advantage of people staying with us is that if, and unfortunately it happens often, their journey to recovery becomes a palliative journey, they can continue on their paths with a known team in an environment they know, saving them yet another trauma of adapting to another new space. The importance of such continuity sounds so simple to people who have not been sent from pillar to post on intimidating medical odysseys. Even just having one familiar face is an incredible relief to people who need others to advocate for them.
So just to prove that this blog is not just emotional ramblings and boring innermost feelings, I am going to make a bullet point list of all the advantages of continuity. I kind of based this on the difference between when a patient uses the same physio they used in hospital when they come to us, as compared to starting the recovery with a brand new one. The latter is usually the case in other facilities who only deal with certain practitioners, but not with us, because we work with all practices and let the patient determine who their allied therapist should be.
In our experience, benefits of continuity include:
Emotional Stability:
Forming new relationships when already in a place of huge vulnerability is incredibly taxing on your emotions. Imagine feeling awful after a surgery and looking at your worst and being forced to meet a new person every few minutes who pokes and prods you. Not adding this burden to our patients and guests aids their emotional wellbeing. In fact, it improves it, when you are around people you know care for you.
Emotional stability fosters better mental health and resilience in facing the next step, wherever it may be.
Stronger Relationships:
Long-term relationships provide a support system during both good and bad times. We often celebrate the victories after a recovery, but we get to be there when there is no good news to share too and allow the person to feel less anxious as bonds are already established.
Shared experiences create deeper connections, especially when people are at their rawest.
Improved Wellbeing:
Lower stress levels and a sense of security contribute to overall wellbeing. Regular routines, like the smell of Dylan’s cinnamon biscuits every morning and the same gentle carer you know who comes to help you bath, creates a consistent environment conducive to improved over all wellbeing. Having George, with his huge smile, help you go for a walk a few times a day, is enough to improve anyone’s mood.
Better Decision-Making:
We are forced to have some very tough conversations here, as you can imagine, with difficult choices. Having a foundation that’s stable and known, surrounded by people you trust, takes the fear out of these discussions.
Resilience in Adversity:
We often wonder why Daphne, who was supposed to live between one and five days when she came to us, is still alive after 23 months. There is absolutely no science that can explain her longevity, and we suspect that it is because she loves her life here with us. She sees her little Yorkshire terroir daily, she gets Dylan to make her wonderful food and on Fridays, she has her hair done by Alan. She has a nail lady that comes every two weeks and every day, Nthabiseng washes her. Daphne has not had one bedsore despite not changing position in her bed for 14 months now. Nthabiseng knows her body. She knows every crevice and detail and without a doubt, she loves Daphne. She notices the second there is so much as a tiny red spot and will ensure no pressure sore develops. This is care in its most compassionate form, and I am humbled every time I see Nthabiseng serve Daphne in this powerful way. Daphne cannot be resilient on her own. It is her carers, her night angel Nobuhle, her family and Sally, the Yorkie, who help her achieve this.
Financial Gain:
Okay, hear me out. I believe without a doubt people heal more quickly here because of the continuity and established relationships. I believe EOL (end of life) patients have gentler journeys with less hospital admissions here, because of consistency. I believe that we are cheaper than other establishments because we do this out of passion and not to satisfy board members. It’s because we really love our patients that we save the medical aids and the patients money.
Enhanced Focus and Concentration:
Our people do not have to keep getting used to new sounds, new people and new routines. They can focus on what they are here to do: to recover, to have some respite or to start their last journey.
The absence of constant disruptions and getting used to new things, allows our guests to conserve their precious energy.
Over the years our traditions give our guests and patients, and us, much-needed comfort. Knowing our fellow staff members’ stories and sharing our lives bonds us. We know Kundai always wears a shell necklace. We know that Felicia dances without even realising it. We know Bongiwe never wears pants and that Storm drinks more tea than the queen of England. Talent walks with such a straight back and Obakeng wears her turquoise scrubs on Mondays. Olida drives like a loon, Leonard always arrives when there is food and Dylan goes to Woolworths on Mondays and Thursdays. We celebrate birthdays with cake and bad singing. We have 6:30am meetings on Tuesdays and Fridays that never follow an agenda. With Zazen we have a Friday IDT (inter-disciplinary team) meeting in the morning where Jodi devises some game for us to make us question the big things, dear Eileen brings Brian muffins and treats every morning and our cat Meenie insists on sitting on your keyboard whenever you need to work.
As our business is growing and changing, we are establishing new traditions that we plan to continue. We verbally tell our colleagues what we appreciate about them every week. We discuss our best moments and admit what we would like to change once a week, and we are learning to be more boundried. My favourite new tradition is that at the end of the week, we toast our survival thereof with a glass of bubbly. We gather in the practice lounge and Dr Jodi contorts herself onto the tiniest couch in South Africa. I’m often lying on the floor or collapse onto a chair and Dr Jesne slouches low into a wingback. We laugh hysterically at the craziness of the week and share how hard certain moments were, but generally we just celebrate that we get to do this work, that we get to meet these people and that we can be in this team who continues to serve, and serve, and serve.