I’ve just wasted another 15 minutes looking for my phone. This is a daily occurrence, I lose keys, phones, and my temper. I also regularly lose my train of thought, my focus, my balance, my direction, my composure, and some would say my mind. I do not lose weight or my appetite though. Fortunately most of the losses I deal with are temporary. What I lose is usually found again quickly and is more irritating than tragic, but in our line of work, we are confronted with real loss daily here at the lodges. It follows us into every room, and lingers next to every bed.
Yesterday we bid farewell to an athlete after her three-week stay with us. She had a devastating fall on a trail run, was medivacked to South Africa from Kenya, and both her knees had to be replaced. Losing (and fortunately, then replacing) joints is common around here. There is almost always a knee, hip, shoulder or even an ankle-replacement patient undergoing physio on our patio. It’s amazing what is possible with surgery and joint replacements, and there are often great outcomes, but it is still a huge loss, especially for a runner whose identity is firmly embedded in her discipline. We watched her take her first wobbly steps and try to regain her confidence. She was so scared of everything: the pain, the future, the time lost, the healing. The care required during this kind of recovery is more about emotional support than the physical care. Strong, healthy, young people heal differently than the frail, overweight or older patients. Our care must therefore also be different. As we support and encourage her, we need to be sensitive to everything she lost, including her confidence, her trust in her own body, and to a certain extent, hope. Instead of sitting quietly and patiently feeding her, or helping with daily living activities, we had to focus on her independence, her love of the outdoors, her competitive disposition and terrible addiction to the sports channel. Being mindful of our patient’s broader losses and struggles, rather than just focusing on their “medical losses” is always important in providing effective and holistic care. We always strive to see the whole person – not just the part of them that needs “fixing”.
One thing many people we encounter meet lose regularly is dignity. A long-staying patient, Prof Grey, was re-admitted to hospital after he was with us for many weeks. There were complications and he spent another month in high care in hospital. My team went to see him daily, to shave him, assist with changing his stoma, to help him bath, and dress him gently. The hospital staff need to be focused on getting the job done, so there is no time to be gentle or tender. Prof got physically better, but we saw him lose hope. Lying in that ward caused him to lose the will to live. We welcomed him back last week, and he started eating again, and found his sense of humour that he’d lost in hospital. The day after his return, his lawyer visited. His lawyer is also his best friend. They met 70 years ago at university. They drew up a living will and we were asked to promise that he will never return to hospital. From now on, whatever happens will be on his terms. Once those documents were signed, we watched him change and regain some of the lost confidence. He lost his voice in hospital. Now, with his regained autonomy, with this advanced health directive in place and a team to back him up, this will not happen again.
We see many other losses here daily. We see the physical losses patients suffer, the loss of hair during chemo, the loss of a breast, a kidney, a bladder. They lose memories as old age or dementia smother those precious recollections. They lose interest in the outside world as their lives shrink to focus on only healing or letting go. They lose mobility, strength and control of bodily functions as diseases ravage bodies. It is our job to help them find the freedom to embrace the journey they did not choose.
Deepak Chopra said “In the process of letting go, you will lose many things from the past, but you will find yourself.” Loss is just change, and as we know, this is the only constant in our lives. The losses our patients suffer are harsh, but what they often find, is profoundly worth finding.
Mrs Antjie Du Toit was medivacked to South Africa. She is a wealthy farmer’s wife; a beautiful and glamorous blonde who even looks good on her passport photo. She suffered the cruellest of strokes, and I admit that I was petrified of having her stay with us. I did not think we could manage her care. She was paralysed and non-verbal. She couldn’t swallow and was delirious. Her medical insurance agent pleaded with us to take her as she was deteriorating rapidly in the institutional environment. Antjie had to be re-admitted to hospital twice during her early stay with us, but then, slowly but surely, she started getting better. We organised a team of neuro-physio’s, an OT who is right up there with mother Theresa, a dietician and the most patient speech therapist, probably in the history of the world. After months and months and months of hard work and diligent treatment sessions, Antjie sat with her family in the sun by the pool yesterday, fed herself a bit of cheesecake and told me my hair looks nice. Yes, she is not the vivacious, independent woman she was last Mother’s day, but our lives were never supposed to be lived just to be happy, or to selfishly just experience pleasure. We are here to learn, grow, build relationships, and do hard work on ourselves.
Of course Antjie would not choose this body she is in right now, but I wonder if she would give up all she has found through the loss?
In the end, perhaps, what defines us as humans is not what we have lost, but what we choose to find in the wreckage. We don’t always get our old selves back: our strength, health or control, but we can find new courage, unexpected friendships, wisdom, peace of mind, deeper empathy, and I guarantee, joy too. At the lodges we get to see firsthand this sacred exchange in what is lost and found. Suffering for solidarity, pain for grace, arrogance for vulnerability, security for hope. While we watch others find these deeper things, we often recover parts our ourselves we did not even know have gone missing.