If I close my eyes right now, I can almost believe that I’m in the heart of Tuscany. All I hear around me are passionate Italian words and expressive sentences. We have a “nonna” here who is recovering after a knee replacement. She has a large family that come and go like waves on the beach – as soon as one lot starts leaving, another lot starts arriving, befriending our other patients as they make their way to Nonna’s room. They chat and laugh and carry with them the smells of whatever delicious treat they’ve brought her.
In another room, we have a very quiet, very serious Swiss dame. She is healing from a shoulder replacement and walks stiffly around the lodge, hardly making eye contact as she quietly navigates life with one arm in a sling. She never gets visitors because her family lives in Europe. What she doesn’t know, is that her children are managing a big renovation project on her home in Sandton, and that when she leaves here, her home in the retirement village will be beautifully revamped.
When I go to room 6, the television is always on a channel broadcasted from Paris or Edith Piaf is singing heart wrenching songs from a little JBL speaker. Our patient here only speaks French. She is the colour of a solid black onyx, unless her bright smile splits her face in two. Her daughter-in-law (who by contrast is white as snow, with long blonde locks and pale blue eyes) is a medical doctor and has flown from the States to be with her mom-in-law who is traversing getting better after a difficult polytrauma surgery. I can only say “hello”, and “I love you” in French, but somehow, we’ve built a remarkable relationship with those few words and some help from Google translate.
For every patient that stays with us, we form a WhatsApp group with his or her family members (and friends if needed). We send daily updates, some photos and communicate about everything from the utterly mundane, to the totally extraordinary.
You very quickly get a sense of how different families operate, where there is tension and where the different characters fit in. For instance, in Nonna’s group, there are a lot of exclamation marks, talk of food and playful teasing. With the Swiss lady we get a lot of clear-cut instructions, straight to the point comments and absolutely no small talk. But despite the lack of warmth in the messages, we note how almost daily, the family alerts us that one of them has sent a parcel, or a Woolies delivery, or have arranged a beauty therapist to come and paint mommy’s toes.
We have another patient, Heather, who battles with soul-destroying chronic pain after spinal surgery. Her children are spread across continents, but none of them are in Africa. As soon as Kundai sends the morning report (usually before 8am) they respond immediately, regardless of the time differences. They are hungry for news on their mom and their sentences drip with feelings of guilt because they are so far away. We make a point of sending them videos of their mom and how she is progressing. We dress Heather up for every possible occasion. On St Patrick’s day she wore silly glasses and a green hat. For Easter she happily popped on some bunny ears. It’s not the same as being here, but I do think it makes the load less to carry if you are able to take part in your loved ones’ life, even if it is from afar. We share with Heather’s children that we notice she always puts lipstick on before the handsome male physio comes to see her, and that she has started doing crosswords again as the pain has started to ease.
Not all families, however, are interested in our patients. Some patients arrive and decline that anyone should receive updates. There are some groups on which we are the only ones that participate, or messages don’t even get read. We have a patient who has three children, all living in Australia, and despite her almost dying after a terrible fall during a hike, they have hardly reacted to any message or clip we’ve sent. As I got to know her, I think I understand why the children are so distant. The patient is sarcastic and manages to find fault with everything we do. She is unkind to my staff, who patiently help her with the most intimate daily life activities, and makes a point of criticizing everything from the weather, to the colour of our scrubs. The other day she even complained that she finds my Afrikaans accent grating on her ears!
I realise that our patients are much more than just a painful spine, or a mending hip. They are people who have relationships and who have spent lives nurturing or breaking down these fragile threads. It’s a privilege for us to become a bridge in these beautiful and often difficult bonds. Looking through all our current WhatsApp chats reminds me that love wears so many different guises. Some love shows up in bright Tupperware filled with biscotti and melanzane. A different kind of love appears in efficient e-mails confirming medication lists.
Sometimes families come limping into our space with a history of broken relationships and communication becomes very complicated. We often have to start two or three WhatsApp groups for one patient because the resentments some family members carry are so deeply ingrained that they cannot even bear to be in one communication group. We must ensure siblings don’t visit at the same time in case there is an altercation. We have to organise more than one family meeting so that stepmothers or half-brothers don’t have to endure being in another person’s presence. We had a Jewish mom with us whose husband and sons could not tolerate each other. They worked out a detailed schedule of whom would be visiting at which time. Towards the end it was clear that they thought Hazel would die with the one she loved most, and all three men would often rush into my office to ask if Hazel had died from time to time when she was very still. . This went on for a week, and when Hazel finally died, she was alone with Nobuhle, our carer. We phoned the sons and husband separately, and I have often wondered how they navigated the funeral.
For the time a person is recovering with us or walking an end of life journey here, we are folded into the family. We know which secrets to keep, who to protect, when to step in to avoid confrontation and also when we can make a joke, or when to distract from the pain with a special memory. When the patient leaves, we remember all the ebbs and flows of the different families, keep space for those who are hurting, and appreciate the families where there is love, kindness and tolerance.
With all these groups on our phones and a view into other’s most private lives, we always remember what a serious responsibility we hold when keeping these frail bonds intact between people while bodies slowly mend or pass away. Our aim is always to help relationships recover too, even if bodies don’t, because really, in the end, nothing matters except each other.
Patient stories are shared with permission; some details are changed to protect privacy.