Learning to say goodbye

How do i say goodbye to a place I've been wanting to come to for the last 10 years ?

I finished my last shift yesterday. It's hard to believe my time is finished here. I feel like it just began. I remember my first shifts so clearly, but I suppose I adapted quickly. Things soon became routine to the point that I was orientating new staff to the ward a few weeks later. This last week has been different though. Maxillofacial surgeons arrived on the ship last week and as a result, the patient population has changed dramatically. The ward was full of patients like the ones i saw on the Mercy Ships brochures 10 years ago. Their faces are what drew me here in the first place.

One young boy, hardly a teenager, walked down the hallway with a large piece of cloth covering his face. He walked slowly, eyes cast downwards as he shielded himself from the prying eyes of the people around him. Once in the safety of the ward, the cloth is removed and a large tumor encompassing the entire right upper portion of his face is revealed. He is very quiet and he never smiles. Most of the time he hides under his sheets. A stoic man sits in the corner, his condition though medically completely different, presents in a similar way. His eye protrudes from it's proper place, concealed partially by heavy framed glasses. He wears his glasses while he sleeps.
An elderly woman sits nervously on her bed, awaiting surgery. Her eyes do not line up like they should. The right one has fallen 2 inches and sits about an inch forward. Still she manages a smile for the nurses, and laughs occasionally at the small family across from her.

I positioned myself between two patients last night in such a way that i could keep an eye on the monitors of the one, and hold a syringe full of tube feed for the other. Giving an adult a tube feed is a good 15-20 minute procedure here most times. It simply means i become an IV pole while holding a syringe in the air, allowing gravity to infuse the 'food' into the patient at a slow rate. While doing this, i turned my head to answer a nurse's question and i felt a tug on my pants. The man i was feeding whispered something i couldn't understand. I got down closer when he said "please nurse, concentration on me, no someone else." I thought this a strange comment, but settled thinking i had inadvertently tugged on his tube when i turned to answer the nurse's question. I admit, i was a little annoyed because the lady beside him was very sick and demanded more attention than he did at that minute. He had been quiet earlier in the shift as i played Jenga with some of the kids on the ward, and later as I flew a toddler around the room airplane style. Occasionally, I would look over at him, asking him if he was comfortable or had any pain. He was fine, he said. I received a patient back from the OR which translates to a good hour of busyness as the patient is settled. In her case, it was a good two hours before she was comfortable and all the lines of the monitor were in a satisfactory place for her. He stayed silent through the procedure, watching my every move. He was fine he said, shaking his head no thank you, that he didn't need anything. But, now, when i was busy with someone else, he needed me. He needed some attention.

Later as i left the ward for the night, I thought back to his comment. I surveyed the room and saw what people at home might very well think a circus. Sadness mixed with hope. I watched a young girl slowly pack up her things. She would be travelling home in the morning. She was prepped and ready for surgery that day, but the surgeon decided after reviewing her CT one last time that he didn't have the skill needed to remove the large tumor from her jaw. Beside her, a small family of three were also packing their things as they settled in for the night. They were heading home with hope. They'll be back in a month or two for the next stage in her treatment. But, after three weeks on the ward, an infection that was eating her nose and upper lip was finally curbed. The antibiotics worked! The man with the glasses pulled up his blankets around his face while he slept, sighing comfortably. IV fluids running in anticipation of surgery the next day. A Mama and her small baby born with a cleft lip & palate are here for the feeding program in preparation for surgery in the fall. They are already sleeping peacefully in the corner.

"Concentrate on me" Was his simple request a mask for what he's been asking for ever since the tumor started to grow? Or was it simply because i pulled a little on his feeding tube? The message received though, while looking at the strange collection of people before me as I left the ward was not far off from his request. These people came to the ship because they had no where else to turn. No one else was 'concentration' on their need. And so they came. I will always struggle with the reality that so many are turned away. So many are beyond surgical help and must go back to their lives of hiding behind lapas and hooded shirts. I cried a long time last night, they too have left their faces in the permanent photo album of my heart along with the VVF ladies who left wet.

I haven't been naive to the fact that we're leaving shortly, and I thought i was ready. For the past few weeks i had been working with patients whose average length of stay was 3 days. Arriving late on the first day, and leaving early on the third day. This didn't leave a whole lot of time to build relationships as with the VVF ladies. I thought it would be a good transition into leaving. But, on my last three shifts I have been faced with the living people that drew me here in the first place. People who need so much more than physical nursing care, and so desperately need love and attention.

Life isn't easy on either side of the ocean. Heartache happens everywhere. Injustice is rampant all over the world. Perhaps here, I feel like I make more of a difference than i do in the lives of patients back home. I know in my head, that probably isn't true. I have learned so much here, and will take home so much. I will always remember the sadness, but with equal clarity I will remember the good. I don't think any nurse can come away from this experience and not be changed. It's not possible to go back to the land of excess and not remember being an IV pole for a few minutes, or using what you have - not what you want. My shoulders and back ache from leaning over these short beds and I will be forever grateful for the powered beds at home. But, I will not quickly forget to look under the bed for a sleeping caregiver. If I trip over something, I'll likely think it was a piece of lego or a small car rather than a patients 4th suitcase. I'll probably open the curtains and welcome day light in every room I walk into. Imagine the delight i will have when there is a commode for a patient to use instead of juggling everything in and out of the world's smallest airplane bathrooms! I will miss all the colourful lapas that encircle the waists of the adult patients, covering their backsides from being seen by the world from the ever indecent hospital gown! I am rather fond of having all my patients in the same room, it's much less walking for me! This is only the beginning of the things i will miss, and the things i look forward to.

This experience has changed me deeply, perhaps not in a way that the average person could decipher, but it has. If anything, it has strengthened weak beliefs I already had and created some new ones. I will come back someday for longer. Maybe with Mercy Ships, maybe not. We'll see. Here, perhaps the only time in my life, have I finally realized the difference one person can make. I look around me and there are 400 people at any given time on this ship. All here to help in various departments, all having sacrificed something to be here. In talking with one of the ship chaplains he said, "if any business person would look at what Mercyships is trying to do they'd think we're crazy. It just doesn't make sense when you account for the expense of running a ship. But, God must be in it because it's been going on for over 30 years." Truth to that! God doesn't consider the expense of caring for his children. Coordinating a volunteer based surgical hospital must be an absolute administrative nightmare, but each one of us was called to be here and the people keep coming to help. So, here we are

"We follow the 2000 year old example of Jesus, bringing hope and healing to the forgotten poor"

Mercy Ships Mission Statement