Ship tales: Sharing laughter, sharing tears.

  It’s not always as it is portrayed. The laughter and the joy, I mean. Sometimes we cry. We cry with our patients, we look to the sky and wonder why. Easter Sunday was one of those days.

Easter on the ship is one of my favourite days of the year. We had a brilliant morning of singing and dancing, crafts and games. Children jumping around and chasing one another. The joy of the ward mixed with a fresh cafetiere of Stumptowns coffee and fresh pastries baked by our very own on board baker was a concoction of pure satisfaction and delight. We started the day on deck with hymns and a dappled Malagasy sunrise peeking over a warehouse on the wharf, from there, the day began.

The reality of working in any hospital is that devastation is never far away from joy. That truth is even louder here in Toamasina on a hospital ship that operates on the poorest of the poor. We communicate the joy extremely well, Facebook screams it out for all to see, but the disappointment and the devastation is not so easy to talk about in any culture. The lady that sobs in bed under the covers on Easter morning because of the shattering relevation that her obstetric fistula has not been completely repaired and may never be completely repaired is unlikely to get so many likes on Facebook, Instagram or twitter. Its embarrassing to me that our species works that way. That some things are more popular on social media than others. Dolphins for example, are always the most popular picture of any field service. Children are always more popular than adults. Babies, more popular than children.

The reality is that the ship is not all laughter. Easter Sunday was a celebration and a beautiful day until I saw the way his face fell.

Jacques is a smiley 18 year old boy who has a particular interest in dominoes. He and his brother traveled the entire length of the country to have this operation. When he was 3 years old he survived an infection called NOMA. The infection left Jacques nose-less. It’s a big operation which is done in a few stages. That day was stage two. He had a nose but his lips were sewn together and a tracheotomy sat just under his chin to allow him to breathe. A new nose isn’t the easiest thing to breathe through for obvious reasons and neither is a mouth that’s sewn together. 

It was his brother’s face that fell, he walked towards me and told me the news.

Jacques sat watching in sheer shock and devastation as his brother, his solid rock packed for his departure, he was  leaving to be the man and do what the man of the family must do,  In a haze of confusion and deep despair

I tried to comfort Jacques, I looked straight in to his eyes as I spoke, but he didn’t even lift his head, not until I said something that clearly resinated with him. A sentence flew out of my mouth without thought. It was a daily known truth, nothing fancy nor poetic, just truth. Truth that he did not yet own. 

As I spoke he lifted his head and starred at me in amazement.
His eyes clouded over with tears and gently filled up until they could not hold them any longer and they tricked down. Down his new nose, meandering through sutures lines and dressings and on to his brand new lips. Lips that his tears have never touched before, then down his stitched chin and finally they bounced off a sea green tracheostomy tube one by one.
Jacques Mother is dead.
He is 600 miles from home.
He is devastated
I promised Jacques that we will take care of him, I told him we don’t just care about his new nose, his flesh or his dressings, we care about him and what is inside. I told him we care about how he feels not just how he looks. That was the moment, that was the truth. It was then that he raised his face from the safe focus of the floor and gave me eye contact for the first time.

Jacques had never heard that before. 

We cried together for a while. Something that is deemed unprofessional and inappropriate for some. A professionalism that I deem as malice 

I walked the brother up the stairs and gave him a packed lunch carefully gathered from my cabin. It seems silly now that I put my Cadburys cream egg in there, but people do silly things when they want to help. We walked passed the ghurkas and down the gangway. I waved goodbye and wished him all the best and he was gone. Gone to bury his mother. 

Back on the ward Jacques was there. His tears were there. His pain was there, you could smell it. But one thing changed. He was not alone. He knew that the nurses cared for him, but not just that. He had another new nosed pal, Stoney who was there sitting with him. Hand in hand they grieved.   Two new noses. Two stitched up mouths. Words impossible and unnecessary.

A new friendship formed. 

Facebook may tell you that Jacques surgery is the best thing that has happened to him, that he has had the time of his life. But for Jacques his surgical memory will always be coated in the overwhelming grief for his mother. He will always be haunted by the fact he was not there for the burial, but he will also remember that he is valued. That he is someone worth caring for. That he has friends and that neither his NOMA scars nor his new surgical nose define who he is inside. 

The woman in C ward still sobs under the sheets and she will not be featured in the newest hashtags. No one knows her name outside of the ship. She has not had the time of her life. But she will remember nurse Noel. Noel sat with her, prayer for her and loved her. She showed kindness In the most desperate of times. And sometimes that was this job is about. Not fixing. Not mending. But simply being available to hold a hand, to cry, to hug, to morn. It’s certainly not all roses and dolphins but it’s real life. Pain and suffering included. 

As my brother-in-law would sing “the bitter and sweet go hand in hand”

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