by Tilda Shalof
Ken looks like a shrunken Hulk Hogan, the same rugged, manly face, a wide, solid frame, big blue eyes, and nicely trimmed blond beard. He waves his cane over at Nurse Charline. “It’s because of her.” Charline sits back in an easy chair, beaming at what they accomplished together.
Four years ago, Ken was mowing the grass barefoot, clearing out the bramble, and got scratches from blackberry bushes. His heels got infected and wouldn’t heal. The infection spread all along his legs. “It quickly got to the point where I couldn’t walk. Couldn’t wear shoes.”
Three times a day for two years, then two times a day for two years, Charline applied dressings, ointments, compression bandages, and helped him get his diet, weight, blood pressure, and blood sugar levels under control. Diabetics heal slowly, sometimes not at all, so it took that much time, plus their perseverance and partnership.
“Yup, she fixed me up real good. She prayed for me and lit candles at church.”
“Surely she did more than that,” I tease him.
“She’s a kind person, for sure. Smart, too.” He grins at his partner.
“I had a dream about your legs last night, Ken,” Charline says affectionately.
“Ain’t that something …”
“See, I’d been a bouncer at the casino on the reserve, but it got so I couldn’t walk. I had to quit my job. I had no choice but to go to a doctor. For me, that’s like having a tooth extracted without anesthesia. That doctor sent me to a whatchamacallit …”
“A vascular surgeon,” Charline says.
“He told me point-blank, ‘These wounds will not heal. The only solution is amputation.’ Let me outta here, I thought. I don’t want to live my life in a wheelchair. It struck a nerve. I started doing what Charline told me.”
“You see, Ken hadn’t been taking good care of himself,” Charline explains. “For starters, he was overweight. Now, that’s a problem I have, too, but it helped me understand him better than a thin nurse might.” Ken also smoked and had poor circulation, sleep apnea, and arterial and venous leg blockages that prevented his legs from healing. “They drained constantly, some days more than a litre. I soaked them twice daily in saline and we tried various ointments – antibacterial, zinc, even honey. His legs were super-sensitive. Elevating his legs helped, but it was too painful. We helped him learn to balance his sugar and got him onto a better diet.”
“Tell her about the surprise you found. The creepy crawlers.” Ken cues her.
“It was a hot summer day. I’d been here in the morning and his legs were fine, but at the afternoon visit, I couldn’t believe my eyes – they were covered in maggots. It turned out to be a good thing because they ate the dead tissue, left the healing skin alone, and did their work painlessly.”
“Miracle maggots, they were.”
“His legs look great now,” Charline says. “Show her our masterpiece,” she prompts him.
Ken takes off his shoes and socks and stands up for my close inspection. His legs are thin, scarred and discoloured, but I see no signs of infection. The pulses are strong and easy to palpate. Best of all, he can slip on his new shoes and walk.
“Without Charline, I wouldn’t have a leg to stand on – literally. Now, I drive, work part-time as prep cook at the diner down the road. It’s all because of her.” He points with his cane at his nurse. “Charline saved my legs.”
“Seeing Ken’s legs heal, now wearing his shoes, it’s like watching my own baby take his first steps. It’s been the most rewarding experience of my career. There’s a chance of recurrence so I drop by once a week to check on him, but soon he won’t need me anymore.”
“It will be hard for me when Charline gives me the heave-ho.”
I have a feeling it will be hard for her, too. Their love is mutual, yet entirely professional. It’s part admiration, part awe. I’ve never seen a patient and nurse as closely bonded, as united as Ken and Charline have been on their mission to save Ken’s legs.
Darin drops me off in a clinic parking lot and zooms off. He’ll pick me up later after my visits with Nurse Claudette. She’s waiting for me at the front entrance to a little clinic that sits right on the ocean shore. “This is my supply cupboard,” she says and pops open the trunk of her car. It’s jam-packed with boxes of catheters, gauze, vinyl gloves, and more. She tells me about her client we’re about to see. Mink is morbidly obese – over six hundred pounds, by my estimation – and needs wound care that he couldn’t possibly manage by himself, given his bulk.
“Why do you meet him at this clinic, not at his home?” I ask Claudette.
“We used to go to his home, but Mink runs a bootleg operation, making moonshine. ‘The Establishment,’ he calls it. There were transactions going on when the nurses would visit, so we told him he had to come here for his dressing changes. He complains about it, but don’t you worry about Mink,” Claudette says. “He’s got a nice life and is richer than you or me. Has an attractive lady friend, to boot. Bee takes care of him, drives him around, gets him groceries.”
“What are you going to do for him today?”
“I’m going to change the dressings on his wounds on his legs, groin, and buttocks. You see, Mink can’t reach his feet or his back. He has a urinary catheter and a huge penis.”
A huge penis? Why is that relevant?
“Why does Mink have a catheter?” I ask, my mind considering the usual possibilities, like renal failure or urethral obstruction. It turns out to be not as complicated as that. It’s pure body mechanics, as Claudette explains.
“He can’t reach his penis over his belly, and it’s hidden deep inside the folds of fat and won’t come out. Urine gets in there and he can’t keep it clean. There is also a hygiene issue.”
While Bee waits for him out in the reception area, we go in to meet Mink.
“They removed a ninety-pound tumour,” Mink tells me right off the bat.
“Mink is referring to his weight-loss surgery,” Claudette clarifies. “You underwent a pannectomy,” she reminds him.
Then it dawns on me: Claudette’s Quebecois accent made “pannus” – the medical term for the apron of fat around Mink’s gut – sound like “penis.” That’s what she was describing as so “huge.” Indeed, Mink’s belly droops down to his knees. Giant pantaloons of adipose tissue hang at the back of his legs. “The surgeons tried to remove them but there was hemorrhage,” Claudette explains, her beautiful accent making that word sound like the name of a French perfume. She helps Mink haul himself up onto the treatment table where he spreads his legs to expose extensive surgical and pressure wounds in his abdomen, groin, and inner thighs. Claudette examines them closely and draws comparisons to the last time she saw them, observing the depth, shape, and drainage from each one. She takes off the soiled dressings, cleans the wounds, and begins a long process of applying new dressings and attaching some of them to a suction machine to improve drainage.
“Every two weeks we change his catheter. Today, it just needs to be irrigated.”
I help her lift the folds of fat so that she can insert the catheter. How would she ever do this procedure all by herself? “First I have to find it,” she says.
Mink grins and chuckles. “Did the hedgehog go into the cave?”
“In the ICU we call that turtle-it is,” I tell him.
After the dressing change, Claudette and I give Mink a bath, scrubbing him with buckets of soapy water and using long, broad strokes, like we’re washing a car. Claudette dries off one side of him with a large bath towel and I dry off the other. We help him get dressed, then ease him down off the stretcher and onto his feet. He seems to feel pampered by that routine, but tiny beads of perspiration have collected on Claudette’s forehead and upper lip. It was hard physical labour. How does she manage to do this all on her own?
Mink loops the electrical cord from the wound suction machine around his neck. It will run on battery until he gets home and can plug it in. Already, cloudy drainage is trickling into the new collection chamber th
at Claudette’s just installed.
“How’s the diet coming along?” Claudette asks as she washes her hands and arms up to her elbows, at the sink.
“Good, good,” he says with an evasive wave. He hikes up his track pants and ties the rubber skipping rope that he uses as a belt.
“Tell us what you’ve been eating.”
“Well … I’m not a salad man.” He gives a sly grin. “I eat yogurt and grapes. Mostly.”
Claudette helps him up onto the veterinary scale once used for farm livestock. They keep it in the clinic just for Mink. She balances the weights.
“Well, you must be doing something right. You lost two pounds.”
“Do you cook for yourself, Mink? Does Bee?” I ask.
“No, she can’t cook, but I make a mean rabbit stew.”
“Just out of curiosity, what goes in a rabbit stew?” Elmer Fudd wants to make a wabbit stew.
“Carrots, of course.”
“Yes. That makes sense.”
“Soya sauce, too. It kills the taste of wild. Onion, too, sometimes.”
We go out to the waiting room to join Bee and discuss the recipe further.
“Pshaw!” Bee exclaims. “Don’t listen to him, the old coot. Onion in rabbit stew? Never! Say, if you come to visit us, we’ll make you pease pudding and blueberry duff.”
“Yeah, and stuffed cat, a roast chicken with dressing and a bit of arsenic thrown in.”
“How do you manage with chores like cooking and cleaning?” I ask.
“I toss leftovers and garbage up onto the roof for the seagulls.”
Afterwards, back at the car, I have to ask Claudette the question any hospital nurse would ask.
“Mink seems so dependent on the nurses. Couldn’t he do more for himself?”
“We are working with him to get him to take more ownership of his care, but he’s resistant.”
“That wouldn’t go over well in the hospital. We push people to do as much self-care as they possibly can, perhaps before they’re ready, but in the belief that it’s best for them. How does it help him to do everything for him?”
“We’ve made small steps of progress. He now brings clean clothes to change into or we won’t wash him. It’s a start. We accept him as he is.” She sees I’m not convinced. Not many hospital nurses would be. But then, Claudette shares something about Mink that we probably wouldn’t have an opportunity to know in the hospital.
“Mink’s had a rough life. His father sexually abused him. His stepfather physically abused him. He’d leave him outside in the winter, and duct-taped him to a chair when he was inside. The kindness he receives from the nurses is new for him. It’s the only kindness he’s ever known.”
Once you know a person’s story, you’re not as quick to judge.
Claudette drives us to her next client – Pierre, a sixty-five-year-old widower with bowel cancer and a recent colostomy. When Claudette removes the bag, it’s like the smell of shame fills the bathroom, and he gets tearful. They speak quietly in French, but I get the gist.
“I want to stay home,” Pierre says. “I don’t want to go to … a … one of those places.”
“As long as you have a bit of help, you can manage at home?”
“I know it smells like shit, but it’s my shit and it’s my home.” Claudette nods and they share a quiet laugh. Magically, she’s managed to normalize the bizarre situation of having liquid stool trickle – sometimes gush – out of a hole in one’s abdomen and into a bag glued to one’s body. As she cleans the skin and places the new bag, she asks about his mood, energy, and appetite. She treats Pierre as a whole, not just his hole. I can see how this kind of nursing helps people cope with life, not just with illness.
In the evening, Darin and Suzanne take me out for a delicious meal of halibut, shrimp, scallops, and lobster, straight from the sea. Even when I’m full, and couldn’t possibly eat another thing, they insist I try the local specialty, râpure, an Acadian dish made of potatoes, cheese, and sometimes chicken, too. Well, I’m always up for a challenge, especially one involving food.
Mmm … I could get hooked on this smooth, creamy comfort food.
They joke that there are only a few surnames in Yarmouth, because everyone is related to one another. D’Eon, Saulnier, Daignealt, Boudreau, Joudrey, and D’Entremont are exotic to me, but common here. It’s a small town, so even those not related by blood seem like relatives due to the close involvement in each other’s lives.
As we get up to go, I’m glad I don’t have to say goodbye just yet. Suzanne has planned a special event for tomorrow evening, so I’ll see her then.
Darin drives me to the B and B. I sit in the back seat, deep in thought, thinking about feet. It’s a subject that has, well, legs. “I’m determined that people go to their graves with both limbs,” Suzanne had said fervently, like it was a prayer.
“Instead of amputations and rehabilitation, let’s keep people on their feet. Most people don’t think much about the health of their feet. Perhaps they feel it’s beneath them.” We laughed at her unintended pun. “In our society, we have an aversion to feet, but I always think about Jesus washing the feet of the poor and the humility that implies. That image inspires me.”
It’s true. We pay so much attention to hearts, livers, and lungs. Rightly so. You can’t live without those organs, yet what’s a life if you lose your feet? Sure, if you’re born without feet or lose them when you’re still young and healthy, you can get a prosthesis and adapt, but what if you’re older and dealing with impaired health already? I’ve often heard it said that prevention isn’t exciting because, when done right, nothing happens; yet that’s exactly what should happen to healthy feet. Nothing. In fact, when Darin asks what I’m so deep in thought about, I’m too tired to explain, so that’s exactly what I answer.
“Nothing.”
Guest-Lovitt House B & B
Yarmouth, Nova Scotia
Twyla’s Banana Muffins
3 large or 4 small ripe bananas mashed in a small bowl
In another bowl, mix:
3/4 cup white sugar
1 1/2 cups flour (half whole wheat and half white)
1 tsp baking powder
1 tsp baking soda
1/2 tsp salt
1 egg
1/3 cup oil
1 tsp vanilla
Add banana,
1/4 cup walnuts, and 1/2 cup chocolate chips
Bake at 375 degrees for 20 minutes
Hope you enjoy!
YOU SAY GOODBYE, I SAY HELLO
“FROM HERE, YOU CAN SEE THE BRIDGE that takes you all the way over to Prince Edward Island.” Darin points to the far shore. I can barely make that out in the dense early morning fog, much less the bridge to P.E.I.
“So you’re not just my driver. You’re my tour guide, too,” I say, but he pays no notice to my teasing. He’s focused on the land and the sea he loves.
“If you squint – or have a wicked good imagination – you can almost see the red earth potato fields.”
“What about the red braids belonging to Anne of Green Gables? Can you see those, too? What about her house in Avonlea?”
“Aww … you tourists are all the same. Once, I took a visitor over there who had to see Anne’s house. Then she asked to go to the cemetery to visit her grave! I had to break her heart and tell her the truth. But P.E.I. is beautiful. It’s so tiny, you can walk across the entire province in an hour, drive across in two minutes.” He tells me they turn the porch lights on and off at night to confuse ships, but I think he’s kidding about that.
Our first stop is at Henrietta Denby’s tidy little pink house with a flower garden overlooking the sea. We sit in her front “parlour,” where I drink tea and listen.
“I never felt ready or prepared, but I’ve been called upon to be a caregiver my whole life. My caregiving career started at sixteen when my grandmother lived with us – my parents, brothers, and sisters. She had Alzheimer’s and I shared my bedroom with her. My mother
was busy with the other kids, so I did all of the hands-on care for her. She would dirty herself and hide the you-know-what. We had no outside help. We did it all ourselves.” We both take a sip of our tea. She settles in her chair, takes a few moments, and then gets to the story she really wants to tell.
“My husband, Coleman, died last year. Two years prior, he had been diagnosed at sixty-four with multiple myeloma – and yes, we dreamed of getting older, getting to sixty-four together, just like in the Beatles song.” As Henrietta speaks, her pensive face and frequent pauses make me feel she is reliving it. The pain of remembering crosses her face, but then she collects herself and continues. “I was just thinking about his pain. Deep, searing bone pain. Horrific pain. They wanted to send us straight to palliative care but Coleman opted for aggressive treatment. Let me tell you, chemo is no walk in the park. He had every complication – nausea, mouth sores, infections, pneumonia.
“One morning he awoke screaming. It was his neck. The tumour had pushed through his vertebrae. He was in terrible pain. Luckily, I remembered we had a cervical collar in the closet and I ran to get it. The ambulance came and took him to the hospital. The doctors told us all along that the treatment was not to cure it, but to stave it off for as long as possible. Then they offered us to be in a clinical trial for thalidomide. That scared us. We only knew of that drug from bad stories growing up, but it helped – for awhile. He accepted his fate, but it took me a lot longer to do so. When he realized he wasn’t going to get better, he was the one to tell me. He began to prepare me for his death.”
“How did he do that?”
“He was a carpenter and appreciated the craftsmanship of old buildings. He’d saved doors and window frames. He organized his door collection for our son. He prepared a detailed blueprint of the house so I could maintain it. He was a big-boys-don’t-cry type but his actions said it all. Not big on words, but I always felt loved. We had a nest egg, but we had to dip into it and that worried him. One of the drugs he was on was experimental and it wasn’t covered. It was expensive and he didn’t want to deplete our savings and what would be left for me.