Camp Nurse

by Tilda Shalof

  Xiu-Ling and Frankie were soon back, for their lunchtime meds. They were giggling madly as they lined up with the other campers. Xiu-Ling had completely forgotten about her sore head but now complained about itchy bug bites. She scratched at her legs, showing me just how severe the situation was.

  “I’m soooo itchy! I’ve got way more bites than Frankie.”

  “I hardly have any!” Frankie crowed.

  “Why do I get covered and they don’t come near you?”

  “I guess the mosquitoes like me so they don’t bite me.”

  “They like me better ’cause my blood is sweeter. Hey, I’m sweet, you’re sour!”

  On that first day of camp, right after lunch, I had gone to check on Daniel, the twelve-year-old with diabetes who was on an insulin pump. His care was complicated, so I asked to speak with his counsellor, and Tim stepped forward. He was a shy, serious-looking guy who listened carefully while I explained that every night at midnight Daniel was to be woken up for blood-sugar testing. If it was too high, the insulin rate would need to be increased; too low, and Daniel was to be given crackers and sugar cubes. If it was very low, he needed to bring Daniel immediately to the Health Centre. I described the early warning signs of hypoglycemia and how, in Daniel’s case, it was very serious. Tim nodded but his quizzical expression worried me. We’d been counting on a counsellor to help with Daniel’s condition and I wasn’t sure about Tim.

  “How will I know when it’s midnight?” he asked slowly, thinking it through.

  “You have a watch, don’t you?”

  “Yes, but …” He looked at it on his wrist. “I don’t know how it works.”

  When I told Alice about this encounter, she explained that Tim was mentally challenged. He worked as an assistant counsellor, helping out in the cabin. Seth was Daniel’s main counsellor and he would be responsible for helping Daniel manage his diabetes.

  Oops! I was going to have to be a lot more sensitive. Someone with special needs didn’t exactly walk around with a label, now, did they?

  It was Alice’s third year at Camp Solomon and I was envious of the friendly greetings she received from all the kids and how she knew not just their names and medical problems but their personalities and quirks, too. I’d never spent long enough at the other camps to have built up these relationships.

  Alice and I spent the rest of that first afternoon going over charts. There was a handful of kids with chronic health issues: some were hidden, others were obvious and visible. Some problems were dormant with potential for flare-ups. There were kids who managed on their own and others who needed help from us. Sophie was a thirteen-year-old, born with spina bifida, a developmental birth defect that affected her ability to urinate. She had to catheterize herself and was prone to urinary tract infections. “We probably won’t even see her,” Alice told me. “Sophie is extremely private. She doesn’t want the other girls in her cabin to know, only her counsellors. Don’t even let on that you know.” There was Beth, a CIT, who had been recently diagnosed with Crohn’s disease.* Alice and I planned to check on her daily, assess her pain and symptoms, and give her medications. Drew was a teenager with a rare metabolic disorder that he’d had most of his life. He was on morning meds and needed once-a-day monitoring but otherwise was healthy and participated in all activities. Steven was a thirteen-year-old who used a wheelchair to get around. I had seen him motoring all over camp, accompanied by his attendant, Dave. Steven had an assortment of developmental delays and physical problems. Everyone seemed to know Steven as this was his third summer at camp. His mother insisted he be treated like all the others. “Please don’t make him an object lesson,” she’d written in a letter to us. “And when the kids act up and are disciplined, make sure he is, too.”

  We were still reviewing charts when Warren, a counsellor, suddenly rushed in with a frightened little boy in his arms. “Nathan can’t breathe!” Nathan was gasping for air, chugging away at forty breaths a minute.* I jumped up and took out my stethoscope, but even before placing it on his chest I could hear how tight it was, full of high-pitched whistles and wheezes. There was very little air moving through his lungs and I knew his airways were likely constricted and inflamed. Alice grabbed an oxygen mask while I put a drug to open up his airways into a nebulizer, a device that aerosolized medication, and attached it to Nathan’s face. We called for Dr. Louise to come immediately.

  Nathan sat hunched over, working hard at breathing. Warren held his hand and Alice, Louise, and I stood by watching closely. When his treatment was finished, Nathan was breathing more easily but looked up at us with sad eyes. He seemed so alone in the world, even with all of us comforting him.

  Alice showed Nathan how to use a small, hand-held inhaler for his medication. But he had difficulty managing that, so she switched him over to a different instrument called a spacer that was easier to use. Still, it was hard for him. It took all of his concentration and he squirmed, jiggled his stick legs, and twisted his feet around on the floor as he tried to master it. I sat down to read through his chart and quickly got a better understanding why all of this was so difficult. Nathan had serious developmental problems. In his chart, there was a sample of his handwriting. It was the barely legible scrawl of a child learning how to write but Nathan was twelve years old. He looked about eight.

  He’d had an asthmatic attack like this at camp the previous summer but there were few details of his health the rest of the year. Alice filled me in on the horrific story of his early childhood. Nathan had been rescued from parents who had abused him, kept him on a leash, and tied him to a chair. Two years ago he’d been placed with a loving foster family. He enjoyed coming to camp even though it wasn’t easy for him to interact with other children and he was emotionally dependent on Warren – his counsellor last summer, too – who was completely devoted to him.

  As they were about to leave, Nathan reached up to be carried. Tough, eighteen-year-old Warren wearing a black do-rag and multiple earrings slung him across his chest like a guitar and Nathan clung on. I said we wanted to check him again later but Nathan shook his head, no. He didn’t want to come back.

  “We want to prevent this from happening again,” I explained, but as soon as I said that I could tell he didn’t know what “prevent” meant.

  As the days went on I got to know many campers well and a few parents, too, over the phone. Daniel’s mother called every other day for an update on Daniel and for a report on his blood-sugar levels. There was anxiety in her voice and I tried to reassure her that her son was doing well and under Seth’s close supervision. She frequently made minor adjustments to his diet or insulin regimen. Later, when I would convey these messages to Daniel, he would roll his eyes or look exasperated. “I like to stay on the down-low about my diabetes,” he told me, only coming to the Health Centre if he had to change the site of his insulin needle or pick up his supplies. Usually, he came by himself, slipping in quietly so he wouldn’t be noticed, but once, he brought a cabin mate with him. “I don’t like needles,” the friend said, giving an involuntary shudder as he watched Daniel give himself an injection of insulin into his abdomen. Daniel looked at me and I had a feeling we were thinking the same thing: He couldn’t afford not to like needles. His life depended on them.

  Every day after lunch was camp-wide rest time and everyone was supposed to be in their cabin, but sometimes I would find thirteen-year-old Dylan pacing around outside my door. “Can I help you?” I’d ask, but “No, I’m good,” he’d say, and run off. I could tell he was trying to place me. I remembered very well where we’d met – the ICU where I worked – but decided to keep quiet about what might be a traumatic memory for him. I told him simply, “I’m here if you want to talk.”

  Mitchell was a more eager visitor who stopped by frequently with minor complaints or just to chat. He was thirteen, overweight, and more at ease with grown-ups than with kids his own age. The Health Centre was a refuge for him. He came so often that we kidded him we were going to make him our m
ascot. Mitchell often looked sad so I asked him how things were going.

  “Camp’s awesome,” he said with forced cheerfulness. “My cabin mates are cool, well, except for Eddie. No one likes Eddie.” His face clouded over as he told me that Eddie picked on him, called him names like “fat-boy,” “wuss,” and “Mitchy Mouse,” and said degrading things about his sister. Then Mitchell abruptly changed the topic and made disparaging jokes about his looks or his weight, such as he was so fat that when he got into the lake, the water level rose. “I’ve tried diets, but they never work,” he said helplessly. He was worried about an upcoming canoe trip and if he’d be able to keep up, and what he’d do if he got hungry. On another occasion, he told me, “I’m starting to think I should go home.” Mitchell settled into one of the couches and made himself comfortable. “I’m thinking maybe I won’t stay for the whole summer.” He said it like going home was an option, but we both knew his parents had signed him up until the end of August. “See, I hate the position I’m in. If I go home, I feel like a failure, but if I stay, I feel horrible. Camp isn’t for me. There’s no privacy and it’s just go, go, go, all the time and, Eddie … well, he and I don’t get along.”

  I felt a swell of affection for him. He enjoyed mountain biking and when I mentioned that, he visibly brightened. We talked about how Lance Armstrong had used his bike to conquer cancer and maybe he could do the same with his homesickness? Mitchell seemed to cheer up a bit with that idea and went off in a better mood, for now.

  Another camper I was becoming fond of was Amy. She was a bright, creative twelve-year-old who had high-functioning autism. I’d seen her around camp, sometimes with her friends, other times standing alone, immersed in her own, very different world. Sometimes she’d stand and stare into the distance or peer down at the ground for a long time. Once I found her gazing into a single green leaf, chanting softly to herself, “back to leaves, back to leaves,” over and over. Occasionally she came to us describing “weird sensations” in her body that bothered her. They usually went away on their own if we helped her take her mind off them.

  Once her counsellor brought Amy in. “Amy didn’t eat a thing at lunch,” she said, looking worried, “well, only the parmesan cheese. That’s all she put on her plate, a huge pile of parmesan cheese, but she just picked at that and kept rolling her eyes right back in her head, you know like this.” She did a frighteningly good imitation. “It was freaking me right out – I mean, it was weird, even for you, Amy, no offence.” She put her arm around Amy, which must have cued her to realize her counsellor was kidding, so after an awkward delay, she gave a little laugh.

  Amy didn’t usually volunteer much information, but that day, she did want to explain what was bothering her. “I was thinking about mud and when I think about mud, I can’t eat.” She gazed around the room, averting her eyes from us when she spoke. “I can only eat white foods and they can’t touch each other.” She spoke in chopped sentences and a monotone, saying each word in a sentence like it was on a list, every item of equal value. As if suddenly overcome with exhaustion, Amy moved over to the couch in her strange, floating way, stretched out and stared up at the ceiling, quietly describing its topography to herself. It was as if she had become the object of her rapt attention, just as I’d seen with the leaf, or another time with a handful of sand. Mud disturbed Amy greatly but she loved sand. I’d seen her sitting for hours on the beach running her fingers through the sand, chortling happily to herself. We decided to let her rest for the afternoon until she was ready to join her cabin again.

  I was beginning to expand my notions of what to expect in a child; there were many different ways to be normal, and clearly there was a spectrum of normalcy. I enjoyed being at a camp that managed to accommodate a wide range of kids with a variety of abilities and to find ways to live and play together.

  It was turning into a pleasant summer. Alice, Louise, and I worked well together and were a great team. Other than at meals, I didn’t see much of Rudy, the camp director. He was either at the canoe docks with Ringo, his constant companion, or in his camp office, which was just as cluttered with equipment and repair jobs on the go as his city office had been.

  Rudy was a quiet leader but he made his presence felt. I remember an incident in the dining hall. After each meal music was played, usually a pop or rock song, which was the signal to get up and clear the tables. As soon as the music started, the kids jumped to their feet and boogied around the room, returning dishes to the counter, scraping plates, and stacking the cups and cutlery. Then, once they were back in their seats, they launched into a longer after-the-meal prayer, this one accompanied by banging the tables, stomping their feet, clapping their hands, and making motions, each corresponding to a line of the prayer. It was fun to be in the midst of it all and I even found myself joining in from time to time. But one day, things got out of control. Kids were adding nonsense words and making rude gestures. Rudy got up and strode to the front of the room. When he spoke, his voice was so strong he didn’t need to use the microphone.

  “Stop!” he said sternly and silence fell. “This is a prayer, not merely a song. We’re going to start over from the beginning. Pounding on the table is okay. Shouting is okay. Making noise is okay. But changing the words or making fun of it is not okay.” Afterward, he kept the counsellors back. “Your kids are watching you. They take their cue from you,” he reminded them. “If you show respect, they will, too.”

  It never happened again.

  Most afternoons, Alice and I locked up and went for a walk along a trail in the woods, staying in touch with a walkie-talkie that one of us always carried. Alice was a true nature lover who appreciated the outdoors in a way I was still learning to. She was always looking around, seeing everything we encountered with a sense of wonder and delight, as if we had entered a museum full of exquisite and precious things. She showed me the delicate colours and intricate striations inside a strip of birchbark that had peeled off the tree. Once, she stopped me just in time from treading upon a large frog sitting on the path in front of us. It had huge, bulging eyes, a pulsating neck, and was so perfectly camouflaged I had almost missed it. Another time, she pointed out a bird that was chasing a persistent chipmunk away from its nest. “What chipmunk eats birds?” I asked.

  “She’s protecting her eggs,” Alice explained.

  “How do you see these things? I walk right past them.”

  “You’re a city girl,” Alice said with a chuckle.

  You only see what you know. Kitch’s words came back to me.

  As we walked, Alice and I fell easily into intimate conversation as if we’d been friends for years. She told me about her marriage to a Jewish man and her conversion to Judaism. She hadn’t converted at her husband’s request nor to appease her in-laws but because she was sincerely drawn to the Jewish religion. She loved going to services at camp and felt the prayers and songs in a deeply spiritual way.

  The daily services were held in an outdoor chapel in a clearing in the woods. I usually took that time to phone home to Ivan or to catch up with paperwork quietly in the Health Centre. But one day, when it wasn’t in use, I went to the chapel by myself to take a closer look. Nestled in the forest, it consisted of a simple wood podium facing benches made of long, heavy logs, arranged in concentric half-circles. Interspersed among the benches were tall trees that provided shade and a canopy of leaves and branches. The blue lake could be seen through the trees. For a few minutes I sat by myself, enjoying the quiet and solitude that are usually so hard to find at camp.

  Perhaps taking a few moments out of each day to express gratitude and to sit in quiet reflection did have a positive effect on all of us. Maybe it was, as Rudy had also suggested, that the presence of the special-needs children and staff brought out the best in the others. I think it also had something to do with Rudy himself. To Rudy, running a camp was a moral enterprise, not just a commercial business venture. The counsellors were a major influence, too. In many ways they were exactly like
counsellors I’d met elsewhere – just as wild at night, just as mature or well-mannered, or not. However, counsellors here made an extra, concerted effort to ensure that each child was part of the group and no one was left out. These counsellors tried to be role models and leaders, not just babysitters or pals. On my first visit to a cabin, I saw a sign on the door, announcing, “Welcome to our crib!” Posted inside the door was a list of rules the kids had come up with under the direction of their counsellors:

  Express yourself, but don’t start drama.

  Listen to one another.

  Respect other people’s space.

  Don’t touch anybody’s stuff unless you ask first.

  Stay clean (showers, flush toilets, etc.).

  Tell someone if you are going somewhere.

  No swearing unless absolutely necessary.

  No violence or rude gestures like flipping the bird.

  “Yeah, like that’s all going to happen,” I heard one kid say scornfully as I stood reading the list. I agreed those rules probably weren’t going to be followed to the letter, but putting them in writing seemed like a good place to start.

  I saw other examples of counsellors leading the way.

  A spider was spotted in the dining hall and after the initial screams died down, I heard a counsellor’s calm voice. “Let’s take it outside and put it back into nature. That’s its home.” They all trooped after her to help her set it free.

  I liked the gentle, low-pressure swim test and the way the staff referred to the ones who “hadn’t completed their swim test, yet,” rather than saying they’d failed.

  There seemed to be an unstated acceptance that not every child was sporty or good-looking or popular. At this camp, a child didn’t need certain clothes, or to be “normal” or mainstream to fit in. Here, the attitude toward competition wasn’t the sloppy love-fest of “everyone’s a winner,” nor was it awards and accolades only for the outstanding athletes. I saw kids who didn’t get a lead role in the play or make a particular sports team and how their counsellors helped them roll with the punches. Here, there was simple, modest recognition for achievement and also for trying your best. The message was, you can be whatever kind of kid you are; you can find something at which to shine.