Never say Never

I can’t remember exactly when or where but I have definitely thought it a few times. I may have even spoken the fatal words once, if not twice.  

“I will never work in the Free State Province!”

But yes, here we are.

Despite having seventeen years to think about it, I didn’t really have a game plan when I finished specialising. Then quite unexpectedly, I was offered the opportunity to come and do some locum work up here and it seemed like a breath of fresh air after four grey years of registrar time. The change that would be as good as a holiday. A great opportunity to try something completely different, stretch my wings a bit and shake up my comfort zone. Incidentally I had also planned to take a few weeks off and this job coincided perfectly with when my savings would run out. Was I aware it was in the Free State? – Yes. Was I aware it was in the middle of winter and likely to be 10 degrees colder than what I was used to? – Yes. It really was only after I crossed the Orange River that it dawned on me that this might be a lot harder than it looked.

I don’t want this blog to be about what’s been tough about the first 3 weeks. I don’t want to rehash the fact that there often aren’t the basics like running water at some of the hospitals, let alone luxuries like ventilators, x-rays and doctors. It’s been tough and eye-opening and hopefully doesn’t stop shocking me regularly (because the danger of desensitisation is that it facilitates this failure).

I’d rather tell you about things that made me smile, and that make me love the work, the profession and the people. I want to tell you about lovely patients that I encountered this week.

The first was a shy, sweet, 9-year-old girl whose mom brought her to the practice with the long-standing complaints of a poor appetite and not being able to hear very well.

They spoke enough English to get through the consultation and the patient could actually answer most of the questions herself. (Always such a win in paediatrics, which often more closely resembles being a vet examining combative baby tigers). After chatting a bit about the problems I got her up on the bed to examine her. She was wearing a pink dress with a beautiful winter white jersey and wool-lined ankle-high boots, exposing her skinny little legs.

“Nana – aren’t you cold?” I asked her.

“Yes” she said.

“Then why did you wear such a pretty dress?”

“I didn’t want to,” she replied. “My granny made me!”

The second was a little boy, about 3.

A pink-cheek, chubby face, blonde haired chap who came for the winter special – cough, blocked nose, vomiting.

He didn’t look too sick and dived into the toy stash unashamedly while I got the story from his mom. He also was very quick to spot the sweet jar on the desk.

“Tannie, kan ek ‘n sweetie kry asseblief?” (Aunty, can I have a sweet please?)

I let him pick a sucker out of the jar.

He carried on playing with the toys, I examined him and reassured his mom that his symptoms were all viral and he would be back to his normal self in a few days.

While I was finishing up notes and a script, he saunters up to the desk, sucker in his mouth and casually asks “Tannie, kan ek nog ‘n sweetie kry?” (Aunty, can I have another sweety?)

In an effort to nip this request in the bud quickly I shook my head.

“Nee, sweeties is eintlik net vir kinder wat inspuitings kry.” (No, sweets are actually only for children who get injections).

I’m assuming this will a) dissuade him from more sugar by the possibility of what all children fear the most at a doctor, and b) make him aware that he actually got a sweet for free today.

He is standing across from me with his rosy cheeks and little head just sticking out above the desk. Sucker in his mouth he tilts his head to one side thoughtfully, then removes the sucker and asks a bit more calculatedly…

“Is dit ‘n baie groot inspuiting?” (Is it a very big injection?)

I never regret choosing to work with children or combative baby tigers.

* “Tannie” which directly translates to English as Aunty is a respectful term used to address female elders.

This is not a medical post - this is me trying to fix me.

Dear Friend

I think that’s what we were for a brief moment – like a supernova, or a firework display – something brilliant and breathtaking and so distinct from the sepia tones of every other day. Friends.

I’m not sure what we are now. Where there was colour and wonder and excitement there is now something grey and blurry, indistinct and uncomfortable.

For the longest time I have been turning our relationship over in my hands, like a rubix cube – trying to figure out how to make the colours line up, but the more I try to create order the more I cause chaos.

I think that is what hurts me first – I am trying. I, alone, am investing. That has always been a poor prognostic factor.

With the hindsight of days, actually probably more like months, I am forced to accept that the first problem was that I didn’t see you as my equal – I saw you as better than me. More beautiful, more intelligent, more disciplined, more adventurous. I saw pieces of myself in you and it gave me hope for me. I put you on a bit of a pedestal, set you apart as someone to aspire to and when one day you approached (or maybe it was me) with an offer of friendship I was so flattered and honoured I let you into my heart without doing my usual safety checks.

We had some great moments. We had some great laughs. We dragged each other through tough days. We talked sometimes too late.

And then one day it stopped.

A wall went up that I feel like I ran full-speed straight into. I was unprepared for the puff of smoke that you disappeared into. It left me winded, and blinded, coughing and spluttering and crying frantic tears.

Of all the possible options, the most likely explanation seemed to be that you had figured out you were too good for me. Whatever that brief fusion of stories had been it was over.

I cannot figure out how to get back to you. I have asked gently, I have groveled pathetically. The wall stays.

And so I find myself having to choose between the possibility that the problem is you, and the fault is beyond my locus of control, or that the problem is me and I must mourn my deficit and accept that I cannot be more than what I am.

They are both impossible situations – each with it’s own mix of frustration and despair.

More than once now, I have tried to overcome this in my heart, forgive you of wrongs I’m not sure you’re even aware that you committed and convince myself to fight for what could be one of those magical-movie-inspiring friendships. But you have retreated into a shell that I cannot force you to come out of. I feel like a lion cub that tries to play with a tortoise and while my intentions are not harmful they seem only to be frightening you and pushing you further away.  Instead of a friend a weed of self-doubt grows.

  

I cannot continue. My heart will not survive.

So this is goodbye.

I’m setting you free.

Always I will wonder about what we could have been.

Always I will miss you.