to the end

Dutt, Monika

The road slopes down ahead of me. It ends in a t-junction, where a left turn follows the hills to the airport (a tiny opening in the trees with a short strip of dirt where pilots have to land and stop within seconds) or a right turn leads past the Northern grocery store, the church, houses. Right now the turns are invisible so the road seems to fade into the water of the lake. The gravel under my shoes creates a layer between the soles and earth, the wetness of the dirt sticking in the grooves of my shoes. I cross my arms, protecting myself from an unexpectedly sharp rain, burying my hands in the fleecy burrow of opposite sleeves.

I can look over the town of about five hundred people and the vast lake beyond from the top of the hill where the clinic stands. The view that meets me outside the clinic surprises me – when inside the clinic the window is blocked by the water treatment plant. The walls of the houses look like thin, angled wafers; they are discoloured and patched, with broken windows lined by jagged-edged plastic sheets fruitlessly arranged to block out the wind and minus forty-degree winter temperatures. Pick-up trucks with streaks of dirt along their sides look sturdier than the houses they stand beside; they wait, ready to make the five-hour drive (three hours when the ice road was there) to the nearest bigger town, which has a slightly less meager selection of clothing and food.

Near the bottom of the hill I stop at a variety store where there are chips filling rows of metal racks, pop lining the refrigerator shelves, cigarettes displayed prominently behind the cash register, and a few fruits and vegetables in a wilted layer at the back. I could buy four boxes of Kraft Dinner or one inhospitable lettuce head. The girl at the counter is arranging CDs – the studiously serious face of a young man looks out from the CD cover. He is seated on a stool, the heel of his left boot resting on the bottom rung, guitar in hand, fingers ready to strum. “That’s my brother,” she says. “He’s good.” I buy a CD.

There is garbage in the grass along the side of the road, thrown from car windows or by walkers. Had I not seen it during previous “doctor trips” here when the sun shone and the kids were running in the street? Perhaps last time I was too distracted by the teenage boy on a skidoo pulling a small child whose head was lost in her toque as she lay on her belly on her sled, her scarf slipping down below her chin, tiny teeth in her large smile bared against the cold, her yells for speed flying back with the spray of snow. I was horrified by the lack of supervision, the lack of regard for safety…but momentarily wanted to be the one being pulled, laughing.

As I walk, I think about the three very different women I had seen in clinic today, all trying to escape with varying levels of success. The woman who picked me up at the airport had started her studies in “human justice” in Prince Albert but could not afford, financially or emotionally, the last year that needed to be done in distant Regina. She moved home and took on casual work, one job being driving the doctor in from the airport and pretending that was what she wanted to be doing. When we crossed the bridge over the water, she sighed.

Isn’t this beautiful?, she asks me. If you go a bit farther north you’ll think you’re in paradise. You’ll never go back south again.

Another woman wanted to return to her family in her home community, but dreaded the discontent and violence simmering in the gangs. Not somewhere where she wanted to raise her three children, aged between eight months and five years. So she came here where her once-kind boyfriend hurls stinging, degrading, painful words and punches.

What is your line to leave him?, I ask.
When he beats me up too bad, she answers.

The third woman comes in with her two sons. She sits without purpose, says little, her unfocused brown eyes barely meeting mine. Neither son is near her. “I’m sorry,” she mutters. To me? Or to one of her children? I can’t tell. One son, already on medication for his hyperactivity, keeps his head buried in his arms as he gives me one-syllable answers and swivels on the stool he is sitting on. He is going to a group home today, as two of his brothers have already done. The younger son is here to be assessed for ADHD. I review the completed questionnaires and coax some information from the reticent boy and the equally uncommunicative mother. I hesitate with every letter I write in his chart; the first time I have given someone the diagnosis of ADHD.

She’s drank through all seven of her pregnancies, a nurse (who knows all), says. All the kids are uncontrollable. Then they get to a certain age and off they go to the group home. Usually they don’t stay in this community though – can you imagine what it would be like to go to school with your brothers during the day and then they go home and you go to the group home?

I reach the t-junction and walk down the “beach” to the edge of the lake. There is garbage on the sand and in the water; with each lap against the shore the waves pull it up and then bring it down in an ongoing rocking motion. Against the grays and browns there is a plastic green and yellow car, large enough for a two-year old to sit on, but now forgotten by the child who once rode it. It is unmoved by the water with one wheel wedged firmly into the sand. I miss the ice road, the lane across the frozen water that seems to recede into forever, where you could drive to…well, to the end.

The melting of the ice has accelerated in recent weeks (it is now mid-June) – there is still some hard whiteness visible against the horizon, against the sliver of blue sky abutting the dark clouds above me. Last visit I had worn my long winter coat and watched the people in cars drive across the lake to the south, to their camps, to visit friends, to go hunting. I had been picked up in a plane that took off from the ice after the pilot shooed the fascinated children away from the turn of the propellers.

I turn to make my way back to the clinic, back up the hill. A lone, black, thin dog patters its way along the main road. At that moment, there is no other sign of life in the motionless, rain-soaked town.

Theme: Patients | Patients
Theme: Health Care Delivery | Prestation des soins de santé
Theme: Family | Famille

Stories in Family Medicine | Récits en médecine familiale [Internet] Mississauga ON: College of Family Physicians of Canada. 2008 --.




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