Plus ça change...

2009
Hobbs, Neil

Dedicated to:
Hazel, my wife and friend these many many years
Dr. Julio Correa, whose epistolary friendship has been the source of much inspiration
Dr. Glenn Colquhoun, physician and poet, who started the whole ball rolling in New Zealand

Written in Fort Good Hope and Norman Wells, North West Territories
March 2010
I thank Dr Ian Cameron for his ideas about the ‘furniture syndrome’, and to Dr Michael Jong for inviting me back to Labrador in 2007 . Several historical details, including patients’ names, have been changed to preserve anonymity; some are attributable to artistic licence

It had been tedious waiting a whole winter’s day for a flight to Black Tickle. The question had come to Henry Tait several times, and in several ways, during that day - what on earth are you doing here? Back in the fall he had been ensconced in his practice in Kingston Ontario, a family physician, comfortable but faintly bored after twenty-five years of often looking after the ’worried well’ and the ‘constantly worried sick’. He did his best to stay alert for the occasional serious or dramatic presentation that quickened his pulse and engaged his brain. He tried to appear hopeful and enthusiastic for patients, and for trainees who, every few months, appeared in his practice. He fretted that his waistline suffered from the ‘furniture syndrome’, his chest somehow ending up in his drawers, and that his zest for continuing medical education had, like Biblical salt, inexplicably lost its savour...

During a recent outbreak of coughs and colds, and chest complaints that accompanied them, Tait had been inclined to discount a nagging cough that would not clear up, as well as some slight but persistent chest pain. ‘It’s just one more case of winter virus’ he told himself. He could not however, ignore a sharp-eyed colleague’s observation of a constricted pupil in his right eye. Tait was always one to waggishly hide his anxieties. “I ‘ve been Hornered” he told his colleagues at a group meeting one morning shortly after this discovery, and indeed it was not long before an oncologist advised him about his options for treatment.

Tait found chemotherapy nasty, brutish and anything but short, but after several months he was finally given a cautious thumbs-up by his medical team. Tait had left England many years ago and had been widowed five years previously when his wife had died in a motor vehicle accident. He and Sonia had had no children to their secret chagrin. Tait was, however, sustained by his colleagues and their families: He was an honorary ‘uncle’ to a number of their children and was loved in the fashion of many Dutch uncles: with unreserved abandon by his ‘nephews’ and ‘nieces’, but in quiet friendship by their parents.

Tait’s colleague, Frederico, was an Italian whose family had immigrated to the Point Leamington area in Southern Ontario a generation ago. He visited Tait one morning. ‘You know, Henry’ he said quietly, ‘you should take some time off before returning to the rat race. Had you ever thought of a spell off from practice?’ Tait admitted that he had not, but once the idea had been mooted, it became progressively more attractive. Usually careful with his money, he wondered if Dr. Hough, lately retired from the University, might cover his practice while he was away...?

---oOo---

So it was that Henry Tait found himself on a six month sabbatical. He had the notion to visit ‘something old, something new’, and took a trip to Mexico and Argentina as part of a new interest in things Hispanic. Recently, he had been lucky enough to meet the director of the regional health centre in Goose Bay at a conference. ‘You should return to Labrador sometime’ he had said, and Tait had barely registered this invitation until recalling it during his recent illness. He was grateful that the offer still stood.

Tait consequently found himself returning to Labrador after a gap of thirty years. In the ‘old days’ - Tait tried not to play the old buffer at Goose Bay hospital by using the phrase too often - he had been based at North West River Hospital, now closed and looking sadly lacklustre when he drove the 30Km road to visit it one weekend. He had looked forward to the director’s offer to visit some coastal communities, and agreed without demur to do clinics in Black Tickle and Cartwright, communities about one hour’s flight south east of Goose Bay by twin Otter.

Tait had forgotten the long waits that went with flights to the coast. Then, as now, weather had been the final arbiter. He had almost given up hope when to his surprise his name was called, and he headed through the snowy dusk to the Twin Otter waiting on the tarmac, headed for Black Tickle.

---oOo---

Imelda Greene has lived in Black Tickle most of her life. Her poor hearing is the result of chronic earinfections in childhood; arthritis has plagued her joints for as long as she can remember. She cannot remember when she last left Black Tickle, her home gripping the bare rock and grass where the sounds of the Atlantic, calm or angry, are ever-present. She has never been further than Goose Bay in her whole life. She is sure that she went out for her first delivery: all her children are now grown up and living away in Goose Bay. She certainly remembers seeing street lamps and traffic lights for the first time on that trip. If asked, not that she would care to be importuned by such personal inquiries, she would confess to the surprise at using a water closet for the first time. Everyone back then in Black Tickle used a ‘honey bucket’, never a favourite job to empty for anyone in her large family that lived on the outskirts of Black Tickle. It was only one of many differences, though now TV is available and the wide world is beamed into her living room. This village of 350-and-some souls is shrinking every year as young people, including her own kids, leave for opportunities elsewhere.

Imelda is used to getting medical care at home from resourceful nurses who come for a few years, but also from a succession of unremembered physicians who come to hold clinics, stay a few days and then leave, mostly never to return. For sure the present-day clinic is better than the old one, now disused, which was a tight squeeze with its one room for the nurse and a room with a hospital bed where the doctor stayed.

She certainly does not remember the balding older physician who sits with her now, pushing his glasses up on his forehead and exclaiming:

‘But, Mrs. Greene, it looks like we have met before!’

‘Sure, and I don’t remember, Doctor’ says Imelda, wishing his accent and her hearing aid were more compatible.

‘Yes, it’s right here. I saw you here in Black Tickle back in 1980..’

‘That’s a long time ago, Doctor. You’re asking an old woman to remember back quite a ways! What did I have then when I came to see you?’

‘Well, Imelda, it looks like you had - my writing was different in those days, and the ink has faded a bit... just a minute - you had problems with hearing and arthritis..’

Bless my soul, Doctor, that’s just what I have come to see you about today!’

---oOo---

With a smile on his face several days and one blizzard later, realizing that he might never see Black Tickle again, Tait climbed aboard the plane realizing that in many ways: some things never change. Oddly, he was greatly comforted by that thought.

Theme: Health Care Delivery | Prestation des soins de santé
Theme: Physicians | Médecins
Theme: History | Histoire
Theme: Patients | Patients

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

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