Volume 196 - Issue 7
The Indian camp
Author: Geoffrey C Mullins
Med J Aust 2012; 196 (7): 477-478. || doi: 10.5694/mja11.11256
Published online: 16 April 2012
Published online: 16 April 2012
Sometimes, the only response to death and dying is silence. The Indians* must have set up camp overnight as there was no sign of Indian activity on his ride home the previous afternoon. Now, early in ...
Sometimes, the only response to death and dying is silence
The Indians* must have set up camp overnight as there was no sign of Indian activity on his ride home the previous afternoon. Now, early in the morning, after taking his usual trail down through the University grounds and on into Queens Park, he was confronted by an entire Indian village set up across the paths, gardens and broad manicured lawns at the front of the provincial parliament building. The people in the camp were waking as he wove his bicycle carefully around the mass of their tall conical tents. Although all was quiet, the smell of smoke and cooking wafted through the air. Two women silently tended a fire and he swerved around men unfurling a large banner as they emerged from the largest of all the tents. He cycled on, mystified by this world he had suddenly entered into and from which he just as suddenly emerged out of and onto the busy city avenue leading to the hospital where he worked.
An Australian, new to Canada, he was fascinated by the Indian people and their stories. Since arriving, he had rarely got to talk with them. When he did, he was often disappointed. There seemed to be a barrier between them and he was often left with silence. In his first months he volunteered to go with a surgical team to the Indian Hospital at Sioux Lookout in the far north of Ontario, hoping to meet with these people away from the cities. Before departing, he was given literature on how to communicate with First Nations people — don’t make eye contact, don’t ask direct questions, try to understand their culture, don’t be judgemental, take it slowly and respect the silences. It didn’t seem to help. It frustrated him that, although they spoke and understood his English, he couldn’t penetrate the barrier. This made him realise how scant his contact with Aboriginal Australians had been. He had never had what he felt to be a true conversation with any of his Aboriginal patients. He remembered the silences rather than words.
In Canada, he had cared for many desperately ill Indian children flown in from distant parts of the country to the intensive care unit of the hospital where he worked. However, they were too sick to talk with him and the parents were invariably shy and would rarely speak. Although their strong brown faces betrayed no emotion, he sensed they were uncomfortable in his presence. He watched them unobtrusively, noticing that they talked very little to each other or to their desperately ill child. They would sit calmly at the bedside, rarely leaving their child and appearing to show little interest in the surrounding activities. Observing these bedside vigils, he began to perceive a dignity and strength in their calm expressionless faces. Still, he longed to talk with them.
He planned to ride home through the Indian camp after his day at work. Perhaps he might talk to someone there. They must have a major grievance to set up camp in front of the parliament. If he showed some interest, maybe they would tell him about it, or perhaps even enlist his support for their protest.
At the end of his day, he was leaving the hospital when his pager emitted the shrill ring he had learnt to detest. A 14-year-old boy in the intensive care unit was now brain dead and his parents had agreed to donate his organs. He was the anaesthetist on call for the night so he could forget about talking with Indians at the camp. Organ harvesting and organ transplantation involved many staff and generated frantic activity in the hospital. He would have to transfer this boy’s limp body, still attached to monitoring equipment and drug infusion devices, to the operating theatre and manually ventilate his lungs during the transfer. In the theatre, he would need to keep the boy’s body warm, the lungs full of oxygen, the heart beating strongly and the blood pressure normal so the organs would be in optimal condition for transplanting into a child or children somewhere in need of a second chance.
He had been recruited to Canada because of his experience in caring for critically ill children, yet for him the most difficult part of this task was always the first sight of the little pale body connected to a tangled mass of equipment and monitors, surrounded by a grieving family. It was worse seeing the photographs that the parents were encouraged to attach to the bed and the nearby walls — photographs which showed all who attended that this is their child, part of a loving family and full of life. He always hoped the families would leave before he arrived. Invariably they stayed, watching silently his every move as he transferred their child’s body and all the equipment onto a trolley for transfer to the operating theatre. Almost always they would follow him, sometimes sobbing, stroking or evening clinging to the body as the trolley was pushed slowly down the hospital corridor to the theatre. He would pause for a few moments at the automatic doors, before pushing through and leaving the family behind. Once through the doors, he tried to erase the images of the family and the child from his mind and set upon the tasks for which he was trained. Strangely, in recent times these images preoccupied and disturbed him more rather than less, and on this day they troubled him more than ever before.
Many organs were to be taken from this child and it would require several surgical teams. Once removed, the organs would be urgently transported to where the need was greatest. His hospital would take the kidneys and the corneas and a nearby city hospital the liver. A surgical team was already flying from Montreal to take the heart, and a research institute was making enquiries about the long bones.
The operating room was, as usual, overflowing with people. The noise of monitors and urgent conversations filled the air. He was busy with his tasks and determined to keep this boy’s body physiology as normal as possible until the last organ was removed. Preoccupied with the demands and tension of this work, thoughts of the child and the grief of the family faded. Finally, after 4 hours of hectic activity, the last organ — the heart — was ready for removal. Clamps were placed across the great vessels, the vessels then severed, and the heart lifted out of the chest and placed in a bowl of ice solution. Abruptly, his job was finished. He switched off the monitors, alarms and machines and turned to his paperwork. Most of the team members quickly departed and there was now no need or desire for conversation in those remaining. The sudden muteness of the monitors and machines caused a quiet to fall on the room. He completed his paperwork and paused to watch an assistant surgeon close the large incisions into the now empty body cavities. As he looked at the lifeless body, images of the child and the family flooded into his mind, filling him with a sadness not just for the child and his family, but for everything in life. Nausea welled within him.
In the empty locker room he changed into his street clothes and walked out of the hospital. It was 2 am and the street, too, was quiet. There was a full moon overhead as he cycled into a warm summer breeze up the avenue towards the Indian camp. All was quiet in the camp as he cycled around the tents. A raccoon appeared across his path, stopped and stared at him. He was still fascinated by the presence of raccoons in such a big city so he too stopped, dismounted and returned the raccoon’s stare. Again, images of the child and the family flooded into his mind. The nausea returned. He sat on the cool grass, closed his eyes and waited for it to pass. When he looked up, the raccoon had gone. Looking around, he became aware of a man sitting nearby. In the moonlight he could see his long dark hair and strong ancient face. Motionless, the man stared calmly into the darkness and appeared unaware or uninterested in the presence of the Australian. Seeing this old man sitting on the grass in the moonlight had a soothing effect on him so he also remained sitting and let the warm evening breeze flow over him.
He wanted to talk to the old man. He wanted to tell him of the grief of his day but he sensed it would do no good. So he sat with this old man in the moonlight in the warm summer breeze and he felt the healing power of silence.
* The events of this story occurred in the 1980s, when the term “Indian” was commonly used to refer to indigenous peoples of America, but gradually being replaced by “First Nations people”. Today, First Nations people prefer to refer to themselves by the name of their nation (eg, Cree, Ojibwa, Oji-Cree).
Competing interests
No relevant disclosures.