Begining my nursing career and some of my early patients

Excerpted from Memories that linger…. by Padmani Mendis

Early on in the year that I started nursing, an epidemic of Poliomyelitis or polio had occurred across the United Kingdom. It had left very many people with varying degrees of paralysis in different parts of the body. The paralysis in polio followed no pattern. It would affect muscles scattered all over the body; anywhere on the trunk or chest or arms or legs. Polio damaged the nerves of the body that made muscles work. When muscles were paralysed, a person could not move the joints served by those muscles.

Many who were more severely affected had come to the ROH for rehabilitation. Looking to the future, however, polio immunisation had come and this would be the last such epidemic in the UK.

Mrs. Wilson was one of the first patients I met who had been part of the epidemic. She had all parts of her body affected and could move no part of it. She could not even breathe on her own. To enable her to breathe, she had been placed in what was called an “Iron Lung”. Because of this, she was nursed in a separate room but had to be under constant observation. A nurse was allocated to visit her room at regular intervals. Mrs. W’s iron lung was the first and last such machine that I had seen.

It was a large machine that covered most of her body. It used a negative pressure to pull her chest out. This would draw air into her lungs. Then pressure would be released and the air would be pushed out of Mrs. W’s lungs. Mrs. W’s head was outside the machine so she could be fed. There were holes on the sides of the machine through which we could carry out nursing care. In the same way, she would have daily physiotherapy too.

Between breaths, Mrs. Wilson communicated with us in a whisper. So we could have some sort of conversation. I don’t think iron lungs are in use any more. They have been replaced by modern “respirators” or “ventilators” which use a different mechanism called positive pressure.

During the time I was in the same ward as she was, Mrs. W’s husband and two young children would visit her on Sundays and spend time with her. The children were quite young and could be seen playing outside the ward. We knew that Mr. W. had employed a nanny to look after the children.

After I left Woodlands I heard that Mr. W. had divorced his wife and married the nanny. Her family no longer came to see her in hospital. I followed her condition. Mrs. W. never recovered the use of any of her muscles. She remained in the iron lung until she died of a lung infection about a year later.

A Pause to Fast Forward with Technology

This was Mrs. Wilson, dependent on an iron lung, confined to a hospital bed and requiring total nursing care. The memory of an exceptional lady very early on in my journey, circa the year 1959. To fast forward now, passing through the next three decades and more of my journey, to another individual called Adolph I was fortunate to know. He was as severely affected by polio as Mrs. Wilson was. Not able to breathe by himself. Not able to move his body except for his fingers,

I met Adolph as a young man, a little younger perhaps than Mrs. Wilson. Adolph lived in a comfortable apartment together with his partner. I was so fortunate to have been invited by this couple I had made friends with to spend time with them when, on my journey, I stopped over in their city in Northern Europe. Adolph had the use of an electric wheelchair fitted with buttons on the arm of the chair; buttons that he could press with the little movement he had in his fingers and use the chair in just the way he wanted to.

To me these advances were miraculous. His chair was so designed as to be able to accommodate and transport a specially designed ventilator to help him breathe. This ventilator Adolph had to have with him 24 hours a day – the technological advance of the iron lung that kept Mrs. Wilson alive in her bed. Such was the construction of the chair and the ventilator that when required, which was every few minutes, Adolph could breathe for a short while and then take a break for a few minutes. A never-ending cycle to ensure that Adolph had access to the essential respiratory function that kept him alive. And which enabled him to carry on a lively discussion and intensive debate, to read aloud and teach, to lead a full and active life.

Adolph had a full-time job with regular hours of work. Disability advocacy was part of his job. He had a specially designed vehicle in which he was driven to wherever he wanted to go. He had an assistant who would drive his vehicle. This assistant was there also for Adolph and his personal needs and to maintain his home – to get him in and out of bed and in and out of a bath (with the use of an electric chair-lift), in and out of his vehicle, prepare his meals, do his laundry, and write his communications.

Getting to know Adolph was for me a truly amazing opportunity. One of the most vivid of the memories I have with him is of my first visit to his home. With the press of a button Adolph opened the lift door. With the press of another, Adolph led us into the lift. With the third press, he led us out of it – and then the wonder of it for me. With the next press his front door opened and all the lights of his apartment came on.

All these had been made possible by an individual who knew his rights, appropriate technology and a welfare state that acknowledged that all its citizens had the same rights to the best quality of life and a state that ensured it.

As a citizen of his country and because of his disability, Adolph was entitled to the apartment, the chair, the helper, the job, and to the other requirements he had. These were his rights as a citizen. It was the responsibility of the state, to have them met by the City Council serving the area in which his home was located.

In the course of his work Adolph was also required to travel abroad on occasion. This he did with his partner, his chair, his ventilator and all. And airlines were required to accommodate and meet the requirements necessitated by his disability. A truly amazing individual I was honoured to know, together with a charming partner.The changing world of disability. And within that, changing experiences for me. Now memories.

Annie

Annie was one of those patients who had a profound impact on me. I was doing my first night duty when Annie came into my life. I had been placed on the Private Ward which consisted of about twelve separate rooms. The Night Sister was known to be a bit of a snob. We all knew that she selected with care those nurses who she would put in the Private Ward. Those selected were always from a certain background. They would have paid for their education and attended a well-known school. She had obviously found out that I qualified in both areas even though it had been in faraway Ceylon.

The Private Ward was next to Ward Seven which was a short-stay Female Ward. Joining the two was a single room which belonged to Ward Seven. As she briefed me for my first night on duty, Night Sister said to me, “Nurse Padi, you have been given another job to do. You will look after Annie who is the patient in that end room belonging to Ward Seven. Annie needs special care and we think you can give her that.” During the day, Annie was the responsibility of Ward Seven. At night, she was mine.

Night Sister took me aside to brief me further in relative confidentiality. I learned that Annie was thirteen years old and had “sarcoma” or bone cancer. She had secondary tumours all over her body. She was in pain all the time. She was sedated heavily in an attempt to make her comfortable; she was almost always asleep, but there was a limit to that and she still felt intolerable pain; so much pain that she would not move, as a result of which Annie had bedsores on many parts of her body; so much pain that she did could not bear to be touched.

Because of all this, Night Sister told me she must be turned over in bed every three hours; and at least four nurses were required to do that in a way that would cause the least discomfort to Annie. Night Sister would send me three colleagues from other wards to help me turn Annie every three hours.

And so it was with much trepidation that I walked into Annie’s room that night. My colleagues had arrived at the pre-arranged time and we set about our task as gently as we could. Before entering her room, we had arranged between us how we would do that.

On removing the especially light covering sheet Annie’s eyelids fluttered, that was her only response. What we saw was a little girl who looked no more than eight or nine years old in age and in size. It appeared as though her illness had caused Annie to shrink. She was rolled into a ball and would not open her eyes when I addressed her and told her softly what we were going to do.

The sheets she lay on were soaked with the discharge from her bed sores. They smelled bad. We lifted her gently to change her sheets and then lay her down on her other side.Soft moans and groans from Annie turned into a crescendo of ear-wrenching screams as soon as she felt our hands on her. And then when she was back down on the bed, when she was free of our hands, she returned to the soft moaning and groaning. This three times a night, night after night.

Night Sister had told me when she briefed me the first time that the doctors did not expect Annie to live through that night. She told me this using other words every night for the next ninety nights. This routine of turning Annie continued on every one of those nights. And on those nights, as I had with Fernao and with many other patients, I spent as much of the little free time I had sitting by Annie’s bedside, talking to her or singing softly to her. And every night I was drawn closer to Annie in her unceasing and increasing pain. And then, during the last night of my three-month spell, Annie passed away.

I was devastated. I could not stop crying. Why tonight? Why could she have not lived another night? Everybody in the hospital came to know of my reaction and many shared my sorrow. I could not be comforted. So much so that Matron sent for me. She was gentle with me. She told me it would be best if I took my two-week summer vacation sooner than planned. She said a break from the hospital routine would do me good.