First published in 2017
Copyright © Leonie Howie and Adele Robertson 2017
The names of some people mentioned in this book have been changed. The authors and the publishers thank all those who have given permission for their stories to be included.
Permission to reproduce ‘Tangi’ by Hone Tuwhare courtesy of the Hone Tuwhare Trust.
All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording or by any information storage and retrieval system, without prior permission in writing from the publisher.
Allen & Unwin
Level 3, 228 Queen Street
Auckland 1010, New Zealand
Phone: (64 9) 377 3800
Email: [email protected]
Web: www.allenandunwin.co.nz
83 Alexander Street
Crows Nest NSW 2065, Australia
Phone: (61 2) 8425 0100
A catalogue record for this book is available from the National Library of New Zealand
ISBN 978 1 877505 84 3
eISBN 978 1 92557 690 0
Cover and internal design: Kate Barraclough
Cover photographs: Leonie Howie and Adele Robertson (top);
Eugene Polkan (bottom)
Internal map by Janet Hunt
Cover photograph captions (clockwise from top left): Leonie in 1973; Adele in 1970; Sunset on Great Barrier Island Aotea
CONTENTS
Map of Aotea
Authors’ note
PROLOGUE
Chapter 1
LANDFALL
Chapter 2
ON CALL, ON EDGE
Chapter 3
PART OF THE FABRIC
Chapter 4
DISCOVERING PARADISE
Chapter 5
ARRIVALS
Chapter 6
GROWING TOGETHER
Chapter 7
ONWARDS, UPWARDS
Chapter 8
ANSWERING THE CALL
Chapter 9
PROGRESS
Chapter 10
NO MAN (OR WOMAN) IS AN ISLAND
Chapter 11
NEARING THE END
Chapter 12
BOLTS FROM THE BLUE
Chapter 13
TE PŌ, TE AO
EPILOGUE
Acknowledgements
About the authors
Authors’ note
He tapu te tangata
Ahakoa ko wai
Kōhungahunga mai
Tai noa ki ngā tamariki
Tai pākeke mai
Kaumātua mai
Tīpuna mai
He tapu te tangata
This whakataukī expresses the sacredness of man through the times of infancy, childhood, adulthood, our elders and our ancestors. Life is a continuum. We—Adele and Leonie—hold this sacredness at the heart of our practice as nurses and midwives.
Nursing is about the privilege of being able to share in the joys and sorrows of people’s lives and of making a difference. It is empowering people to make decisions about their health, birth and death, and supporting them in their choices.
Nursing is about talking, teaching, touching, smiling and crying. Nursing is caring. Life is sacred.
We live on Aotea, an island that locals call a world of its own. We hope to share with you the specialness of the island people and what it means to be a nurse and midwife living and working in such a remote environment. This book is for all those people who have invited us into their lives.
PROLOGUE
TANGI
I did not meet her
on the bordered path
nor detect her fragrance
in the frolic of violets
and carnations.
She did not stroll riverward
to sun-splash and shadows
to willows trailing garlands
of green pathos.
Death was not hiding in the cold rags
of a broken dirge :
nor could I find her
in the cruel laughter of children,
the curdled whimper of a dog.
But I heard her with the wind
crooning in the hung wires
and caught her beauty by the coffin
muted to a softer pain—
in the calm vigil of hands
in the green-leaved anguish
of the bowed heads
of women.
—Hone Tuwhare (1977)
It is about knowing.
That is what the textbooks on rural nursing tell you, and it is true. There are ways of knowing people and places, and there is a special combination of these ways that defines rural nursing. You become part of the place and, in so doing, you become part of its people. You know them, and they know you.
We are separately reflecting on this as we stand here to honour Jill. We are shaded by the tree that arches over the heads of the gathering. Cicadas seethe in its branches, and in the background there is the other ubiquitous sound of the Barrier, the sound of the sea, the gentle slap of wavelets on the sandy shore. The sun is warm, and the heat rises as if in answer from the ground. The prospect from the dappled shade where we stand is the sparkling water of Allom Bay, framed by the bush-clad slopes of the hills. Beyond the entrance to the bay is the broad expanse of Okupu, otherwise known as Blind Bay, and the high land behind the far shore. Other high hills rear behind us. There is a sense, standing here, that we are enfolded by the land.
We all drove to Okupu in our modern vehicles, but then relied upon far more traditional Barrier transport to make the final leg of the journey.
We are standing shoulder to shoulder with a group of people whom we have come to know and deeply admire. An outsider might look at them askance—the men variously unshaven and, by some people’s standards, in need of a haircut; the women in colourful attire chosen for its practicality rather than for the way it coordinates, or reveals, or covers. Some of them, men and women, choose to be barefoot, and most of the rest are in jandals or sandals. Insiders—and that now includes us—do not notice details like that, though. And we have learned not to judge this assortment of books by their covers.
Ask one of the men what he does for a living, and he will shrug and say he is a digger driver. It is true, but he also has got a Master’s degree in English Literature. There is a mussel farmer who used to be a university lecturer in his former life. And over there is a company director who left school at fifteen.
Children are running about freely. It would look to an outsider as though no one was watching over them, but we know that everyone is keeping an eye. They are island babies: they belong to their parents first and foremost, and to everyone else besides. We helped birth many of these children. We helped birth the parents of more than a few of them. We know their stories, as we know the stories of their families, and we can fit them into the wider story of Aotea—of Great Barrier Island—itself.
We are living a part of that story, even now. Jill is being laid to rest. In some ways, it is the final chapter in her story. But, in another way, it is only really the beginning, as her children are here—tearful at the cruel finality of the death of their mother—and, of course, their story goes on. Jill is part of that story. We are privileged to be part of it, too.
As we listen to the speakers—it is the custom on Aotea to give everyone space to address the gathering—we think about our involvement with Jill and her family, all four generations, down through the years. Adele thinks of the first time she met Jill’s father, and of Jill’s birth stories, and of how the very day Jill’s baby was born, her father died.
Leonie remembers, too,
and she feels fresh tears in her eyes. You are supposed to maintain boundaries in nursing, between your professional and your personal life, between patients and friends, between your emotions and your rational self. It is not always possible in the enforced intimacy of rural life, and especially not on an island. We are all called upon to perform different roles for one another in a community such as this: nurse one moment, friend the next. Under these circumstances, the boundaries are fluid and negotiable. The textbooks might not tell you that. But it is true.
Leonie thinks of the lines of Hone Tuwhare’s poem ‘Tangi’ and they ring terribly true. She holds all of her memories of Jill as though in a basket: the happy times, the sad and, finally, the most recent and tragic. If she turns her head she can see the very spot where the haunting resuscitation took place only days before—the last time she was to see Jill.
She listens to the kōrero about her friend and patient, and she knows. It is the special kind of knowing of a rural nurse, as much in the heart as in the head.
Chapter 1
LANDFALL
The word ‘isolation’ comes from the Latin word for island. Apart from the early years, when we trained and worked in hospital situations, our professional lives have been shaped by isolation. People who come to the island for the first time often tell us that they never realised it was ‘so far away’. Te Motu o Aotea is the Māori name for Great Barrier Island—the island of Aotea. In Māori, Aotea translates as ‘white cloud’, and it is also the name of one of the original waka that came to New Zealand at the time of the great migration. It stands as the largest offshore island from the North Island and provides a natural barrier to the Hauraki Gulf. Captain Cook, taking note of this, named it Great Barrier in 1769, and this name remains in common use today, yet many islanders (or ‘Barrierites’) prefer Aotea.
On Aotea, we’re physically isolated. And, while aircraft technology has somewhat closed the gap and we are only half an hour’s flying time from Auckland Hospital, time becomes of the essence in an emergency. It is as though time is a currency that is abruptly devalued when someone’s life is ebbing away. The turn-around time for evacuation is extended to at least two hours, which is more than enough time for a serious situation to become severe, even fatal.
And, when we are talking about isolation in the context of Aotea, we don’t just mean the physical and psychological distance from the mainland and its secondary health facilities. It is also common for first-time visitors to the island to shake their heads and admit that they didn’t realise the island was ‘so big’, or ‘so mountainous’. The residents of Great Barrier Island can even be isolated from one another. There are several main communities, tenuously connected by roads. But there are many people living in bays or gullies or on several outlying islands that are accessible only by sea. Telecommunications have advanced dramatically in recent years, but while the rest of New Zealand—and indeed, most of the rest of the world—takes cell phones for granted, the mountainous terrain of the Barrier means there is patchy coverage at best. There is no reticulated power, water or sewerage; people make their own arrangements for each. Each household is like a little island apart. You get this sense in winter especially, when you navigate the wilderness of land or sea and arrive at the home you are visiting to be welcomed into the warmth where, as often as not, there are children running around and the smell of bread baking in a wood stove. Being welcomed into that human warmth is like reaching a port in a storm. It is like making landfall.
The engine note rises and, with a gentle lurch, the plane begins to roll across the tarmac and down the boat ramp. With a swish, it is afloat and taxiing out on to Waitematā Harbour, living up to its name, which means ‘sparkling water’. It is high summer, January 1985.
The Auckland boating fraternity are familiar with the comings and goings of the Sea Bee Air aircraft, so there’s no need to wait for clear water. The pilot swings the nose of the plane towards Browns Island and eases the throttle lever forward—Adele and the rest of the passengers can see him do this, as there’s no bulkhead between the flight deck and the passenger compartment. The engines roar, and spray begins to hiss past the windows as the plane gathers speed. Everyone aboard thinks of Fred Ladd at this moment, the flamboyant seaplane pilot who pioneered this very seaplane service out of Mechanics Bay, and who became famous for his cry ‘A shower of spray and we’re away!’
The pilot eases back on the throttle and the vibration and hiss of water abruptly cease. The plane skims down the harbour, seemingly a few centimetres from the surface. The wooden lighthouse on Bean Rock flashes past on the left, and Bastion Point and Ōkahu Bay on the right. By the time it is abreast of St Heliers, the plane is in a shallow climb. The last drops of water creep across the windowpanes and are gone, leaving trails of salt behind them, sparkling in the sunshine. By the time the distinctive crater of Browns Island is passing beneath, the plane has flattened into smooth, level flight. Any turbulence Adele feels is internal. She is leaving her comfort zone—not for the first time, but that does not make it any the less daunting—and venturing into the unknown. She consoles herself with the thought that, if she and Shannon, her husband, survived outback Western Australia for as long as they did, then they are ready for anything.
Beyond Waiheke, the colour of the water changes. It is no longer the blue-green of the inner Hauraki Gulf, mottled with rocks and reefs. The white-fringed Noises are sprinkled beyond Rakino Island like a farewell offering. Then the sea turns Prussian blue, and the swell pattern, given complexity by the northern tip of Coromandel Peninsula and the southern tip of Great Barrier Island, is etched undisturbed across it. Whereas boats lazily drag their wakes to and fro among the islands of the inner Gulf, there are only one or two braving the passage to Aotea. They serve only to emphasise the emptiness of this 100-kilometre stretch of sea. And meanwhile the high, rugged profiles of Coromandel to the right, Little Barrier Island to the left and Great Barrier Island directly ahead impress upon Adele the untamedness of their destination.
After 30 minutes’ smooth flying, they are approaching Aotea, the high, western coast indented with its many bays and harbours and with its profusion of rocks and islets off the rugged headlands. Through and over the spine of the heavily wooded mountains, Adele glimpses the white sand of the ocean beaches, fringed with surf. She can’t suppress an excited grin.
Kaikōura Island, the guardian of the gateway to Aotea’s northern port, passes beneath the plane, and then they rapidly lose altitude as the pilot lines up the still, green waters of Rarohara Bay. There are lots of boats—mostly yachts—moored and at anchor, but the pilot’s practised eye identifies the clear stretch of water designated as the seaplane access lane. With another shower of spray and deft manipulation of the engine speed, the plane is back on the water. It rocks gently in the wash of its own landing as it threads a course through the watercraft, and then, with a final squirt of power, it grounds on the pebbly beach below the shop. The pilot kills the engines—the passengers’ ears ring in the sudden quiet—walks down the aisle and flings open the door for the passengers to disembark.
There is a small group of people standing on the grass, either waiting to greet passengers or ready to depart on the outgoing flight. Among them is the nurse, who Adele recognises from a previous visit to the island.
‘Hi, Fay. Great flight. It’s good to finally get here.’
Fay is a similar age to Adele and she looks relaxed but tired. She helps with Adele’s luggage as, all about them, people carry mailbags and crates of milk and bread from the plane to the little store. One or two cars fire up. Doors squeal and bang shut, and one by one the vehicles lurch off and grind their way up the gentle hillside.
‘I’ve just got to pick up my mail from the store, if you don’t mind waiting,’ Fay says.
‘Not at all.’ Adele shrugs.
Fay has a quick shuffle through her mail and takes a copy of The New Zealand Herald. She introduces Adele to the storekeeper. Adele feels the weight of t
he storekeeper’s appraising gaze as they shake hands.
‘Welcome to the Barrier,’ he says. ‘Anything you need, you know where we are.’
Once outside, Fay and Adele make their way across the road to a two-storey weatherboard building.
‘The shortest commute ever!’ Adele laughs.
Once they have deposited her bags, Fay takes Adele into the lounge, where there is a family, a small boy and his tired-looking parents. After introductions, Fay checks the boy’s temperature and provides advice to his parents about what to do in the event of a recurrence of croup. They offer thanks and set off to return to their boat. Fay gives Adele a tour of the clinic, which does not take long. It is a single room that doubles as office and clinic, and there is a little waiting room, which has a toilet off it.
‘He came in last night, and we have been up all night steaming and monitoring him,’ Fay explains. ‘So if you don’t mind, we’ll have a bite to eat and then I might try to catch up on a bit of sleep.’
This suits Adele just fine. She was up until the early hours helping her husband, Shannon, get started packing up their house. So at one o’clock in the afternoon on her first day at work as the Great Barrier Island public health nurse, Adele finds herself drifting off to sleep in a warm room with a glorious view out over Port FitzRoy and reflecting that this is turning out to be a great job. Fay’s exhaustion doesn’t strike her as significant—for now, at least.
‘Cooking is on this,’ says Fay. It is evening, and she is showing Adele the wood stove in the little kitchen. ‘It heats the water, too. There’s a wetback on it.’ Off to the side are two burners and a grill run by gas for use when the fire is not going. ‘Lounge . . . This is my bedroom. You’ve seen yours. This is the bathroom. The water’s cold unless you’ve had the fire going, but it’s not too bad in summer. Then you can be pretty grateful for a cold shower.
Island Nurses Page 1
