Bringing It Home

by Tilda Shalof

  In the early evening, in a cooking class kitchen over a no-frills grocery store, ten teen moms-to-be cluster around, buzzing with excitement. Dressed in baggy sweatpants, hoodies, and running shoes, they compare bellies and chatter about pregnancy symptoms and upcoming baby showers. I hope they’ll be this happy when the baby arrives and reality hits. One girl has come to the class with her mother. Two dads have come. They sit together, slouching in their chairs, trying to be invisible, looking like they wish they were somewhere else, anywhere but here.

  Maria asks questions to get a discussion going. “How much time have you spent thinking about the baby’s room? Whether it will be a boy or a girl? What about baby names?”

  They chatter excitedly, smiling and animated about these topics. However, at Maria’s next questions, their mood becomes subdued and they fall silent.

  “How much time have you spent thinking about your baby’s brain development? About the kind of parent you want to be? What would you like people to say about your child when they are sixteen or seventeen, the age you are now?”

  She hands out stationery for them to compose a letter to their eighteen-year-old child. “You are not just about to be parents but teachers, too.”

  One girl reads her letter about how hard this experience has been. Another warns her grown-up child not to do as she’s done. They all write their wish that their grown-up babies will be successful and happy.

  During the break, I ask Maria about labour and delivery. As I recall, those were the main topics covered in the prenatal classes my husband and I attended when I was pregnant the first time around.

  “It’s a luxury I can’t afford. I have this one, brief window of opportunity to impress upon them the importance of the role they’re about to take on.”

  Next, they pull topics out of a hat.

  On spanking: “What is the message you’re sending? That hitting is okay? Be sneaky and don’t get caught? Think about what you want to teach your child. This is a blank slate, your chance to create something good.”

  On the topic of temper tantrums, one father has a strong opinion. “They happen because the baby is spoiled, given everything it wants.” He folds his arms across his chest like that’s that.

  “You will not spoil a baby by responding to its needs,” Maria tells them. “With a child, you must set limits, but with a baby, pas possible, you cannot spoil. Show up and look into the baby’s eyes. The message you want to give whenever your baby cries is, Hello. I’m here. If you don’t show up each time, there will be a loss of trust.”

  She tries to impress upon the fathers that their role is more than doing chores and paying for things. She advises them not to yell, and to walk away when stressed until they calm down.

  “What reaction did you get from your parents when you told them about your pregnancy?” she asks the class.

  “No one said congratulations.”

  “I got thrown out of the house.”

  “My parents couldn’t believe how stupid I was.”

  “My mother told me I’d ruined my life. She asked me, ‘Are you trying to kill yourself?’ ”

  “Maria was the first person who congratulated me.”

  After the class, I sit with Maria and tell her I was surprised to hear she’d congratulated the teen moms. “It sounds as if you approve of the situation they’re in. They have such a hard road ahead of them.”

  Maria has no reservation about offering encouragement to teen moms.

  “Every child born is good news. Whether this baby was wanted or not, whether the mother is happy about her situation or not, it’s fait accompli. A baby is on the way. We have to move forward in the most positive way possible. The last thing we want is for these babies to end up in foster care.”

  She would know. Maria and her husband have fostered twenty-six children over the years, even crack babies whom she cradled and soothed while they went through drug withdrawal with shaking, fevers, seizures. Even after a child leaves, Maria still holds each one in her heart. “I think about them, wonder how they’re doing, who’s saying I love you, who tucks them in at night. Some stay in touch with us. We attended a wedding recently.”

  On the way to our next stop, Maria tells me her dream is to create a home where single mothers could stay as long as they need, have a healthy pregnancy and a safe delivery. It would be run by mothers and fathers who would teach these young mothers to mother their babies. “It would set them up to succeed at the most important job in the world – being a parent.”

  Of course, sometimes a young, single mother decides the best thing is to let the baby go. Maria tells me about one teen who knew she wasn’t ready to be a mom. She was adamant that she wouldn’t leave the hospital with the baby and has never looked back.

  “This choice is preferable to mothers whose babies are with them but are not thriving, or mothers who neglect their children, like the one who didn’t bother to fill a prescription for asthma medication and the child went into respiratory arrest. There was one child who kept running away from home, looking for me. I always knew how the children had been treated in the homes they’d come from by watching how they played with their dolls and teddy bears. Observing them in the schoolyard during recess is also very revealing about a child.”

  She’s wistful and fierce, determined that babies, children, and their young mothers get the nurturing they need. “We never had a lot in our house but the kids made me feel rich. Our home was always a fun place. The most important thing is connecting with others. Relationships.”

  She says that word like she’s savouring the taste of something delicious.

  “My dream is to end the legacy of foster care,” she says with sad determination. “Of course, there are good foster parents, but I’ve seen some scary things.”

  What she takes me to next is the opposite of scary – safe and secure.

  It’s late evening, so this will be a short visit to a single mother with three children who has a home of her own, thanks to a partnership between VON and Habitat for Humanity.

  “When they contacted us, we put the word out for a family in great need. There are homeless young moms who live on the streets, in parks or shelters.”

  Thérèse has an infant, a ten-year-old girl, and a thirteen-year-old boy whom she had at sixteen. Her husband left after the baby was born. They were living in a rat-infested, poorly heated fire trap above a store in the worst part of town. They slept on the floor, had little food, no phone, no lock on the door. The son didn’t complain, but often stayed out of the house, sometimes all night.

  “This house is a hand-up, not a hand-out,” Maria emphasizes. Thérèse works as a health care aide in a nursing home and pays six hundred dollars a month toward the mortgage. She also makes “sweat equity” payments by doing five hundred hours of volunteer work in the community.

  “When Maria told me I’d been chosen, it was the happiest day of my life.” Thérèse’s face shines at her unbelievable good fortune. “I never dreamed I’d have a house. I still can’t believe it’s mine. ‘Is this house ours?’ my son kept asking, over and over, the day we moved in.”

  “Mommy was crying when we got the house,” her daughter pipes up.

  Thérèse guides me on a room-by-room tour of the small, tidy house, decorated with exuberance. “The kids chose the colours.”

  Ahh … that would explain the lemon meringue pie living room walls, her daughter’s cotton candy room, and her son’s Froot Loop palette. Entering each room reignites her high-wattage smile. She beams with joy; she’s queen of her castle. Her happy face tells the truth of the old adage that there really is no place like home.

  “Such a worthy candidate, n’est-ce pas?” Maria says.

  After that full day of listening and travelling, I planned to sleep in, have a leisurely brunch, relax, then take a taxi to the airport for my afternoon flight home, but no – mais non – they won’t hear of it. Rob Zwicker, nurse manager, is waiting for me in his office with coffee and croissants
at eight a.m. Later, he’ll give me a ride to the airport. For now, he has more to show me.

  Rob reminds me of myself a few months ago when he says, “I swore I’d never work in the community. I had no interest in it. My whole career has been critical care. My hospital friends don’t take my work seriously. They’re dealing with ventilated patients, trauma, moose accidents. They’re saving lives and –”

  “Moose accidents?” I interrupt.

  “Yes, especially this time of the year, there are a lot of moose-related injuries. With their non-reflective eyes and dark colour you don’t see them until you suddenly plow into them. Whenever I see one, I always think, Whose life is that moose going to take?”

  I have never actually seen a moose, not even in a zoo. What kind of a Canadian am I?

  Rob was a manager of the emergency department at a hospital and knew nothing about maternal care, immunizations, or mental health – the specialty programs in this community – but he learned. “Even though it’s not life or death like in the ICU, it’s no less important. The first thing you notice outside the hospital is happy nurses. There’s none of the negativity and complaining about being stressed that you hear all the time in the hospital. It’s a well-kept secret that the community is a great place to work, supportive and fun.”

  We walk out to the parking lot to drive to our next stop. “We butter our bread differently out here,” Rob says, looking proud and giving me a playful wink.

  I don’t know if the buttering of the bread refers to working in the community or the province of New Brunswick. Come to think of it, probably both.

  In the car, Rob asks if I got to see everything I wanted to see.

  “Not quite. I’d like to see a moose. Can you arrange that for me before I leave?”

  “I’ll see what I can do.” He laughs at my little joke, but tops it with a much funnier one.

  “Someone here in town called 911 to ask that a deer crossing be moved because it was interfering with traffic. ‘Have them cross at a different intersection, where there’s less traffic.’ ”

  On the door of the Travel Clinic, a sign says in French and English, “Please make an appointment with the nurse.” I meet a retired couple, snowbirds, planning a Caribbean cruise in a few weeks, over New Years. Luckily, it’s after hurricane season, Nurse Louise says. She tells them what shots they need and the precautions they must take in various ports of call. She knows all about the titres, interactions of various meds and vaccines, stuff I know nothing about. “No one ever remembers what shots they’ve had,” she says, “but I can sort that out.” Louise echoes Rob’s sentiments. “You have to have good people skills to work here. A grumpy nurse would not fit in here, but they seem to find a place for themselves in the hospital, n’est-ce pas?”

  I remind Rob that I have to get to the airport, my flight leaves in a few hours, but he wants to squeeze in a few more visits. He drives me to the local community centre, where I sit on the floor and immediately become absorbed in the ultra-sweetness of the babies who are sitting with their mothers. Each one ventures out, takes a step or two, falls down, looks back, and finds their way home to Mom. The mothers delight in the interaction and in their babies’ successes.

  There’s Olivier in a petit Montreal Canadiens jersey; Emilie in a striped Manchester United soccer jumpsuit; Josie in a furry white coat and stunning black-and-white dress with lace. The cooing, crying, fussing, giggling, and shrieking settles down when Maria leads the mothers in song. Is it the music or the mothers’ voices that has an immediate, almost hypnotic effect on them, faster-acting and more potent than any narcotic I’ve ever given a patient?

  “Ou est François? … Nous sommes très heureux. Ou est Emilie …”

  “Le petit cheval qui marche, marche, marche … qui trot, trot, trot … qui gallop …”

  “Papillons dans le ciel, près du sol, papillons, partout …”

  “Songs are the best way for a baby to learn,” Maria says.

  I loved the baby stage with each of my sons, but looking back, I probably spent too much time worrying if I was doing everything right, fretting over my lost freedom and grumbling about the drudgery of being at home, alone with a baby and then with two. I didn’t appreciate those days at the time as much as I appreciate them now, looking back and reminiscing.

  I look at my watch and remind Rob that I have to get to the airport soon.

  “Don’t worry, if you arrive a few minutes before your flight, that will be enough time.”

  I guess it’s not like the Toronto Pearson International Airport, where you have to wait in long lines for baggage handling and to go through the security check.

  We pull into the parking lot of the local waste-management facility, known as “The Dump.” Nurse Monique Godin, an occupational health nurse, offers biometric screening tests to identify early signs of diabetes, hypertension, and cardiac risk factors, and to screen for hepatitis and tetanus. Based on the results, she offers individual counselling, health teaching, and support to quit smoking. It seems to me like basic self-care, but as Monique points out, many of the workers here are uneducated, even illiterate. Many are willing to do work most Canadians won’t touch. Some are First Nations people, others are undocumented workers with no Canadian health insurance, refugees from war-torn countries, or simply unaware of health practices most of us consider “basic,” like a nutritious diet, hand washing, and hygiene.

  “They don’t understand the risks of toxic substances,” she says.

  The risks she’s referring to become immediately clear when Monique takes me to the trash sorting area. Some of the items that have shown up in the trash that workers handle and sort: a skinned dog, deer heads (there’s a taxidermist in town), sea flares, mouldy furniture, the remains of a grenade, explosives, unidentified chemicals, used syringes and needles, and contaminated toys.

  “Even though they’re dealing with such yucky stuff, it’s still hard to impress upon them the importance of wearing gloves and a mask. They don’t get it, so they don’t bother.”

  Some of their basic needs have never been addressed.

  “Most have never seen a doctor or nurse before. Never had a checkup or immunizations. Many need dental work, glasses, or hearing aids. You can see how you can make a huge impact on their lives, and their ability to get educated, by getting these primary health needs met.”

  Monique is also a home care nurse who visits veterans, young and old, active and retired from duty; many suffer post-traumatic stress disorder from wars, both current and past. They have chronic pain, fragile mental health, and substance abuse problems. One client is a forty-one-year-old veteran who served in Afghanistan. His wife left him shortly after he returned home – damaged and shell-shocked, angry and depressed. He suffers from nightmares and wakes up screaming, feeling like he’s being choked.

  “He has flashbacks to crowds of women begging for food, then later seeing them murdered. He has a recurrent nightmare of children being murdered, others horrifically injured – one who had a bomb blow up in her face. Now he has a cocaine addiction and recently took an overdose in a suicide attempt. He gets agitated, but I never feel threatened in his presence. We’ve built a trust, he and I, you see.”

  The mental health issues that Monique identified in her practice gave rise to an initiative that Rob tells me about on the way to the airport. Directed by Karen Ursel, a nursing professor at the University of Moncton, they’ve created a support group where people with depression can share their experiences; no doctor’s diagnosis or referral is required. Depression was chosen as the focus because, according to the World Health Organization, it’s the leading mental health problem in the world, and the number-one cause of disability to work.

  “For our purposes, depression is whatever the person says they feel. We ask simple questions like, ‘What does living with depression mean to you?’ or ‘How does depression impact your life?’ ” Rob hands me a sheaf of papers that compile the responses.

  “No energy. I
want to sleep all day.”

  “It makes me feel like I’m a zombie, or the walking dead.”

  “I want to be left alone, yet feel rejected when left alone.”

  “I can’t do my job because the smallest things seem insurmountable.”

  “I want to sleep all day, not wake up. I feel disconnected from everything and everyone.”

  “I’ve lived all my life with depression and have tried so hard to hide it.”

  Depression can lead to absenteeism or “presentism,” Rob says, “where people show up in the workplace, but are not engaged or not working to full capacity or potential. All you have to do is listen to a mentally ill person describe what they feel and share their story and you get it. This is not about trying harder or behaving better. It’s an illness that needs treatment.”

  “What treatment do you offer?”

  “Connection is the main one. Listening, another. On a practical level, we make referrals to doctors, talk a lot about self-care, like exercise and diet, and also explore the meaning of their depression with them. We constantly ask, ‘What would be most helpful to you?’ One thing that emerged from asking that question was the consensus that they wanted a support group. We set one up. We advertised it and waited, but no one came.”

  “Too depressed?” (This is a joke that only someone who’s experienced depression can get away with.)

  “The stigma kept them away. But we knew there was a problem because the nurses were identifying it. In some cases, a home care nurse was their only connection. But we want every door a person goes to to seek help to be the right door.”

  Rob gets me to the airport a few minutes before my flight, which is plenty of time to zip through security and board the plan. Settled in my seat beside the window, I munch on a sandwich Maria made for me. I can’t wait to get home and see my family after being away for two weeks. Maybe I’ll fit in a few ICU shifts, just so they don’t forget me.