by Tilda Shalof
Once again, my nursing practice was teaching me how much more we can endure, and achieve, than we think we can.
Later that night, I was working, long after midnight, and Rudy showed up unexpectedly. At first, I thought he was sick, but he looked well. He sidled over to me with a sly look in his eye. “I have the key to the tuck shop,” he whispered in my ear. “What’s your pleasure?”
I gasped. Was he coming on to me? “Oh, no, I don’t think so,” I stammered.
“What’ll it be? What do you crave?”
“I couldn’t … possibly …”
“Your choice: Kit Kat or Twinkie? How ’bout a Crunchie?”
I burst out laughing for having misread his intention. Anyway, I desperately needed chocolate way more than sex!
The outbreak showed no signs of abating. More and more children were getting sick and counsellors, too. Somehow, Alice and I stayed well and kept going. Nurses can’t get sick, or so the legend goes.
Camp had become a strange and uncomfortable place. Everyone kept their distance. No hugging or holding hands, no CITS sitting in each other’s laps. Visitor’s Day, which was coming up in two weeks, might have to be cancelled. Camp might even have to be shut down for the rest of the summer. Worst of all was the eerie quiet. The music stopped. Silence fell over camp.
* Possibly because of the recent explosion of shows like CSI? In fact, so many mentioned an interest in forensics that I figure the crime rate will have to soar to keep them supplied with work.
15
CAMPFIRE NURSE
The crisis continued. Kids begged to go home. The mood was bleak.
Louise, Alice, and I were stunned at how fast this thing was racing through camp. Our efforts to contain it seemed to have no effect. There were new cases every day. Rudy was worried.
“They’ve all lost their sparkly eyes,” he said in dismay. “Morale has never been so low.”
When’s it gonna hit me? counsellors caring for sick kids wondered. Most kept a sense of humour – especially the lipstick namer who came up with “Pretty in Puke Pink” and “Viral Violet” – but understandably, there was also grumbling and rumbles of discontent. “I didn’t sign up for this,” some said. A few packed up and left. “I can’t take the chance of getting sick,” said one. “I’m outta here.” “Me too,” a friend said. “This place is contaminated! It’s teeming with pestilence.”
“Yeah, right,” said Seth. He was disgusted with those who jumped ship. “They’ll never be able to show their faces here ever again.”
Rudy got sick and retreated to his cabin with only Ringo for company.
By the morning of Day Four we reported the outbreak to the public health authorities. They planned to come by later that day to investigate.
We studied the situation. There had to be a logical “chain of transmission,” but if we couldn’t discern the pattern we had no way of knowing if our control measures were effective. I came up with an idea. I ran to the arts and crafts shed and returned with a large sheet of cardboard, markers, and stickers in assorted colours. I drew a box for each cabin and put a red dot on Murray’s cabin. Murray was the first case. For Day Two, I put two green dots for his co-counsellors and two more for the boys in his cabin. That makes sense, they’re in the same cabin. For Day Three, ten yellow dots. Those kids sit together in the dining hall. The sick CITs had been working with that cabin. Today, Day Four, we had thirty-five purple dots and the web was getting more intricate. It was far from over. I only hoped it would end before we exhausted our entire range of colours.
Camp had come to a standstill. Activities were cancelled. The dining hall seemed particularly empty and mealtimes were subdued. Seth, Matti, Layla, and others got on the case. They picked up their guitars and played outside the cabin windows of the sick kids and entertained them with skits, pantomimes, and juggling. They started up a drumming circle, an activity that almost everyone could do, and it got kids with bad cases of cabin-fever outdoors again. In fact, the drumming group became such a hit that long after the kids went to sleep, the counsellors kept the beat going late into the night. They reinstated the dining hall music and not just the religious songs, but their own playlist, too. “Will Santana or Sly and the Family Stone pick up the mood better?” “Does Zeppelin go better with mac and cheese, or Judas Priest?” they asked one another, considering the various pairings with the same attention a doctor gives to choosing the appropriate antibiotic. Once again, the sounds of those classic bands, along with the upbeat tunes of Great Big Sea, OutKast, and Dispatch, boomed out of the speakers. Those who were able got up and moved to the beat as they cleared the tables after meals. Like a restorative tonic, the music brought them back to life.
Two surprise leaders were Lee and Jasmine, last summer’s “bad girls” who were now CITS. They even volunteered for the cleaning squad. “We’re stoked,” they said, “down for whatever.” The squad roved around, mopping up messes, airing out cabins, and stripping beds. They probably didn’t do this kind of thing at home but here they took it on with a cheerful attitude. They squealed with delight when we issued them a walkie, and with that in hand and spray bottles of disinfectant hooked onto their shorts, they patrolled the camp, doing their chores and keeping us in the loop along the way.
“Cleanup in aisle five” or “puke puddle alert,” one would say over the walkie to summon the rest of the crew to bring the bags of kitty litter, brooms, buckets and mops.
“Nurse Tilda? Are you there? Over and out.”
“Yes, Lee. I’m here.”
“Hey, it’s Jasmine. I’m down at the canoe docks with two little Flame girls who are spewing chunks!”
“Okay. Bring them in.”
A few minutes later, I heard, “FYI: two other girls from the same cabin aren’t feeling well. I think they’re about to hurl.”
“Bring them in, Jasmine, over and out.”
“This is Lee. I’m all over it! Ten-four, Nurse Tilda!”
They didn’t seem worried about getting sick themselves. They even offered to supervise our isolation ward, which had been dubbed “The Colony.” They played an elaborate fantasy game with the children based on the TV show Lost, pretending they were survivors of a plane crash, stranded on a deserted island, having to band together to protect themselves from monsters, doomsday warriors, and evil island inhabitants. The male counsellors had their own style of fun, lining up garbage cans for duelling barf-fests, cracking lots of diarrhea jokes, and devising clever poop descriptions and fart charts.
In the afternoon the health inspector arrived. He strode in, carrying a briefcase like a detective, determined to get to the bottom of the case. First, he inspected the kitchen and found it spotless, quickly ruling out food contamination as a source of the infection. He examined my diagram charting the rapid, exponential spread and interviewed Murray, the first or “index” case, who had by then completely recovered.
“Continue exactly as you’re doing,” he concluded. “Disinfecting all surfaces, frequent handwashing, and minimizing physical contact is the only way to beat it.” But as he got up to leave, he warned us, “If there’s any escalation, you’ll have to close the camp. As for Visitor’s Day in a week and a half, I’d advise you to cancel it.” He must have noticed our shocked faces because he added: “Go ahead if you must, but no touching.”
Visitor’s Day, without hugging or kissing? Unheard of!
Before parting, he offered guarded encouragement. “When the number of new cases starts to level off and you’ve hit a plateau, it’ll be the beginning of the end.”
We notified parents about the outbreak and the possibility of cancelling Visitor’s Day. Some wanted to come and get their kids right away but we advised against it. They’d probably be feeling better in a day or two, and at home they’d be exposing family members, including possibly elderly grandparents or others who couldn’t easily withstand a debilitating illness. Distraught, some mothers and fathers called daily. Anxiety was spreading like the virus itself.
From his sick bed, Rudy composed a group e-mail.
“The children who have gotten sick are all recovering,” he wrote. “If symptoms persist once your child comes home, please contact your doctor.” And your lawyer, I heard him mutter. He must be joking! But no, Rudy was worried that some would try to lay blame.
“It’s easy to criticize but it’s no one’s fault,” I said. “These things happen.”
“You’re handling this quite calmly,” he remarked.
“I guess my standards are different than most people’s,” I admitted. “Don’t forget, I’m an ICU nurse.” At least here my patients weren’t dying. I never lost sight of how bad things could be, and there was another reason I could keep things in perspective: I had lived through something far worse – SARS.
It was 2003. A mysterious pneumonia was suddenly making people gravely ill. Some were dying. SARS was not the first time I’d worried about my safety and what dangers I was bringing home to my family, but it was definitely the scariest. Over the years, I’d taken care of patients who’d had infectious diseases such as hepatitis, tuberculosis, and HIV-AIDS, but SARS was different. The virus that caused SARS – short for sudden acute respiratory syndrome – travelled lightning fast and was transmitted person to person by incidental, casual contact. It was lurking in the air, potentially blown your way by the wind, a breeze, a breath, or a sneeze.
Overnight, SARS turned Toronto into a ghost town. Travel was banned by the World Health Organization; hotels and restaurants emptied out, streets were vacant. Many people were quarantined. It was a new disease, and at first even infectious-disease specialists didn’t know what they were dealing with. People felt confused and afraid. At a party I went to during that time, guests jumped away from me and refused to shake my hand or come near me. Mothers cancelled play dates with my kids. Those of us caring for SARS patients, doing this hazardous but essential work, felt a punishing sense of isolation.
I’ll never forget how dark and quiet the hospital was during that time. Only hands-on, front-line caregivers came to work. It was mostly nurses who kept the hospital open. Wearing two pairs of gloves, gowns, plastic face shields, and heavy masks, customized to fit our individual faces and impermeable to viruses, we worked in closed, negative-pressure rooms, caring for our patients. Overtop our masks we watched our patients, and in our eyes, patients sought assurance they would not be abandoned.
In a crisis a leader is needed, and Toronto had one. Dr. Sheela Basrur was the city’s Officer of Public Health at the time and she led Toronto in the same calm, courageous manner that Mayor Rudy Guiliani guided New York City during 9/11. As more people got sick and mass hysteria threatened to erupt, Dr. Basrur reassured the public. She explained the need for the drastic quarantines and how they were the only way to stop the chain reaction. She acknowledged it was a serious situation, but not an emergency. “My job is to do the worrying,” she said.
Dr. Basrur understood nursing. Like a nurse, she cared about the nitty-gritty, such as the proper handwashing technique and ensuring that we were equipped with the special masks, not the ordinary, one-size-fits-all paper ones. She was concerned that caregivers would become exhausted and unable to carry on. Then, just when the situation seemed to be coming under control, a second wave of SARS broke out. A nervous city became terrified, and again Dr. Basrur took control. Working around the clock, or so it seemed, she held daily press conferences in which she distilled complex information so it could be understood by everyone. In the end, in Toronto alone, there were over four hundred cases of SARS, the majority of them health-care workers. Forty-four people died. It was a terrible time, but many were left with a sense that it could have been much worse had it not been for the dedication of health-care workers and the leader ship of Dr. Basrur.*
I tried to be that kind of leader, too. Together with Alice and Louise, we communicated openly with the counsellors, explaining everything to them. We encouraged them to ask questions, express their frustrations, and let off steam. We acknowledged their efforts. During a lull one day, I spoke with Seth, who was looking mighty haggard. “How are you holding up?” I asked. He came in each evening, dropping by discreetly for his medication, but he didn’t stop to chat or joke around like he used to.
“I’m good,” he said, forcing a smile.
“It’s been rough, hasn’t it?”
He looked at me in surprise. “No, it’s been the best summer ever. We’ve pulled together and are closer than ever. We’re like family now.”
Of course. I knew Seth loved a challenge. He was an extraordinary counsellor, an outstanding student and athlete, a terrific guy. He excelled at everything he did. I knew he’d gotten a full scholarship to university and I asked him how that was going.
“I dropped out. Couldn’t hack it,” he said blithely, but then sat down with me and told me the real story. “Something happened,” he said, shaking his head. “I still don’t get it. It was my birthday and birthdays mean a lot to me. I’d broken up with a girlfriend and none of my friends were around. I was alone in my dorm. It was August, right after camp, but before classes started. Suddenly, I snapped. I went over to the dark side. Nothing made sense. For days I couldn’t even get out of bed. My parents came but they didn’t know what to do. My mom cried and my dad kept telling me to pull myself together.”
“What helped? You must have felt well enough to come to camp this summer.”
“Camp was the only place I could be. What helped was being around people like you, Tilda. People who don’t judge, who just listen, and don’t tell me what to think or do. My parents are great but they give me advice when I just need them to listen.”
“Are you lonely, Seth? When you’re not with your kids, I always see you by yourself.”
“My buddies know I need space. For awhile I was into meaningless hook-ups but no more. It was messing me up. At school, I dated someone I met on the Internet, but she’d never been to camp, so she didn’t get it. I’m on my own right now and I’m cool with that.” We sat together in silence for a while until he spoke again. “I’ve discovered you can go very far away and still make it back.”
“How are you doing now?”
“I’m okay to be with kids, so don’t worry, but I’m terrified the dark side will come back. I’ve got to make up the year I missed, so this will definitely be my last year at camp.” He looked out the window as if taking it all in at once, this place he loved.
By the end of two weeks we reached the plateau the health inspector spoke about. Lab tests confirmed that, as expected, it was a norovirus, the most common culprit in this type of illness. In total, twenty per cent of the camp had gotten sick and everyone recovered. It could have been so much worse.
The night before I left, we gathered around a huge bonfire. Other than the campers and counsellors who were still recovering, everyone was there. Matti led them in this song.
O Lord, my God,
I pray that these things never end:
The sand and the sea, the rush of the waters,
The crash of the heavens, the prayer of the heart.
I looked around the circle. Everyone looked happy. Even the sick ones who’d wanted to go home were smiling once again. They were all content within themselves and connected to their friends – this was camp happiness. They were glowing with it that night.
I returned to the Health Centre and gave out the evening meds. After I locked up and headed toward my room, I heard far-off rhythmic sounds. The music beckoned me and I retraced my steps to the campfire where the counsellors had gathered. I approached tentatively. (I didn’t want to crash a private ritual as I’d done once before, accidentally intruding upon a band of bare-chested CIT boys performing a war dance.) They were sitting in a circle. Some of them were holding drums – tom-toms, bongos, djembes – and some had tambourines or maracas. In unison they beat a rhythm as compelling as my heartbeat, which suddenly welled up and throbbed inside my core. A girl got up and wordlessly handed me an instrument. No, I shook my h
ead, I’ll sit out and just listen, but she kept her hand outstretched. At last I took the instrument, waited for the beat, found my place to enter, and joined in.
Later, as I left the drumming circle, I felt quietly happy – and proud, too. Finally, I’d won my place at the campfire.
* Dr. Basrur resigned from her position in 2006 in order to undergo treatment for a rare form of cancer. When she died in 2008, nursing lost a great ally.
16
THE CURE FOR HOMESICKNESS
“You’ll never guess who’s back!” Alice threw out a teaser. We were busy unpacking supplies and organizing camper meds, getting ready for the start of a new summer. By her impish grin, I knew she was also gearing up for the fun to begin.
“Who?”
“Eddie! He’s a counsellor, now!”
Unbelievable. Well, Rudy always said kids can change, didn’t he? Later, I heard that Eddie was Max’s counsellor and I felt uneasy about that but decided to keep quiet, watch and wait. I trusted Rudy’s judgment and knew that if there was an issue with Eddie, it would be dealt with. I was getting better at letting go, at allowing my kids to solve their own problems and turn to others if they needed help. But it had taken me one more camp lesson to get that message.
I’d been strolling past Harry’s cabin. It was quiet, a perfect time to sneak in for a peek – if his guitar was out, I’d know he was playing it; if his laundry bag was full, I’d remind him to send his clothes to be washed. If I could just get a glance at the skew of his flip-flops beside the bed … I mounted the creaky wooden steps and checked that the coast was clear. I knocked on the door, just to be sure. Harry’s counsellor came to answer it. His eyes narrowed when he saw me. A trespasser.
Awhhh! Busted.
“What do you want?” he asked warily.
“Just dropping by, to, ah – visit.” I squirmed.
