Paying Attention

How many of us can remember being told by a school teacher or a parent to pay attention? When you’re a child full of energy and curiosity barely able to sit still, waiting for the moment the bell rings to be allowed to run outside and play with friends, paying attention in the way well meaning adults intended for us was a foreign concept. We did pay attention to things important to us, whether our best friend was at school that day, whereabouts in the yard the class bully was lurking and how much money we had to buy tuckshop. Paying attention is a subjective and often fleeting experience for children and adults alike.
I read, this morning, in a book called “Learning to Walk in the Dark” by Barbara Brown Taylor the following words: “If we could learn to be attentive every moment of our lives we would discover the world anew. We would discover that the world is completely different from what we had believed it to be.” That in a nutshell has been my experience of working with people of different cultures as a remote area nurse. Listening and watching what was going on around me lessened my fears of being among strangers in places I didn’t belong. I learned quickly that Indigenous Australia was very different from what I’d believed or imagined it to be.
Beginning to work among Torres Strait islanders on Badu island, at first, and later working on another seven over the following two years. I listened to the sounds of another language I never knew existed, I ate fresh seafood that melted sweetly in my mouth, I attended family gatherings decorated with colourful flowers and plaited palm fronds, I read the history of the pearl industry and listened to the elders recounting their fight for justice for land and sea rights. I watched the movement of the tides across the fish traps on Darnley and pondered who made them so many years ago. I imagined what it was like to be a parent who has to take their kids all the way to Thursday island to visit a dentist, the cost and inconvenience of it.
Paying attention enables us to live more in the moment and less in our thoughts, more in our bodies and less in our minds. It brings riches into our lives we could barely begin to imagine. But, we are normally so busy running around searching for security and planning for the future, that we forget that childhood lesson. We need an adult to remind us to stop and pay attention.

Expectations

When I arrived for my first agency nurse contract on Badu island in the Torres Strait I wasn’t aware of having any expectations. My main thought was that I was having an adventure. After a day or two I realized I was waiting for “something” to happen. Maybe shouting in the street, or some other type of sudden violence. The Cape York community I’d worked in for two years experienced a high level of violent outbursts. Raised voices in the streets were often the background noise to every other day. I had been initially shocked at that, but by the time I left I had grown accustomed to it.

The Cape York community was my first experience in working as a remote area nurse. I learnt my emergency skills there and began to have some understanding of the health and social difficulties of Indigenous people living in traditional lands. I didn’t know, though, that I expected every group of Indigenous people to be similar. Leaving the place I knew and arriving to work on a small island, my first lesson was about my own expectations. The fact that I had them, and that they were wrong.Since then I have worked almost two years in various Torres islands and can count on one hand the number of times I’ve heard shouting in a street. Becoming aware of my expectations and letting them go is a lifetime’s work. I learnt after those first few days to be more open to what I actually saw and heard instead of living from my assumptions. And I’ve been constantly and wonderfully surprised at the differences within Australian Indigenous cultures and individual people.

Singing Days

The French author Marcel Proust once wrote “There are hilly, difficult days that one takes an infinite amount of time to climb, and there are downward-sloping days that one can race down singing.”

I knew I was going to have many singing days when I stared out of the window of the small plane flying low over the Torres Straits, just off the top of north Queensland. The water below was a collage of blue greens and tiny uninhabited islands. I was on my way to work my first nursing agency contract on Badu island. I had grown used to island life in Samoa, where my partner came from. The long, lazy fishing days, the close knit family and community life that comforted me with the feeling of never being alone, and the endless beauty of the surrounding sea.

From the moment the plane touched down on the Badu airstrip and I saw coconut palms fringing the fence line, I couldn’t stop smiling. The two years I’d been in Aurukun on the western side of Cape York, had been mostly “hilly difficult days”, coping with being a long way from family and friends in a harsh environment. I was looking forward to living and working in a quieter environment. There is nothing as restful as being able to look at the sea and what I enjoyed as I walked in through the door of the Badu clinic, was being able to see straight down the corridor to sparkling water.

Singing days can be created or caused by any number of reasons. My Badu six weeks were filled with songs from the sea.

New Chapters

When I left Aurukun and began working for a nursing agency it was certainly a new chapter in my life. I’d worked for Queensland Health for around 20 years. I enjoyed the certainty and security of permanent work and, while I listened in awe to the stories of agency nurses I’d worked with, I was too afraid to follow them into the wide world of choices and possibilities.
In late 2010 I began work on my first agency contract on Badu island in the Torres Straits off the top of North Queensland. Prior to arriving I knew hardly anything about the islands, but the flight from Cairns to Horn island and then on a smaller plane to Badu whet my curiosity. I had never imagined any kind of life off the tip of Cape York. There had been a time in my adult life were I’d never been further north than Bundaberg, and even that felt like I was about to drive off the edge of Australia.
Flying over the Torres I stared down through a smudged plane window at a blend of ocean blues and greens and tiny uninhabited islands and knew I wanted to stay awhile to get to know this place.
So much has been written and said about new beginnings, basically the fact that the past needs to be let go of to embrace the new. I let go of the need for certainty and security and whole-heartedly embraced a sense of adventure which opened a fascinating chapter of island life and culture.

Loss

Everyone experiences loss, in different ways and at different times. Each loss has a different meaning. I’d worked in Aurukun about a year and a half and decided I’d stay for another year and a half. I bought a Toyota landcruiser, rescued a camp dog puppy and was given a scrawny bedraggled looking black kitten, with a car and pets I was ready to settle for a bit longer in a place far from home. Fasi and I nursed our puppy named with the Samoan word for baby, Pepe, to health. We delighted in her antics, Fasi even let her sleep on him. When she was about six months old I went to Samoa for a few weeks to visit Fasi as he’d returned to care for his elderly mother, and arranged for a nurse who lived next door to care for her.

Apparently all went well until the day before I was due to fly back into the community, Pepe became unwell with gastro symptoms. I wasn’t contacted. I had only her to look forward to seeing when I returned, as Fasi had left Aurukun permanently. I kept imagining her joyful welcome during the long flights from Brisbane to Cairns to Aurukun.

As soon as I reached the gate to my yard in the semi-dark of a Cape York evening I knew there was something wrong. The manager of the clinic came across and told me she put Pepe to sleep herself that morning. She hadn’t bothered to phone me.

I walked away and up my steps and sunk to the floor once inside and sobbed. I phoned Fasi in Samoa to tell him and we both cried. It seemed such an unnecessarily cruel thing to do, normally the nurses do all they can to save each others dogs.

I lasted a few days and handed in my resignation, I couldn’t work with the attitude of that manager.

There isn’t just one side to a loss. I felt Pepe’s death keenly, especially the way she died and the thoughtlessness of a nurse from whom people would expect better. After a few days Fasi rightly pointed out that Pepe would have kept me in Aurukun had she lived, I couldn’t travel with a dog. So I reluctantly turned to the next stage in my remote area nursing journey and took up life as an agency nurse, travelling over the top end of Australia experiencing places and people I barely knew existed.

Thank you Pepe.

Mental Health

I just finished reading a book called “Madness: a memoir” by Melbourne doctor, Kate Richards. It’s an honest and poignant account of her experience with mental illness. She ends the book by saying…”I’m grateful to be living in a country where medication and therapy are mostly available and affordable. However even in Australia, we are still not caring for the most vulnerable members of our communities. Those who, through no fault of their own, are not as lucky as I have been to respond to medication or to be able to find the right kind of therapy. These people are of all ages and backgrounds, and we ignore their suffering because most of us don’t understand their ways of seeing the world or we are afraid of their difference or embarrassed by their appearance and because we don’t see their injuries. No-one ever wakes up one morning and thinks, today I’d like to go mad, lose my job and friends, and end up odd-looking and living on the streets, anymore than they think, today I’d like to get cancer.”

Aurukun has the highest number of mental health clients in Cape York and is serviced well by visiting mental health teams. The RFDS built a Wellbeing Centre (pictured here) in the grounds of the clinic a few years ago which offers support, counselling and education. But providing services is just one way to support “vulnerable members of our communities”, having, and showing, kindness and compassion, firstly on ourselves in our demanding work as remote area nurses and then to others is the key to our continuing mental health and our patients healing.

The Royal Flying Doctors

100_8090Every Australian knows what the RFDS is and what work they do. Every remote area nurse will at some stage in their lives have looked longingly at the sky to see the first glint of silver approaching or strained to hear a faint engine rumble along with hopes that their patient would stay stable during the wait.
During the two years I worked in Aurukun and later in other far away places it was the knowledge that the RFDS was only a phone call and a flight away that enabled me to work without overwhelming fear. I still marvel at it’s history and the initial concept of a “mantle of safety” covering outback Australia. What a man of vision John Flynn must have been. Barely a day went by when I worked in Aurukun that I didn’t enjoy working in partnership with the RFDS staff based in Cairns. I think as Australia Day comes around again the RFDS can be numbered among our local heroes.