Storytelling

Last May I went to as many events as I could at the Northern Territory Writers Festival in Darwin. The highlight for me was a panel of speakers discussing memoir writing and how family might react to the stories shared. All four women had published a recent memoir.The questions asked ranged from, “Do writers edit out parts to protect feelings?” to, “How much time has to pass before dirty laundry can be safely aired and can it ever be aired?”.The consensus was that you have to tell your own story and navigate the “hard stuff” about who it’s going to affect, the wisest, kindest way you can. There was no easy answer to any question raised. Each writer recognised the problem and each had worked out for themselves how to tell their own story with minimal negative impact on family.

Magda Szubanski reminded us that Aboriginal people are very conscious of not telling a story that doesn’t belong to them.She struggled with writing her fathers story, balancing her words carefully so as not to disrespect the Polish Jewish and Catholic communities the family had been a part of. She taught herself to write by finding her own voice and thus making the telling her own, if not the story itself.The memoir took her eight years to complete.

Each person has a unique story, unlike any other. And to be able to tell it freely enables a person to make sense of their life’s experiences. To clarify their emotions, to heal from losses, to inspire and encourage and to preserve cultural identity and so much more. Storytelling is fundamental to human experience. As listeners or readers we are entertained, we learn, we experience vicariously and we are enlarged by the contact with another person’s world. But, for all the benefits it’s still a balancing act to be honest in our telling and to share our story, without taking away from those closest to us what is rightfully theirs. Their story, their perception, their life. And isn’t that the same compromise we face day after day, whether writing a memoir or living our lives.

 

Poverty and Opinions

I’ve been interested in health and wellness for as long as I can remember. My kids weren’t allowed lollies, I made them homemade fruit and nut thingies, my husband wasn’t allowed the skin on his chicken, those were that days of low fat and preferably the Pritikin diet. I studied both popular and natural health books and recipes long before the days of internet and so had a vast paper collection of many opinions, hints and guidelines. And, mostly, for the past 30-40 years I and my kids, and now my grand-kids have been fit and well. But, in the last year my body has taken it’s vengeance on all these ideas and gone off on it’s own path. I’ve been diagnosed with pericarditis, MS and melanoma all in a year. Now, with the aid of Google and books I’ve studied even harder and I’ve found that more ideas and opinions abound than I ever imagined! I am also a Chronic Disease nurse so it behoves me to know a thing or two.

I’ve learnt that the idea doing the current rounds (and it does have it’s basis in history as well) is the benefits of a low (very low) carbohydrate diet with healthy fats (the subject of what constitutes a healthy fat is a whole other sub-strata of opinions). The theory goes like this, carbohydrates, especially simple carbs, are broken down into sugars by the digestive system, insulin is released and turns a lot of that sugar into fat which is stored in the body’s fat cells. That’s the simple version, there are many books on the subject which give careful explanations of the process. What I’ve read so far, plus a phone consult (I’m still living and working in a remote part of Australia) with a dietitian in Tasmania and a naturopath in Queensland, makes sense to me and I’ve been eating like this for a month and have lost 5cms off my waist! Wonderful and I hope it continues.

But I also want to mention something in the book I’ve just finished reading (pictured), it explains the same theory of carbs=sugar=insulin=fat, but makes the observations that poor people the world over, according to his research, eat high carbohydrate diets because they’re cheap, easy and readily available. Foods made with white flour such as breads, pancakes, damper, scones, pasta etc. He then gives examples from American Indian tribes since the early 1900’s of overweight mothers and undernourished babies and children and bases the cause on high carb diets they’ve eaten since colonisation. I’ve seen this phenomena in many of Australia’s Indigenous, and people, in other low socio-economic situations,and  have wondered at the reasons for it.

He writes, “The coexistence of thin, stunted children, exhibiting the typical signs of chronic under-nutrition, with mothers who are themselves overweight…poses a challenge to our beliefs-our paradigm.If we believe that these mothers were overweight because they ate too much, and we know the children are thin and stunted because they’re not getting enough food, then we’re assuming that the mothers were consuming superfluous  calories that they could have given to their children to allow them to thrive. In other words, the mothers are willing to starve their children so they themselves can overeat. This goes against everything we know about maternal behaviour”.

Interesting theory and if it’s true, which it well might be, even though it turns accepted food theories, triangles and advice on their heads. Health professionals and most of us are going to have to think long and hard about our opinions and prejudices and the enormous inequities in our societies, not to mention whats best for our own, and our families health.

One last thing this writer incidentally mentions about the Sioux, one of the tribes studied, in South Dakota, is as follows…’These Sioux lived in shacks “unfit for occupancy, often 4-8 family members per room…15 families, with 32 children among them, lived chiefly on bread and coffee’. This was poverty almost beyond our imagination today.” The writer might be shocked to know that many of Australia’s Indigenous people still live in similar overcrowded accommodation and lived mainly on tea and damper.

An excellent resource is the film “That Sugar Film” and it’s accompanying book “That Sugar Book” by Australian actor, Damon Gameau, who gives carefully and humorously explained, health advice and an interesting story about his own 60 day experiment with “healthy” foods. And, who also continues to do positive work in Indigenous Australia.

 

 

Fragments

Do you enjoy fragments? I do. A glimpse of a strangers face, a remembered line of an old song, a whispered conversation on a bus, a delicious aroma teasing from someone else’s house, the middle of a movie you haven’t got time to watch till the end, a dream that vanishes on waking, a phrase you just have to copy down…

They arouse my curiosity and imagination more than any completed experience.

Australian writer Elizabeth Jolley, wrote fragments  on scraps of paper for years before she was first published in her fifties. She was too busy raising a family and working at an assortment of jobs to have enough time to write at length and at leisure. I was one of her many correspondents whom she  encouraged to write short notes about the weather, landscape, overheard conversations, because I too had a full life with little time. She was quoted in 1986 as saying: “If anybody had asked to see a work in progress it would have been lots of bits of paper with scribbles on.”

A fragment is defined as “an isolated or incomplete part”. But, although incomplete, it is at the same time complete in itself because it contains the potential of what it may become…a story, poem, song, healing memory, nourishing meal, something understood, a puzzle solved.

Fragments allow mystery into our lives and curiosity leads us on….

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.

Sleep Deprivation

When I applied to work in a remote clinic I assumed that being on call after hours would be like doing night shift. It wasn’t. With night duty you know what hours you are rostered to work, with remote area after hour call outs, nothing is certain. You quickly learn that you could be woken up several times a night, rarely for real emergencies.Nurses are often told to educate the community on what an emergency is, but at 3am arguing with someone who’s woken you with a toothache,simply guarantees that you lose more sleep than if you just get out of bed and go and see them.

The US National Sleep Foundation recommends that adults need between seven and nine hours sleep a night. Continued lack of uninterrupted sleep results in sleep deprivation with potentially fatal effects.Remote area nurses usually have fatigue leave (if they don’t work in a single nurse post) which is supposed to make up for lost sleep. While we all value it, it is rarely a substitute for sleep. If staffing is short or clinic demands many, a nurse repeatedly on call can be functioning at a much reduced level of competence. When important decisions have to be made for patients health one has to wonder if the added responsibility put upon them to “educate” the community about what an emergency is, is a wise thing?

Among the many results of lack of sleep are an increased risk of accidents and injury, impaired attention, alertness, concentration, reasoning, memory and problem solving. It can lead to health problems such as heart disease, stroke, diabetes and depression. Judgement can be impaired, especially in regard to being able to assess what lack of sleep is doing to oneself. Also hurting their ability to make sound judgments because of a reduced ability to assess situations accurately and act on them wisely.

Before deciding to work in remote areas nurses do well to assess how well they function without sleep.

Learning

There are many ways to learn, many paths to education. I completed my nursing training at Maryborough Base Hospital in 1991. It gave me a Certificate in Nursing. I now have that certificate plus over 25 years of nursing experiencing. I never had the time or money to upgrade my certificate to a degree as I was responsible for bringing up my four children. Now I plan to begin a creative writing degree next year, but I’ve been writing one way or another for over 50 years!

There is endless discussion on whether hospital or university education produces better nurses. Valid arguments come from both sides. Each needs to qualify what they mean by better, but it’s difficult not to be in agreement with both sides. And what about the many writers over the years who have never been to university and yet have produced much loved and treasured stories? The ideas and thoughts around learning and education are endless.

When I began remote area nursing, I had my certificate in nursing, 15 years of paediatric experience and two years in a small private hospital. I wasn’t an emergency trained nurse. The DON (Director of Nursing) in Aurukun told me, when also telling me what skills were needed for remote work which I didn’t have, ” They’re just skills to be learnt, but we need someone of your experience and temperament.”

I was taught to suture, cannulate, plaster, take blood and evacuate patients by ambulance by my colleagues. I was doing the work for six months before I was offered a four day course in remote nursing skills. By then I considered myself capable. I read recently of a post graduate course in remote nursing. My five years of experience has turned me into a competent practitioner.

What am I getting at in todays post? Just a reminder that learning and education comes in different guises and to be open to accepting what’s offered to you, don’t discount learning experiences that come less formally, Life’s a great teacher. I have probably learnt the most during my nursing years from people considered the least important, patients and their families, enrolled nurses and health workers and agency nurses like myself.

The photo is me sitting with visiting desert women to Aurukun in October 2008 learning to weave baskets, they spoke no English.

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More Culture Shock

100_0269When that shop assistant told me to Google culture shock, I’m sure I did, but I don’t remember a thing I read, neither have I written anything about it in my journal. Thats a puzzle to me and unlike what I normally do. I read to figure things out and record my thoughts.

I probably read that the definition of culture shock is “The feeling of disorientation experienced by someone when they are suddenly subjected to an unfamiliar culture, way of life, or set of attitudes.” It may be experienced due to immigration or a visit to a different country, a move between social environments or simply travel to another type of life.” But I don’t remember being helped by any words about it.

Culture shock is a type of transition shock. Its a predictable state of loss and disorientation caused by a change in a person’s familiar environment that requires adjustment. Completely understandable when you read back  a few years later from the comfort of the familiar place, but when, without warning you suddenly lose sense of yourself and the reality of the country you thought you knew, no written words will enlighten your rational mind.

It has degrees of severity, different effects and time spans but the most commonly experienced symptoms are as follows:-

  1. Sadness and loneliness
  2. Over concern about your health
  3. Headache, pains, allergies
  4. Anger, depression, vulnerability
  5. Idealizing your own culture
  6. Trying too hard to adapt by becoming obsessed with the new culture
  7. Feeling insecure and shy
  8. Homesickness
  9. Feeling lost and confused
  10. Clinging to everything familiar by the need to email/phone home
  11. Compulsive eating/drinking
  12. Irritability

In the first few months and beyond of arriving in Aurukun I experienced all of the above and it was only a stranger behind a shop counter who thought to tell me about it. There’s a lot of helpful information on the internet but being aware of, and prepared for, culture shock would be the most help. The problem is that it’s an overwhelming reaction that once you’re experiencing it is difficult to get perspective. I’ve just found an on-line cultural competency course from “Unite For Sight” a US charity organisation. It gives the following helpful advice to dealing with cultural shock:-

  1. Pursue information gathering
  2. Look for logic in your new surroundings
  3. Make sense of the environment
  4. Use wisdom and patience
  5. Use humour (A big help!)
  6. Have faith in yourself (what you’re feeling is normal!)
  7. Don’t pity yourself
  8. Stay mentally, physically and socially active
  9. Get enough rest
  10. Eat a balance diet
  11. Take reasonable risks (go exploring safely)
  12. Ask for help
  13. Use friends and family as emotional supports

Thinking about all this five years later I look back over my life and recognise a few times of transition when I’ve experienced a sense of dislocation, moving interstate with my family as a teenager, staying at home with small babies after I married in my early 20s and returning to a hospital to do my nursing training in my 30s are the main times that come to mind. But beginning life as a remote area nurse was by far the most overwhelming and has taken the longest to come to terms with. In lots of ways I’m still dealing with culture shock.