Anouk’s ongoing adventure in the Canadian healthcare system…

Well, it’s been a week and a half since Anouk came to the Janeway Children’s Health and Rehabilitation Centre in St. John’s. She continues to improve day by day. It is absolutely precious to see the little tyke running around the pediatric surgical recovery ward (no, she has not had surgery, but the docs felt this was the best place to put her) in her little pink surgical scrubs. All of the nurses love her, constantly telling us how beautiful she is, what blue eyes she has, how fair and blond she is, “ain’t she some precious”, and “ain’t daddy going to have his hands full keeping the boys away” (HA! Little do they know of my plan to not allow Anouk to date until she is 37 — sorry Liam, Colin, Sammy, and William).

They are now changing the dressing every other day. The first layer is a silver sheet called Acticoat (I don’t fully understand how it works, but it is supposed to help debride the dead skin and somehow keep the burn site damp). The doctors are going to look at her progress on Monday. When cosmetic surgeon Dr. Cluett looked at it this past Monday, she was still concerned that two areas might possibly develop into third-degree burns and may need skin grafts, but she wanted until Monday.

So, we continue to keep our fingers crossed. I’d swear that Anouk is faring this ordeal better than her Mommy and Daddy. What an amazing little girl…but then again, I am biased.

The worst day...

Warning: this is a pretty graphic, emotionally charged brain dump that Rich convinced me should be posted to the blog because he feels our family and friends will want to know… I wrote it initially as an email to a few folks and I admit that I don’t have the heart to do much editing, so here is the story…

We have had what perhaps (I hope) will be the worst day of our journey… On Tuesday morning, May 20, we were getting ourselves organized for a day of errands here in St. John’s. We’d arrived in the city the night before and had some random life maintenance kinds of stuff to tend to like getting a local cell phone, finding the Toyota dealer to get a flat tire mended, refilling our propane tank, etc. In the afternoon, I was to meet with a faculty member at Memorial University, a meeting I was looking forward to as it felt like the official launch of my project. None of that happened.

Instead, as I was rummaging through my gear crate looking for something as mundane as clean socks, Anouk, who was roaming around our campsite like a drunken sailor on her wobbly but increasingly confident little legs, ambled up to the boat trailer, a perfect height for baby to regain balance. She reached the tongue of the boat trailer where her maman, that would be me, had stupidly stupidly stupidly set her tea mug down for just a moment (did I mention stupidly?). You can guess what happened. She reached for it and it came tumbling down on her. A scream like I have never heard before hit a chord inside of me and I knew my baby girl was experiencing pain on a scale unimaginable. It was horrible! Horrible!

I flew into action, somehow knowing in my gut what to do (perhaps all that Wilderness First Responder Training paying off)… Called for Rich to get water, ripped her clothes off and poured and poured and poured. Her skin was blistering, sloughing off, red… She screamed, and pushed away, trying desperately to get away from the pain. I knew instantly we needed to take her to the ER. Rich dropped the pop-up camper in a flash. Adrenaline flowing, action mode… Hold back the maman-freak out, keep it in control, deal with the issue, help Anouk NOW! Shit where are the car keys, find the spare. Where the hell is the hospital? I know, it is down the street, I saw it on the map. (For some reason, I had gotten in the habit from day one of the trip of identifying where medical help was located…perhaps such planning backfired, foreshadowed our urgent need). Highway, shit we missed the hospital, ask the car next to us, open window, screaming baby practically leaps out of my arms she is so frantic to get away from the pain, “Oh love, you missed it, Health Sciences is back there.” U-Turn, Rich driving like mad, move MOVE, get out of my way, yet driving safe, composed, fighting panic. Turn, there it is I think, why the hell don’t they have the big H sign on the road… Leap out of the car before it is stopped, running with naked Anouk into the Child ER, no one at the desk, a room full of parents and kids watching me and my screaming baby. Admitting nurse walks by. MY BABY IS BURNED! “Sorry love, I’ll get this nurse to look at her in a minute.” SHE CAN’T WAIT A MINUTE. Am I screaming too? ER nurse hears the commotion, “Come in quick this way, me love.”

Within minutes, four nurses are applying cold compressed to the burns. Or trying. Anouk squirms and flails, screams and screeches, her eyes wild, her normally pink cheeks crimson with fear and anguish. Minutes later, a shot of morphine in the leg. A few more minutes, she calms to whimpers. Eyes fluttering, glassing over. The ER doc says something, don’t know exactly what. Anouk is in my arms and I rock her. I am about to puke. Rich takes her. He has beads of sweat all over his forehead I notice. I sit on the bed, the tears start coming.

Anouk has second degree (with the possibility of some parts being third degree) burns on her right arm to below the inside of the elbow, her front shoulder and down the chest until just above her nipple. There is also a spot on her neck where there was obviously a splash. The doctor says third degree burns can take up to several days to manifest themselves so it is too soon to determine. Anouk has been in a dressing of polysporin and a paraphin-soaked gauze (Jelonet) covered by dry gauze and a stretchy material worn like a t-shirt to hold it all together. Yesterday she went through a whirlpool treatment with bubbling water to help clean out the wound and slough off any dead skin. Today, she will go through the same thing. They gave her morphine again for the tub treatment, otherwise she has been on Tylenol. The pain relief is calming. When it kicks in, our little Anouk comes back to us, giggles, laughs, captures everyone’s heart. “God love her, she’s some sweet.” We feel well cared for here. I am working hard to let my rational side convince my emotional side that I am not to blame.

……

A few days later…

As the truth of her burns slowly manifest themselves, so does her character: sweet, strong, loving, brave, and a belly-laugh-inducing teasing streak. It is amazing to me that all the joy that is a 13 month old baby, all this development that happens seemingly daily, sometimes hourly, all this continues. For me, it feels like time stopped at about 9:20 AM on Tuesday, May 20, 2008, and it is only coming back to itself in slow motion. For Anouk, life has marched on, every day something new to laugh about. She is discovering how to give hugs, true wrap-your-arms-around-someone-and-squeeze hugs. She darts around the hospital corridors with an emerging confidence that belies the trauma she has experienced. On her hallway walkabouts, she checks in with me regularly, but today she went around a bend without looking back. When she falls, nine times out of ten, she just picks herself back up, having learned seamlessly to stand with the help of only one hand. Though the other hand is limited because of all the bandages on her shoulder and arm, she works hard to pass an amaranth cookie from one hand to the other. If she were an adult, I’d swear she just wants to keep fluid motion in her arm, not let the wound site atrophy. But Anouk is just going about her daily business, being the busy baby she is. “God love her,” as the nurses have said a hundred times, “she’s some pleasant, isn’t she?”

Saint John’s, Newfoundland, the Good, the Bad, and the Ugly...

...Or, Anouk has an unintended adventure in Canadian health care

The Good…

On Monday, 19th May, Victoria Day, we landed in Saint John’s. In some regards, Saint John’s is an old city (it is described as the oldest city in North America), having been around for hundreds of years. In other regards, it is not all that old since the city has burned numerous times—the fire of 1892 burned over 1,500 buildings—so not many structures predate the turn of the century.

The old port, down by the waterfront, has loads of charm: Technicolor “jelly bean houses” line the blocks around Water and Duckworth Streets; pubs aplenty, enough to put Saranac Lake (in New York State’s Adirondack Mountains) to shame, seemingly each hosting traditional music; Signal Hill with its views of icebergs; the outport community of Quidi Vidi, a separate community within the city limits, perched like a seabird colony on the cliffs near the harbor entrance. Saint John’s is a steep city with major elevational change between streets parallel to the harbor.

And perhaps the single best thing about the city (and the province) is the people. Whether you are a “townie” (a person from Saint John’s), a “bayman” (what people from Saint John’s call someone from anywhere else in the province), or a “CFA” (“comes from away”), everyone is treated like a friend. On three separate occasions, when I asked for directions while walking around, the person began describing where I needed to go, then ended up saying it would be easier for them to show me.

The Bad…

The day after we landed in Saint John’s, Anouk managed to pull a cup of tea, fresh off the stove, onto herself. She sustained second-degree burns on much of her right arm, shoulder, and the chest above her right nipple. It was sickening to see the skin literally melt away from the scalding water. We stripped her, poured cold water over the burn, and took her the one kilometer to the hospital within minutes. Despite the intense pain, once she was treated and her pain managed, Anouk has been a real trooper, generally being her usual happy self. Natalie has written an emotion-filled piece which will be posted soon describing the ordeal. Needless to say, this has been the worst moment of my life! The one good thing that has come out of this trauma is meeting the wonderful nursing staff of the emergency room and the pediatric ward.

The Ugly…

Saint John’s would not be a city without its share of strip development, box stores, malls, asphalt, parking lots, and miasma of roads. The roads and traffic are a nightmare requiring an advanced degree in navigation! It is definitely NOT pedestrian friendly. And, what may be the worst part of it is that to get from the hospital, Memorial University, and our campsite—all located within a region known as Pippy Park—to the old port, you have to navigate your way through the maze of ugliness.

What's this about sabbatical research?

May 15, 2008, by Natalie

We have set up camp along a dirt road at the western end of Notre Dame Bay, too deep up Halls Bay to see the icebergs but they are not far, I hear. Our dirt road runs parallel to the shore on one side and is lined with thick woods on the other. The road is by no means deserted. We appear to be camped along the stretch where residents of nearby Springdale fetch and store their fire wood. In the hour we have been here, at least 4 pickups have driven by, drivers waving their greeting to the CFAs ("Come From Aways"). This is a gorgeous spot with islands dotting the water out our window and a tiny little fishing harbor down the way. We’ll have to check that out later and maybe chat with a few lobstermen. Or maybe they are crabbers. They could also be shrimpers, and though there are some communities that do have limited cod quotas these days, chances are good they are not cod fishermen… Which brings me to the topic of my sabbatical project.

My interest here in Newfoundland is to learn how coastal communities, outports as they are called, are faring since the cod fishery collapse and moratorium of 1992. Specifically, I’d like to learn what role tourism has come to play in these communities, as they search for options to help them survive. The cod fishery off of Newfoundland, the very fishery that fed the world and Atlantic trade for centuries, came to an abrupt halt in the early 1990’s. Dozens, perhaps even hundreds, of outports have simply been abandoned completely for lack of economic options since the cod collapse, thereby effectively erasing a way of life based on the sea. Emigration out of the province is practically epidemic. They say that Newfoundland’s biggest outport is now in Alberta.

And yet, Newfoundlanders have a deep connection to place, even more deeply felt than any multi-generation Mainer that I have met. When Newfoundlanders are gone, they pine away for home, and those that do stay work hard to find ways to stay put. (A whole tradition of “Come Home Year” festivals has emerged to draw the emigrants home to specific outports for a week-long party to reconnect with those who have stayed). Newfoundlanders are also fiercely and rightly proud of their abundant natural resources and the rich culture and heritage that the Province’s environs have generated. And so, heritage- and nature-based tourism are emerging as a beacon of hope for the future. Just how that hope is panning out is what I hope to explore this summer. I’ll keep you posted.

For those wanting to dive in, here are some cool resources: