It always gets me

I used to say one of the worst parts of a night in the trauma ward was the combination of smells. That mix of blood and alcohol and then urine on top of it is fairly unique. But last night was off the charts and added a far deeper dimension to this matter. When a small very unkempt man lifted his tshirt and jersey and out jumped several fleas! I mean unkempt because his toenails were black and long. His hair was patchy and in tight curls on his head. His clothes torn.

He was tiny. About 40kg. And the interesting thing is he looked much younger than he actually was. He was 63 years old.

He told me that all his family had died, only he was still living. I am sure he was lonely. He asked me several times to arrange some food for him but it was 3am and I told him he would need to wait for the early morning tea and sandwich around 5am. He fell asleep there on the examination table while I did his ecg. He was an old man and staying up all night had tired him out. Understandably. When he awoke he reminded me that his stomach was hungry. The first thing I asked him when he entered the consultation room right in the beginning was if he lived in a house. If he had a home? He said, “Yes.”

And then these plump small brown fleas just sprang out of his jersey as he lifted it up. They just jumped out! About 3 plump fleas! And they jumped away onto the examination bed and then straight onto the floor before I could even do anything to stop them!

That was actually even ok. So he has fleas. I tried to get my head around the concept of his home and care; Of his surroundings and his lack of hygiene and self-care. I tried to balance my judgement about his self-neglect and the magnificent contrast in our two worlds.

Later the next day, I realised the amount of “neglected” patients we had in our ward currently. Thin, wasted men with prominent ribs and facial bones and very little skin and flesh covering them. Some unable to speak due to strokes. We had to figure out if the disabilities from the stroke were new or old by examining the degree of permanent disabling contractures.

Some men had old healing sores and scars from falling over or old assaults. I saw fingernails that were so long and thickened and over-grown, it reminded me of the old pictures I used to look at as a child in the Guinness Book of Records – for longest fingernails. It would show these Indian men with long dreadlocks and long fingernails that grew in twirls as they extended way beyond normal nail length. I personally like my nails short.

All these things add information to your clinical perception and holistic understanding of a patient. His beard was trimmed though. Long elsewhere but trimmed around his lips. I noticed that the nurse was feeding him. I couldn’t make out his answer when I asked if he can walk by himself.

But none of this was new and was part of the raw and very real experiences in the trauma ward in a state hospital in South Africa.



Sprinkled with an over-riding feeling of hopelessness and disconcerting reality of the grave social conditions in our beautiful rainbow nation; and blessed right here and now with the opportunity of connection.

That part is hard.

Numbness is often a fair substitute for most of us. Focusing on the troubling organ system is a wonderful plan of action to fix the problem and discharge home, without having to really see the ‘person’.

But then – while I was writing the notes my ankles started itching around my socks and I moved them around and a flea or two jumped off me! And that was it. The entire shift I was itching and twitching in different areas around my body. I even took off my socks and shoes and shook them out to loosen and free these little hungry suckers!

They completely challenged my very vegetarian stance on animal protection. I just wanted to squash these little buggers that almost symbolised the epitome of neglect, dirt and not caring enough to take care of yourself. I mean normally we deflea dogs. And now I had someone else’s fleas nestling around my ankles!

Anyway we adeptly managed his concerns and needs and off he went with his file firmly in the discharged pile. I am not wanting to sound callous about it but there is a certain amount of efficiency needed when working in a trauma unit. Though I actually suck at it because I am known for spending too long with patients, I do truly try to do my best in the given situation.

Still that is not what I really wanted to share in my writing this today. I want to share the story of this one young man.

He was turning 26 years old in 2 days. He had a stabbed lip. It wasn’t all the way through but it was fairly deep and needed stitches. So I anaesthetised his lip and put in three stitches while he kept some gauze between his lips so his blood did not drip into his mouth.

Before that he shared some of his story with me. He was stabbed by someone who was repeatedly stealing from his friends. He took it upon himself to defend them by stabbing the thief first. He told me he stabbed him on his left arm. Close to the shoulder.

When I was preparing the local anaesthetic he was asking so many questions about the substances and comparing what he had learnt in his substance abuse workshops while he was in prison. He was there for 3 years and came out about 2 years ago. I didn’t ask what he was in for. You never really know anyway. 3 years and 9 months actually. That is what he said. I think when you go through that – every month truly counts. He was transferred out to a smaller prison in a very small town in the Western Cape.

We didn’t discuss much more about his prison experience. He told me instead about his life. He said “I have had a hard life.” He was born to parents who did not care for him. They were more interested in drinking alcohol and neglected him. He was left on his own and not cared for in his early childhood years. Eventually he was carted off to family or other people deep in Transkei, Eastern Cape. He was basically sold for labour and was shepherding and caring for sheep, goats and cows.

When we traveled through these areas I have seen young boys shepherding goats, sheep, sometimes cows. The sheep and goats follow the deep crevices and landscapes of the mountains and lands and the boy goes with him with his staff and home-made shelters to protect him from the harsh elements.

I actually liked the simplicity of these lives and the connectedness to nature. But now I was feeling something else. That this young man had his childhood stolen from him, as well as education. He ran away from them in Transkei when he turned 12 years old. And started his own life.

We didn’t have time to fill in all the missing parts. Now he is living on the streets. He has connected with another couple on the streets. He sleeps under the post office on the main road of the small town. He said he likes to stay with this specific couple because they are wise and they share wisdom with him.

This man was a wisdom seeker. Not only that but I actually felt his understanding and connection with the Light. As rough as he sounded, he had a depth of spiritual awareness and guidance. He looked me in the eye and in deep authentic appreciation said, “Thank you.” There was some depth that we both connected on. He was a wise traveled soul, a light seeker.

I helped him as best I could. Limited by the trauma ward rituals as well as his social situation. He had developed piles, painful bleeding haemorrhoids while in prison. The diet is very processed and known deficient in fibre and fresh fruit and vegetables. He was repeatedly given “bullets” that he put inside his anus to soften his stool. It never got rid of the problem but gave an immediate and temporary solution. He wanted to deal with the problem at its root – to get rid of it. I showed him how to push it back in manually and hold it in and how to repeatedly do this to truly get rid of it. Though I did consider the practicalities of this if you do not have a home, never mind a shower or a bath…or a basin. Followed by the medical treatment, dietary advice and clinic follow-up so he does not get lost in the system, I hope.

The night rolled on. We paused at 5am for a refreshing drink. I had my mate tea flavoured with a sweet rooibos and honey mix.

On the way home, I started reflecting on the night. I felt overcome with grief at this man’s situation and the obvious call for his pull towards the light, in his current situation.

His journey.

His karma.

I felt silly for every single time I have complained about my lot. And I respected him for following his journey and obeying the call of his heart, his higher self. His yearning for wisdom and his integrity to know the difference. And I cried. Because he is so severely challenged by his life’s circumstances. And I felt absolutely helpless. Yet I wanted to help. I wanted to be able to go to his shelter and offer him a job and some money.

Sitting in the language of spirit with this young man and his dear soul – I realised spirit is always available.

So I prayed.

I prayed that he will get cared for by the light, that he will continue to follow his highest integrity and that he will get some form of blessing that only Divine can know best for him.

I trust that prayer will be as powerful and that his highest calling can become reality.

Similar Posts