MARK SMITH FROM SCOTLAND  

On the other side of care

 I’m feeling a bit sorry for myself this month. I’m sitting at home trussed up like a turkey, having taken a tumble while skiing during the February mid-term break, breaking and dislocating my left shoulder, which required an operation and a few days in a French hospital. And I don’t even have a good story to tell for my woes. I’ll come clean. I fell after losing control towards the end of a beginner’s lesson on a nice gentle slope. I knew from the moment I went over I was in trouble. I needed care.

 The next few days were undoubtedly miserable. I was in terrible pain. I was ferried by ambulance from the ski resort down hairpin mountain roads to the nearest sizeable hospital, having left my daughter to round up and care for my sons. Despite this I felt cared for and, as the whole nature of care is something I’ve become increasingly interested in, I whiled away some of my time reflecting on this experience of being cared for. A few themes come to mind, some of which I discuss in more detail in a recent article in Relational Child and Youth Care Practice (Smith, 2006).

 What struck me immediately was the responsiveness of the medical services. Within minutes of having fallen I was manoeuvred into a stretcher on skis and taken down the mountain to a waiting ambulance, which took me to the local clinic. Having been x-rayed and the break discovered, I was put in another ambulance and taken to hospital. On arrival there, the orthopaedic surgeon was waiting for me. He was an engaging Gallic character, who I immediately liked. He explained what he was going to do and that he was going to do it that evening to avoid nerve damage. When it came to being put under anaesthetic I had few qualms. I knew I was in good hands.

Like the ambulance men before him, the surgeon knew what he was doing; he was competent, a pre-requisite of care. It became apparent to me after the operation as he was explaining what he had done that he took a pride in his work. He was a craftsman; he was obviously pleased with how the operation had gone and with what he had done.

 But care isn’t only an activity; it’s also a disposition. From the time I arrived at hospital I came across those who obviously cared — and those for whom caring was a job. They did that job competently enough and I appreciated that but, for them, I was just the next bed-bath or the next round of medication. There were others who although doing very little, conveyed to me that they cared. This was evident in the expressions of a young male nurse moving me from one ward to another who obviously picked up on the pain I was in and was instinctively sympathetic. It was evident in the appreciation expressed in the face of another nurse as she acknowledged my difficulty being away from my family in a foreign land. I thought of Leon Fulcher’s notion of cultural safety at this point; that sense of someone sensing and acknowledging the importance of ‘my people’.

 Few of these expressions of care required to be spoken, which was just as well as my embarrassingly rusty French was in most cases all we had to work with, and that didn’t get us very far. But most acts of care don’t require language for them to be given or received.

This last point about the giving and receiving of care is an important one. Although physically helpless, I nevertheless had some agency in the care I received. I was a good patient, full of ‘Bonjours’, ‘Merci beaucoups’ and watery smiles, partly because I knew it was in my interests to be so, but mostly because I genuinely appreciated the care I was experiencing and trusted those offering it. This is where my experiences and those cared for in Child and Youth Care settings diverge. Very often they can’t accept their need for care; they want to fight against it and those providing it. Care takes on a very different complexion.

While I wouldn’t recommend going to the drastic lengths I did, I would suggest that child and youth care workers reflect on what it is to give and receive care; it is after all at the heart of what we do.
 

REFERENCE

Smith, M. (2006) Act Justly, Love Tenderly, Walk Humbly in Relational Child and Youth Care Practice 19 (4)