Knowing your neighbours

September 21, 2016

 

A stone figure stands watch over the cemetery at South Walls on Hoy. Dressed in oils and life jacket he marks the graves and memory of the eight men who perished in the Longhope Lifeboat disaster. On the 17th night in March 1969, the T.G.B lifeboat capsized in 60 ft waves, killing all aboard and leaving the small community devastated; each family having been touched by the event, one woman lost her husband and both sons in the catastrophe. 


Whilst taking a different route home one evening, I'd come across the memorial and the words beneath it , "Greater love hath no man than this. That he lay down his life for his fellow men." 


The crew members were all volunteers from one small hamlet. 


When considering this, it is difficult to think of a more fitting example of 'community spirit' and yet I'm finding that this theme continues to emerge in what I observe here and what I'm told by the islanders every day. 


I experienced it again only this afternoon as I accompanied the practice nurse to a very unique dwelling on the island. Situated within an ex-military battery, there is a small living quarters where an elderly gentleman has lived for the majority of his life. Without central heating or bathroom  (he must cross a quad to reach the facilities) he has remained there through the harshest of winters and the most ferocious of storms (100mph winds are a common occurrence here).  


Sadly he was forced to leave the island, for the first time in many years, only a few weeks ago as the cold and isolation had brought him to a state of very low mood and poor physical health. He required hospital intervention and respite care. 


In his absence the island medical team have worked tirelessly to liaise with his respite placement to ensure his quick return; the gentleman hates being off the island and is desperate to come home. Yet, his admission in itself illustrates the difficulty of caring for the elderly and isolated on the island. He simply was not coping in his surroundings and clearly needed more help which can be hard to arrange, in a formal way, in this rural setting. I was surprised to hear, therefore, that he would be discharged this week after only a fourteen day stay on the mainland. 


Having recently finished a job in elderly care medicine, I am well versed in the complexities of patient discharges, especially when an increase in care or home alterations are needed. Whilst there are usually many marvelous people working together to make these things happen, I have seen and I think most who have worked in the same setting could share similar experiences , a number of people sitting in hospital for prolonged periods of time waiting for things to be put into place. Time seems to slip away and weeks can go by. 


As we drove the gravel drive to the battery, questions circled in my mind of 'how could the changes to his home have been made so quickly?' and 'who would be bringing in food?' and 'what would he do to keep warm now that the dark is setting in?'


We arrived not to an Occupational therapist or discharge team but to an Englishman, an Irish man and three Orcadians carrying between them a reclining chair, two rolls of carpet and a new bed. It sounds like a bad cracker joke but there was nothing funny about how hard this team of family and neighbours had been working to have things in order by Friday. The old bed was out and the new one in. The reclining chair, given on 'permanent loan' from the surgery was instilled and the icing on the cake; central heating installed by Scottish Heritage within a week. He'd wanted to come home; he'd lived here for as long as they could remember, and therefore it was going to happen. 


There is a sense of 'making things happen' here, a feeling that you might not like your neighbour but that if their car was pulled into the sea by a rogue wave, you'd probably dig out the tractor and help them get it back on the road. 


During a conversation with me, an islander made the comment that 'you get on alright here if you pull your weight', summing up an idea that it's perhaps not enough to just be here, that looking out for each other and 'doing your bit' is an absolute requirement. 


Of course on an island of 400 people I'd expected an element of 'community spirit', but I'm not sure I'd fully thought about what that might mean. In terms of healthcare,  I'm not sure I'd predicted that patient management plans would consider which neighbours were back from holiday and could drop in, or expected to hear stories of men in their 20s on an evening out  coming across an elderly neighbour confused and wandering, taking them back to their home and staying with them for hours until they were settled.


It's becoming clear to me that these ideas of 'neighbourliness' and of people 'pulling their weight' are not simply rosy consequences of a small and tight-knit community but are essential for the function and survival of this island population.


Life will still be a struggle for the elderly gentleman living up at the battery.  There are concerns that he will never again cope with the house the way it is or indeed again may find the isolation too much. He is elderly and frail and if he were to become suddenly very unwell again, he might not make it off the island in time to receive the treatment he needed. But he wants to be here and a lot of people, under no obligation, have worked hard to get him to where he wants to be for the moment... I can't help but be more than a little impressed by that. 

 

 

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