conversations about medicine and life

“In the Night Kitchen”: an allegory for the patient experience?

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Emily Duncan

Did you ever hear of Mickey, how he … fell through the dark, out of his clothes past the moon and his mama and papa sleeping tight into the light of the night kitchen?”

Maurice Sendak’s In the Night Kitchen is one of those masterpieces I revisit in adulthood. Its rhythm and phrasing were tattooed on my young mind. There’s a recording of the text by the late actor James Gandolfini. Even though it was only a few years ago that I heard this, and I’m a Gandolfini fan, the petulant child in my wanted to protest, “You’re reading it all wrong!”

The appeal of In the Night Kitchen isn’t merely sentimental whimsy, but Sendak’s complicit understanding of what our parents wouldn’t admit. He encourages us to embrace the (unspoken) fear of night-time and face uncanny and surreal happenings in the dark.

Children are tough, though we tend to think of them as fragile. They have to be tough. Childhood is not easy. We sentimentalize children, but they know what’s real and what’s not. They understand metaphor and symbol. If children are different from us, they are more spontaneous. Grown-up lives have become overlaid with dross.”  Bernard Holland.

I think of the book when in hospital. Suspended in insomnia in a seventh floor isolation room, looking over the ‘night kitchen’ of Dunedin North. Like Mickey meeting the bakers, I’m alert to the labour that continues under focused beams of light while most of us sleep. There’s that that must go on. And fear. Hospital is discomforting no matter your age, so I ask: could In the Night Kitchen be read as an allegory for the patient experience?

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Poetry: “a long document about the species”

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Yoram Barak

Yoram Barak is a judge for the poetry competition Changing Minds: Memories Lost and Found, organised by the Dunedin Public Libraries and the Neurological Foundation of NZ.  Find details on how to enter here. 

I became aware of the importance of poetry through American poet Sharon Old’s poem, “Back Rub”. Originally published in her 1992 collection, The Father, the poem was reprinted in a special edition of The Lancet focused on Literature and Ageing. The poem chronicles the poet’s father’s dying, as well as her own process of acceptance and healing as she moves with him to his death and beyond.

In my work as a psychogeriatrician I often witness patients, caregivers, families and communities struggling through the journey of dementia as they are faced with the daunting loss of memory. Can poetry help us along that journey?

The loss of memories is experienced as the loss of “I”, of the core element of “self.” We grasp our sense of individual self and, in most Western cultures, push away the true meaning of impermanence. As dementia takes its toll we experience the impermanence of our memories and for most of us this is a horrifying insight. Poetry as a truly heroic attempt to capture the human condition is a major art form that can help transform the horrifying into the empathic.

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The treasures we surround ourselves with …

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Max Reid

woodcut by Janet de Wagt
Woodcut by Janet de Wagt

Some years ago, I was managing a large not-for-profit aged residential care facility in Wellington. We offered a range of rest home, hospital and dementia level care, and we were operating in a very competitive market, a market increasingly dominated by private ‘for profit’ aged care providers.

A perennial question for organisations in the aged residential care sector – be they private or not-for-profit – is, ‘What makes what we offer distinctive?’ Even earlier in my career, while undertaking a business degree, I remember a marketing lecturer defining the three key aspects of ‘market distinctiveness’:

You have to be either the biggest, demonstrably the best, or the most innovative.”

Sound enough concepts in themselves, perhaps, but somewhat difficult in a sector (like aged residential care) where virtually every aspect of the service you provide is detailed in standardised specifications and contracts, and then audited to within an inch of a contract’s life.

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Smoke in the head

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Grace Carlyle

opening blindsI have an elderly neighbour. We have a signal: each morning I look to see whether she has pulled her curtains. Then I know she is all right. This became less important after she had three falls followed by two operations and acquired a St John alarm, as well as home help to call in three times daily. Still, every morning I look to see the curtains are pulled. I go across whenever I am able and we have a cup of coffee. Often I cannot walk that far but I try to manage at least once a week.

She arrived in New Zealand with her eldest daughter sixty-five years ago, soon after the New Zealand government allowed Chinese wives to immigrate. She speaks a Chinese dialect and her English is limited but her ability to capture difficult concepts with the words she does know frequently takes my breath away, they are so poetic. What a poet she would have made had she only learnt to read and write. My only language is English but we mime at times and laugh a lot. She gave birth to twelve more children and worked in her husband’s market garden. She cannot manage the garden she has now, but for years I would see her out there for hours – small wonder her garden and house were immaculate. They put mine to shame. Once house-proud, now I value poetry above dust.

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Mother language medicine

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Tui Bevin

Tui and her father Kaj Westerskov in Naenae 1955
Tui Bevin and her father Kaj Westerskov in Naenae (New Zealand) 1955

My father lost his English three times. Once, he reverted to his mother language when he was very ill in intensive care while visiting Germany, but his English returned as he recovered. However he lost it twice more before he died in Dunedin Hospital ten years later.

Dad grew up in Denmark and lived in New Zealand for his last fifty years. His enjoyment of words, languages and bilingual jokes is an important part of how I remember him. It’s not surprising therefore, that the issue of language emerged when I wrote a series of poems about my parents.

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