Elf and the System

All My Puny Sorrows is the latest novel from Miriam Toews. My two degrees of separation from Miriam is that she is friends with my good pal and writer Melissa Steele. I met Miriam once when she was playing pool in a bar on Corydon Avenue in Winnipeg. (It’s a tenuous connection with fame, but that’s all I have).

Corydon Avenue is featured in her newest book, as are a number of Winnipeg landmarks like the Assiniboine River, and a thinly veiled hospital on the French side of the river. It is at this hospital that Miriam’s protagonist, Yoli, visits her sister Elf. Elf has been admitted to the psychiatric ward after a stint in the ICU following a suicide attempt.

This is a sad book, touched with desperation and humour. Yoli wants her sister to live, or at the very least to die in peace and surrounded by loved ones. Elf is determined to die by suicide. Elf’s will is strong.

I was struck by the passages in All My Puny Sorrows that recounted experiences in the psychiatric ward. The encounters with the nurses and psychiatrists were, for the most part (and ironically), dark and depressing.

There are restrictive visiting hours for families and a ban on food. The nurses at the desk serve to stand guard to grill visitors. The only reprieve from the hardened staff is one psych nurse named Janice, who wears light pink track suits and tangos on her days off. She also doles out important hugs to family members.

Otherwise, the time and the people in the psych unit are bleak. The attending psychiatrist refuses to treat Elf and her ‘silly games,’ nurses are experts at avoiding eye contact with pleading family members, and finally, it is the uncaring system that lets Elf and her family down in the end.

This is a work of fiction, so it is fair to question if the treatment of the mental health experience is accurate.   But All My Puny Sorrows is also a deeply personal novel for Miriam Toews, as her own sister Majorie died by suicide four years ago.   So yes, I would assume that there is more than a glimmer of truth in her words.

Half way through the book, Yoli issues a plea for what her sister needs from the mental health professionals entrusted in her sister’s care:

“Imagine a psychiatrist setting down with a broken human being saying, I am here for you, I am committed to your care, I want to make you feel better, I want to return your joy to you, I don’t know how I will do it but I will find out and then I will apply one hundred percent of my abilities, my training, my compassion and my curiosity to your health – to your well being, to your joy.”

Isn’t that a beautiful sentiment for all health professionals? But that never happened for Elf, or a multitude of other patients who slip through the health system not feeling cared for.  For Elf, that crack in the system leads her to her end.

All My Puny Sorrows is an examination of a sister’s bond, a family’s love for each other and growing up Mennonite. It is also a mournful commentary of our broken mental health system. I am grateful for those who apply their compassion and training to their patients’ well being. I personally know of three exceptional nurses who work in mental health – Lisa, Heike and Laurene – how do we bottle their passion for their patients, and share it with their colleagues?

For those who don’t, or can’t, demonstrate compassion – can we educate people to care? Can we teach empathy? Is there a way to open up a heart to understand the perspective of who may be the toughest patients of them all – those with mental health illness?

I don’t know the answers to any of these questions, but I’ll keep preaching about kindness and compassion to students, health professionals, and anyone who will listen.  All My Puny Sorrows is a stark reminder that we need to keep trying to find the answers: for all the Elfs of the world, and for the thousands of patients in Canada who struggle with mental illness every single day.

 

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