Chapter 16 - A Fresh Start in Canada
Starting a job in Telegraph Creek, British Columbia
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Trish hoisted her suitcase onto the luggage stand in her hotel room and let out a tired sigh. She was utterly exhausted, but she knew better than to collapse onto the bed–if she did, she would be asleep within seconds. First, she needed to get ready for bed properly. As she unpacked her pajamas, she reflected on how grueling her journey from Manchester to Vancouver, and then to Prince Rupert, had been. It felt just as draining as some of the worst nightshifts she’d ever worked.
In the morning, she would meet with a staff member from the Department of Health, Medical Services and start her orientation for her new health promotion job. But tonight, all she needed was sleep.
The orientation was several weeks long. Trish had no previous experience with health promotion–her training had not covered it, and while it wasn’t exactly the “hands on” nursing she preferred, she found the opportunity to learn something new intriguing. Unlike her last job, where she’d worked for the United Church and had received no orientation, beyond where to pick up her ticket to get to Namu, her new position with the federal government came with a structured orientation. Through a series of meetings with staff, Trish learned about the structure and aims of the Dept. of Health, Medical Services, who she could contact, and how to reach them. She also learned about the specific health promotion activities she needed to do in Telegraph Creek. These included running pre-natal clinics, teaching school kids about oral hygiene, and checking them for head lice.
On the bright side, she would get a government-issued winter parka–a definite benefit since it was only February and freezing temperatures would linger for weeks, if not months, before spring arrived. She gladly provided her measurements. She was told the jacket would be shipped to her in the coming weeks.
During orientation, Trish joined a field visit to Klemtu, a village about 30 miles north of Bella Bella, where she had previously lived. She shadowed Dr. Ellis, assisting him in running a week-long health clinic. Smaller villages like Klemtu did not have a nurse living in the community, rather, a nurse from a nearby community would travel to the community to do health promotion. Sometimes they would join a doctor for a medical clinic, as Trish was doing now. She and Dr. Ellis arrived by seaplane, hauling an impressive amount of gear, including X-ray films and supplies to keep the clinic's equipment operational.
When they landed, a group of men and boys were on the boardwalk, leaning on the railing, watching as the passengers disembarked. To Trish's surprise, none of them offered to help unload the heavy cases. This was a stark contrast to Bella Bella, where lending a hand was second nature. Instead, Trish and Dr. Ellis wrestled the equipment up the ramp while the locals stood by and watched. The lack of help left her uneasy–a feeling that lingered throughout the week. By the time the clinic wrapped up, Trish was eager to leave. She couldn’t help but wonder what kind of reception awaited her in Telegraph Creek.
After completing the orientation, Trish boarded a small plane, a Beech 18, for the flight to Telegraph Creek. There was a gravel road that had connected to the community to Dease Lake, a community about 70 miles away, but a bridge had washed out and not been repaired, so flying was the only way in or out.
The isolation of Telegraph Creek was breathtakingly clear from the air. As the plane flew over snowcapped peaks, frozen lakes, and endless wilderness, the beauty of the coastal mountains was spectacular. The landscape shifted as they followed the meandering Stikine River toward Telegraph Creek. Rugged terrain gave way to deep canyons and plateaus, and a small cluster of buildings came into view along the riverbank.
Trish had been warned that the landing would be quite exciting. The airstrip was located northwest of the village, surrounded by hills on both sides, and another on the approach. At the far end, a deep canyon cut through the landscape. The hill on the approach was so steep it felt like the plane was skimming the treetops, before it dropped sharply toward the short runway. The runway itself was uneven, with noticeable rises and dips. This was why, she learned only small aircraft, the Beech 18, and the Otter, were able to land there. Years later, the airstrip was moved to a more suitable spot, but in 1972, landing in Telegraph Creek was a gripping experience for both pilots and passengers.
On the ground, Trish was greeted by Janet, the nurse she would be replacing. Janet was leaving to get married–she was engaged to a doctor she had met when he came to the small community to run clinics. Trish had already known this, as the Employment officer who hired her had brought it up. He had told Trish that the nurse before Janet had married an RCMP officer, and now Janet was marrying the doctor. The thought flashed through Trish’s mind that her friend Jean might have better odds of marrying a doctor in the Canadian wilderness than in a big Manchester hospital!
There wasn’t much time to talk, as the plane was making a quick trip to deliver mail and supplies to a nearby mine before returning to pick up Janet and other outbound passengers. Janet hurried to show Trish the Nurse’s Station, which doubled as her home. It had two bedrooms–one with a single bed for her and another with twin beds for visiting doctors–a kitchen, a bathroom, a treatment room stocked with medical supplies, and a small office for meeting with patients.
As Janet quickly went over the essentials of running the Nurse’s Station, Trish realized that, although her job was supposed to focus on health promotion, there was no other healthcare provider in the community. Just like in Namu, she was the only health professional in Telegraph Creek. Occasionally, a doctor would visit, and a nursing supervisor might show up unannounced to check that Trish was completing the required health promotion tasks. But most of the time, she would be alone. She wondered if, once again, her experience in the busy casualty department in Hull, and her midwifery training, had been a factor in her being hired to this job. It was not legal for a nurse to perform procedures like starting an intravenous, suturing a wound, or delivering a baby without a doctor present, but as in Namu, if those circumstances arose, it wasn’t always possible to get a doctor on site in a timely manner. At least Trish had experience if she needed it.
Janet also introduced her to Mary and Jimmy, the Native couple who lived next door to the Nurse’s Station. They took care of the clinic's cleaning and maintenance. Mary would also work as Trish's assistant during the day when needed. Their warmth and friendliness were a comfort to Trish, who was acutely aware of just how far she was from home. When the sound of the Beech 18’s engine signalled the plane’s return, it was time for Janet to leave. Trish turned her focus to settling into her new home. Telegraph Creek, home to about 400 people, was divided into two areas: the buildings along the riverbank ("town"), and the plateau above ("the village"), where the Nurse's Station was located. On her first walk down the steep trail into town, the first building she came to was the Hudson's Bay store, where residents shopped for everything from groceries to household supplies. Trish was stunned by the prices–they were outrageously high. When she voiced her surprise, the clerk explained that the damaged bridge meant everything had to be flown in, drastically driving up the costs. Trish wondered how people afforded food with such high prices.
Leaving the store, Trish continued on along the river, coming to a church–St. Aiden’s Anglican Church–according to the weathered sign out front. There were more buildings along the riverbank; some were obviously abandoned, while she couldn't tell for certain if others were still occupied. Janet had told her that the RMCP officer and the minister lived down in town, but it wasn’t obvious to Trish which houses were more lived in than others.
After returning to buy a few food items from the Hudson Bay store, she braced herself for the strenuous hike back up the trail to the village. She was relieved that the Nurse’s Station was in the village, rather than down below on the riverbank. The fewer trips she had to make up and down the steep trail between town and the village, the better. Still, she knew she’d have to make the trek for groceries and to use the radio at the Hudson’s Bay store–the only way to contact the doctor, or anyone else outside of Telegraph Creek.
As she trudged up the slope with her bag of groceries, the trail took Trish through the cemetery. It rested on a smaller plateau halfway up the steep bank. Further along, there was another bench in the hillside, and that was where she came across the school and a house where she presumed the schoolteacher lived. Once back in the village, she walked along the gravel road that paralleled the river along the plateau, before looping back on itself. This area was home to the Native families, and Trish.
After familiarizing herself with the layout of the village, Trish turned her attention to the Nurse’s Station. She thought about the health promotion activities that comprised her new job. Even with her limited knowledge of the community, many of the activities didn’t align with the actual needs or interest of the residents. For example, she was to conduct regular pre-natal clinics, but Janet had mentioned there was only one pregnant woman in the entire village, and this wasn’t her first pregnancy. It seemed highly unlikely she would avail herself to a pre-natal clinic once, let alone regularly.
It didn't surprise Trish that her days quickly filled with walk-in patients arriving at the Nurse's Station, seeking medical care for both new and ongoing medical issues. Mary's help was invaluable. Although she had not been formally trained as an aide, she had been working in the clinic alongside nurses for some time and had a common sense approach to the daily activities, as well as a subtle sense of humour. Trish enjoyed working with her, it was nice to have someone to talk to. Mary was curious about Trish and her background. She and her husband had two grown children, and she regularly shared updates about them with Trish. Their eldest daughter worked as a hair dresser in Dease Lake, and their eldest son was a pilot. They also had two teenagers who were away in Terrace for school, they came home on the holidays. It was obvious to Trish that Mary and Jimmy were proud of their kids, particularly the careers of their eldest two kids. Mary also knew each family in the community, which was helpful as Trish became oriented to the needs of the village.
The homes in Telegraph Creek didn't have electricity. This information surprised Trish, since the Nurse's Station had electricity, but Jimmy told her that was because it was powered by a generator, as was the school and the teacherage. It was his job to look after the generators and make sure the buildings had power.
Trish soon found a routine to her work, treating wounds, managing infections and illness, setting broken bones, and arranging transportation for patients who needed advanced care in Terrace. She also prepared a bag of medical supplies for house calls, as occasionally she needed to see patients in their home, or elsewhere in the village. These home visits gave Trish the opportunity to meet more members of the community and see their living conditions firsthand. Although the village was small–less than a half mile from one end to the other–the difference between homes at either end were striking. At one end, homes were clean, children were well-fed, and they performed well in school. Homes were tidy and welcoming; Trish instinctively took her shoes off at the door when visiting.
At the other end of the village, however, many homes were in an alarming state of neglect and disarray. Alcohol-fueled parties were common, and some children suffered from developmental issues. In these homes, Trish kept her shoes on–for safety. It was also at this end of the village where she was most often called to deal with serious injuries, often in the evenings, when the parties started in earnest.
On quiet evenings, Trish prepared herself a simple meal in the kitchen of the Nurse’s Station before finishing the day’s reports and clinical notes. Having lived most of her adult life in nurses’ residences, save a few months when she had her own apartment, cooking was not something she had paid a lot of attention to in the past. There also wasn’t much variety in the groceries available in the Hudson’s Bay store, so she just did the best she could with what she had. She decided it didn’t need to be fancy, only edible. Some evenings, however, as she was about to sit down to eat, there was a knock at the door. It was the minister, a frail old man, dressed in threadbare clothes, with uncanny timing. He lived down in the town, and Trish knew he had climbed the steep trail to arrive at her door at dinner time, so she could hardly turn him away. She served him a plate of dinner and chatted with him, musing to herself that the Anglican Church had probably forgotten about him decades ago and simply left him there. During one of their chats, the minister told Trish about Miss Whiteside, a retired nurse who lived in a rundown cabin down in town. Miss Whiteside had been the nurse for many years in Telegraph Creek, working in two part time jobs that made up a whole salary. Now, in her retirement, the pensions from her part time service were so small the minister said she couldn’t afford to leave the community. Or perhaps, he mused, she had just been there so long, she had nowhere else to go. Trish wondered if that was his situation, as well.
When doctors came to the village, they stayed at the Nurse’s Station, and Trish had to cook for them as well. She particularly enjoyed the visits from the ophthalmologist, who came on a regular schedule. He brought groceries with him, which not only added variety to her meals but also spared her the steep prices at the Hudson Bay store.
She met Dr. Phil D’Entremont, the doctor her predecessor, Janet had married, he came to the community quite regularly to run clinics. He was French-Canadian, and in the evenings, he liked to challenge Trish to play a game of Scrabble in French. Trish was keen to play Scrabble, but not in French. Fortunately for her, he agreed to play in English.
Other doctors came to the village more occasionally. One, Dr. Roger Page, left an impression with Trish. Roger had previously worked at the hospital in Bella Bella, so they shared that in common. He was also very caring toward his patients, and the residents who came to see him in Telegraph Creek clearly liked him. Trish appreciated being able to have practical conversations with him about cases she had managed, and about providing medical care in remote locations in general. After a few visits, they had become friends. Roger worked in a clinic in Terrace, and also did shifts in the emergency department at the hospital there. Trish appreciated the growing friendship, and the feeling that she was part of a bigger health community.
She was also starting to feel more connected within the small community of Telegraph Creek. Sometimes, Helmut, the schoolteacher, hosted a potluck and musical evening at the teacherage, and invited her to join. The gatherings were lively and filled with laughter, as locals and the small group of non-Native residents came together to share food, stories, and musical performances. Trish welcomed the evenings, and the social connection.
Other evenings, when Trish knew of elderly villagers who were not well, she visited them in their homes. Many of them were cared for by family, using traditional remedies passed down through generations. For example, families believed in treating fevers by bundling the sick under heavy blankets in small, overheated bedrooms, with roaring fires to help them "sweat it out."
This approach clashed with Trish's medical training, which emphasized cooling the patient, identifying the source of the fever, and treating the root cause. Despite her gentle attempts to persuade the family to lower the temperature and remove the blankets, they remained firm in their tradition. They were, however, open to accepting antibiotics if Trish recommended them. Although there was ongoing disagreement on fever management in the village, Trish was relieved that no one succumbed to fever-related illnesses during her time in Telegraph Creek–and that was what mattered most.
Near the end of her first month, Trish received a package from the Medical Services office in Prince Rupert. There were memos and updates, but there was also a checklist. It listed all the health promotion activities she was to have completed over the month. The instructions were to check off the activities she completed and return the list to the office. Trish stared at the list; she had done few of the activities–only the ones that had made sense. She had spent the rest of her busy workdays treating the patients who came to the clinic. Regular nursing duties.
She thought back to her orientation, but she didn’t recall any mention of a checklist. She couldn’t imagine that there would be a penalty for not checking all the boxes, but then again, she had not expected to be fired from Bella Bella for speaking her mind, so anything was possible.
“Fair enough” Trish thought, if she was being paid to check boxes, she would check the boxes. It would not change her day-to-day approach to receiving the patients as they presented themselves to her at the Nurse’s Station, or when they called for her to come see a family member who had fallen ill in their home. There were no other health services in the community, she wasn’t about to turn them away. She quickly filled in the checklist, sealed it in an envelope ready to be sent out on the next flight, and went about her day.
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Author’s Notes
N.B.1: In 1970, as Trish was introduced to the people of Klemtu, Telegraph Creek, and Iskut, the language of the time, “Natives”, was used. Today, the people living on the lands where Trish worked, have reclaimed their traditional identities, leaving behind the nomenclature assigned them during colonization.
The Village of Klemtu sits on the traditional territory of the Kitasoo Xai'xais First Nations, and the communities of Telegraph Creek and Iskut sit on the traditional territory of the Tahltan First Nations. If you would like to read more about the identity and culture of First Nations people in Canada, including insights from Indigenous authors and advisors, here is a resource from the “First Nations & Indigenous Studies” program at the University of British Columbia.
N.B.2: We often see our parents through the lens of their roles in our lives— caregivers, disciplinarians, cheerleaders. Perhaps they are our role models or mentors, but who were they before they became these things to us?
To better understand who my parents were before they were, well, my parents, I set about interviewing them about their lives before marriage and kids. I started with my mom.
Trish Lewis was 18 years old and desperate to escape a mind-numbing administrative job at a factory in Liverpool in the 1950’s. She made the impulsive decision to join a friend to interview for nurse’s aide training at Alder Hey Children’s Hospital. That decision changed the trajectory of her life and launched her into an interesting and rewarding career as a nurse.
Trish is my mom, and this is her story, as told to me in a series of interviews in 2024. The story is pieced together from Mom’s memory, photos, and documents. As we all know, memory is fallible. In the telling of this story, some names have been changed, either because they could not be recalled, or to protect the privacy of the person. The Journey is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.
N.B.3: If you are enjoying this story, you may also enjoy reading my memoir, “Resilience in the Rubble: A True Tale of Aid and Survival in Kashmir”. The book shares my experience as a first-time medical aid worker in Azad Kashmir, Pakistan, after an earthquake devastated the region in 2005. It also tells the story of Nadeem Malik, a local teenager who lived through the earthquake, and his struggle to provide for his family in the aftermath.