Chapter 17 - Melting Snow, and Other Work-Arounds
First months in Telegraph Creek and Iskut
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Trish was surprised by how far she’d wandered from the clinic, bucket in hand, without finding any clean snow to melt for water. Scanning the ground for an untouched patch, she wondered aloud just how many dogs lived in this tiny village.
Iskut, a small Native village about 50 kilometers east of Telegraph Creek by air, had no running water. The community had a water system, but it often froze in the winter, as it had now. Trish was visiting Iskut for the first time, accompanying a doctor who was running a clinic for a few days. Her role was to conduct health promotion activities while the doctor saw patients in the clinic, but even basic hygiene was proving to be a challenge. She collected the least soiled snow she could find, muttering under her breath that it wouldn’t even be clean enough to wash her hands. Back at the clinic, the doctor didn’t seem fazed by the sorry state of the snow in the bucket.
“We’ll filter out the worst of it, and see what we are left with,” he said with a shrug. Using a steel pail and several clean tea towels layered together to make a strainer that would remove the largest contaminants, they started melting the snow. As it melted, water filtered through the towels, and eventually they had a few inches of water that, after being boiled, would at least do for handwashing.
Eyeing the water suspiciously, Trish wondered how families in the village managed to cook, bathe, and get through daily life with such limited access to clean water. Collecting snow, melting it, then boiling it was an ongoing job to get enough water for basic daily needs when the water system wasn’t working.
Dirty water wasn’t the only hurdle Trish faced when trying to promote basic health in Iskut; the local priest was another. Based on conversations with the residents of Telegraph Creek, she had learned there was an interest in an educational clinic about birth control. Trish thought the residents of Iskut might have a similar need, so she advertised a birth control clinic during her visit. However, the priest caught wind of her plan. During Sunday mass in the village’s small Catholic church, he preached against her and the clinic, scaring the women who might have wanted to attend. When Trish heard what happened, she quietly rescheduled the clinic for the evening and spread the new time through word of mouth, inviting women to enter through the back door of the clinic if they wished to attend discreetly. The clinic went ahead at the new time with a discussion about safe sex, and birth control was provided to any women who requested it. Nonetheless, returning to Telegraph Creek when the visit was over was a relief. There, she might have to cook for the local minister occasionally, but at least she wasn’t the topic of his sermons, and she could be clear and direct about the services she provided at the clinic. She also had clean, running water.
As Trish learned more about life and work in Telegraph Creek, she became familiar with the “sked”–the term locals and pilots used for the scheduled flights serving the remote communities in the region. With no road access to the community, flights were the only way in or out. Much like in Bella Bella, where the whole community gathered to greet arriving seaplanes or supply boats, nearly everyone in Telegraph Creek headed to the airstrip when a plane was due, whether they were expecting a delivery or not. Trish often joined them, wondering if this would finally be the flight that would deliver the winter parka she had been measured for during her orientation. The jacket still hadn’t arrived, though with the weather warming, it was becoming less essential. Fortunately, Trish still had the heavy coat she had bought during her first winter in Bella Bella.
Whenever Trish flew in or out of Telegraph Creek, the pilot often invited her to sit in the co-pilot seat. Trish enjoyed the views from the cockpit, and chatting with the pilot. It was a great way to learn more about the landscape below and to hear news from the outside world or other nearby communities.
Not long after Trish arrived in Telegraph Creek, a new pilot named Walter arrived on the sked. He had recently started flying for TransProvincial–the airline serving the region–after working as a bush pilot in the arctic, based out of Watson Lake in the Yukon Territory. Like the pilot he replaced, he was friendly, confident, and always made time to chat with Trish when she met the plane or was a passenger. When she was a passenger on his flight, he always invited her to sit in the co-pilot seat. Walter’s regular appearance in Telegraph Creek helped Trish feel connected to the outside world, and she looked forward to seeing him.
The occasional social evenings and potluck meals at Helmut’s home also helped Trish feel like she was part of a social circle in the small community. Once, she casually mentioned a recent gathering at Helmut’s to Walter when they were chatting on the airstrip. Walter surprised her when he told her he and Helmut had been classmates at the University of Victoria, where they were both studying to be teachers. He liked and respected Helmut. Trish had seen the men greet each other at the airstrip before but hadn’t realized they had a prior connection. Somehow, that knowledge made Telegraph Creek feel a little bigger, a little less remote.
Trish also noticed how many people passed through the small community. In the spring, a few newcomers joined a dinner gathering at the teacherage. The two young men had arrived for the season to operate a helicopter out of Telegraph Creek. One was the pilot, and the other a mechanic. They were there to fly guides and sportsmen to and from hunting and fishing lodges in the area. They also served the large ranches in the area that Trish had heard of, but not yet seen for herself. Glenora was the nearest one, all Trish knew about them was that they had a lot of horses, many of which were used on guiding and hunting expeditions during the summer and fall. She realized there was a lot going on around the little community of Telegraph Creek, and the more people she met, and the more she learned about her new home, the less remote it felt.
Not all encounters, however, left Trish feeling connected or reassured. One such experience was the first “unannounced” visit from Mrs. Fretwell, the nursing supervisor–Trish’s boss, from Medical Services. The somewhat fussy, though not unfriendly woman arrived on a flight one afternoon, catching Trish off guard. Trish was at the airstrip to meet the plane, as usual, when a woman clambered off the plane, greeted a startled Trish introducing herself as the Nursing Supervisor, then made a beeline for the Nurse’s Station. Once the surprise wore off, Trish hurried to catch up to her, inviting her into the kitchen for a cup of coffee, and showing her to the second bedroom to drop off her overnight bag. Meanwhile, Mary, who had also seen the supervisor arrive and recognized her immediately, had scooted back ahead of Trish and Mrs. Fretwell. She quickly slipped into the examination room and put away clinical equipment–equipment that Trish wasn’t supposed to be using. Mrs. Fretwell was checking up on the health promotion nurse, after all, not a clinical nurse.
The supervisor’s inspection of the Nurse’s Station was puzzling. She took notes about everything, including seemingly irrelevant things like the number of teaspoons and other flatware in the kitchen, and the inventory of postage stamps in the office. Was she trying to determine if Trish was losing teaspoons, or using government stamps for personal mail? Trish couldn’t help but feel uneasy.
The tension escalated when Mrs. Fretwell inspected the examination room and noticed a suture kit out on the counter–Mary must have overlooked it when tidying up.
“What on earth do you need a suture kit for? You are supposed to be running pre-natal clinics!” she said sharply.
Trish was at a loss for words. Surely the supervisor understood that patients came through the clinic, whether a visiting doctor was present or not. Their health needs didn’t come and go on a schedule, but in that moment, her explanations felt inadequate.
Unfortunately, that night Trish was unable to avoid the reality that she was providing clinical care when necessary. Late in the evening, after Mrs. Fretwell had retired for the night, a heavily pregnant woman arrived at the clinic in active labour. Trish quickly and quietly prepared the treatment room and got the woman settled.
Babies were not meant to be delivered in Telegraph Creek–especially without a doctor present. According to the direction at the time, all pregnant women were supposed to travel to Terrace two weeks before their due date and wait to give birth there. However, most women refused, preferring to stay home with their families as their due dates approached.
On this night, the labouring woman now occupying the treatment room was struggling, and not quietly. As this was the woman’s fourth pregnancy, and it had been uneventful, Trish expected the delivery to progress quickly–quickly enough, she hoped, that it would be all over with by the time Mrs. Fretwell woke in the morning. If the Supervisor found a wayward suture kit distressing, Trish could only imagine what she would think of this new turn of events.
With an even louder shriek, the woman bore down and pushed, and the baby’s head finally appeared–but something was wrong. For a moment, Trish wasn’t sure what she was looking at–the mass emerging from the woman did not resemble a baby’s head. As she stared, she heard a second shriek, this time from behind her. Mrs. Fretwell, woken by the escalating sounds of distress, had entered the room, and was also staring at the pulpy, misshapen mass. Within seconds, Trish realized the issue: the amniotic membrane was covering the baby’s head. She firmly told her supervisor to leave the room, and glancing quickly over her shoulder, she saw the woman was already scrambling toward the door. Trish turned back to the mother and newborn and carefully cleared the membrane away from the baby’s face before suctioning the tiny nose and mouth.
Speaking gently to reassure the mother, Trish guided her through the final pushes, and the baby was born without further complications. The baby boy appeared vigorous and healthy, but Trish was concerned that he might have aspirated amniotic fluid before she had cleared his airway. Aspiration can quickly lead to a life-threatening infection in newborns if not detected, or if left untreated, so the baby needed to be flown to Terrace for a chest X-ray to rule this out.
Trish had no choice but to discuss the case with Mrs. Fretwell. It was clear to Trish that her supervisor, who was still a registered nurse despite her administrative role, was neither comfortable nor confident in a clinical setting. Trish considered the situation, the newborn was not in any immediate distress, or in need of any urgent treatments or interventions, but he did need to be assessed in Terrace, so they could do a chest X-ray. Trish suggested transferring the newborn to the hospital in Terrace for assessment, with Mrs. Fretwell accompanying him as the medical escort on the next flight. After a thorough discussion of the implications of sending the baby to Terrace, and the risks of keeping him in the village, both the mother and the supervisor agreed the baby should be transferred to Terrace.
Later that morning, Trish walked down the hill to town to call the hospital in Terrace, requesting an incubator to be sent to Telegraph Creek on the sked later that day. After confirming the transfer, Trish climbed back up the trail to the village feeling relieved–the newborn would get the care he needed, and Mrs. Fretwell was leaving the village, earlier than planned.
When Walter flew in that afternoon, he personally delivered the incubator to the Nurse’s Station. He needed to carry on to another community, but he would return in a few hours to transport the newborn and Mrs. Fretwell. Trish plugged the incubator in to ensure it was warm and ready for use. Her previous experience in the Neo-Natal Surgical Unit in Alder Hey Children’s Hospital in Liverpool gave her confidence in operating the equipment and explaining how it worked to the mother, so she wouldn’t be alarmed when they placed the baby inside.
Trish explained the incubator was necessary for keeping the newborn warm and providing supplemental oxygen during the flight. The small plane Walter was flying that day, an Otter, didn’t have a pressurized cabin. That meant the oxygen level and air pressure in the cabin dropped as the plane climbed. If the newborn had aspirated amniotic fluid, and he was developing a lung infection, he may not be able to compensate for the changes.
When Walter returned, Trish carefully placed the infant into the incubator under his mother’s watchful eye, reassuring her that her son would be well cared for and back in a few days. Together, Trish and Walter carefully moved the incubator back onto the plane, secured it, and made sure Mrs. Fretwell was comfortable as the medical escort. She really shouldn’t have to do much on the transfer, other than keep an eye on the baby, and the gauges. Trish stayed and watched as Walter taxied the Otter down the airstrip and took off. As the small plane banked and disappeared beyond the hill, Trish became aware her eyes were dry and scratchy, and her limbs heavy, as if all her energy had just flown away like the plane. She had been up most of the night, and now that the baby was on his way to Terrace, and the visit from her supervisor had mercifully ended, weariness was taking over. She hoped there wouldn’t be anyone waiting for her at the clinic. She ran clinic hours every weekday afternoon for anyone in the village who had an ailment they wanted to show her. She still had to finish the documentation for the delivery during the night, and the transfer of the infant to Terrace.
She finished her workday in a haze of exhaustion and went to bed as soon as she could. The following morning, despite many hours of sleep, Trish still felt heavy and tired. She wondered why, she regularly was up through the night with patients, that wasn’t new. By afternoon she noticed she was losing her voice. The mysterious laryngitis that she had experienced so many times as a nursing student seemed to be back. She thought little of it, but tried to limit situations which would require her to do much talking. She hoped it would pass quickly. Still feeling tired, she went to bed early for a second night in a row.
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Author’s Notes
N.B.1: In 1970, as Trish was introduced to the people of 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 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.