Nokwanda’s Journey (3)

Nokwanda’s Journey (3)Part three in our four-part series tracking the life and death of Nokwanda, an Eastern Cape mother of four. In this instalment Nokwanda slowly begins to let go of her life as her caregivers sing her soul to rest.

Part three in our four-part series tracking the life and death of Nokwanda, an Eastern Cape mother of four. In this instalment Nokwanda slowly begins to let go of her life as her caregivers sing her soul to rest.

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17 March

Nokwanda is disoriented some of the time today. She carefully examines photos of Malwanda and her family but doesn’t keep them. She’s letting go of her life.

Dorothy, one of the sisters who has compassionately counselled Nokwanda throughout her illness, immediately checks on Nokwanda’€™s condition when she comes on duty in early afternoon. She finds Nokwanda on the floor next to her bed. Nokwanda attempted to deal with a soiled pad on her own and fell out. Dorothy heaves Nokwanda back onto the bed, then rubs baby lotion onto the parched skin of all the patients in the room. Nokwanda throws off her covers to expose her chest for the lotion like a cat’s invitation for a tummy rub.

18 March

Sarah has brought in two more roses for the vase of flowers. One of the roses is a perfect peach on the verge of opening, with strong perfume.

Nokwanda’€™s condition has deteriorated. The seizures began before dawn and, unable to speak, she barely responds to communications. Her seizures come on every hour. Her eyes open wide, in a glazed stare that looks beyond the room. The pupils begin to spasm, the eyelids flutter. Her mouth yawns into a silent scream and her eyes roll upward like a window into terror. Her tongue is coated with pale yellow scum from the sores and blood gurgles in her mouth. She raises her arm, reaching to the heavens. This looks like the end.

Five nurses gather around her in the morning to sing a hymn. Later a young preacher with a grand voice lays his hands on her and prays.

Across the room, Sindisa, who has a huge abdominal ulcer, howls with pain when she passes any fluid. The sound is like a piercing death song.

In her occasional lucid moments Nokwanda insists that her Coca Cola and the bending straws be shared with Sindisa.

‘€œMy heart has stopped speaking to me now,” she states, a fact of this day, as though she is discussing the weather. The seizures continue to occur hourly until Sarah orders some morphine at 2200 hrs. Finally Nokwanda sleeps.

Sarah does not expect her to live through the night.

Sleep… prepare for the journey ahead, this dying is hard business. You will not leave this earth easily – the red dust of the land you have walked that has powdered the leather like soles of your feet, the feathered grasses that tickled your ankles – it will not relinquish you willingly.

This is a huge mistake.

The hospital is quieter at night. The sisters are less harried; the television has been turned off.

At dusk a tough grey tabby cat strolls into the ward and leaps onto the reception table, settles down on the papers and washes. The feline owns this ward.

19 March

At dawn Nokwanda opens her eyes and requests porridge and a drink of water.

Then she has a seizure.  

Later in the morning the seizures abate but her speech is slurred and her voice has become deep and raspy. Like she’€™s tipsy – but she knows what she wants. She’€™s good-natured, making occasional jokes about the life that goes on around her.

Nokwanda insists on some Coca Cola, but she vomits it back up. She vomits baby food as well. She argues several times throughout the day for more Coke but acquiesces to a decision to stay with water to avoid more vomiting. Her fleece robe has large bloodstains on it because she continues to have trouble keeping the IV in her arm. The wrangling between Nokwanda and the sisters flares every time she removes the IV herself.   She has vomited on her bright pillowcase. A sister steps forward to help and offers to take the soiled items the hospital laundry.

Nokwanda searches for someone from either family to visit. The hospital provides for the needs of those who are distanced from family by encouraging visitation from the clergy. Sarah and Dorothy are especially pleased when, during a visit from a nun, Nokwanda spontaneously announces, in a loud and unusually robust voice, to all who can hear, “I…am a child of God!”

Dorothy brings in four other nurses of religion for an hour of preaching and prayer with the women in the room. Nokwanda remains somber and responds to them with her eyes.

The peach-coloured rose is still perfect. When she smells it, her face breaks into the irrepressible smile she releases when she comes close to something she loves.

Nokwanda meets the night with gay nonchalance about the tomorrow. She promises to keep the drip in her arm, and to refrain from annoying the nurses.

20 March

The hospital bustles with normal early morning routine but there is a vacuum of silence in Nokwanda’s room. The white privacy panels have been arranged around Nokwanda’s bed. The hospital spread has been pulled over her head.

She’s gone.

Dr Sarah was with her when she died. During morning rounds Sarah found Nokwanda gasping with imminent death. Sarah and a sister stayed with her and prayed, Sarah in English, the sister in Xhosa. While the last of the young woman’€™s life drifted away, the prayers turned her over to God. Sister closed the eyes, made sure the mouth would remain closed with a pillow, and Sarah continued her rounds, knowing all that was humanly possible had been done, and now the rest is up to the forces beyond.

Nokwanda… who became a woman and then a child again… who went to hell before going to heaven.

Three sisters clear out Nokwanda’€™s personal belongings to make room for another patient. They are matter-of-fact about their duty but the chatter is missing. Most things are simply transported across the room to Sindisa: the Coca Cola, bending straws, washcloths. Nokwanda’€™s clothing is stored for her mother. The other patients in the room are somber while they watch. Sindisa says, “I am sorry about Nokwanda.”

Sindisa’€™s bag of urine has more blood in it today.

In death Nokwanda’€™s face is beautiful again as though the AIDS left with the life. Some of the bending straws she used for drinking are scattered on the floor under the bed.

An hour later a woman arrives, asking for Nokwanda. Joyce has asked this neighbour to come to hospital to find out about Nokwanda’€™s condition because she cannot come herself. Dorothy takes her into the duty room to explain.

Joyce tarried at the neighbor’€™s house on her way home from work. Wearing the same gum boots she had been wearing on the day Nokwanda told her she had AIDS, Joyce stopped when she saw the same women at her house as had been there on that day. At first she waved to her surprise guests and walked toward home but then she froze. Her eyes searched the scene from the distance. When she saw her daughter was not among the visitors, without a word spoken, she raised her apron to her face and began to weep.

The women assured Joyce that Nokwanda was at peace when she died and that her last day was good.  

To be continued.