If not for Marilyn

She came north on her way to Churchill in 1965. Clutching her new nursing degree she had plans to join the merchant marine. At that time, any vessel above a certain size had to have a qualified nurse or doctor aboard. Had Marilyn not planned on staying in The Pas for a week things might have turned out differently. She may have realized her dream.

However, she met her husband-to-be, worked at the local hospital, had a daughter and eventually ended up as supervisor of home care for the Manitoba government.

I was a social worker and later served as Director of Income Security in The Pas. We often ran up against case situations where no proper government agency was set up to meet the individual’s needs. Most people think of social workers as people whom "do good works" in the community. However, that is not the case. They are very specialized. Some handle only adoptions, others probation and still others only deal with children.

So, what happens to people who need help in ways not foreseen by government? I will give you an actual case example.

A man from eastern Ontario settled for a few years in The Pas. He was self sufficient on old age pension but soon developed a type of rapidly spreading stomach cancer. When he came to my attention, he lacked the ability to look after himself. He absolutely refused to enter hospital, which was his right.

He could not cook, wash himself or his clothing or even care for his dog. Something had to be done for this man but it was two o’clock just before a long weekend and the wheels of government turn slowly. I decided to form a multi-disciplinary task force where we would pool each department’s resources.

I spoke to the mental health group. The response?

By your own acknowledgement, he is not a danger to himself or others. He is not our responsibility.

I then consulted with the social workers.

The man doesn’t have children who need care and he also does not need marital counselling.

Ah-ha, I’d try the nurses.

He doesn’t need inoculations against diseases and we doubt that he needs help from our nurse in charge of education or the nurse in charge of sexually transmitted diseases.

I knew that the man did not require welfare and I lacked the ability to hire someone to care for him, even for a short time. I even approached the environmental protection branch.

I was informed, "We would really like to help but the guy is not an environmental health hazard."

"Yes," I replied, "But in his poor health, he soon will be. Meanwhile if a good Samaritan calls the Winnipeg Free Press, the stink that will cause will affect all departments."

There was one last department to try. I went to see Marilyn Friesen, the supervisor in home care. I explained the situation.

She was quiet for a long time and then asked, "What is this man’s prognosis?"

"His doctor says that he is on heavy doses of pain medication which is mainly why he can’t care for himself. That said, he will live for another week, possibly two."

Marilyn went away and spoke to two of her staff in private. When she returned in 10 minutes, she had only two questions: Will the patient accept a strange nurse? Is the dog dangerous?

"He is in desperate immediate need. He’ll welcome your staff. The dog? Sometimes dogs are very protective of owners who are ill."

Home care nurses and aids are dispatched under very specific conditions. People may receive help to remain in their homes but a panel must be convened to authorize the intervention and that takes several weeks.

"That won’t help our guy," I commented.

"No," she replied, "and I haven’t the authority to change that, but there may be another way."

I gestured for her to go on.

Marilyn continued, "I may personally authorize community-based, paid workers to visit and attend to the needs of any discharged hospital patient so that he/she may continue to recuperate at home."

"But this guy has not spent time in hospital!"

"Sure he did," she said, "and your records will reflect that, won’t they?"

I nodded slowly. "Sure he did, for weeks, months even."

Marilyn became all business. "I’ll need your report by closing today. My assistant is dispatching a visiting cook and two community nurses who will be hired today for a term of, say, two weeks. There is one more thing though..."

"What do I have to do Marilyn? Cut your lawn all summer?" I asked in jest.

"No, just adopt the dog. Now. Today. You have a farm."

Less than two weeks later Marilyn and I attended that man’s funeral. No one else showed up.

Three years later, in 1999, Marilyn entered hospital for a routine hip replacement. She caught a staph infection and died within hours.

She continues to be missed by all for performing a thankless job well. Thinking back, I suppose she did realize her dream. She made a difference.