A purposeful life

As doctors, it is sometimes hard to respond to the stories we hear

Miranda recounted how in the cool of the morning, she hung her washing out to dry. The line was taut and recently cleaned. The clothes pegs she kept in the cupboard in the utility room, just beside the laundry basket, were multicoloured. Each year, old pegs were discarded, and new ones were bought. Usually at the end of February, in anticipation of breezier, drier March weather. It was important to have a few dry days before putting out the first wash of the year. Because once she had started this ritual, there was no going back to using the dryer until mid-October.

This was how Miranda marked her days, her months, her years. Laundry was done every day, even if it was only half a load and sometimes less. Dried indoors in the dryer from October to March, but otherwise, each day she made a trip to the clothesline. Throwing away the old pegs was like divesting herself of all the things she no longer wanted. Every day there was cleansing; sins of omission or commission washed away, the walk from the back door to the clothesline, a symbolic walk away from everything. Every evening, order was restored as the laundry was folded and put away. 

This was what she did. No disruption to the routine unless she was away, which was rare. Once she came home, the first thing she attended to was the laundry. It had a soothing effect. Predictable to an extent, but never completely so. Always the chance of rain. Always the need to be on the alert. And if one was on the alert for washing, it was difficult to be alert to anything else. Other things; her husband’s mood when he came home; whether the baby’s crying would irritate him; whether she would irritate him; a blazing row or stony silence. All of these preoccupations took second place to the laundry.  

One day, she would leave, she said. Walk away from it all. But that would not be for a while. Her youngest child was only one year old. This child would be an adult before she left. But then she would go. Every week, she put €10 into a credit union account that she had furtively set up in her own name. This money, like her determination, was compounding. When the time came to leave, it would be a big enough fund to get her started. But she didn’t think too much about that. Her life didn’t have a big picture. It had small purposeful acts, completed every day to the best of her ability. This was all she could do for now.

Her family didn’t know about her husband. “The shame would be too much,” she said. They would say, “I told you so.” They never liked him anyway. They would insist that she return home with the children. But she knew him. He would never let her do that. When she left, she needed to be sure that there was no risk of her being persuaded to return.

Miranda told her story as if in a trance. As if describing a film she had seen recently. Not obviously conscious of any presence. It was as if she had recounted this story to herself so many times in the hope of convincing herself that she was doing the right thing, that she had matters in hand. She wasn’t expecting a response. She simply had to talk to someone.

“I’d better go, doctor,” she said finally. “I have taken up enough of your time. And anyway, there’s rain forecast, so I’d better get back.” The baby squirmed on her knee.

The doctor got up to open the door and say goodbye. There was so much she could have said, advice she could have given. She could have compiled a list of things that Miranda ‘should’ do. The doctor was familiar with the existing protocols for domestic abuse, but she had learnt that there is no quicker way to shut a person down than by pressuring them to do something that they are not ready to do. This was not Miranda’s first disclosure, so the doctor simply thanked her for coming and said she was sorry that things were so tough. She checked that Miranda had an emergency plan in case of impending danger, had the contact details for support services, and believed her when she said that she and her children were safe for now.

It is only by engendering trust that a doctor remains available to their patient. This trust can be a powerful catalyst for change. In time, Miranda may also learn to trust her family and friends and, with their help and appropriate support services, free herself from this situation. Until then, all the doctor can do is believe Miranda is doing her best and remain available.