Autumn equinox A reflective ritual

A few weeks after Tipkamol turned twenty-five, she visited her grandaunt, Ratana who lived in a popular riverside village located at the foot of a mountain. Tipkamol had rented a cabin 1km west of her grandaunt’s jungalow and 2km north of the Pia River because her grandaunt; Ratana was all for sweating it out; no air-conditioning. Tipkamol wasn’t ready for a long lecture stating how the world was burning, and air conditioning was undoubtedly a factor in that. She would be reminded that the hydrofluorocarbons, the refrigerants used in a/c units, are far more potent greenhouse gases than carbon dioxide or methane. Grandaunt Ratana was a preservationist; observing the effects of global warming on the tropical environment, and learning about the indigenous Thai people.

After a plate of mushroom soup, bitter greens with tomatoes the size of peas, rare roast beef slices as thin as paper, and noodles in a green sauce, they ate melted cheese served with sweet blue grapes as they sat on Ratana’s wooden floor. They casually drink tea while discussing and laughing out loud until deep into the night. At last, Ratana said, “maybe it’s about time you went to your cabin.” Tipkamol crawled up and walked to the door.

“It’s completely dark outside,” she shrieked and shut the door immediately. Grandaunt Ratana lit the lantern and said, “Why not take this?” Just as Tipkamol was about to take the lamp from her grandaunt’s hands, Ratana blew out the flame. Tipkamol was surprised but she suspected it could be a prelude to one of Ratana’s Zen teachings. Yes, she was right.

“It is not just another night; in a few hours, the sun will be exactly above the Equator and day and night will be of equal length. It’s another equinox Tipkamol!” Ratana announced excitedly.

Grandaunt Ratana held Tipkamol by the hand into the darkness and they walked along an unlit footpath through a field into an open scenery. “Darkness is a thing many have come to fear and shy away from. It has become a metaphor for evil and depression, a place held at bay by our electric-lit world. But we must not shut ourselves from our natural surroundings, we must embrace the novelty of the night. A deep unfamiliar sound roused Tipkamol from her reverie and Ratana told her it was the cronk call of a raven ahead. They continued walking as the breeze caressed their faces.

“The Autumn Equinox is a meaningful time of year to honor the harvest. Whether of a “real” harvest of the things planted in your garden or the harvest of efforts and intentions for your life path that you set earlier in the year,” explained Ratana.

Thick cloud cover prevented the moonlight from illuminating their way ahead. Yet, as their eyes began to get used to the darkness, the landscape around them revealed itself in a new light – albeit a shady one. “Walking at night is a powerful way of reconnecting. When your vision is reduced, your other senses are sharpened,” Ratana stated as the night became chilly and darker.

Tipkamol was so engrossed in her Grandaunt’s talk that she barely knew they were back at her Grandaunt’s half-timbered facade. “Like other seasonal transitions, the autumnal equinox is celebrated in cultures around the world. For instance, a few years ago, I witnessed the Mabon festival celebrated in Thornborough Henges in North Yorkshire. It was such a delight; it typically involved apple picking, feasting, and making an altar for the Celtic god of harvest. Also in Japan, practitioners of Buddhism honour the dead during the six-day holiday of Higan, celebrated during both equinoxes. Indigenous cultures recognized earth-based wisdom and understood that the four focal points of the year: the Winter Solstice, Spring Equinox, Summer Solstice, and Autumn Equinox; are illuminated stages of an inner spiritual journey – a spiritual cycle that the individual takes within themselves,” Ratana expounded passionately.

They both got onto the wooden porch and sat in the recliners as Ratana continued, “The changing seasons are key points in the cycle of life in nature, and within this cycle, many ancient cultures perceived a powerful deeper message for humanity. The many elements of autumn either intrinsically deliver happiness or trigger memories of past joy from which we can keep taking bites, as from a freshly baked apple pie. While we celebrate the seasonal joys, we should remind ourselves that they are blazes on a trail that goes deep into a beautiful forest of wisdom and meaning.”

“On the Autumn Equinox you may want to honour all that you have in your life and shift your consciousness from one of lack to one of prosperity and gratitude in some ways through a small ritual or ceremony,” she advised.

“Would you care to join me for my favorite ritual?” she asked. “I take the 15 minutes before and 15 minutes after the precise moment of the equinox to sit quietly on the ground in thoughtfulness and meditation and open my mind and my senses to the intelligence of nature all around,” Grandaunt Ratana disclosed. “In this time spent in thoughtfulness around the moment of equal light and equal dark, I acknowledge my personal growth cycle and ask for harmony and balance to be the fertilizer in the soil of my life’s garden,” she added.

Ratana went on to prepare the Autumn Equinox ritual on her perfectly rolled lawn. She placed a red candle in the center of a dish, made a circle of salt around the edge, then placed rose petals over the salt. Ratana repeated the process on another side. Some minutes later, she invited Tipkamol into one of the circles. They sat facing each other, cross-legged in a half-lotus position. They took some time to get comfortable, sitting peacefully and breathing in and out to calm their minds. They lit the candles and upon the Autumn Equinox, amid the chilly air, beneath the noble starry black, they observed the beauty of the moon giving thanks. They visualized their minds, bodies, and spirits being cleansed, with new doors opening for them as they transitioned with the planet.

Dancing in the Rain: A Dream Deferred but not Denied

Abigail drove Jason to school on a Monday morning. Jason was excited and proud to have his grandma by him for his “show and tell”. His grandma was his most favourite person and he didn’t have a hard time telling his class that his grandma was a practicing nurse for thirteen years. Abigail enjoyed answering several questions from the children. It was so much fun. Finally she watched her grandson settle in his class. She had a cordial talk with Jason’s teacher, before she left to pick him up again at school closing time.

Abigail drove to the Crowell shopping mall, some distance away from Pearson Elementary School. As she was busy shopping for fresh groceries; moving up and down the aisles, she came across a very familiar face. The face hadn’t changed much. Abigail pushed her shopping trolley around and passed by the young man to be sure. He took no notice of her. She turned around again to see if it was really Onyeka; the nine year old boy she nursed many years ago at National Orthopedic Hospital, Igbobi. She hastened to follow him from behind, and overtook him.

“Are you Onyeka?” she said aloud. He heard her, and looked towards her direction. He took a closer look at her, and pointed his finger across to her, trying to be sure if she was the most compassionate nurse he used to know. “Nurse Abigail?” he asked.

“Yes, I am Onyeka,” he answered, with a loud shout. “Where did you go all these years? We wished to contact you, when we were told you left NOHIL, but we had no one to ask your whereabouts. My parents hated to ask anything about you from Nurse Rachael because we knew she didn’t like you at all,” he said.

“You did?” you were such an adorable boy back then, I am so glad you got your miracle,” she replied as she hugged him as firmly as she could. There was an explosion in her brain… the good sort… the type that carries more possibilities than she could be conscious of… but there were hundreds of questions there in that buzz of electricity… “I can’t believe this; you can walk now and you look great! How did this happen or is this really not Onyeka?

“Actually, I have been walking for over twelve years now. In fact, I had my spinal surgery a few weeks after you resigned with the help of Dr Willams Abade. He told us about his friend; Dr. Yasir Salimon; a renowned Nigerian-American neurosurgeon and academic who was starting out a healthcare development company with his wife, Perpetual. The company was launching out with free spinal surgeries to underprivileged Nigerians in Lagos state. That was my miracle! My condition fit perfectly with the description they needed. Dr Willams Abade provided them with all the medical history needed for the surgery.”

“Originally, Dr Willams Abade thought I would need two separate surgeries to complete the realignment. He also thought I might need to wear a body cast after the operation.

However, after examining my scans Dr Yasir Salimon was able to combine the surgeries into one and used only a brace on me. He came to Nigeria with implants and equipment from the US so that they could operate for free on people with spine-related problems like me. He was the lead surgeon and a couple of others assisted him at the time. They carried out about 10 surgeries and mine was one of them.
“I finally got to experience a completely unconscious ability to walk, stand, and chat with people without being reminded that I have pain to attend to and that’s what I call a medical miracle.”

Two months after my surgery and recovery period at home, I was ready to start the hard work of rehabilitation, which began with range-of-motion exercises, gait retraining and pool therapy. Rehabilitation was a slow process, it took 12 to 18 months; I underwent six weeks of inpatient rehabilitation. After completing six weeks inpatient rehabilitation, I began outpatient rehab. I stood for extended period of time and practiced walking with a cane. After six months my gait and walking mechanics had greatly improved.

My parents, older sister; Ada and I were not discouraged, we had our eyes on the prize — numerous dancing at family celebrations, afternoons of sunshine and playing and countless years of active companionship.

Dissimilar to numerous others with my background, I received a scholarship to study medicine in Stanford through the Agency for External Aid, a Nigerian government program which is targeted at improving the quality of life for Nigeria’s most vulnerable communities.

I went on to receive a combined MD/MSc degree at Stanford Medical School, Stanford, California and I have recently completed my post-residency fellowship training in complex nerve reconstruction at Louisiana State University and complex spine surgery at the Medical College of Wisconsin in Milwaukee; all in the States.

His narrative was quite unbelievable, shocking really. Abigail’s mind was sent reeling, unable to comprehend or process the array of achievements that he had grossed. She felt giddy with excitement. She wanted to run, to shout, and to tell everyone that her Onyeka had risen above his medical limitations. She felt pumped, excited, more alive than she had ever thought possible.

Over the years I have learnt never to cave in when bad circumstances occur. I realize that whatever happens to me only breaks the old me and build the new me. It’s my choice to stay down when things go wrong and never allow what happens to me, keep you down. I see every situation as a chance to become what I have always intended to be, hard times will not make me bitter but will leave me better,” he added with his trademark smirk that Abigail recognized.

Dancing in the Rain: No Silver Lining

Whenever Nurse Abigail left the children’s ward at the end of a shift; she often told herself that none of the patients or their families existed outside of the building. It would be as though she’d walked out of a cinema, and she’d left behind all their tragic stories; but there was one patient who refused to cooperate.

Onyeka was nine-years-old, the same age as her youngest son at the time, which made it that much harder. He had been brought to the National Orthopedic Hospital, Igbobi a week ago after a sudden fall on a concrete floor while dancing in the rain. Nurse Abigail first nursed Onyeka after he’d been in the hospital a few weeks. Dr Willams Abade and his team had tried every type of non-surgical treatment including pain pills, shots, and physical therapy – all with little or no improvement. It seems that day after day, it just gets worse.

According to his MRI results, the doctors learned that his disc had torn between the L5/S1 regions of his spine and was no longer hydrated; not as a result of the fall but a birth abnormality. The fall only evoked the reality that Onyeka had a spinal deviation called congenital scoliosis. On the MRI image, his disc appeared as a black shadow; spine surgery was his best bet. His parent mulled over their two options: either to let Onyeka live with an excruciating back pain; whilst confined to a wheelchair forever or take a chance to restore his life through surgery. The first options seemed more likely because his parents had exhausted their possibilities to pay for his medical bills. They had already sold a few prized valuables and were now subjected to asking relatives and friends for assistance.

Onyeka often needed to be catheterised; to drain his urine because he couldn’t do it himself and also needed help to clear his bowels. However he kept a positive attitude; holding on to his fond memory of being able to run around like a healthy child. He would zip around the ward in his wheelchair, visiting other children and sharing hope, always keen to meet the new ones. Every weekend his family would come in to visit him. His sister; Ada would rush up to him and shower him with hugs and kisses and tell him how much she had missed him. It was wonderful, but more than ever he wanted to be back on his feet. “I would walk out of this hospital unaided,” he said to Nurse Abigail each time she attended to him. His faith gave rise to the optimism that filled her heart each time she saw Onyeka.

One afternoon shift Nurse Abigail came for her regular checkups and monitoring of the pain that radiated from Onyeka’s back. She gave him a second dose of acetaminophen meds and two spinal injections, then he told her he wanted to speak to his mum who had gone into the doctor’s office. She went on to get his mum. The door was ajar and his mother was seated next to her husband while the doctor addressed them. She listened from a distance.

“Onyeka needs surgery urgently; he has a spinal disorder that could lead to a tumor that would trap his spinal cord, causing it to stretch as he grows; this could make him lose his mobility totally if not dealt with.” Dr Williams explained.

“The good news is that we can carry out an anterior/posterior fusion,” he continued, now pointing at a spinal anatomy chart. We would make an incision in the front (anterior) of his body and enter the spine through his stomach. Through this incision we should remove the disc and attach cadaver bone to the front of his spine. Cadaver bone is used to help the spine fuse. Next, we would make another incision through his back (posterior), attach a piece of his hip bone to the back of his spine, and stabilize (support) everything using titanium screws.”

Listening to the explanation of the procedure left Onyeka’s parents afraid but also excited at the possibility of their child living life again. They asked for the price of the surgery and were told that the surgery costs 1.3 million naira, they were bewildered. There were tears in the room. Onyeka’s parents had known surgery was on the horizon for their son, but it’s never an easy conversation or decision. They obviously couldn’t afford the surgery. Without surgery, Onyeka’s condition would continue to deteriorate. Onyeka’s dad explained to the doctor that they hadn’t the means to raise the money. He agreed to the sad options of Onyeka remaining in a wheelchair until a miracle.

They were expecting some money from the traders’ monthly Ajo- contributory saving scheme they were involved in. The money was to be used to clear-up the accumulated hospital bills and perhaps get Onyeka a wheelchair. The thought of that made Onyeka’s father stutter for a moment; every part of him went on pause while his thoughts caught up. “My only son!” he muttered. After a wash of cold they both got up from their seats, feeling new warmth to the day. He placed one hand on his wife’s shoulder, “It’ll be okay, it will,” he reassured his distraught wife.

When Nurse Abigail stepped outside at the end of the shift, she tried to pretend Onyeka was just a character in a film, and that his story had no life outside of that building, it didn’t work. When she looked at her youngest son, running around like a healthy nine-year-old, Onyeka came to mind. The thought that Onyeka would be wheelchair bound for the rest of his life brought about a wave of sadness that pervaded her being leaving unbearable hollows. She was sure that Onyeka had a chance at walking again if he had the surgery. “Onyeka’s parents shouldn’t have had to make the decision to stop his treatment based on financial costs if good medical care was affordable,” she cried. “Such an adorable little boy with so much ahead of him shouldn’t the bound by a treatable medical condition,” Abigail was deeply saddened. When the thought of Onyeka came, her appetite was ash on the floor. The food would get stuck, four bites and she was done. It wasn’t until she developed stomach ulcers and almost had a breakdown, that a friend asked why she was putting herself through the emotional pain. “Just quit,” her friend advised, and so Nurse Abigail did. But then she missed caring for patients. She didn’t hate the job; she just found it hard to take in.

The next month she ended up back in a pediatric ward at a different hospital. Nurse Abigail thought she could do it again, but as she heard repeated horrid cases during handover, she buckled. She couldn’t cope with the challenging experience of sharing in the emotions of traumatized children and their families. She tries not to cross professional boundaries yet it seemed almost impossible, she walked out of that hospital and never went back. Now she owns a retail supermarket in the city of Lagos away from the complexities of everyday medical practice. Her son is 21 now. He’s driving, has a girlfriend, plays professional football in Spain, and hangs out with his mates. She often thinks of Onyeka and wonder how he is at 21.