I love my work, and it’s always been about the quality of care. I wouldn’t have been here 25 years if it wasn’t something to take tremendous pride in.
Dan Chisholm, RN
This year Casey House marks 25 years of providing compassionate, exemplary HIV/AIDS care. Below, RN Dan Chisholm, who was part of the very first team of nurses hired at Casey House in 1988 and who has continued to serve at Casey House ever since, reflects on what this anniversary means to him. All of us at Casey House are proud to have Dan and the many other excellent, caring nurses on our team.
We’re pleased when we get to send someone home. Fifteen years ago, we didn’t get to do that. I started at Casey House in November of 1988; it had been open about eight months. I came from ICU at a major downtown hospital. I had heard of Casey House and that it was a great place, and I felt like I needed to be of service to my community. And the staff was a majority gay, which was liberating. At the time we didn’t know that much about AIDS. We just knew it was deadly. There was a lot of stigmatization, homophobia and AIDS-phobia out in the community. Meal trays weren’t delivered because dietary staff were afraid to go in; partners were being left out — there was a lot of hysteria. I knew transmission was sexual, so I had no fears or qualms. And Casey House was grassroots, the community rallying together because our loved ones deserved better. You can have a building, but if you don’t have caring compassionate staff . . .
When I arrived the house was full. Not all were actually dying, but most were bed-dependent. We weren’t experts in the beginning. We were just managing symptoms of pain and nausea. We became experts in pain management. If you could manage the pain and symptoms, they wanted to live and enjoy another day. It seemed somewhat never-ending — lots of deaths, there were no treatments. I was always asked if it was depressing, but strangely it was sad but not depressing. A lot of death happened here, but a lot of life happened. On the good days we celebrated and on the bad we consoled. There was a lot of laughter. Coming here from a hospital was like coming in from a violent storm. We focused on quality of life. No one was left alone, not until that final breath. That’s what we did. We talked people through, coaching them through the dying process. It was very sad but relieving that this courageous battle was over. We developed rituals: the candle in the front window that was lit when a resident passed. A memory book with the date, time and a couple of sentences describing each client’s uniqueness and character. It was acknowledging but also cathartic. You see a name and it all comes back to you.
There were many joyful moments here. Five or six years ago, a client who had been in and out many times over two years was sent to the hospital for chemo that didn’t work. They offered palliative radiation, but instead he came to Casey House. He wanted to go home to northern Manitoba to die. We got all the resources together but had a lot of trepidation; we weren’t sure he was going to make it. And if he dies in flight there are all sorts of legalities. I worked a full day. I was tired but exhilarated; it was someone’s dying wish and I was a part of it. We took an ambulance to the Island airport and left about 9 pm. I sat beside the client and held his hand and talked to him. It was hard to tell, but I think he knew he was going home. I saw the northern lights and thought, “It’s a sign.” They were so incredible, a spiritual experience. He couldn’t swallow, so I administered a painkiller, and he slid in and out of a comatose state. We landed in a northern town at 3 am, and the ambulance got him to the hospital. About 20 family members were outside to greet him. I said my goodbyes and got hugs from everyone. He died three days later, but I was just thankful that he got there. It’s just one of the many wonderful moments that Casey House could give back to our clients.
At that time we called them residents. Now they are clients. The face of AIDS has changed. People are living longer; they come in for supportive care, for rehabilitative care. We focus on getting them out in good physical and mental health. This is a beautiful old building, but it was not meant to be a medical care facility. Wheelchairs and walkers are hard to manoeuvre. It’s exciting because we’ve been discussing the day programs for many years. It’s so needed in the community and will increase our capacity, extending and enhancing the services we already have. If we keep people healthy, we keep them out of emergency rooms and hospitals. People often get lost in the system, but those who are isolated will be able to connect. Community-based health organizations are so needed, more so in Toronto because this is where the vast majority of HIV is. We’re in the centre of the city, we’re accessible, people don’t always have to make an appointment. One of the things that worries me is the increase in HIV. It is scary and worrisome. Why is this happening? There might be the perception that it’s a manageable disease, but it is also a lifetime commitment to medications. There’s been a tremendous amount of education, but we need to do more.
I love my work, and it’s always been about the quality of care. I wouldn’t have been here 25 years if it wasn’t something to take tremendous pride in. I will miss this building tremendously. It has a lot of memories. But I’m going to take all those memories with me.
Originally published in Xtra! magazine, this interview was conducted and transcribed by editor Drew Rowsome.