“It’s the journey that counts,” they say, “not the destination.” I still learn. Learn! Learn!
I have travelled this far though, not counting years, but single steps. How many? How many!
Psychology degree, nursing degree. Who counts? How boastful! Nursing and
education are the crossroads where my passion meets praxis and where wisdom of the past
nurtures the future.
Who am I? A small plant, too old to bend to the wind and too young to stop wondering about
the sun. What do I know? My journey is only midway. I dream about the destination, remember
to enjoy the process, and keep an open mind. –Mar’yana Fisher
I entered the nursing profession later in life, and it has been my passion and a humble honor for the last five years to support patients with life-limiting illnesses and their families, reduce physical and emotional suffering, and promote quality of
life within my role as a palliative care nurse. However, the extent to which palliative care is urgently needed across various practice settings for structurally vulnerable individuals in Canada came to my attention quite recently. In fact, the recent
worldwide pandemic highlighted for me two crucial aspects of palliative care in Corrections Canada: A tremendous gap in services, accessibility, and infrastructure on one hand, and acute demand on the other.
I wish I had a compelling story to describe how I came to such a realization or a harrowing account from the life of a single inmate to sway your perceptions for the sake of my cause. There are many—but they are not my story to tell. This reality
bloomed to life before me from the unheard choir of inmates’ voices in a body of literature on palliative care.
As current graduate student, I engage in extensive research on various topics to complete my assignments. Through my explorations, I observed that while some strides have been made to achieve equity and equality that address palliative care needs of disproportionally
disadvantaged populations, the issue of palliative care for inmates is predominantly excluded from the nursing literature.
From a few articles that discussed the topic, I learned that retributive and corrective approach of prisons, current dominant views on crime and punishment, and the provision of public safety create a disconnect between ethical obligations toward inmates
with life-limiting illnesses and justice. Specifically, significant moral and philosophical tensions exist between the punitive nature of correctional settings and access to palliative care for Canadian inmates.
So, instead of a compelling story to describe how I became a vehement nursing advocate for accessible palliative care for inmates and a firm believer in the provision of dignifying death for all, I can say that this profound awareness was born
from serendipity.
I embraced this serendipitous learning, but quickly found my efforts to address the gap in access to palliative care in correctional settings met with ignorance within and beyond the nursing profession. On numerous occasions, I heard, “Oh, I never
thought of that!” or worse, “This is not a nursing issue.” I refused to be discouraged! Instead, I realized that a change of paradigm, a fundamental shift in public perception, is needed before confronting this multifaceted and complex
issue.
An overwhelming task. Where does one even begin? To calm my swirling thoughts, I put pen to paper. From a quieter mind, I can think clearer—less rooted in discouragement and more grounded in action. This compelling poem was born from this exercise,
and I hope it highlights for you, too, the innate value of human beings, a demand for dignity for all persons, and the realization of shared accountability for transgressions.
DEATH HUMILITY
New age is ripe with rhetoric.
Propaganda machine unearths trendy fragments
better than archeologists.
Human fallacies surpassed dinosaur bones, 2:1.
We display humanity issues like Christmas decorations:
racism, inequities, dominant hegemonies, Black
lives, power imbalances, and colonial policies are brandished
across the social media and we reach for them, as prayers,
in a display of righteous for our neighbours.
In this marketplace of empty acknowledgements
I feel like a forgotten fossil, chained and judged.
My cause is shunned by the decent sorts.
Where is the glory in endorsing the unsightly mob,
whose sins have been proven
and life bartered
into the currency of captivity
to renumerate for our transgressions?
Yet, I hardly seek to undermine your discomforts
and ask of no favours to improve my life
that has been already confined to its fate.
Instead, I appeal for a dignity in the dying hour,
for a freedom from pain, humiliation, and harshness of the environment
as I come to an end.
Perhaps audaciously, I implore you to ponder
how my old and sick peers will have no accommodations
for a wheelchair or a bathroom or to see a friendly face…
How a nurse will doll out a meager dose of opioids to support my agony
as distrust runs deep between us.
New age is ripe with opportunities
to embrace a paradigm,
where my incarceration will be enough…
to satisfy the insatiable appetite for justice in unjust society,
leaving the dignity of my death intact,
as is my right!
This coming September, I will continue my learning journey as PhD student at University of Victoria. My goals are to re-envision current social and economic policies and develop unique community partnerships and practical strategies that will make palliative
care more accessible for Canadian inmates. I aspire to achieve these goals through applied research and relational engagement with correctional and governmental systems. Until then, I will summon my muses and wield my pen to foster awareness of this
important matter.
Despite the intricate complexities of ethics, philosophy, human dignity, and societal beliefs with regards to justice and punishment, the responsibility to support dignifying death lies within all of us. Perhaps there are no coherent ways to express or
identify what a “dignifying death” is or how to cross the divide between retributive justice and unnecessary sufferings. Possibly, only when we pause and examine our attitudes towards death and dying can we find a way to move forward—reclaiming
our morality and nurturing views that embrace the intrinsic worth of humanity.
Mar’yana Fisher, BA, BSN, RN, is a graduate student at the University of Victoria in Victoria, British Columbia, Canada, and a member of Sigma’s Xi Eta at-Large Chapter.