The English Patient: Michael Ondaatje's characterization of the nurse-patient relationship.

I recently used The English Patient (both the novel and the movie) with an undergraduate health science class to explore the unique character of the patient-provider relationship. Through the interactions of a young Canadian nurse and her "English" patient, author Michael Ondaatje presents an interesting view of the nurse-patient relationship. In this essay, I use quotations from the novel to demonstrate that Ondaatje sees the nurse-patient relationship as somber, sensual, and compassionate. The theme is particularly relevant to nursing students and those who teach them. As World War II ends, Allied Forces withdraw from the African desert, as the retreating German armies had done, across Italy and northward toward home. They drag parts of the desert, its people, and its culture with them, thus changing Europe forever. Hana, a young Canadian nurse, chooses to remain behind in a bombed-out Italian villa to care for a dying man she calls simply the English patient. He is too sick to travel, and she will not abandon him. Through Hana's interactions with her English patient, Ondaatje defines the nurse-patient relationship. It is somber, sensual, and compassionate. A SOMBER, GROWN-UP WORLD Death and dismemberment come directly at the battlefield nurse. Soldiers die in her arms. Colleagues are alive and laughing one minute and dead the next. The responsibilities and consequences of wartime nursing are both awesome and grim. A nurse abruptly leaves girlhood behind. Ondaatje puts it this way: "Nurses too became shell-shocked from the dying around them. . . . They would carry a severed arm down a hall, or swab at blood that never stopped, as if the wound were a well, and they began to believe in nothing, trusted nothing" (Ondaatje, 1993, p. 41). It is no different for Hana, a 20-year-old Canadian nurse and Ondaatje's protagonist. "She swabbed arms that kept bleeding. She removed so many pieces of shrapnel she felt she'd transported a ton of metal out of the huge body of the human that she was caring for while the army traveled north" (Ondaatje, 1993, p. 50). Perhaps in an effort to depersonalize things, everyone was simply, Buddy. "Hello Buddy, goodbye Buddy. Caring was brief. There was a contract only until death" (Ondaatje, 1993, p. 51). War had brought a coarsening and a hardening that simply snuffed out girlhood. "Her face became tougher and leaner" (Ondaatje, 1993, p. 50). CARING: A SENSUAL BUSINESS Ondaatje portrays nursing as intimate and sensual, but not sexual. He describes how Hana cares for the burned body of her English patient. She "pours calamine in stripes across his chest, where she can touch him. She loves the hollow below the lowest rib, its cliff of skin. Reaching his shoulders, she blows cool airs onto his neck, and he mutters. . . . She puts her hand into her pocket. She unskins the plum with her teeth, withdraws the stone and passes the flesh of the fruit into his mouth" (Ondaatje, 1993, p. 4). He is oft en unable to sleep at night. "She reads to him. . . . He listens to her, swallowing her words like water. . . . If it is cold she moves carefully into the bed and lies beside him" (Ondaatje, 1993, p. 5). Later in the book, Caravaggio, a Canadian vagrant/refugee who had taken up residence with the nurse and her patient at the villa, tells Hana that what she feels for the English patient is not love, but adoration. Hana's response provides a glimpse of the character of the nurse-patient relationship. "He is a saint. I think. A despairing saint. Are there such things?" She continues, perhaps equating a nurse's care with affection and protection, "Our desire is to protect them. . . . I can love him" (Ondaatje, 1993, p. 45). These sentiments differ from those Hana feels toward Kip, a young Sikh and an officer in the British Army who specializes in defusing bombs; with Kip, Hana shares a sexual relationship. The words and sounds between lovers differ from those between nurse and patient. …