This article appeared in the November 1998 edition of the Catholic Medical Quarterly
To Lourdes ... by Jumbulance
Robert Keston describes a very special journey
At this time of year we GPs are usually plagued by requests from patients to fill in forms confirming their fitness to travel. Imagine my surprise when last year I was asked to complete an "unfitness" form. The story began when one of my patients with severe chest disease expressed a desire to go on a pilgrimage to Lourdes in the Pyrenees although she was, without doubt, totally unfit to fly. Acting on her behalf, I managed to contact the Scottish branch of a group called the Across Trust, a charity which arranges holidays for the 'unabled' by means of Jumbulances. These vehicles, which are a cross between luxury coach and fully equipped ambulance, can carry a total of eight bedridden or unabled passengers together with 16 helpers including a doctor and nurses, all of whom pay their own way.
As a result of last years contact with this group, I was given the opportunity earlier this year to join an Across trip on a journey to Lourdes: a trip which began at 3ain in the B uchanan Street Bus Station in Glasgow and was scheduled to take 30, hours of continuous travel.
As we headed south down the length of Britain, we picked up passengers at points on the way and reached our full complement in London. Our unabled suffered from a variety of complaints from multiple sclerosis to carcinomatosis. Interestingly, however, the most commonly presenting problems encountered on the journey were indigestion and constipation, not helped by a diet of fry ups and beer in a warm moving bus!
The wheelchair-friendly Dover ferry duty free lounge helped gel the group, then a combination of prayer and medication settled the remaining excited banter for the journey down through France. Nursing chores still had to be performed even in this ward on wheels, but during the next six hours while our VIPs slept, the helpers chatted quietly in the kitchen over warm drinks. Our journey continued through the night with only breaks to change drivers at the "Peages" on the auto route.
On the Saturday morning our happy band of pilgrims arrived in Lourdes, tired and ready to inspect the Chateau which was to be home for the next week. Our accommodation was in shared mixed- ability dormitories. Those of our group who were ill had nurses in their dormitories while their relatives slept nearby and were given a little respite.
The pilgrimage to this healing shrine is like any other holiday except for the fact that everyone also had their own personal reason for the journey- whether it be a memory, a thank-you, a promise or even a hope, although no one actually admitted to a desire for a cure!
Lourdes itself is an amazing place - even if you have no faith. It is not the first but it is the largest healing shrine in Europe, and it has its own unique atmosphere. After the stress of the 36-hour Jumbulance journey, my initial reactions to the place were amazement and speechlessness. Superficially it appeared to be some kind of religious theme park where French architecture had gone mad. It all centred on three basilicas built on top of each other like a Disneyland castle with the Grotto in the rock beneath. The Basilicas, the Springs, Baths and the Grotto are situated in the Domain while, across the River Gave, there is a new 900 bedded "Hospice" with further chapels. The sound of the gushing river pervades the silence of the Grotto with its associations with St Bernadette and the apparitions of the Virgin Mary. There is a soothing atmosphere even when thousands of people are present.
The commercialisation in the town presents another picture, but it is-kept away from the religious sites. The town of Lourdes presents the face of mass tourism - with over 850 hotels and pensions. Its tourist shops are unbelievable in their range of taste - and lack of it! To appreciate them a sense of humour is absolutely essential: I am glad to say this essential was not lacking in our group. On the plus side, however, a variety of unusual solutions have evolved to deal with the huge numbers of sick people who are attracted to Lourdes. For instance, the town now has wheelchair priority lanes on its roads and an alternating one way system to even out the effects of vehicle pollution in the town. As in other resorts throughout the world, the local medical services have a temporary resident problem, but in Lourdes they come in thousands and they are sick even before they reach their destination. (I find myself wondering how a Scottish town of the equivalent size - for example, Dingwall - would cope with a problem of these dimensions).
But back to our group. After a day of rest, the pilgrimage proper began. It was then that the organisation of the Across Trust was seen to pay off. The Teams's work enables the unabled to take part by means of mini-jumbulances which are specially adapted buses with hydraulic lifts to take beds or wheelchairs. They are also used for excursions to vineyards and nearby lakes as well as picnics to the Pyrenees. These vehicles mean that previously house bound and forgotten people can rediscover some of the joys of a normal life. In Lourdes, pilgrims aim to celebrate the sites associated with St Bernadette which include drinking and bathing in the incredibly cold spring water which is claimed to have miraculous properties. They are also given the chance to take part in the daily religious services and processions where the sick and disabled are given pride of place.
When I returned home the question on everyone's lips was "Have you seen any miracles?" To this question I had to reply "Yes, but not the expected ones." The intangible morale boost, the caring respite for accompanying relatives of the seriously ill, the fulfilment of long sought wishes all produce their own healing and personality changes. Actual cures and miracles are more elusive, especially if you use current guidelines. Even miracles, it seems, are governed by protocols and are examined by the International Medical Committee. Indeed in the last 18 years only three cures have been retained as inexplicable and possible "miracles". Many of the miracles of the last century are cures of a different age when orthodox medicine was impotent - cures from tuberculosis figure prominently. However, healing is "holistic" and can't be measured in double blind trials.
Curiosity and the opportunity stimulated my interest, then, as the pilgrimage progressed I became aware of changes in our group. It became more cohesive and relaxed, we were actively helping each other and living at the slower pace of the disabled. There was time to talk about other things than health in an easy and relaxed way.
Although the two members of our party suffering from carcinomatosis had deteriorated substantially, they still continued with the pilgrimage. The long journey back to Scotland was marred by their rapid descent into terminal illness; but their close family were with them throughout and had shared a last common experience without the burden of nursing care.
Since returning from this pilgrimage, I have been asked whether it is really justifiable to transport ill people on such long journeys. I can truly say I have no qualms about this - it gave these people a chance to live out their greatest desire in life instead of being confined to the premature coffin of four walls.
I found the experience different, disturbing and demanding but also enlightening, fulfilling and fun. I will repeat the experience.
Sequela - On 2 June 1998 - An un-named Italian woman with a twenty-year history of spastic paraplegia claimed she could now walk. The Lourdes International Medical Bureau will now step in. Do you think it was a miracle? (Reported in The Universe on 14 June). That will have to be investigated by the medical bureau.
The office of the Across Trust can be contacted at: 70/72 Bridge Road, East Molesey, Surrey KT8 9HF Tel: 0181 783 1355. Fax: 0181 783 1622.
If you would like further information on the work of across Scotland contact them at: 52 Westermains Avenue, Kirkintilloch, Glasgow G66 1EH Tel/Fax.. 0141 777 6931.
Robert Keston is a part time GP - ex. Principal - from Livingston, Scotland.
Reprinted with permission from Scottish Medicine Vol 17 No 3, 1998.
Mini jumbulances in action
Rest in the shade
Photos by courtesy of Across Trust and Dr Keston