Hazel McHaffie

Three months and counting

Milestones are useful hinges for reflection: three months ago this week the first Covid-19 death was reported in the UK. Since then, as per the official statistics yesterday, in this country there have been a further 39,727 deaths recorded where the deceased had a positive test for the virus. Say that again slowly – THIRTY-NINE THOUSAND SEVEN HUNDRED AND TWENTY SEVEN DEATHS. Not to mention the legion of unconfirmed cases. These are indeed unprecedented and calamitous times, so it seems fitting to consider something quite different here. Not a book; not a scientific paper; not even a film. But a newspaper article.

A beautifully written article in the Review section of the Guardian on Saturday, and one of the most sobering and moving pieces I’ve read in the proliferation of writings about this devastating disease. I wasn’t surprised to find that, before going to medical school, the author, Dr Rachel Clarke, was a current affairs journalist and documentary maker.

Her usual habitat is palliative care medicine in a hospice, but during this crisis she’s been working with patients dying of coronavirus. Politicians and journalists speak ‘loftily, from afar, an Olympian perspective’, she writes, and listening to them can feel like ‘a mathematical abstraction, an intellectual exercise played out in curves and peaks and troughs and modelling‘. But where she is, in a hospital, dealing with real people caught up in this horror, ‘the pandemic is a matter of flesh and blood.‘ And she is utterly appalled by the gloss the politicians have been putting on the devastation and loss.

Used as she is to comforting, hugging, being up close and personal, the very execution of her job now cuts her to the quick.
‘In PPE, everything is sticky and stifling. Voices are muffled and smiles obscured. Sweat starts to trickle into your underwear. Even breathing takes more effort. Behind our masks, we strain to hear each other speak and are forced to second guess our colleagues’ expressions. Being protected entails being dehumanised.’
Approaching relatives of the dying is immensely painful and counter-intuitive.
‘I am a doctor with neither name nor a face. My hospital badge is hidden from view and my eyes – the only part of my face still visible – are obscured by a layer of Perspex. So much for the healing presence of the bedside physician. I scarcely look human … Everything about this is wrong.’

She illustrates her experiences poignantly with reference to a single encounter with an 89-year-old man slowing drowning in his own secretions. His sons, bewildered and afraid, enter the other-worldly scene only for the last farewell. Her own emotions plummet as she watches helplessly, unable to offer the human warmth that is her instinctive response. Neither she nor they, want this elderly gentleman to be a mere statistic – a number reported in the next day’s death toll. He is so much more than that.

Dr Clarke and her colleagues at the frontline know for sure that the soundbites trotted out at the central podium in Downing Street each day have not been borne out by the reality in the Covid wards or the care homes. Social isolation, PPE, testing, lockdown – the deficiencies and delays and shortfalls have appalled them; the article captures the discordance perfectly.  Once lockdown was established, and the quarantined population were trying to manage its fears using ‘the unconventional strategies of baking bread and stockpiling toilet rolls’, the medical staff were reeling. Fearlessly, urgently, frenetically, they threw themselves into delivering high-quality pandemic medicine. They could only look on in disbelief as staff were obliged to fashion PPE out of plastic bags, patients were sent into care homes without tests to establish their Covid status, and restrictions were being lifted in the absence of the necessary infrastructure for proper testing and tracing.

The country may be letting its collective breath out cautiously as the numbers decrease, but they are still battling this deadly enemy. They feel sick as the politicians declare the success of their strategies; they know at first hand the stupendous costs of delay and deficiency, the real tragedy of thousands upon thousands of deaths and bereavements. They were, they still are, there, ‘up close with this dreadful disease‘,  seeing ‘the way it suffocates the life from you‘. For them political judgements ‘were grotesque‘. They themselves are ‘exhausted, stunned – shellshocked, even‘. Clarke’s verdict? The loss of so many vulnerable citizens is ‘entirely and inexcusably wrong … no one is expendable‘.

I certainly don’t envy any of the people who must make these decisions, but putting a spin on the devastation, peddling untruths and half statistics, making false promises, doesn’t engender trust or confidence. And as Dr Clarke says, ‘The point of our response to corona virus is not to flatten curves, ramp up headlines, protect the NHS or invent mathematically nonsensical equations: it is to prevent unnecessary dying’. And there you have it. The heart of the matter. Summed up by someone at the very kernel of this global catastrophe.

She’s the author of Dear Life, paperback version due out in September this year. It’s top of my wish list.

NB. To be fair, First Minister Nicola Sturgeon, in her daily updates for Scotland, always stresses the tragedy of every single death.

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In it together

In a week where the fallibility of the UK government has reached a new low, I’ve been revelling in the human face of celebrity.

What a fabulous opportunity! I’ve been at the virtual Hay Book Festival – one of the most famous literary events in the world. Outside the dreaded virus might be lurking, political storm clouds may be gathering, but I was squirrelled away in my study, with no one to irritate me or distract me, before me a parade of authors and orators and experts, speaking from their own homes, to an international audience of hundreds.

And not unnaturally, frequent mentions of Covid-19, the very thing that has made it impossible to hold the real event in its normal location in Wales. Indeed, many of the events were specifically about the virus.

Regurgitating the science or philosophy would send you to sleep, but what struck me was that, against the background of their natural habitats, the speakers seemed more real, more authentic; they shared intimacies about their families, their lives, which somehow brought them closer to us.

So, for example, best-selling novelist, Maggie O’Farrell, was talking about her latest book, Hamnet, a fictionalised story woven around the life and death and memory of William Shakespeare‘s son of that name, who died probably/possibly of the Black Death (the most deadly epidemic in recorded human history), aged just 11. Obviously parallels with our situation today, and Maggie confessed she related very much to Anne Hathaway, Shakespeare’s wife. She had needed to wait until her own son passed the age of 11, before completing the scenes of Anne sitting at Hamnet’s bedside, watching him die, laying him out for burial, mourning him for the rest of her life. Knowing that at any moment Maggie’s own children might erupt into the room, gave her responses both piquancy and urgency. And I loved the picture of her hiding in the Wendy House in the garden for a couple of hours to get some work done during lockdown.

Former Chief Medical Officer for England, Dame Sally Davies, with yards of qualifications and distinctions, gave the special John Maddox lecture about anti microbial resistance. It could have been way above the heads of most people, but she came across as warm and understanding, with a lovely sense of humour. She shared her palatial study with us, but took all the pretentiousness out of it by showing how her husband had hacked off more of her hair than she’d requested. And her slogan: ‘work together and wash your hands’ – had a ring of truth and realism that the official messages from the Downing Street podiums often lack.

A message from this pandemic which came across clearly was: work together towards a kinder fairer world. I came away with a sense of a shared strategy, a world-wide community, that no mere political aide flouting the rules could dent.

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A serendipitous find

Well, what d’you know?! In amongst the plethora of books the kind people of my neighbourhood are putting on the communal bookshelves, I found one that grabbed my attention. There, on the back cover – fertility treatment, human experimentation … wahey! My kind of key words!

And the author? Val McDermid, whose skill with words leaves me battling the green-eyed monster. This particular edition of Blue Genes might look as if it’s been dropped in the bath, and stuffed under a pillow, and bent backwards energetically enough to release the middle pages from their moorings, but it nevertheless did a wee detour into my hands, and I devoured it over two days. Pure diversion.

Kate Brannigan is a private investigator whose life is disintegrating all around her.
a) She’s on the verge of buttoning up a case of fraudulent exploitation of bereaved people, posing as a new widow herself, when the supposed deceased man erupts into the scene at precisely the wrong moment, and blows her case to kingdom come.
b) Her partner in the firm, Bill, is selling out and she can’t afford to buy his share of the company.
c) And she discovers her best friend, Alexis, has been concealing a massive secret about the child she’s having with her lesbian partner, Chris.

Now she’s suddenly deep in an investigation where one of the chief protagonists is lying murdered on her own kitchen floor.  Her name’s Dr Sarah Blackstone, a leading gynaecologist, specialising in sub-fertility in Leeds. Her picture’s in the paper. Or … is it? Not according to Alexis, who identifies the murdered woman in the photo as Dr Helen Maitland, the Manchester specialist who helped her towards her dream of parenthood. So why has this doctor been practising under two different names? And why has she been killed? And why has she adopted the name of a real live medical colleague high-profile enough to have published extensively on recent advances in gene replacement therapy? And just how far is someone pushing at the frontiers of what is allowable in fertility treatment?

Criminal, legal and ethical quagmires aplenty. My kind of territory. What a treat!

And all delivered with Val McDermid’s customary brio. I don’t want to deliver any spoilers but I can share a few literary gems with you:

Ironing out the problems in my relationship with Richard would have taken the entire staff of an industrial laundry a month. It had taken us rather longer.

Alexis grinned and blew a long stream of smoke down her nostrils. Puff the Magic Dragon would have signed up for a training course on the spot.

As well as the red-rimmed eyes and the stubble, a prospective employer had to contend with a haircut that looked like Edward Scissorhands on a bad hair day, and a dress sense that would embarrass a jumble sale.

… a three-bedroomed semi with a set of flower beds so neat it was hard to imagine a dandelion would have enough bottle to sprout there.

The devil finds work for idle hands; if you can’t manage any other exercise, you can always push your luck.

Treasures one and all.

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On my bookshelves

It’s notable that so many folk we’re seeing on our screens these days – politicians, scientists, celebrities, TV presenters – appear in front of bookshelves. But hey, when I’m at Zoom meetings, so do I! Probably because for many of us, our main computers are in the rooms where we work. But it didn’t occur to me to criticize the material on other people’s shelves until Michael Gove was harangued for having a book by a Holocaust denier alongside other rather extreme literature, on his. Hmmm. It made me wonder … what would people make of my choices? Well, the truth is, it depends on which way the camera is facing in the room. Different walls display different genres. And the books I’m especially devoted to, appear in front of me – ie. behind the camera. But in any case, I certainly don’t agree with the substance or premises of every book we own. What would be the point in only reading things that you agree with? Surely you need to understand other perspectives, other ideas, in order to hone your own thinking.

It made me wonder, though. How do people judge me? As you know, I’ve been putting books outside at the end of our drive for passers-by to help themselves to, by way of distraction for lockdown. For the first few days the books, DVDs and CDs were all mine, but a neighbour put a post on Facebook about the bookcase, and since then I’ve had a tremendous selection of books, jigsaws, games, DVDs, quietly popped on the shelves – beautiful coffee-table hardbacks, dense tomes on the -ologies, best-sellers, how-to manuals, fourth-hand paperbacks, much loved children’s tales. The turn-over has been amazing. And despite the number that are snapped up rapidly, we’ve reached three shelves-full this week! An unexpected bonus. But … am I personally being judged by the books on display? Who knows.

Lockdown is offering lots of unforeseen opportunities for random acts of kindness and helping others, and I’ve been the beneficiary of one myself this past weekend. I attended a virtual Book Festival!

No need to take out a mortgage to pay for tickets, travel, accommodation. No necessity to hang around aimlessly for hours between events. This one came free, a composite of events originally scheduled for different venues around the country, now beamed directly into my study – no one able to peer critically at my book titles either! And I could even knit while I listened – a bonus when you’re just starting an adult jersey – a Gansey from Guernsey in fact – on size 13 (2.25mm) needles.

I particularly enjoyed listening to Terry Waite and Michael Morpurgo, who have such interesting takes on life as well as being brilliant writers. But there was something for everyone, so perhaps it’s not surprising that over twenty thousand people tuned in! Fabulous.

Hats off to the enterprising people who are masterminding these fantastic opportunities. I’ve already booked in for the famous Hay Book Festival later this month – what a treat. As are the multitude of programmes available to watch/hear: fabulous ballets, operas, plays, concerts, masterclasses. The arts and artists themselves have risen to the occasion magnificently, giving their time and skills generously, and I for one am profoundly grateful for all the extra cultural offerings which help to maintain mental stability and well-being in these troubled times.

 

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Misery: Learning from a master storyteller

OK, I know, I know, the one thing we don’t need when life is so out of kilter during a pandemic, is depressing literature. Certainly none of my ‘death’ and ‘tragic options’ stuff –  you’ll have noted I’ve been steering well clear. But long before we’d even heard of Covid-19, back in those halcyon days when there was nothing to prevent me poring over psychological thrillers, searching for the magic ingredients that keep you turning the pages long into the night, I read a cleverly constructed thriller that impressed me. Now I think about it, it puts a whole different perspective on lockdown; imagine not just being isolated and captive in a remote place, but being incarcerated with a violent maniac! So I thought I’d share its merits with you today, not just because it has parallels with our present situation, but because it’s the product of an exceptional mind and an impressive facility with words.

REPORTED MISSING: Paul Sheldon, 42. Novelist best known for his series of romances about sexy, bubbleheaded, unsinkable Misery Chastain; by his agent, Bryce Bell. ‘I think he’s fine, Bell said, ‘but I wish he’d get in touch and ease my mind. And his ex-wives wish he’d get in touch and ease their bank accounts.’ Sheldon was last seen in Boulder, Colorado where he had gone to finish a novel.’

Paul Sheldon is a writer of novels of two kinds, good ones and best-sellers. Annie Wilkes is his number-one fan. When he’s involved in a car accident during a violent storm, he comes to after being unconscious and delirious with the agonising pain of two shattered – no, pulverised – legs, and a horribly damaged pelvis, to find it was Annie who dragged him from the wreckage of his car, and took him to her remote mountain home in Sidewinder, Colorado. Having crudely splinted his legs, she is caring for him with large amounts of pain killers which have the side-effect of suppressing his breathing, necessitating occasional mouth-to-mouth resuscitation.

About ten days after regaining consciousness he discovers a number of things about his ‘nurse’. She is in possession of a great many drugs of a dubious nature; she has already managed to render him addicted to one of them, Novril. She is dangerously crazy. Everything she says comes out in the wrong key.  She’s also given to frequent episodes where her mind goes blank. She has a volatile temper; she is a woman full of tornadoes waiting to happen. She has previously had to take the stand for some major crime in a Denver court of law …

And she has told no one he is in her house.

As Sheldon discovers the hard way, Annie is seriously mentally ill – hovering on the murky borderline between ‘the Sovereign State of Reality and the People’s Republic of Paranoia.’ What’s more, she is much more than his carer; she’s a stern critic of his work. When she discovers he has killed off her favourite character, Misery Chastain, heroine of a string of romantic bestsellers … that he has then gone on to write a story full of profanities, 190,000 words of it … she exacts a terrible penalty. And Sheldon can only lie immobilised, his vivid imagination in overdrive, his present reality and his future destiny growing daily more horrific.

Misery is the perfect title – shared by the principal character in Sheldon’s book, a pig on Annie’s farm, and the total experience of Sheldon’s captivity and torture.

Master storyteller Stephen King has created a  terrifyingly grotesque character in Annie Wilkes, and devised a fearful form of entrapment for his hero, Sheldon. Both are so brilliantly realised they inhabit the pages and suck us into their reality. And having experienced the lengths to which Annie will go to punish him, we live in constant fear of still more appalling things happening to Sheldon. We can have no confidence at all that the hero will escape a terrible fate or even survive the story.

I don’t want to spoil the book for you, but I do want to draw attention to a few devilishly clever aspects of the writing.

First the stories within stories. Inside the whole tale of Sheldon’s captivity and Annie’s revenge are mini-tales – what Sheldon’s literary character Misery Chastain is up to; what Annie’s Memory Lane scrapbook reveals of her former life.

When Annie ratchets up the torture, Sheldon realises he is doubly cursed. Not only are his sensitivities acutely tuned to pain, but his writer’s mind is destined to remember every tiny detail of the horrors inflicted on him. And in his analysing, he reveals technical tips about creative writing – some in response to his lived experience, some through his writing. He’s acutely aware too that his captor understands certain truths about what writers can and cannot do, even though she is unable to enunciate them in writerly jargon. A few examples will suffice:

… resigned to the fact that he could not read stories as he had when he was a kid; by becoming a writer of them himself, he had condemned himself to a life of dissection.

… not being sure of things  ... was a charmless corner of purgatory reserved for writers who were driving fast with no idea at all where they were going.

a gothic novel … more dependent on plot than on situation.

The reason authors almost always put a dedication on a book, Annie, is because their selfishness even horrifies themselves in the end.

He felt as he always did when he finished a book – queerly empty, let down, aware that for each little success he had paid a toll of absurdity.

It gives an extra dimension of reality to what could be a totally unbelievable tale. Except that in the hands of Stephen King you believe it could actually happen.

An ancient manual typewriter is central to this book and indeed features on the front cover of my version. King’s description is wonderfully evocative: It was an office model from an era when such things are electric typewriters, color TVs, and touch-tone telephones were only science fiction. It was as black and as proper as a pair of high-button shoes. Glass panels were set into the sides, revealing the machine’s levers, springs, ratchets, and rods. A steel return lever, dull with disuse, jutted to one side like a hitchhiker’s thumb. The roller was dusty, its hard rubber scarred and pitted. The letters ROYAL ran across the front of the machine in a semicircle …  it already looked like trouble. The ribbon was a faded two-tone, red over black … A real antique … with a missing n … the missing striker like a missing molar in a mouthful of teeth worn but otherwise complete.

And there are 26 pages of the text of a new book Paul writes on that same typewriter with the n strangely skewed where it’s been inserted ‘by hand‘, reproduced in the book, giving a very clever ring of authenticity. And later, when the machine loses its t, that too is inserted by hand. T: the second-most-common-letter in the English alphabet. Imagine the labour involved. Imagine the implications even for someone writing this novel on a modern computer!! When the key hammer for e eventually falls off, there is nothing for it but to resort to longhand. An exercise that rendered Sheldon’s hand almost useless, so the last few pages are typed on the hated machine with ns, ts and es all filled in ‘by hand’. It’s a masterly touch.

It’s a brilliantly conceived and realised horrifying thriller, but I must confess I found the closing few pages which constitute Part Four disappointing. Indeed I read them twice, thinking I must have been too tired, too distracted, or missed the point. And of course, that realisation – when it’s found in a work by one of the best selling names in the world – teaches me something in itself. Which is what my endless reading is all about.

 

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The front line: then and now

Health Minister and Conservative MP, Nadine Dorries, was the first member of parliament to be diagnosed with Covid-19. This was back in early March … at a time when there were only 382 reported cases in UK, only 6 people had died. Halcyon days, huh? Less than two months later, we’ve already exceeded 26,000 deaths!

The news about Ms Dorries triggered a memory: I’d read somewhere that she was a trained nurse, and intrigued, I’d bought two of her ‘nursey’ novels in a coffee shop on my way to Wigtown, Scotland’s National Book Town a couple of years ago, stuck them on my shelves, and promptly forgotten about them – The Angels of Lovely Lane and Christmas Angels. Time, methinks, to dig them out and read them … a kind of tribute to the nurses today working so hard to care for people with the virus in a very different world.

I must confess neither the genre, nor the style of writing, are ones I’d normally go for, but there were aspects of these books that gave me pause for thought and sober reflection. These nurses were practising not long before I trained; their experiences resonated with me. Rather like BBC1’s drama, Call the Midwife.

Reading about and recalling those days made me so grateful for all that modern medicine and social care can offer today. How far we have come from those days when
– the NHS was in its infancy
– antibiotics were wonder-drugs
– women had limited career options
– smoking was the norm
– lecture notes were written on typewriters using carbon paper
– rubber tubing was boiled before being inserted into various orifices
– patients were lifted manually
– doctors were revered and all powerful
– women died or were imprisoned following illegal abortions
– ten days bedrest was de rigeur after a simple D&C; three weeks after childbirth
– nurses wore starched collars and frilly caps, always kept their hair off their face tucked inside their caps, lived in hostels with rigid rules, and were all known by their surnames
– silver buckles on petersham belts denoted qualifications
– the Irish were openly discriminated against …

Compare all that with communication, technology, medical expertise, opportunities, science, in 2020. What would have happened if the dreaded coronavirus has struck then?

In her fiction centring on Liverpool in the 1950s, Nadine Dorries has captured a world I knew, and for a few days took me away from the uncertainties and restrictions and anxieties of our present situation, to a bygone era. Memories both happy and sad. But overwhelmingly reasons to be devoutly grateful for what’s available to us today, and the amazing work our front-line staff are doing – and are able to do – to beat Covid-19.

 

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Unprecedented times

We’re repeatedly reminded that we are living in unprecedented times, the normal rules of engagement don’t apply. And indeed nobody can be unaffected by the restrictions, embargoes and uncertainties caused by the Covid-19 pandemic. They have the capacity for making us look more closely at what really is important in life.

Maybe it’s that sense, or maybe it’s because we’re being reminded every day of the frailty of human life, but I have this week broken the habit of a lifetime … swift intake of breath … yes, it’s true. And that is …? I have abandoned a book a mere one third of the way in. Me!! Someone who prides herself on always … ALWAYS … giving a book the benefit of the doubt until the very last page! As I say, normal rules of engagement don’t apply right now.

With all this extra time at home, and an unusually empty diary, it seemed like a good idea to delve into the terrible hardships endured by Jewish partisans trapped behind enemy lines in occupied Russia during the last years of WW2. The unimaginable hardships they endured before and during their time in the ‘republic of the marshes’ – gut-wrenching deprivation, torture, imprisonment, starvation – that would surely put our present situation into context. So I duly settled down with Primo Levi‘s modern classic, If Not Now, When?

OK. There are some lyrical passages … the story comes from the heart and Levi’s own lived experience (among other things he was a holocaust survivor) … but oh dear … I struggled to maintain concentration. And it’s hard to pinpoint exactly why.  Is it because there’s so much going on in real life right now that’s taking up brain space? Is it because dark novels aren’t what we need when today’s news is full of grim statistics and dire predictions? Is it because our present emphasis on people coming together feels so much more edifying that a tale of nations and people in conflict? Or is it the book itself? Would it have defied me in more normal times? I don’t know.

Suffice to say that I believe I’d have persevered at any other time – on principle, if nothing else! But not now. Life feels too short, and I have plenty of other books calling me.

But not as many as I had last week. Because, in a spirit of community support, I’ve set up a bookcase at the end of our driveway, and each day I put a selection of books, DVDs and CDs out, with a notice inviting anyone to help themselves by way of distraction for lockdown.

And passers by are availing themselves of the opportunity every day; some leaving a little message, or throwing an appreciative message across the road at the Thursday clapping for the NHS and key workers. We’ve even had someone expressing interest in having the bookcase when this is all over!! And last night someone asked if her friends could add books and jigsaws to the shelves. Brilliant. I’m delighted that people are finding the time to read, that books still appeal. And there’s an added bonus: I’m freeing up space on my own shelves at the same time. If not now, when? It’s an ill wind …

Stay safe, everyone.

 

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Justice, rights, entitlement

The latest casualty of the coronavirus lockdown in this country is fertility care. As of Wednesday of this week, no new patients will be accepted, and even those in mid-treatment, those for whom this is their last hope, those who will be too old to qualify or stand a chance of success by the end of lockdown, will not now receive the necessary procedures towards which they’ve been working for so long. Yet another tragedy. More heartbreak. More hopelessness.

Which brings my thoughts to the ethical issues around assisted conception …

It’s now fifteen years since I wrote Double Trouble, a book about surrogate pregnancy. Fifteen years! Yoiks. But as with so many ethical dilemmas in medicine, the issues are still relevant today.

I was fascinated then, to watch the serialised BBC1 drama, The Nest, which finished this week, about a very wealthy but childless couple, Glasgow property tycoon Dan and his beautiful pampered wife Emily, who decide to go down this route. Click on the picture for the official trailer.

All attempts at IVF have proved unsuccessful. Dan’s sister has already tried to carry a baby for them but miscarried. They have one precious embryo left. One. Only one more chance. Emily meets the troubled teenage Kaya when she accidentally knocks into her in her car. Kaya sees an opportunity to get out of her impoverished life, and offers to be a surrogate for them in return for £50K. But as the story unravels we find that Kaya has secrets in her past and a very dubious pedigree indeed …; the would-be father Dan is something of a rough diamond too, dealing with a lot of shady characters and skullduggery …; Emily is single-minded about motherhood and what she wants, but privately troubled by the morality of what they are doing – always setting herself up as ‘the principled one‘ according to her sister-in-law. No-one in the UK will implant the last embryo. However, the Dochertys can well afford to go abroad for the simple procedure, and they do so.

On the face of it everyone stands to win. Kaya will be set on her dreamed-of pathway to becoming a successful business woman, able to ‘go on a plane, have one of these pull-along cases‘. The wealthy couple get their hearts’ desire. Better yet, surrogate and intended parents establish a relationship, even friendship. Kaya moves in with the Dochertys and gets a taste of a life of privilege. The baby will not only be much wanted, but will have every advantage money can buy.

Naturally – this is, after all, fiction, drama, a series requiring cliff hangers – things go pear-shaped. Relationships get confused. Loyalties are divided. Dubious and unsavoury motives emerge. But the underlying questions and challenges remain pertinent.

Is parenthood a right?
Is ‘want’ the same as ‘need’ in childbirth terms?
Payment for this service in the UK is forbidden. Should it be?
How binding should a contract between intending parents and surrogate be?
Should private arrangements for surrogacy be permitted?
Does a woman have the right to do whatever she likes with her own body?
What constitutes ‘reasonable expenses’?
Should those with the wherewithal be allowed to circumvent ethical and medical guidelines?
Does using someone far less powerful in this way constitute exploitation?
In the event of a dispute about whose baby it is, whose rights should take precedence, and who should decide?
What if the child is damaged/imperfect/not what was expected? Should the contract still stand? Who should accept responsibility for him/her?
What of the baby’s rights?
How much of its origins should a child be told?

Back to the drama … enter Kaya’s long-estranged mother, who encourages her to renege on the contract, hang on to the baby, become a mother herself, a better mother than she has been. But Dan already loves this child. Even when he finds out she is not his genetically, she’s still his daughter in his heart. The Dochertys call in their lawyer; the case goes to court. It’s left to the judge in the Family Court to put things into perspective – severely castigating their self-serving recklessness, the complete imbalance of power, the undesirable qualities on both sides. But, she says, at the end of the day it’s not a question of how she would judge them; it’s about what is in the baby’s best interests.

Contrary to expectation, there is a happy ending to this story, and both sides demonstrate they’ve learned important lessons about what matters in life. But the drama perfectly illustrates the power of fiction to challenge us to think about what society today should endorse, and how far the law can go in dealing with the fine nuances of moral questions in assisted reproduction. Well done, screenwriter Nicole Taylor.

 

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Disclaimer

We’re deep in a situation of lockdown still and the stark reality of our world-wide war against Covid-19 has made most of our everyday preoccupations seem trivial. But it behoves us all to find strategies for keeping our mental as well as our physical heath as robust as we can. My first go-to respite activity is reading (no surprises there, huh?); getting lost in a whole other world, so I’m going to share my thoughts on a psychological thriller bought back in the (g)olden days when life was busy, and books accumulated waiting for time to read them. Those far off days when I was immersing myself in thrillers in order to learn the mechanics of writing in this genre. Before real life took over the role of sending shivers down our spines.

It’s Renée Knight‘s debut novel, Disclaimer.

How many people bother to read the small-print information at the beginning of a novel about publication, rights, cataloguing, typesetting and copyright? Very few, I’d guess. And those few, other writers and publishers probably. But in amongst all that boring detail you’ll find a disclaimer to the effect that any resemblance to actual persons, living or dead, is purely coincidental.

What if, though, that disclaimer had a red line drawn through it? THAT would make you sit up and take notice, wouldn’t it? And so it is when award-winning documentary maker, Catherine Ravenscroft, finds a book on her bedside table with the disclaimer crossed out. With a chill of horror coursing through her veins, as she reads, she becomes increasingly aware that she herself is not only the foundation of the story, but the key player. The words ricochet around her brain, slam into her chest, one after another. The names may have been changed, but the details are unmistakable. And this story will reveal a secret she thought no one else knew; a secret she has carried unshared for two decades.

Who has written it? Who has delivered it? Who has sent a second copy to her only son, Nicholas? Who has spelled out her death – under the wheels of a train – the price she must pay for pretending that everything was absolutely fine. Her dread increases exponentially as the stalker closes in.

We, the readers, know the sender is an elderly English teacher, Stephen Brigstocke, who himself has something rather unsavoury in his history. After the death of his wife Nancy, he stumbles across a stash of erotic photographs, and a secret manuscript written by her – clues she left for him to find. Clues relating to the tragic death of their only son, Jonathan, who drowned in Spain trying to rescue a five year old boy, and to a terrible truth Nancy had concealed from her husband during her lifetime.

Desire for revenge consumes him. He publishes Nancy’s story, The Perfect Stranger, and hand delivers his grenade.

‘… the  book was like a terrier, my Jack Russell of a novel which would sniff her from her hiding place and chase her out into the open. Its sharp, pointed teeth would expose her, strip away the counterfeit selves she’d assembled.’

But the wait for revenge is slow and protracted. Alternating chapters give us the feel for the cat and mouse game being played out by these two. Extracts from The Perfect Stranger paint a picture of what happened in that Spanish holiday resort all those years ago. But gradually, chillingly, we are made aware that nothing is what it seems; a far more terrible reality underpins the tale told by those incriminating photographs.

As expected the story twists and turns and we’re exposed to the worst aspects of the characters’ inner selves, none of whom are very likeable. But it’s cleverly designed, and I was intrigued by the author’s ability to slowly but inexorably turn the entire story on its head. Tightening the screw one more time right at the very end.

An unpredictable but intriguing diversion in these weirdly nightmarish days when the real world is spinning into an uncertain and unknowable future.

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Decisions in a time of coronavirus

Week 2 of the lockdown because of Covid-19 and I am reflecting back on an extraordinary seven days. Unprecedented. Grave. Frightening. But one of the most unexpected developments has been a positive one, closely connected to my professional interests: people have been thinking and talking about the ethics around end of life care, and specifically about Advance Directives, teasing out the kind of interventions or treatments they would wish to avoid.

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I wrote my own living will years ago, and have revisited it periodically just to be certain it reflects my sustained wishes. It does. My husband and children have known about the documents and their contents ever since I drafted them, but suddenly these matters seem much more urgent and relevant. There’s a greatly increased possibility that I might become seriously ill soon; that I or they might be called upon to decide whether it’s appropriate or not to accept aggressive or invasive treatment. That it might be futile. So, this week I sent copies of my Advance Directive to refresh their memories as to the detail. If they’re called upon to represent my views, they will know precisely what to say.

However, more importantly, this crisis has prompted other people I know to think about their own mortality and how they feel about these issues, for the first time. Sobering stuff. But so right.

At the very least we all need to have the conversation with our nearest and dearest; better still record our decisions, have them officially witnessed, make the documents known and available.

And the questions even for hardened ethicists have been widened and thrown into stark relief by developments during this pandemic:
what if our hospitals are already full, and I can’t be admitted if I succumb to the virus?
what if being admitted to hospital means I risk dying alone?
what if I live alone and I contract the illness?
what if I fall outside the criteria for treatment?
what if the medics deem me to be highly unlikely to survive?
what if it’s a choice of me versus another patient?
what happens if no-one can attend a funeral?
… and so on …
This public health catastrophe and its horrific statistics has brought us face to face with undreamed-of dilemmas confronting our society in the spring of 2020. Now.

The time has never been more urgent for a weighing up of the risks and benefits, and an analysis of our beliefs and values. For having the conversation. It’s personal. It’s real. It’s not going away.

What will you choose?

 

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