Hazel McHaffie

BBC

Call the Midwife

Looks like I missed a trick! In 1998 a nurse/midwife/midwifery lecturer, Terri Coates, pointed out that midwives are virtually non-existent in literature. Doctors and nurses yes, – in abundance – but not midwives. Given that they’re at the centre of one of the most spectacular experiences common to all human beings, why is this so?

‘The responsibility they carry is immeasurable. their skill and knowledge are matchless, yet they are completely taken for granted, and usually overlooked … Why aren’t midwives the heroines of society that they should be?’

Jennifer Worth, reading about this in the Midwives Journal, picked up the gauntlet and in 2002 the book, Call the Midwife, was born. It reads rather like a novel in places, but it’s actually based on the true story of life in the East End of London in the 1950s. And of course it rose to fame when Heidi Thomas serialised Worth’s books on BBC TV, series 1 beginning in 2012, and series 7 recently ending on a tragic note which suggests it’ll be back to heal the wounds. And yes, Thomas has indeed signed up for another two series.

The experiences Worth relates rang very true to me. I trained as a midwife myself in the 60s (third from the right in the photo below, taken outside the world’s most famous maternity hospital) and remember vividly that era. Abortion was illegal, premarital sex and illegitimate children were stigmatised, the Pill wasn’t available, racial prejudice was rife, soap and water enemas and pubic shaving were common practice. I too worked in homes where the kiddies ran around in vests and nothing else, free to urinate anywhere without making washing. I learned to take newspapers with me to provide a sanitary base for my bag and coat. Young women did die of eclampsia, infections, undiagnosed complications, back-street abortions. Naive and relatively inexperienced, we accepted the responsibility of being alone in houses with no telephones, few mod cons, but the legendary lashings of boiling water on standby! We too worked long unsocial hours and attended lectures on Saturdays. We too sallied forth anywhere at all hours confidently, wearing our uniforms with pride, and turned our cloaks inside out to parade through the wards in festive red, singing carols at Christmas time.

But Jennifer Worth worked in post-war London; I in Edinburgh and Paisley. She saw a level of poverty and degradation below that I encountered. Prostitution, meths drinkers, homeless immigrants, drug addicts, huge families living in condemned buildings. Mothers desperately trying to keep their families together with no regular income, no benefits, selling hair and teeth as a last resort before being taken in by the workhouse. This was her world.

My own mother regaled me with plenty of stories of those same years and i could only admire the strength and courage of these families who took adversity in their stride and showed such fine examples of parental love and integrity.

It’s a fascinating read, and the success of the BBC show indicates that the topic has widespread appeal. The book includes a potted history of the professionalisation of midwives for those unfamiliar with developments, but the real meat is in the characters and experiences Worth grew to love and appreciate. And the enormous privilege it is to share this most miraculous experience of new birth.

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Truth stranger than fiction

Normally I stay clear of religion and politics in my blog, but this week I just can’t ignore the craziness bombarding us. There comes a time when staying within the safe and respectable writerly world, simply won’t do.

We’re rather inured to improbable happenings on our screens in dramas, aren’t we? Professors of neurosurgery who beat the living daylights out of a colleague who taunts them, and then walk straight into theatre and perform some intricate ground-breaking surgery on a patient to widespread acclaim. High ranking detectives who get suspects into quiet corners and extract information by foul means. All without repercussions. You know the kind of thing I’m talking about. And yet, reviewers are wont to criticise authors quite harshly if their characters don’t ring true; a person in that position in those circumstances just wouldn’t behave like this, wouldn’t say that.

Well, if I were to include in my novels some of the real-life activities in the news recently, I’d be accused of writing unbelievable fiction too. Or dubious hyperbole, at the very least. I ask you.

Mature (in years) men, MEPs, indeed, brawling … abroad  … when they are supposed to be representing their country …?

High ranking ministers promoting harsh discriminatory ideas completely opposed to views they themselves expressed as their deeply-held beliefs when they were lower down the food chain … ?

A last-lap US presidential nominee, bidding to lead the largest and most powerful free country in the world, who has already openly scorned many minority groups (eg muslims, immigrants), now admitting he has sexually abused women …, seeing them as the entitlement of any ‘alpha male’ … especially ‘a star’ …?

Hugely important questions about Brexit being decided by a tiny cabal with neither MPs or the people having a say …?

Large numbers of high-earning BBC employees being accused of dodging taxes …?

Hmmm. Looking at this list I note they’re all except one about politicians. Houses of ParliamentOK, I could develop that theme but it could get nasty, so instead I’ll share my thinking about the matter of credulity.

Decent civilised people living in decent civilised communities tend to assume the integrity and honesty of public and professional figures. We want to trust doctors, lawyers, policemen, teachers, clergy, royals, social workers … we want our children to be able to trust them. But coming on top of all the scandals exposed by the media in recent years, these current horrors challenge our credulity. Can this really be happening? How is it possible? The more I thought about this, though, the more I realised that this is the stuff of thrillers. When apparently trustworthy people step outside the boundaries of the acceptable and believable. Unreliable narrators, unscrupulous colleagues, immoral perpetrators.

Shutter IslandFor example, this week I watched the film Shutter Island, a disturbing glimpse inside the world of insanity. US marshal, Teddy Daniels (Leonardo diCaprio) is sent to Boston’s high security prison for the criminally insane, on a remote hurricane-blasted island, to investigate the disappearance of a female murderess. Daniels himself has a traumatic past having witnessed the aftermath of the atrocities at Dachau and lived through his wife’s murder. But on the island he is determined to gain access to the ward where the most dangerous patients are housed, a ward in a lighthouse to which the medical team are denying him entry. It’s a film that challenges received wisdom, professional facades, and the limits of humanity. What is believable? Can I trust what I’m seeing and hearing?

Nor is it just thrillers that do this. I’ve also been reading All the Light we Cannot See by Anthony Doerr, a beautifully written, haunting novel about a blind French girl, Marie-Laure, and an orphan German boy, Werner, whose paths cross in occupied France as both try to survive the devastation of World War II. It’s by no means a thriller, but inevitably there are troubling scenes that make us question just how far humans can sink and still retain their humanity. Happenings which Marie-Laure’s great uncle says ‘sound like something a sixth-former would make up.’ In other words, unbelievable. But of course we today know about the atrocities of that era, and much as we might inwardly recoil and think, Surely not, we know these things were real and do/did happen. They become utterly credible in a spine chilling kind of way.

Spine chilling. Now that’s what I’m pondering in my own writing at the moment. I’ve always worked consciously to make my characters believable. For each book I’ve asked a raft of experts as well as discerning readers, to check the manuscript for credibility before it goes for publication. But I’m starting to wonder if any of us can predict how low human beings can sink, or how unlikely any extreme behaviours really are. And now that I’m experimenting with thriller-writing, perhaps I can push the boundaries further in my writing about a young mother who exhibits pathological behaviour, without being condemned by the literary critics. Certainly I need to keep pushing that ‘What if’ button. See how far I can go.

 

 

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Interviews

You may or may not be aware that I’ve recently added a new page to my website: Interviews. Obviously not all interviews are available in an accessible format, but the ones I’ve done this year that were recorded can be seen at the click of an icon, giving folk an idea of what I think and how I come across. Apparently I do a lot of hand gesturing!

Having added a third interview this week, I was watching other interviews on TV with more than usual interest. And one with Fay Weldon, the veteran novelist, jumped out at me – not just because she has very large hands which she uses a lot close to her face, but also because I’ve actually met, and subsequently corresponded with Fay. We appeared together at a Literary Salon at the Brighton Festival many moons ago, and she gave two of my novels very kind endorsements back in 2005. I was particularly pleased with her comment that they were ‘…medical, ethical, romantic and fascinating. An entirely new genre for fiction‘. Back then it lent credence to my contention that there was an unfilled niche in the market for these stories. Fay Weldon said so!

Anyway, she was on BBC Breakfast this week talking about her new book, Habits of the House, and Bill Turnbull and Susanna Reid asked her lots of good questions. Some interviews come across as very superficial and rigged, don’t they? but this one wasn’t; they seemed genuinely interested and engaged. I discovered that she chose the title because a much-travelled guest in her own home once said, the secret of being an accommodating guest is learning the habits of the house. Fay’s ears pricked at this: an excellent title for a book. I agree, but I like the concept behind the comment too.

There’s a sticker on Habits that says, if you enjoyed Downton Abbey you’ll love this book. No, Fay admitted, she hadn’t watched Downton Abbey – she was ‘too jealous’ to watch it ‘without pain’ – but she was happy with the caption as a marketing ploy. She was also quick to chip in that she was there first, and this I can believe. Publishers have their own speed of working, and the time lapse between conceiving a book and its appearing in the bookshops is considerable, usually years. It’s frustrating when you the author are then thought to have copied someone else’s idea. I’ve had news items as well as TV dramas mirroring points in my plots before my books reach the bookshelves. However, Fay’s an experienced interviewee, and she managed to make all her responses sound amusing and faintly self-deprecating, and she kept her toothy smile fixed firmly in place.

Habits of the House is about a large household with servants and rich masters. I haven’t read it (yet) but the first paragraph sets the tone:

In late October of the year 1899 a tall, thin, nervy young man ran up the broad stone steps that led to No. 17 Belgrave Square. He seemed agitated. He was without hat or cane, breathless, unattended by staff of any kind, wore office dress – other than that his waistcoat was bright yellow above smart striped stove-pipe trousers – and his moustache had lost its curl in the damp air of the early morning. He seemed both too well-dressed for the tradesmen’s entrance at the back of the house, yet not quite fit to mount the front steps, leave alone at a run, and especially at such an early hour.

I draw a veil over the scathing comments my editor would make if I used that many adjectives and parentheses! But then I don’t have Fay’s credentials or track record or sales figures.

She was asked, why this subject? Haven’t upstairs/downstairs stories been done to death? (Now, you might not know it but this question had particular resonance because Fay wrote the first episode of the legendary BBC film, Upstairs Downstairs, broadcast in the 1970s, a fact which I’d forgotten.) Not a bit of it, she said, we’re all interested in injustice, and the haves and have-nots in these large households are just one expression of that kind of inequality and unfairness. Besides this, her personal fascination with the period around the turn of the 20th century, fuelled by her grandmother’s stories and her grandfather’s writing, make such choices natural ones for her.

Habits is the first of a commissioned trilogy and Fay has already finished the second one, so Bill asked her, did she know what happened in the third book? No, she admitted, she had no idea. Wasn’t that daunting? ‘Very frightening!’ Fay admitted. But her laugh and bounce said she would soon crack that little conundrum. And indeed, I know myself that by the time you’ve written two books about characters, they’ve got passports and birth certificates; indeed it can be hard to keep pace with their antics and decisions.

Watching this interview I concluded that I should try to

  • write an episode for a landmark TV series
  • sit on my hands, or at least keep them low
  • find a very good manicurist
  • come across as warm and witty and humble
  • pretend I’m all at sea and it’ll take a miracle or my huge talent to resolve this situation
  • make sure interviewers give my credentials not me
  • read Fay’s book.

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Locked in to a fate worse than death

Tony Nicklinson is 58. He’s paralysed from the neck down, can’t speak, and his only means of communication is by moving his eyes on a screen linked to a special computer. And yet his brain is so alive and intelligent that he can hold his own in arguments with twitters and QCs alike.

Prior to the stroke, Mr Nicklinson was a handsome, successful, fun-loving man, keen on extreme sports. He was in Greece on a business trip, when he suffered a catastrophic stroke in 2005. Now he is in a locked-in state, dependent on carers for his every need, with no hope of recovery. He considers his life as ‘miserable, demeaning and undignified‘. He ‘has no privacy or dignity left‘, and he rates it a state worse than death. He’s held that view since 2007; it’s no passing whim. It’s what’s described as a ‘voluntary, clear, settled and informed wish’ in legal parlance. Watching him on The Channel 4 documentary, Let Our Dad Die, surely no one could help but sympathise with his viewpoint. Even the Greek doctor who saved his life is appalled by the consequences of his actions, although no blame attaches to him.

In March Mr Nicklinson won the right to have his case heard by the High Court. The hearing took place last week (starting 19 June). There was considerable media interest in the run up to it. Lord Falconer visited the family at home. BBC’s Fergus Walsh went to see for himself what kind of a life a locked-in patient has. Channel 4 aired its documentary. Though he could communicate with these people in his own home, Mr Nicklinson was unable to attend the hearing in person, so he stated his arguments through emails and lawyers.

His case? Simply put, he is incapable of taking his own life, so he wants the judges to rule that, when he decides he wants to die, a doctor will be immune from prosecution if he/she helps him. Mr Nicklinson fully realises that the law as it stands prohibits anyone else taking his life; that would be murder. His defence rests on the view that he is being discriminated against, because of his disability. He is looking for assistance to do what he would do for himself were he able. Furthermore he adds poignantly, why should other people be allowed to condemn him to a life of increasing misery?

His barrister described it in more ponderous legal terms: ‘a serious interference of his common law and Convention rights of autonomy and dignity’.

It’s important to note that Mr Nicklinson is not seeking a change in the law. He is seeking two declarations from the court.

1. That in the circumstances of his case – and where an order has been sought from the court in advance – ‘the common law defence of necessity would be available to a doctor who, acting out of his professional and human duty, assisted him to die‘.

2. That the current law of assisted suicide and euthanasia is incompatible with his Article 8 rights of autonomy and dignity .

The QC acting for this family argues that a prior sanction by a court ‘would provide the strongest possible safeguard against abuse’. And furthermore ‘it would also provide a safeguard against the concern, often expressed by disabled opponents of legalisation, that a change in the law would lead to a change in people’s attitudes to disabled people, who they predict would come under subtle pressure to seek an assisted death through fear of being a “burden”.’

But any loosening of the limits frightens the legal fraternity. Speaking directly to Mr Nicklinson, Lord Falconer made it perfectly clear that in his judgement, modifying the law to accommodate such an act would be ‘crossing the Rubicon’. He was himself sympathetic to assisted suicide in cases of terrible disability with no prospect of improvement, where the patient expressed a sustained wish to put an end to their misery, but ending someone else’s life is murder and that must always be unacceptable.

Pause here for a moment and ask yourself: What answer would I give to Tony Nicklinson?

Watching the documentary I wanted to weep with this man. His chagrin, his pain, were palpable. But there again, as Christina Petterson put it in The Independent,

‘… the law isn’t about how we feel. The law isn’t about how you feel if you were once healthy and fit and happy, and now aren’t. The law, as Lord Falconer said on that Dispatches, is the same for everybody. “If people want to kill themselves,” he said, it’s an “entirely private matter”, but “they can’t kill somebody else”. The law, as the disability rights campaigner Kevin Fitzpatrick also said on the programme, is meant to offer protection. “When you develop a society where some people judge that other people’s lives are not worth living,” he said, “that’s the Rubicon.”‘

There can be no happy ending for the Nicklinsons, neither Tony, nor his wife, nor his daughters. But each time a tragic case like this comes to court, and I watch the family being forced to parade their lives in front of others, to expend dwindling energy on fighting their cause, I feel there has to be an alternative.

I can, of course, see the dangers inherent in a change to the law against taking life. The consequences could be inconceivably horrible. I accept too that these extreme cases make bad laws. But the fact remains, that these exceptional circumstances do present from time to time. And they seem to cry out for special judgements.

Would it be so terrible to openly acknowledge this fact, and to relieve these families of the necessity of taking their cases to the courts? Why not constitute a sort of Ombudscommittee – a gathering of carefully selected, experienced and wise folk, representing law, medicine, religion, ethics, patients – who could quietly, rationally, compassionately, debate the very few cases which fall into this terrible legal limbo, taking guidance from others as and when they need it? Not in such a way as to drive the debate underground, not to sweep the anomalies under the carpet, but to take individual cases away from the heat and distortion of media coverage, protecting and supporting those for whom this dilemma is a lived reality not a theoretical argument.

I haven’t ever seen this idea promoted, and it’s the first time I’ve aired my own view on this. So what do you think? Would you be in favour? Or can you see some glaring reason why this would not be an acceptable way forward?

What would your solution be?

 

 

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One click ethics

Thanks to my daughter’s vigilance, I’ve just found an amazing website, tailor made for people like me who don’t get round to noting programmes about ethical issues until it’s too late, or who forget the ones they’ve seen. If you share my obsession about ethics you’ll probably know about it already. But just in case I’m not the very last ostrich out of the sand, I’m going to share this discovery with you. And no, the BBC aren’t paying me a penny!

It’s http://www.bbc.co.uk/ethics/ and it gives information about religion and ethics programmes broadcast by the BBC on TV and radio – past, present and future, so pretty comprehensive. And of course, giving appropriate links. Loads of cross referencing and fascinating diversions. The usual suspects are there – abortion, euthanasia, assisted conception, sexual exploitation … arguments for and against, recent controversial cases, documentaries, drama, comment. It’s great to have one site that gives easy access to the more obscure references as well as prime-time coverage.

I’m off on my travels again this week, so it’s good to know in advance what’s coming up and to know exactly where I can go with one click to catch up the following week if trains don’t run to time, or the hotel stages a fire alarm at the wrong moment, or I get so lost in my latest Robert Goddard novel that I lose all track of the hour.

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