Hazel McHaffie

Canada

Storytelling the world over

We all love a story, don’t we? One reason why I turned to fiction – to share the excitement of medical ethical challenges.

We’ve just returned from a visit to Western Canada (Calgary to Vancouver) and every day I was reminded of the importance of storytelling.

The country is celebrating 150 years this year and remembering its roots, its pioneers, its history. Everywhere we went we heard fascinating stories.

City areas, rivers, even mountains, are named after people who have left their mark in this world – including this brave young lad who spent his last days raising funds for cancer research. He is lastingly remembered; what boy wouldn’t be thrilled with the Terry Fox mountain.

And before white Europeans discovered this beautiful land, the First Nations told their own stories. We could picture the families, the communities, gathering to listen to the legends and folklore which continue today in the totem/story poles and in the inherited tales from descendants who still work in the areas their forebears claimed with such diligence and vision.

And some of our own relatives sought their fortune during the great goldrush. Their stories also seem more real here.

The scenery is stunning too, and it’s been therapeutic to trek in the pure air of the Rocky Mountains, explore forests and rivers, watch bears, cranes and marmots in the wild, and generally forget all the humdrum responsibilities of everyday life. I’ll share a few photos with you by way of light relief and please note, they’re the real thing; no airbrushing, despite the seemingly improbable colours.

Oh, and the wildlife wasn’t to be sniffed at either!

A fabulous part of the world.

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Conversations on Dying

‘And that’s the reality of all human lives when it comes down to it, isn’t it? That we choose the narrative we write with our lives every day. By the decisions we make, by the ways we chose to spend our days, we craft the lives we live in, our story.’

Dr Larry Librach lived a rich life, told an impressive story.

‘If you had to imagine an archetypal favourite uncle, you’d probably come up with someone like Larry. His eyes crinkle because a smile is his face’s default setting. His trademark moustache, which has been grey since I first knew him, is always neatly groomed, but it’s constantly being worked – curling upward at each end, He still has a full head of hair, despite his sixty-six years, and it always gives the impression that it’s on the cusp of being unruly – that it might any second explode into an Eisteinian mop.’

Dr Librach? … Who? … He was a palliative care physician in North America, co-founder and director of the Temmy Latner Centre for Palliative Care, one of the largest such centres in the world. He dedicated his working years, his distinguished career, to helping his patients navigate their final journeys, to teaching others to truly understand and provide empathy, sensitivity and real support. He readily agreed to assist journalist and writer, Phil Dwyer; to be interviewed, to be shadowed as he went about his work caring for dying patients in the community. Here was an opportunity to teach a far wider circle of people than those in his immediate circle of students and colleagues. To improve care everywhere.

It was a body blow to Dwyer when he learned that Larry himself had been diagnosed with terminal pancreatic cancer. But such was the generosity of the doctor (and his wife) that Larry continued the interviews, now sharing his own personal experience of dying at every stage, to give an even more intimate insight into what it feels like to walk this painful path. One more teaching opportunity – perhaps the most powerful. One more chance to tell those who would come after him – patient, relative, friend, physician – what helps, what hurts, how care could be made better.

‘It wasn’t the cancer that crafted Larry’s narrative, but the choices he made after he knew about it. Larry chose to die, as he had lived, with purpose. It was only that, only his intent, that gave his death meaning. But it was enough. More than enough.’

Conversations on Dying is the book that came out of this joint venture. It’s a beautifully hopeful, energised story of love and commitment, of family and friendship, and a seemingly bottomless well of compassion. Larry somehow manages to combine an honest appraisal of the emotion and pain of his situation, with a rather unnervingly detached scientific perspective and analysis, even when things seem bleak and overwhelming.

Phil Dwyer too is impressive. His intimate connection with his co-worker is plain to see, his own grief and pain raw, and made all the more poignant because he is simultaneously reliving the death of his own elder brother three years before from throat cancer. He compares the two experiences, learning, understanding, mourning … and with new illumination comes new sorrow. But in spite of the personal cost he manages to write with elegance, wisdom and sensitivity, creating a narrative both moving and intensely readable.

No detail is too small, no nuance missed. His brother John had craved a Chelsea bun and a pint of beer; the mass in his throat prevented him ingesting either.

‘These are the things we lose. Everyday things. Things we’ve experienced thousands of times without pausing to savour them. These are the things that become important when they’re taken away from us.’

Phil (in Canada) and John (in the UK) were continents apart. He lived in dread of that  unexpected family phonecall from a foreign land, the terror, the immediate imaginings of death or disaster.

Mayhem lurks in that transatlantic static
‘… hollowness would open up as I lifted the handset’

And finally …

‘When she [his sister] did [speak] it was in a voice that had been washed clean of every bright note, a flat, emotionless tone from the country of the mourning. She couldn’t even say the words. All she could say was “it’s happened”.’

It might be supposed that Dr Librach’s own experience would be one of gold standard care. After all he was famous, it was he who taught his personal physicians how to care. But no, he too was subjected to thoughtlessness, insensitivity, even negligence at times. A receptionist chose to file her nails rather than give him thirty seconds of her time to supply a document he needed. Dr X completely fouled up Larry’s treatment for jaundice. But he faced the good, the bad and the ugly equally with courage and clear sightedness. He listed the deficiencies of current provision in his own discipline boldly and wisely:

  • Liaising between parts of the system is poor; appointments are not dovetailed, making impossible demands on dying people.
  • There’s too much centring on disease not on the person and family; insufficient true caring; not enough team spirit; too little respect for the patient’s time; too little empathy; ineffective information exchange; too little welcome.
  • The government is all about performance indicators; healthcare administrators are more into spreadsheets, too far from the bedside.
  • Not everyone with cancer needs to have treatment; quality of life as opposed to quantity is important. Chemotherapy can kill the elderly as well as cripple the health care system. Why try to save the dying at all costs? What for?

Ring any bells?

In the face of ‘the gut shreddingness of the emotions that tear into us at such a time’ there are certain key things that matter. Typically he gets to the very kernel of what counts in the end:

  • being respected and cared for as an individual
  • being heard
  • being free to ‘let it all hang out’, sharing the emotions, not bottling things up
  • keeping communication lines open
  • finding your own meaning and value in life

Simple things. Human, compassionate, loving things.

I’ve written and talked about the issues around dying myself for many many years (ad nauseam my family would say!); I’ve read countless books on the subject; I’ve even written a novel about assisted dying. But this one, Conversations on Dying, is unique in my experience. Its candid and energetic approach, the intimacy of the collaborators with each other and with death, their courage and generosity in allowing us to witness their raw emotion and vulnerability at close quarters, their clear summary of the issues that matter, offer us at once an enormous privilege and a lesson for life. I salute them both.

And thank you, Amanda, for recognising that this is my kind of reading, and for your generous gift of this special book. I shall treasure it.

(NB. You may like to know that radio broadcaster Eddie Mair has recently recorded a series of talks with journalist Steve Hewlett – who died a couple of weeks ago – about his experience of terminal oesophageal cancer. They cover similar ground.)
 

 

 

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A Place Called Winter

All except one of my trusted readers/critics have now given me their feedback on my latest book, Listen. Exciting times. But before I sit down for a serious edit, I’m immersing myself in some exquisite writing, beautiful language from the pen of a master, that will be a incentive to me to raise my own game – I hope!

The author? Patrick Gale. The book? A Place Called Winter. A sad, tender, compelling tale of Harry Cane’s battle with his own demons, the taboos of his day, and the wild wastelands of a new country. It’s an intensely personal novel inspired by a true story from Gale’s own family history: one gay man reaching out with sympathy and deep feeling to another (his mother’s grandfather) across a century of social change.

Harry Cane is born into privilege, raised to ‘believe that what mattered was to be unmistakably a gentleman’. He rides horses; others muck out their stables. His soft hands remain idle while callouses build up on the palms of his social inferiors. But his childhood is emotionally impoverished, with his mother dead and his father absent, schooldays punctuated by all the trials upper class boys can inflict on those they see as weaker prettier mortals. Consequently his life is centred on his younger brother Jack. It’s Jack who drags his shy insecure brother into society after their father’s death and introduces him to Winifred Wells, his future wife. Theirs is a gentle undemanding relationship which reluctantly produces one daughter before it settles into platonic coexistence.

The time is the early 1900s; apartheid is unchallenged; class distinctions rule; abortion and homosexuality are unlawful, the latter punishable by hard labour and utter disgrace; ‘treatment’ for psychiatric illness and ‘deviance’ is draconian. When his brother-in-law discovers Harry’s guilty secret, Harry – now an exiled ‘unmentionable‘ – signs up for a new start in a new country, Canada, one of 511 passengers on a ship sailing to the unknown.

The vast impossible prairies are simply waiting to be tamed, and after serving his year-and-a-day apprenticeship to a Danish farmer, Harry commits himself to converting 160 acres of wild wasteland into a self-sufficient thriving homestead within three years. Setting out with simply the map coordinates SW 23-43-25-W3, and directions to a place called Winter scribbled on the brown paper the cheese was wrapped in. An English innocent in a harsh unbroken landscape where there is ‘not much call for cash‘, and ‘neighbour is a relative term‘.

His closest neighbours are a brother and sister, Paul and Petra Slaymaker, whose lives become intimately entwined with his own. Beautiful relationships are established which are tested in the cauldron of  gossip, violence, war and illness. But their peace is threatened much more by the reappearance of a common enemy whose actions and knowledge cast a long shadow over their lives.

Gale’s writing is superb. His characters are beautifully realised, their emotions are captured with tenderness and palpable truth, and the abiding fear of loss, disgrace and exile haunts every hour of reading. Much as I revelled in the writing, though, I had a powerful feeling of desolation at times. Harry’s apologetic personality, his sad acceptance of the degrading things that happen to him, his gentle resilience, his innate decency even in the face of extreme provocation, stand in sharp contrast to the militance and ferocity of modern day campaigners for individual and collective rights. I wanted to reach out to him with compassion, understanding and reassurance.

But it’s a novel. I must instead give you a flavour of the lyrical prose:

… hot breakfast rolls as soft and pale as infancy.

… torn rags of sentences.

… they gave the impression of having emerged, fully formed, from eggs, as brittle as the waxy shells they had discarded.

There’s the heir and the spare and the heiress-beware.

A horse is ‘like a sofa with hooves‘.

‘Vaccinated by this cruel loss of his first daughter, he approached fatherhood the second time round with a certain reserve. He did not consciously harden his heart, but he loved with hands metaphorically behind his back.’

… war was declared in August, when harvest preparations were at their height. The news was sown swiftly, shaken from pulpits and scattered by posters and threshing gangs.’

I rarely give a book 5*s – this novel reminds me why. It wholeheartedly merits them. Highly recommended.

*****

 

 

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Neither male nor female, bond nor free

It’s a long time since I read my last (and until now, only) novel about hermaphroditism: Middlesex by Jeffrey Eugenides. MiddlesexPerfect title, huh? But I loved that, so when I saw that another one on the subject had come out this year, it went straight onto my wish list. It’s Annabel by Kathleen Winter. A brave subject for any author to tackle, never mind as a debut novel. And it became my second read on a Kindle.

Annabel is set principally in the wild wastes of Labrador, populated by self-sufficient trappers and the women they leave behind. Kathleen Winter’s descriptions are amazingly evocative of a 1960s Canadian landscape and a way of life far removed from 21st century life in the central belt of Scotland.

AnnabelThe rather old fashioned, sedate prose seems to fit with the lives of these families. Restrained and economical. Caught in a time warp. Veiled references to ambiguity and its consequences, tucked into all sorts of corners and margins of the text – in descriptions of places and people, in experiences urban and rural, in relation to the psychological as well as the physical dimensions of its characters – reflect the ambiguity attached to the subject matter.

Treadway Blake is a silent, introverted but well-read trapper, more at ease in the wilderness than at the hearth. When he eventually finds out his firstborn child is ‘neither a son nor a daughter but both’ his decision is clear: ‘He’s going to be a boy. I’m going to call him Wayne, after his grandfather. We’ll get the doctor in and we’ll see.

Jacinta, his wife, is a city girl at heart, who is doing her best to adjust to the deprivations and restrictions of life as a trapper’s left-behind girl. Her maternal love accepts her child as he/she is; she is content to leave well alone, to let Wayne grow up ‘without interference from a judgemental world’; the two complementary halves giving him/her extra power, unusual sensitivity.

I don’t want to spoil your enjoyment of the story so I won’t give any more of the plot-line away but suffice it to say that it’s a tender and sympathetic tale, rather slow-paced but insightful. Much of it captures the normal mundane everydayness of life in a backwater in the 60s, but it also contains quite horrifying developments and experiences in Wayne’s life which shocked me into thinking in a different way about this complex topic.

Overall I felt I had a better sense of the confusion and consequences of gender ambiguity after reading it. And yet, there was no sense of the issue dominating the narrative.  And you know how this is an abiding concern of mine.

So if you’re looking for something different, something that will be discomforting at times, heartening at others, but will make you think, then this is one for your Kindle or bookshelves.

The eagle-eyed among you will have noticed this week’s post is going out early. Next week it’ll be late. Explanations to follow in due course. Plus the latest developments in my attempts to convert my backlist to ebooks.

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