Hazel McHaffie

eating disorders

Missing …

I do love discovering a new author and devouring their books. It’s a bit like getting to know a new friend. One such recent discovery was Samantha Hayes. You might – or much more likely, might well not! – remember I posted a review of a psychological thriller by her at the beginning of August. It rang lots of bells with me, which sent me off in search of more of her books. I bought four – enough to give me a feel for the kind of writer she is, I thought.

Until You’re Mine which came out in 2013, was her first published thriller, so it was appropriate that this was the first one I read. Had her style changed over the years? Is she a predictable author? Would I find her later novels as exciting? I’m very aware that there are downsides to immersing oneself in the writings of a single author – even the best can pall somewhat with over-exposure.

Well, Hayes specialises in scary, skin-crawling tension, that’s for sure … and missing persons … and last minute unpredictable twists. I’ll give you a brief summary of each novel in chronological order of publication.

You Belong to Me (2015)
Three women have been terrified by stalkers. Two of them – Alexandra Stanford and Melanie Carter – are now dead. Both had red hair, both had infinity tattoos surgically removed from their bodies. The third one, Isabel Moore, also red haired with the same tattoo on her neck, vanished without trace.

DI Lorraine Fisher is haunted by the memory of Alexandra’s dead body. She feels responsible; Alex had reported her terror but there had been insufficient evidence for the police to do anything about her stalker, Jimmy Hardwick. Melanie’s case was different, but some time after her death, Lorraine is told about a man having hassled her too. Could this be the same stalker? Is there a serial killer on her patch?

Isabel Moore, the third woman, has hidden herself away in India, but she comes out of hiding when she receives word that both of her parents are dead; killed in a car crash. And to her horror, she learns that the driver of the car was Felix Darwin, the same controlling man who had made her life a living hell.

Three first person voices tell the story, all with serious issues. One of those voices is that of the seriously disturbed man who terrorises women. It’s scary stuff and certainly gets inside the experience of abusive control. I didn’t guess the final twist but I did find some of the action rather stretched my credulity.

In Too Deep (2016)
Gina Forrester is struggling – first her son Jacob dies; then her husband Rick disappears. Now someone is taunting her. Is she going mad? Who was watching her from inside that house in Evalina Street? Who really booked a week’s holiday in a luxury hotel for her? And what exactly is her daughter Hannah hiding from her? Everywhere she goes Gina sees ‘bits of Rick, as if he’s been blown into a million pieces‘, and she’s determined to gather them all up, piece him back together again.

Some of the clues are rather too clunky/unsubtle for my liking and I did guess the main twists well before they were revealed, but the question of how it would all resolve itself remained, and that tension kept me reading. Nothing, however, prepared me for the last few lines. (It was the final page of Until you’re Mine that blew me away too.)

The Reunion (2018)
It’s every parent’s worst nightmare. The Reunion conjures up the cold horror felt by a family when a thirteen year old girl, Lenni, vanishes. It’s 21 years ago now … and the family are in trouble once again. Her father is suffering from Alzheimer’s disease; family rifts are unresolved; someone is sending creepy messages saying the caller knows where Lenni is. It’s time to sell the property which gave such joy and security to the children and their friends. Lenni’s sister Claire decides they’ll have one last hurrah at the house and arranges a reunion of everyone from those halcyon days – which means all those who were present when Lenni actually went missing. But the week intended for reminiscence therapy for her father and healing for them all, turns into a nightmare. Another teenager goes missing. Crimes are committed. Trust is shaken.

This one ticks lots of boxes. It covers my kind of territory: eating disorders, dementia, family dynamics and secrets. Again the ending was a surprise, but for me, the writing isn’t as good as the first one of Hayes’ books I read, and that took the edge off my enjoyment.

So, overall, Samantha Hayes gets a big tick from me for her devious plotting, and for her breathless ‘well-I-didn’t-see-that-coming’ endings. And I’ve learned something more about how to tingle spines in a domestic psychological thriller. But comparisons show me that the component that grabs my interest most is the topic under review and its ethical dimensions. Part of my mind is sorting, seething, delving beneath the surface, wondering What would I do?

 

 

 

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Challenges and choices

The International Arts Festival is currently in full swing in our fair city, and it’s easy to get caught up in the exciting momentum of events and performances. Guilty as charged.

But of course, for many, far far more serious questions beset them than which actors, writers, musicians or artistes to support. I currently have six special people on my worry/prayer list all facing major challenges in relation to their health, life and death.

It’s not appropriate to be specific about them, but perhaps they are behind my extra sensitivity to the difficult choices so many face. For this post I’m thinking of those people who’re involved in the consequences of legal change, medical advances or financial restrictions associated with healthcare – my kind of workaday world. I’ll enumerate but a few (with links) reported in the national press in just 36 hours by way of illustration. All raise a number of thorny issues and I leave you to ponder those for yourself.

Relatives and health care workers caring for patients trapped in unresponsive bodies with minimal or no consciousness no longer need to go to court to resolve the question of withdrawing/withholding life sustaining measures. Decisions about dignified death can be made quietly and privately in a timeous way.

In figures released last month, the first trial of a pioneering immunology vaccine called DCVax has shown some real promise. DCVax essentially uses the patient’s own immune system to fight the tumour, tailoring treatment to their specific needs. This trial has already been running for 11 years and came to public attention when MP Dame Tessa Jowell was not eligible to receive DCVax for her glioblastoma. Sadly she died in May, but not before she had successfully campaigned for increased funding for brain cancer research. To date patients have needed to stump up £200,000 for this treatment.

New National Guidelines, known as Saving Babies’ Lives Care Bundle, have been issued in response to the alarming statistic that 600 babies could be saved from stillbirth annually if the mothers were adequately monitored.  SBLCB focuses in on the incidence of smoking, signs of failure to grow, reduced fetal movement, inadequate monitoring in labour – risk factors that were all known about decades ago when I was in clinical practice. Given that 3000 babies are stillborn every year in England alone this seems like an important area to concentrate on.

ASDA has apologised for selling a pregnancy test that issued false results leading a young woman in Devon to believe she was pregnant when she wasn’t. However the store has not recalled this product and insist it has been quality tested.

One in five people who have eating disorders have their lives cut short, but a considerable number are turned away from help because they are not skinny enough. And this in spite of National Institute of Health and Care Excellence guidance to disregard body mass index. (I found this to be true when I was researching Inside of Me.) A campaign is now underway to ensure the NICE guidelines are being adhered to.

News at the end of July was that more than half of Scotland’s population have pledged to donate their organs and/or tissues after death. That’s the highest rate in the UK and comes after a high profile awareness campaign. It’s good news for the 550 or so waiting for transplants and a significant factor in the discussion about whether we should change to an opt-out system, currently under review. Interestingly 90% of the population support organ donation, so one wonders about the mismatch.

I could go on but I promised just a brief snapshot. But I’m doing my best to keep perspective during my annual summer sortie into the world of drama and art.

 

 

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Ethical issues for everyone

I’ve been taking stock of where I am in my writing career of late and I thought I’d share with you a couple of noteworthy things from this appraisal.

The first relates to the prevalence of my subject matter.

To one side of my desk I have three large boxes full of folders. Each file contains material related to topics I’m interested in; each one a potential novel. (Yep, you’ve got the picture. I’m obsessive. Nothing newsworthy there.) But some of these files are very thick; one topic even runs to two volumes. And reviewing the contents, I’m reminded of how often I cut things out of the daily papers to slip into the said folders. Deduction? My kind of subjects must help sell newspapers; ordinary people must be interested in them.

Alert to this, I did a mini survey. Result? Just on one day this week there was something on
– mental illness (OCD and depression and self harming all dealt with)
– organ transplantation (growing human organs inside other mammals)
– assisted suicide (the BMA’s position: should doctors to be free to follow their consciences?)
– body image and identity (eating disorders, celebrities’ experiences)
– balance of risks and benefits (related to heart disease)
– care of the elderly and those with dementia
All on just one day in one newspaper.

Right to DieThe second point relates to the currency of my subject matter.

When I start planning a new book, I do try to imagine life a bit ahead of present understanding so that when it comes out it’s still relevant and topical, but I’ve been surprised at how much these issues remain current. Take assisted dying, for instance. My novel, Right to Die, was published in 2008. In the eight years since then parliament has revisited the issue repeatedly; professional bodies have regularly debated the pros and cons; a considerable number of high profile cases have come to public attention; campaigns have been fought. It’s still a hot potato and it doesn’t show any sign of cooling any time soon.

Remember-RememberThen there’s dementia. Remember Remember came out in 2010, but the ethical dilemmas it explores are as thorny today as they were then. What’s more, the number of families grappling with them is growing as the human lifespan increases; more and more individuals are exercised by the questions.

I’ve been working on an outline for the tenth and eleventh books recently and I’m staggered by the thickness of the folders on those two topics. I’m having to write notes of notes, and lists of lists, to sort out the wealth of facts and the evolution of thinking and knowledge, in order to establish what arguments and counter-arguments obtain today, and to start developing a coherent plot-line. When I first set out on my pathway to becoming a novelist, a very highly regarded agent advised me to leave my academic background behind me. I knew what he meant: the meticulous research mustn’t show through in the finished product. However, from my point of view, those decades as an university researcher stand me in good stead when it comes to delving deep, sifting and sorting facts, and understanding science.

Of course, I’m well aware that at some point I shall have to put away my writing pen, my days as an author done. But it certainly won’t be because I’ve run out of subject matter! Medical ethics is very much alive and thriving.

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Peeling back the gilt of Christmas

Nativity carouselAt this time of year it somehow seems extra tragic when bad things happen to good people. Aside from the global crises afflicting our world and unravelling before our eyes in our living rooms, I personally have a number of friends currently facing serious illness, impending death, sudden bereavement, and yet it must seem like everyone around them is caught up in trivia and pleasure, festivities and excess – in reality of course, who knows how many others are only hiding stresses and problems from public consumption?

Mrs Santa straw figureIt’s in this spirit that my mind has been wandering over the huge dilemmas facing different families; what would I choose in their circumstances? how would I cope?

Metropolitan police officer Heidi Loughlin, 33, discovered she had an aggressive form of breast cancer the day after finding out she was pregnant with her third child. She decided not to have a termination of the pregnancy but to delay treatment until after the birth. Her condition became so serious however that her baby girl was delivered by Caesarean Section on Friday, 12 weeks early, and Heidi has been given a short time to recover from the operation before starting powerful chemotherapy next week. She faces a pretty gruelling Christmas, but is determinedly looking forward to March when she will get her baby girl home to her two brothers. She has risked her life to give her daughter a chance and says she has no regrets; it was all worth it. What would I have chosen in this situation, I wonder? What would you?

Then there’s fireman Patrick Hardison. He entered a burning house in Mississippi; the roof collapsed on him leaving him with severely disfiguring burns across his face, head, neck and upper torso. Think for a moment of the pain of a small burn from an oven shelf, a hot iron … Multiply that by ten trillion. Even after 70 operations he was still so terribly mutilated (see pictures here if you can cope with them) that he would only go out heavily disguised. What kind of Christmases has he endured, I wonder? He recently underwent the most extensive face transplant ever performed. Factor in not only the excruciating pain at every stage but the risks … would I have been courageous enough to want to go on living? Would you?Antique Santa candle holder

Within the last two months, two transgender women have been found dead in their cells in all-male prisons: 21 year old Vikki Thompson in November, and 38 year old Joanne Latham in December. No more Christmases for them. Many difficult questions present themselves where transgender people are concerned and there is generally much greater sensitivity to their issues, but what about when they commit crimes, serious offences that land them in prison? Not only their own welfare is at stake but that of their fellow prisoners. Where would you have housed these two? Nearly 150,000 people signed a petition to house a third person, 26 year old Tara Hudson, in a female institution even though she had been convicted of assault. Would you have signed it?

A 50 year old woman, mother of three, is so determined not to grow old and ‘lose her sparkle’ that she has refused to undergo kidney dialysis. Her kidneys were seriously damaged when she took an overdose following a diagnosis of breast cancer. For years her life style has been chaotic to say the least, and one wonders, what is Christmas like in that household? Whatever, the Hospital Trust responsible for her care appealed to the courts to have treatment imposed against her wishes. But a senior judge has upheld her right to an autonomous choice to die. Was he right to do so, do you think?

I’m merely scratching the surface by way of illustration. Remember all the cases we’ve heard about recently – various scandals around abortions carried out on the grounds of gender alone; teenagers killing themselves because they’re obsessed with losing weight; all the dire warnings about how to deal with declining fertility; the consequences of a simple blood test at 18 weeks pregnancy that allows screening for thousands of genetic conditions  … the list goes on and on. My files are bulging with clippings and articles.

Scandinavian figuresSo at this time of celebration and joy, let’s spare a thought for families caught up in tragic circumstances, and the courageous souls who try to support and guide them. May they find wisdom, courage and strength. And I wish all visitors to this blog peace as you prepare for the festive season whatever it means to you.

 

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Editing editing editing … and more editing

To Kill a MockingbirdIn all the recent hype about Harper Lee‘s second (or was it actually her first?) novel, Go Set a Watchman, one issue keeps recurring: who was really the inspiration behind the bestselling To Kill a Mocking Bird? Was its success down to her editor? Or was it in fact her own genius?

I’m particularly sensitive to the influences which shape novels at the moment. Comments from my own raft of experts are flooding back to me about my own latest story and the book is changing daily as a result – plot strands are being recreated, dialogue changing subtly, language and emphasis reflecting new thinking, characters adopting new habits and voices. Is it any less my baby? I don’t think so. Other people shine a light on areas which don’t quite work for them; the author decides how to respond to those comments.

I ask everyone to be brutally honest at this stage; that after all is the whole point of the exercise. And believe me, it can be daunting – even traumatic – to have masses of red pen highlighting potential flaws, but I’m hugely grateful for all this input. Yes, it represents a lot of extra work now, but the end result should be a richer, tighter, more authentic and plausible story. I take comfort from the comment by Ian Rankin recently that even after decades writing and countless bestsellers under his belt, his editor sent back a draft requiring him to go back to the drawing board and re-write it. Which he did.

Hey, enough of this reflection … head down. Every character must be revisited, every narrative thread tugged tight and re-tied, every page of dialogue re-analysed. Right now I’m inside the head of a teenager with an eating disorder who’s searching for her lost father. Not a comfortable place to be. It takes me a while each day to re-enter the real world so approach with caution if you try to speak to me during writing hours. Writing hours? That’s pretty much any hour these days!

Harper Lee maintained a dignified silence in the face of huge public criticism; she has remained an intriguing enigma. Sounds like a good idea to me!

 

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Girl Under Pressure

Priority at the moment has to be the promotion of Over my Dead Body, so research on the next book has been relegated to a back seat. Sad but true. However, that doesn’t stop the ideas simmering.

Anorexic booksRemember this row of books about anorexia? Well, so far I’ve read only 7, but already I’ve come to a definite decision: weight loss mustn’t drive my story. Frankly I’m bored out of my skull with it already! Admittedly most of the books have been teen fiction and not really my kind of reading in the first place, but they’ve served a useful function in that they’ve shown me clearly what to rule out of my own writing.

It was Girl under Pressure, an ebook by Michele Corriveau, that clinched it. The only one to date with anything approaching a gripping storyline, which has held my interest, and had no sense of being a cautionary tale. It’s also sufficiently whacky to make me admire the author’s courage in tackling such disturbing themes.

The story begins with the abduction and death of a little girl, Jessie. Not an easy topic but it came as a breath of fresh air after the previous six books, and I was struck by the literary possibilities it offered. The horror for the two main families of discovering Jessie has been snatched offers a potentially powerful hook to create tension and emotional engagement from the outset. I say ‘potentially’ because sadly the author doesn’t fully capitalise on her good idea. The incident is dealt with too quickly and too coldly – a source of considerable frustration for me as a reader; but at least I could appreciate what might have been.

NB. If you’re considering reading this book, I should warn you the rest of this post contains spoilers.

 As a child, the main protagonist, Maggie, uses food to bargain with God to stop bad things happening to those she loves – it’s called magical thinking. But then food becomes an obsession. As the years go on, her OCD escalates and she progresses to stealing in an effort to stop the pressure mounting inside her. She can’t think straight until she’s stopped the voices that demand she carries out this act. Once she’s done it, she can calmly go on living her life. Stealing then gives way to a compulsion to seek out strangers for sex.

 She gets beaten up and raped more than once by the men she goes with and the reader starts to get a real sense of the power of the OCD that has her in its grip. These horrific experiences aren’t enough to stop her continuing to put herself at risk. Maggie’s husband, Alex, becomes increasingly anxious and bewildered by her behaviour; she either conjures up improbable stories, or simply refuses to talk about what’s happened. Then one day, things come to a head. She meets a man on a park bench and accompanies him to his home for sex. He thinks she’s a child because she is so tiny and looks immature, and when he’s unable to dominate her as he wants/needs, he becomes extremely violent. When she sees his face on TV as a man wanted for questioning in relation to the abduction of little Jessie, the only daughter of her friends, Maggie is appalled. He can’t be guilty; at the time in question he was with her.

In spite of her dread of exposing her own sordid behaviour, and the effect of such a revelation on her beloved husband, Maggie’s conscience drives her to go to the police to clear this man’s name. Alex is utterly appalled when he learns the truth. He leaves her, taking the children with him. But in fact her alibi is false because one of her children had changed the clock in the car. This man hadn’t been with her at the critical time. He had killed Jessie just before he picked up Maggie in the park. So she’d risked and lost everything for a murderer and paedophile.

I found the plotting intriguing and the storyline very different, but it was spoiled for me by the litter of typographical errors and the muddled point of view in places. I wanted to give it a good edit and send it out into the world spruced up.

 But, thanks to Corriveau, I’ve been able to turn a negative into a positive and learn a valuable lesson about what not to do in my own writing.

 

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Slim pickings!

Well, the stack of books about eating disorders I ordered by way of research for my next novel (working title: Skin and Bone) is growing steadily. Here’s the first haul awaiting my attention – I’ve managed to read a measly two so far.Novels about anorexiaAnd here are some of the Kindle titles also waiting for that glorious time when I can lie back with a clear conscious and wallow in one of my favourite pastimes. Ebooks about anorexia

But marketing Over My Dead Body takes precedence right now. Much as I should love to have a team of elves scurrying around in the background doing all the work, and agents and demi-agents and assistant demi-agents all cracking whips, the sad truth is they are a mere figment of my fevered imagination. In my rational world, I’m making myself allocate time most days to it. Reviews are pending; I’ve had several invitations to speak at events; word is filtering out; so behind the scenes we are moving in a forwardly direction.

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Away from it all

KinlochlevenI’ve just spent four days in the Highlands of Scotland, walking boots on my feet, camera in hand, no intention of working in my head. A complete break after all the frenzy around publishing the latest book.

I absolutely love this stunning scenery; the majesty, the mystery, the rawness, the sheer peace of it all, so indulge me while I give you a glimpse of its beauty.GlenfinnanView from top of Aonach MorGlenfinnanBut in spite of my best intentions, medical ethics (as portrayed by newspapers) did winkle its way into that bolthole. My eye and brain homed in on two issues close to my heart at the moment. Individual rights: triggered by the discussion on veiling the face in court or in school. Abortion: the question of whether there’s any meaning at all in the Abortion Laws of this country if doctors are not prosecuted when they’re caught authorising the abortion of fetuses because they happen to be the ‘wrong’ gender. But my resolve held! I merely saved the relevant articles, and refrained from scribbling a single word into my notebook.

Now I’m back in harness, refreshed and raring to go. The work of promoting Over My Dead Body goes on, and invitations to speak about it are coming in, but I’m ready to get thoroughly immersed in a new topic too. I’ve just downloaded 14 e-books and ordered 21 paperbacks on the issue of eating disorders which should hopefully get me started.

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