Inside of Me
Image and appearances
It’s 4 years now since I published Inside of Me, but body image and transgender issues keep popping up above the parapet, and hauling me back into that world of tortured self-doubt and secret longing.
– In the last few weeks we’ve had the BMA saying that people should be able to gain legal recognition of their changed gender without the input of a registered doctor, and indeed with no more than a witnessed sworn statement. As things stand, you need a diagnosis of gender dysphoria, and a report from a registered doctor detailing treatment received, and proof that you’ve lived for at least two years in your chosen gender, and intend living in for the rest of your life.
– But subsequently the government announced that plans to allow transgender people to self-identify as the opposite sex have been shelved; they feel that the current system means that ‘proper checks’ are in place. However the current fee of £140 is to be reduced to £5.
– Then, the transgender community, already incensed by JK Rowling‘s comments about what a woman is, have trained their sights on her yet again, because her latest Robert Galbraith novel, Troubled Blood, features a serial killer who dresses in women’s clothing.
– And then there’s the mother of a dead transgender 18 year old, campaigning to honour her daughter’s dearest wish: to have children. The youngster changed gender from boy to girl in the teen years, but had sperm frozen at 14. The mother is planning to launch a landmark legal case to preserve the sperm (now due to be destroyed) to enable her to have a grandchild via a donor egg and a surrogate mother.
Just a few of the news items. But of course, each one brought the complicated ethical issues very much back into my mind, and that in turn, led me to a book near the top of my tbr pile – For Today I am a Boy by Kim Fu.
One day I’ll grow up, I’ll be a beautiful woman.
One day I’ll grow up, I’ll be a beautiful girl.
But for today, I am a child. For today, I am a boy
This truncated quote beautifully sums up the essence of this brave novel.
Peter’s father only ever wants a son: ‘In a family, the man is king. Without you, I die – no king.’ But two daughters come first, before Peter, followed by another girl. With only one chance, Mr Huang is determined to make a real man of this longed-for boy, forcing Peter into male ways from an early age. He teaches him how to shave when he’s 6 years old, tears anything female out of his schoolbooks, approves and rewards brutish male behaviour, makes sure his son doesn’t do ‘women’s work‘ like the dishes. Peter is acutely aware that his sisters get much more lenient treatment.
But Mr Huang is steeped in Chinese traditions about ancestors and what is right. Appearances matter. He has high expectations of his only son, even whilst being unfaithful to his own wife. Peter describes his father’s mistress, the neighbour Mrs Becker, beautifully. She was …
‘Pale and thin and seemed to quiver at the edges, like she was made of water. She had limp red hair. Her freckles were a handful of sand tossed in her face … light shone through her skin to the blue veins along her forehead … her smile looked unstable.The structure of her face couldn’t sustain the weight’ … and when she betrays Peter – ‘a jittery nobody, the human equivalent of onionskin paper.’
Mr Huang is appalled at a deep level by Peter’s ‘differentness‘, his ‘weaknesses‘. his proclivities. He must at all cost keep them secret, not shame the family, not let down his ancestors. And even when facing his own imminent demise, he reminds Peter he’ll still be watching him ‘from the other side.’
With this threat haunting him, even excursions into the female world carried out behind closed doors are fraught with fear and guilt for the conflicted Peter. When he puts on a wig, pouts his lips, looks in a mirror, ‘I felt my father staring through my eyes, the grotesque image in the mirror, the halfsie freak. The grandfather I hadn’t known, the great-grandfather, all watching as my father strove not to shame them, every day until he died. All of them watching me now.’
In this fragile tale, shot through with melancholy, Kim Fu powerfully captures the young child’s only-partially-understood longing to be other than he was. The ‘nightmare years‘ of adolescence. The ongoing desperate struggle to live up to the expectations of others – gang members, pals, work mates, family. The terrible loneliness of not being understood. The pervasive malevolent forces that would crush people like Peter Huang, learning slowly and painfully the real meaning of being a woman. The terrifying consequences if he names his inner conviction.
He becomes increasingly aware of consequences outside his battles with his own body, too; the larger fight against hatred and prejudice. ‘It’s not just about me and my body. There were marches, vigils, hate crimes, unjust laws, a world that needs education. There were other people like me … there were forces that had crushed us.‘
I was struck by the essential loneliness or unresolved doubt. Do any of us really understand what goes on in the lives and minds of others? Books like For Today I Am a Boy help us to sidled a little closer, understand a little better.
Living the dream
What a week I’ve had! OK, I may be confined to barracks post-surgery, strictly forbidden (by authoritative medical personnel no less) from all housework or exertion of any kind, having to keep my leg elevated day and night … but, bored? Not a bit! Frustrated? Nope. Secretly sorry for myself? Certainly not! I’m capitalising on the situation and achieving far more than I ever anticipated. And buzzing! Has to be good for the soul.
OK, I knew it was coming. Before surgery I accumulated the usual materials for sedentary occupations like knitting, reading, writing, DVDs, etc etc. What I hadn’t bargained on was a complete takeover bid!
It started as soon as I began to actually write the annual Christmas story/play I compose and direct for my grandchildren. As part of my research I began dipping in and out of my all-time favourite books … soon lost in memories and other lives, somewhere in my head my own quite distinctive characters from different strata of society and various times in history who form the core of the play.
Then it was time to start actually committing ideas to the computer.
I began tentatively, feeling my way gently, setting the scene, getting to know the principals, but suddenly one after another they assumed accents and speech patterns and habits of their own. And away we went! Enormous fun. All without the constraints of my other kind of writing (this story is for a very select and exclusive readership indeed; not a single literary critic or publisher’s delicate sensibilities to be factored in).
On the day of the play itself, the youngsters will bring their own personalities to the characters as they assume their roles, but afterwards, once it’s in book form, I want these people to live on the page. Their mannerisms, their language, their reactions, must convey so much. It’s proved both a welcome challenge and a runaway delight!
Then there’s the side effect of recuperation. Lots more thinking-time. Without all the usual time-consuming domestic responsibilities there’s more leisure to watch TV and read papers, and it’s astonishing how many programmes and articles impinge on my own fields of interest. Factual as well as fiction, they make me reflect, which has to be good for my mental state.
So, for example, there’s the news this week of a patient who’s been in a persistent vegetative state for 15 years, who has now had his vagus nerve stimulated to some effect, putting him into a minimally conscious state. Progress, you might think. Clever stuff. Could this be the start of new hope for many? But hey! Is it really better to be aware you can’t move or do anything spontaneously? Would I want such a thing for my husband/son/brother in his thirties? Does this influence my thinking on assisted dying?
Then there are the up-coming court cases. Victims of the contaminated blood scandal from the 1970s/80s have finally won a ruling allowing them to launch a High Court action. Imagine! Forty years of waiting! And they’re a long way from a resolution or compensation even now. Something in the region of two and a half thousand – 2,5000! – have already died. Whose fault is/was it? What are the pros and cons of a legal system that grinds so slowly? How could we deal more effectively with such a catastrophe in the future?
And what about the families devastated by the consequences of giving Sodium Vaproate to pregnant women. That too goes back decades and it’s left to the families to fight on for justice. My brain is throwing up questions and doubts right left and centre. Not necessarily for a book; just challenges about the morality of what’s done in the name of medicine.
Ahhh, back again comes that old chestnut, abortion. Irish girls have been coming to England and Scotland to have pregnancies terminated for decades. (I remember being troubled by the questions way back in 1960s when I was in clinical practice and saw it first hand.) This week it was announced that Ireland is to hold a referendum next year on whether to repeal its ban on abortion in almost all circumstances. Are the issues any different today? Could this have been resolved more appropriately? Should religion influence laws? Is a referendum the best way forward? And what about all the other forms of medical tourism …?
The BBC2 programme aired a couple of days ago, Being Transgender, was billed as dealing with ‘one of the hot topics of the moment’. Well, that was my thinking when I published Inside of Me last year. But even though I’d immersed myself in the topic of gender and identity for a couple of years, I was still fascinated by these personal experiences, still wondering about the issues, but be warned, the footage of reassignment surgery in this case is pretty shocking.
So all in all the days are flying by faster than I feared they would. My mind is in overdrive. And I’m hoping to be ahead of the game when I return to normal functioning … God willing.
New vision
Eebie jeebie! A year ago I invested (I use the word advisedly) in new spectacles. One pair cost some astronomical price so I got the second pair for next to nothing – they call it a special offer. Hmm. But hey, my eyes are beyond priceless, so they need cherishing.
This week I had my next regular annual check and oh woe, both eyes need stronger lenses. Ahah! Time to capitalise on the old investment and just replace the lenses, methought. And yes, these lovely smiling gentlemen specialists assured me, they could do that in such a way that I was able to keep one pair on while the other was re-glazed, and then swap them, so I’ll still be able to function as normal throughout the transition. Perfect.
However … yep, you knew there was a ‘but’ coming … even allowing for the miserly skin-flinty, curmudgeonly, option of recycling the old frames, the bill for four small ovals of plastic came to over £300! Phew! And it’s not as if everyone exclaims over one’s sartorial ocular elegance, is it? Who notices your lenses are brand spanking new? Who even recognises you’re wearing designer frames? Only an optician!
But hopefully my own eyes will, and they’ll return to days of intensive reading and peering at computer screens with renewed energy, comfort and ease. A precious blessing.
By way of celebration, after two weeks of intensive promotion of Inside of Me, I’m giving myself a mini break, allowing some reading-purely-for-pleasure to creep into the days between bursts of promotional activity. Feels like a weekend away! But just as I was starting to relax into Harlan Coben’s No Second Chance, up pops a profound thought to challenge my belief and opinions and put me into more work-like mode. The narrator is Dr Marc Seidman whose infant daughter Tara has been kidnapped and his wife Monica shot dead. Marc is a plastic surgeon who uses his skills, not to pander to the vanity of the rich and famous, but to help children severely deformed or damaged in accidents or war. I know people just like him and I really admire their selfless dedication and sacrifices. Marc also goes regularly to wheel his disabled father around the neighbourhood, and during one such jaunt he reflects on the values he holds:
‘I could be doing cosmetic plastic surgery and making a mint. My parents would be able to afford better care for my dad. They could move someplace nice, get the full-time nurse, find a place that could cater more for their needs. But I don’t do that. I don’t help them by taking the more traveled route because, quite frankly, working such a job would bore me. So I choose to do something more exciting, something I love to do. For that, people think I’m the heroic one, that I am the one making the sacrifice. Here’s the truth. The person who works with the poor? They are usually more selfish. We are not willing to sacrifice our needs. Working a job that provides for our families is not enough for us. Supporting those we love is secondary. We need personal satisfaction, even if our own family is made to do without. Those suits I now watch numbingly board the NJ Transit train? They often hate where they are going and what they are doing, but they do it anyway. They do it to take care of their families, to provide a better life for their spouses, their children, and maybe, just maybe, their aging and ill parents. So, really, which one of us is to be admired?’
What d’you think?
Then much later defence lawyer Lenny Marcus says ‘I can only be as happy as my saddest child.’ Is this a universal truth? Does it apply to me?
Challenging thoughts. Such is the power of the written word.
Mental health awareness
You’d have to be an ostrich to miss all the attention given to mental health of late. It’s Depression Awareness Week this at this very moment. Heartening to see; we can all do with better understanding and sympathy.
Since Inside of Me came out, my own working days have been much taken up with fathoming the extent of provision for adolescents grappling with psychiatric ailments and issues. I had absolutely no concept of the number (hundreds in Britain) of centres and units and teams devoted to this vulnerable group. Impressive. And all this is going on largely unsung and unremarked.
Naturally I did a stack of research before and during the writing of Inside of Me, but now it’s published I’m exploring different aspects of the topics and finding them fascinating. Not only increases my own awareness but all helps when I’m being interviewed or fielding questions at book events.
There’s been plenty of exposure in the media too. The A Word, on BBC1, is currently unravelling the effect on the Hughes family of young Joe’s autism. It’s still ongoing so I won’t say too much about it meantime. But, knowing a number of people on the spectrum personally, I’m particularly interested in the reactions and behaviours of his parents struggling to accept the situation and deal with the comments and criticisms and insensitivities of other people, what it’s doing to the whole family.
I’ve also been reading a book written by a young man who has synaesthesia as well as Asperger’s: Born on a Blue Day by Daniel Tammet. ‘I just did not seem to fit in anywhere, as though I had been born into the wrong world. The sense of never feeling quite comfortable and secure, of always being somewhat apart and separate, weighed heavily on me.‘ Not surprisingly Daniel craves order, security and predictability; but in many ways his life is outstandingly vibrant and uniquely different.
Numbers are never far from his thoughts no matter where he is or what he’s doing, but he sees them as shapes, colours and textures. Calendars delight him – all those numbers and patterns in one place. On the other hand social interaction is problematic, but if a person reminds him of a number he feels more comfortable around them.
Daniel also has savant syndrome for which he has become a minor celebrity. He can perform extraordinary mathematical calculations and memory feats in his head – outdoing sophisticated computers! He can learn to speak a foreign language fluently from scratch in a week – eat your heart out teens sitting exams this term!
Daniel Tammet was born in 1979 on a Wednesday. ‘Wednesdays are blue, like the number nine or the sound of loud voices arguing.’ Remarkably for the times, both his parents understood his needs and patiently provided a secure and encouraging environment for him, indulged his obsessions and believed in him. What’s more, in spite of the extra care their firstborn required, they went on to have a further three boys and five girls, who, by their noisy and continuous presence, forced Daniel to gradually develop interpersonal social skills. Nevertheless, he would be completely thrown by small distractions – squeaking shoes, inexplicable reactions, noisy breathing, would lose him a game of chess which he would otherwise easily win.
By the time Daniel was 13 he had eight siblings. By the time he was 19 he was ready to leave home and go abroad on VSO work. By the time he was 22 he was ready to live with his partner, Neil. By the time he was 25 he was ready to recite 22,514 digits of pi without error in public for 5 hours and 9 minutes thereby setting a new British and European record. So remarkable has his life been that he became the subject of a one-hour documentary, Brainman, filmed in Britain, the USA and Iceland in 2004. A year later he was confident enough to travel abroad unaccompanied, stay in unfamiliar hotels, stroll down unknown busy streets, and be interviewed for TV in the USA. He attributes much of his prowess to the constant unwavering love and support of his family, especially his parents. But reading his book you get an inkling of his own determination to overcome the odds.
Born on a Blue Day gives a compelling glimpse into a unique mind and life. Precisely and carefully written. Sometimes stilted. Sometimes meandering through detailed descriptions, sometimes diffidently explaining the differentness of Daniel’s thinking. Always gently enquiring, shy and grateful. Much like the Daniel Tammet who comes across in the film.
A novel idea
Not a lot to report of interest in the publication process at this stage – the work of promotion involves lots of emails and letters and phonecalls and the occasional interview. Not the stuff of riveting reports, then. Yawn, yawn. No spectacular coverage in Hello magazine; no prime time interview on TV’s Breakfast show; no six-figure deal through a top literary agent; no glorious battle for rights at the London Book Fair. Even I have to set myself timetables to ensure that I don’t lose momentum, and that I apply myself a few hours every day to the mundane practicalities, gaining readers one by one.
So imagine my surprise to find my face on the front page of a newspaper yesterday!
With a bright red caption in keeping with that red stilletto shoe! Yeah!
And there on page 7 a full article (with a different photo) talking about my use of fiction to highlight important issues thrown up by modern medicine.
Now, as anyone knows who’s ever been interviewed, it’s terribly easy for one’s words to be distorted and convey a completely different meaning. This time half an hour of questions and answers has been condensed into 13 short paragraphs, so inevitably comments and connections have been omitted, other phrases repeated to preface a paragraph, losing the overall smooth flow of conversation to staccato reporting. But hats off to the reporter, Kevin Quinn, who captured the kernel of what I try to do: make medical ethical issues accessible and increase understanding and empathy.
Hold back the hordes … form an orderly queue for copies of Inside of Me, guys!
OK, OK, OK, I know. It’s only the local paper, the Midlothian Advertiser. But I’m chuffed that this particular reporter was interested enough in mental health to feature the news item as he did. That’s what it’s all about.
.
No experience wasted
They say no experience is wasted on a writer. Well, inasmuch as broadening horizons and sharing feelings and empathising with others goes, that’s probably true. But I think it’s also a fact that if we’re receptive we can make the most of unexpected opportunities life throws at us too.
Last week, for instance, I had to visit my dentist. No big deal. Once there I didn’t have long to wait but long enough to read an article in Good Housekeeping about Jo Cannon whose recent (as of January this year) phenomenal success as an author has been emblazoned on Facebook. What I didn’t know was that she left school at 15 with one O-level in French, she worked at some pretty mundane jobs, but then decided medicine was the career for her. Hello? Ambitious then. Prepared to work jolly hard, too.
She did indeed apply herself with huge determination, funding her studies by delivering pizzas at night, and finally qualified as a medical doctor at the age of 41. Wahey! What a triumph. Psychiatry appealed to her, but she was troubled by many of the cases she saw, so by way of catharsis, she began writing a blog. Success with that led her to do a creative writing course, which in turn led to a top agent taking her on, and terrific success with The Trouble with Goats and Sheep. And along the way she was always ready to use her experiences across the board to authenticate her writing.
Her impending second book has attracted a seven figure sum. What an inspirational tale. All power to her writing elbow! Ten minutes in the dentist’s waiting room well spent for me too.
Then, taking yet another break to wander in a motorway station to unravel my poor compressed spine on a long journey, I chanced on these two books by Holly Bourne: Am I Normal Yet? and The Manifesto on How to be Interesting. Now, I confess that YA books really aren’t my thing, but having just included a fifteen-year-old narrator with issues in my own latest novel, Inside of Me, I was curious enough to buy both of them. The style of writing swings between breezy, funny and poignant, capturing the everyday reality for youngsters grappling with teenage insecurity, bullying, obsessive compulsive disorders, self harm, illicit relationships. Holly Bourne is another writer who has used her own experience of life as a teen and a journalist and an agony aunt, to get inside the skin of her protagonists.
As the heroine in TMOHTBI says: It’s material; it’s material; it’s material. Question is, what material can I get out of my current experience: promotion of my latest book ……?
Hot off the Press!
Well, here they are, still warm. My first batch of Inside of Me. They arrived yesterday, bang on target.
And as I hold the finished product in my hands, I’m enormously grateful to all those people who made this moment possible. To those who gave me the benefit of their wisdom and expertise, checking facts were correct and scenarios authentic. To those who provided their technical know-how and capabilities to ensure the final product looked so good. To those who encouraged and supported me through the entire process. To those who continue to believe in me, even – no, most especially – when I start to doubt myself.
I salute you all. And I hope you can feel a sense of ownership too. You’ve earned it.