pandemic
The Vanishing Year
Well, I can’t imagine many people will have been sorry to see 2020 vanish into the mists of history; some indeed are willing 2021 away now, given the dire statistics and predictions. A thousand deaths each day in the UK; a total now exceeding 80,000 – the worst statistics in Europe; 2 million lives lost worldwide. Our NHS struggling to cope; long term problems accruing with the overall health of the nation.
Watching this horror emerging, we’ve all had to find ways of keeping hope alive and maintaining mental well-being. Icy conditions make even outdoor exercise treacherous, another lockdown forces us to stay at home … Eeh dear! Not surprisingly, for me – as well as countless others – books have played a major part in this struggle. It’s well recognised they offer escape and a way of making sense of the world and our place in it. Indeed, several people who took advantage of our pandemic bookcase went so far as to say books had saved their sanity.
Not surprising then, that one novel should pop into my head as we watched 2020 disappear in our rear view mirrors: this thriller, The Vanishing Year by Kate Moretti. Apposite title, but nothing to do with the pandemic, so forgive the tenuous link.
‘Sometimes I feel as if I am made up almost entirely of secrets.‘ That pretty much sums up the main protagonist, Zoe Whittaker.
Outwardly, Zoe has an enviable life – not yet thirty, a fabulous Manhattan home, a rich and charming husband, influence, looks, wealth, connections. But untethered, with too little to do. She feels like a marble in a huge jar, suffocating under the sense that she is accomplishing nothing. Useless, apart from her charity work supporting orphaned and disadvantaged children.
What’s more, in spite of her privileged life, she is haunted by her past, living in fear of being recognised. Because five years ago, Zoe wasn’t Zoe at all. And even her husband Henry doesn’t know her real name. Nor that she was penniless, unable to afford to bury her own mother, until that is, she became a drug dealer, addicted herself to pills and drink, peddling her wares in the presence of children. Until she confessed all to the police, testifying against two human traffickers to a grand jury. Before vanishing.
And now an attempt has been made on the life of the reinvented Zoe. Her home has been ransacked. Her credit card is missing. Someone from her past has come back for her. Threats are being made.
The old classic trademarks are there – control, manipulation, layers of issues, rags-to-riches, fear for life. And the plotting is so devious that, once you know the truth, you want to go back and read it again to see all the clues you missed first time around. An excellent diversion. And a good illustration of how books can give us respite from the stresses of real life, transport us into a different world and time and place – an invaluable bonus during this time of national crisis and mental fragility.
Speaking of a different world and being transported … this opportunity to tramp in a winter wonderland does wonders for my own mental health, too. And yep, it’s well within the current rules of staying local!
Mental health in a time of pandemic
Well, twelve months ago, as we headed towards Christmas, who’d have thought 2020 would be a year like no other? Were you truly savouring each family hug, each shared celebration, each freedom? I certainly wasn’t. We took it all so much for granted, didn’t we?
But plenty of evidence has been emerging that the mental health of the nation has deteriorated during the pandemic, and that’s on top of already soaring mental health issues. One only needs to think isolation, job insecurity/loss, uncertain future, economic hardship, fear of disease and death, bereavement, domestic abuse, cancelled medical appointments/operations, etc etc, to understand why. And official reports bear this out. We heard in September on World Suicide Prevention Day of the serious effect on men’s mental health of lockdown, and now this month, a coroner in Wales has highlighted the tragic suicides precipitated by the profound and detrimental effect of the pandemic.
Recognising the stresses, lots of organisations are offering informative and/or therapeutic sessions online to help people combat the associated effects, some generic, some focused – relaxation techniques, mindfulness, breathing exercises, coping strategies, that kind of thing. I’ve dipped in to some myself, and as well as helping the participants to understand the legitimacy of what’s happening to them, these opportunities enable wider social connections to be made. Just chatting, or simply listening, to those who admit to also feeling beleaguered by developments, can be a comfort in itself.
Then there are the amazing events being streamed online, making uplifting experiences and cultural events accessible to so many more than would normally travel to expensive shows or courses. Ballet, opera, drama, concerts, masterclasses, demonstrations, tutorials … something for pretty much any interest. And again I’ve personally availed myself of these opportunities. It’s so heartening to see and hear artists and experts, actors and athletes, craftsmen and academics, turning their own troubled times to good effect by sharing their expertise with the masses – drawing, running, playing musical instruments, creating beauty, and so on. A bonus for both sides.
The recent doorstep musicals project is a case in point. West End actors have set up Doorstep Productions in a bid to bring theatre to ordinary people in streets across the UK, simultaneously entertaining and lifting their spirits, whilst helping out-of-work actors whose jobs have dried up as theatres are forced to close. Big names like Andrew Lloyd Weber and Cameron Mackintosh are backing this initiative. Heart warming. And the Dundee Rep have just begun to bring their production of A Christmas Carol to the streets of a select nominated few too.
It all says much for the fighting spirit of the nation, doesn’t it? and the resilience of individuals, and the kindness of strangers. I want to add my thanks to everyone anywhere doing their bit to boost morale and unite our nation. In these days of dire health statistics, economic crisis, and uncertainty over Brexit, news of individual or collective positive endeavour or heroism or compassion is a real tonic.
Sobering realities from the Covid-19 frontline
I love the idea of a story about a detective hunting lost triangles! A man whose imagination conjures up that plot for his children has my ear!
A doctor who lets his small daughter paint his toenails lurid colours during a pandemic and leaves it on – It’s a little piece of home to take to work, a talisman to protect me and a token to remind me – gets my attention.
One who’s fearless enough to spell out unpalatable facts about our health service in the face of repeated political assurances of world-beating everything, gets my vote.
And when that medic is so incensed by the government’s spineless response to Special Advisor Dominic Cummings’ blatant disregard for instructions to the nation during lockdown, that he tweets a photo of himself in full PPE, stating that if Cummings doesn’t resign, he will, and then does so, has my heartfelt respect.
That man is Dr Dominic Pimenta, Specialist Registrar in cardiology. His story in Duty of Care begins in London in January 2020, when he becomes increasingly aware of a tsunami of disaster heading this way. It’s the stuff of his nightmares.
The book is certainly not comfortable reading. It exposes a stark picture of our country woefully lagging in health care provision:
The simple numbers are so bad they speak for themselves; at present, we have the worst A&E waiting times on record, the worst operating waiting times and the worst record on hitting targets. Even life expectancy is on the decline. We are short-staffed by a figure of around 100,000 staff, including 40,000 nurses. We also have one of the lowest number of critical care beds, general hospital beds and doctors per head of all the 37 countries in the Organisation for Economic Co-operation and Development (OECD). If we were an army, we would be a band of bedraggled, starved and exhausted soldiers. And that was all the case before any sign of coronavirus.
Now, I must confess that I personally have a lot of sympathy for our leaders trying to steer a course between many competing demands, balancing livelihoods against lives, damned if they do, damned if they don’t. It’s all too easy to criticise from the sidelines, or with hindsight. I cringe watching opposition MPs constantly carping about the decisions of government, knowing full well they aren’t going to be held accountable themselves. But this man, Dominic Pimenta, is a medical practitioner, and he had his eyes wide open from the outset. He isn’t scoring political points. So when he catalogues a litany of failings – incompetence, mendacity, lack of transparency, disregard of WHO advice – which have led to thousands of people losing their lives, thousands losing loved ones, thousands developing serious health problems, thousands having vital treatments postponed, thousands suffering serious mental ill health, then we ought to sit up and take note. These are desperately serious consequences indeed.
We could see the pandemic unfold, in high definition, live, 24/7, before our very eyes. And yet, for too long, we did nothing at all.
But in spite of his acute awareness of the true picture, shining through is his pride in the NHS: they responded magnificently to an overwhelming situation. He outlines convincing detail of their titanic struggle, their frustrations, their failures, as well as their triumphs and heroics.
With the right mindset, we are capable of incredible things.
Amen to that.
His own personal energy and determination to make a difference are exhausting to contemplate:
– writing articles spelling out the coming danger
– tweeting analysis and warnings
– publishing in the national press
– appearing on live TV shows
– campaigning for change
– garnering signatories for public appeals
– establishing a charity, HEROES, (now rebranded as Healthcare Workers’ Foundation) for the protection and support of healthcare workers
– attracting celebrity support
– designing prototypes for PPE (personal protection equipment)
– setting up a second organisation, SHIELD, to bring industry leaders and experts together in the creation of innovative solutions to meet the demand for PPE, including cutting edge ‘printing hubs’ …
all while working as a clinician way outside his own comfort zone – at the frontline in ICU – and trying to be a husband, father, brother, son, uncle, friend, in unprecedented times. His manic activity leaves one fearful for both his mental and physical health, but as he says himself, the problem was so vast, it would never feel as if any level of effort was enough.
In Duty of Care he leaves the story at the end of the first lockdown, knowing a second and possible third tsunami are coming. Since he published it, we have all entered that predicted second wave and are dealing with its consequences right now. This week the death toll in the UK passed 62,000. I feel fairly confident we’ve not heard the last from this extraordinary ma, but I leave you with his own parting shot:
So stay informed, stay safe and be kind.
Stress busting!
I’ve been reminded all over again this week of the importance of books in the nation’s health; never, I suspect, has that need been greater than now when a pandemic is threatening our very foundations and security.
It’s been an uncharacteristically stressful week in my own little world, most of it stemming from the vagaries of technology. Frightening how much we depend on the internet and all things electronic in our everyday lives, isn’t it? Being without connections feels like working with one and a half broken arms.
But I know that my personal stresses are as nothing compared with those of countless others during this time of Covid. The BBC wheeled out some big guns in the world of psychiatry during the past few days, who all tell us about the abnormally high incidence of worrying symptoms for mental illness, symptoms sufficiently serious to warrant medical intervention under normal circumstances.
Well, I’ve always been acutely aware of the fine dividing line between normal and abnormal when it comes to mental health. I rapidly but determinedly side-stepped psychiatry in my training, even though the way the mind works and its link with physical health fascinate me. And I’ve never forgotten the patient who first alerted his family to pathological disease when he started cutting his sausages lengthwise … but that’s another story. This week, when things started unravelling for me, it was time to segue into active stress-management mode.
Aromatherapy, mental puzzles and games, exercise, relaxation techniques, helping others less fortunate … the whole gamut came into play. And breathe … And relax …
But of course, books remain one of my main go-to resources. There’s nothing to beat losing yourself in another world. And in this context all I need is something unexacting but gripping. Time to turn to a tried and tested author: Harlan Coben.
I have a stack of his books on my shelves for exactly this kind of situation; these are just a selection, collected over many years. First off the shelf was Run Away.
First page, opening paragraph …
Simon sat on a bench in Central Park – in Strawberry Fields to be more precise – and felt his heart shatter … he stared straight ahead, blinking, devastated …
and I’m already asking who, what, why, when?
His once lovely daughter Paige – who ran away from her comfortable, professional, stable, ordered family life, to shack up with a criminal and wallow in addiction, has been seen busking in that very park where Simon sits with his heart splintering into fragments. Watching her. He’s appalled by what he sees: a malodorous, strung out bag of bones with matted hair and yellow teeth and a cracked voice. Trickster, manipulator, thief. And that encounter leads him deep into the dark and dangerous underworld that swallowed her up – guns, violence, murder, drugs …
because if someone hurts your daughter, a father has an obligation to stop him, no matter what.
But when the man who took her to this hellish place is murdered, Paige vanishes. He’s lost her again.
A second plot line shows a series of young men being targeted and killed. Why? What’s the connection? I twigged the ‘what’ by P167, and the ‘who’ by P194, but not the ultimate ‘why’… P319. Kept me turning the pages. Better still, it crept close to my own field of interest – genetic inheritance, infertility, adoption, ethics … now you’re talking my language!
And all the threads don’t fully come together until the epilogue. The work of a devilishly clever mind. And balm to my troubled one.
Virtual Wigtown Book Festival
What a week! What a treat! I’ve returned to Wigtown, over in the south west of Scotland, in Dumfries and Galloway, this time for their annual Book Festival – for the very first time a virtual event.
Before each session the camera has taken me through the town with its plethora of independent bookshops, and I’ve been reminded of the unique atmosphere and warm welcome Scotland’s National Book Town extends.
I was spoilt for choice. A few sessions were actually filmed in Wigtown in the familiar arrangement of author and interviewer actually speaking to one another, appropriately socially distanced; most were from homes or offices around the UK and abroad. And what a rich variety of topics were covered, light-hearted and deadly serious, entertaining as well as challenging. A taster will suffice for my purposes.
Wigtown’s own curmudgeonly bookshop owner, Shaun Bythell, now author of two bestsellers, ‘nibbling away at the hands of those who feed him’ in his confessions of a bookseller, appeared on his home turf. Except that he’s now undergone something of a transformation since I last saw him: neatly trimmed hair, smartly dressed, positively benign about his fellow man! Hello? Fatherhood seems to have smoothed some of his jagged edges!
Award-winning freelance Scottish journalist Peter Ross was new to me. He gave a fascinating insight into his work and writing about graveyards, weaving stories about the living as well as the dead, in a gentle almost reverential tone. And yes, the story of Wigtown’s martyrs featured. He came across as rather shy, but his writing style is assured and beautiful – a joy to hear some of his choice phrases and astute observations.
Writer, photographer, crofter, sheep-breeder, Tamsin Calidas, gave a mesmerising account of her life on a remote Hebridean island, battling the savage weather, local animosity, betrayal, and fearful loneliness. Her session ended with a film from within the waves around her island home, made by her, and overlaid with her voice paying tribute to the healing power of cold water swimming. Altogether moving and uplifting. And her own inner peace, achieved through a catalogue of vicissitudes, pervaded her responses.
More well-known personalities included Alastair Campbell, appearing, not to talk about the years as political aide and strategist to Tony Blair, but to share his levelling experience of depression and alcoholism, and to appeal for more understanding of mental illness. It seemed somehow appropriate that his image was poorly-focused and quite dark, capturing a much softer and more likeable person than in the political glory days.
It was against a backdrop of books and folders that Baroness Helena Kennedy shared something of her multitudinous and high profile activities as a barrister specialising in human rights and civil liberties, as she was questioned by a reporter from Beirut. She’s been involved in a number of infamous international cases, and shared fascinating details of specific incidents, as well as her opinions on world leaders and regimes. Rivetting stuff.
One of my favourite event speakers, forensic anthropologist, Professor Dame Sue Black, gave her inimitable insights into her work and knowledge of bones, combining facts and stories to bring a potentially dry subject to life. What constitutes a ‘good hanging’? How you can determine so much about a person from fragments of their skeleton. How the bones of a newborn baby can survive from Roman times. How much she enjoys working with crime writers. And even though she frequents haunts like murder scenes or disaster sites, her joy of life, her sense of the ridiculous, bear out her philosophy: ‘You have to work by the light rather than let yourself be consumed by the darkness.’
These and others kept me enthralled – and all from the comfort of my own home. Hats off to organisations everywhere who have risen to the challenges of life under a pandemic with such energy and professionalism. The opportunity to escape to a book festival has to be a brilliant tonic for isolated writers everywhere.
The jigsaw begins to take shape
You could be forgiven for thinking I’d buried my writing pen for good. Even I was beginning to be suspicious!! Well, news on that front at last.
We’ve all had to make adjustments during this past six months, but exercise has consistently been held up as a ‘good’ for everyone, even designated a legitimate reason to go out of the house during the initial country-wide lockdown. It’s certainly been an important part of my well-being. Over the weeks, my early morning solitary constitutional along mostly deserted routes has become a valuable time for quiet reflection and uninterrupted processing of ideas.
On the steeper uphill sections, when my muscles protest and my cardio-vascular system is under pressure, the activity in my brain is a welcome distraction. On the easy downhill paths the ideas rush along at an exhilarating pace.
Where the ground levels out I occasionally stop to soak up the tranquillity around me and reflect on where my brain is taking me.
There’s been so much to sort and sift and mull over arising out of this weirdly different experience of a worldwide crisis and its effects on us all, and I’ve made a conscious decision to ring-fence this time when I can leave my mind pretty much to its own devices.
I’ve become very aware that I’ve been unusually reluctant to start a new book. Normally I’m raring to go; not this year. I just haven’t been in the right place psychologically. And strangely enough, I’ve accepted that without protest. Time to concentrate of different priorities.
However, of late, the ideas and possibilities for novel number 12 have been increasingly jostling for pre-eminence in my head and begun demanding action. A structure has been gradually emerging that has stood the test of time, with the pieces fitting together rather like a jigsaw puzzle, and this very week a milestone has been reached: that outline has actually been committed to the computer. Wahey! A fairly robust skeleton methinks on which to hang more new details as they emerge. So, it’s been a long time coming but I think perhaps we might now be on a roll … ? Maybe …? Possibly …? Clovid-19 permitting …?
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.