Hazel McHaffie

Our NHS – what’s it worth?

Well, I don’t know how you feel about the proposed pay rises for NHS workers announced last week, but for me there’s an uncomfortable mismatch between the plaudits and superlatives and clapping during lockdown, and the value of the suggested tangible ‘rewards’ now. These people who save the lives of strangers, and treat our sick neighbours, and care for our children and our grannies, and keep vigil with our dying, are demoralised, exhausted, burnt-out, and now feeling undervalued.

I’ve recently shared on this blog several new publications about life on the frontline written during the pandemic, but I wanted to remind myself of the commitment and dedication health care practitioners always show, day after day, year after year, so often unseen and unsung. So, I turned to an old book on my shelves written long before anyone had ever heard of Covid-19 – A Paramedic’s Diary: Life and Death on the Streets by Stuart Gray (2007). Gray – who hails from Glasgow originally – came to the health service relatively late, having been a professional musician, dabbled in business and computers, and completed a three-year stint in the Royal Army Medical Corps, and he brings an interesting perspective to the experiences he relates.

You couldn’t get much busier than the streets of London, and I’ve often wondered how on earth service vehicles ever get to the emergencies there. London is Gray’s stamping ground, but far from lamenting traffic issues, he concentrates on the human obstacles to delivering the care he’s trained to administer: ‘ignorant  time-wasters’ he calls them, who stop him from saving other lives.

People who dial 999 …
for a broken fingernail,
or for help to wrap Christmas presents,
or to move furniture because the feng shui isn’t right,
or to be helped to their bed (because they’re vastly overweight).
You couldn’t make it up!

Then there are the hoax callers who attack or abuse the crews when they turn up, the  drunks who have to be removed from buses or out of the gutter, the drug users and any of their cronies who might be lurking in the shadows with malicious intent.

Not many of us joined this profession desperate to wade through as much drink, vomit and stupidity as we could. Most of us are here to care for people who really need it, not selfish self-harmers who go out of their way to blitz the system with their lifestyle problems.
My colleagues and I stand in the wasteland of other people’s lives and watch as they destroy themselves in a bottle.

At the other end of the scale he cares nothing for the inconvenience or danger if the call is legitimate. His commitment shines through as he describes the awesome responsibility of attending a birth, of comforting a mother with a dead baby, or dealing with someone traumatised by a miscarriage. He’s even been known to weep himself once he’s back at home re-living the emotion.

He’s moved by the poignancy of scenes of normal everyday activities like shaving or getting dressed or going shopping – activities which will now never be undertaken because the person who intended to do these things has suddenly left this world. He grieves, not only for the lives cut short by sudden medical catastrophes or accidents, but also for the relatives whose lives have been irrevocably changed in an instant.

Experience has taught him that much can go wrong with attempted suicides. He’s seen at first hand the mess of a botched job, or an incomplete death under a train or a bridge or at the end of a rope. He’s sat alongside people who’ve witnessed suicides, traumatised beyond coherent speech. And he’s all too aware of the risks to paramedics of electrocution, or crushing, or being trapped. To this day he refuses to stand near the edge of a station platform, all too aware of the possibility of being accidentally pushed (I thought I was alone in this obsession). There are enough dangers already in his job.

The hours are long, meal breaks often missed, the pay not commensurate with the tasks undertaken.

EARLIES. Shifts which start at 6.30am, or 7am. They usually present a slower start because people are not yet up and around so they aren’t trying to kill themselves by falling, crashing, running into brick walls, arguing with their drunk neighbours or mainlining speed. You get to see daylight and it’s safer than working late at night. You might even get breakfast.

These are the everyday incidents that make up the working lives of paramedics. Highs and lows, successes and failures. Sights and smells – ‘outrageous’, ‘hellish’ – that few of us could tolerate. But Gray has had his moments of high drama too. He was part of the massive emergency response to the 7 July 2005 (7/7) terrorist attack when three bombs exploded on three separate tube trains, and a bus was blown up in Tavistock Square (medical colleagues of mine were yards away from this one so it’s vivid in my memory). As fast as they could ferry critically ill patients to hospital, the paramedics were sent back out again and again to carry more casualties. ‘It felt like a war zone.’ Some were risking their own lives, alongside the police and firefighters, to get to the injured and dying deep underground.

In spite of it all, the good, the bad and the ugly, Stuart Gray loves his job.  It’s ‘almost addictive. It gets under your skin.’ It’s ‘exciting … varied … allows me the honour of walking across a stranger’s threshold and into their private lives.’

What kind of pay rise do YOU think such professionals deserve? And the nurses and doctors who continue where the paramedics leave off – dealing with the vomit, the faeces, the blood, the brain matter, the human emotion, the abuse, the violence, the massive responsibility, the guilt, the dread? What are these amazing people worth?

 

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On that date …

I’ve been mulling over a strange thought this week. The significance of dates.

It began when I started to read yet another book about the Nazis: this time The Day the Nazis Came by Stephen R Matthews. This one is set in Guernsey at the beginning of the Second World War, and it’s written by a man who was a small child there and got caught up in the horrors. He was just four years old when he was deported with his parents to a camp in Germany.

To begin with, and with due respect, I should say, the author is not a natural wordsmith, but he has a family story to tell which I found worth persisting with, because these times were relevant to my own history. My parents started their family in 1941; they too were eking out a meagre living because of the deprivations of war; they too were seeking shelter from air raids, observing blackouts, watching developments fearfully. It resonated.

I’ve visited the Channel Islands twice and can envisage the places and scenarios Matthews talks about.

At the end of the 90s a beautiful tapestry had finally been completed commemorating the events of occupation, and I was blown away by the vibrancy of its panels and the profound sense of history it captures. The bulk of the embroidering was done by skilled needle workers, but anyone could add a stitch under their guidance, to give them a personal connection. And it’s that personal identification with events and experiences that I’ve been preoccupied with this week.

Identifying with dates and details in this book, I’m reminded of the profound feeling I had in Berlin where there is so much to remind one of the horrors perpetrated in the 40s which must never be forgotten. I felt devastated by a sense of terrible loss when I stood on the edge of a railway line marking the number of Jews deported to the concentration camps on the day of my birth. I was bereft of words looking at the memorials to the Romany people, to the trains taking children to life or to death, to the six million Jews who died in the concentration camps – all of which happened in my early childhood.

And isn’t that what we try to do with novel writing? Take the reader into that place, that time, that emotion? Leave them feeling the connection. So even though The Day the Nazis Came isn’t going to win any literary prizes, it’s enabling us to hear what it was like to live innocently on these beautiful islands, and nevertheless be sucked into a darkness, an evil, beyond comprehension.

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Craftsmanship

If you’re a follower of my blog, you’re almost certainly a lover of good books.

But have you ever held a book in your hands, and felt awed by the design and craftsmanship that went into its creation and physical assembly? I’m thinking of … The Night Circus, maybe – the original hardback version. Every detail exquisitely reflecting the value of the product, the mystery and magic of the story. Red ribbon book marker, pertinent graphics, echoing colours throughout, beautifully co-ordinated. A joy to handle and to savour. Beautifully created with love and sympathy for the written word.

 

It was my PhD thesis that really made me pay attention to how a hardback book is actually constructed.

One bookbinder turned out a shoddy end product – ragged pages, loose stitching – fit only as a lending-out copy, getting more and more uneven the more it was used. The second bookbinder took time and trouble and created a sleek, even, secure version, worthy of respect.

So I was thrilled to have the opportunity this week to actually create a book myself, thanks to an event arranged by my daughter. It took best part of a day, but renewed my appreciation of the skill involved. Hand sewn pages, hand cut edges, hand glued layered covers, precision measuring, attention to every detail. A book can indeed be a thing of beauty in itself.

Oh, and did you know that books have been bound in a huge number of different kinds of skin – kangaroo, sting ray, shark, ostrich, skunk, boa constrictor, elephant – even human!! How would you like to hold that in your hand?!

 

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Extraordinary twins: Separate or together?

There are times in life where I’m rendered speechless in the face of courage or fortitude way beyond my comprehension. And this week brought just such a moment: listening to the parents of conjoined twins in the ITV/STV programme, Extraordinary Twins, and to the doctors who undertake this gruelling and risky surgery.

The questions are overwhelming and often unanswerable. As one surviving separated twin said, whatever you decide you will be criticised. Ethics may be my field of interest, but these issues are in a different league from most.

Not only do the families have to contend with the shock of discovery when scans reveal this extremely rare anomaly, but they are then faced with a raft of massive questions.
Do we go for abortion?
If not, how will we feel when they are born?
How will we deal with other people’s reactions?
How will we care for these children?
Will we choose to have them separated?
When is the right time to do so?
How will we cope if one or both then die(s)?
Can we handle the responsibility?
What will it do to us and our family?
Can we live with the sense of guilt?
Will the children resent/hate us for making this decision?
Tears at my heartstrings just contemplating these dilemmas.

All this came across powerfully in the programme, through the experience of families who’ve trodden this path. I was on an emotional and ethical roller coaster throughout.

For some, separation was impossible, the shared parts were too intimately and vitally interconnected and important to each. One set of sisters shared sensations: even feeling the other one being touched, and seeing what the other was being shown! Another set spoke the same words together. In other cases, where separation might be possible, a joint life was deemed better for them, and indeed was way more full than I could ever have imagined. Some pursued different careers, got married, drove a car together!

But for others, the advantages of separation were compelling, though the risks were always huge. The burden of responsibility came across powerfully through the experience of one couple who were very undecided about separation, and inclined to wait till the twins could decide for themselves. They were put in touch with another mum whose girls were joined in exactly the same way – separate heads and torsos, but just one set of legs. Her bright, bubbly girls were now leading separate lives, both with one prosthetic leg and a colostomy bag. Her advice was robust: we parents choose to bring our children into the world; it’s our job to choose what’s right for them. Don’t you want independence for them? she challenged. (This idea of parental responsibility was a view I heard time and again in my own interviews with parents of infants for whom life-and-death decisions had to be made, so it resonated with me.) But this couple remained undecided. They visited other families – where different decisions had been made, met the children, asked them the questions, listened with strong emotion to the replies. And bravely came to their own considered conclusion.

As for the surgeons concerned – well, I can’t begin to imagine the price they pay. The series of operations needed to separate conjoined twins is tremendously complicated and only a small number of surgeons in the world are skilled in this work. They plan meticulously beforehand, every move plotted and rehearsed before they ever pick up a knife. The theatre is packed with people and machinery. Some parts of the procedure take many many hours – in one case 17! Sometimes the surgeons’ stamina and ability to make decisions, as well as the condition of the children, makes it necessary to stop mid-operation and continue another day – seems impossible, huh? Sometimes sadly the separation is a success, but the babies suffer complications like brain damage or stroke. Sometimes they die. But these skilled and exceptional doctors not only bear the responsibility, but also engage emotionally with the families. It was so lovely to watch one cranio-facial consultant visiting the children he had separated, months after surgery, and playing with them so beautifully. Heroes without a doubt.

I salute them all. They moved me to tears. I have absolutely no idea what I would choose in these circumstances.

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Love, life, death in a time of pandemic

Rachel Clark was a television journalist before training as a doctor – that probably helps to explain her brilliance with words and her laser focus on exactly what happened, and when, in the early days of the pandemic.

Her latest book, Breathtaking, spans the first four months of the ongoing Covid-19 pandemic, January to April 2020. At its peak, during that first wave, a thousand people were dying each day. And every single day the grit and devotion of colleagues astounded her. She says she has never been prouder of, or more humbled by, the NHS and its people, but that doesn’t stop her probing beyond the heroism, the sacrifices, to the core of what went wrong.

She knew it would be impossible, and probably inappropriate, to try to convey her inside experience to non-medical friends and family, so she used her laptop to vent her feelings. Writing became an anchor, helping to distil her fears, a compulsion that took her through the night and into the early hours of many a morning. Looking back over her insomniac’s diary much later she discovered that what she’d thought of as an unrelenting stream of darkness was actually illuminated by pinpricks of light. Acts of kindness and solidarity, altruism and selflessness, resilience and decency, shone through the storms, and they glimmer throughout the book which evolved from her midnight ‘scribbling’.

Rachel Clark graciously acknowledges the public’s generosity and sacrifice in withdrawing from the public sphere, foregoing so much that makes society and relationship valuable, in order to protect NHS resources.
Invisible threads of everyday sacrifice tie the world outside to the one within the hospital.

But from the outset, she and her colleagues watched with growing horror and incredulity, the UK’s casual approach to the coming tsunami … the effects of deficient supplies of PPE … delayed restrictions … the exposure of the elderly and vulnerable to risk … the appalling gulf between public rhetoric and supplies on the ground … the Prime Minister’s defence of indefensible behaviour when his chief adviser flouted the rules he’d helped to devise … And she’s haunted by the sense that we are all complicit in the betrayal; the alarm should have been raised sooner, been more insistent, more strident.

She is shocked too, by the spin put on the tragedy. When the UK had the third highest death toll from Covid in the world, and was the worst hit in Europe, senior government figure were trumpeting ‘success’!
How very cheap, how spectacularly expendable, one human life must be to them if the avoidance of tragedy is consistent with the deaths of nearly 27,000 people.
(
Since then, of course, the death toll has risen vastly – currently in excess of 128,000.)

For this palliative care specialist every person, every loss, every family, matters. And in her view, the only reason the NHS was not officially overwhelmed was because so much of its function was suspended. Real people suffered the consequences. Many felt abandoned.

The professional workforce too paid a heavy price. Entering the personal spaces of strangers steeped in the virus again and again involved massive risk.
The Covid ward is humid and restive. We are on the move, no pausing or lingering, with strained expressions and a twitchy hypervigilance that is as exhausting and stifling as the masks we wear. It is all around us, the virus. It coats our clothes, our hair, the backs of our necks, the keyboards we type on, the surfaces we touch. It hangs in the air, it drops on to our shoes, it floats and waits, ready to be inhaled by anyone too unwell to be masked up in a hot zone.
They endured appalling working conditions, worked ridiculously long hours, put themselves through agonising processes. Their own families suffered. Some professionals lived in hotels rather than put their loved ones at risk. Some gave their very lives.

And on top of that they were unable to relate as normal to those in their care.
Kindness, undeniably, is the glue that ensures patients feel safe and hospitals humane.
But now, everything human was taken away – contact, personal details, names, faces, relatives (the cruellest feature of all).
Covid, in short, necessarily compromises every instinct to deliver humane and compassionate care. It violates something at the heart of good medicine – and the cost to the team is profound.
All they could offer from behind the layers and layers of protection seemed …
grotesque, a parody of communication. It could not be less warm, and more wrong.
And even in extremis, as death approached, they could only clutch at the remnants of human contact, to ensure no one was alone for that final stage.
In the end, as death bears down, there is almost no situation that cannot be made better by someone reaching out, with love and tenderness, towards one of our own. What we have, in our grief, is each other.

Rachel’s own compassion and care and humanity, perfect attributes for someone dealing with people at the end of life in palliative medicine, pervade the book. And for her, words are the most powerful drug used by mankind.
No one knows this better than a palliative care doctor. When drugs run dry, when cure is no longer an option, I deal in words like my patients’ lives depend on it. Words build trust, allay fears, dispel myths, inspire hope. They clarify, challenge, encourage and console. Words leap beyond the constraints of masks and gloves and gowns. Titrated carefully, dosed just right, words can take a dying patient all the way from the depths of despair to a place of hope and even serenity … Above all, our word must be our bond.

In the midst of this revelation of the flaws and deficiencies that have characterised the pandemic, the pain, the frustration, the humility, the dedication, glimpsed in this soul-searching book, are themselves evidence of what is right with the practice of medicine. Beyond price, beyond value.

 

 

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Decision making on the Covid frontline

Jim Down is an anaesthetist and intensivist in University College London Hospitals. He was working as a consultant there when the Covid pandemic hit this country, and in his book, Life Support, he has captured the slowly emerging horror. We all know so much more about it now, but back in March 2020, not even those at the front line were fully up to speed with what was required. Reports were patchy and conflicting; provision was far from satisfactory; knowledge rudimentary.

By his own admission, Jim Down is a worrier, so what should he do in the face of this emerging crisis? Should he go home to his young family? Should he visit his elderly parents? How close should he get to people? Should he wear a mask? In many ways he felt safest at work protected by layers of suffocating PPE.

I confess, the work of an anaesthetist is much more far-reaching than I was aware of. (Apparently 50% of the country still believe they aren’t doctors!) But in reality, as Dr Down says himself, there are few departments anaesthetists don’t support in one way or another. And throughout the pandemic, it’s been the tribe of c11,000 anaesthetists around the UK who have been vital to the Covid response, converting all available space into fully-functioning Intensive Care Units in record time, delivering care to eye-watering numbers of patients, and designing protocols for some of the most dangerous procedures.

Amongst his other responsibilities Dr Down was given ethics to oversee. Forgive me if I home in on this aspect of his roles – it’s part of my personal raison d’etre, as you know. He set up a ‘three wise people system’ for all major and controversial decisions, and established an Ethics Group for the Trust. But questions and dilemmas presented at every level.

The cost of a day on ICU is approx £1700; what benefit does that need to accrue to be cost-effective? What constitutes a meaningful quality of life? When does a therapy become futile? What risk/chance of disability or suffering makes life not worth living? What constitutes meaningful life? Who decides? When resources are stretched beyond capacity in a pandemic how do we compare relative benefits between patients? All questions that haunt medical practice, but with Covid there were three new crucial differences from the normal balancing acts: the sheer number of patients, the flimsy knowledge of this new disease, and the unusual speed with which decisions might need to be made.

Ethical dilemmas presented too around how far to go, when to stop, when to call family in, in situations where so much was unknown. Then there was the matter of how to effectively deploy limited resources – equipment, drugs, people. The staff themselves were suffering from emotional and physical exhaustion, giving them a diminished capacity to empathise with others, poor concentration, irritability, feelings of helplessness, frustration. Not a good foundation for making sound judgements – thereby increasing stress still further.

Dr Down himself adopted a benchmark: What would I do if it was my brother, sister, mother, father, wife, child? It felt like as good a test of a decision’s rigour as he could muster.

But the personal toll was colossal; the work loads unprecedented. One trained ICU nurse to up to six patients instead of the usual one! One consultant to 42 patients. Teams of medical students and surgeons roaming the units twice a day just to turn people from supine to prone or back again. So much was unknown and unknowable. The patients were extremely sick, for a long time, very fragile and unpredictable, and denied family support. With no simple solutions, very few fixed protocols, the staff constantly questioned themselves, worrying about the repercussions of what they were doing.
We are all acutely aware that something could go wrong for any of us at any time. When it happens to a friend we are reminded of our vulnerability.
They were caring for
the biggest cohort of the sickest patients we’d ever seen, and we were desperately trying to work out how to manage them.
And at times they were treating their own frontline colleagues. Sobering indeed.

This book captures the everyday reality, the swing from the sheer mundanity of meetings and conversations at one end, through the anxieties that proved to be damp squibs, to the overwhelming responsibility of far too many competing demands, the crises at all hours, the inability to support everyone all the time. The frustration of insufficient staff or equipment to carry out the fundamental tasks. The constant questioning.

It underlines the enormous debt the whole country owes to the key workers who bore the heaviest burdens for us all.

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Many Different Kinds of Love

Listening to Michael Rosen speaking at the Hay Festival was enough to make me immediately order his book about surviving Covid: Many Different Kinds of Love. And read it as soon as it arrived! It’s an account like no other.

He was a whisker away from death because he didn’t fit the criteria (at the time) for serious illness. But thanks to the intervention of a skilled and determined GP friend, Michael bypassed inappropriate advice to stay at home, and was whipped into hospital with a dangerously low level of oxygen in his blood. So ill was he, indeed, that he spent 47 days in Intensive Care, much of it in an induced coma on a ventilator.

During this time, even though they were working ridiculous hours under extreme pressure, often way outside their comfort zones, the staff took the trouble to pen personal, encouraging, reassuring messages in a diary. Their entries make fascinating reading. Learning of their care, seeing them in action, Michael was reduced to tears by their devotion and love; it was akin to that of a parent keeping vigil with a sick child.
They aren’t my parents … It’s a kindness I can hardly grasp.’
Michael was, of course, a celebrity patient, a well known and loved children’s author and poet; they were willing him to return to his natural milieu of writing and performing again for others.

Reading their words, I was personally struck by the vast range of occupations these novice writers came from. Here they were in a high-tech, fast-paced, highly specialised environment, a unit packed to the gunnels, surrounded by patients presenting with a hitherto unknown infectious disease affecting multiple systems, and they were, in their other lives, speech and language therapists, physios, children’s nurses, school nurses, infection control personnel, urology specialists, even dental hygienists!  Mind-blowing!

After ventilation, Michael spent another long period hovering somewhere between life and death, and it was his wife, Emma, who brought him through to the other side of this, surrounding him with love and the favourite soundtracks of his life.

It was only then, as he re-entered consciousness and self awareness, that he could pick up the threads of the story for himself.

Reviewing that time while he hovered on the brink of life/death, he himself could see the humour in his situation.
Of the constant monitoring he says:
There is now a ledger telling
the story of my ups and downs.
I have become an account.

He was mesmerised by the multiple tasks these caring hands accomplished.
Your hands speak.
Touch is a language.
Each palm
each fingertip
is a line from your stories.

He saw the ‘Land of the Dead’ as having taken bits of him prisoner. (His left eye and ear are still markedly impaired.)
They’re waiting for me to come back.
The ear is listening.
The eye is the lookout.

Recovery of strength and will power became a painful inch by inch struggle.  Early on, trying to will his leg to move, was like speaking to a blank space.

As he improved physically he became alive to humour around him.
The nurse tells Peter in the bed opposite,
that his urine is dark.
‘The times are dark,’ he says.

But at each stage of progress Michael feared this was as good as it got …
… now in a wheelchair – is this me?
… using a zimmer frame – is this me?
At intervals: I’m not going to get better – am I?
… remaining on one level in the house  – I’m 74. Maybe I’ve become a kind of 90 ...
Watching and listening to the monumental struggle made me value in a new way his personal appearance at the Hay Festival this year. He had learned from OTs how to own his frailty.

And when he eventually went home:
I am not sure I am me.
I can’t see as I used to see.
I can’t hear as I used to hear.
My legs feel like cardboard tubes,
filled with porridge.

And ‘I’m not sure I am me’ became a bit of a refrain.

But he did get home and little by little he did gain strength and mobility. Returning as an outpatient:
Woman at the door asks me
if I want anything sharpening.
My wits, I say.
(I didn’t.
My wits aren’t sharp enough.)

By now you’ll have got the sense of the style of writing – short staccato entries, written as poetry, as if that is all his recovering brain could handle. Lots and lots of white space. But underpinning it, the irrepressible wit and wisdom for which he is known and loved.

All perfectly illustrated by Chris Riddell‘s wonderfully evocative and delicate pen and ink drawings.

I was pleased to see that, even though he’s so conscious of the great debt he owes the NHS, Michael’s not afraid to criticise the government and scientists where they got it wrong. Perhaps he sums up the whole handling of the pandemic as well as his personal progress when he says:
And it never stops:
we are always becoming.

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Hay Festival: second instalment

They say authors should wait a decent interval before starting to write about pandemics. Well, who exactly are ‘they’, these authorities who know such things, huh?

Even before Covid struck, Val McDermid had already written a radio play about a scenario where a pathogen appeared which no drugs could treat, so she was way ahead of the game. Didn’t stop her publishing it. As she said: There’s nothing more dramatic than the end of the world as we know it.

She then collaborated with a graphic artist, Kathryn Briggs, to produce a graphic novel based on the play: Resistance. Their discussion at the Hay Book Festival with Louise Welsh about how they worked together, was both insightful and humorous. When Professor Welsh said that no person had been left unchanged by the experience of the last fifteen months, she hit on a fascinating fact leading into a fertile line of thought.

Lionel Shriver had just started her latest novel when the pandemic struck, and she’s woven topical lines and references into her story of a couple in their fifties, both medical professionals, contemplating a joint suicide when they reach 80. What would they miss/be spared? What possibilities might present? Dementia? A nightmarish Cuckoo’s Nest retirement home? The end of civilisation? A cure for aging? She has written, and included in the book, twelve alternative scenarios, all with different but parallel endings. As you know, assisted suicide has been an issue very much in my sights for many years, so I’m looking forward to reading  Should we Stay or Should we Go.  I loved the bit she read aloud, and reviews tell us it’s packed with humour as well as provocative thoughts.

And the pandemic theme even cropped up in a session where comedian/actor Frank Skinner was interviewed by fellow comedian/actor/satirist Marcus Brigstocke about his book, A Comedian’s Prayer Book. Skinner is a devout Roman Catholic and spoke movingly of his commitment, and response to taunts, revealing wide reading and studying alongside much heart-searching. Brigstocke said at one point: ‘I think you are this pandemic’s Galileo!‘ Skinner certainly had clever answers for anything thrown at him, chortling at the excitement of not being quite sure where any sentence would end up, but he came across as respectful of others’ opinions, non judgemental, eloquent and measured, whilst openly sharing his own moral code. The whole event was a magical mix of laugh-out-loud fun with serious and warming reflection. And a fitting ‘last Hay event’ for me this year.

Massive thanks to all who brought this fantastic festival to our homes. I for one, hope it will continue to offer an online version.

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Hay Book Festival

I’m like a pig in muck this week!! Hay Book Festival is online again. Wahey! They’ve already reached upwards of 2 million people, and I feel privileged to be one of those visiting and enjoying such thought-provoking and stimulating events. I’m immensely grateful to the team that ensures it happens. They’ve had more than their fair share of technical glitches unfortunately, but I think we’re all acclimatising to those kinds of issues in this era of Zoom. Puts our own mishaps into perspective.

In this first week, I’ve already listened to vaccine hesitancy, the effects of the pandemic, motherhood, grief, the first human cyborg (who has MND), deafness, adoption, racial discrimination … I won’t bore you with a rundown on them all, but three really stood out as exceptionally memorable for me. (Please excuse the quality of the photo – screenshot during the performances, so no time for finesse!)

The title, Life and Death with Covid, sums up one brilliant session. Dr Rachel Clarke, Palliative Care Specialist/author, who’s always good value, was in the chair and sensitively and confidently steered the conversation between herself, the legendary author/poet/presenter Michael Rosen, and a specialist in critical care and anaesthetics/author, Dr Jim Down.

The two doctors spoke eloquently about the impact of the pandemic on staff, and the imperative and willingness to care –  really care – for all their patients, be they serial killers or prime ministers, to the end of their lives. Their selfless dedication shone through. Michael Rosen spoke from the Covid patient’s angle. He survived 48 days in intensive care and 3 months in hospital, and compared the attention he was given to the love that drives a father to sit all night beside the bed of his sleeping son. The NHS, in his judgement, is the most ‘caring collective cooperative thing’ he could ever imagine – polar opposite of the Holocaust that killed so many of his relations. One of the most engrossing literary events ever. I simply HAD to buy all three books: Many Different Kinds of Love (Rosen), Breathtaking (Clarke), Life Support (Down). Reviews will doubtless follow on this blog! They arrived lovingly encased in red tissue paper too!

I’ve heard Ruby Wax and Alastair Campbell on the topic of their depression before – both appeared again this year with new books to talk about, but new to me was travel writer and teacher of creative writing, Horatio Clare, talking about his mental health experience.

In Heavy Light: A journey through madness, mania and healing, he has eloquently captured the reality of being sectioned/detained when he developed bipolar disorder, an action he believes saved him. And he really underlined the importance of listening to the patient and tailoring care to individual need. What an articulate and sympathetic speaker. I was riveted.

Then there was Rev Richard Coles speaking to psychotherapist Julia Samuel (the ‘Queen of Grief’ as Richard described her). He spoke eloquently of the devastation, and the powerful emotions of anger, guilt, emptiness, he has experienced following the death of his beloved husband David, who was an alcoholic as well as fellow priest. No empty platitudes or trite sayings or pious hopes from him! And what sensitivity he must bring to bereaved parishioners. Julia Samuel concluded with poignant accuracy that, though he is still grieving acutely, he is taking David with him into a planned future of ministering to prisoners where the effects of addiction are seen as their harshest. A wonderfully honest and moving conversation, laced with humour, about a subject that needs more openness and candour. I’ve heard Coles speaking before; here I think he was at his best.

To be continued …

 

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Writerly round-up

Time for my occasional round-up of the titbits about writing/writers that have appealed to me over the months of trawling through literary journals.

Did you know …

Psychologists have found that access to creative ideas will be enhanced if you have ongoing exposure to the actual smell of what you’re writing about – cigars, lemons, fish etc.
(Creativity Research Journal Vol 31)

Nearly 200,000 new titles are published every year!! No wonder getting your book noticed is such a difficult task for all except major celebrities and world famous writers. But at its heart has to be an online presence, advertising, and good professional advice. Oh, and a high quality product! Making your book the best it can be is the starting point for every marketing campaign. (Mslexia Vol  84)

Well-known authors and creative writing tutors and researchers all acclaim mindfulness and meditation as offering a range of benefits – alleviating depression, lowering blood pressure, managing stress, improving focus and creativity.  (Mslexia Vol 88)

Good advice for writing, and indeed for living, is: dwell whole-heartedly and unselfconsciously in that moment of vulnerability. And we’ve all felt rather vulnerable of late. It’s the first step towards recovering our confidence and sense of hopefulness. (The Author Vol 132.1)

Novel-writing easily tips from being absorbing to obsessive, and that takes its toll mentally. (Monica Ali 2021)

A good dose of self-doubt is essential for a writer, but a total loss of confidence is disastrous. (Monica Ali 2021)

Interaction increases engagement. (The Author, vol 132.1)

Probably the weirdest word in the top ten most used in 2020 according to Collins Dictionary is mukbang. It’s a South Korean word meaning ‘a host who broadcasts videos of themselves eating large quantities of food’.  (The Author vol 132.1)

If that doesn’t leave you smiling I fear you are having a bad day! Sorry.

 

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