London
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?
Call the Midwife
Looks like I missed a trick! In 1998 a nurse/midwife/midwifery lecturer, Terri Coates, pointed out that midwives are virtually non-existent in literature. Doctors and nurses yes, – in abundance – but not midwives. Given that they’re at the centre of one of the most spectacular experiences common to all human beings, why is this so?
‘The responsibility they carry is immeasurable. their skill and knowledge are matchless, yet they are completely taken for granted, and usually overlooked … Why aren’t midwives the heroines of society that they should be?’
Jennifer Worth, reading about this in the Midwives Journal, picked up the gauntlet and in 2002 the book, Call the Midwife, was born. It reads rather like a novel in places, but it’s actually based on the true story of life in the East End of London in the 1950s. And of course it rose to fame when Heidi Thomas serialised Worth’s books on BBC TV, series 1 beginning in 2012, and series 7 recently ending on a tragic note which suggests it’ll be back to heal the wounds. And yes, Thomas has indeed signed up for another two series.
The experiences Worth relates rang very true to me. I trained as a midwife myself in the 60s (third from the right in the photo below, taken outside the world’s most famous maternity hospital) and remember vividly that era. Abortion was illegal, premarital sex and illegitimate children were stigmatised, the Pill wasn’t available, racial prejudice was rife, soap and water enemas and pubic shaving were common practice. I too worked in homes where the kiddies ran around in vests and nothing else, free to urinate anywhere without making washing. I learned to take newspapers with me to provide a sanitary base for my bag and coat. Young women did die of eclampsia, infections, undiagnosed complications, back-street abortions. Naive and relatively inexperienced, we accepted the responsibility of being alone in houses with no telephones, few mod cons, but the legendary lashings of boiling water on standby! We too worked long unsocial hours and attended lectures on Saturdays. We too sallied forth anywhere at all hours confidently, wearing our uniforms with pride, and turned our cloaks inside out to parade through the wards in festive red, singing carols at Christmas time.
But Jennifer Worth worked in post-war London; I in Edinburgh and Paisley. She saw a level of poverty and degradation below that I encountered. Prostitution, meths drinkers, homeless immigrants, drug addicts, huge families living in condemned buildings. Mothers desperately trying to keep their families together with no regular income, no benefits, selling hair and teeth as a last resort before being taken in by the workhouse. This was her world.
My own mother regaled me with plenty of stories of those same years and i could only admire the strength and courage of these families who took adversity in their stride and showed such fine examples of parental love and integrity.
It’s a fascinating read, and the success of the BBC show indicates that the topic has widespread appeal. The book includes a potted history of the professionalisation of midwives for those unfamiliar with developments, but the real meat is in the characters and experiences Worth grew to love and appreciate. And the enormous privilege it is to share this most miraculous experience of new birth.
The macabre and the make-believe
Last week we took our youngest grandchildren to London.
As you do, we soaked up the usual history and took lots of photos of the famous sites and spun a few yarns to bring the past alive, but a couple of the attractions on our list turned out to be far too scary for them to even try. Fair enough; no pressure. I was a ridiculously fearful child myself with far too vivid an imagination that got me into a lot of trouble, so I sympathise.
But their reaction made me think about tolerance levels and the power of the imagination. Which led me to the extraordinary talent some writers have for sucking you in to a horrifying or disturbing world. It’s just words on a page, isn’t it? A mere 26 letters strung together in various combinations. Make-believe. But put together in just this way those words can blot out reality, take over your emotions, keep you on the edge of your seat dreading what’s coming but compelled to read on. That’s clever. That’s power.
So in this frame of mind my eye was caught by reviews such as ‘the go-to queen of contemporary brain-twisting crime‘; ‘the twistiest plots known to woman’, ‘everyday tales of warped psychology’. Intriguing. And who is this queen of twists? Sophie Hannah, that’s who. OK. Heard of her, not read any of her work. But I appreciate good plotting; I’m fascinated by psychology; I’ll give her a go. Broaden my horizons.
I chose a recent one: A Game for all the Family – billed as her ‘first standalone psychological thriller‘ on her website.
Justine Merrison has escaped from the rat-race of life in London (I’ve just been there so have an up to date sense of the pace and pressure of the metropolis) to an idyllic home in Devon (my neck of the woods so I know all about the very different pace of life and the picture postcard scenery).
Appropriate choice so far.
Justine plans to spend her days ‘doing Nothing. With a capital N. Not a single thing’, so she cuts off all connection to her old life as a stressed TV executive. But before long her teenage daughter, Ella, becomes withdrawn and miserable. She eventually confides that her ‘best friend in the whole world‘, George, has been expelled from school for stealing her coat, a coat which she gave him as a gift. Incensed by the injustice, Justine puts pressure on the headmistress to reconsider her decision, only to be told that there is not, and never was, a George in their school. So far so good. I’m hooked.
Then Justine sees a creative writing essay Ella has written and she knows at once this is no innocent teenage make-believe. Here is a darkly disturbed mind spinning a macabre tale of a dysfunctional family spiralling out of control. Where has this information come from? And how does it link to the mysterious George for whom she’s pining? Before long, anonymous calls start … then threats … then sinister events. Graves are dug. Justine is caught up in a whirl of frightening happenings, which are wilder than any drama she ever worked on in her former life. Just where do the boundaries of truth lie? And how can she protect her family from the forces gathering against them?
I was sufficiently curious to keep turning the pages, but I have to confess the ending disappointed. Why? Because I was looking for something less obvious given the build up. Because the ‘bad guy’ was always ‘the bad guy’. Because the psychology seemed suspect to me. Because it left me disappointed.
So no more Hannah novels for me then … Ahhh, now there’s the moral of the tale. How unfair of me. She’s an internationally famous, best-selling writer with a string of awards under her belt; she must be doing something right. Even this book has been well reviewed by some critics. And yet I’ve judged her on a first taste. I’d hate it if someone did that to me, so it’s only fair that, at some point, I give her a second chance.
I am resolved.
7/7 remembered
You’d need to have a heart of stone not to be moved by the commemorative events on Tuesday, ten years on from the 7/7 bombings in London. The ‘ocean of pain’, the quiet grace and dignity of those who lost loved ones, the abiding friendships forged in the face of tragedy, the powerful silences – all eloquent in different ways. The nearest I personally came to the horror back in 2005 was fear for medical colleagues attending a conference nearby in Tavistock Square – all of whom survived, many rushing out to help the injured. The effect of this devastation on those at the heart of it we can only begin to imagine.
But for me one of the most amazing tributes came in the form of a drama. A Song for Jenny, based on the memoir with the same name, was shown on Sunday, two days ahead of the tenth anniversary, and dedicated to the 52 people who lost their lives in the explosions. It didn’t attempt to capture the full scale of the atrocity, focusing instead on one family and the unravelling horror that took place in their lives. Emily Watson is brilliant as mum Julie Nicholson, a Bristol Church of England priest whose 24 year old daughter was killed in the Edgeware Road tube station blast, her own faith shredded in the process. Frank McGuiness‘ screenplay is incredibly powerful and the supporting cast excellent.
Sharing the dawning realisation that Jenny is unaccounted for; listening to the police telling Julie it’s inadvisable to see her daughter’s mutilated body; standing with her beside the coffin as she strokes the familiar hand and struggles to find the words for the anointing of the dead; hearing the cabbie declining payment for running her from London to Reading because he wants her to know ‘there are still good people left in the world’; looking over her shoulder as she dares to view the horrific photos of her daughter’s ‘stations of the cross’ … I defy anyone to remain dry-eyed. The utter futility and bewilderment are embedded in the detail: the fault on the Picadilly line which meant Jenny was on a train taking her in the wrong direction for work; the underground official describing the scene as ‘hell on earth’; Lizzie scribbling all over the photo of her sister’s murderer; the policeman sharing his thoughts about his sleeping sons. The isolation and numbness that both protects and excludes are also sensitively portrayed – my heart bled for Jenny’s father sidelined so often by his strong managing wife (the couple parted after the funeral).
It’s harrowing but it’s also a story of love triumphing over evil, with those left behind determined not to let the bombers ‘win’. And as good art can, it creeps behind the instinctive protective barriers and touches the rest of us deeply, forcing us to reflect on issues which affect us all. Which is why I chose to devote today’s blog to this topic.
Maternal love
In March of this year, Tania Clarence was 42. She lived in a smart five-bedroom house in an affluent area in south-west London. Her husband was an investment banker. She employed a nanny. The trappings of wealth and privilege, you might think.
But on 22nd April, while her husband was abroad, Mrs Clarence ended the lives of three of her children: 3-year-old twin sons, Ben and Max, and daughter Olivia, aged 4, all of whom suffered from type 2 spinal muscular atrophy, a degenerative wasting disease. She suffocated them and then tried to kill herself with an overdose. She was adamant that she didn’t want to be saved; she couldn’t live with the horror of what she’d done. How often must she have regretted that her suicide attempt failed.
Six months later, this week in fact, her defending QC said, ‘caring for three children with this condition was exhausting, distressing, debilitating and turned out to be overwhelming.’ Indeed. She pleaded guilty to manslaughter on the grounds of diminished responsibility. Medical reports described how she was suffering from major depressive illness. The courts have decreed she will not be charged with murder, but she will in all probability be treated in a psychiatric hospital.
Unless we’re drowning in her problems, it’s impossible for any of us to really empathise with the depths which drove her to this point, but I’m sure we can all understand her despair and depression. There was never going to be an escape from this intolerable burden, not just the relentless workload, but watching all three beloved children getting steadily more disabled.
I feel huge sympathy for her. And I say this with some feeling, because when my own firstborn collapsed aged 3 weeks and his doctors predicted a lifetime of disability, pain and suffering for him, I distinctly remember feeling that death would be preferable for him: better that I should be the one bearing the pain of losing him, than that he should suffer. So I for one am devoutly glad that the courts have decided Tania Clarence should not have to face murder charges. She is already serving a life sentence, poor woman.
Amongst the files on my desk for future novels is this one, labelled ‘Mothers Convicted of Child Death or Damage’. I’m not sure I will ever have the courage to write it, but Mrs Clarence’s story goes into it for now.
PS. For those who don’t know, my firstborn defied medical prognoses, and is a totally healthy young man today; he has always been hugely loved. So please don’t waste any sympathy on me. Or castigate me for my callous approach to motherhood! Not for a second did I ever contemplate actually killing him, but then I was never driven beyond endurance.
On a roll
I’m buzzing!
Nine hours stuck on a train to London and back on Monday … could have been tedious. In fact it reaped rich rewards. On the way down it was four hours’ reading time. On the way back though, my mind went into overdrive and I got totally stuck into mapping out my next novel. Yep, the whole thing! The catering team plied me with drinks and food and smiles, my fellow passengers respected the rules of the Quiet Coach, and by 11.30pm my notebook was full.
Since then the old brain has been in sixth gear (or whatever it is that facilitates speed and efficiency), and a great big bit of me wants to escape to a remote island and just write. Life though, in all its humdrum-ness, can’t be shelved that easily, so I’m contenting myself with thinking and jotting whenever and wherever I can, empowered by that clear framework.
Rather than leave you high and dry though, I’m simply going to share some pearls gleaned from the latest Mslexia which appealed to the pedant in me. We all quote famous phrases at times, don’t we, but how often do we misquote, I wonder?
Which of these sayings do you think is accurate?
1. ‘Elementary, my dear Watson’ (Sherlock Holmes speaking)
2. ‘Bubble, bubble, toil and trouble’ (the 3 witches)
3. ‘Methinks the lady doth protest too much’ (Hamlet’s mother)
4. ‘Theirs but to do or die’ (The Light Brigade)
5. ‘A rose by any other name smells just as sweet’ (Juliet)
6. ‘Hell hath no fury like a woman scorned’ (Congreve)
7. ‘Please, sir, can I have some more?’ (Oliver)
How many did you rate as accurate? Below this picture of a beautiful tree currently blooming in our Japanese garden, are the results, so don’t look yet if you haven’t finished the exercise.
In reality, every one of these is a misquote. Yes, really! The correct versions are:
1. It doesn’t appear in any of Conan Doyle’s writings!
2. ‘Double, double, toil and trouble’
3. ‘The lady doth protest too much, methinks’
4. ‘Theirs but to do and die’
5. ‘That which we call a rose by any other name would smell as sweet’
6. ‘Heaven has no rage like love to hatred turned/ Nor hell a fury like a woman scorned’
7. ‘Please, sir, I want some more’
How did you fare?