The Hard Game of Life

 ‘Hope springs eternal in the human breast.’

If only the 18^th century words of Alexander Pope were true for every person. Hope, that powerful emotion that, when present, so readily dispels its antithesis despair, is sadly lacking from many people’s lives. The result is a never ending spiral into an increasingly black hole at the bottom of which resides suicide; the thought of which curiously acted as a ‘great source of comfort’ to the German philosopher, Friedrich Nietzsche. Yet our true source of comfort ought not to be found in death, but in an optimistic outlook on life, fuelled by a game plan to bring our great expectations into fruition.

The statistics for suicide are a cause for great concern. The World Health Organisation calculates that every year some one million people worldwide die by suicide, corresponding to one death every 40 seconds. This is more than the annual loss through murder and war combined. Yet, the situation could be far worse as up to twenty times this number of people fail in their attempt at suicide. It is calculated that 5% of people attempt suicide at least once.

Often hidden by other events (such as road traffic accidents and cases of drowning), suicide is the leading cause of death amongst young people (100,000 adolescents per year). Those overwhelmed by stressful life events and emotional distress, in chronic pain, or suffering from a psychiatric disorder, alcoholism or drug addiction are most at risk. Overall, more men die by suicide, whilst more women attempt suicide. In terms of age, the suicide rate is high amongst middle aged men and highest in people over 75 years.

The costs to society from suicide are enormous, estimated to be equivalent to billions of US dollars per year. The psychological and social impact on families and communities is even greater. Yet, despite its frequency, suicide is often under-reported for fear of family stigma, religious concerns and negative social attitudes.

The good news is that suicide can be prevented. It was with this simple fact in mind that September 10^th marked the 10^th anniversary of the World Suicide Prevention Day. The latter exists to raise public awareness of risk factors, improve efforts to strengthen society’s protection of the vulnerable, and to teach people where they can seek help. The focus is on public awareness campaigns, increasing supportive networks for young people, increasing training for healthcare professionals, improving mental health resources and reducing the barriers to accessing these.

That said, even at present, there are various readily accessible support groups outside of the normal health services. For example, the Samaritans, founded by the Reverend Chad Varah (who was born in Barton upon Humber), provides a 24 hour support line on 08457 90 90 90 (www.samaritans.org). There is also Nightline; a student-focused support line, whose Hull number is 01482 466272 (www.nightline.ac.uk).

Life was never promised to us as something that is easy; but neither, contrary to the lyrics of the theme song to the television programme MASH, is suicide painless. Somebody, somewhere, always gets hurt to an unfathomable extent. Working together, society can reduce that pain.

(First published in the Scunthorpe Telegraph, Thursday, 20^th September 2012)

Thought for the Day

'I believe in Christianity as I believe that the Sun has risen - not only because I see it, but by it, I see everything else.'

C. S. Lewis (1898 - 1963)

Out of the Frying Pan into the Fire

Stagecoaches were the main means of long-distance travel before the advent of the railways. Drawn by horses, each journey required regular stops to change the tired horses for fresh ones. Travelling at slow speeds (4-7 mph), a lot of effort was involved just to cover short distances. Indeed, it could take an entire day’s journey to travel from Barton upon Humber to Boston; a long, arduous journey without any meaningful change of scenery.

Last week saw the Prime Minister change many of his horses in a mid-term re-shuffle of the Cabinet. Amongst the ministers put out to grass was the former Secretary of State for Health, the Rt Hon Andrew Lansley. Vaunted as the architect of the Health & Social Care Act 2012, many would prefer to see him cast as a demolition man rather than a designer; in this case, the destruction of the National Health Service. Having spent almost nine years holding a health portfolio (the first six in Opposition), it is astonishing that he so spectacularly failed to understand that the National Health Service works better as a functioning whole rather than as fragmented bits. After all, who in their right mind buys a jig-saw puzzle ready made up, dismantles it into 1,000 pieces, and then stands back to admire the result?

That, however, is what Andrew Lansley has managed to bring about after nine years of studying the NHS. Albeit rickety and demanding high-maintenance, what was once a functioning and coherent service is now lying in broken chunks scattered over the landscape. The irony is that Aristotle understood the principle as far back as the 3^rd century BC, commenting that ‘The whole is better than the sum of its parts’. Integrated health care is something clinicians have desired for many years. Yet, the concept of co-ordinated, comprehensive and seamless care has been laid to waste by a Secretary of State who was deluded into thinking he understood the complexities of life at the forefront of health care. For someone who holds a degree in politics, it is astonishing that he was unable to assimilate the lessons of the past, and in particular the Porritt Report of 1962 which stated ‘We have concluded that in future one administrative unit should become the focal point for all the medical services of an appropriate area’. That was what the now terminally-ill Primary Care Trusts were for.

The Prime Minister’s change of horses has produced Jeremy Hunt as the new Secretary of State for Health. Hunt is on record as holding controversial views on health care, which do not exactly encompass Aneurin Bevan’s vision of free-at-the-point-of-use medical care for everyone. A failed exporter of marmalade, Hunt is clearly the right person to pull the NHS on to its final stage of destruction.

The only real hope of rescue is a change of government with the next election when, as one senior NHS executive said to me recently, another major reform will be needed to stitch the NHS back together again. Perhaps the French novelist, Jean-Baptiste Karr had it right when he wrote ‘Plus ça change, plus c'est la même chose’; the more it changes, the more it is the same thing. After all, even after a long arduous journey, the Wash still looks a bit like the Humber.

(First published in the Scunthorpe Telegraph, Thursday 13^th September 2012)

Thought for the Day

'Faith need not be unacceptable to contemporary culture, and contemporary culture need not be unacceptable to faith'

Paul Tillich (1886-1965)

Thought for the Day

'To study theology is to set out on a voyage of discovery that is at times enriching, at times challenging, but always profoundly interesting.'

Alister E McGrath (2011)
From the Preface to Christian Theology - An Introduction

In a Motivational Mood

Continuing with my theme of the Olympics and Paralympics serving as motivators to those who for some reason psychologically feel unable to achieve something with their lives, I watched with interest as Professor Stephen Hawking opened the Paralympics with an opening ceremony designed to ‘celebrate the possibilities that lie within us all’, as the brief for the artistic directors was phrased. 

Tapping those inner possibilities is not something we are always good at; either as individuals or as adults with a responsibility to do precisely that in respect to our younger members of society. I still remember the moment my headmaster informed me that, in his opinion, I would never become a doctor. I could so easily have been discouraged at that first hurdle, spent my time at university reading the Classics and be running a bookshop by now. I could also have been dissuaded of my heart’s desire when, in the 4^th year at medical school, a general surgeon pompously informed me that I was wasting my time by wanting to enter General Practice. Fortunately, my well-polished rebellious streak came to the fore on both occasions and I ploughed my own furrow with a focused determination.

However, not everyone can be so self-motivated. It is then that such reservations need to be overcome by those who recognise the untapped potential. It was with those thoughts in mind that I recently listened to BBC Radio 4’s programme ‘Lewis’s Return Home’. Based on the life of the writer Ted Lewis (author of the book behind the famous film, Get Carter), it told the story of how, when a pupil at the Grammar School in Barton upon Humber, Lewis was taken under the wing of his schoolmaster, Henry Treece. Treece, in his own right a celebrated poet and author, recognised the artistic talent within Lewis and persuaded both him and his parents that the Hull Art College was the place for Ted to go. From there, Ted Lewis began a writing career and, as the saying goes, the rest is history.

The story was far different for Nicholas McCarthy. McCarthy only has one hand; he was born without his right hand. At school, his head teacher told him that ‘having one hand would always hold him back and it was better not to waste his and other people's time’. The comment was made in respect to McCarthy’s desire to learn the piano. Not to be daunted, McCarthy taught himself to play the keyboard. Last month he graduated from London’s prestigious Royal College of Music. Last week, he played as part of the paraorchestra, Britain’s first disabled orchestra. Next month he embarks on a tour as a concert pianist, starting with the Fairfield Halls in Croydon. (McCarthy’s remarkable story and the opportunity to watch and listen to him play can be found at www.bbc.co.uk/news/uk-england-surrey-19179499).

Teachers such as the headmasters both I and Nicholas McCarthy were exposed to have no place in the lives of children. Demotivation is the last thing young people need. Every child should have a Henry Treece at their elbow, seeing the hidden potential and driving them forward to achieve what is in their hearts and minds, regardless of the hurdles they might face along the way. ‘Celebrating the possibilities that lie within us all’ is what the London Paralympics was focused upon. It should become everyone’s mantra for life.

(First published in the Scunthorpe Telegraph, Thursday, 6^th September 2012)

The Frustrating Field of Human Endeavour

As a doctor, I have realised that people broadly fall into three categories when it comes to illness and disability. The first consists of those who are so severely ill or disabled that they require assistance with all activities of daily living. They are unable to perform even the most minor task. They need and deserve all the assistance that medicine, social services and society as a whole can provide to ease their misfortune.

Then there are those who, regardless of how severe their diagnosis is, shoulder the burden and carry it with aplomb, determined that they will continue to live as actively as they possibly can. They overcome psychological and physical burdens, as well as social prejudices and discrimination, to make their lives fulfilling. They are largely uncomplaining, being appreciative of everything done to lighten their load. They strive to meet everyday challenges, including working for as many hours or days they can manage. They do not expect to be totally kept by the nation on benefits, and instead earn money and pay their tax as well as any able-bodied person. They are a credit to themselves and to humankind.

Finally, there is the opposite group to the aforementioned. They usually have some genuine illness or disability (although some do fabricate their condition), but they magnify their symptoms and wear their suffering like a badge for all to see. Regardless of how capable they remain, they consider themselves to be totally incapable of work for even a reduced number of hours per week.  These are people who are quick to blame others, including the medical profession, for their misfortune in life. They also believe that society owes them something and that it is their right to live on state benefits. The fact that they still have a functioning brain, or the use of their arms, or can sit even if they cannot stand for long (and so on) is immaterial to how they see themselves and their ability. In their eyes they are totally disabled and incapable of contributing to their own care or to society as a whole.

It is this third group that I admit to professionally finding the most frustrating. With such people, there is a part of me that wants to confiscate their unnecessary walking stick or crutches, shake them by the shoulders and tell them to get a life. As a reader, you will know someone like that. You may even recognise yourself as one of this group.  To such people let me say that I know you are often in pain, or have difficulty with your heart, lungs, bowel, bladder, or a limb or two, and that life is not always easy; but it is not impossible. Life is also precious; a once-only gift and you are wasting yours.

Dr Ludwig Guttmann shared the same professional exasperation when he was put in charge of a spinal unit at Stoke Mandeville Hospital in 1943. Refusing to allow his colleagues or his patients to see people with disability as totally incapable, he strove to make patients focus on what they could do rather than what they could not. As a result, the Paralympics was born. This week we will watch with awe, pride and fascination as men and women show how they have overcome enormous difficulties and suffering to excel and make something of their lives. As you watch, ask yourself one question. If they can do it, what is stopping you from achieving more than you currently imagine you are capable of doing? 

(First published in the Scunthorpe Telegraph, Thursday, 30^th August 2012)