Second Thought for the Day

Interviewed by Lucey Jarrett in the ALCS News (Spring 2011), Russell T Davies remarked:

'... gradually I came into contact with writers, and realised they were ordinary people. This was before I realised that they are all, in fact, mad.'

Thought for the Day

A marvellous quote in the ALCS News (Spring 2011):

'The freelance writer is a person who is paid per piece, or per word, or perhaps.'

                        Robert Benchley (1889 – 1945)

Snap a Quill

Whilst in recent conversation with Penny Grubb (www.pennygrubb.com) , crime-writing author and Chair of the Authors Licensing and Collecting Society, I remarked that there ought to be a literary equivalent to the acting world's 'break a leg' salutation when wishing a writer good luck in a forthcoming venture.

The suggestion from Penny was 'snap a quill', which seems wonderfully appropriate.

So, over to the rest of the writing world – who knows, it may be a phrase carried on into the literary centuries to come!

Happy Talk

'What is this life if, full of care, we have no time to stand and stare?'

So begins the famous poem by the Welsh poet, William Davies. There can be no doubt that the lives of many of us are under pressure; not only because of the current economic climate and the (often difficult) changes thereby necessitated at home and within our workplaces, but also through a predilection for the tendency of those living in a western society to squeeze more and more into each day and week, until the months and years become but a passing blur - so much for the 1970s concept that computers (for example) would make life easier for us all, and allow for greater leisure time.

    Holidays are a time when many of us realise the undesirable qualities and true nature of our working lives. It was the topic of leisure that was on William Davies's mind when he penned his 1911 poem. It was also something he took very seriously, living his early adult years as a tramp (I recommend to you the Wikipedia website for a fascinating account of his life). Leisure was also the topic on my mind when I pensively sat overlooking the terraced farm land and distant slopes of the Troodos Mountains in Cyprus last week, where life in the hillside village of Pissouri is still conducted in the slow lane of time. Whilst there, I pondered on the various blessings of my life, some of them immediately tangible; others less so, such as the privileges of being a Freeman of the City of London (it is such a great comfort to know that, should I ever be hanged for treason, it will be by means of a silk-rope: so much easier on a delicate neck).

    Of course, as individuals we have a myriad of ways of finding happiness, and it doesn't need a trip abroad or the quasi-benefits of an archaic preferment to discover happiness within our lives. Being happy and feeling free of stress are often two overlapping concepts. It was therefore interesting to learn about a new campaign recently launched by the likes of the Buddhist leader, the Dalai Lama, and our own poet laureate, Carol Ann Duffy. Called the Action for Happiness Campaign (http://www.actionforhappiness.org), and drawing on research by the London School of Economics, the campaign aims to encourage and assist the British to rediscover the pleasures to be found in even the most simplest of lives.

    We all know that stress is, in its extreme, bad for our health. However, how many of us make the time within a busy week to sit still for even a short while and reflect on the pleasant aspects of life? Perhaps we should all take a leaf out of the Quaker practice of sitting quietly still for at least one hour per week? For, as William Davies ended by saying: 'A poor life this, if full of care, we have no time to stand and stare'.

First published in the Scunthorpe Telegraph, Friday 15^th April 2011

The Coffin

I this week discovered that a poem from my first collection was used at a recent funeral.

It is always a momentous occasion to send a piece of work out into the world for public consumption, as one never quite knows how it will be received. It is therefore rewarding to know that some poems subsequently take on a life of their own.

The poem in question is The Coffin, taken from the collection A Journey with Time (ISBN 978-1-4092-2847-9), first published in 2008.

The Coffin

A lifetime encased:

your boundless intellect and

energy, swathed in

a vast cloak of achievement,

simply borne by two trestles.

©Copyright Robert M Jaggs-Fowler 2008

Looking into the tea-leaves

Anyone who has opened a box of Twinings tea will be familiar with the quotations on the inside lid. One is from George Gissing (a 19^th century English novelist), who is reputed to have said 'The mere chink of cups and saucers tunes the mind to happy repose'. It is in the spirit of trying to induce even a mild state of euphoria that I am now drinking a large cup of Breakfast Tea whilst writing this article. However, the conversion is proving to be a challenge, and I will explain why.

My medical career began in 1980, when I entered a London medical school with tremendous enthusiasm and the single focus of qualifying and practising medicine. Even then, I knew I wanted to be a GP, despite various professors trying to sway me in other directions. I was one of the lucky ones, having previously gained a place in one of the country's top grammar schools, and then, with the aid of a decent student grant, topped up by a small scholarship award. I was, as the saying goes, upwardly mobile.

    After several years of working a long and arduous passage through a variety of junior hospital jobs (120 hour weeks were the norm), I landed in North Lincolnshire and had the great fortune of being offered a medical partnership. For the major part of the past twenty-one years I have tried to offer a decent quality of service to my patients; many of whom, by virtue of living within a small community, I would now call friends. The long working days and pressured demands have been compensated for by the firm belief that I have been helping others in need and putting something back into society.

    Now, in 2011, the present NHS reforms have overturned my enthusiasm and ideology. Whilst it is true to say that I still enjoy the individual patient-doctor relationships of everyday general practice, the pathway the NHS is now being forced down makes me increasingly look for alternative ways of spending the next decade of my working life. Such a statement comes as a surprise to many who have known me for a long time. However, the truth is, I (and many others on a national basis) fear for the future of general practice in particular and for the future of the NHS in general. Along with a large proportion of my GP colleagues, I can see through the political rhetoric of 'giving GPs the power to run the NHS'. Whilst it is true that we are to be given the responsibility of keeping within restricted budgets (not a bad thing when dealing with tax-payers' money), the exhortations of the Secretary of State for Health that the reforms are going to 'free up GPs to spend more time with patients', 'empower clinicians to make the decisions', 'liberate the NHS', and that 'the majority of doctors support the reforms' are, many of us believe, far from the reality.

    It is true that there are a few doctors who are enthusiastic about the changes. There are slightly more who are pragmatically getting on and trying to make something decent out of the reforms. However, the majority of GPs are disquieted and fearful; certain that the changes will see greater privatisation of NHS services and hospitals, a loss of experienced managers, greater demands on GPs' time in respect to running the service rather than treating patients, increasing pressures to achieve unreachable targets, insufficient money to provide a decent service, closure of some hospitals and surgeries, and ultimately a dismantling of primary care as we know it. Of course, GPs will get the blame when it all goes wrong (nothing new there), whilst those presently in Government, who should carry the responsibility for the wholesale destruction of our national health service, will have moved on to pastures new. In the meantime, it is you, the patients, who will suffer.

If you think I write as a burnt-out fifty-year old GP who can no longer stand the pace, you are quite wrong. However, I am angry, demoralised, and reflectively surprised that I should find myself seriously considering a career change after years of enthusiasm for life in medical practice. I strongly believe that the nation needs to wake up to what is happening before it is too late. Don't swallow the political rhetoric without reading the label; there are some serious side-effects to these present reforms, and many of them are yet to become apparent. Use your wits and start asking questions of your MPs and doctors. Seek out the truth and then decide whether you personally wish to influence the changes before it is too late.

There, I have said my piece. As I drain my cup, I am mindful that Noel Coward once asked 'Wouldn't it be dreadful to live in a country where they didn't drink tea?' I quite agree, although I find myself wishing I hadn't used a tea-bag; a few tea-leaves may have helped decipher the future. As it is, looking at the bottom of my cup, there is nothing there. Then again, perhaps that is also the future of the NHS as we know it...

First published by in the Scunthorpe Telegraph, Friday 1^st April 2011

‘Robin in Flight’ by Paul Adrian

The winner of the Poetry Society's National Poetry Competition 2011 is Robin in Flight by Paul Adrian.

Previously unknown, Paul Adrian has produced something that many poets will envy (apart from the fact that he won £5,000 for it). It is a beautiful conceptual work, which has caused me to read and re-read it many times. I find the last two lines particularly impressive.

Hopefully, this will not be the last we hear of Paul Adrian. I, for one, will be keeping an eye on his progress.

Robin in Flight can be found at: http://www.poetrysociety.org.uk

The Power of Love

Earlier this month the national newspapers reported the death of L/Cpl Tasker, a military dog-handler working in Afghanistan. What makes this sad loss of a member of our armed forces even more poignant is the fact that his specialist dog, Theo, died of a seizure three hours after the death of his master; such was the bond between the two.

    The above case may not be considered unusual by animal lovers, who often form strong emotional bonds with their pets. That the same applies to humans is also well-known; I have often encountered stories where someone with a serious illness has evidently stayed alive against all odds, simply to meet an important personal or family deadline (a wedding anniversary or landmark birthday, for example). The determined power of the human spirit is the only factor deciding on life or death. Never, however, had I met the situation in person until shortly after I qualified as a doctor:

'She refuses to die whilst her husband is still alive,' said the staff nurse.

I was in the first week of my first hospital job as a House Surgeon in Kent. Mary (as I will call her) was in her mid sixties and extremely frail. She was quiet and undemanding, and held little in the way of conversation apart from requesting a daily report on her husband. Her diagnosis had been confirmed some four months previously; inoperable cancer of the ovary. Over the ensuing months, Mary became progressively weaker, being unable to take food and surviving on the occasional sip of tea and the fluids being dripped into her veins. Such was the extent of her emaciation that her skin appeared to have been wrapped like Clingfilm around every curve and contour of her bones.

Mary's husband used to visit her every day at 2.15pm precisely. He was a dapper little chap; always in a tweed jacket and tie, and carrying fresh flowers. He would give her a gentle

kiss on the cheek then sit down in an armchair next to the bed. A few words might pass between them, perhaps some small happening from events back at home. However, for most of the time they would remain quiet; content in that easy silence that comes of many long marriages. Often, Mary would sleep. For his part, her husband remained vigilant, quietly stroking her bony hand; reassuring her by his continued presence. Then at 5pm, he would rise, give her another kiss, move the odd wisp of hair from her face, give her hand a final two-handed squeeze, pick up his cap and leave. Mary would follow him with her eyes until he disappeared from view. All of this I would observe from the distance of the ward office.

One day, in the cruel way that fate often works, Mary's husband suffered a major stroke, which left him paralysed and unable to speak. As a result, he was admitted to another ward within the same hospital. Both being too ill to move, the only contact between them was Mary's daily enquiry after her husband. Then, at 8am one weekday, the telephone call came through to the ward to inform us that Mary's husband had died in his sleep during the early hours of that morning. The ward Sister broke the news to Mary, who listened carefully but showed little in the way of emotion.

Just after lunch, my pager summoned me back to the ward and I was asked to see Mary. I knew at once that she had passed away. I stood there, quietly pensive, noting the hand stretched out towards the empty chair beside her. As the nurses averted their red-rimmed eyes, I knew that I was not the only one to be moved by her death. For many months, Mary had survived against all odds, taking strength from the power of her husband's love and her love for him. Then, within a few hours of being informed of his death, she had simply stopped living.

I still wonder at how the power of love fuelled Mary's resilience. The story of L/Cpl Tasker and his dog Theo reminded me of this story, and of how love for another being is sometimes stronger than any medicine.

First published in the Scunthorpe Telegraph, Friday 25^th March 2011

Just, Perfect and Regular

My wife thinks she is sleeping with the enemy.

    Before there are any misunderstandings, my opening reference is to the 1991 film of the same name (starring Julia Roberts, Patrick Bergin and Kevin Anderson). It is most certainly not a sleight on my wife's fidelity; nor am I suggesting that I am an abusive husband. However, Patrick Bergin's character and I do share one thing in common; we both stack the contents of the kitchen cupboards in tidy, orderly rows, with the labels facing outwards.

    Initially, my wife put it down to my army background instilling in me a strong sense of regimentation. However, having known me for a while, she started to reconsider her preliminary diagnosis. The colour co-ordinated shirts, socks and sweaters in my wardrobes were further clues, as was the need for absolute precision when hanging paintings and arranging furniture. Twenty years on, my wife was reminded that the years have not changed me (at least not in this sense) when I proudly demonstrated to her the results of my weekend's work of re-arranging the library at home. Shelf upon shelf of neat books, arranged according to category, and then alphabetically by author within each category. Furthermore, all the books are forward adjusted to compensate for differences in size, so that the leading edges are all in a wonderfully straight line. The CD collection suffered a similar fate last month. To me, the result is one of blissful order, if not a work of art; to my wife, it is a sign that I most certainly have an obsessive-compulsive personality. Psychiatrists know it better as Obsessive-Compulsive Disorder or just 'OCD'.

    Whether it is put down to my military training or the fact that I am an Aquarian, or any other plausible explanation, the fact remains that I prefer a structured pattern to my life; which is perhaps that is why I was drawn to joining the army. It would seem that such a preference extends deep into my subconscious mind, as I often wake at precisely 3.33am, 4.44am or 5.55am; a fact which then keeps me awake and starring at the clock in wonderment that it has happened yet again (and I often wonder what numerologists would have to say about it all). I was even born at 5.55pm; which, you have to agree, is a great start in life for someone with OCD.

    For me, OCD does nothing more than renders me a mild eccentric in the eyes of my family and friends. By and large, I am not perturbed by my predilection for routine and life goes on in an harmonious fashion. The problem comes when that routine is disturbed by major upheaval and change. People with OCD do not greet change with any degree of warmth or enthusiasm unless it is of their own making (so imagine how I feel with the current re-organisation of the National Health Service). The truth is, for some people change in their routine is immensely disturbing to the point of making them psychologically ill. Such people may also demonstrate far more obsessive characteristics than I do; such as the need for continual hand-washing (although not a bad trait for a doctor to have), repetitive checking of door locks, and that gas knobs and taps are turned off, etc. For those people and their families, OCD can become akin to a living nightmare and is most certainly not a joke. Such issues create poor health, ruin jobs and destroy marriages. The trick is to recognise the behaviour early, well-before it becomes a major problem. It is important not to be frightened of confronting the issue and seeking help if you think the condition is affecting you in an adverse way. Your GP can act as a guide to local counselling and therapeutic services, and there are also support groups available (such as OCD-UK, which can be accessed at http://www.ocduk.org/4/groups.htm).

    Meanwhile, I am looking forward to the next weekend. Those tools in the garden shed could do with a bit of a tidy-up, and then of course there is the garage, the loft, the wine cellar...

First published in the Scunthorpe Telegraph, Monday 21^st March 2011

 

    

The Value of Childhood Reminiscences

As all members of the National Trust will know from the recent issue of the members' magazine, there is a poetry competition running until the 31^st March. Called 'Landlines', the competition has two categories: 'under 16' and 'over 16'. The judge is the well known poet Ian McMillan (who, amongst other things, is the Humberside Police's Beat Poet.) Introducing the competition, McMillan reflects on how the great outdoors, landscape, weather, buildings and places can all be strong images we carry in our memory for years to come.

I know this for a fact, as I carry fond and vivid recollections of my teenage years in Kent spent in the buildings and grounds of great houses such as Knole (the setting for Virginia Woolf's novel, Orlando), Sissinghurst Castle (home to the writer Vita Sackville West), Winston Churchill's home at Chartwell, Down House (where Charles Darwin lived and wrote his On the
Origin of Species), and Quebec House (childhood home of General James Wolfe). That these historic houses and grounds, along with their eminent owners, left a lasting mark on my formative years is beyond question, as even today I recognise parts of my actions, thoughts, words or possessions as relating to those early experiences.

    Early memories play an increasingly important role as we get older. They are the first memories we have, and those of a greater age than I will often relate more to those early years than to recent events. I am sure that we all have the experience of aged relatives relating stories of their younger years for the thousandth time as though they were telling them afresh.

The same memories can be a source of great value when it comes to dealing with someone with early dementia. For such people, the present can often be bewildering, strange and even frightening. The usual platitudes of reassurance are of little value and quickly forgotten, and the person is left fearful, distressed and mentally alone in a perplexing modern world. Such people will often still respond in a positive and knowledgeable manner to stimuli which provoke images from their childhood and early adult years, and it is to these memories that family members and other carers should be looking in an effort to satisfactorily communicate with their loved ones. The present means very little to them. However, pictures of familiar places, houses, countryside and people will often trigger deep-seated memories which will bring some meaningful actions or conversations.

As an example, I can remember the case of a gentleman who lived in a residential home. He had dementia, was relatively immobile and was quite isolated within the home. One day a care assistant started playing records of dance music from the 1920s. To everyone's surprise, the man got out of his chair and accompanied the care assistant in a faultless waltz around the day room. Unbeknown to his carers, he had won medals for ballroom dancing in his twenties and the playing of the records had unleashed those memories.

So, if you find yourself looking after, or trying to relate to, someone with dementia, forget about the present and look to the past. The trick is to discover the background of the person you are dealing with; you may be in for some pleasant surprises.

First published in the Scunthorpe Telegraph, Friday 11^th March 2011

I Am Alive Awareness Day

As I write this article I am conscious of the fact that Wednesday 9^th March is this year's No Smoking Day. Once again, there will be substantial local and national news items aimed at trying to persuade people of the sense in stopping smoking and to highlight the assistance available to smokers in order to raise their chance of achieving this more than sensible aim.

Laudable though this endeavour is, it has made me ponder the wisdom of having specific days set aside for highlighting such issues. After all, in respect to the subject of smoking cessation, it is not as though the problems of smoking are not highlighted all year round through a variety of sources and not least of all from GPs. I am sure smokers must be surprised these days if they can attend their surgery and come away without having been advised that they should stop smoking. Of course, it is also only eight weeks since we underwent the joyful celebration of welcoming the New Year; is it really the case that we have already forgotten our well-intended resolutions that we need an entire day set aside as a reminder of specific ones?

    I do not mean to sound negative over such important issues. Stopping smoking is one of the most important health-enhancing activities a person can take, and I am all for stressing the importance of being smoke-free. However, I am concerned that by having specific days set aside in the year to highlight such matters, rather than lending renewed emphasis to the subject we run the risk of reducing the impact to just a twenty-four hour period, after which the topic can be dropped as we prepare for the next one. I have the feeling that it risks turning important issues into nothing more than the equivalent of a passing festivity. After all, who now holds the memories of the last Christmas festivities foremost in their minds, or can instantly recollect the occasion of their last birthday? Whilst such occasions are very important, we do not continue to lend emphasis to them all year round. However, that is what we should be doing with topics which presently crop up as specific 'Awareness Days'.

    A quick survey informs me that we have at least fifty-four observance days set aside as 'world observance days' for the remainder of 2011 (excluding religious festivities, national saints' days, and specific occasions such as Mothers' Day, etc), with many more 'awareness days' on a national basis (over 100 at the last count). The majority of these will no doubt pass unnoticed by the majority of the population, which makes me question the entire purpose. There are now so many that it becomes nonsensical, with a new one almost every other day. Do we run the risk of 'awareness day fatigue' as a result? (Now there is an idea for a new 21^st century medical syndrome.)

    About ten years ago I lost a well-respected, aristocratic friend and colleague. The week before he died of cancer he attended a black-tie charity ball in London. Remarking on how good it was to see him there, I gently enquired as to how he was getting on. His reply has stayed with me ever since: 'I am alive; it's all that matters', he said. I must think about that comment several times a week. As a result, every day becomes something special, and I often find that my friend's words urge me to squeeze just a bit more out of every day, no matter how busy or tired I am. There is always extra one can do, a resolution to adhere to, a little more to learn, something new to experience or appreciate; and when all else fails, there is the simple act of sitting back and relishing the company of a loved one and simply rejoicing in being alive.

    So, for me, all the hundreds of 'awareness days' and 'world observance days' amount to very little. I prefer to make every day an 'I am Alive Awareness Day'. As my friend said, that is all that really matters.

 

First published in the Scunthorpe Telegraph, Thursday 3^rd March 2011