Author: kidsaregifts20

Two overlapping worlds.

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The Bhagavad Geeta addresses the ethical and moral dilemmas around the questions of who we are, how we should live our lives and act in this world. If this voluminous text was to be summarised in two sentences, they would be:

  1. Do what needs to be done, knowing that all actions come from God.
  2. Do not be attached to the results of your actions.

Six weeks ago, I re-entered the world of Suicide Prevention due to a presentation I agreed to make. It took me back to a familiar battleground where strong currents of injustice flowed through me. I went over our story yet again, in mind and body. It burnt me up. It made me restless and irritable. It kept me staring at the ceiling at night. It brought back the shit of guilt in big droppings. It was silly of me to agree to do it, but it was too late already. I wrote it down, prepared a set of PowerPoint slides to support the story.  I repeated it for the nth time to many. I wondered, to what end, but I did it anyway.

Four and a half years ago, when my road gradually swerved from the Suicide Prevention world towards peer support with other parents, it was like a cool breeze gently blowing in my face. That conversation felt like a proper invitation. Instinctively I knew it was good for me. Despite huge self-doubt, I trusted that path. I went with it. This work was also about preventing isolation and possibly suicide amongst parents, as our risk is 60-70% higher than others. It did not feel like work at all. We formed strong bonds of friendship. We shared deeply and held each other in understanding and compassion. This felt like home.  

The organisers at National Confidential Inquiry into Suicide and Safety in Mental Health provided me the best possible support to be able to present my thoughts. The comments on the chat were that of gratitude and inspiration to change. One person said that it was better than any training course they had attended. I am glad that I did what was needed. The strength to do it came from somewhere. Now, it can do its work and I can go back home.

The recording is here (‘Bridging the gaps’ starts 6 minutes and 45 seconds in).

Wrap-around?

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“What can we do to offer wrap-around care to our patients?”

In the live Q&A at the end of the NCISH conference yesterday, this question was asked of the panel. The Chairperson directed it towards me. I can’t remember what I said. This morning I woke up with what I would have liked to say.

For wrapping, we need two things. One, the fabric which we are going to use to wrap and the person we want to wrap. Let’s discuss them one by one.

  1. The fabric

The fabric of Suicide prevention in Health-Care is made up of two things – people and systems. Let’s look at them a bit closely.

  1. People

What are the beliefs of the people?

I know of an ENT surgeon from another country who wanted to move to the UK and the only job he could find was in Psychiatry. So, he is now training to be a Psychiatrist. Is he interested in suicide prevention? Do Health-care professionals believe that suicides are preventable? Are they content that simply by treating mental illness they are doing their job?

What are the attitudes and abilities of the people?

When the Emergency department calls to say there is a suicidal individual waiting to be seen, how do they feel? Are they excited to have an opportunity to make a difference? Or is it a drain on the limited time and energy they have? Do they know how to build a compassionate connection with someone who has lost all hope? Have they received any training in Suicide Prevention? Do they have enough self-compassion to look after someone else well?

Do they have the resources and the knowledge to do a good job?

Do they have access to their past history? Do they have beds on the ward? Can they ask a colleague for a second opinion if they have a doubt about how to involve family or friends in their care? Do they know of other resources, like charities, activities and people that may help this person? Do they have comprehensive and informative leaflet they can share with them? Do they have the means to follow them up?

b. Systems

Does the system have capacity? Are the various parts of the system effective and joint-up enough to be able to hold the person they are trying to wrap or are there big holes in this part of the fabric? Do the various parts of the system share the same mental model, a shared knowledge, pre-suppositions, and beliefs that can be used to help achieve mutual goals? Are their practices evidence- based? Do they investigate deaths with a view to learn lessons and implement change? Do they look after the well-being and emotional health of their employees? Do they hold themselves accountable when things go wrong?

2. The person

Allowing space for them to express themselves. Help maintain their sense of agency. Inform them it is safer for them to involve other people who care for them. Equip them with resources. Give them the support they need. Ask them what would help them? Listen. Sit with their despair. Acknowledge it. Keep them connected with their life as they know it. Keep hope alive for them.

Know that the person at the centre of the wrapping is of great value.

Information is useful if it becomes knowledge. Knowledge is useful when it becomes wisdom. So, let us not stop at information.

Ref:

Reaching common ground: The role of shared mental models in patient safety : https://journals.sagepub.com/doi/full/10.1177/2516043518805326

Thirty-one.

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(Courtesy: astronomy.com)

“Longing is divine discontent, the unendurable present, finding a physical doorway to awe and discovery that frightens and emboldens, humiliates and beckons, makes us into pilgrim souls and sets us on a road that starts in the centre of the body and then leads out, like an uncaring invitation, like a comet’s tail, felt like both an unrelenting ache and a tidal pull at one and the same time, making us willing to give up our perfect house, our paid-for home and our accumulated belongings.

Longing is felt through the lens and ache of the body, magnifying and bringing the horizon close, as if the horizon were both a lifetime’s journey away and living deep inside at some unknown core – as if we were coming home into a beautifully familiar, condensed strangeness.”

  • An excerpt from an essay on Longing by David Whyte in his book ‘Consolations’.

I long for the warmth of that hand on my right shoulder, that lovely smile, those big brown eyes and that dimple on his chin.

Blessed is the day you were born. Bless you my darling, wherever you are.

Stories are us.

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Why are they here? These random strange-looking foreigners? One is white and the other we’re told is from the north of India. Wonder which is worse. At least one of them is easy to steel from. Surely the other is obnoxious. But she teaches English at the Primary school for free. Wonder what’s in it for her. Oh yes. She’s using our kids to learn Kannada for free. That must be it.

The minds of the villagers are desperately trying to make sense of what we’re doing here, in this remote village. The nearest airport is 5 hours’ drive away and the closest decent hospital, at least an hour from our village. We don’t speak the local language and hardly anyone speaks Hindi or English.

The first story of us was that I am a film director and Si, an actor. We’re scouting a suitable location to shoot a period drama. But then no camera or crew showed up. So, that was discarded.

The next tale was that we are here to set up a petrol station. That’s how people with connections in high places syphon off their black money. That fits, they believed, knowing nothing about us. But then no signs of construction appeared for months.

The next guess was that we want to open a bar and restaurant. As we are close to the highway, it’s a great place to open-up something for the travellers to rest and refresh. That didn’t seem to be happening either.

What can it be? Oh. They both have seriously grey hair. All their friends must be old. They must deeply empathise with old people. They must be planning an old people’s home. Well, no signs of that yet.

What are they about after all? The dogs and kids seem to love them. They seem like nice enough people. Maybe they’re planning to start an orphanage?  Don’t know. We’ll have to wait and watch.

Well, all they seem to be doing is planting more trees and making more compost and playing music to their plants, setting up irrigation systems and so on. Maybe they’re doing all the groundwork to ultimately grow cannabis.

Oh! How we need stories!

The C-word.

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He was born in May. I was 28. A pleasant pregnancy. Normal birth. No fuss, just like him. The Army hospital sent us a bill for Rupees 16 afterwards.

I want to organise a party. I want to sing a song for him even though I know he’ll be embarrassed if I did that. I want to see that look on his face. I want to put together a playlist for the party. Plan a menu and draw up a list of guests. Find a venue and a theme.

Most of all, I want to see him. Wish him a happy birthday and a great year ahead. I want to kiss his forehead. I want to present him the book, “A Gentleman in Moscow” by Amor Towles. I think he will love it.

I want him to know I feel blessed to be remembering him, for all this love. I want to celebrate him and the day he was born.

Oh! The C-word. Can I?? Am I eligible?? Do I meet the inclusion criteria?

Yes. Celebrate.

I can. I want to. I will.

Notwithstanding the yearning, I celebrate the essence of him.

Despite the apparent separation, I celebrate the felt connection between us.

Though the approaching day intensifies the pain, it also pushes the roots of love deeper into the ground.

Despite everything, I cherish the little piece of eternity we shared.

“You were a wave in the ocean

For a sliver of time, an age ago

and the sand on that beach

Still awaits your return.

It remembers being soaked in you

for a few glorious moments.

It remembers who you were.

The quiet beach and the setting sun

Smile at the memory of your face,“