Could I?

She ran around chasing her multiple ‘to-do’ lists the whole time. She managed to tick things off it with fare speed. Yet her chores never ended. She didn’t allow herself the slightest slip-up. She slowed down for nothing or no one. Despite running herself down she kept carrying on. Yet she thought she wasn’t quite hitting the mark. There was so much more to do. She lived so much in the future that she could never see the landscape of her own heart or anyone else’s. She didn’t know that if your own cup is empty, you can’t fill someone else’s.

She thought she had everything under control. She didn’t ask anyone for help or advice. Even if they offered it, she seldom took it. She did her own thing. Deep down she knew that she didn’t know best but had no idea how to admit it. She took herself way too seriously. She bull-dozed her way around the marshland of her life and crushed a poor little soul every now and then. She didn’t know how to apologise even when she was truly sorry.

She took herself off to far-away places as and when she fancied, oblivious of the impact it would have on those left behind. She just wanted to fly high, be happy, be free. She made it look like she had it all figured out when in fact, she was lost. She had no names for her feelings. Somewhere along the way she had learnt that it was ok to be a martyr and a bully and she managed to play both those roles to perfection. She didn’t know that it wasn’t ‘hard work’ but kindness that made a life good.

She had been unfulfilled and ignorant in so many ways for so many years but she had no clue. She was under the impression that she was successful. There was so much that she did not know. But none of it was her fault.

Could I forgive her?

She was the mother of my son before Day 0.

Could I accept her? Even love her? Embrace her? Could I?

Our own voices

Paramedics and trainee paramedics rotate through our Department of Anaesthesia to learn to manage airways safely. A few weeks ago, I had a young man in his mid-thirties, a trainee paramedic with me, learning about airway management. Out of curiosity I asked him, “What is the most annoying part of your job?” He was straight-up, “When people inflict injuries on themselves, I think it’s such a waste of time. It takes away from others with real problems, who really need our attention.” I just smiled. I wasn’t surprised. I know full well that paramedics do a great job of looking after all kinds of people in all kinds of trouble. But attitudes can only be changed through education.

A professor of Psychiatry tweeted today “Twice in the last week I’ve been told of cruel comments by health staff to people who had self-harmed. I really believe this is unusual now but it shows there is something deep-rooted that we have to eradicate.” A classic example of ignorance within medicine of attitudes within medicine.

No training of first responders is complete till someone with lived experience of a mental illness has spoken with them, be it a police academy, social workers, fire fighters, nursing or medical students or ambulance crew. Lived experience includes suicide attempt survivors, others who have experienced a suicidal crisis and those who have lost a loved one to suicide. Sharing by these individuals can be a powerful agent for challenging prejudice and generating hope for people at risk. It enriches the participant’s understanding of how people with these serious disorders cope with their symptoms, recover and lead productive lives with hope, meaning and dignity. The program also empowers those who are faced with mental illness and provides living proof that recovery is an ongoing reality. Presenters gain confidence and self-esteem while serving as role models for the community.

Disproportionate focus on research and clinical expertise too frequently fails to see the person at the centre of a crisis as well as their loved ones who ride the wave of terror of suicidal behaviour. This needs to change and with urgency.

Lived Experience is an underutilised and underappreciated resource in the UK.

Roses in the ocean, a charity in Australia is an excellent example of harnessing this invaluable resource and making a huge difference.

Men and boys

International Men’s Day is designed to help more people consider what action we can all take to “Make A Difference” and “give men and boys better life chances” by addressing issues such as high suicide rates, sexual abuse and health.

I had no idea when this day was until yesterday morning, when I received 4 photographs from Aidan who lives in Malasia. He is one of Saagar’s close friends and he shared a house with him at Durham. His comment read “Delivering a Mental Health talk to Schlumberger in conjunction with International Men’s day.’

Invaluable, undying friendships.

Here’s another set of friends. Rene’s friends, who are racing across the Atlantic later this month in his memory – Race for Rene. They are raising a huge amount of awareness and funds for 2 charities: PAPYRUS and Child Bereavement UK. They say, “We lost Rene to mental health in 2017. We don’t want anyone else to have to feel what that’s like.” That is a vision worth having.

Here’s a conversation with James, one of Rene’s friends: https://www.youtube.com/watch?time_continue=4&v=Aerqfealiwk&feature=emb_title

Good luck to the crew. Here’s to all the men and boys we love:

Thanks for this Mary.

Three friends

This is an approximate transcript of a presentation I made at a TCF (The Compassionate Friends) gathering of bereaved parents earlier this month. The topic was “Finding Hope after Catastrophe”. I hope you find it useful in some way.

“Hello. My name is Sangeeta. I am an Anaesthetist by profession and it’s my job to put people to sleep. Thank you TCF, for having me here this evening.

My son is called Saagar Naresh. I could often hear his cackles emanating from his room. I am pretty sure he’s watching cat videos again. He loves to laugh and make other people laugh. He’s as bright as they come, astutely picking up languages, accents and mannerisms of people around him. He would go shopping with his best friend Hugo to Oxford street and they would pretend to be South African tourists all day.

We loved cooking together. It involved chopping of onions. He got tired of his eyes stinging and watering and found a way out – he would wear his swimming goggles whilst chopping onions. It worked brilliantly!

He was an excellent cricketer. A fast bowler to be precise. He also played the drums in a band. He loved to go to the gym. Most of all, he had a heart of gold and even when he was a teenager, he loved cuddles. He spoke French and German fluently and chose to study Arabic from scratch at University as he wanted to challenge himself.

After his second year at Durham University, he came home for the summer holiday and was diagnosed with Bipolar Disorder. He was unable to go back to pursue his studies as his depression started to deepen. We saw a doctor on the 14th of October 2014. He told us that Saagar would have to wait till his medications kicked in, that he was on the right medicines but they would take time to work. On the 16th of October, Saagar ended his own life.

That was like a bomb going off in our lives. Losing him suddenly, out of the blue was our catastrophe.

Finding hope …

The Oxford dictionary defines Hope as “a feeling of expectation and desire for a certain thing to happen”.

For me, Hope is the belief that it is possible that some of the best days in my life are yet to come.

Soon after Saagar passed away, just getting through the day was an achievement. The time ‘yet to come’ was a huge burden. I had nothing left to offer to the world and the one thing I wanted, the world could not offer me. My own mortality stared me squarely in my face and it was strangely seductive.

What was I left with? My logical mind had been turned into an emotional pulp as there was no logic to this. The more I tried to make sense of it, the more I suffered. It was like banging my head against a brick wall. It did not make any sense. Period. Deal with it.

What was I left with?

  1. This moment, right NOW
  2. Me, mySELF.
  3. Nature.

NOW

How deep rooted was my belief that Saagar would always be around? How much did I take that for granted?

What am I taking for granted right now?

My breath.

My parents.

My partner.

My job.

My health.

Let death be your teacher. ‘Right now’ is all I have left. Like a bird trapped in a cage. The door is open but the bird is unable to fly away. The cage is where he/she belongs. In the ‘now’, I could only sit and watch the door, knowing that it was open. I could breathe in, take a pause, breathe out, pause, breathe in and repeat… I could fully acknowledge and feel the dark hollow that was my chest and hear the echoes of my sobs returning from the black hole within. Connecting fully with the present moment was the only way past it. There was no short-cut. No secret escape route. One moment at a time. Now, I am walking upstairs. Now, I am halving cherry tomatoes. Now, I am watching the steam rise from my cup of tea and so on… My refuge lay in this moment, right here. Right now. The future is a story. The past exists in our thoughts. Yet, our mind is in one or the other. What is real is this moment.

I had a patient once who had a black ‘Gratitude’ tattoo on her left forearm in a big bold decorative font. I asked her the story behind it. She said, ”I work with kids with learning disabilities. By the time I’ve brushed my teeth in the morning, I’ve achieved more than they can. So, I am grateful every moment.”

SELF

I was lucky to have so much support at that impossible time. My mum and brother came over from India to be with me. My friends, Saagar’s friends, their parents, my work colleagues. Everyone stood by me with love and compassion but ultimately it was up to me to live with this utter devastation. I was filled with so many questions, so much guilt and grief that I felt like I was drowning. 

It took 2-3 years but slowly I taught myself to be kind to myself. I am still teaching and reminding myself that our everyday reality is made up of stuff that is unthinkable for most people. We live the life that is other’s worst nightmare. Many can’t even imagine what it’s like to be in our shoes. 

So, we need to honour ourselves for carrying on living with as much grace and dignity as possible after having absorbed the impact of such a huge catastrophe. To know that the harsh inner critic will continue to chatter but we need to witness its mumbling, recognise the pointlessness of it and let it go.

We need to have compassion for ourselves. Compassion being not just a gentle kind feeling but small acts of courage. For instance, I used to love dangly ear-rings ‘before’. I would change them every day, to match my clothes. But for 3 years ‘after’ I didn’t change out of the boring old gold studs. One day I decided to change into one of my favourite pair of ear-rings for no particular reason. It was a small shift. It took courage. I cried. But it was an act of kindness towards myself. I needed my own friendship, my own affection. I needed to once again find ways of being at ease with myself. Lord Buddha has said “If your compassion does not include yourself, it is incomplete.”

I am learning that I need to be a ‘compassionate friend’ to myself.

NATURE

That wretched day in the middle of October was cursed but also resplendent with autumn colours. It was a festival of orange, ochre, red, green, yellow and terracotta. These decorative leaves carpeted our street. I stared out of the window watching these leaves gracefully dance their way to the ground. The trees went from being semi-nude to naked. This was the cycle of life. Nature was reminding me and showing me the devastating beauty of life. Cycles upon cycles of change, millions of times over. The impermanence of everything.

Over the next few months, I sat gazing at the Himalayan mountain range, marvelling at its history and all the changes it has undergone. I sat on a beach in Goa, watching the ocean waves change every second. Over time, I started to allow Nature to teach me what I needed to learn and soothe me when I needed to be soothed. I learnt that we humans can carry the utter tyranny of life in one hand while simultaneously carrying the spectacular beauty of it in the other.

I requested everyone to join me in singing this song by ABBA and was delighted by the upward shift of healing energy in the room as everyone sang together. It was a powerfully uplifting evening.

I have a dream, a song to sing
To help me cope with anything
If you see the wonder of a fairy tale
You can take the future even if you fail
I believe in angels
Something good in everything I see
I believe in angels
When I know the time is right for me
I’ll cross the stream, I have a dream

I have a dream, a fantasy
To help me through reality
And my destination makes it worth the while
Pushing through the darkness still another mile
I believe in angels
Something good in everything I see
I believe in angels
When I know the time is right for me
I’ll cross the stream, I have a dream
I’ll cross the stream, I have a dream

I have a dream, a song to sing
To help…”

One whole month

It wasn’t just a physical transportation but also an emotional one. For four weeks I was not an anaesthetist or a wife. I was just a traveling (Churchill) Fellow, curious to learn everything about ways of supporting vulnerable people through crises, advocacy for struggling families and attempt survivors, intentional and effective peer support, safe care-transitions and timely compassionate support for families, friends and communities affected by suicide.

Two contrasting towns with distinct landscapes. Concord in New Hampshire was a small, friendly town resplendent with autumnal beauty, a quiet serenity and a lot of ‘heart’. New York, a big blustering metropolis with clanking trains, crazy-ass driving (yes, worse than London), much honking and many high-level policy-makers. Hence, more like the ‘head’ of the suicide prevention community.

Rail-trail from Concord to Franklin

Since Saagar’s passing, I have not been on my own for that length of time. Especially as his 5th anniversary fell right in the middle of it. It was not easy living fully immersed in the world of Suicide prevention (SP) almost every day for a month. Sometimes it was overwhelming and ‘too much’. It turned out that I was not alone. I was met with much warmth, kindness and understanding. Some old friends made time to catch up with me and some new friends emerged.

One sunny autumn day I had the pleasure of riding a 3-person- tandem bike with an amazing couple who have cycled thousands of miles in tandem all over the world for the past 27 years. On the 16th Ann (an excellent SP trainer) and I went for a nice long walk in the woods in Derry with Dr Indiana Jones, her Border Collie. This was followed by a much needed brunch at a classic American ‘Red Arrow’ Diner where I had the best ever Tuna melt sandwich.

Polly’s pan-cakes was our destination one afternoon as we set off towards the north – Elaine, Pauline and I. We spoilt ourselves with a rich variety of pancakes before taking a walk along the river and visiting ‘The Basin’.

On my return to the UK, I joined the 50th anniversary celebrations weekend retreat of an amazing charity that supports bereaved parents and their families. It’s called ‘The Compassionate Friends’. The film below captures many aspects of the experiences as bereaved parents/siblings. Changed forever.

“Say their name”

I am happy to be back home and back at work. My life greatly enriched, I hope to share the learning and bring about changes for the better, working with various charities, the NHS and the Mayor’s office as effectively as I can. Right now I am assimilating it all, bit by bit by bit.

Emergency Numbers

Earlier this year, at a Medical school in North India I spoke to staff and students about the stigma and ignorance around Mental Health. At the end of the lecture one of the senior faculty members asked me a question, “Is it helpful for people with a mental illness to be a part of a religious community?”

‘Yes’, I said. ‘Most certainly. Just like it is helpful for someone with Diabetes to be part of a religious community. It might also be a good idea for them to see a doctor.’

Earlier that day Si and I had taken a walk around the hospital and found this list of ‘Emergency Numbers’ prominently displayed on a notice board in the medical library for medical students, nursing students, dentists and doctors.

Need I say any more?  

PS: It is important for every student in every educational organisation to have ready access to reliable and knowledgeable resources if they feel the need to discuss their thoughts and feelings or are concerned about a friend.

Ode to Fall

Spring falls

leaving traces behind  

on every leaf.

Leaves fall

As if in love

with the ground.

Trees

Display their skeletons

For Halloween.

Standing bereft

Pretending

To celebrate.

A curtain once green

Now a crunching

crispness

Beneath my feet.

Moon falls.

Full no more.

Light falls at

Slanting angles

Turning everything

to gold.

Apples fall

Fill the air with honey.

Acorns fall

All over the pavements.

Each one

A possible tree.

Crack. Crush. Crush.

Pumpkins sit

Outside every door.

Toothy smiles

To match the kids.

Kids fall.

Whimper.

Get up and go.

A season for cuddles.

For magical beauty

And transformation.

Night falls.

Love, let go.

Grow, let go.