Mind the Gap

 You are 28.
 Married 4 years. 
 No babies yet?
 Your mum’s bursting with unspoken questions. 
 The answer arrives finally. 
 A perfectly miraculous baby.
 Born to you, so ordinary. 
  
 He’s way beyond your dreams.
 Your life’s now embellished. 
 He’s much loved and cherished.
 First grandson on both sides.
 That smile! Those cackles!
 Those big bright brown eyes!
  
 He can’t wait to grow up.
 As if in a big hurry, 
 He rushes into walking, talking.
 Loving mangoes and chicken curry.
  
 You work hard for your family. 
 That’s the way you’ve learnt to be.
 From the life of your Papa and Mummy. 
  
 He thrives. 
 Multiple moves
 He survives. 
 So many new houses, schools and friends.
 So many new towns, cities and trends. 
 He takes all of them in his stride.
 Builds up a repertoire of languages 
 from far and wide.
  
 He learns to play the drums
 Lovely unfamiliar melodies he hums.
 Spinning red cricket balls on summer afternoons.
 Reveling at night to heavy rock tunes. 
  
 You split your sides 
 with his impressions of accents 
 and caricatures of the brown, the black, 
 the yellow and the white.
  
 Paul Choudhary and Russell Peter.
 He loves their comedy.
 Their lines he recites to perfection
 At every opportunity. 
  
 Two things delight him most – friends and food.
 Stars at GCSEs and A levels come easy. 
 He’s quiet the dude.
  
 Uni takes him away to Durham.
 You miss his laugh, his wit and his hum.
 You find it painful to cook for one.
 And long for his cocktail –
 The old-fashioned rum.
  
 Two years go by.
 You think you are learning to comply.
 The holidays come by.
 Each and every moment you enjoy. 
 One day his closest friend, Hugo calls to say,
 “The guy I’ve known most of my life? 
 Saagar is not that guy.”
  
 The summer soon turns scary.
 You find yourselves in A&E.
 His laughter replaced with 
 Anger and paranoia.
 The Liason Psychiatrist calls it ‘hypomania’. 
  
 He starts him on ‘Olanzepine’.
 Puts him under the Home Treatment Team.
 They keep you well out of the scheme.
 They know what’s best for him. 
  
 Two weeks pass.
 He responds well to the pill. 
 He’s told he has Bipolar Disorder.
 You’re told nothing. Nil. 
  
 As his mood returns to somewhat normal,
 He wants to return to University.
 He is discharged to your GP.
  
 The GP receives a discharge letter.
 With no diagnosis. 
 No mention of signs of getting worse 
 Or better. 
 No list of warning signs.
 No safety plans or designs. 
 He’s just another number to quote. 
 A delivery note. Completed in rote. 
  
 He went back to Uni but just for 2 days.
 His mood slumped.
 He is too quiet. You are stumped. 
 At the next visit to the GP
 You describe his sadness.
 You are weepy.
 Then you hear the wise doc say
 Take more pills, Citalopram and go away.
 In 3 or 4 weeks
 They will start to play.
 Wait.
 Rome was not built in one day. 
  
 “Would you please refer him back to the psychiatrists? You plead.
 “They will do exactly what I am doing.” Says he.
 “This is not the first time I’m treating someone like this.”
 Take this slip please.
 You remember the look on his face.
 It’s now clear
 As if in front of you right here.
 The lines you thought were concern,
 Were fear.
  
 As advised, you go for walks and have a routine.
 Weekly CBT, daily gym, nice food and TV. 
  
 Multiple episodes of ‘Office’ and ‘Friends’
 Didn’t bring about any upward trends.
  
 He is but a hollow shell.
 You don’t know what to do. 
 Who to tell?
  
 This is your NHS.
 It’s honest and good.
 You know it. 
 It’s you. 
 May be waiting is the best thing to do.
 If they say he’ll get better
 It must be true. 
  
 One Thursday afternoon you return from work.
 An A4 sheet lies flat on the fourth step from the door 
 “Sorry. I can’t take this any more.”
  
 The hand writing unmistakable.
 The implications unthinkable.
 A dash upstairs. Screaming his name.
 A call to 999. 
 He’s only a child. A sweet child. 
 And he’s not well. 
 Surely they’ll find him.
 All will be swell. 
  
 Standing bare feet 
 in the middle of the street
 A festival of autumn all around me
 Red, orange, ochre and green. 
 A car pulls up in front of our house.
 Two uniformed men with his
 Keys and wallet … talk about
 Black hair…
 Brown skin …
 Grey hoody with a penguin …
  
 No one said anything about death or suicide
 What was there to hide?
 10 weeks from the first hospital visit.
 2 days from the last GP visit. 
  
 Later you find out they knew.
 But they didn’t tell you.
 And they didn’t know what to do.
 They sent him home with you.
  
 They call it ‘Care in the community’.
 Do we know the difference between 
 Treatment and care?
 If this is your community,
 What a pity!
 These are your colleagues.
 You trust them implicitly.
 With your baby. 
 Like they would have trusted me.
  
 I grieve for his guilt,
 His shame, his self-blame.
 Him. All alone. Forlorn.
 His quiet desperation.
 Separation.
 His terror. His fright.
 Night after night.
 Misunderstood.
 Behind a hood. 
 No one should have to suffer so.
 Nobody.  
  
 “To be or not to be” 
 That comes up for me.
 Time goes round and round pointlessly
 Never too far from complete insanity.
 Oh! The finality.
 I wonder if this is a movie or reality? 
  
 The official investigation says 
 everything was 'thorough and reasonable' 
 despite all the missing bits and 
 complete lack of clarity.
  
 The doctor stands up in Coroner’s court 
 and announces boldly
 “Suicides are not predictable or preventable.”
 I shudder in disbelief. Here stands a lay person.
 The only one who could have helped.
 I marvel at Saagar for staying alive 
 for as long as he did. 
  
 The Coroner sees the gaping holes 
 that swallowed him alive.
 Same old themes.
 Listening to understand.
 Communication. 
 Closing the loop. 
 Meaningful sharing of information.
  
She asked the Service Improvement manager of the distinguished Mental hospital what he would do to make things better.
He said he would discuss it at the next Business meeting and then spewed such jargon that I could have puked all over the floor of that spotless court room.
  
 I meet with other parents of deep loss.
 Story upon story of utter tragedy.
 Avoidable, preventable travesty.
 Immense outrage and consternation.
 Let’s start afresh with compassion. 
  
 They say when something good happens, learn.
 When something bad happens, learn.
 At a random conference, over coffee,
 I shared Saagar’s story 
 with a seasoned doctor of Psychiatry.
 He said plainly 
”This has been happening as far back as my memory ... ”
  
 I read somewhere:
  
 The opposite of love in not hate.
 It’s indifference.
 The opposite of art is not ugliness.
 It’s indifference.
 The opposite of faith is not heresy.
 It’s indifference.
 The opposite of life is not death.
 It’s indifference. 
  
 I questioned everything about me.
 Every decision, every word spoken, unspoken.
 Every move. Every choice.  
 I even questioned our love.
 But I learnt.
 I learnt to write. To speak. 
 I learnt that there is no ‘they’ or ‘thee’
 No ‘you’ and ‘me’.
 There is no other.
 It’s just ‘us’ and ‘we’.
 Saagar was our future. Our own. Our community. 
  
 Despite everything, I’m learning to love me.
  
 Did the others learn anything?
 Did my son, your son die of nothing. For nothing?
  
 No. There is a Saagar shaped hole in my heart.
 There is an Ed shaped hole in the NHS.
 There is a James shaped hole in A&E.
 At least seven thousand and fifty 
 more holes in the world since Saagar. 
 And rising.
 There are too many holes in this net. 
 In fact, there is no net.
 Just gaps.
 So, one and all, Mind the Gaps.
 And let’s please begin
 To close them in.  

[ Please support this film: https://igg.me/at/1000days ]

Me and Thee

Ron and Jeanette

The first time I saw Jeanette, she was acting in a play called ‘Hearing Things’ being staged at South London and Maudsley (SLaM) Hospital, where Saagar received (inadequate) treatment. The play was inspired by events and conversations from real ward rounds of patients with serious mental illnesses. It was written by the playwright often described by critics as the ‘English Chekhov’- Philip Osment, well known for giving a voice to those at the margins of society.

The play highlighted harsh facts through a story sensitively told. Just three actors  illuminated the wide swathes of blurred lines between sanity and insanity, between the healer and the ill, between strength and fragility. I learnt a lot from it. It was a powerful blast that left me thinking about my roles as an ordinary member of society, a doctor, a mother, a patient. It gave me an insight into how and why the system does and does not work. I thought it gave me a little peek into Saagar’s mind.  It certainly made me feel utterly close to him in an unearthly compassionate way.

A few weeks later I arranged to meet with Jeanette. I trusted her even before I knew her. She listened. We talked for a long time. She read the blog. I suggested a documentary. I spoke with some of Saagar’s friends and they wanted to participate. So was Si. We all had something to say. Ron and Jeanette filmed it last year.  

This year we aim to complete it and release it. We have a name – ‘1000 days’. We have found a suitable and brilliant editor. We need to find some platforms to showcase it and we will. We are working on a crowd-funding campaign which will be launched within the next 10 days. The intention is to make this world a kinder and more understanding place. Watch this space.

Many thanks in advance.

Mirror, mirror …

5 feet 5 inches. Average frame. 67 kilos. Completely owns her 52 years. Medium brown skin, a shade darker in a horizontal oval shape around the lips and in half-moons under the eyes.

It used to be thick black and curly but now it’s scant, allowing pale scalp to peep through in places. The blackness now replaced with streaks of silver, grey and pale brown that she wears in a bunch behind her head. The curls are now looser, more manageable. The hairline, less defined.

The oval face bears a forehead with 2 thin but clear, straight horizontal lines running parallel, about 1 centimeter apart, from one side of the face to the other. A baby line is forming on top of these two. Faint but visible on a closer look.

Asymmetrical eye-brows, the left one bearing a scar from a childhood fall. Not bushy, not sleek, not modified. Just plain, normal, slightly curved, unremarkable black brows concaving over dark brown eyes with microscopic gold flecks. The ones she passed on to her son. They are almond shaped and carry a sadness which lingers even when her face breaks into a smile. She didn’t know that her eyes closed when she laughed. A stranger told her once. He’s now her husband.

Her nose is odd. She’s always been embarrassed about it. Too broad. Too big. Strangely no one else seems to think so. Maybe they’re just being polite. Maybe they don’t really care. Maybe its inconsequential.

Her small shapely ears, adorned with traditional diamond studs set in the shape of a flower with 6 petals. Her lips, brownish-purple with a hint of pink where they meet. Her husband says she reminds him of the ancient drawings of apsaras at the caves of Ajanta and Ellora. Her teeth, perfect. Her chin, proud. Her jawline, clean. Her neck and shoulders, silky.

Her loose-fitting, sleeveless olive-green linen tunic has a modest V-neck. It allows her to freely move and breathe. And lets her hide herself. A pair of grey tights cover her legs.

She sits out in the sun in her backyard which is green with grass and weeds. One shrub with big round heads of purple and yellow flowers dominates half the square patch. She trims it every autumn and it comes back bigger and ever-more-loving the following year. Some say it looks untidy but who cares. She loves it.

Her study table is a mess and so are her ward-robes. Only she knows that. Everyone else seems to think she is super organised.

Halfway down her left arm, half a tattoo can be seen from the front. It is blackish-green in colour. It has English letters hanging off a horizontal line, like they do in Hindi script. The font is predictably called Ananda Namaste.  One afternoon in September 2016 in Lagos, Portugal, a skinny middle-aged man with glasses took 45 minutes to make it. He didn’t make small talk. What did this word mean? Why this? Why now? She was relieved. All she knew was that she would never change her mind or heart about this one. She would always love Saagar.

Constantine Bay

The entire coastline covered in Sea Pinks, bunched together in shapes resembling piglets. They could easily be called Sea Pigs. Poor soil – no problem. Lashing winds – no problem. Salt laden air and water – lovely! These little pink flowers are hardy as hell. Unperishable. Their leaves stay green all year round – sun or rain.

A week in Cornwall, the perfect escape from the Big Smoke.

From the white sands, rock pools and sand dunes of the bay, we could see a classic white light-house standing tall. A beacon of hope for hundreds of years for hundreds of people, lost at sea.

Lovely long walks along the headlands, fresh sea-breeze and delicious sea food. And, lots of exceptional cream-teas- especially the one at Bedruthan steps. Wowwie!!! It was indeed, like a dream. Our Scrabble travelled with us. In London we don’t get time to play it. So, here was our chance.

After dinner on Wednesday, I opened the green cardboard box. We were with friends who were half willing to play. We agreed to form 2 teams of two each so we would be able to consult and won’t have to wait too long between goes. As I unpacked the box, I found some old score sheets in there. They had 2 columns of scores – one for Saagar and one for me.

My heart lurched up to my throat and my eyes stung and burnt. I took a deep breath, closed my eyes and smoothened out the contortions of my face. I didn’t want to spoil the evening for everyone. A good game is had by all and we are off to bed by 11 pm.

“I am in a strange building in a strange sandy seaside town. I am wearing strange flowing green garments. Someone says three people are waiting to see me outside. After a while I walk out to see these people. 3 young men are seated on comfy cane sofas in a shaded balcony. As I walk towards them, one pair of eyes glints back at me bathed in recognition. A knowing smile flashes across his handsome olive face.

I freeze and stare. His hair has grown. He has blonde highlights, like he did when he was 15. He is wearing a big tan jacket and looking so good! He stands up and steps gently toward me. I look at him is disbelief. He holds me in his trademark big bear hug.

“You know how much I’ve cried.” I whisper.

“I know.” He whispers in his sweet young-man voice.

I hang on to him, never to let him go.”

Then the flood gates of my conscience are flung open and once again I am staring at a gaping hole. Another day … love … longing … The sea pinks … endure. The light house … hope …

At 15.

Cricket in the summers and badminton in the winters. That’s what Saagar chose to play during his school years. He was good at both and wanted to be better.

I often went along to watch him play, even though I didn’t appreciate all the technicalities of either game. One evening we gathered in the Sports club to watch him play. I noticed that every time he missed a shot he hit his right leg hard with the badminton racket gripped in his right hand. That must hurt. I didn’t understand. It distressed me. I spoke with him later. “It’s only a game, darling.”, I said. He kept quiet, neither defending his action, nor arguing with me, pointedly focussing on the piece of ground hit by his obliquely downcast eyes.  In him I saw a boy in pursuit of perfection.

Out of the blue he broke up with his lovely girl-friend of 7 months. That too on Valentine’s Day. His first love. Sweet and innocent. On being asked why, he said, ”It’s boring.” Soon after, late one night I gleened tears in his eyes as he hugged me, pretending not to sob. In him I saw a boy, trying to be a man. Oh! The pains of growing!

After a night out with friends, one weekend I noticed a cluster of 3 pea-sized fresh burn marks on his right forearm. Horrified, I asked what happened. He said it was a dare. A few of his friends were being goofy and challenged him to hold the burnt end of a cigarette on his skin and he did. He laughed as if it was a joke. I didn’t know what to make of it. How could this bright kid with an astute sense of right and wrong be talked into this kind of silliness? In him, I saw a boy trying to fit in with his peers.

Was there more to see? Did he tell me everything or just what he thought I could handle?

Uganda Diaries

Frantically searching for an important document, I rummaged through all my papers up and down the Study. My mind can’t be trusted with anything anymore! My memory is shot. I exhausted myself and all my options. Over a cup of tea, I thought about all the places I had not looked through. A box full of Saagar’s books and diaries. I never read through any of his personal stuff. But that day, before I knew it, I had read all his musings from his travels to Uganda with a friend. They were there for 2 weeks to help at a local school supported by their College.

It seems when he was struggling, he wrote. Like me. He wrote exactly as he spoke, leaving some words half said and stretching out the first letter of unspeakable words. His diary was reading itself to me in his voice. I felt like he was in the room. I was an intruder. It wasn’t my place to read it. It was personal to him. But it was also my conduit to him even if it was written 27 months prior to Day 0.

It was clear that the boys were totally unprepared for the massive change. This is the note from his last day there.

30/7/2012. 2300 hrs.

“Never before have I been able to say the words “I want my mommy!” with as much certainty as now. This sucks ass. I feel like such a pathetic little shit. I hope missing Mother is no more than a manifestation of homesickness.”

A deep feeling. Then a judgement. Then an admonishment and then a substitution. A minimization. A classic example of a young man being brutally unkind to himself even though he is suffering. Being a ‘man’. Not allowing for any fragility even in the face of a harsh reality.

Fact: He missed me. Thinking of me brought him comfort. I have evidence.

How could I ever doubt that? By judging myself too critically. Why do we do this to ourselves?

That was a beautiful gift from you to me on your birthday my son. 25th birthday! Bless you my love.  

Heartbreak Syndrome

Screen Shot 2019-04-27 at 18.48.41

Carrie Fisher: Date of death 27th Dec 2016.
Her mother, Debbie Renolds’ date of death: 28th Dec 2016

Emiliano Sala: Plane Crash – 21st Jan 2019
(Death confirmed 13 days later).
His father, Horatio Sala’s date of death – 26th April 2019

Both these parents died of natural causes. Horatio Sala was only 58. For days after the crash, he was not sure what was happening. “Hours go by and I know nothing. It makes me think the worst. I know nothing. Nobody has spoken to me. Not a call from the Embassy, the club, from anyone.”

I cannot imagine how stressful that must be. After the ‘worst’ was confirmed, the investigation was a protracted one. Horatio’s angst is palpable on the video clips. The grief and anger of it must have caused a sustained and prolonged release of adrenaline which greatly raised his pulse and blood pressure, making his heart work harder, making his blood sticky and ruining his immune system. Research also shows that in the first 30 days after a loved one dies, your risk of dying too is significantly increased. There are many stories validating this finding.

More than a month after the crash a BBC report said, “Some operational aspects are yet to be determined, such as the validity of the pilot’s licence and ratings.” What must that do to a parent! “Air accident investigators will continue to look at all operational, technical, organisational and human factors which might have contributed to the crash.”

They will continue to look I am sure but for the bereaved families, there is no resolution till the investigation is complete. They don’t feel settled until then. They are haunted by unanswered questions. The big and noisy fight inside overshadows everything else. There is no sign of ‘peace’ for at least a thousand mile radius. A prompt, fair and proper investigation is essential for them to start grieving properly. Losing a child is bad enough. A parent should not then have to fight for facts and justice.

Sadly, even the medical profession does not understand sudden traumatic grief. Often the investigations are a sham, take forever and produce vague statements like the ones above. I know many parents whose suffering is insulted and prolonged for this reason. This must change. It breaks my heart and many others.

PS: Very sorry for the pilot, Mr Ibbotson’s death. The system failed him too. If he did not have an appropriate licence, the system did not stop him from flying.