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Day 832

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The hospital where we went when he was ill is just down the road from where we live. It is 18 minutes by bus, 10 minutes but car on a quiet day. The Emergency department is on the left. The Mental hospital is on the right. There is a visitor’s car park in front of the Mental hospital. That is where we parked the car. That is where we waited for a couple of hours to be seen by a psychiatrist. That is where I had to make my own way that day because Saagar refused to have me in the car with him and his father. That is where he should have been when he was severely ill a few weeks later. That is where he could have been saved.

That is where I went this afternoon to watch a play called ‘Hearing Things’, a play co-produced by patients and professionals, based on insights derived from 6 weeks of workshops involving actors and people with a mental illness, offering both an opportunity for expression, transformation and co-creation. Through a cast of 3, we met people of different races and age groups. It was about challenging assumptions. It was about the empathy and personalities of patients. It was about ‘the system’ and the dynamics within it, mental well being of health care providers and role-reversal. It was about giving people a chance.

“I am off now to be mad and I don’t have to be sectioned for it”, remarked one of the participants as drama gave him the freedom to be who he is, without fear of judgment. It was about the possibility of being ‘re-assembled’. It was powerful and moving. It did not mince words. I spoke loud and clear. It was accessible, funny, clever and heart-breaking.

One young person describes his experience of drama:

“…after you do the drama you get this feeling…it feels as if whatever was bothering you went away and you feel light and can do whatever you want around you, it makes the day simpler and you can concentrate on your activities, it makes you feel better, like at the end of the day when you come home from work tired and you want to put your feet up, you don’t feel guilty relaxing as you have done a hard days work. I wanted to understand the person and put myself in their shoes.  At the end of it I felt good.  150% happy!”  

 It was about creating a new paradigm of relating to people suffering with mental illness.  It was all heart.

Ref:

http://playingon.org.uk/hearing-things-2016-2017/

Day 831

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widow-twanky-3

(Saagar playing Widow Twanky in Aladdin at Durham, Christmas 2012)

Recently a young man taught me how to save pictures from Facebook. I went to Saagar’s page and found a huge treasure! Smiles, fancy dress parties, gigs, hanging out with friends, pulling faces, playing the clown, doing a ‘Usain Bolt’, being on stage …

Memories warm me up from the inside but they also tear me apart. Sometimes they sneak out of my eyes and roll down my cheeks.

They flood my mind with the light of a thousand bright stars.

A million memories. Countless thoughts. One person. One love.

Love you and miss you my delightful, beautiful boy!!!

poser

(Comment: ‘Why can’t I stop myself from doing this at parties?’)

Day 830

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Now, I belong to a network of mums and dads who share the same loss. We exchange stories, everyday struggles and our little achievements. Sometimes it is something as small as getting through an hour, a day. But then, fighting to get through the night, an all too familiar scenario. We know. We understand. We listen.

Sometimes, it is an inspirational piece of craft, a moving piece of music, a long walk or a rant. All of us desperately trying to hold on to who we were and make sense of who we now are, hanging on to the shreds of our being with all our might, seeing ourselves in each other, watching our helplessness and grief spill across the screen over and over again only to gather it all up and see it as nothing but love. All the rags weave together to form a mesh that strengthens each one of us. We recognise our reflections in each other and feel our little angels sending us collective blessings. All that is inside of us is alive even if it feels like it isn’t. It’s the purest form of love.

Day 829

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Loneliness – a disturbing word, often invoking a sense of sadness and despair.

It’s not one thing. It is subjective. Imprecise.
It can be found anywhere.

When after many requests you still don’t have a sibling.
When you are born with skin colour darker or lighter than it should be.
When you are the new girl in class.
When you don’t get picked for the team.
When you sit alone at lunch time.
When you are not sure what you want and settle for what is available.
When you are stuck in a loop of cold-hearted bureaucracy.
When you are different.
When you are told ‘you should be happy’ by the one you are married to.
When you work from home and see no humans for many days.
When you feel you have to be somebody else to be successful and accepted.
When you are unable to have children.
When you have an abortion or a miscarriage.
When you have children and don’t see anyone but them all day everyday.
When your family is no longer a family.
When you have a fracture and are stuck in bed for weeks or months.
When ‘Facebook’ and ‘Instagram’  constantly offer comparisons.
When you get fired.

When you have just retired.
When a loved one suddenly disappears.
When you are blamed for a mistake you did not make.
When you get mugged.
When you are diagnosed with a serious illness.
When you are old and so easily forgotten.

Solitary confinement is one of the most severe forms of punishment because it can break your spirit. In 1951 researchers at McGill University paid a group of male graduate students to stay in small chambers equipped with only a bed for an experiment on sensory deprivation. They could leave to use the bathroom, but that’s all.  They wore goggles and earphones to limit their sense of sight and hearing, and gloves to limit their sense of touch. The plan was to observe students for six weeks, but not one lasted more than seven days. Nearly every student lost the ability “to think clearly about anything for any length of time,” while several others began to suffer hallucinations. “One man could see nothing but dogs.” A study at Harvard found that roughly a third of many solitary inmates they interviewed were “actively psychotic and/or acutely suicidal.”

In the biggest literature review into the subject of loneliness, the University of York looked at 23 studies involving 181,000 people for up to 21 years. They found that lonely people are around 30 per cent more likely to suffer a stroke or heart disease, two of the leading causes of death in Britain. More than 1 in 5 people in the UK privately admit they are ‘always or often lonely’. It is a public health problem.

I welcome the ‘Commission on Loneliness’ launched in memory of the murdered Labour MP Jo Cox, to look for practical solutions to reduce loneliness in the UK. Let’s do our bit, however small.
RIP Jo.

“Fools,” said I, “You do not know –
Silence like a cancer grows.
Hear my words that I might teach you.
Take my arms that I might reach you.
But my words like silent raindrops fell
And echoed in the wells of silence…
-Sound of Silence by ‘Simon and Garfunkel’

Ref:

http://www.telegraph.co.uk/news/2017/01/31/mps-launch-jo-coxs-commission-loneliness/
http://www.telegraph.co.uk/science/2016/04/19/loneliness-is-public-health-problem-which-raises-risk-of-stroke/

 

Day 828

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Kimberley Hiatt was 50, a nurse for 24 years, she worked in the Cardiac Intensive Care Unit at Seattle Children’s Hospital. In September 2010 she accidentally overdosed an 8-month-old infant with calcium chloride as a result of a mathematical error. Ms Hiatt, immediately reported the event to colleagues. Unfortunately, the child didn’t survive the error. The hospital put Hiatt on administrative leave and soon dismissed her. It broke her heart when she was dismissed, not just because she lost her job but also because she lost a child. In the following months, she battled to keep her nursing license in the hope of continuing the work she loved. Six months after the event, Ms Hiatt died by suicide.

The suffering of caregivers in the face of a serious medical error has been termed the ‘second victim’ phenomenon.  These individuals feel personally responsible for the patient outcome. Many feel as though they have failed the patient, seriously doubting their clinical skills and knowledge base. They may suffer from extreme fatigue, sleep disturbances, increased Blood Pressure, muscle tension, frustration, decreased job satisfaction, difficulty concentrating, flashbacks, loss of confidence and grief or remorse.

The risk factors for suicide among health professionals, including doctors, are similar to those found in the general population. However, there are some additional risks among doctors such as their unwillingness to seek timely help, access to potent drugs and the skills to self-medicate. Other risk factors include exclusion from work, poor support networks, ongoing investigations, complaints, court cases, inquests and multiple jeopardy from having a complaint considered by a range of bodies including employers and the GMC.

Scott’s 3-tiered interventional model of support for Second Victims is well recognised (Ref: https://www.muhealth.org/app/files/public/1405/Scotts_Three_Tier_Support.pdf)

It’s too late for Kimberly, but her story can serve as a catalyst for a much needed change in healthcare – support for second victims of errors.

“People make errors, which lead to accidents. Accidents lead to deaths. The standard solution is to blame the people involved. If we find out who made the errors and punish them, we solve the problem, right? Wrong. The problem is seldom the fault of an individual; it is the fault of the system. Change the people without changing the system and the problems will continue.”

  • Don Norman Author, the Design of Everyday Things

Dedicated training for all medical students and GPs in suicide prevention must be made mandatory in the NHS and all over the world as prevention of harm means prevention of first and second victims. However, as long as humans are a part of any system, errors will occur. To err is human.