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.

Feathers etc.

10 weeks back I was surprised to find an all-day course in ‘Mindful Self-Compassion’ for Health Professionals advertised on the Trust intranet. It sounded great and it was for free. Wow! We are recognising the pressures on health care professionals and moving slowly but surely in the right direction. To organise a course like this and make it available to all staff at no cost is nothing less than super-fantastic.

I enrolled instantly and waited patiently for the day to arrive. The day arrived.  I entered the room to find all these items scattered neatly around the room: a bowl of smooth tactile pebbles in purple, maroon, white and yellow, little bottles of lavender and vanilla extracts, fantastical eye-catching postcards, maracas and manjiras, a white rosary in a tiny wooden box, sketch pads with charcoal tree sticks, a bunch of sea shells, sprigs of fresh rosemary and mint, a dried corn on the cob, a few white and brown feathers, a spongy red ball and a spiky yellow plastic one, a tiny hand-crank music box and an hour-glass with pink sand. These things were for us to appreciate, touch, feel, smell and listen to.

Two gentle young women led the day taking great care of everyone in the room and in complete harmony with each other. We started with a ‘soft landing’ – becoming aware of our feet on the floor, bum on chair, our breath and our finger tips. They called these short snatches of peace, the ‘green moments’. We were encouraged to create/access these green moments to transition from seeing one patient to the next or from work to home mode and vice versa.

The word ‘discernment’ was brought into my awareness. While the dictionary meaning of it is “the ability to judge well”, we were encouraged to scan our thoughts and ‘notice what’s not helpful’. It was a useful concept. It helped me locate stuff that was unnecessarily cluttering up my mind and blocking light from entering this sacred space.

I remembered that as a teenager I had a big scrap book filled with my collection of feathers of all kinds, my favourite being the peacock feather. Where did that dreamy girl with 2 pig-tails go?

For a while I could hold the little girl in me lovingly in my arms and marvel at her innocence and beauty, appreciate her child-like sense of wonder and creativity. This sweet girl is me. Perfect and complete in every way. All she needed was to be seen. By me.

Caring with compassion for you and me.

Day 715

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She’s my friend.  She sees hearts everywhere – in candle flames, on flower petals, on unevenly toasted bread, on random clouds and other unlikely places. Basically everywhere. She actively seeks them out as though they are quietly waiting to be discovered, playing hide and seek with her. They fill her with child-like wonder and glee. She goes on to excitedly share her hearts with the rest of the world. It’s infectious and now I see them too.

The heart is the ‘chakra’ that balances the body and spirit, with 3 chakras below and 3 above it. It is also known as ‘anahata’ in sanskrit which means ‘unhurt, unstruck and unbeaten’. It is green in colour.

This morning’s yoga session was about opening up the Heart chakra. It made me aware of the sensations in and around the chest. At times it felt like a flutter and others like an ache. It brought up the tears easily and induced a sense of expansion where I felt like all the kids in the world were mine and all I wanted was for everyone to be happy and free. My spirit seemed to have taken wings, soaring high while my mind and body stayed centred right where I was.

I am free to just be.
I am free to be happy.
I am. I am. I am.

anahata_mandala-svg

Day 708

suicide_homicide_warA survey of 500 people revealed that a third of people didn’t feel comfortable at all talking to someone at work about mental health related issues and only 15% have had a colleague speak to them about their mental health.

The survey also uncovered an interesting trend: nearly a third of all male respondents have never had a friend, family member or colleague speak to them about their mental health. Worryingly, this statistic rises to 42% for males aged 45 and over and increases yet again to 60% for males aged 54 and over.

( Source:  www.team24.co.uk/suicide-prevention-day )

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33_per_cent_dont_feel_comfortable_talking

31_per_cent_males_never_speak_mental_health

30_per_cent_suffered_depression28_per_cent_14_17_dont_feel_comfortable

 

15_per_cent_colleague_mental_health

“I would say that the vast majority of people who die by suicide, don’t necessarily want to be dead—they want to end their suffering and don’t know what else to do. We know from our clinical treatment research that suicidal suffering can be effectively treated. There is hope; suicidal states can be effectively treated and people can and do recover from suicidal suffering.”

David A. Jobes, Ph.D., ABPP. Professor of Psychology. Author of Managing Suicidal Risk

Prevention starts with a conversation.

Let’s start the conversation.

Day 700

When our GP heard of Saagar’s death, the first phone call he made was to the Medical Defence Union and they advised him not to call us. Despite having known us for more than 7 years and seeing Saagar every 2 weeks with us for the last few months of his life, he did not call us on his death.

A qualitative study of GPs’ experiences of dealing with parents bereaved by suicide by Emily Foggin et al was published last month in the British Journal of General Practise.

It acknowledged that bereavement by suicide is a risk factor for suicide but the needs of those bereaved by suicide have not been addressed and little is known about how GPs support these patients, and how they deal with this aspect of their work. 13 GPs in the UK were interviewed in a semi-structured format. It explored experiences of dealing with suicide and bereavement.

GPs disclosed low confidence in dealing with suicide and an unpreparedness to face parents bereaved by suicide. Some GPs described guilt surrounding the suicide, and a reluctance to initiate contact with the bereaved parents. GPs talked of their duty to care for the bereaved patients, but admitted difficulties in knowing what to do, particularly in the perceived absence of other services. GPs reflected on the impact of the suicide on themselves and described a lack of support or supervision.

It concluded that GPs need to feel confident and competent to support parents bereaved by suicide. Although this may be facilitated through training initiatives, and accessible services to refer parents to, GPs also require formal support and supervision, particularly around significant events such as suicide. Results from this qualitative study have informed the development of evidence-based suicide bereavement training for health professionals.

Ref : http://bjgp.org/content/early/2016/08/15/bjgp16X686605

This evening a vigil was held by SOBS (Survivors Of Bereavement by Suicide) at Hyde Park to remember those lost through suicide. Some of the people there had lost a brother 25 years ago or a sister 5 years ago or a friend 1 year ago and so on. Some of the families had not been able to speak about it for many years. Others had kept quiet as they were not sure if anyone would understand. But in that space, we sat together on the brownish-green grass with the pictures of our loved ones and lit candles in their memory and we opened our hearts. For about 2 hours we claimed that space and made it our own knowing full well that we are being listened to and perfectly well understood. What a rare gift that is!

When it comes to suicide, post-vention is pre-vention.

 

Day 697

s-bench-2

Last week, Saagar’s bench was dedicated to his memory at his old school. I was asked to speak. It’s never easy but I do have a lot to say and so I did speak. I also wore a sari as Saagar would have liked that.  It was attended by many of his teachers and friends, some of our friends and family and some who didn’t know him at all. Here is an except of what I said:

“We got married in 1990. I was 24. Very close to my ‘sell by’ date, which in India is about 25 for a girl.

3 years on and no kids! Both sides of parents were politely not asking, only hinting obliquely every now and then. 3 years was too long! Concerning! I was a junior doctor and Naresh was a captain in the Indian army. In the 4th year of our marriage, Saagar was born. He was beautiful! First grandchild on both sides of the family. Much adored and absolutely adorable! At 5 years of age, while moving from nursery to Kindergarten, he was asked to write numbers from 1 to 10 and then all the alphabets. He started with 1 and wrote all the numbers till 9 which he wrote the wrong way around and it became a P. He then carried on writing QRS…Z.

As he was growing up, he coped with many changes, moving from one city to another in India and then to Northern Ireland and then London. The reading homework in Primary school was more about the accent of the day rather than the reading. He had a great sense of fun. He made good of wherever he found himself. He never made a fuss. Although, age 9, after school one day he did ask me if his name could be changed to ‘Aron’. He had his own brand of humour and an infectious laughter. He loved dressing up. He valued his friendships greatly. And grew up to be a talented young man. His accomplishments far surpassed our expectations, as an academic, as a musician and linguist, a sportsman and as a human being. I always thought he was too good to be true. It turned out he was.

His brief illness was very painful and confusing for all of us, most of all for him. He did his best to manage it. He followed every advise he was given. He wanted to get better but sadly that wasn’t to be.

In the UK suicide is the leading cause of death for young people, both male and female, 3 times more than road accidents. Every day in the UK alone, 4-5 young people take their own lives. 3 times more men than women. Majority of people don’t know this. I didn’t know it. But it is the sad truth and it is closer to home than we think. It needs to be treated as an urgent priority. I am immensely grateful to the college for honouring Saagar and keeping his memory alive in so many ways. Thank you for recognising the need to raise awareness and to empower everyone to be able to make a difference.

I am very proud of Saagar. He would be very proud of me seeing me use an i-pad today. He was the one who coaxed/encouraged me to move from my good old Sony Vaio to Apple. It always amused him to see ‘old people'(me) work on a computer. Even today when I am stuck, my first instinct is to call out to him.

For me this bench is a reminder of Saagar’s friendly, creative and playful nature, his wit and charm and his ability for compassion. I hope the boys will enjoy it and know that they never have to suffer alone. I hope that it will be a source of strength and hope for many for a long time to come.

Thank you all for being here today.”

Thank you.