Day 439

In times of the Buddha, a woman named Kisagotami suffered the death of her only child. Unable to accept it, she ran from person to person seeking a medicine to restore her child to life. The Buddha was said to have such a medicine.

Kisagotami went to the Buddha, paid homage and asked, ”Can you make a medicine that will restore my child?”
“I know of such a medicine,” the Buddha replied. “But in order to make it I must have some ingredients.”

Relieved, the woman asked, “What ingredients do you require?”
‘Bring me a handful of mustard seeds’ , said the Buddha.

The woman promised to procure them for him. But as she was leaving he added, ‘I require that the seeds be taken from a household where no child, spouse, parent, sibling or servant has died.’

The woman agreed and began going from house to house in search of the mustard seeds. At each door, people agreed to give her the seeds but when she asked them if anyone had died in that house hold, she found no home where death had not visited – in one house a daughter, in another a husband or parent had died. Kisagotami was unable to find a home free from the suffering of death. Seeing she was not alone in her grief, the mother let go of her child’s lifeless body and returned to the Buddha who said with great compassion, ’You thought that you alone had lost your son; the law of death is that among all living creatures there is no permanence.’

Kisagotami’s search taught her that she had not been singled out for this terrible misfortune. This insight didn’t eliminate the inevitable suffering that comes from loss but it did reduce the suffering that came from struggling against this sad fact of life.

Day 436

Compassion is defined as ‘a feeling of deep sympathy and sorrow for another who is stricken by misfortune, accompanied by a strong desire to alleviate their suffering.’

NHS administrators now see the value in ‘teaching’ compassion to nursing and medical staff. Obama emphasizes the need for compassion amongst people in his Christmas message.

Research has shown that when we feel compassion, our heart rate slows down, we secrete the “bonding hormone” oxytocin and regions of the brain linked to feelings of pleasure light up which often results in us wanting to approach and care for other people.

Compassion makes people more resilient to stress. It lowers stress hormones in the blood and saliva and strengthens the immune response. Compassionate people are generally happier as their mind does not focus too much on what has gone wrong in their lives or might go wrong in the future. They make better parents, friends and spouses as a they tend to be more optimistic and supportive when communicating with others. They are more socially adept, making them less vulnerable to loneliness. Employees who receive more compassion in their workplace see themselves, their co-workers and their organization in a more positive light, report feeling more joy and contentment, and are more committed to their jobs.

Stanford University’s Compassion Training Programme’s top tips are:

  • Look for commonalities: Seeing yourself as similar to others increases feelings of compassion. A recent study shows that something as simple as tapping your fingers to the same rhythm with a stranger increases compassionate behavior.
  • Calm your inner worrier: When we let our mind run wild with fear in response to someone else’s pain (e.g., What if that happens to me?), we inhibit the biological systems that enable compassion. The practice of mindfulness can help us feel safer in these situations, facilitating compassion.
  • Encourage cooperation, not competition, even through subtle cues: A seminal studyshowed that describing a game as a “Community Game” led players to cooperate and share a reward evenly; describing the same game as a “Wall Street Game” made the players more cutthroat and less honest. This is a valuable lesson for teachers, who can promote cooperative learning in the classroom.
  • See people as individuals (not abstractions): When presented with an appeal from an anti-hunger charity, people were more likely to give money after reading about a starving girl than after reading statistics on starvation—even when those statistics were combined with the girl’s story.
  • Don’t play the blame game: When we blame others for their misfortune, we feel less tenderness and concern toward them.
  • Respect your inner hero: When we think we’re capable of making a difference, we’re less likely to curb our compassion.
  • Notice and savor how good it feels to be compassionate. Studies have shown that practicing compassion and engaging in compassionate action bolsters brain activity in areas that signal reward.
  • To cultivate compassion in kids, start by modeling kindness: Research suggests compassion is contagious, so if you want to help compassion spread in the next generation, lead by example.
  • Curb inequality: Research suggests that as people feel a greater sense of status over others, they feel less compassion.

Day 429

Day 429

The aftershocks continue.

The scabs have been ruthlessly peeled off the special scar and it has been prodded and poked. It was angry and raw, releasing toxins that causing a violent aching of the head, bilious retching and undamming a torrent of tears.

The suffering that my poor baby endured was known and not addressed, avoidable and not avoided. On the contrary, it was probably made worse by the medications he was put on. It all happened in front of my eyes but I could not see it. In fact I was so sick with worry that I couldn’t make sense of anything. I feel like such a fool for having placed so much trust in the people ‘looking after’ him.

The Coroner didn’t have to but she said, ”If Saagar’s loving parents bear any burden of not having done everything they could for him, they have no reason to.” I don’t think I will ever be convinced of this but it sounded pleasant to the ears.

My thoughts are not me. I need to once again get to the place where I am the ‘witness’ – of the thoughts, the feelings, the happenings, the entries and the exits on the stage where the drama of life is played out.

“Anyone who cannot come to terms with his life while he is alive needs one hand to ward off a little his despair over his fate… but with his other hand he can note down what he sees among the ruins.” – Franz Kafka.

 

 

 

 

Day 422

The inquest at the Coroner’s court is to be continued on Thursday, the 17th of December 2015. It will be a dignified and detailed process as it was the last time. We will go over all the details once again.

This has happened many times before. The NICE guidelines will be looked at. All those concerned will do their best to say they did their best. The aim will be to make some useful recommendations and those will be made.

Yet again there will be lessons.

Will anyone follow them in the future?
Will it make any difference at all?
Will there be any lives saved?
Will it make people stop and think?
Will anything good come out of it?

I don’t know. I suspect not.
It has happened many times before.
We will not find anything that is not already well known.
What can be done to have a different outcome the next time?

I think if every health practitioner looked at a patient and approached them thus –
“What would I do if this person was my very own?”:
if the highest possible PHQ-9 score on a piece of paper meant “SUFFERING” rather than an unreliable piece of data; if picking up the phone for a bit of advise did not mean admitting incompetence;
if nothing but the best interest of the patient was the prime consideration while looking after them each and every time;
the correct course of action would be crystal clear.

Recommendations and guidelines can only be effective if they are backed by love and empathy. 

Day 419

While in the general population, men are 3 to 4 times more likely to complete suicide than women, it is quite the opposite amongst doctors. Women doctors are more than twice as likely to complete suicide than their male colleagues.

Doctors are more likely than the general public to:

– be divorced
– have addictions – to alcohol or other substances
– suffer a burnout
– have a psychotic episode

Not surprisingly, they are extremely good at hiding their mental state.

In the NHS, 25% of doctors are from other countries but they form a disproportionate 40% of those seeking help for significant problems such as depression and excessive alcohol consumption.

The document ‘Understanding why doctors present late’ from the 1st European Conference. PAIMM 2001 states:

“Doctors are one of the most unattended populations in terms of health care.”

This is a generalisation but these are said to be common traits of doctors: perfectionists, narcissists, compulsives, denigrators of vulnerability and martyrs.

Given the combination of the above traits with the current TOXIC work environment of the NHS and the high emotional burden that doctors have to carry by nature of their work, is it any surprise that their mental well-being is seriously jeopardised?

Myths:

  • Doctors are invincible
  • Sick doctors always know when they are sick
  • Sick doctors who know they’re sick always know what they need to get better
  • Sick doctors always get excellent treatment
  • Doctors always follow doctors advice
  • Doctors look after themselves

I am sure some of these are applicable to other professions. I also hope that I am not being too much of a martyr here!

Are we kind enough to ourselves and to each other at work?