It’s an ordinary day that starts as the sun peeps from somewhere behind the horizon and ends as it vanishes somewhere behind another at different times for different people on the globe scattered all over these continents everywhere. It is not a singular day as it claims to be.
It’s not my enemy and yet it circles around each year as a reminder of what happened as if I need reminding. It’s not my enemy even though it feels like one. It’s just another day, innocent and ignorant, asking me to sit down. Have another cup of tea.
It was nameless and inconspicuous until it arrived hiding a deep darkness within its light wearing the face of a sacred place and a robe of expansion and growth and holding a promise of transformation before I knew what that meant, unlocking the path to an invisible destination.
This endless path covered in thorns and nettles with no alternative or detour must be trodden with bare feet. It is essential they bleed.
To my desperate open eyes the destination remains invisible. When I let them close I glean a faint ray of hope.
“What can we do to offer wrap-around care to our patients?”
In the live Q&A at the end of the NCISH conference yesterday, this question was asked of the panel. The Chairperson directed it towards me. I can’t remember what I said. This morning I woke up with what I would have liked to say.
For wrapping, we need two things. One, the fabric which we are going to use to wrap and the person we want to wrap. Let’s discuss them one by one.
The fabric
The fabric of Suicide prevention in Health-Care is made up of two things – people and systems. Let’s look at them a bit closely.
People
What are the beliefs of the people?
I know of an ENT surgeon from another country who wanted to move to the UK and the only job he could find was in Psychiatry. So, he is now training to be a Psychiatrist. Is he interested in suicide prevention? Do Health-care professionals believe that suicides are preventable? Are they content that simply by treating mental illness they are doing their job?
What are the attitudes and abilities of the people?
When the Emergency department calls to say there is a suicidal individual waiting to be seen, how do they feel? Are they excited to have an opportunity to make a difference? Or is it a drain on the limited time and energy they have? Do they know how to build a compassionate connection with someone who has lost all hope? Have they received any training in Suicide Prevention? Do they have enough self-compassion to look after someone else well?
Do they have the resources and the knowledge to do a good job?
Do they have access to their past history? Do they have beds on the ward? Can they ask a colleague for a second opinion if they have a doubt about how to involve family or friends in their care? Do they know of other resources, like charities, activities and people that may help this person? Do they have comprehensive and informative leaflet they can share with them? Do they have the means to follow them up?
b. Systems
Does the system have capacity? Are the various parts of the system effective and joint-up enough to be able to hold the person they are trying to wrap or are there big holes in this part of the fabric? Do the various parts of the system share the same mental model, a shared knowledge, pre-suppositions, and beliefs that can be used to help achieve mutual goals? Are their practices evidence- based? Do they investigate deaths with a view to learn lessons and implement change? Do they look after the well-being and emotional health of their employees? Do they hold themselves accountable when things go wrong?
2. The person
Allowing space for them to express themselves. Help maintain their sense of agency. Inform them it is safer for them to involve other people who care for them. Equip them with resources. Give them the support they need. Ask them what would help them? Listen. Sit with their despair. Acknowledge it. Keep them connected with their life as they know it. Keep hope alive for them.
Know that the person at the centre of the wrapping is of great value.
Information is useful if it becomes knowledge. Knowledge is useful when it becomes wisdom. So, let us not stop at information.
The second time around, I was as sure as one can be. It felt like fun. An adventure. A way to deepen our friendship. Si and I worried that things might change after we got married. We didn’t want them to. But they did.
We found that we could be silent together. Our shared space became sacred. We felt closer. More intimate here than in the world of words. It gave another dimension to our togetherness, one that felt like cruising over deep blue still waters with the sun shining on us. It felt whole and complete.
The cages of our ribs expanded and contracted rhythmically without a sound. They breathed love and understanding. They rested and connected through the music of silence. A river of song flowing between them. Circles of time danced in overlapping squiggly whirls, periodically stopping at the end of each expansion and each contraction.
Five today.
Years of hope, love and possibility.
Creating the same for many others.
Walking together. Hand in hand. Silently.
“We need to find God, and he cannot be found in noise and restlessness. God is the friend of silence. See how nature – trees, flowers, grass- grows in silence; see the stars, the moon and the sun, how they move in silence… We need silence to be able to touch souls.“
After a long wait, we can watch it. Not in a cinema but on the largest screens available in our homes. You might know that a few years ago we set out to make a short documentary on the life of Saagar and our lives after him. I am so happy that it can now be watched at the link below by clicking on the box that reads 1000 days and entering the password as suggested: hiddenFF2021
Presently this film is available through the Hidden Film Festival website but in time it will be a resource to increase the understanding of suicide and bereavement by suicide and the value of kindness. I hope it will generate constructive, life-affirming and healing conversations. It is 20 minutes long and is available till Friday, the 4th of June. At present it is doing the rounds of international film festivals and has been selected for 7 major ones. Thank you for holding Saagar in your hearts the way you do. For shouting out love and hope.
Cast: Freddie, Hugo, Seb, Sam, Bex, Rosie, Azin, Simon, Saagar and I.
Filmed and produced by the magical duo Jeanette Rourke and Ron Bambridge.
What some people have said:
“I cannot get the film out of my head (in a good way!). I am really impressed with the professional job done on the filming and opening drone shots of where you live etc.”
“It is beautifully made and the editing done with such sensitivity. I also loved the music – definitely sounded like a professional music for film composer.”
“Thank you so much for the film and it really brought me a lot of comfort especially in a rough week like today when I have grief burst. I am grateful to have to know you in this difficult journey and what you have been sharing about your beautiful Sagaar, your thoughts and your journey milestones has helped me tremendously.One thing I learnt from 1000 days is that the hope of surviving this unsurvivable pain which you gave me through your story. Thank you so much Sangeeta.”
Thank you all for funding this film. For illuminating this world in your own special way!
Building up to today, hope of movement. Till this morning, half-fearing the radio might say – it’s been cancelled. After nearly 13 months of this regulation and that and then the other, bungled numbers coming from unreliable sources, u-turns based on dodgy science, I am not sure what is to be believed.
This morning I opened my eyes to snow descending like down-feathers, dancing and swirling outside my window. Wow! There is hope. A clean, fresh start.
As an anaesthetist, over the last few months I’ve been speaking with patients, re-assessing their fitness for the operations that they were supposed to have March 2020 onwards, which have not happened yet but will hopefully happen soon. Several of them have had to live with painful knees and hips and other uncomfortable conditions for at least a whole extra year, unable to move around and exercise. Many of my patient’s health has deteriorated over the last year. They have gained substantial weight, some are drinking much more than before. A few have decided not to have their operations as they are worried about visiting the hospital, leave alone be admitted, for fear of getting the virus.
A few got Covid and have recovered fully while a small proportion have lingering issues. Others have discovered new health conditions like heart disease, diabetes and asthma. Some elderly patients have developed new ‘minor’ issues after having the vaccine, like loss of balance, making independent living impossible. So many have lost confidence.
The incessant repetition of “you may be next to die a terrible death alone soon” on TV and radio has filled the psyche of the populace with terror. The thorn of fear has made a home in so many chests. It’s easy to put it there but difficult to pull it out. How insiduously our greetings have changed from ‘Have fun!’ to ‘Stay safe’.
Monday, a good place to start afresh. May we find the courage to recover, open and experience life in all its fullness in the coming weeks and months.
“Avoiding danger is no safer in the long run than outright exposure. The fearful are caught as often as the bold.” -Helen Keller
kidsaregifts 