Day 790

Home is so sad

Home is so sad. It stays as it was left,
Shaped to the comfort of the last to go
As if to win them back. Instead, bereft
Of anyone to please, it withers so,
Having no heart to put aside the theft

And turn again to what it started as,
A joyous shot at how things ought to be,
Long fallen wide. You can see how it was:
Look at the pictures and the cutlery.
The music in the piano stool. That vase.

  • by Philip Larkin

Here is a link to the video recordings of presentations made at a Suicide Prevention conference in Belfast, Northern Ireland on 17th November 2016. Stories of triumphs, visions, ideas and tragedies. All worth watching. The 10th one tells the story of Saagar and my sad home.

Day 780

Money alone will not solve the problems within Mental Health Care Systems. We need a radical shift in the understanding, training, outlook and organisation of our society as a whole, each individual and  every health service and professional. Paul Kirby writes about this comprehensively and optimistically. He points out failings and offers transformational solutions. Here are some excerpts:

“The medicalisation of mental health assumes that doctors can solve medical problems on their own, in the way that they do for physical illness with biomedical testing, drugs and surgery. That is rarely true in mental health where getting better relies significantly on the patient’s own therapeutic actions and their interaction with their friends, family and colleagues. Outpatient psychiatric care rarely works with the other people in the patient’s life, dealing with the patient one-to-one. Worse still, medical ethics prevent doctors discussing their adult patients, even vulnerable eighteen year olds, with their family and friends.

England, like other countries, has only ten per cent of the inpatient places, per head of population, that it had in the 1950s. The US has even less. It wasn’t just the asylums closing. England has halved the number of inpatient places it still had in 1998. Community-based crisis services have not worked well. Only fourteen per cent of English patients who’ve experienced a mental health crisis felt they had appropriate care and there are no English community services rated as good. In the absence of appropriate inpatient care, people who are severely ill are labelled, and dealt with, as non-medical problems, as criminals, as homeless, as addicts, as a public nuisance and as suicides.”

Doctors tell people that anti-depressants have a positive effect on half of the people who take them. That is true, but misleading. Even drug companies only claim that their drugs have a positive impact on one in eight people who take them. Drug companies are also clear that the beneficial effects of the drugs take two to six months to kick-in. Without medication, a third of people with depression are better after three months and two-thirds are better after six months. For the people who do benefit, these drugs are probably best compared to a band-aid, increasing the natural healing process a little.

A minority appear to be greatly harmed by taking anti-depressants, with a doubling of the suicide rate for people with depression and the triggering of psychosis in significant numbers of people. But the biggest harm of the anti-depressant accident is that their domination of psychiatric care has crowded out better and more varied solutions to common disorders and left millions unable to get well again.

Mental illness and poor health are often based on underlying feelings that one has lost autonomy and/or community-connectedness, experienced as helplessness, hopelessness, passivity, boredom, fear, isolation and dehumanisation. These are social problems that have medical consequences. The best solutions are, often, therefore social rather than medical. In terms of physical health, many of the biggest achievements have come from non-medical solutions. We live longer and better in large part due to clean air, safe water, better vehicle and workplace safety, less tobacco smoking, more and better food, fluoridated water. We need a similar public health approach for the social causes of mental health issues.”


Day 763


The semi-circular Green was covered with autumn leaves. The skeletons of trees stood semi-nude, exposed yet statuesque. Andy, who normally clears up the leaves is away on a long holiday. The others in the neighbourhood took it upon themselves to fill in for him. One woman with a new hip came on to the Green with her ‘Bulldog’ rake and leaf-collector called ‘Anita’. The gadget was a Christmas gift from a few years ago. She thought it was rather quaint at the time but it had proved to be cleverly designed and very useful. Next came her friend who is 79. She brought her ultra-light yellow rake and a couple of light wooden boards that served as efficient leaf collectors. Along came a couple in their 60s with a wheel-barrow, another metal rake and huge bags to carry the leaves in.

They caught up on the gossip, exchanged remedies for wasp stings, made jokes, talked about their respective pets and took pictures of each other. Together they piled the leaves up in little hillocks dotted randomly across the Green, deposited them in a big bag, mounted it on to the wheel-barrow, took it away to a designated spot, emptied it out and brought it back for more. That cycle repeated itself a few times with team members assuming different roles at different times. More people joined in and left at various points over the course of the activity. The Green was green again.

We gathered in our house for a cup of tea. A country morning well spent.



Day 738

It’s Halloween or All Hallow’s Eve, a feast of all saints and all souls.
This morning ‘Thought for the day’ on Radio 4 was delivered by Professor Tina Beattie :
“ ‘Death,’ said Hamlet, ‘is an undiscovered country from whose bourn no traveller returns.’ These holy days seek to bridge the abyss between the live and the dead. Through rituals and imagination they are intended to assure us that those who have died are not beyond our companionship and our prayers.

No tradition can survive unless it is relevant to people’s everyday messy lives and gives meaning to their deepest struggles, sorrows and hopes. Death is the most sorrowful and messy reality of all. It’s a universal truth and the most impenetrable of mysteries.

As a culture we have been alienated from the power of hope to reconcile us to the helplessness and despair we feel when confronted by death. This feast brings us into communion with the dead, not to frighten us but to console. These feasts are an invitation to see what it means to be mortal and to seek reassurance that terrifying though death is, it is not the end. Love is more powerful than death and life, not death, will have the last word.”

2 meetings around Saagar today : one about the future and one about the past. Both called for reliving, retelling, revisiting the circumstances of his tragic death. It was too much! Lesson : plan only one meeting a day. Be kind to yourself.
That I survived the day is proof that love is more powerful than death and life, not death, will have the last word.

Day 734

2 months ago I made a presentation entitled ‘Understanding Resilience’ to a group of roughly 30 people in their twenties. It was well received and the feedback was encouraging. Here is the quantitative analysis, marked out of 5.

Content:  4.39

Presentation: 4.38

Relevence to me:  4.13

Overall:  4.38

It was interesting to see that the lowest score was to do with relevance. It means that while most of them liked the content and had an overall good impression of it, many of them thought it didn’t apply to them.

Perhaps it reflects the fact that at present they feel strong. Great! Long may it stay that way! If I had attended a presentation like that a few years ago, I would have thought the same. But I do hope that if any of their friends, colleagues or family is in a vulnerable place they will be able to spot that and reach out to them. I also hope that if they see a distressed stranger, they will be sensitive to that and offer support.

The low score could also indicate an inability of some of us to acknowledge our own fragility.


Day 739

What do the following TV serials have in common?

I love Lucy.
Sesame Street.
Different Strokes
Mad about you
Will and Grace
Sex and the City

All very popular. All featuring happy, funny, quirky characters. All based in New York City.
It seems NYC is not such a happy place after all.

– At least one in five adult New Yorkers is likely to experience a mental health disorder in any given year.
– 8% of NYC public high school students report attempting suicide.
– Consequences of substance misuse are among the leading causes of premature death in every neighbourhood in New York City
– Each year, 1,800 deaths and upwards of 70,000 emergency room visits among adults aged 18 to 64 can be attributed to alcohol use.
– 73,000 New York City public high school students report feeling sad or hopeless each month
– Approximately 8% of adult New Yorkers experience symptoms of depression each year
– Major depressive disorder is the single greatest source of disability in NYC
– At any given time over half a million adult New Yorkers are estimated to have depression, yet less than 40% report receiving care for it.
– There are $14 billion in estimated annual productivity losses in New York City tied to depression and substance misuse.
– Unintentional drug overdose deaths outnumber both homicide and motor vehicle fatalities.
– The stigma of mental illness has been found to have serious negative effects on hope and an individual’s sense of self-esteem. Stigma also increases the severity of psychiatric symptoms and decreases treatment adherence.

The First lady of NYC, Ms Chirlane McCray recognised this as matter of public health in crisis and launched a bold initiative last year in order to tackle it. It cost nearly a billion dollars. It is called Thrive NYC ( It relies heavily on peer counsellors, who are not mental health professionals but are already entrenched in underserved communities. One of its main objectives is to address the stigma associated with mental illness. The plan is aggressively ambitious, attempting to make life easier for New Yorkers in every community and of every age.

I hear the Mayoral office in London is making plans of a similar nature. Can’t wait to hear more. It’s about time!



Day 737

“I wish it need not have happened in my time,” said Frodo.
‘So do I,’ said Gandolf, ’and so do all who live to see such times. But that is not for them to decide. All we have to decide is what to do with the time that is given to us.’

Tolkein wrote this roughly 80 years ago but it is ageless.

‘It must be really hard talking about Saagar in public meetings. Is it?’
The answer is ‘Yes. It is. Very hard.’
But I have decided to do it with the strong intention of creating awareness, breaking the stigma and making sure that through the lessons learnt from the poor management of his illness, other lives can be saved. I have decided to put this intention out to the universe with the promise that I will do everything I can. It is my belief that the universe is responding and will respond to support this true intention.

I can’t get how he died out of my heart and head,  even tough it happened in 1 second. I sometimes forget to honour who Saagar was and how he lived. He lived for 20 years, 5 monthS and ten days! One of the comments his Head Master made about him was, ‘he spoke to me the same way he spoke to a student 3 years younger than him.’ He treated everyone with respect and light heartedness. He found every opportunity to laugh and make others laugh. He brought out the best in people. I need to learn from him to enjoy my life and relationships, to enrich my life and that of others through every interaction. I must decide to do that too.

Day 735

Today, I woke up determined to have a ‘normal’ day.
Fed the cats. Helped Si make a breakfast smoothie. Got ready. Gulped the thick fruity drink down and headed for the train station. On the way, I received a text from a junior doctor who thanked me for sharing this blog with her as she thought it was full of very valuable insights. From her own experiences, she knew how reluctant society was to talk about mental illness. She is seriously considering specialising in Psychiatry.

At work I had a capable young trainee working with me. Aside from anaesthesia we talked about the gentrification of Brixton that had gone too far and how doing admin is far more tiring than looking after patients. Then I caught up with some admin.

‘Grassroots’ in Brighton sent an e-mail thanking me for contributing to their World Suicide Prevention Day celebrations :

One of Saagar’s school friends sent me a ‘friend request’ on face book! Yay!!! 🙂

Went to the gym after work. There was a beautiful, slim, tall blonde lady training at the same time as me. I overheard her saying that she did not like to look at herself in the mirror. I couldn’t think of one reason why that might be the case.  Wonder what her story was! After finishing the session had a heart to heart with my trainer who shared his difficult time looking after his father in a hospice for 3 months before he passed away.  We both had tears in our eyes and we gave each other a warm healing hug before saying bye. While having a shower I realised that if I stood absolutely still under the warm shower, it felt like being inside a warm duvet.

On the way home, I slept with my mouth open on the train. Luckily didn’t miss my station or swallow a fly. Got a phone call from R’s Mum. She has not had a good week. R’s inquest is coming up next month and she really wants to talk to me about it. So, we set a date for next week.

Got home and lit a candle for Saagar. Sat down with a cup of tea and heard a knock on the door. There was a lady from Greenpeace. After talking to her for 5 minutes at the door I invited her in. For the next half an hour we had a great conversation. I didn’t mind missing the ‘Archers’. We spoke about many topics close to my heart – air quality on London, lack of proper usage of solar energy in India, people forming strong bonds with technology while loosing their deep connection with nature, writing, campaigning and so on. I am now a proud member of Greenpeace!

Now I am about to cook dinner for Si as he is working late…again.

So, I suppose I did have a ‘normal’ day.

Day 726

Sarah Fitchett is a neonatal nurse and a lecturer. She is also a mother bereaved through suicide. Like me, she is affiliated with PAPYRUS Prevention of Young Suicide Charity by way of fundraising and awareness raising. This is an e-mail from her:

“I delivered an awareness session to GPs in Birmingham last week and they were desperate for more training.  They were literally asking me,
“What should I say?”
“What if the answer is yes?”
“What am I looking for?
“There are no services available to signpost young people to – CAMHS is so stretched”
“How will I know?”
“How do I cope with losing a patient to suicide?”
I really hope they will come on ASIST.  Such a lot of work is needed. One of our young volunteers, a mental health nurse from Bristol self-funded a place on ASIST because she had no idea how to help someone at risk of suicide, neither did any of her colleagues. Her training hadn’t covered it and there was no training available to her.  A WM police officer self-funded a place on ASIST and used her annual leave to attend because so very much of her role is attending people in crisis.”

This is an article she’s written about the absence of suicide prevention training on the nurse’s curriculum and the stigma associated with suicide within the medical community:

11th October 2014 was a saturday. I had tickets for the Omid Djalili show for us. Saagar loved stand-up comedy and I thought it might help him. He sat on my right. I watched his responses. He appeared to be under a cloud. He did laugh but his laughter was subdued. At break time I bought him a drink and for some strange reason it felt like a significant happening, like an unforgettable scene in an iconic film. It was the last time I bought him a drink. It was the last time we went for a show together.

Let us do everything we can to save young lives.


Thank you Omid for bringing him some happiness. Even if it was short-lived.

But then, everything is temporary, short lived! 

Day 724


First law of Thermodynamics : Energy can neither be created nor destroyed.

Within my basic understanding of physics, I think of it as: when breaks are applied to a moving car, the kinetic energy from the movement is converted to thermal energy causing the break-pads to heat up. Similarly the turning blades of a wind turbine transform wind (kinetic) energy into electrical energy.

May be each one of us is a field of energy. May be that is why the interaction between two people changes when a third person brings their energy into the equation. May be that is why we like someone for no reason at all and dislike someone for no reason at all. May be our energy can neither be destroyed nor created. So even after someone’s physical form disappears, their energetic form continues to exist. May be it just changes its expression. May be it flows through the people they knew.

Being with Saagar’s friends is comforting for me as I feel his energy in them. It’s the same for them, being with me.

I see our compassion grow. I see us being creative. I see us going out of our way to deepen our understanding of the human condition. I see us wanting to make the world a better place. I see us taking small steps. I see us all constantly loving Saagar and carrying his beautiful energy within us.