Thank you for noticing.

Posted by kidsaregifts20

She was listed for a minor surgical procedure on my list. I called out her name in the waiting area and escorted this pleasant, middle aged lady into a cubicle for her pre-anaesthetic check-up. We both sat down at right angles to each other. She had an unmissable racoon’s eye on the right side of her face. I looked again. Just to be sure. It was there in its fading pinky-blueness. She was in hospital for a totally unrelated reason but I ventured into asking, “What happened here?” pointing to the eye.

‘Oh. I had a run-in. Couple of weeks ago.’

“A run-in with what?”

‘You know … It’s okay. I don’t want to talk about it.’

“Have you spoken to anyone about it?”

‘Yes. I am okay. I really don’t wish to speak about it.’

“That’s fine. How are you doing today?”

We went ahead, staying focused on preparing her for the upcoming procedure.

I took a moment to call the Safeguarding department of the hospital. They said that it was normal for people suffering abuse, to not talk about it for a long time. They advised us to signpost her verbally. A written set of resources might make her more vulnerable, if discovered by the wrong set of hands.

Two women are killed by a partner or former partner every week in England and Wales.

One in five people suffering domestic violence will plan or attempt to take their own lives.

One in eight of all female suicides and attempts in the UK are due to domestic violence and abuse. This equates to 200 women taking their own lives and 10,000 attempting to do so due to domestic abuse every year in the UK. That’s nearly 30 women attempting to complete suicide every single day.

Men endure domestic abuse too. This can include physical violence, as well as emotional and psychological bullying, sexual violence or financial control and abuse.

It is living hell. An invisible prison. Isolating, with no one to confide in.

It takes great courage to speak. It’s often ignored. Many suffer in silence.

Survivors do come in contact with health and social services but disclosure is difficult.

If done right, it is life changing. Appropriate response is invaluable.

Front-line staff must recognise signs and highlight issues.

It is important to ask and act.

After her procedure, I went to see her in the Recovery room.

“Have a nice evening.” She said. “Thank you for noticing.”

Resources:

https://www.rcn.org.uk/clinical-topics/domestic-violence-and-abuse/general-resources-and-support

https://uksaysnomore.org/get-involved/ask-for-ani/

https://www.mankind.org.uk/help-for-victims/types-of-domestic-abuse/

What are the chances . .?

Posted by kidsaregifts20

It was Tuesday, not my usual day to be working at St Thomas’ Hospital.
It was lunch-time and there was time enough for a proper break, which was extremely rare.
I was able to physically leave the Theatre complex for fifteen minutes, which was usually impossible.
I wanted to clear my head, so I went to the cafe, looking for a seat by a window. I was in my raspberry scrubs, wearing my most expensive necklace which is a green lanyard with my ID batch. The round table by the french doors had three chairs, of which one was occupied. I asked the older gentleman if I could share his table and he didn’t mind. As I sat down I noticed that his left arm was heavily bandaged. My curiosity got the better of me and I asked, ‘What brings you here?’
He looked straight at me and replied, “I tried to die.”
‘I am sorry you found yourself in that impossible place. Must have been terrible. Are you getting the support you need?’
“Yes. They’ve been very good here.”
‘I am glad.’ I paused to wonder if I should tell him but the words left without my permission.
‘You know, I lost my son to suicide a few years ago.’
His gaze connected with mine like a laser beam and his eyes moistened.
Softly, almost apologetically, he stated “When you are in that place, you can’t think about other people.”

Pause.

“Here comes my wife.”
Holding two paper-glasses and a brown paper bag, she joined us and placed one of the glasses in front of him. She took out a Jubilee cupcake from the bag to share.
“Have you traveled a long way today? I asked, shifting gear.
‘Sussex. Straight train. Not too bad.’
“Beautiful part of the world!”
‘Yes. But we lived in Australia for eighteen years which was really pretty. We came back to be with the children.’
“Nice. I wish you all the very best. I must get going now.”

‘Us too. Our appointment is in fifteen minutes.’ she said.
‘You take care’. He said, making that eye-connection with me again.
“You too.” I looked straight at him, nodded, smiled a polite smile and walked away.

(Resources for attempt survivors, their families and friends:

https://www.sprc.org/livedexperience/tool/resources-suicide-attempt-survivors-their-families-friends)

Emergency Numbers

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Earlier this year, at a Medical school in North India I spoke to staff and students about the stigma and ignorance around Mental Health. At the end of the lecture one of the senior faculty members asked me a question, “Is it helpful for people with a mental illness to be a part of a religious community?”

‘Yes’, I said. ‘Most certainly. Just like it is helpful for someone with Diabetes to be part of a religious community. It might also be a good idea for them to see a doctor.’

Earlier that day Si and I had taken a walk around the hospital and found this list of ‘Emergency Numbers’ prominently displayed on a notice board in the medical library for medical students, nursing students, dentists and doctors.

Need I say any more?

PS: It is important for every student in every educational organisation to have ready access to reliable and knowledgeable resources if they feel the need to discuss their thoughts and feelings or are concerned about a friend.

Green Tara

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Once again, I found myself in Swansea. The meeting was planned weeks in advance and I had travelled 4 hours to be there. I, a practising doctor, once again, seeking light in the realm of the unexplained. Why was I there? Because I wanted to write a book and I wanted to know what Saagar thought. Does that make sense? Like hell it does. That’s why I had trudged all the way there and would be changing trains for the rest of the day to get back home.

One whole wall in the waiting room was teaming with thank-you cards, mostly from women who believed they had had babies as a result of Acupuncture or other therapies received at the centre. It was a modest space with a tired fawn carpet and upright wooden chairs with plastic, foam maroon coverings. Like all waiting-room-chairs all over the country.

Her big smile snatched my gaze away from the wall and welcomed me into her space. She guided me up the stairs into the same consultation room where we had met more than a year ago. The familiar potted palm, the large window and the same arrangement of the 2 comfy sofas by the fire-place, facing each other with a small wooden table placed in between. Déjà vu, all over again.

I sat facing her and the window. She sat facing me and the door. We started with a brief catch-up and then she connected with Saagar. She said he’s happy. He’s growing his hair and following the cricket. She thinks she can hear him speak French. Is he saying something about Guy’s hospital? He says he enjoyed his time and friendships at Dulwich. He mentioned a particularly close ‘black’ friend. I am sure he means the one coming home to lunch tomorrow. He says he loved the large window by his bed with the great view of the London cityscape.

He felt there was a place for him at the wedding. It was fun, especially the bit by the river in the early morning hours. He must have meant the photo-shoot of Si and I in our normal clothes. It shows us in our ‘natural habitat’. The camera loved the early morning sun. So, we complied. ‘Natural’ and ‘photos’ don’t belong in the same sentence. We tried our damnedest best, seeking inspiration from Hollywood and Bollywood combined, getting confused and dramatic and giving rise to some cracking moments. He was there.

He offers me a Green Tara through her. A Buddhist manifestation of active compassion, Tara is the saviouress, the one who reaches out and responds freely to all who suffer. She is fearless and boundless. He wants me to have a jade statue of Tara. He knows my heart and mind. We walk in the same light.

She says the book will happen. A book of beauty and joy that was him. Of his continued presence. Of hope.

( A 20 minute video of an awareness raising presentation for trainee anaesthetists at a national conference in Glasgow from earlier this month: Being Human)

[E-mail address for Moya O’Dwyer, the medium: moyairishmagix@yahoo.com]

Community is the answer.

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“…the lonelier a person gets, the less adept they become at navigating social currents. Loneliness grows around them, like mould or fur, a prophylactic that inhibits contact, no matter how badly contact is desired. Loneliness is accretive, extending and perpetuating itself. Once it becomes impacted, it is by no means easy to dislodge.” – By Olivia Laing, The Lonely City.

In the summer of 1999 I moved from New Delhi to a little place called Antrim in Northern Ireland. I lived in a tiny room in the accommodation for junior doctors on hospital grounds. I didn’t know a soul there. Slowly I made a few friends at work. Unlike now, there were no mobile phones, whatsapp, skype, facetime or facebook then. Telephone calls costed a bomb. People were friendly but everyone was a stranger. Initially I didn’t get their sense of humour at all. I felt foolish. I longed to speak my own language with someone. Anyone. But there was no one who would understand.

One evening I went to buy some chocolates to a nearby petrol station. There were 2 cashiers but only one of them had a long queue of people waiting their turn. I didn’t understand why. I went up to the cashier without a queue and made my payment. I didn’t get the meaning of the looks on people’s faces. It didn’t help that I was the only coloured person for miles. From some face expressions it was obvious that they had never ever seen a coloured person outside of the television. I felt alone. Very alone.

Urban loneliness is a common phenomenon. Isolation causes inflammation. Inflammation can cause further isolation and depression. The cytokines released as a result suppress the immune system giving rise to more illness.

Frome is a historical town in Somerset. It is known as one of the best places to live in the UK. Dr Helen Kingston, a GP, kept encountering patients who seemed defeated by the medicalisation of their lives. They were treated like a cluster of symptoms rather than a human being with health problems. Staff at her practice were stressed and dejected by what she calls “silo working”.

With the help of the local council and Health connections Mendip, she launched a community initiative in 2013. It main intervention was to create a stronger community. They identified and filled gaps in communications and support in the community. They employed ‘health connectors’ and trained up volunteers to be ‘community connectors’. They helped people with handling debt or housing problems, sometimes joining choirs or lunch clubs or exercise groups or writing workshops or men’s sheds (where men make and mend things together). The aim was to break a familiar cycle of misery.

In the three years that followed, emergency hospital admissions rose by 29% across the whole of Somerset. In Frome they fell by 17%.

No other intervention, drug or procedure on record has reduced emergency admissions across a population.

A vacuum in the NHS.

Posted by kidsaregifts20

When Saagar was ill, he filled out an online form and referred himself to IAPTs – Improving Access to Psychological Therapies. This programme began in 2008 and has transformed treatment of adult anxiety disorders and depression in England. Over 900,000 people now access IAPT services each year. I have used this service in the past and found it useful. I suggested to him to fill out the form a second time and he did. They usually call back within a day or two. He didn’t hear back from them.

I recently found out that IAPTs does not look after suicidal people. I would like to know what they do when they read a self-referral form of this nature.

There is a vacuum in the NHS. There is little face to face support for those who feel life is no longer worth living. Why do most people with physical illnesses ask for help? Possibly because they trust they will receive appropriate help from the system. Why is it that many people with mental anguish don’t approach the medical services for help? Probably due to lack of trust.

The Listening Place works towards filling that vacuum. A few days ago I visited their premises, a short walk from Pimlico station, in the heart of London. This airy, green, warm and welcoming place felt ideal for anyone in need of care, support and understanding. Here, individuals can speak openly about their feelings without being judged. They receive on-going support from trained volunteers over a number of weeks as deemed appropriate. The volunteers help relieve emotional pain and stress and offer opportunities to consider alternatives to suicide. Anyone over 18 can be referred to them by themselves, other charities, NHS as well as health and social care organisations. They try to give continuity by facilitating you to speak with someone who knows you from before. They charge nothing and keep your information confidential. It is remarkable that they are open 9 am to 9 pm, 7 days a week.

Phone: +44 2039067676; Email: referrals@listeningplace.org.uk

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Sarah Anderson, who was once director at the largest call centre for the Samaritans, set up The Listening Place in 2016 and the service has since helped hundreds of individuals with its unique approach to care. During our chat, Sarah’s passion and dedication to the cause comes through, loud and clear.

The world needs more people who give a damn about other people.

(PS: Through the grapevine I hear the future funding of IAPTs is in jeopardy. The vacuum grows.)

Day 968

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Artspace

‘Art should comfort the disturbed and disturb the comfortable.’ – Cesar A. Cruz

Yesterday’s play on ‘Shifting perspectives’ through theatre and today’s trip to the Dragon café brought this truth home.

The work done by the patrons of the Dragon café was compiled into a big black book called ‘Artspace’. Looking through it was an immersive experience. Some brought me comfort and some disturbed me, making me a mixture of ‘comfortable’ and ‘disturbed’.
I shall let you find out how they make you feel.

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Certain events or times of day are more difficult – like being alone late at night, or having arguments. During these times it can often be more difficult for us to feel a sense of hope, to feel connected to the idea of safety, to feel our own resilience. This is the times when ‘self-care’ is essential – taking time out to be kind to ourself, to find activities that feel good, or allow us to connect with ourself again. Self-care is about caring for ourself, inside and out.

Focusing on the present moment, the present activity, whilst allowing thoughts and feelings to just be – has a long history of helping people with their mental wellbeing. By allowing ourself to become absorbed in the moment it’s possible to feel a sense of calm and focus that can distract from painful thoughts and feelings. No wonder colouring books for adults and kids alike are taking a special place on book store shelves.

Here’s PAPYRUS’ bright idea –