Day 841

His bathroom has 3 lights, one on top of the mirror and the other 2 on the ceiling. The switch for the mirror light is just underneath the mirror. The switch for the ceiling lights is outside the bathroom door. I sometimes found the mirror-light switched on, on the way to his room even when he wasn’t there. I would tell him off for repeatedly forgetting to turn the light off after use. Now, it is my bathroom. I still find the mirror light on sometimes when I go upstairs, even if I haven’t been there for hours.

It is so easy to forget to turn the mirror-light off. I know that now.

I would arrange mail-order deliveries for the times when he would be home. Sometimes he would be in his room on the second floor and fail to open the door for them, especially if they came very early in the morning. We would then have to go around chasing our parcels. Again, I would get a bit annoyed with him for missing out on the deliveries.

Now we sleep in his room. One morning last week, I almost didn’t hear the deliveryman’s knock on the door. I thought I heard something like a knock in my sleep but disregarded it, believing it to be a dream. An identical sound came again and nudged me out of my slumber. Had the man not had enough patience, he would have left us a note and gone to his next destination. But I did manage to bundle myself up and roll myself down the stairs in a semi-comatose panic to get to the door just in time.

It’s so easy to miss a delivery. I know that now.

 

Day 832

The hospital where we went when he was ill is just down the road from where we live. It is 18 minutes by bus, 10 minutes but car on a quiet day. The Emergency department is on the left. The Mental hospital is on the right. There is a visitor’s car park in front of the Mental hospital. That is where we parked the car. That is where we waited for a couple of hours to be seen by a psychiatrist. That is where I had to make my own way that day because Saagar refused to have me in the car with him and his father. That is where he should have been when he was severely ill a few weeks later. That is where he could have been saved.

That is where I went this afternoon to watch a play called ‘Hearing Things’, a play co-produced by patients and professionals, based on insights derived from 6 weeks of workshops involving actors and people with a mental illness, offering both an opportunity for expression, transformation and co-creation. Through a cast of 3, we met people of different races and age groups. It was about challenging assumptions. It was about the empathy and personalities of patients. It was about ‘the system’ and the dynamics within it, mental well being of health care providers and role-reversal. It was about giving people a chance.

“I am off now to be mad and I don’t have to be sectioned for it”, remarked one of the participants as drama gave him the freedom to be who he is, without fear of judgment. It was about the possibility of being ‘re-assembled’. It was powerful and moving. It did not mince words. I spoke loud and clear. It was accessible, funny, clever and heart-breaking.

One young person describes his experience of drama:

“…after you do the drama you get this feeling…it feels as if whatever was bothering you went away and you feel light and can do whatever you want around you, it makes the day simpler and you can concentrate on your activities, it makes you feel better, like at the end of the day when you come home from work tired and you want to put your feet up, you don’t feel guilty relaxing as you have done a hard days work. I wanted to understand the person and put myself in their shoes.  At the end of it I felt good.  150% happy!”  

 It was about creating a new paradigm of relating to people suffering with mental illness.  It was all heart.

Ref:

http://playingon.org.uk/hearing-things-2016-2017/

Day 830

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Now, I belong to a network of mums and dads who share the same loss. We exchange stories, everyday struggles and our little achievements. Sometimes it is something as small as getting through an hour, a day. But then, fighting to get through the night, an all too familiar scenario. We know. We understand. We listen.

Sometimes, it is an inspirational piece of craft, a moving piece of music, a long walk or a rant. All of us desperately trying to hold on to who we were and make sense of who we now are, hanging on to the shreds of our being with all our might, seeing ourselves in each other, watching our helplessness and grief spill across the screen over and over again only to gather it all up and see it as nothing but love. All the rags weave together to form a mesh that strengthens each one of us. We recognise our reflections in each other and feel our little angels sending us collective blessings. All that is inside of us is alive even if it feels like it isn’t. It’s the purest form of love.

Day 828

Kimberley Hiatt was 50, a nurse for 24 years, she worked in the Cardiac Intensive Care Unit at Seattle Children’s Hospital. In September 2010 she accidentally overdosed an 8-month-old infant with calcium chloride as a result of a mathematical error. Ms Hiatt, immediately reported the event to colleagues. Unfortunately, the child didn’t survive the error. The hospital put Hiatt on administrative leave and soon dismissed her. It broke her heart when she was dismissed, not just because she lost her job but also because she lost a child. In the following months, she battled to keep her nursing license in the hope of continuing the work she loved. Six months after the event, Ms Hiatt died by suicide.

The suffering of caregivers in the face of a serious medical error has been termed the ‘second victim’ phenomenon.  These individuals feel personally responsible for the patient outcome. Many feel as though they have failed the patient, seriously doubting their clinical skills and knowledge base. They may suffer from extreme fatigue, sleep disturbances, increased Blood Pressure, muscle tension, frustration, decreased job satisfaction, difficulty concentrating, flashbacks, loss of confidence and grief or remorse.

The risk factors for suicide among health professionals, including doctors, are similar to those found in the general population. However, there are some additional risks among doctors such as their unwillingness to seek timely help, access to potent drugs and the skills to self-medicate. Other risk factors include exclusion from work, poor support networks, ongoing investigations, complaints, court cases, inquests and multiple jeopardy from having a complaint considered by a range of bodies including employers and the GMC.

Scott’s 3-tiered interventional model of support for Second Victims is well recognised (Ref: https://www.muhealth.org/app/files/public/1405/Scotts_Three_Tier_Support.pdf)

It’s too late for Kimberly, but her story can serve as a catalyst for a much needed change in healthcare – support for second victims of errors.

“People make errors, which lead to accidents. Accidents lead to deaths. The standard solution is to blame the people involved. If we find out who made the errors and punish them, we solve the problem, right? Wrong. The problem is seldom the fault of an individual; it is the fault of the system. Change the people without changing the system and the problems will continue.”

  • Don Norman Author, the Design of Everyday Things

Dedicated training for all medical students and GPs in suicide prevention must be made mandatory in the NHS and all over the world as prevention of harm means prevention of first and second victims. However, as long as humans are a part of any system, errors will occur. To err is human.

 

 

 

Day 827

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Trading Stories

I have a story
about us.
You may like it.

Is it true?
Certainly not.
But it is a
most satisfying
lie.

Hmm..
The truth?
Truth has no words,
You know that.
Wonder why people
claim to speak it.

You have the truth.
or half of it.
My half
is a twinkle in the eye
shrugging off
the words
with no meaning
chuckling softly
at this frantic search
for a cloak that fits.

Let the truth be.
Let us trade stories
Till these new clothes
Fit better.

  • By Jo Aggarwal.

Day 826

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This forgotten book-mark in a book being revisited after two years is an origami crane – a symbol of healing in Japan. A school kid had given it to me at Hiroshima as a token of gratitude for helping him practise his spoken English.

Paper folding started in China in the first century and reached Japan in the 6th century. Here it was cultivated as an art of understatement. Origami suggests. It implies without announcing outright. It intimates without brashness. In Japanese folklore, a crane is fabled to live for a thousand years and is held in high esteem. It is believed that folding 1000 paper cranes brings the folder’s wishes come true.

A young girl called Sadako Sasaki survived the Hiroshima bomb when she was only two years old. Less than 10 years later she was diagnosed with leukemia, a cancer of the bone marrow. The disease progressed rapidly and the prognosis was not good. She set out to make a thousand paper cranes. She could complete 644 before she died on Oct. 25, 1955, less than a year after being diagnosed. Her classmates, family and friends made more to bring them up to 1000 and buried them with Sadako.

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Her story captured the imagination of the country and the world. Today, we recognize the crane as a symbol of peace and hope.

“She let out both the pain of our parents and her own suffering with each crane.”
“Her death gave us a big goal. Small peace is so important with compassion and delicacy it will become big like a ripple effect. She showed us how to do it. It is my, and the Sasaki family’s responsibility to tell her story to the world. I believe if you don’t create a small peace, you can’t create a bigger peace. I like to gather those good wishes and good will and spread to the world,” said Masahiro, her brother.

Peace and hope to Sadako and to us all.

Day 820

One of the French companies worst affected by suicides has been the telecommunications giant, France Télécom/Orange, where 12 employees took their own life in 2008, nineteen in 2009, 27 in 2010 and 11 in 2011. Despite a new agreement on workplace conditions negotiated with the trade unions, there has been a renewal of suicides in recent years with eleven cases in 2013 and ten suicides in 2014.

Suicides took place at a time when the company was restructuring, including a plan to cut 22,000 jobs in three years. Suicidal individuals shared a similar profile: these were typically skilled male engineers or technicians in their fifties who had been forcibly redeployed into low-skilled roles, often in call-centres.

On 17 January 2014, a 42-year old employee dealing with business customers at a France Télécom/Orange office in Paris, threw himself under a suburban train on his way to work. His sister, who is pursuing a claim against the company, contends that her brother had repeatedly complained to his bosses that he was a victim of bullying by his manager. Occupational doctors had also reported a deterioration of working conditions at the agency where he worked, with a rise of workplace stress as a result of company restructuring. Prior to his suicide, the victim had sent e-mails to family members complaining of an unmanageable workload and of constant surveillance and he referred to “humiliation”, “intimidation” and “bullying”. He held several meetings with senior management where he complained of harassment by his manager. Five days before his suicide, he sent an e-mail to his head of service in which he reiterated his request to change teams. These e-mail exchanges are being used as evidence in the investigation by the public authorities into his suicide.

Whilst in France work place suicides are an urgent public health phenomenon, in the UK, despite severe deterioration in working conditions, workplace suicide is not recognised in legislation and there are no specific official mechanisms for data collection. Even when it takes place in the workplace, suicide is presumed to be an individual and voluntary act and according to Health and Safety Executive (2016) legislation: “All deaths to workers and non-workers, with the exception of suicides, must be reported if they arise from a work-related accident.”

(Source: When work kills : http://www.emeraldinsight.com/doi/abs/10.1108/JPMH-06-2016-0026?mobileUi=0&journalCode=jpmh)