1+50+176+?

Merchandise at the Manchester Firing Line. Manchester New Hampshire. USA.

On a board of chess, both sides stand face to face

Using wise moves, strategies and tacts.

No drones, no justified assassinations   

No sneaky cyber-attacks.

Two rooks, bishops and knights, both sides have by rights.

Those are the rules of the game. For both sides, the same.

Some things are clearly wrong and others that are right.

Whether your pieces are black, or brown or white.

The way the moves are made,

the way the game is played,

a knight is often not the first to be slayed.

A murder in plain sight

Yet, everyone kept quiet.

No criticism. No outcry?

The killers had good reason. That is why.

They always do.

But do they speak the truth?

Who knows? Do you?

Vietnam, Iraq and now this.

For what? For who?

He was someone’s dad, someone’s son,

A military leader, not holding a gun.

This was an act of cowardice, just for fun.

Guns are a sport in the land

from where the assassin came.

The killers proudly laid claim

To this, their ‘good deed’.

Knowing full well that yet again,

they are sowing a seed.

A seed of death and conflict.

Within a week, a stampede.

Multiple counter-strikes

Hitting innocent planes and passers-by.

Who are the ones that die?

People like you and I.

While the international bully

Keeps on keeping on fighting

In the name of self-defence,

‘Freedom and Liberty’?

When a gun is fired, two people die.

The one hit by the bullet

and the one who let it fly.

War is not the answer. Please.

How can we tolerate this?

Instead of wrapping the world in daisy-chains,

We are covering it in wreaths.

(Footnote: Sixty thousand war veterans, many of them young men, have died by suicide in the USA in 2008-2017. On an average 17 to 20 suicides per day and the rates are not falling despite massive efforts.

https://www.military.com/daily-news/2019/09/23/alarming-va-report-totals-decade-veteran-suicides.html)

One whole month

It wasn’t just a physical transportation but also an emotional one. For four weeks I was not an anaesthetist or a wife. I was just a traveling (Churchill) Fellow, curious to learn everything about ways of supporting vulnerable people through crises, advocacy for struggling families and attempt survivors, intentional and effective peer support, safe care-transitions and timely compassionate support for families, friends and communities affected by suicide.

Two contrasting towns with distinct landscapes. Concord in New Hampshire was a small, friendly town resplendent with autumnal beauty, a quiet serenity and a lot of ‘heart’. New York, a big blustering metropolis with clanking trains, crazy-ass driving (yes, worse than London), much honking and many high-level policy-makers. Hence, more like the ‘head’ of the suicide prevention community.

Rail-trail from Concord to Franklin

Since Saagar’s passing, I have not been on my own for that length of time. Especially as his 5th anniversary fell right in the middle of it. It was not easy living fully immersed in the world of Suicide prevention (SP) almost every day for a month. Sometimes it was overwhelming and ‘too much’. It turned out that I was not alone. I was met with much warmth, kindness and understanding. Some old friends made time to catch up with me and some new friends emerged.

One sunny autumn day I had the pleasure of riding a 3-person- tandem bike with an amazing couple who have cycled thousands of miles in tandem all over the world for the past 27 years. On the 16th Ann (an excellent SP trainer) and I went for a nice long walk in the woods in Derry with Dr Indiana Jones, her Border Collie. This was followed by a much needed brunch at a classic American ‘Red Arrow’ Diner where I had the best ever Tuna melt sandwich.

Polly’s pan-cakes was our destination one afternoon as we set off towards the north – Elaine, Pauline and I. We spoilt ourselves with a rich variety of pancakes before taking a walk along the river and visiting ‘The Basin’.

On my return to the UK, I joined the 50th anniversary celebrations weekend retreat of an amazing charity that supports bereaved parents and their families. It’s called ‘The Compassionate Friends’. The film below captures many aspects of the experiences as bereaved parents/siblings. Changed forever.

“Say their name”

I am happy to be back home and back at work. My life greatly enriched, I hope to share the learning and bring about changes for the better, working with various charities, the NHS and the Mayor’s office as effectively as I can. Right now I am assimilating it all, bit by bit by bit.

Emergency Numbers

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.

Treatment versus Care

It was a clean, warm and open space with well-designed floral furniture in pastel blues and greens. It had plenty of natural light and pots of healthy looking plants thoughtfully dotted around the floor. The artwork on the walls was selected by someone who knew their stuff. It would be hard to guess that this was the entrance to the New Hampshire Hospital. which provides acute inpatient psychiatric services for all age groups.

As I was guided through the facility, I was enamoured by a lush beautiful big greenhouse, two well-stocked libraries, a massive gym for staff and patients, 3 cafés, an outdoor patio and play area for kids, a vegetable patch, a healthy colourful aquarium on wheels, loads of Halloween decorations all around, an art workshop and cooking class in progress, television screens, a chapel, a small shop, a pool table, a ping-pong table, lots of board games and cheerful group therapy, treatment and visitor’s rooms.

Each kid had a room to himself or herself with nice bed-linen of their choice. 2 adults often shared a room. The age groups were appropriately separated. The youngest patient there was 6 years old and the oldest a septuagenarian. The nurse’s station was not a demarcated area. It was part of the ward layout. Social workers, occupational therapists, doctors and nurses didn’t wear any uniforms. They were dressed in everyday clothes. Everyone spoke softly and the atmosphere was relaxed and caring.

The most impressive part of the service was the presence of an Aftercare Liaison officer. It is well known that patients are at the highest risk within 30 days of discharge from inpatient services or Emergency department. (Ref: Luxton, June and Comtois 2013) They concluded that repeated follow-up contacts appear to reduce suicidal behaviour.

Aside from following up on these patients, the Aftercare Liaison Officer has the following roles before the patient is discharged:

  1. Speaks, listens and connects to each child and adolescent patient. Educates them and their support system about warning signs of suicide, triggers, risk factors, protective factors and restriction of means of self-injury.
  2. Draws up a detailed Safety Plan with them and their carers.
  3. Helps them identify sources of social support (trusted adults) and develop personal resources through open conversations.
  4. Interface with other professional agencies (eg. for DBT) and community services that will help dilute their identity as a person diagnosed with a Mental Illness. For example, they match their interests to activities such as therapeutic horsemanship, a running group or a Mountain Teen Project.
  5. Engage their parents, families and friends and anyone they would like to involve.
  6. Use technology if possible – MY3App.

I don’t think we have this service in the UK. I know we don’t.

The one thing that is most important to me and worth living for is … to continually express my love for Saagar and help other parents do the same for their kids.

Little things

Croydon, Berlin, Lebanon, Antrim and Troy, all within a few miles of each other. Yes. This is the New Hampshire (NH) part of New England. But the capital city of NH is not New London. It is Concord.

1.35 million inhabitants of NH live in 9,300 square miles.

9 million inhabitants of London live in 600 square miles.

It’s a different world. Time and space assume a different dimension here. They are both expansive. I have a sense of abundance and connection.

I have met nothing but kindness since I’ve been here. On the very first day, I was offered two lifts, one from Manchester airport (yes, they have a Manchester too) to Concord and then from my AirBnB house to the grocery shop and back. I have no car as I can’t trust myself to drive on the right (wrong) side of the road. I can literally hear the wires clanging and short-circuiting in my head as I watch the cars move on the roads.

Apples, maple syrup, random conversations with the locals on the street, excellent assistance in shops, witty Halloween decorations and the fall colours. Within the last week, a festival of colours has unravelled in all their glory. I don’t think any camera can do full justice to the drama of Orange, Yellow, Red, Terracotta and Green.

I have really noticed the small things. I spent yesterday morning cutting out small squares of felt in preparation for a community meeting at a small village school where they have recently lost a student to suicide. These pieces are for everyone who attends. They serve as tiny ‘blankies’, something for people to hold on to and fiddle with, to help them cope with the difficult conversations taking place in the room. I would have never thought of that.

When we got there, each table was decorated with twines, hydrangeas, little pumpkins and squashes to make the atmosphere a little bit festive. Warm and welcoming. Not too sad and drab. These little things made such a huge difference for everyone present.

On World Mental Health Day and every other day, let’s remember the little things. They are the big things.