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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)

Patients first.

Credit: Mario Sanchez Nevado (www.aegis-strife.net)

When I speak with gatherings of doctors, I often start with asking them to shout out whether they think the statements below are True or False. What do you think?

  • Sick doctors know when they are sick.
  • Doctors are good at asking for help and following advice.
  • Doctors take good care of themselves.
  • Doctors have strong support networks.
  • Doctors are kind to each other.   

Irrespective of which country I am in, without fail the auditoria flood up with a big resounding ‘FALSE’ for each of the above, accompanied with some sniggering. Isn’t it shocking? One would expect that people who work in ‘healthcare’ would know a thing or two about their own health as individuals and as a community.

These are the highlights of a survey conducted by the Royal College of Anaesthetists in 2016-17:

The NHS Sickness statistics consistently show that NHS hospital doctors have the lowest rate of sick leave as compared to any other staff group.  Here is a list of personality traits of doctors (a broad generalization, of course) that might explain this:

  • Perfectionism (I must do this right!)
  • Narcissism (I am good at what I do.)
  • Compulsiveness (I can’t give up till I finish.)
  • Denigration of vulnerabilities (If I need help, I am weak.)
  • Martyrdom (I care for my patients more than myself. Their needs come before mine.)

The very traits that make us good doctors are the ones that may not be very good for us. But our seniors have not been aware of this and hence they have not been able to help us understand ourselves. This tradition has been going on for generations of doctors. There is a nobility associated with such self-sacrifice, which we all have bought into. The fact is that if your own cup is empty, you cannot serve others well.

Things add up – a dysfunctional department, work pressures, lack of support outside work, ill-health, emotional burden of the job, a traumatic adverse incident, lack of sleep, fatigue, a complaint made against you, poor diet and no time to exercise or pursue hobbies, impaired judgement of one’s own symptoms, fear of letting others down, difficulty in admitting that they have a problem.

Burnout among medics is not unusual. It looks much like depression and sometimes ends in devastating tragedies. But help is available. Sadly, unlike other illnesses, for mental health issues, the onus of getting help lies with the sufferer. It takes courage to acknowledge one needs help and seek it out in good time. It might be the best thing a doctor can do for themselves and their patients.

Sources of support:

  1. https://www.bma.org.uk/advice/work-life-support/your-wellbeing/sources-of-support
  2. Doctors in Distress, a charity set up by Amandip Sidhu in memory of his brother Dr Jagdip Sidhu who was an eminent cardiologist and tragically died by suicide on 27th November 2018.

Me and Thee

Ron and Jeanette

The first time I saw Jeanette, she was acting in a play called ‘Hearing Things’ being staged at South London and Maudsley (SLaM) Hospital, where Saagar received (inadequate) treatment. The play was inspired by events and conversations from real ward rounds of patients with serious mental illnesses. It was written by the playwright often described by critics as the ‘English Chekhov’- Philip Osment, well known for giving a voice to those at the margins of society.

The play highlighted harsh facts through a story sensitively told. Just three actors  illuminated the wide swathes of blurred lines between sanity and insanity, between the healer and the ill, between strength and fragility. I learnt a lot from it. It was a powerful blast that left me thinking about my roles as an ordinary member of society, a doctor, a mother, a patient. It gave me an insight into how and why the system does and does not work. I thought it gave me a little peek into Saagar’s mind.  It certainly made me feel utterly close to him in an unearthly compassionate way.

A few weeks later I arranged to meet with Jeanette. I trusted her even before I knew her. She listened. We talked for a long time. She read the blog. I suggested a documentary. I spoke with some of Saagar’s friends and they wanted to participate. So was Si. We all had something to say. Ron and Jeanette filmed it last year.  

This year we aim to complete it and release it. We have a name – ‘1000 days’. We have found a suitable and brilliant editor. We need to find some platforms to showcase it and we will. We are working on a crowd-funding campaign which will be launched within the next 10 days. The intention is to make this world a kinder and more understanding place. Watch this space.

Many thanks in advance.

No shame. Just love.

Last week I met Matt. A young man, calmly determined to share his story and open up a rainbow that would envelop the world and knit it closer together. A story of a glorious love, a damning shame and a tragic unnecessary death.

Matt and Naz met in Birmingham in the year 2000 and instantly fell in love. Matt Ogston and Dr Nazim Mahmood. Both men. Men in love. They tried having a relationship in that city but knew that if they wanted to live like normal people doing normal things, they’d have to move away. So, they did. Over the next 13 years they built and lived a fulfilled and happy life together in London. All this time they managed to hide their gayness from Naz’s family as it was guaranteed to create unhappiness.

One weekend Naz needed to go back to Birmingham for a family event. The question of his sexuality came up and he spoke the truth. As expected, his family reacted badly. He was told that he was living in ‘sin’ and his ‘condition’ was treatable. I cannot imagine how he must have felt. Deeply humiliated I guess. That day he must have known that now, he could never be the man he was born to be. His love for his fiancé would always be seen as sin by others he deeply loved.

He returned to London. To Matt. Two days later he ended his life.

In his utter devastation, Matt found the determination to do what he could, to stop religion from getting in the way of love. He set up the Naz and Matt Foundation.

“Our mission is to never let religion, any religion, come in the way of the unconditional love between parents and their children.”

Molly. Oh Molly!

When I look back I can clearly see we were headed this way. But once again, it has taken the shocking death of 14 years old Molly Russell, to call the big bad media companies to account. They claim to be helpful and in some ways they are but their algorithms aren’t.

A few weeks back I was researching base-ball caps for a piece of writing and now I can’t log on to the internet without someone trying to sell me one such cap. I feel like I am being hounded, sitting alone in my study. It’s all about unabashed, indiscriminate, aggressive marketing. “We’ll give you want we think you want and more”, they scream.

In the last week of January, Ian Russell shook the media world by naming and blaming Instagram directly for making a major contribution to the death of his lovely Molly, by her own hands, in November 2017. Even after she had passed, she was being sent inappropriate images and material in response to her previous search for ‘Depression’ and ‘suicide’. The heart-break was written all over him. The very next week, Instagram was hauled up by the Parliament and its CEO agreed to take responsibility for removing and monitoring harmful content. Google and Facebook are yet to follow suit.

As indicated by this data from the ONS, there has been a worrying rise in female suicides, at either end of the age spectrum. The rise has been consistent in young women, 10 to 29 years of age, since 2013.

Screen Shot 2019-02-12 at 19.32.42

Last week, at the National Suicide Prevention Alliance Annual Conference, there was much discussion on the same subject. The minister for Suicide Prevention, Jackie Doyle-Price spoke briefly, trying to convince us that she would do everything she can to tackle the issue and we are watching. Like hawks.

 

9 days to go.

Why? How did we get here?
Why us? How can this be?
Why him? Such a sweet child!

How did it feel to be him at that point?
How did it get that bad?
Why could no one see it?
How could I be so blind to his pain?
Did he try to tell me in code?
Could I not hear his cryptic messages? Why?
Did he hide it? Was he trying to protect me?
Were there clues I missed?
How could all this be happening straight in my line of vision?

Is this a crazy practical joke? Fake news?
Could I just go back and rearrange events like my dressing table?
Did he tell anyone else? His friends? His hair-dresser?

Why did he say nothing to me?
Did he not trust me enough?
Did he think I loved him too much to bear hearing those words?
Did he think I loved him too little?
Did he think I wouldn’t understand? Would I have understood?
Would I have freaked out?

Did he think I’d be better off without him?
Did he have any idea how wrong that could be?

Was it a choice or a complete lack of choice?

How bad was his pain? How unbearable?
I want to stand where he stood.
I want to see what he saw.
I want to feel what he felt.
I want to experience what he experienced.
I want to go back there. NOW!!!

How much love does it take to keep someone alive? Why was mine not enough?

The annual festival of my beastly treacherous demons has begun.
Thank you Autumn.

Shauna’s Mum says

” A schoolgirl’s been murdered in our area. It’s a horrible, horrible thing to happen – never should have and is just another reminder of this shit world we live in. I’ve been trying not to follow the news on it but they released CCTV footage of her last known moments and it was actually somewhere my brother drives past on the school run four times a day so I did watch it all and check the timings to just make sure he wouldn’t have been there and possibly seen something. (Different time of day)

I’ve just been struck by how it’s pulled the community together. There’s been balloon releases, marches, leaflet drops – the mum is clearly being very much supported ….I couldn’t find one person willing to have a cup of tea with me; three years on I still can’t. And I know suicide is different. Murder is evil; what was done to this poor girl, there’s absolutely no doubt people should be outraged by it…and I know suicide is about making a decision – albeit a stupid and flawed one…. but there are things I don’t understand why they’re quite so different.

The Head teacher of the girl’s school implored students to come forward because answers were needed. We needed answers with Shauna and anyone at her school who knew anything got told it wasn’t an appropriate thing to discuss. We even had a girl go to her teacher with some information, get told off for it and then to choose to write independently to the Coroner’s Court (with info we found hugely relevant but was promptly disregarded.)

Today the girl’s school announced that they’ll be making a memorial garden for her with lots of nice words about there always being a place for her and her never being forgotten. Shauna’s name wasn’t even allowed to stay on the Year 11 hoodies. The gesture is nice but the words; it would have made such a difference to us if someone had said stuff like that to us.

There was just both girls of a similar age and it’s just really brought it home how differently people see these things. I’m glad this Mum has the support that she so desperately needs, I don’t begrudge her it – I just wish it wasn’t so glaringly different how people reacted – this Mum is a heroine because of what she’s had to endure, we’re just potentially neglectful parents who should be forgotten about/ignored 😦

I don’t know if I’m making any sense. Like I say I do understand it. It doesn’t stop it hurting though. 😦 “