Day 707

While the government in England aims to reduce the rate of suicide by 10% in 5 years, an independent charity ‘Contact’ (http://www.contactni.com/) in Northern Ireland (NI) holds the vision of creating a society free of suicide. Its mission statement is – ‘Getting you through the most difficult times.’

Here are the salient features of its manifesto for this year:

  1. Zero Suicide is the only target to aim for, the ultimate expression of our commitment to patient safety. Driving suicide to zero must commence with health and justice care systems, affirming the conviction that, ‘no one should die alone, in despair, by suicide’.
  2. All learning achieved from saving lives in our care must be urgently applied to community and family settings. Continuity of care at crisis point must ensure critical real-time information sharing agreed by memorandum of understanding, investing in robust multi-agency relationships, applying 24/7 ‘air traffic control’, gold standard patient safety quality assurance for everyone in our care.
  3. No wrong door – every patient at risk of suicide must receive comprehensive clinical assessment and safety plan at first point of contact (including family/ loved ones, GP and crisis clinical support), testing safety plan relevance on every subsequent contact.
  4. No wrong door at times of crisis. Perfect crisis care requires 100% commitment to a ‘no blame’ culture, championed by accessible, visible and competent corporate leadership accountability – with immediate learning from honest mistakes celebrated as opportunities to achieve continuous service improvement excellence.
  5. Civic leadership must invest in competent, courageous suicide prevention championship, encouraging compassionate understanding while promoting courageous lived experience voices of hope and recovery.
  6. A regional Suicide Prevention Standing Conference to celebrate what works and drive the zero suicide challenge. If suicide is preventable, then NI health and justice systems have a unique opportunity and compelling obligation to provide world-class suicide prevention integrated care, from crisis-point, to stabilisation and recovery, with a renewed, ambitious, relentless resolve to drive the NI suicide death rate down, establishing NI as the safest-from-suicide region in the UK and Ireland within the next five years. Every suicide is preventable until the last moment of life.

Belfast was home for 7 years. Saagar was there from the ages of 5 to 12. He did a fantastic ‘norn-irish’ accent! I never thought I would be going back there to participate in a Suicide Prevention Conference but in November I am.

Day 706

On some days the words come tumbling on to the page and arrange themselves exactly the way I want them to. Other times, they need coaxing, cajoling and persuading. They need a stage or a platform to be able to show up.
I sit down to write with my laptop at the kitchen table and notice that the sink has a tea cup and a tea spoon in it. Well, better wash them up before starting. Just then Milkshake comes in through the cat-flap looking very hungry! Got to feed him now. Look, the cushions are all over the place. Better fluff them up and sit them properly. Oh, the flowers and vases look a bit tired and dirty respectively. The water needs changed, dead heads discarded and the stems need trimmed down an inch or so. Nice! While I am at it, let me just quickly water the plants as well. May be add a bit of plant food too. I think the clothes are washed. This is a good time to move them to the drier. Oh! The drier already has dried clothes in it. Let me just sort them out while I can. That reminds me, there is dry-cleaning due for collection. Well, may be another time.
Right now I really need to write. But before that, I think a cup of mint tea would be really nice. I open the fridge to get some mint leaves and I find a box of strawberries. Let me just stem and halve these berries while the kettle is boiling. Si would love to have them after dinner. That done, I notice the land-line phone flashing at me. Let me just check the answer phone messages while the tea is brewing. What a lovely surprise to hear from a dear old friend in America. Can’t wait to catch up with her again. The time is about right, considering the difference in time zones. Shall I call her after finishing the writing?

May be just a quick call.

© Procastinators : Leaders of tomorrow. Or the day after.

 

Day 705

2637237-main_image

Sometimes the strangest events stick in one’s memory. One such moment is the one when I fell in love with Brad Pitt. The one and only Miss Oprah Winfrey interviewed him on her show and asked him,
“What is your favourite age or time in your life?”
“Right now” said he.
(Ref : https://www.youtube.com/watch?v=a1lfPp-ZgDg)

Mrs Smith files for divorce.
6 children, the true victims.
Being born into show biz is risky enough.
A custody battle on top!

Children brought up by single parents and in step families are three times more likely to suffer from mental health problems according to the Millenium Cohort Study, one of the largest longitudinal studies carried out on more than 10,000 kids in the UK. It collected and analysed information on various aspects of lives of children such as schooling, housing, parental marital status, employment and education.

(Source: http://www.cls.ioe.ac.uk/page.aspx?&sitesectionid=1330&sitesectiontitle=MCS+age+11+initial+findings)

It found that those brought up by both natural parents are far less likely to suffer severe emotional and behavioural problems. Experts said the findings added to “a mountain of evidence” about the damage caused to kids by the stress of family breakdowns.

Overall, 6.6 per cent of children living with both natural parents were found to have severe mental health problems, compared with 15 per cent of those living with single parents and 18 per cent of those living in step-families. Higher levels of mental health problems were found among boys, who were more likely than girls to suffer from conduct problems, hyperactivity and inattention.

Good luck dear Smith-lets! Look after each other. xxx

Day 704

I love Mondays!
Yes. I did get strange looks when I made this declaration at work one time. But it is true and I don’t feel like a sad old soul for saying it.

Today is a Monday but I don’t like it. After being here for 5 lovely weeks, my parents left for India this afternoon. I got back to an empty house after all these weeks of coming home to beautiful aromas emanating from the kitchen and a nice cup of tea with them. This evening the house was dead quiet and I went straight to bed.

Not having them at the dinner table was really sad, especially because Mum had cooked our favourite okra dish for dinner before she left. They left the house filled with colourful lilies and chrysanthemums!

I feel envious of my friends when they say – ‘I am going for lunch with my mum’ or ‘we are going to see our folks this weekend’. I can’t do these things normally as my folks live more than 4000 miles away. But it’s been party-time everyday they’ve been here. We’ve had a great time together and I am very grateful for every second of it.

Good byes are always hard but now, more so than before.

Day 703

If music be the food of love, play on…

Listening to the melodic sound waves coming from the vocal cords, strings and drums on stage was exquisitely pleasurable but my mind was trying to understand it. How many beats in this rhythm? What raga? Which set of notes? Whose composition? And so on… I was struggling to ‘know about’ it instead of relaxing and allowing it to reach my heart.

It was time to do nothing but feel the music. Immerse myself in it. After a while I was not there any more. All that was left of me was the tingling in my ear-lobes, the tapping of my fingers and toes, the goose-bumps on my skin, the tidal waves of love in my heart, the surges of pathos in my being, the soothing meditative calmness in my mind, the slow joyous breaths in my chest, the merging of the tunes with me, the submergence of my self in the sea of harmony, in perfect unison with it, whole and complete, pure and pristine, flowing, dancing, drowning …

“Oh Khusrau, the river of love
Runs in strange directions.
One who jumps into it drowns,
And one who drowns, gets across.”

Amir Khusrao (https://allpoetry.com/Amir-Khusro)

775big-1

 

Day 702

In one month it will be 2 years since Saagar’s time on this planet came to an end. I don’t want that date to arrive. I am absolutely dreading it. I remember when Saagar was coming close to finishing school, the thought of him going off to university made me feel terribly sad, almost panicked, knowing it was bound to happen. It’s the same feeling, only different. Another year! Another slot of time. A longer gap between him and me, more distance between the time when he lived and now. More fade. More erosion.

This evening we attended a unique black-tie event – a dinner/dance to honour and celebrate Ruth’s life. She was only 44 when she got tired of her Bipolar Disorder. She had suffered with it for most of her adult life. Her friends and family got together and had a great big fun party for her. It was a happy event. I have never met Ruth but her Mum and I have a unique bond. It felt special to be there with Si and my parents. I felt deep gratitude for all these lovely people in my life. All the proceeds went to the charity Mind.

The same adjectives I use to describe Saagar were used  to describe Ruth. She was actively involved in amateur theatre and her gorgeous photographs from various productions were displayed for our pleasure – Kismet, Sweet Charity, South Pacific and Oliver. Her twinkling eyes and cheeky smile sparkled through every photograph.

“Mem’ries light the corners of my mind
Misty water-colour mem’ries of the way we were
Scatterred pictures of the smiles we left behind
Smiles we gave to one another for the way we were
Can it be that it was all so simple then
Or has time re-written ev’ry line?
If we had the chance to do it all again
Tell me, would we? Could we?
Mem’ries may be beautiful yet
What’s too painful to remember
We simply choose to forget
So it’s the laughter we will remember
Whenever we remember
The way we were… the way we were…”

The way we were from ‘The way we were’.

Bless you Ruthy!

Bless you Saagar!

Day 701

img94joktmu72618

Today I attended a Mind-Body Interface Conference at the Royal College of Physicians. I have no idea why I enrolled for it. I am attracted to any event that might deepen my understanding of the magicians that work with the intricate workings of the mind. This was the first conference of my career where I did not know anyone at all. I had no idea what the trade stalls were talking about and I felt like an alien. Yet, in the breaks I had insightful conversations with a GP, a mental health nurse who is now a Resuscitation lead in his hospital and a child psychologist.

I learnt from the experts about the relationship of mental illness with cannabis, tobacco, functional neurological syndromes, diabetes, Obstructive Sleep Apnoea, Restless leg Syndrome, Insomnia. There was also a very descriptive talk on emergency management of Anorexia Nervosa. It was all very interesting but my intellectual mind and emotional mind were in constant battle with each other giving me a severe headache. It brought up more questions about Saagar. The idealistic solutions proposed by some gave me an insight into how far the theory is from the practical realities of life like poor funding and poor access to specialist services.

Being there made me really angry at GMC’s decision to not carry on with investigations into Saagar’s death in any detail. They seem to think everyone did their job properly. If that is the case, how did he die within weeks of his diagnosis?

In medicine it is a common teaching that when we treat someone, we should make decisions guided by what we would do if the patient was a dear one of ours. I wonder if the Examiners at the GMC apply that principle to themselves while taking decisions – how deeply would I investigate if this damaged/deceased young man was my child?

Day 700

When our GP heard of Saagar’s death, the first phone call he made was to the Medical Defence Union and they advised him not to call us. Despite having known us for more than 7 years and seeing Saagar every 2 weeks with us for the last few months of his life, he did not call us on his death.

A qualitative study of GPs’ experiences of dealing with parents bereaved by suicide by Emily Foggin et al was published last month in the British Journal of General Practise.

It acknowledged that bereavement by suicide is a risk factor for suicide but the needs of those bereaved by suicide have not been addressed and little is known about how GPs support these patients, and how they deal with this aspect of their work. 13 GPs in the UK were interviewed in a semi-structured format. It explored experiences of dealing with suicide and bereavement.

GPs disclosed low confidence in dealing with suicide and an unpreparedness to face parents bereaved by suicide. Some GPs described guilt surrounding the suicide, and a reluctance to initiate contact with the bereaved parents. GPs talked of their duty to care for the bereaved patients, but admitted difficulties in knowing what to do, particularly in the perceived absence of other services. GPs reflected on the impact of the suicide on themselves and described a lack of support or supervision.

It concluded that GPs need to feel confident and competent to support parents bereaved by suicide. Although this may be facilitated through training initiatives, and accessible services to refer parents to, GPs also require formal support and supervision, particularly around significant events such as suicide. Results from this qualitative study have informed the development of evidence-based suicide bereavement training for health professionals.

Ref : http://bjgp.org/content/early/2016/08/15/bjgp16X686605

This evening a vigil was held by SOBS (Survivors Of Bereavement by Suicide) at Hyde Park to remember those lost through suicide. Some of the people there had lost a brother 25 years ago or a sister 5 years ago or a friend 1 year ago and so on. Some of the families had not been able to speak about it for many years. Others had kept quiet as they were not sure if anyone would understand. But in that space, we sat together on the brownish-green grass with the pictures of our loved ones and lit candles in their memory and we opened our hearts. For about 2 hours we claimed that space and made it our own knowing full well that we are being listened to and perfectly well understood. What a rare gift that is!

When it comes to suicide, post-vention is pre-vention.

 

Day 699

Remember me

Remember me when I am gone away
Gone far away into the silent land
When you can no more hold me by the hand
Nor I half turn to go yet turning stay
Remember me when no more day by day
You tell me of our future that you planned
Only remember me, you understand
It will be late to counsel then or pray.
Yet if you should forget me for a while
And afterwards remember, do not grieve:
For if the darkness and corruption leave
A vestige of the thoughts that once I had,
Better by far you should forget and smile
Than that you should remember and be sad.

– Christina Rosetti

You are never gone too far away to be forgotten.
The beauty of your soul fills me with inspiration.
It is never too late for love and prayers.
For hope and kindness to dispel despairs.
One day grief and love together will stay
Without me pushing either of them away.
Learn to smile through tears I will.
The joy you brought stays with me still.
And always will.

-Me.

Day 698

“Take care of your feet” has been the resounding advice and part of best wishes from all my friends and colleagues over the past few days, on hearing of the upcoming long walk. Guess what. All that distance and not a single blister. Regular trainers. Nothing fancy. Regular hiking socks and lots of ‘compede’ in the bag but none on the feet. My feet just don’t blister. Must be my thick skin!

Before the walk, I didn’t think I could do it.
Before Saagar passed away, I didn’t know I could survive it.
After the walk, I know I can even though at times it seemed impossible to go on.
Nearly 2 years after Saagar, I know I can, even though at times it seems impossible to go on.

Both of these experiences, while not comparable, took me right outside my comfort zone and put me in a very vulnerable and painful place. And I am still here, learning new things about myself and the world around me everyday.

A young man from Scotland survived a serious suicide attempt in May 2015. He suffers with depression. He is now cycling around the world to raise awareness of mental health and suicide prevention. His journey will take him to 80 countries on 6 continents. He calls himself ‘The Tartan Explorer’  (http://tartanexplorer.com/) and his name is Josh Quigley. Good luck young man!

screen-shot-2016-09-13-at-23-03-27