It's not coming home

Well, it was definitely Spain's day on Sunday, wasn't it? with triumph at Wimbledon in the afternoon and in Berlin in the evening.

 

I must confess I don't miss all the hype and hysteria surrounding our poor footballers, trying to win 'the first trophy on foreign soil', as the media never tired of telling us. And I was quite grateful not to have been woken by celebrating drinkers pouring out of The Bay Tree in the late or early hours. 

Someone close to me observed that the excitement seemed a trifle excessive because it was 'only the European Cup'! I took their point, but then I'm old enough to remember the 1966 World Cup. Indeed I remember exactly where I was when the result came through, not in the UK in order to witness Kenneth Wolstenholme's famous commentary, 'They think it's all over.... It is now.' Is it possible today, I wonder, for anyone to score a hat-trick at international level? Because that's what we need - not just England, but generally. I heard Chris Sutton talking of 'the beautiful game' of which he said, in contrast to England, Spain was an exponent. The English team certainly has a handful of very skilful footballers, but they, in company with most highly paid male players, do not play beautifully. 

I have some suggestions to restore the beauty to the game:

• Get rid of VAR (Video assistant referee)! I've written about the difference that would make before: see here VAR. It makes for more grown-up sportmanship.

• Give yellow cards for shirt-tugging, tripping and diving;

• Red cards for dissent, i.e. disputing the referee's decisions, and for professional fouls, i.e. cynical fouls designed to prevent possible goals.

• And off the field more generally don't pay already wealthy players to don the national shirt. To have our teams appearing simply for the privilege of representing the nation, or even - dare I suggest? - for the love of their country, would prevent them being mercenaries but afford them a genuine reason for respect, and even possibly to merit, win or lose, the award of one of those absurdly coveted minor honours of imperial days. If that's not good enough for one of our 'star' players, too bad. No one is indispensable.

Talking of honours, it does seem to me that Gareth Southgate has been the best manager of the England team since Sir Alf Ramsey, who managed his team to World Cup victory in 1966. Whether or not he chooses to remain in post for another two years, he for one deserves recognition for his contribution to the game (and beyond) in this country. 

PS Sadly, I see that he has now resigned. Well, I suppose that like Jürgen Klopp he has been wise, having restored his team's fortunes, in taking a break from the almost unendurable pressure placed on managers by media and public alike. 

PPS How absurd for example for fans to spend tens of thousands of pounds, as I gather some did, to obtain a ticket to watch the match - and how wicked of touts to exploit such misplaced dedication!

A very wise woman

Well, as I promised myself in February ('ITV, please repeat Breathtaking'), I have now read Rachel Clarke's wonderful and moving book Dear Life. It is what its subtitle says, 'a doctor's story of love and loss'. As a hospital doctor, she chose to specialise in palliative care. As someone said, she's the kind of doctor we'd all want at our sides when we're dying. Her profession is truly put to the test when her dearly loved father, a local GP of the old school, who is her inspiration, is diagnosed with terminal cancer. Her account is both heartbreaking and life-affirming. Significantly, she chooses to keep her counsel on the vexed subject of assisted dying - as does the subject of this piece, Dr Kathryn Mannix.

I first came across Dr Mannix, when she gave a very short talk on BBC Radio 4 in 2018. Her title was 'Dying is not as bad as you think'. It was a simple description of the normal process of dying - and it was not as bad I'd thought. If you've not heard it, it's certainly worth listening to. A few weeks ago she gave an interview to a Financial Times journalist, Emma Jacobs, in which she talked about herself, her books and about "ordinary dying". It's so much about the listening. Of course the journalist brings up the hot topic of assisted dying. I've previously commented on Esther Rantzen joining the advocates of legalising assisted suicide. She's since been joined by Keir Starmer, and most recently by Bake-Off judge, Prue Leith. Dr Mannix is more circumspect:

"Mannix fears for the texture of the debate. 'We can be opponents about an issue and agree with far more than we disagree about, but the point on which we disagree is so important to us . . . Increasingly [political debate] is about point-scoring.' It means that we fail to include nuanced conversations on palliative, social and healthcare. 'We’re not hearing any of that. We’re just having a ding-dong about where the law sits.'” She particularly fears for the sick and the elderly, who might have their peace of mind destroyed every day with the thought they are yet again being a burden to their family. (And I would add an unwanted expense to the state as well.) As her BBC talk taught me, dying is not as bad we are given to think. 

More recently she's given a very personal interview in the BBC Outlook programme:
https://www.bbc.co.uk/sounds/play/w3ct4r4d. Listen to it! It's very reminiscent of Rachel Clarke's Dear Life. And it's magnificent.

"There’s something sad about the idea that the only way we can help [make] dying better is to be dead." Ordinary dying is even better. What wisdom!

An electoral dilemma

As my readers will have gathered, I have reservations concerning legalising assisted suicide. At the last general election, at our local hustings I asked the candidates their views. Rather uninterestingly, all four of them agreed with the idea that people should be able to choose the time of their death, when they were in terminal pain. 

😏😎😌🙊

That didn't help me decide, and so I voted with my old inclinations. However the urbane Conservative, David Johnstone, was comfortably elected. But if the same is true this time, I shall face a dilemma. In the wake of Esther Rantzen's comments, Sir Keir Starmer, who is likely to the next Prime Minister, declared that he would give some government time for a private members' bill to legalise assisted dying. And so I wrote to the leader of the opposition.

"Dear Sir Keir

"I had hoped to kick the Tories out of this true blue constituency and vote in a Labour candidate, as I believed was achievable.  I was at one time a member of the Labour Party when it espoused truly socialist values and policies.  However your latest pronouncement that you would make government time available for a private member’s bill and that you were yourself in favour of legalising assisted dying/suicide has been the final straw for me. 

"I clearly don’t know where our election candidates will stand on the issue, though I know our present MP’s views, but I view a change in the law dangerous, both from the precedence set in other jurisdictions and the pressures it would put on the vulnerable, and a betrayal of our past record of upholding the sanctity of life.  I know you won’t change your mind in an election year when polling (which depends on the framing of the question - for example ‘Would you prefer a Labour or a Conservative government?’) seems to indicate a majority of voters sharing your view. 

"So, anyway, regretfully, I’m writing to inform you that you have lost at least one vote here. 

"By the way I have Motor Neurone Disease.

"Yours sincerely..."

 

I wonder what the Reform UK Party's policy about it is...!

ITV, please repeat 'Breathtaking'

All photos ITV

Last night, we watched the final episode of Breathtaking, the three-part docudrama based on Dr Rachel Clarke's memoir of being a hospital doctor during the Covid pandemic. Joanne Froggatt gives a tour de force performance as Dr Abbey Henderson, an acute medicine consultant, from meeting the new coronavirus for the first time until the first roll-out of vaccines. Somehow she expresses the whole gamut of emotions mostly with a mask covering half her face and often with a visor as well.

There are very short counter bursts of complacent politicians (such as a Prime Minister announcing he wouldn't stop shaking people's hands, and a smiling Chancellor handing out dishes in a restaurant at the announcement of the "Eat out to help out" scheme) blandly pronouncing that everything is under control while we watch the continuing reality of the situation in the hospital wards. 

(The following paragraph has a number of plot spoilers, and so if you've not watched it you may wish to skip it, though the real thing is infinitely more powerful and moving.) This episode had many scenes which stick in my mind. For example, Ant, the registrar, pleading by phone with his vulnerable mother to stay at home until she can get the promised vaccine, and her regurgitating social media stories of the mythical disease, empty hospitals and dangerous vaccines; and later Abbey running the gauntlet of shouting and spitting Covid-deniers at the hospital doors on her home after an emotional and exhausting shift. Then there was the scene of Emma, a student doctor, whom Abbey finds crouching in emotional collapse and the two of them together silently sharing their intolerable grief. There's the scene of Abbey smoothing the brow of a dying terrified patient, and of her having to explain to the husband of a Covid patient with MS that if she deteriorates her preexisting conditions means she won't be moved to Intensive Care (on the assumption that her chances of recovery are compromised - thank God I was spared that, I thought). At other times we see her desperately and furiously arguing with the administrator and senior doctors hidebound by NHS and Government rules and guidelines, and later we witness her whistleblowing radio interview in which she reveals the real situation in hospital dealing with Covid and risks disclosing her name and job. 

What are my abiding reactions and conclusions? First it was one of gratitude to Rachel Clarke for writing her memories and for creating the drama with Jed Mercurio, and to ITV for broadcasting it. More it was of overwhelming gratitude to the doctors and nurses of the NHS in whose debt we were and remain. It was eye-opening to see the reality of life inside a hospital during a prolonged emergency - from the staff point of view. It was heart-breaking (yes, I did cry) to witness the stresses and the sacrifices made on doctors and nurses. Having watched all the episodes, I do wish that everyone, including MPs, would watch it and give our medics the honour and reward that they are due. I trust that ITV will broadcast it again - perhaps when the Covid Inquiry publishes its findings, or when it is next in the news. Lastly, I intend to read Breathtaking myself and Rachel Clarke's other books.

A clarification

I was upset today to find an email thanking me for "speaking out so clearly" "in the Christian institute’s weekly email". I don't remember speaking to them, I thought. And so I looked them up on line. I hadn't spoken to them. And if they had asked me to comment on the subject of assisted dying, I would probably have politely declined.

Why?

First of all, it is, I understand, basic journalistic courtesy to ask an individual before you name them in a story. And I wasn't approached. Secondly, examining the Christian Institute's website confirmed to me what I vaguely recalled, i.e. that it campaigns on certain issues with which I am not in sympathy and represents an extremely conservative type of Christianity which I no longer hold, if I ever did. For one example, it appears homophobic, which for me is the antithesis of the Christian good news - which this weekend we celebrate is for all people. I suspect that I could not in all conscience subscribe to all its tenets.

However I do acknowledge that I wrote a letter to the Guardian on the subject of assisted suicide and therefore put my views in the public domain, as they are also, of course, on my blog. So I can't complain, but simply dissociate my views from those of the Christian Institute - and hope that if they ever want to quote me again they are polite enough to contact me first.

Where is love?

Mike Chapman 'Christ Child'

 

HOLY INNOCENTS DAY

The first words we were taught in Latin
Were amo, amas, amat, amamus, amatis, amant:
Verb, transitive; meaning love.
Outside the church on Trafalgar Square
Stands a great block of Portland Stone
With a carved new-born baby soft and smooth
Lying not in Christmas card manger
But on a rough bed of rock.

Round the plinth is inscribed:
‘In the beginning was the word…
And the word became flesh
And dwelt among us’.
Look once more at the naked baby
His cord has not even been cut
He lies without defences and alone
Can this truly be the Word made flesh?

Naked new borns lie in Mariupol’s wreckage
Mothers weep for their Infants in al-Shifa
With ash grey dust their only shroud
‘What kind of a country is afraid of hospitals
and maternity wards and destroys them?’
Is it leaders lusting to unleash
Their fear full fury while they can?
Wounded they see not neighbour but stranger,

Not brother but alien, animal, pest
To be butchered, mortared, missiled from our land.
We are the chosen inhabitants of this place
Pity we can’t afford, we dare not open our eyes
To the mothers drowning in agony
To children scraping away the rubble
Wailing for lost baby brother Isa
Loved in Gaza’s hell. Are you here, Emmanuel?

28th December 2023

What do you think of Esther?

"What do you make of Esther Rantzen?" asked my brother.

I knew what he was talking about, as no doubt all listeners of Radio 4's Today Programme would have done. Clearly the advocates of assisted dying, or specifically suicide, have launched the next round of their campaign, even enlisting the late Diana Rigg, whose resemblance to my wife was once commented on by an old welsh policemen, as a witness. The Today Programme devoted a great deal of airtime to the subject on a number of days. My reply to my brother was that I thought it was a good thing if we were more open about the subject of death and dying. After all they are events everyone without exception will come in contact with at some point or another. So the sooner we stop treating it as a taboo subject the better. However the dangers of legalising assisted suicide, are proved by places like Canada and Belgium.

In January this year I made a submission to the Parliamentary Health and Social Care Committee consultation on Assisted dying/assisted suicide:

"I am writing as an individual who was diagnosed with a rare form of Motor Neurone Disease twenty-two years ago and who has experienced the condition’s relentless deterioration since then. There are a number of my contemporaries who have survived that long. That, and witnessing the ravages of the disease on friends in our local MNDA branch plus an Ethics qualification from Oxford, is the extent of my expertise.

"My first observation is how positively my contemporaries, with short or longer prognoses, with the disease seize hold of life. Clearly there are some who, like Rob Burrows, devote themselves to fund-raising and creating awareness; while others enjoy the opportunities of life that come their way. What might have seemed a death sentence has proved a challenge to live.

"Secondly, I have recently discovered myself how expert professional care can enhance what is often portrayed as undignified dependence. Good caring can in fact add to quality of life. The sad thing however is that it is not something which the state will normally provide. Along with terminal palliative care, domestic social care must surely be a spending priority for any government that cares about the well-being of all its citizens. I’m fortunate to live an area of excellent MND provision and good, though not abundant, palliative care. But I understand that this is not equally spread through the country. If it were, I suspect it would reduce the fear of dying which must be a major motivator for assistance to ending one’s life.

"Ironically, in MND, according to the Association’s information sheet, How will I die?, those fears are greatly exaggerated: ‘In reality, most people with MND have a peaceful death. The final stages of MND will usually involve gradual weakening of the breathing muscles and increasing sleepiness. This is usually the cause of death, either because of an infection or because the muscles stop working.

‘Specialist palliative care supports quality of life through symptom control. practical help, medication to ease symptoms and emotional support for you and your family.

‘When breathing becomes weaker, you may feel breathless and this can be distressing. However, your health care professionals can provide support to reduce anxiety.

‘You can also receive medication to ease symptoms throughout the course of the disease, not just in the later stages. If you have any concerns about the way medication will affect you, ask the professionals who are supporting you for guidance.

‘Further weakening of the muscles involved in breathing will cause tiredness and increasing sleepiness. Over a period of time, which can be hours, days or weeks, your breathing is likely to become shallower. This usually leads to reduced consciousness, so that death comes peacefully as breathing slowly reduces and eventually stops’ (EOL5-How-will-I-die-2018, rev 2021).

"So this is a third and subtle danger of legalising assisted dying/suicide. It would increase people’s fear of the inevitable fact of death and dying. I think this can be one factor in explaining why, in jurisdictions which have introduced it, we see it being extended beyond the first strict limits. It is held out as an answer to this fearful fact, death, whereas in fact death and dying should be talked about in realistic terms, as normal, as concisely outlined by Dr Kathryn Mannix (https://www.bbc.co.uk/ideas/videos/dying-is-not-as-bad-as-you-think/p062m0xt). As she says, normally dying isn’t as bad as we think.

If the government should be doing anything, the first thing it might well do, is to promote informed education about dying of the sort exemplified by specialists such as Dr Mannix, as well as adequately funding her former specialism of palliative care. It should start with schools’ curricula. After all every child will have encountered death at some stage.

Fourthly, the dangers of coercion, in my experience, are not so much external as internal. It’s often rightly observed that prolonged pain is worse for the engaged spectator than for the sufferer. If you care for someone, seeing them struggling is barely tolerable. You may wish to see their struggle over, but underlying that wish is your own desire to be spared more of your own horror show. The person who is ‘suffering’ however has that EOL5-How-will-I-die-2018, rev 2021 strong survival instinct, common to all humans, and is more concentrated on living than dying. Having said that, when you are depressed, as might be natural, that instinct gets temporarily eclipsed. Then you need protection from your own dark sky. It is at such times that your other inner demons emerge: your sense of being a burden - to your family, to your friends (if you have any), to the NHS and to the state purse; your fear of losing your savings and of leaving nothing to your loved ones; your fear of pain and of dying (exaggerated by popular mythology), and your sense of suffering, heightened by your depression. 

"For most of us with long incurable diseases, it’s these internal perceptions that are most coercive, although they can be easily compounded or even exploited from outside. I don’t see any way to protect us from such coercion, internal or external, except to demonstrate through legislation that every life, however tenuous, is equally important to our society and worth caring for. ‘Any man’s death diminishes me...’ and so we will value it to the end."

I'm grateful that when I received my 'motor neurone disorder' diagnosis, which was initially frightening, I couldn't be tempted to opt for an early death. Instead of one Christmas with my family (as I warned them), I've enjoyed 22 more Christmases. That was the law against suicide fulfilling its safeguarding function, protecting the vulnerable, as I was then. Contrary to my preconceptions, my form of MND (PLS) is very gradual and I've been able to live a full if increasingly limited life, thanks to my wife, Jane, who cares for me 100% 24 hours a day seven days a week. 

My view is still that legalising assisted dying/suicide has more cons than pros. The better choice is to invest in hospice and palliative care, so that everyone may have access to pain and symptom care in the last years of their life.