Rachels' books

To Pete, Jane & Evelyn

I've recently had a birthday, and among the very lovely presents I was given were two books by authors whose Christian names (or forenames, as we're meant to call them now) are both Rachel. They both, for different reasons, captivated me - which you can tell because I who these days am a slow reader read them quickly.

The first is The Music Shop by Rachel Joyce, whose other novels (The Unlikely Pilgrimage of Harold Fry and The Love Song of Queenie Hennessy) I also recommend. It is primarily set in 1988, with the final chapters 20 years later. The story revolves around the single-minded, arguably obsessive, Frank for whom the only worthwhile form of recorded music is vinyl and his shop in a run-down cul-de-sac in a cathedral city which is itself depressed and still bears the scars of wartime bombing. The remaining shops in the street are a florist, a Polish baker, an undertakers', a tattooist, a Catholic souvenir shop, and Frank's music shop. On the other side of the street are terraced houses in various states of disrepair.

All the while there are threats from a development company and racist gangs. It is a picture of a community under pressure from progressive and reactionary forces.

Frank is no musician, but he has inherited from his Bohemian mother both a love of music and a fear of relationship. However he has a unique gift - the ability to hear instantly what music every person needs. His world and the life of the street is profoundly changed when a woman in a green coat collapses unconscious outside the music shop. All the characters in the book have their own back-stories and carry their own scars. I won't spoil the plot, but content myself with saying that, as with Rachel Joyce's other books, it is ultimately hopeful and carries a message that redemption is possible though hard won.

At the moment Jane is reading it. I shall be interested to hear whether she was as captivated as I was.

The other book, which arrived out of the blue from my least "respectable" cousin, is Evolving in Monkey Town (now retitled Faith Unravelled). What a gift! It's by Rachel Held Evans (from whose blog I've previously quoted : Pain in the Offering). It's not a new book, published in 2010. It recounts her growing up in the southern states of America, and in particular Dayton, Tennessee, where her father went to teach theology in the conservative Bryan College. For one thing, she is an excellent writer. Dayton was the site of the famous 'Scopes Monkey Trial', staged to draw publicity to the small town. In 1925 John T Scopes, a secondary teacher, was prosecuted by the state for teaching evolution in a state school. The whole thing turned into a debate between 'Modernism' and 'Fundamentalism', between creationism and evolution, and gained worldwide notoriety.

This Rachel tells how she developed from knowing all the right Christian answers to sceptics' and seekers' questions to being open to accept the mystery of faith. She ends, "If there's one thing I know for sure, it's that serious doubt - the kind that leads to despair - begins not when we start asking God questions but when, out of fear, we stop. In our darkest hours of confusion and in our most glorious moments of clarity, we remain curious but dependent little children, tugging frantically at God's outstretched hands and pleading with every question and every prayer and every tantrum we can muster, 'We want to have a conversation with you!'

"God must really love us, because he always answers with such long stories."

I found the book invigorating and liberating. It helped me to understand my own journey and myself. As I commented to a friend who asked me how my summer had been: I suppose what reading Rachel’s book helped me see was, a. that I wasn’t a freak and b. that I do still have faith - which has been a considerable relief and a sort of liberation. My doubts and questions are by no means fatal. Phew!

Give Gatlin a break

I suspect a lot of people, including journalists, will be very surprised at whom they see welcomed to heaven. As Shakespeare has Portia declaring, mercy is an attribute of God himself. Therefore,
"Though justice be thy plea, consider this,
That, in the course of justice, none of us
Should see salvation: we do pray for mercy;
And that same prayer doth teach us all to render
The deeds of mercy."

On Saturday evening, after watching a football match which proved that women's sport could be just as good as men's (pace Dominic Lawson), we caught the World Athletics 100 metre final and witnessed both the best and worst of responses to a race. You'll scarcely need telling that Justin Gatlin came first, followed by a whisker by Christian Coleman and Usain Bolt. People were understandably disappointed that the extrovert and brilliant Bolt hadn't won his final competitive race. However, the tragic thing was that apart from Bolt and Coleman no one had the grace to congratulate Gatlin. The London crowd booed and the commentators prefixed his name with some qualification like "twice banned drug cheat" Gatlin. That was repeated in every subsequent news report I heard on the BBC, and I gather that the booing was repeated at the medal ceremony. I don't condone drug-taking to enhance performance, not that I have illusions that my opinion matters! Nor do I doubt that in one way or another it's more prevalent than we're told. But is it even true?

Photo: Telegraph online

However he had served his sentence and, without doubt, is now as rigorously tested for illegal doping as any athlete on earth. Bolt was magnanimous in defeat. He after all came third. The general view seems to be that he had not recovered his previous Olympic form and so overtook Coleman in neither the semi- nor the final. Gatlin, meanwhile, surpassed himself achieving his season's best when it mattered. But the British public, egged on by the media, is an unforgiving animal. Maria Sharapova has been similarly branded for her use of a newly banned drug. And Chris Froome, the gritty Kenyan/British cyclist, fails to receive the plaudits he deserves, partly, in my view, because of Sky Cycling's dubious history in the pharmaceutical department.

And so we have the sad spectacle of athletes who have served their sentences for past misdemeanours branded as cheats. There is, it seems, no room for redemption. Justin Gatlin, as well as striving for the top, has also been spending his time educating young Americans about the folly and danger of doping. For a very informative article on the facts of case, I recommend this short account from one of our top sports lawyers: Mike Morgan, Gatling Article, which leads me to question the very word, "Cheat" - which is frequently used. It seems to verge on the libellous. Even so, as Gatling himself has said this weekend: “I’ve served my time and done community service. I’ve talked to kids and inspire them to walk the right path. That’s all I can do. Society does that with people who make mistakes and I hope that track and field does that too.”

So why, I wonder, are we so slow to acknowledge that a debt can be paid? I suspect it might be because we lack the divine quality of mercy. Which according to Portia is bad news for all of us. If we don't have it, what call can we have on mercy dropping as the gentle dew from heaven? We run the danger of a life and death ban.

PS I've just seen the latest news that Sara Errani, the Italian who reached the Paris Open Tennis final, has been suspended for an absurd drugs offence which seems to have been caused by entirely accidental food contamination (http://www.bbc.co.uk/sport/tennis/40854182). Bonkers.

Women at work

I was a bit disturbed this morning listening to World Business, I think, on BBC’s World Service. They were talking about women at work, things like the gender pay-gap, maternity/paternity leave, and the small proportion of women on company boards. Sweden was focused on as the “best” for women at work.

The assumption was of course that good = being in remunerated employment. Now far from disagreeing with that, I think that the opportunity to do a fair day’s work for a fair day’s pay is highly desirable for everyone, women and men. But it is not the only good. That is a modern and harmful fallacy.

What most struck me was a comment about bringing up a family at home being “drudgery”. Drudgery? Hard work – certainly. But as Jane pointed out to me, nearly all work has an element of drudgery in it. Sitting in front of computer screens. Answering phone-calls in a call centre. A production line. Agricultural labour. Even the caring professions. But home management is not exceptional drudgery; it’s not unusually dull. In fact there’s probably more variety and skill in being a housewife (or househusband) than the majority of jobs. It’s time we stopped running it down as somehow second class (or third…).

It’s often been pointed out how many skills a stay-at-home mother employs. There’s a cheesy YouTube video of a job interview for being a “mom” (https://www.youtube.com/watch?v=MWcJZ210AaM). From this side of the pond, the Daily Telegraph listed 26 morning tasks that mothers have (http://www.telegraph.co.uk/news/uknews/10151000/Mothers-have-26-morning-tasks-study-shows.html). But they don’t convey half of the importance of the role of parent, of either sex, passing on language, life-skills and values. Neither do they convey the situations that parents navigate, nurturing children, negotiating teenagers, and often caring for elders.

Come on! Let’s stop denigrating the role of homemaker, and instead give it the honour it deserves.

General election seen from a riser-recliner chair

I listened to two items on the radio this morning.  The first was an interview with Sir Andrew Dilnot and the second was a reading from Henry Marsh’s Admissions.  And I can keep quiet no longer.

Sir Andrew Dilnot, economist and the country’s leading expert on social care (You may remember his authoritative and widely welcomed report on the subject, which broadly recommended a national insurance scheme to take away the fear of the cost of care in old age - https://mydonkeybody.blogspot.co.uk/2011/07/medical-day.html), was commenting on the imminent Conservative manifesto proposals concerning funding for the elderly.  You can hear the interview here - Today programme, at 1 hour, 10 min in. He was measured and he was scathing in his assessment.

According to a newspaper account, ‘Theresa May’s social care package fails "to tackle the biggest problem” facing elderly people, the man who carried out the coalition’s review into service in England has said.

‘On the election campaign trail the PM had said politicians could no longer “duck the issue” and that the Government had been “working on a long-term solution” for the needs of an ageing population. 

But Sir Andrew said he was “very surprised” by the new thinking from Downing Street. “New thinking that I’d argue shows a less than full understanding of the problems when there is a green paper that is due to come out later this year,” he added.

‘Speaking on BBC’s Radio 4 Today programme, Mr Dilnot, who is also a former head of the UK Statistics Authority, said: “The disappointment about these proposals that we’re expecting to hear in the Conservative manifesto later is that they fail to tackle what I’d argue is the biggest problem of all in social care, which is at the moment people facing a position of no control.

“There is nothing you can do to protect yourself against care costs; you can’t insure because the private sector won’t insure it and by refusing to implement a cap. The Conservatives are now saying that they are not going to provide social insurance for it, so people will be left helpless knowing that what will happen is that if they are unlucky enough to suffer the need for care costs they will be entirely on their own until they are on their last £100,000.

"The analogy is a bit like saying to somebody you can't insure your house against burning down. If it does burn down then you're completely on your own; you have to pay for all of it until you're down to the last £100,000 of all your assets and income," he said.’

(The Independent)

Someone whose political views are unusually well-informed and reliable messaged me this morning. “Cruel, cruel Conservatives! Sir Andrew D very good on it on Today. Cost needs to be socialised not put on individuals like this."

And he’s right. It’s not just social care which is at risk. Henry Marsh is an eminent neurosurgeon. His book, Admissions – a life in brain surgery, was published a fortnight ago. He retired from the NHS in 2015. In today’s reading he recounted a day’s operating list, of whom the fourth was a lady with diabetes. It revealed the unsustainable pressure that “efficiency” and “targets” have increasingly imposed on the service. The result for one patient was fatal, and for one operating team clearly traumatic. The episode ended with him breaking the news to the family:

‘… I wanted to scream to high heaven that it was not my fault that her blood sugar level had not been checked upon admission, that none of the junior doctors had checked her over, that the anaesthetists had not realised this. It was not my fault that we were bringing patients into the hospital in such a hurry that they were not being properly assessed. I thought of the army of managers who ran the hospital and their political masters who were no less responsible than I was and who would all be sleeping comfortably in their beds tonight, perhaps dreaming of government targets and away days in country house hotels and who rarely if ever had to talk to patients or their relatives. Why should I have to shoulder the responsibility for the whole damn hospital like this when I had so little say in how it is run? Why should I have to apologise? Was it my fault that the ship was sinking? But I kept these thoughts to myself and told them how utterly sorry I was that she was going to die and that I had failed to save her. They listened to me in silence, fighting back their tears. “Thank you, doctor,” one of them said to me, eventually.’

It happened last night that a group of us were enjoying each other’s company in my favourite coffee shop, the Cornerstone Café in Grove. We were talking about the questions we’d like to put to candidates in our local hustings on 1^st June, and I found myself concluding that Labour was more likely to provide adequately both for health and social care – and more surprisingly that their financial plans were not as daft as the corporate media would have us believe. Nationalising utilities does not increase national debt, in that they become national assets, like a house (or recovering the family silver). Borrowing for investment when interest rates are at an all-time low makes good sense. Raising tax revenues from corporations and the wealthiest 5% in society doesn’t wholly work only if those firms and individuals decide they don’t want to contribute to the common good and set about avoiding or evading their share. Sir Andrew’s comment about the social care proposals is relevant. 'Mr Dilnot said he was “very disappointed” by the proposals in the manifesto. “Not personally. I feel very disappointed for all of us – the millions of people who are very, very anxious about this,” he added.'

I guess that’s what all of us have to decide, captains of industry, the comfortably off, those with no jobs and those who depend on benefits and food banks - and everyone in between. Will we care about the millions or will we care just about ourselves? It’s all too easy to think, “I’m all right, Jack. The rest can go hang.” The issues are really too important to be reduced to schoolyard name-calling and character assassination.

The infinite variety of creation

Photo: Butterfly Conservation

Last weekend we had the fun of having our grandchildren and their parents to stay. When one’s surrounded by news of bereavement and illness it’s easy to be overwhelmed by sadness – and to forget that there’s much to enjoy. For example, just this minute a yellow brimstone butterfly has settled on the mini cauldron of deep mauve violas which have been flowering non-stop since some good friends gave them to Jane last autumn. Now it has bounced away over the garden in the spring sunshine, while a wren sings with its surprising piercing trill on our fence. I wonder whether this year it will complete its nest in the eaves of our neighbour’s garage. I think the males build a number of nests – and last year this one wasn’t used.  

Observer's Book of Birds

And yesterday evening we were at my favourite coffee shop, Cornerstone in Grove, with some good friends. We watched a three-minute video clip, which Tim described as the macro and the micro. It’s called Cosmic Eye. It starts with a girl, Louise, lying on a lawn in Google headquarters in California, and pans out fast through the universe and beyond to the limits of our knowledge and then reverses the process into her eye until it reaches the opposite limits of our knowledge to quarks and beyond, before bringing us back to the human being lying on the grass. Some of us understood it better than others. The big unanswered question, according to Tim, is what’s the unifying theory bringing the cosmic and the quantum together. Being a simple non-scientist, I was left with a sense of awe at the extraordinary diversity of existence.

I’m reminded of the most memorable lectures I went to in Cambridge, which were given by Professor Donald MacKinnon, not about my subject, English, but about philosophy. Besides his eccentricity and the gripping intensity of his engagement with the topic, I particularly remember one phrase of his, “the infinite variety of creation” or maybe “of nature”. I remember I thought at the time, “Yes, that’s the excitement of being alive.”

Hot air, much wind and cool sense

Oh dear, oh dear! I’ve been looking back at the start of this blog. What a boring old fart I’ve become since then. My posts have increased in length and in grumpiness. I’m surprised anyone reads them any more. I know some people do. Probably my family….

Anyway, here I am today, sitting in my favourite Cornerstone café admiring the new kitchen in the children's corner, that Sarah the manager raised money for, by going without sugar throughout February. The sun is shining and all’s well with the world.

On Saturday we had the local branch MNDA AGM. As usual it was a friendly time. We did the business bit, and after lunch had a talk about the NIHCE Guidelines on MND. Wow, it’s a weighty tome! And I suppose GPs and Health Commissioning groups are meant to have a grip on scores of similar documents…. We also heard about the Happy Valley Festival, a seriously cool one-day music festival in aid of MND on 17^th June (http://www.happyvalleyfestival.co.uk/) - tickets on sale tomorrow.

I asked one of our local MND experts what I could expect dying to be like. The answer was compassionate and honest: “The hardest part of MND is the living with it, not the dying. As the muscles weaken, the oxygen level drops, carbon dioxide rises. Usually people die in their sleep.” Or words to that effect. Reassuring. Confirmed my view that dying with MND is no more distressing for all involved than any other death.

Care - what's it worth?

Yesterday I happened to hear an interview conducted by Anna Magnusson on BBC Radio 4's Sunday Worship. It gave me an insight to the vocation of nursing:

 

Nursingtimes.nets

"One of my nieces is a newly-qualified Staff Nurse. Ellie’s 23, and works in a vast London hospital. She’s in the kind of job which gives her insight and maturity beyond her years. Every day, she looks after strangers. We sat down together one afternoon to talk about caring, and giving back what we receive. And what the story of Jesus washing the disciples’ feet means to her:

It’s the son of God; it is the most holy person saying, 'I don’t care if you’re homeless, I don’t care if you’re the scum of the earth, I am here to serve you.'  It’s just throwing every ideal we have out the window that you have to be the most rich, you have to be clean, you have to be good at your job – as long as you are a person, that’s what makes you valuable, and I am looking past anything other than you being a human – you are a human so I am going to serve you.

As a nurse you do have to do that, you have to say, I don’t care if you’re a drug-dealer, I don’t care if you’re a criminal, I don’t care if you’re a nun – I am going to treat you exactly the same because I have a duty to serve every person that comes through this door.

Tell me a bit about feet, though – what kind of feet do you encounter in your work?

Ooh … They come in all shapes and sizes, all lengths of toenails and smelliness and grottiness.  We’ve got patients who come off the streets, who are homeless.  And sometimes it can be quite horrible! 

But clearly you can’t allow yourself to be squeamish because that’s your job; it involves a lot of putting your hands on people, on giving intimate help?

Yeh, and I think over the years you do, you become a bit more immune to it.

I remember one of my patients, he had come off the street and he had this massive beard which he said he never used to have, and he was quite stinky, so I scrubbed him.  And you could just see the dirt all falling off.  And then goes, ‘Oh, I really want to have a shave!’.  So I chopped off all of his beard with some scissors and then I got the shaver out.  And I shaved his whole beard.  And he just couldn’t thank me enough, it was great.  And it was such a lovely bonding time between us, because I asked him about his life, I was able to find out what he was like when he was younger, and when he left he just couldn’t stop shaking my hand.  Because it’s one small thing that makes such a big difference, and I think everyone would want, I think people would want to do that, to give a tiny bit to someone and for them to receive so much from it...."

She added another insight into the folly of our policy of squeezing more and more out of the resource which we deliberately limit financially. We can't expect the time and level of compassion we'd like, when we understaff the NHS because we underfund. Time is money - and money provides time. 

"One of the main reasons I love nursing, and especially when I was a student – I was able to give more of myself to them because I wasn’t pressured by being a staff nurse; I had that little bit of extra time take the effort to make sure that it’s done in the most lovely way, to say, 'No, don’t rush this, this is someone, this is your grandma, this is your mum, take the time to make this as nice as it can be – even if it’s just 10 minutes, giving someone a little bed-bath in their hospital bed.' And then very quickly you’re getting a picture of their life.  So I never view them really as strangers."

In the same programme Anna Magnusson related,

"I’ve a friend in London who used to work for a home-care service.  

The allocated time for each visit was 15 minutes, and it was never enough.  She couldn’t allow herself to leave someone soiled or half-dressed, so she would over-run. Then she had to rush off to the next person, always behind schedule, always distressed over what she could not do to help. 

She was paid peanuts and, in the end, she couldn’t continue and care for her own family as well.

She trained as a bus driver instead, and was paid a decent wage."  

We know that's true - and yet it seems that as a society we are not willing to pay the price of providing care to those in need at their point of need. And then we, led by the media, have the gall to complain at waiting times or cursory treatment. And politicians find it convenient to collude in the blame game - to deflect our attention away from the fact that they don't have the courage to face themselves and us with the truth that care costs. Care is worth paying for. The NHS is worth paying for. And that means nurses and those in the care professions deserve rewarding.