Some musings

ON KEEPING WHAT WE DARE NOT LOSE

Over the last year, General Practice workload has increased to levels which are unmanageable, unsustainable and, on occasions, undoubtedly unsafe. Why is this? The reasons are undoubtedly many and varied but they do at least include the following.

1. The effects of Covid 19. Whilst a few patients continue to attend with delayed presentations of conditions that should have been dealt with a couple of years ago, far more significant is the fact that the pandemic has left many on long hospital waiting lists and who, as a result, find it necessary to visit their General Practice for interim help for conditions for which they require specialist care.

2. The underfunding over successive governments of an NHS which is now, as a consequence, on its knees but which, nonetheless, continues to be expected by everyone to be there whenever it is needed and able to provide all the care that is asked of it.

3. Increased patient numbers per GP because, despite government promises to the contrary, there has been a reduction in the total number of GPs nationally. Furthermore, in some areas, the closure of GP practices has seen the subsequent reallocation, often at short notice, of patients to neighbouring practices without the necessary additional staff being made available.

4. A surge in the number of those struggling with mental health problems often as a result of the measures taken to combat Covid 19. Social isolation has taken its toll on many, not least children and young people, as too has the economic hardship which now seems only likely to increase over the next year or two.

5. A negative media which has encouraged some to think that GPs are not doing their job properly and led many to demand more of us mistakenly imagining that we have the capacity to do so when in truth we do not.

6. Having been sold the lie that life should be without suffering, there are many who are now intolerant of even the most minor of problems and insist on treatment for things that in the past people would, perhaps, have accepted and put up with for longer. Add to this the fact that, as a consequence of our living in an ‘Amazon Prime’ culture where all our desires are guaranteed to be delivered free tomorrow, many find themselves unable to wait and so insist that their treatment must be ‘now’.

7. An inability of many to tolerate any degree of anxiety with a good number of those who now present to GP practices falling into that group of patients sometimes known as ‘the worried well’.

This last group I think is huge but it is the medical profession who must take much of the responsibility for their growing number. For it is not surprising that we have the worried well when, for years, we have told the well that they should worry. Neither is it surprising, then, that we find ourselves spending inordinate amounts of time dealing with those who are not ill at all.

So what we can do about it? Many of the problems mentioned are beyond our control and though we should still petition for a better NHS, continue to hold the government to account and endeavour to engage with the media to accurately describe the current crisis that we all now find ourselves facing, we need also to a accept that we can’t single handedly change the society in which we live.

What we can do though is rediscover what it is to be good doctors. So what is it that good doctors do?

Well, for a start, they care for patients. And irrespective of how strong the temptation may sometimes be to think otherwise, they remember that the patients are NOT the enemy!

We need to take up our posts once more and act as the gatekeepers of the NHS protecting hospitals from patients but, far more importantly, protecting our patients from hospitals. We need to stop being people pleasers, something I will find particularly hard, and seek to do what is right by our patients rather than that which is popular, telling them the truth rather than what they want to hear. We need to apply a little wisdom in our consultations and avoid falling into the trap of mindlessly following protocols and merely acting according to algorithms. And, instead of adding to the anxiety of our patients, we need to be prepared to carry some of their anxiety ourselves. Because taking on that responsibility is what being professional is all about.

And finally we need to remember what good doctors DON’Tdo. Good doctors don’t turn away those who are sick and no doctor should feel compelled to do so. To take such an action would be to play into the media’s narrative that we are reneging on our responsibilities as GPs, it would turn our patients against us and so lose their support which is so vital to us if we are to come out of this in one piece, and it would make the already difficult working lives of our receptionist even harder. And of course, rather than being gatekeepers to the hospital, it would make us those who had abandoned our post and left the gate wide open. To do so would be to dump on our friends and colleagues in secondary care who are themselves struggling every bit as much as we are.

So in short it would sadden me hugely if we were to ever cap the number of patients who could see us on any individual day, if we were ever to become a profession which refused to see those who came to us in genuine need and thus deny them the help which was most appropriately provided for them in primary care.

And whilst appreciating the reasons for taking such drastic measures, I hope that I’m not the only one who would be at least a little embarrassed to be associated with such a move if, as some are advocating, it were to be deemed necessary. I fully understand how difficult things are at present, but alternative solutions must be found. Because to be a part of such a profession would, for me at least, only worsen the situation by making my working life even less satisfying. For there is still a joy to be had in helping others in need, a pleasure that comes, not merely from miserably doing our duty and soullessly performing what is required of us, but that comes as a consequence of our being in the privileged position of being able to make a positive difference in the lives of so many.

And that is something we dare not lose.

To read ‘On Being Overwhelmed’ click here

To read ‘Bagpuss and the NHS’, click here

To read ‘Health – it’ll be the death of us. Is there institutional arrogance in the NHS?’, click here

To read ‘The NHS – the “S’” is for “Service”, not “Slave”’, click here

To click ‘Something to reflect on’, click here

To read ‘The Repair Shop’, click here

To read ‘The Medical Condition or Hannah Arendt is completely fine’, click here

To read ‘The Abolition of General Practice’, click here

To read ‘Blaming it on the Boogie’, click here

To read ‘On being crazy busy – a ticklish problem’, click here

To read ‘Too busy to be happy’, click here

To read ‘Contactless’, click here

To read ‘From A Distance’, click here

To read ‘General Practice – a sweet sorrow’, click here

To read ‘I’ll miss this when we’re gone’, click here

To read ‘The Reintroduction of GPs Anonymous’, click here

To read ‘Mr Benn – the GP’, click here

To read ‘A Bear called Paddington’, click here

To read ‘The Three Little GPs and the Big Bad Secretary of State for Health’, click here

To read ‘A Mission Impossible’, click here

To read ‘A Hard Year For Us All’, click here

LIFE AFTER LIFE

“What if we had a chance to do it again and again, until we finally did get it right? Wouldn’t that be wonderful?”

Kate Atkinson, ‘Life After Life’

‘Footfalls echo in the memory
Down the passage which we did not take
Towards the door we never opened
Into the rose-garden’

From T.S. Eliot’s ‘Burnt Norton’

This week I have been watching ‘Life after Life’. Though, for me, it is was a flawed drama with a less than entirely satisfactory ending, the BBC series based on Kate Atkinson’s original novel does, nonetheless, present an interesting idea, one perhaps we have all at some time or another wished was true. What if, when we die, we had the chance to live our lives all over again, what if we were able to behave differently at key moments of our existence such that, as a result of acting better, the days that followed would run more smoothly for us and enable us to therefore avoid the pitfalls that in previous lifetimes we were made to endure?

Would we, I wonder, fare any better? Second time round, would we live a happier, more fulfilled, life? Or would we just find yet another of the infinite number of ways that are available to us to mess things up and so be forced to live an alternative but equally flawed existence complete with another, equally unsatisfactory, ending? And would we then be compelled to spend all eternity constantly working out our lives in an endlessly futile cycle, one in which we were always striving to do better, always hoping to somehow make everything all right?

Also this week I listened to the distress of a young woman. Not having benefited from the best efforts of those who have sought to help her with treatments of both the talking and pharmaceutical kind, she told me of her loneliness, her anxiety and her despair. She told me how she was tired and how she wanted it all to stop. And, without any sense of the melodramatic, she told me how she longed to die – more than that she told me how she needed to die if things were ever to get better. Because, for her, without any hope for the future, death seemed the only way to end the pain, the anguish that was hers as a result of existing in a world in which she felt she did not fit.

But, of course, were she to die, there would be no second chance for her. As for countless others before her, there would be no opportunity to live life differently. And though perhaps her distress would be over, that of those left behind, that of those who love her and already know what it is to sorrow over her sadness, would surely only increase.

So what is the answer? Is there an answer at all? Is my young woman right when she says it’s all just pointless?

I for one am not that nihilistic. And whilst I don’t have all the answers that I would like to have for those who struggle as this young woman does, I nonetheless refuse to believe that her struggle is without meaning, I refuse to believe that it has no purpose. And so, believing that suffering can be redemptive, believing it can even be the means by which suffering itself is ultimately brought to an end, I will, at least, continue to care and, in so doing, endeavour, as best I can, to know something of her distress, share a little of her sadness and bear with her the burden of her sorrow.

And though she may have given up hope, I will not. I will hope for her, continuing to believe what she cannot – that a better tomorrow is on its way. And this, not merely in some imagined parallel universe conjured up by the imaginations of those who cannot face the genuine awfulness that is all too often apparent in the one we already know. On the contrary, I will continue to hope for a better tomorrow for this beautiful yet broken world, a better tomorrow when, not only hers but all our tears will have been wiped away, suffering will be no more and each and every one of us will have found a place that we can call our home.

Because when that ‘life after life’ finally comes, all this ‘death before death’ can be forgotten.

And won’t that be wonderful?

Related blogs:

To read ‘General Practice – A Sweet Sorrow’, click here

To read ‘Eleanor Rigby is not at all fine’, click here

To read ‘Do you hear the people sing?’, click here

To read ‘An Audience with Grief’, click here

The following are explicitly Christian blogs:

To read ‘T.S. Eliot, Jesus and the Paradox of the Christian Life’, click here

To read “Suffering- A Personal View”, click here.

To read “Why do bad things happen to good people – a tentative suggestion”, click here

To read “Luther and the global pandemic – on becoming a theologian of the cross”, click here

To read ‘Real Power’, click here

To read, ‘But this I know’, click here

To read ‘Good Friday 2022’, click here

To read “Easter Sunday – 2021”, click here

To read ‘The World is not Enough’, click here

To read “Hope comes from believing the promises of God”, click here

To read “Waiting patiently for the Lord”, click here

FAITH AND DOUBT

It was eight days after his resurrection that Jesus appeared to the disciple who is generally remembered, perhaps unfairly, as the one who was slow to believe that Jesus was indeed alive once more. But, despite the fact that ‘doubting’ Thomas is frequently given a bad press, I would like to say that I am genuinely grateful to him.

For the account that we read in John 20:26-29 reassures me that, despite those living in first century Jerusalem being just as unlikely to believe a story about a dead man coming back to life as those who are living today, so convincing was the evidence for the resurrection that, when presented with it, even a dyed in the wool sceptic like Thomas could not help but believe that the seemingly unbelievable had in fact taken place. And so, face to face with the risen Christ, an intellectually honest Thomas followed that evidence and rightly declared Jesus to be both his Lord and his God.

After Thomas believed the evidence that his eyes would not allow him to deny, Jesus said to him, ‘Blessed are those who have not seen and yet have believed.’ In saying these words Jesus was referring to us. But the reason that we can believe without seeing is, partly, the result of Thomas not being able to believe until he did see.

John tells us that he wrote his gospel so that we might believe that Jesus is the Christ, the Son of God, and that, by believing, we may have life in his name [John 20:31]. Our faith, therefore, is partly down to the fact that Thomas’ story was there to be recorded, a story of one who, initially doubtful, demanded the evidence that we all need if we are to have confidence that a faith placed in Jesus is a faith placed in one who can be wholly depended upon.

Confident then that He really is alive, may we, like Thomas, follow the evidence and, therefore, gladly recognise Jesus to be our Lord and our God too.

For, thanks in part to Thomas, we all have very good reason to do so!

Related blogs:

To read ‘Good Friday 2022’, click here

To read “Easter Sunday – 2021”, click here

To read, ‘The Resurrection – is it Rhubarb?’, click here

To read, ‘Real Love?’, click here

To read ‘Real Power’, click here

To read, ‘But this I know’, click here

To read “Hope comes from believing the promises of God”, click here

To read “Waiting patiently for the Lord”, click here

GENERAL PRACTICES ARE GO!

It was January 2021 and Lady Penelope was taking tea in the drawing room of Creighton-Ward Mansion when her chauffeur, Parker, appeared at the door.

‘I’m sorry to bother you milady’ he began, ‘but the Secretary of State for Health is on the phone. He’s at some Downing Street party and wondering if you’d care to join him’.

‘Not him again,’ replied Lady Penelope striding over to where Parker was holding the phone. ‘When will that lecherous little man realise I don’t want to have anything to do with him. And, what’s more, to attend a social gathering in the present circumstances is completely wrong and whilst some in government may consider themselves above the law, this lady of the realm most certainly does not! Give me the phone Parker, I’m going to give him a piece of my mind’.

Lady Penelope took the phone from Parker and, before the caller could say a word, that’s exactly what she proceeded to do.

‘Mr Secretary of State’ she growled down the line, ‘you should be ashamed of yourself, partying whilst daily Covid deaths sore ever higher. You need to do something and do something quick. If you had any sense you’d be calling on those who can always be relied upon in an emergency. If I was you, I’d be calling on the new primary care wing of International Rescue.’

And with that Lady Penelope ended the call and threw herself down onto the chaise lounge that was situated by her side.

‘That’s the way to deal with men like that Parker. Now, if you would be so good as to bring me another pot of Earl Grey I’d be most awfully grateful. And, perhaps, a large measure of Talisker to accompany it. Speaking to people like that leave one somewhat in need of a restorative.’

*****

Meanwhile, far away on a remote island somewhere in the South Pacific, Jeff Tracey was in a meeting with two of his five GP sons, the other three joining them via Zoom from International Rescue’s space station. Also present were other allied members of the organisation. They were all discussing what their response should be to the news they had recently received from Lady Penelope. In her role as special agent in London, she had discovered that their evil nemesis, ‘The Hood’, had managed to infiltrate British politics and subsequently risen to become Prime Minister. By employing his powers of hypnosis he had even managed to convince a large proportion of the electorate that he was both a competent and respectable national leader.

Their deliberations were interrupted when the phone on Jeff Tracey’s desk flashed red indicating that a distress call was being received. Picking up the phone and listening to the voice on the other end of the line, he echoed back the callers opening words.

‘You say you’ve had a wonderful idea?’ He said, his voice suggesting that he doubted that such a thing was possible. Covering the mouthpiece of the phone he indicated to the others that it was the Secretary of State for Health who was calling. He then continued the call, repeating key statements so as to convey to the gist of what was being said to everyone one else who was in the room. ‘No I didn’t see the announcement on the television this evening…a national vaccination programme to commence tomorrow you say…with jabs being made available in local centres right across the country.’

When at last the caller had finished speaking, Jeff paused for a moment, considering his reply.

‘Well you might have thought to speak to us before you made such an announcement to the general public. General Practice may well be ideally positioned and though the efforts of those who work within it are not infrequently superhuman, it remains the case that each and every person who makes up the primary care workforce, as well as those who work elsewhere in the NHS, are ordinary individuals whose willingness to help cannot, and must not, be taken for granted in this way. Even so, since International Rescue exists for the sole purpose of saving human life, we will do all we can to help. You can rely on us.’

Ending the call Jeff looked around the room and formulated his plan. First he gave instructions to his bespectacled lead scientist.

‘Brains, you and Tin Tin, must work alongside those infinitely resourceful and wonderfully capable practice managers and coordinate the implementation of the delivery of the vaccine.’

‘Just as you say, Mr Tracey. We’ll get on to it immediately’. Brains and his trusted assistant stood up and made their way to the door. Then Jeff Tracey turned to the two sons who were present with him in the room.

‘Scott, you take Thunderbird 1. I want you to be first on the ground overseeing the set up of vaccination centres across the country. Tap into the eagerness to help, not only of GPs but also of practice nurses, admin staff and receptionists and thus pull together a team capable of delivering the largest vaccination program in history. And Virgil, with Pod 6 packed full of vials of Pfizer, Modena and AZ vaccines, you are to take Thunderbird 2 and distribute them the length and breath of the UK. Have you got that boys.’

‘F.A.B. Father. Thunderbirds are Go!’

And so began the roll out of the highly effective national vaccination programme, the like of which the country had never seen before. Shy of publicity, and eager to keep their identity a secret, International Rescue members smiled inwardly to themselves as those in Government sought, perhaps, to take a little too much credit for what was actually achieved as a result of the tireless efforts of countless individuals. Still, it was enough for those involved to know that there’s was a job well done.

*****

A year or so later, a lone GP sat at his desk and waited for the lateral flow test that he had just taken to reveal it’s result. It had been another long day and as the last consultation had drawn to a close Dr Mungo had begun to feel slightly unwell. Perhaps he was just worn out given how impossible the job had become. Workload had never been so heavy and patient demand had never been so high. It was no surprise of course, given the ever lengthening list of those waiting for hospital treatment, the surge in patients suffering with poor mental health and a workforce crises that was resulting in the collapse of GP practices right across the country. Furthermore, GP morale, already at an all time low, was only being made worse by criticism in the press, a criticism, tacitly endorsed by some in government, that suggested that it was simply lazy and overpaid GPs who were responsible for the problems that the NHS was experiencing.

‘Oh that you could get an ambulance as quickly as the result of a Covid test’, Dr Mungo said to himself recalling how he’d had to wait three hours for an emergency response vehicle to arrive having called for one earlier in the day for a patient experiencing marked difficulty in breathing. ‘Well that’s me working from home for the next week or so.’ he sighed as the second red line appeared in the window of the plastic test that lay on the desk in front of him. He didn’t relish the prospect. It wasn’t only that his being away would put additional strain on the practice, it was also that he did so hate consulting remotely and not being able to see his patients face to face.

As he sat with his head in hands, he remembered something that an aristocratic friend of his had once said to him. Penny, as he had known her, had told him that, were he ever to find himself in dire need of help, there was a number he could call that would be sure to lead to him receiving the assistance he required. He’d kept a note of number she’d given him ever since and he now scrolled through his contacts desperate to make use of it. At last he found it. ‘Under I’, he said to himself smiling, ‘just as you’d expect.’

He entered the number into his phone and waited for what seemed like an age. Eventually a voice came onto the line.

‘Hello’ it said hesitantly. ‘Can I help?’

‘Is that ‘International Rescue?’ Dr Mungo asked, questioning for a moment if he might have misdialled given how uncertain the one who answered his call seemed.

‘Well it used to be’, came the reply. ‘I’m just the caretaker. Most of the others have gone now, what with all the changes we’ve had round here. It’s the funding you see. We used to get some government support but that all dried up, as a result of all the money that was wasted on the crippling expensive, not to mention disastrously ineffective, test and trace service, the budget for which was greater than that for the whole of primary care. And then there was the stress of it all. Scott left to take up a job stacking shelves in a local supermarket and Virgil eventually burnt out and joined the ranks of the long term sick, his precarious mental state evidenced by the fact that he began writing pastiches whose storylines were as stilted as the movements of the characters in a Gerry Anderson TV series of the 1960s. The Thunderbirds themselves have all been decommissioned and sold for scrap – except for Thunderbird 4 that is. Dr Gordon Tracey continues to offer a service as best he can but, without Thunderbird 2 to transport the yellow submersible, it isn’t always possible to reach people in as timely a fashion as he would like. Even so, I’m sure he’ll do what he can if you know someone who’s drowning.’

‘Oh I know a few of those’, Dr Mungo whispered in response, ‘but not in the way you’re thinking. I’m not sure your submarine will be of much help to them.’

And with a ‘Thanks anyway’ not dissimilar to those he’d heard from patients who had sometimes left his consulting room seemingly dissatisfied with what he’d been able to offer them, Dr Mungo said his goodbyes and ended the call.

‘Thunderbirds are go’ he thought to himself. Not any longer. Now it was more a case of ‘Thunderbirds are gone’.

And he wondered how long it would be before the same would be said of General Practices too.

GOOD FRIDAY 2022

Sorrowful, yet always rejoicing. Happy, yet always sad.

It was true last year in times of pandemic.
And it’s true this year in times of war.
Trouble abounds.

Though Covid 19, for the time being at least, may be less on our minds than the events in Ukraine, what remains abundantly clear is that difficulties continue to surround us and make up part of all our lives. Even so, it is still the case that there are things for which we can be grateful, things that, though they do not nullify our ongoing distress, can nonetheless cause us to smile. Similarly, how ever good our lives may be at present, there remain those things that persist in pulling us down. The truth is that sadness and happiness coexist, neither one ever entirely absent, each simultaneously intensifying and diminishing the other. There is for all of us, pleasure in our sadness, heartbreak in our delight. I see it on the news, I see it in my patients, I see it in myself – genuine causes for sorrow sat alongside sources of real joy.

Sorrowful, yet always rejoicing. Happy, yet always sad.

Perhaps we cannot know what happiness really is without knowing the pain of sorrow and, for sorrow to be fully realised, perhaps it requires us to have had the experience of knowing what it is to be truly happy. If so, if we are to be happy, it must be alongside our sadness and we must not insist that all sorrow is gone before allowing ourselves to be happy any more than we should deny our sadness simply because there are things for which we can be happy.

Life is not black or white, it is a kaleidoscope of grey. Paradoxically we can be happy and sad at the same time. We can smile even as we cry.

Today is Good Friday – a day like no other, a day on which I find it helpful to ponder such things. For me it helps to make make life more meaningful, more understandable, more bearable. Perhaps it will for you too.

Because even the eternally happy God knows what it is to weep.

What follows is the same as I posted this time last year. I repeat myself for no other reason than what was true in days of pandemic, is still true in times of war.

I remain sorrowful, yet always rejoicing. Happy, yet always sad.

One Maundy Thursday I wished a good friend of mine a happy Easter break. He hesitated however to return my good wishes because, he said, that he understood that Good Friday was a day for Christians like me to be miserable. It got me thinking to what extent he was he right.

Paul, writing in his second letter to the Corinthians, describes Christians as, ‘Sorrowful yet always rejoicing’ [2 Corinthians 6:10]. If such a paradoxical existence was the reality for Christians back in Paul’s day, it is surely no less true a reality for Christians living the 21st Century. ‘Good Friday’, the name we give today, is itself a paradox – for how can we apply the adjective ‘good’ to describe the day of Christ’s crucifixion? For sure, it is a day on which Christians should grieve over their sin and what it was that Jesus had to suffer in order to secure their redemption, but, at the same time, it is a day for rejoicing in the triumph of his sacrifice as we anticipate and remember his subsequent resurrection from the dead on Easter Sunday.

‘Sorrowful yet always rejoicing’ – it was the experience of Paul and it was also the experience of Jesus himself. For he was himself ‘a man of sorrows and acquainted with grief’ [Isaiah 53:5]. Matthew recalls the words of Jesus to Peter, James and John, in the Garden of Gethsemane:

“My soul is very sorrowful, even to death; remain here, and watch with me.” [Matthew 26:38].

And yet the writer to the Hebrews has it that Jesus, ‘for the joy that was set before him endured the cross’ [Hebrews 12:2].

Suffering, then, is not the end of joy – it can even be the passage to joy. Again this is not a contradiction – but it is a paradox! A paradox that the second thief, even as he was being crucified alongside Jesus, understood. There he was, in just about as bad a position as it is possible for a person to be in, minutes away from an excruciating death, when he, nonetheless, made his remarkable request:

‘Jesus,’, he said, ‘remember me when you come into your kingdom’ [Luke 23:42].

Like everybody else that day, the second thief saw Jesus suffering and dying on a cross. But unlike the religious rulers, the Roman soldiers and the other thief who was also being crucified that day, he didn’t see defeat. He continued to speak of Jesus as one who was coming into his kingdom. For him Jesus’ death didn’t mean an end to all the kingdom and salvation talk. Whilst all those others, those who mocked Jesus as they watched him die, were looking for a salvation FROM death, the second thief saw that the salvation Jesus was bringing about was a salvation THROUGH death.

Jesus’ death wasn’t the end of Christ kingdom, on the contrary, his death was its beginning.

This is a profound truth – one we do well to try and grasp some understanding of.

Far from a simple faith, the second thief’s faith was remarkable. And it is on account of his wonderful faith that we should not be surprised by Jesus when he responds to him with these words:

‘Truly, I say to you, today you will be with me in paradise’ [Luke 23:43].

Jesus saw in the second thief somebody who got it! Somebody who trusted the power of God despite seeing that which to unspiritual eyes was nothing but weakness. Somebody who saw victory where most saw only defeat. Somebody, indeed, who understood the paradox of Good Friday.

That suffering is not irredeemable,

That sorrow is not incompatible with joy,

That even the darkest nights can be followed by the brightest days.

‘Sorrowful yet always rejoicing’?

It was the experience of Paul. It was the experience of Jesus. It was the experience of the second thief. And it will be our experience too.

Some of us are sick? Some of us mourn the loss of loved ones? Some of us worry over our future? Some of us have experienced great tragedy in our lives – some recently, some longer ago but who nonetheless still feel the pain just as keenly as if it were yesterday.

There is indeed much today for us to be sorrowful over. Some Christian types can sometimes well meaningly suggest we should always be happy. ‘Smile’, they say, ‘Jesus loves you’. But though they are right to proclaim the truth that God really does love us, they are wrong to suggest that we should never be sad, for even the eternally happy God knows what it is to cry. [1 Timothy 1:11, Luke 22:62]. Even Jesus wept at the tomb of his friend Lazarus, his grief no less intense for knowing that he would soon bring him back to life. [John 11:35].

Perhaps, then, even God knows what it is to be sorrowful yet always rejoicing.

So it’s not wrong to be sad, it’s simply normal. The Bible never tells us to masochistically rejoice about our suffering. But it does tell us to rejoice in our suffering.

Because despite our sorrow – there is much to rejoice over! We truly are loved with an everlasting love, a love that transcends our current struggle, a love that means that we too can be sorrowful yet always rejoicing.

As we suffer we can rejoice because of the Gospel. The good news is that Good Friday was followed by Easter Day, that Jesus died for our sins, bearing the punishment we deserve, and that when he rose from the dead Jesus proved the sufficiency of his sacrifice. By it we are justified, counted righteous, declared to be ‘not guilty’.

Some of us grieve over our unrighteousness and can not even lift our eyes to heaven. We beat our breasts and cry out, ‘Have mercy on me, a sinner’ [Luke 18:13] But because of Jesus’ work on the cross on our behalf we are made right with God – regardless of our current situation.

Not because of our worth – but because of his grace.

Not because of what we do – but because of what he did.

Not because we are lovely – but because he is loving.

So, if you’re sorrowful today, remember you’re not alone, God weeps with you. And know that, because of Jesus, his life, death and resurrection, ‘Weeping may tarry for the night, but joy comes with the morning.’ [Psalm 30:5].

It’s Good Friday – but Easter Sunday is coming. Because of what took place over those two days nearly 2000 years ago, we can know real forgiveness for all those sins that we so bitterly regret, no matter how great they are.

But if that were not enough to rejoice over this Eastertide, we can also look to the future with a certain hope. Suffering is all too real today but the day is coming when God ‘will wipe away every tear form [our] eyes, and death shall be no more, neither shall there be mourning, nor crying, nor pain anymore, for the former things [will] have passed away.’ [Revelation 21:4]

‘So we do not lose heart. Though our outer self is wasting away, our inner self is being renewed day by day. For this light momentary affliction is preparing for us an eternal weight of glory beyond all comparison, as we look not to the things that are seen but to the things that are unseen. For the things that are seen are transient, but the things that are unseen are eternal’. [2 Corinthians 4:16-18]

It’s Good Friday – but Easter Sunday is coming.

So may we all know happiness this Eastertide – even those of us who are sorrowful.

Especially those who are sorrowful.

Related blogs:

To read “Easter Sunday – 2021”, click here

To read ‘Real Power’, click here

To read, ‘But this I know’, click here

To read “Suffering- A Personal View”, click here.

To read “Why do bad things happen to good people – a tentative suggestion”, click here

To read “Luther and the global pandemic – on becoming a theologian of the cross”, click here

To read ‘Covid -19. Does it suggest we really did have the experience but miss the meaning?’, click here. This is a slightly adapted version of “T.S. Eliot, Jesus and the Paradox of the Christian Life’.

To read “Hope comes from believing the promises of God”, click here

To read “Waiting patiently for the Lord”, click here

BAGPUSS AND THE NHS

Once upon a time, not so long ago, there was a little girl and her name was Emily. And she had a shop. It was rather an unusual shop because it didn’t sell anything. You see, everything in that shop window was a thing that somebody had once lost and Emily had found and brought home to Bagpuss. Emily’s cat Bagpuss – the most important, the most beautiful, the most magical…saggy old cloth cat in the whole wide world.

Well now, one day Emily found a thing and she brought it back to the shop and put it down in front of Bagpuss who was in the shop window, fast asleep as usual. But then Emily said some magic words:

‘Bagpuss, dear Bagpuss, old fat furry cat-puss
Wake up and look at this thing that I bring
Wake up, be bright, be golden and light
Bagpuss, oh hear what I sing’

And Bagpuss was wide awake. And when Bagpuss wakes up all his friends wake up too.The mice on the mouse-organ woke up and stretched. Madeleine, the rag doll, Gabriel, the toad, and last of all, Professor Yaffle, who was a very distinguished old woodpecker. He climbed down off his bookend and went to see what it was that Emily had brought.

He inspected the object and then made that characteristic cackle of his, the one he always made prior to passing judgement on things about which he new little about. ‘That,’ he said, ‘is nothing more than a very heavy, very old, blanket. I’m not sure why Miss Emily brought it here. Don’t you agree Bagpuss?’

Bagpuss yawned as he gazed down on the item that lay before him. ‘It looks to me like something which has been pressed down by the weight of heavy expectation. Take the blanket off and let’s see what’s under it.’

‘Ridiculous, ridiculous, fiddlesticks and flapdoodle’ said Professor Yaffle. ‘There’s nothing under there which is of any value to anyone.’

But even as he said these words the mice set to work. Slowly they dragged the blanket to one side and revealed what lay beneath. What they saw was a tied and rather worn out organisation, one that had clearly been neglected for years, one that had been misused by many and taken for granted by a great number more.

‘What is it?’ the mice squealed excitedly.

‘I rather fancy it’s the National Health Service – or a least it was once,’ replied Bagpuss. ‘It looks as though it’s been overwhelmed by excessive demand and has long since seen better days. It really does appear to be terribly broken’.

The mice looked sad. ‘What should we do?’ they asked in unison.

‘Well, for a start, we all need to look after it better,’ Bagpuss replied.

The mice looked at each other and then one pulled out a role of music and loaded it into the marvellous mechanical mouse organ. Soon they were all singing.

‘We will mend it, we will tend it. We will treat it with care, care care.
We adore it, we’ll restore it, We it’s burdens will bear, bear, bear’

Eventually the song came to an end. ‘I know’, squeaked one of the mice. ‘Let’s train Charlie Mouse up as a GP and then make him work extra sessions over the bank holiday weekend’. The other mice cheered in excited agreement and started to haul the smallest of their number toward the door of the shop, forcing into his hand as they did so a discarded medical bag that Emily had brought back to the shop some months previously.

‘Stop that at once!’ shouted Madeline. ‘You can’t inflict being a GP on Charlie Mouse. He’s only little and without proper training he wouldn’t last five minutes working in primary care, not with current levels of demand. And besides it’ll take more than a few extra GPs to put things right.’

‘How about employing health care professionals from overseas?’, suggested Professor Yaffle. ‘Better still, let’s parachute in an oversized mouse like creature, one of a race of knitted individuals from a far off planet not dissimilar to the moon?’

‘That’, began Gabriel picking up his banjo, ‘would be to drop one enormous clanger! Sad to say some people would ignorantly question the creature’s ability to do the job simply because they sometimes found it difficult to understand what it was that it was saying. But that is neither here nor there. We can’t go round depriving others of the medical care that they need. Who would remain to look after the soup dragon! I’ll tell you what though. I know a song about the NHS. Several songs in fact. Would you like me to sing one for you?’

‘No, thank you’ growled Professor Yaffle a little more harshly than was strictly necessary. ‘We’ve heard far too many of your folksy tunes that bare such little resemblance to real life. What I want to know is what the NHS was really like.’

‘Madeline, do you know?’ asked Bagpuss turning to the rag doll who was gently rocking back and forth in her rocking chair.

‘When I was young my parents used to tell me stories of the NHS’, she said. ‘Of how when you called an emergency ambulance, one would come, when waiting times for hospital appointments were a matter of weeks rather than years, and of how pharmacies could always supply the drugs that patients needed. Back then, those served by those working in hospitals and GP surgeries were invariably appreciative of the help they had received and recognised how fortunate they were that their care was free at the point of access. Back then it was even said that people actually used to enjoy working in the NHS.’

‘I find all that very hard to believe’, began Gabriel. ‘Some might complain that my songs portray a somewhat romanticised view of the world’, he continued, glaring at Professor Yaffle as he did so, ‘but surely Madeline, weren’t your parents looking at the NHS through rose tinted spectacles. Weren’t their stories actually just fairy tales?’

‘I don’t think so,’ said Madeline. ‘I believe things really were once as my parents described them. Or at least more so than they are now. But things have changed. The NHS isn’t like that anymore.’

Everyone fell silent, staring at the crumpled mess that lay on the floor before them. Nobody felt like singing now, not even Gabriel who laid his banjo down at his side. Some of the mice started to cry.

After a few minutes Madeline looked up. ‘Bagpuss,’ she asked, ‘Do you think the NHS could ever recover?’

‘Oh, I do hope so’, Bagpuss replied. ‘But it’ll take some careful thought’

And with that Bagpuss closed his eyes and began to think of all that would be required for the NHS to be restored. He imagined a government that funded the NHS adequately and enabled it to deliver the care that so many relied on, a government with policies that promoted both the physical and mental wellbeing of its population. He imagined a people who were realistic about what the NHS could do for them, a people who no longer expected it to solve their every problem and instead took more responsibility for their own health, a people who treated those working in the NHS with a degree of respect, recognising that everyone was trying to do their best in what was often an impossible job. He imagined a press which didn’t undermine staff morale with their constant criticism of what they didn’t understand. He imagined a world in which every aspect of everyone’s lives was no longer medicalised, a world no longer full of the worried well as a result of the well no longer being constantly told to worry about their perfectly healthy medical parameters. And he imagined those working in primary and secondary, rather than blaming each other for the problems in the health service, coming together and appreciating the difficulties each other faced.

Eventually Bagpuss opened his eyes again and looked once more on the NHS. And he saw how the mice had been working hard, each busily trying to implement all that he had been thinking about. As a result, the NHS was looking once again as it had done in its prime.

‘Isn’t it beautiful’, whispered Charlie Mouse seeing how it now shone so brightly.

Their work complete, the mice then pushed the NHS into the front window of Emily’s shop. And everyone hoped that those passing by would recognise it for what it was – the National Health Service, not the National Health Slave.

Bagpuss gave a big yawn, and settled down to sleep. And of course when Bagpuss goes to sleep, all his friends go to sleep too. The mice were ornaments on the mouse-organ, Gabriel and Madeleine were just dolls and Professor Yaffle was a carved wooden bookend in the shape of a woodpecker. Even Bagpuss himself, once he was asleep was just an old, saggy cloth cat – baggy, and a bit loose at the seams.

But Emily loved him.

[With apologies to Oliver Postgate, Peter Firmin and everyone at Smallfilms]

ON BEING OVERWHELMED

Yesterday would have been my mother-in-law’s birthday. Almost two years on from her death we spent much of the day with my father-in-law. Flicking through old photographs I was reminded of how it’s not only the dead that are mourned – there are those who grieve for the good times that once were commonplace, for the laughing child who now no longer smiles, for the wasted years that will never be recovered. Later we had lunch in the restaurant of a garden centre where my mother-in law used to like to go for coffee. Sitting at what was once her favourite table, the memories again came back. But she didn’t. All we had were the memories – and the memories weren’t enough.

This week, for a great many, what there was, wasn’t enough.

For some, what they had in the bank wasn’t enough to pay for them to have sufficient heating.
For some, the protection afforded by the law wasn’t enough to stop them from being brutally murdered.
For some, the NHS wasn’t enough to cure them of their disease.
For some, their own sense of self wasn’t enough to get them out of bed in the morning.
For some, the combined force of NATO and the United Nations wasn’t enough to prevent them from becoming victims of the atrocities of war.

And for some, it was me who wasn’t enough. Not strong enough, not wise enough, not kind enough. Not for those who needed me to have been far more of all these things, not for those who discovered that I too wasn’t enough for them.

This week, in a world of grief, a world filled with so much sadness, so much pain and so much suffering, there have been those for whom the whole of the world wasn’t enough. And, for far too many, it won’t be enough next week either.

Because sooner or later, everyone needs more than the world has to give. More than we have to give.

No wonder then that sometimes work is hard. We are overwhelmed by what we can do, let alone by what we can’t. What we are asked to do each day doesn’t just seem impossible, impossible is what it all too often really is.

So let’s not be surprised when we are not enough, let’s not add to how difficult it is by being that unfair on ourselves. For there is no shame in being asked for more than we’ve got and only being able to give all that we have.

Three blogs which, in my head at least, make up a trilogy on the subject of burnout:

To read ‘Somewhere over the Rainbow’, click here

To read ‘When the Jokes on You’, click here

To read ‘With great power…’, click here

And one blog on the dangers of perfectionism:

To read ‘Professor Ian Aird’ – A Time to Die?’, click here

A couple of stories about GP life:

To read ‘Mr Benn – the GP’, click here

To read ‘A Bear called Paddington’, click here

a silent tear

alone today

she dies

a little more

a silent tear

now screams the fear

of her defeat

no more fight

no more rage against

the dying of the light

so alone

tonight she’ll die

just a little more

Related Blogs:

To read ‘together in line’, click here

To read ‘the wrong patient’, click here

To read ‘beaten’, click here

To read ‘Resting in Pieces’, click here

To read ‘Crushed’, click here

To read ‘Masked’, click here

To read ‘She’s The Patient You Don’t Know You Have’, click here

moving closer

He’s older now – and frailer, his footsteps not so sure,

He lingers for a moment – outside the shut front door,

The house, his home of fifty years or more,

No longer his.

He hopes

It’s for the best,

He’s moving closer.

Reluctantly he takes the arm of one who’s standing near,

His failing health and frequent falls her ever present fear,

What if, with none his cries for help to hear,

He lay alone?

She feels

It’s for the best,

He’s moving closer.

The years have all too quickly passed, the months, the years, the days,

Her memories forever strong, his fading in the haze,

It won’t be long the parting of the ways,

They know too well.

Slipping away,

It’s for the best,

He’s moving closer.

BECAUSE THE WORLD IS NOT ENOUGH

For many this week, what there was, wasn’t enough.

And for some, it was me who wasn’t enough. Not strong enough, not wise enough, not kind enough. Not for those who needed me to have been more of all these things, not for those who discovered that I too wasn’t good enough for them.

This week, in a world of grief, a world filled with so much sadness, so much pain, and so much suffering, there have been those for whom the whole world was not enough. And, for far too many, it won’t be enough next week either.

Life is hard – we are overwhelmed by what we can do, let alone by what we can’t. What is asked of us doesn’t just seem impossible – impossible is what it all too often really is. So then, let’s not be surprised when we are not enough because everyone sometimes needs more than the world has to give and there is no shame in being asked for more than we’ve got and only being able to give all that we have.

Even so, wouldn’t it be great if there was someone who was enough, someone who could do what we cannot?

Today is Palm Sunday, the beginning of Holy Week, the day on which we remember how Jesus rode into Jerusalem on the back of a donkey. As he travelled, cheered on by the people who welcomed him as their king, thousands of lambs were also being driven into the city in preparation for Passover, the Jewish festival that recalled how, back when they were enslaved in Egypt, the angel of death passed over those households where the blood of a lamb had been daubed on the doorposts of Jewish homes thus sparing the life of the eldest son within.

Like those lambs, Jesus too would soon be slaughtered. For five days later, on that first Good Friday, rejected by the people who had once rejoiced at his coming and now wearing only a crown of thorns, he would allow himself to be crucified. But unlike the blood of animals which was never enough to deal with sin and which was only ever meant to point towards this greater sacrifice, Jesus blood, shed for us on the cross, really is sufficient to take away our sin, secure God’s forgiveness and guarantee that, even though we all will one day die, those who trust him will, nonetheless, go on to live forever. And it is Jesus himself who assures us that this is true, the one who, as he raised Lazarus from the dead, declared himself to be the resurrection and the life [John 11:25], the one who, by his own resurrection, proved this was no idle claim. For as John the Baptist recognised some three years earlier, Jesus really is the true lamb of God, the one who really does take away the sin of the world [John 1:29].

This week, therefore, whatever your need, whatever the thorn in your flesh might be, know that God’s grace is sufficient for you [2 Corinthians 12:9]. Though the pain may yet linger, though the suffering may still continue on, there is a certain hope for a better tomorrow, a day when every tear will be wiped from our eyes and death shall be no more. [Revelation 21:4]

Because, for all those who, like me, know themselves not to be good enough, the good news is that, though we should all still try to make a positive difference in the lives of others, the final outcome does not ultimately depend on us. The genuinely good news, the gospel no less, is that Jesus is the one on whom we can depend. Being perfectly good, he alone is good enough.

And as we travel through Holy Week we can be sure that his cross, his blood, his mercy, grace, and deep deep love are more than good enough for us all.

A hymn for those who know how much they need to be held

Related blogs:

To read ‘The Sacrifice of Isaac – Law or Gospel?’ click here

To read ‘Water from a Rock’, click here

To read “Good Friday – 2021”, click here

To read “Easter Sunday – 2021”, click here

To read, ‘The Resurrection – is it just rhubarb?’, click here

To read ‘Don’t forget to be ordinary if you want to be happy’, click here

To read, ‘T.S. Eliot, Jesus and the Paradox of the Christian Life’, click here

To read “Suffering- A Personal View”, click here.

To read “Why do bad things happen to good people – a tentative suggestion”, click here

To read “Luther and the global pandemic – on becoming a theologian of the cross”, click here

To read, ‘True Love?’, click here

To read, ‘Rest assured’, click here

To read, ‘Hope Comes From Believing The Promises Of God’, click here

To read “Waiting patiently for the Lord”, click here