‘THE DIG’ – IT’S WELL WORTH IT

‘Raking is easy, but all you get is leaves; digging is hard, but you might find diamonds.’

John Piper

Recently I watched ‘The Dig’, the excellent new Netflix Film based on the Sutton Hoo archeological excavation. It is well worth a watch. Alongside the story of Basil Brown, the amateur archaeologist who, in 1938, began exploring what lay beneath a grassy mound near Woodbridge in Suffolk, the film explores the importance of trying to hold on to the transient by remembering the past.

I’ll not spoil the film for those who have yet to see it, but the character of Rory is at one point asked what it was that drew him to photography. He gives the answer, ‘It’s just a way of trying to fix things as they go past, to keep what’s vital from being lost’.

‘To keep what’s vital from being lost’. I suppose that’s what, in large measure, we who are doctors, along with all those in healthcare and, indeed, many other fields too, are trying to do in our work as, daily, we act to try to preserve the preciousness of life. But we are not up to the task. Like the character who is distressed by his failure to protect the one he had been charged to care for, and no matter how much, like him, it’s not what we want to hear, we too have to be sometimes reminded of the truth: ‘We all fail, every day. There are some things we just can’t succeed at, no matter how hard we try.’

A little later in the film Rory asks Peggy, one of the site archaeologists, what would be left of them both if a thousand years were to pass in and instant. Looking around her Peggy replies, ‘Parts of your watch, the torch, fragments of the mug’. Rory then adds what Peggy’s words have left unspoken, ‘But every last scrap of you and I would disappear’.

It’s a sobering thought, one which brings with it with an implication, expressed in the words of another character who reveals what she herself has come to realise, that ‘Life is very fleeting. There are moments you should seize’.

But if there are moments that we should seize, then there are moments that we should remember. Because the past is part of who we are, part of what makes us what we are today and part of what will determine our tomorrow. I’m not referring here merely to our own personal back story, on the contrary, as the film seeks to portray, we are all shaped to some extent by the whole of human history.

As Basil Brown has to be reminded, his work ‘isn’t about the past or even the present. It’s for the future. So that the next generations can know where they came from. The line that joins them to their forebears.’

Our past, it is suggested, will last longer than our future.

So, as we consult with our patients, perhaps we should sometimes cease from our constant striving to achieve those things which we can not hope to succeed at and seek instead to remember together what it is that we are all a part. As individuals ‘We die. We die and we decay. We don’t live on.’ But, as Basil Brown replies to the one who speaks these stark words, ‘From the first human handprint on a cave wall, we’re part of something continuous’. As a result, Brown claims, ‘We don’t really die’.

It’s a comforting notion but is it one that’s true? For, no matter how prettily we try to wrap it up, the ugly reality is that we do all die. Even so, perhaps there is something worth thinking about here. If we make our lives only about ourselves and what we can experience or achieve, all of what we are will indeed die with us. But if we are part of something bigger, something we gladly accept our being a part of, something vast that continues on beyond the few years of our existence, then there is a sense in which what we are does indeed continue after our death.

Sometimes we, as well as our patients would do well to be encouraged to appreciate this bigger picture. Because sometimes, rather than looking in, it is better to look out, rather than looking down, it’s better to look up, and rather than looking forward, it’s better to look back.

Without denying the ugliness of death, we all need to remember the beauty of life. There are moments that we do indeed need to fix as they go past, moments that ground us in something bigger than the here and now, moments that will stop us from being lost in our own individual present and, perhaps, enable us to muster some hope for our future. Maybe it is the inability to do this that contributes to the tragedy of dementia, that cruel disease that vividly displays for us the importance of our need to remember, that we are not meant to live merely in the moment, that we are not meant to live such lonely disconnected lives.

But if we would do well to see our lives as a small part of the whole of human history, might we not do even better by considering if we might not be part of something even greater still? I believe we would. And that’s why, unlike Alistair Campbell, who famously said that he didn’t, I do ‘do God’, both here and, yes, occasionally, with my patients too. For me it’s too important not to. It is dishonest to pretend that medicine has all the answers to the problems that we are presented with, not least that of our own inevitable demise. Our lives are about far more than merely attending to our clinical parameters in the vain hope of eking out a few short additional years of life. For, no matter how meticulous we are in adhering to clinical guidelines, all our lives will, in time, draw to an end.

Even so, it is my belief that my death will be but temporary, for I consider that my life really is a part of something far bigger than my own individual existence, that life really is all about someone who is far greater than me, and that that someone really will one day restore everything to how it was always meant to be. And it is all on account of what has happened in the past that, regardless of how difficult the present might be, I can remain confident that the future really will be as good as it has been promised to be.

Because the dig really is worth it in order that we might uncover what happened, not under a grassy mound in Suffolk but on top of a green hill far away. Like Basil Brown could say of Sutton Hoo, I can say of Calvary, that ‘a man could dig the earth his whole life through and not find anything like I’ve discovered here’. For there is found the greatest treasure of all, in amongst which is a future where every tear will have been wiped away and death shall be no more.

For me then, if we are to not really die, it’s that particular historical event that we all need to remember. It’s that which is truly vital, it’s that which must not be lost.


To read ‘Something to feast your eyes on’, click here

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

To read ‘Hope comes from believing the promises of God’, click here

To read ‘On being confronted by the law’, click here

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

To read ‘Easter Sunday’, click here

To read ‘Good Friday’, click here

SHOT OF LOVE

SHOT OF LOVE

This week brought the sad news of Captain Sir Tom Moore’s death with coronavirus. The last of his 100 years was certainly a remarkable one as he made the headlines, and many admirers, by lovingly walking around his garden a hundred times. As a result of his tremendous fundraising efforts, £33 million was donated to NHS charities. I, for one, am grateful for his efforts.

Another frail elderly man died this week. Also from Covid 19. Few will know his name, just those who loved him for who he was, many of whom won’t have been fully aware of the ‘heroics’ of his life, how he worked to provide for his family, how, year after difficult year, he was there for his children, and how it was his habit to show kindness to those he lived alongside in the community where he made his home.

His too was a remarkable yet ordinary life.

Last weekend I spent a day at a local vaccination centre. One patient stood out as she was wheeled to the station where I was working. Lost under a swathe of blankets, her bent body was curled up in one of those chairs which allowed her to lie out rather than insisting that she be sat up. With her chin on her chest and her eyes closed, she neither said, nor appeared to hear, anything. Hers seemed to be a life that it might have been easy to dismiss as without value but for the fact that she was clearly loved by the daughter who brought her. I did not know the story of her life but, as we tunnelled through the layers in order to find a small area or aged skin in which to plunge a needle, it felt good to live in a society that values the elderly enough to offer the vaccine to all, regardless of an individual’s achievements or current economic worth. It was a privilege and a genuine joy to vaccinate this particular elderly lady.

It is good to herald the exceptional achievements of individuals, but we do, I think, need to be a little careful that in doing so we don’t lose sight of the value of the ordinary. Most of us will not achieve greatness in the eyes of the world, but our everyday contributions still make a significant difference to those among whom we live and work. Furthermore, as my vaccinated elderly lady demonstrates, our value isn’t lost the moment we no longer contribute or achieve in the way we may once have done.

Life shouldn’t be competitive, a race to see who wins, rather it should be collaborative, ensuring we all get to the finish line in as fit a state as is possible. Constantly judging each other’s worth, on the basis of our achievements does none of us any good, burdening as it does the currently ‘successful’ with the need to maintain their lofty position whilst demonising and demoralising those deemed to have failed. We, and those with whom we live alongside, need to learn how to be kinder to one another, accepting each other and acknowledging our humanness. We need to stop insisting that we all must be more than we actually are and start, instead, to accept one another despite our being the flawed people we, inevitably, sometimes prove ourselves to be.

Because we would all feel a lot more loved if we all became a lot more loving.

Captain Tom is quoted as saying that he always believed that things would get better, that the sun would shine again and that we’d all have a lovely day tomorrow. He’s not the first to have said such a thing. Some of us will be familiar with the words of the psalmist who wrote how, ‘Weeping may tarry for the night but joy comes in the morning’. I don’t doubt the truth of these words written, as they were, thousands of years ago, but equally we must accept that, for some, the night has already been long and the day still seems an eternity away.

So until that better tomorrow, that wonderful day when all our tears will have been wiped away, we’ll do well to support the weak as well as celebrate the strong, to rejoice with those who rejoice whilst weeping with those who weep.

Because one day soon, we too may be glad to have somebody who loves us enough to wheel us to a vaccination centre under a sea of blankets and allow us to be the recipient of what is itself an expression of something we all need – a shot of love.


Related posts:

To read ‘Room Enough’ , please click here

To read ‘Vaccinating to remain susceptible’, please click here

To read ‘True Love?’, please click here

To read ‘Because sometimes not even chocolate is enough’, please click here

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

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

To read ‘For when we can’t see’, please click here

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

To read ‘Somewhere over the rainbow’, please click here

To read ‘When the jokes on you’, please click here

To read ‘With great power’, please click here

To read ‘Nikki Alexander – Dr Perfect?’, please click here

Room Enough

With her back bent, and her eyes closed,

she is lost in a sea of blankets.

She says, and hears, nothing.

.

But still, she is lovingly brought,

The wheels of her chair turn,

As she takes hers.

.

In silence

A small island of aged skin is found

Yet there’s room enough – for her

.

To finally, fully feel,

The point of it all –

In the jab of a needle.


To read ‘I knew a man’, click here

She’s the patient you don’t know you have

She’s the patient you don’t know you have
Sat all alone
Forgotten, unknown
She’ll not answer her phone
She’s the patient you don’t know you have

She prefers it that way

She’s the patient you don’t know you have
She’s given herself licence
To suffer in silence
Her pain and her violence
She’s the patient you don’t know you have

She prefers it that way

She’s the patient you don’t know you have
Her tears you’ll not see
They’re for her eyes only
She’ll just let them be
She’s the patient you don’t know you have

She prefers it that way

If only for today

A Not So Shaggy Dog Story

Two weeks ago I was faced with a clinical dilemma, a patient of mine who was repeatedly eating, yes eating, the dressings that his carer kept applying to his non healing leg lesion and who was thus working his way steadily through a box of Elastoplast.

I sought the advice of my medical colleagues. What, I asked them, might I best do for my patient. Should I:

a) For fear of provoking an intestinal obstruction, counsel the carer to desist from applying the dressings and instead suffer the consequences of the lesion bleeding all over the carpet,

b) Seek a psychiatric opinion, or

c) Advise the carer to take a more authoritarian tone with the patient and threaten no further doggie chocs if the behaviour were to continue.

Their recommendations for action came back from all corners of the country. Had I considered pica, had I checked his ferritin levels and, from those more fully appreciating my patient’s four leggedness, had I tried a cone of shame. This last suggestion, however, despite its suitability and soundness, was not one that was possible for me to employ since all I had at my disposal was a cube of discontent and a cylinder of regret.

Of course the only real option open to me was to seek out a specialist opinion. But having done so and received the advice that a surgical solution was what the leg lesion required, the surgeon sought out my opinion as to whether the procedure should go ahead.

My initial reaction was an unqualified yes but, after reflecting on the matter, I realised that, in terms of quality adjusted life years, performing the operation on a nonagenarian patient made poor financial sense irrespective of how much the old fella was loved by those dear to him.

I sought the opinion of my esteemed colleagues once more in the hope that their collective wisdom would aid me in my ethical dilemma. I asked them whether, in these days of ever increasingly tight purse strings, I should

a) stick with my original advice and, as his allocated key worker, bear the cost of the surgery myself.

b) withdraw my support for the proposed intervention and advise instead that the patient be kept off the furniture for fear of him bleeding on the upholstery, or

c) remove, as it were, the patient from my list, and take on a younger, less arthritic patient who was likely to have better smelling breath.

The advice was universally in favour of proceeding with the proposed surgery, a decision which in truth was never in doubt.

And so, this morning, after a night during which the air was filled with the rancid smell of necrotic tissue, and the silence was disturbed only by the incessant sound of a wound being constantly licked and all too many Elastoplasts being declared lost, presumed missing in action, [does that still count as ‘nil by mouth’?], my elderly patient slipped into an acute confusional state on account of his carers refusing to give him his usual breakfast of cornflakes with milk. [I know, but I’m sorry, he really likes milky cornflakes!]

Transport was duly arranged and he was promptly conveyed to the surgical assessment unit from where he, soon after, was taken down to theatre.

A few hours later, after a brief spell in recovery, he was back home with nothing to show for his ordeal save for a bald patch on his leg, that long overdue cone of shame, and an anaesthetic induced propensity to stagger amusingly when he tried to walk. [Is it wrong to laugh at the afflicted?]

So today was a good day as a result of a job well done. Thank you to Eric, Glen, Jessie and everyone at The Mount Veterinary Hospital, Wellington for early diagnosis, prompt referral and timely surgical intervention all combining to ensure, for today at least, a happy outcome.

His breath still smells though!

Gratitude and Regret

“Dead people receive more flowers than the living ones because regret is more powerful than gratitude”

Anne Frank

These words, written by the German-Dutch diarist Anne Frank were brought to my attention earlier this week. I found them arresting and started me wondering as to why, if true, such a thing might be so. Not many of us can honestly sing along with Frank Sinatra and claim that our regrets are ‘too few to mention’ and neither, surely, would anyone join with Edith Piaf and genuinely claim ‘Non, je ne regrette rien’. On the contrary, for there are things in all our lives that we wish were not, things we wish had never been, and things we wish we had never said or done. And there are things that have happened to us or to those we love, things that we continue to bitterly regret ever took place.

But why might it be then, as Anne Frank suggests, that regret is more powerful than gratitude in provoking a response from us when gratitude is something that surely we have all also experienced.

I wonder if the answer might lie in what we have come to expect from our lives. Might it be that we too easily take for granted the good things in our lives, considering them as our right? Might we have become less grateful for them, less appreciative of the kindnesses we have been shown, all as a result of coming to believe, perhaps, that they are all somehow deserved? If so, might that be the reason why we feel less gratitude than we should, and why we may express our thankfulness less forcefully than we could?

In contrast, it seems, we tend to be more easily moved by those things we regret, those things which upset our rosy view of the world. Promised as we have been that, if we believe in ourselves and listen to our hearts, all of our dreams will come true, we have come to expect good things in our lives, that health, wealth and prosperity are there for us all to enjoy. But we have been lied to. And when the reality of the difficulties that invade all our lives can be denied no longer, when it is all too plain that both our lives and we ourselves fall far short of that ideal, we are startled into a response.

Despite the existence of both good and bad, we have tried to airbrush our view of life in an attempt to maintain the illusion that all will be well. So adept have our efforts been that, when pain and suffering inevitably comes, we are shocked, when sadness fills our lives we are surprised, and when death rears its ugly head we are overwhelmed.

And so it is then that we buy flowers – a reminder of beauty, a reminder of love, a reminder of life.

Anne Frank of course knew how hard life could be, spending two years hidden away in a secret annex in an Amsterdam house before being arrested by the Gestapo and eventually dying in the Bergen-Belsen concentration camp in 1944. She was just 15. And yet her writing reveals that, despite the horrors that she undoubtedly experienced, she knew what it was to be grateful. Without denying the bad, she was able to appreciate the good.

‘As long as this exists’, she wrote, ‘this sunshine and this cloudless sky, and as long as I can enjoy it, how can I be sad?’

Perhaps it was because she had learned that the good things in life were not to be taken for granted that she was able to appreciate those good things when she had them to enjoy. Perhaps, instead of allowing anger and criticism of others to flow so readily from within us when things go wrong, we could too. Perhaps we could be a little more thankful and appreciative than we are.

In these days of pandemic nobody’s lot is a universally happy one. The truth is that life is difficult for everyone just now and it may well remain so for some considerable while yet. But ours is not the first generation to find it tough. And though the sky may well be full of dark clouds at the moment, they will, as they have before, one day part and the sun will shine once more. And when it does we will be grateful for its brightness and warmth, just as we can be grateful for all the many things, big and small, that we can take pleasure in today.

Despite, then, the universal nature of sadness, happiness can still be experienced alongside it. Perhaps it might even be true to say that we cannot fully know what happiness is without knowing the pain of sorrow and that sorrow itself requires the memory of the temporary nature of happiness for it to be fully experienced. If so then, if we are to be happy, it must be alongside our sadness. We dare not wait for the absence of sorrow before allowing ourselves to be happy. It is not that we can not be happy because we know sadness, nor that we can not be sad because there are things to be happy about. Paradoxically, we can be happy and sad at the same time.

Even so, as we wait for those infinitely better, brighter days that we all so long for, we would do well to take another leaf out of Anne Frank’s book where she quite rightly once wrote:

‘How wonderful it is that nobody need wait a single moment before starting to improve the world’


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

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

To read ‘The Life I Lead’, click here

To read ‘Monsters’, click here

Vaccinating to remain Susceptible

VACCINATING TO REMAIN SUSCEPTIBLE

‘Grey hair is a crown of glory’

Proverbs 16:31a

Last Saturday I spent the day at a local Covid Vaccination Centre jabbing octogenarians, not to mention one or two even older folk, with the Pfizer vaccine. And, after getting over my initial trepidation of adding 1.8 mls of saline to a glass vial, not something that would generally bring me out in a cold sweat, what a genuinely enjoyable day it was. In large measure, the pleasure I experienced came from working alongside lovely people, many of whom I’d never met before, to deliver something that, please let this be true, will make a real difference in the ongoing fight against coronavirus.

But every bit as enjoyable was meeting the warm hearted, good humoured and affable elderly folk who were being vaccinated. As I merrily stuck needles into their arms I was struck how, since it was they that we were vaccinating first on account of their greater vulnerability, it is in large measure similar folk to them who are being represented in numerical terms when each depressing day the number of deaths from coronavirus are announced.

It has frequently been remarked that there are three kinds of lies: lies, damned lies, and statistics. Mark Twain wrote of how statistics can beguile us into thinking things we shouldn’t and this is most certainly the case with regard to the figures we are currently being presented with daily. I am not referring here to whether or not the figures are an accurate reflection of the true number of coronavirus deaths, rather I am thinking of how they lie to us by distancing us from the personal tragedy behind the numbers, numbing us to the sadness associated with each of the deaths as they are marked down by another stroke of a statisticians pen.

Because however statistically significant it may be, it is all too easy to lose sight of a statistic’s significance.

For example, I wonder how many of us would find ourselves rejoicing next week if there were ‘only’ 500 deaths each day. Whilst we might understandably be pleased that the numbers were falling, might we also find ourselves forgetting how such a number would still represent considerable heart break and pain to those affected. And how many of us have guiltily allowed ourselves to be comforted by considering how a large percentage of those who die from Covid-19 are the frail and elderly who, we may be tempted to tell ourselves, are ‘dying anyway’. Sadly, of course, there may perhaps be some truth in this but we have unquestionably believed a lie if we take that to mean that it therefore doesn’t matter. Last Saturday, for me at least, was a reminder that thinking in such a way is to forget that the lives of the elderly that are being lost are the lives of warm hearted, good natured and affable folk like those I was vaccinating that day.

People aren’t statistics. Each individual who has succumbed to the coronavirus is more than merely one more of the approaching one hundred thousand who have thus far had to be counted. On the contrary, to those who loved them, they are those who were considered as one in a million.

This is not to dismiss as comparatively inconsequential the very real sacrifices being made by the younger generation in the battle against Covid-19, nor is it a call to pursue a particular course of action in the naive belief that every elderly life can be saved. Rather it is to acknowledge that behind the dispassionate statistics there are real people, in real pain, experiencing real grief and that, although, sadly, the deaths of many may be unavoidable, it is, nonetheless, not OK.

As the great vaccination effort continues, let us never become immune to the sadness surrounding those for whom it came too late, let us always stay susceptible to the reality of grief.

And may we mourn the loss of the frail elderly every bit as much as we do those who die early in their lives. Because to believe that the death of somebody who is old or clinically extremely vulnerable is one that should somehow be wept over less than that of someone who is young and fit is to value the strong over the weak and opens the door to a world where the aged and infirm can be forgotten and discarded.

And that’s not a world in which any of us want to grow old.


To read ‘I knew a man’, click here

To read ‘If’, click here

To read ‘Yesterday and Today’ click here

I knew a man

I knew a man of modest means,

Content to love his wife, his teens,

Who, ever hopeful, made the best

Of years constrained by heaving chest.

.

Till came the night for want of air,

His ceiling scored with ‘ward based care’,

Compelled by some he bore the cost,

His battle fought, his battle lost.

.

You smug-faced crowds who gather still

With scant regard for those who’re ill,

Stay home and pray you’ll never know

That hell where all too many go

.

[After Siegfried Sassoon]


To read ‘If’, click here

To read ‘patient’, click here

To read ‘crushed’, click here

To read ‘masked’, click here

To read ‘resting in pieces’, click here

A Pregnant Pause?

In these days of lockdown, there’s not much that’s fun

That’s something that everyone knows

The highlight of each of the weeks as they pass

Is sticking a swab up ones nose

.

Two evenings a week we all sit on our own

And watch a short film as it shows – a

Sequence of steps that we now must all take

To sample our nasal mucosa

.

The adding of saline to tubes, it is easy

But then comes the bit that one hates

The ticklish problem that has to be faced

Of brushing ones own turbinates

.

Once done though it’s then that we nervously sit

As pregnant with tension we wait

If two lines appear then the questions will come

Of who we’ve spent time with of late!