Tag Archives: life

On revolutionary medicine

On Thursday I spent the evening on Hampstead Heath with a group of people brought together by an organiser in Medact. We met to sit in the sun, share a picnic and discuss Che Guevara’s speech to recruits of a new post-revolution training program at Cuba’s Ministry of Public Health. On revolutionary medicine, is both specific to a time and place, and timeless in it’s analysis of how society defines, creates and sustains health or, more often, fails to do so.

‘Che and Medicine’ is a collection of his writings on medicine from Seven Stories Press. It argues for a collectivized health system and the integration of every health worker into the revolutionary movement.

Che was born premature, had pneumonia as an infant, and suffered with difficult to control asthma throughout his life. He had extended periods off school when his mother would home-school him. Rather than accept chronic illness, Che looked for ways to support his body to heal. He altered his diet, fasted, and pushed himself to be physically active outdoors. He adopted the principles of Lifestyle Medicine intuitively and saw the benefits, years before the evidence base would catch up and I would complete a diploma with the International Board of Lifestyle Medicine. Che’s personal experiences heavily influenced his later vision of a Cuban health system, but he wisely saw the limits of individual action, and the need for a collective community-based approach to health.

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Death Cafe

I saw someone die this week. This is not unusual; hospitals are places of life and death. I sometimes forget how far death is from most people’s day to day life and how difficult it can be be when it comes crashing in. This week two people, completely independently, asked me if I was still hosting Death Cafes. These are events spaces for people to come together to drink tea, eat cake and face our mortality. I’ve attended many Death Cafes and last hosted one in 2017.

Breaking the death taboo over tea, cake and candlelight

Talking about death is hard. But not talking about it can be damaging, with wishes unknown, plans never actualised, questions never answered and things left unsaid. There is so much to be gained from engaging with the finite nature of our lives. And so I’ve decided to run a series of Death Cafes again.

There will be tea. There will be cake. There will be facilitated conversation. If previous Death Cafes are anything to go by, there will be laughter, vulnerability and comfort.

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New year, new hope

It’s a New Year! January the 1st is not only the start of the New Year in the Gregorian calendar, but also the Roman and Julian, so if you’re still following the Julian calendar like the Amazigh people, then we’re in synch. There are of course New Years all through the year in different countries and cultures, and some New Years which move. This feels destabilising. I like the predictability of seasons and festivals. This week I learned that January the 1st is a feast day in the calendar of Eastern Orthodox calenders because it is the Feast of the Circumcision of Christ. I’m not sure this knowlege has enhanced my life. And now you can reflect on whether it has enhanced yours.

I did not stay up until midnight. I was pretty exhausted from work so had the most luxurious evening eating a lovely dinner and retiring to bed. My favourite thing about getting older is that I feel less and less need to do what’s expected and instead I do whatever I like! P__ stayed up but he’s a definite night owl, wheras I’ve had to accept that I’m more of a morning lark.

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Yuletide cheer

I had a lovely Christmas week, full of family and friends, and food, and thoughtful gifts. We had Mushroom Wellington and Maple Glazed Seitan Ham for Christmas dinner. It was super.

I was working for the days around the Bank Holidays. We rotate who does Christmas Day and, having done last year, I get a break for a few years. Hospitals are strange places at Christmas, a mixture of intense sadness and heart warming joy. Maybe that’s always the case, but Christmas somehow magnifies the contrasts. The people who remain inpatients at Christmas are those who are too sick to care or notice, and those for whom hospital is their best option. We’re always under pressure to discharge people and make beds, but to be honest, in the few days before Christmas I don’t discharge anyone who wants to be there. If home does not have something better to offer than a hospital bed then who am I to inflict loneliness, fear or sadness on anyone.

There is flu and RSV everywhere. People with chronic medical conditions are very sick. Even those who are usually well are strugling to shake off the persistent cough and fatigue. Vaccination rates remain much lower than pre-COVID. It’s hard to see how we’ll ever improve the situation and convince people of the benefits when there is so much misinformation and fear around vaccines.

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Impatience

I was recently asked what my primary emotion is, and I answered, without hesitation: impatience. This is both a blessing and a curse. It drives me to work hard try to change the problems I see everywhere, every day, and makes me very productive. But it also makes me a bit of a nightmare to work and live with. I struggle to slow down and to accept the slow pace of change that is a common reality. I tell others to remember their sphere of influence and not to expend energy on things way outside it, as this way burnout lies. I often fail to take this advice myself. This week I have felt very impatient.

COP 29 is happening. At least 1,773 fossil fuel lobbyists have been granted access to the summit in Baku. In an open letter, a group of international experts have stated that the UN Climate talks are no longer fit for purpose, and called for reform. Global emissions continue to increase, carbon sinks are being degraded and we are headed for more than 2.9°C of warming by 2100. I respect those who continue to participate in COP but I would not have the patience or diplomacy required.

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This meeting could have been an email

I spend more of my life in meetings than I would like and often think “this meeting could have been an email.” But this week I have been in several short and very effective meetings. It is amazing what can happen when there is a clear shared purpose and the right people are in the (virtual) room. There has been research into the psychology of work meetings, and the impacts for organisational outcomes and culture. I wish everyone would be more critical of meetings and ensure they always had a clear purpose that could not be achieved by another communication method. I for one commit to pausing before sending any future diary invites!

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Every day I pray for love

I was off work this week, but somehow found myself even more busy than usual. Being off work I had more time to watch the live streamed horrors in Gaza and Lebanon. I signed more petitions. I stepped up my boycott of companies profiting from Israel’s crimes. I sent money directly to a family in Khan Younis. Osama is 22, the oldest of 8 siblings, trying to keep his displaced family safe. His father needs medication, but with Israel’s military targeting hospitals and killing healthcare workers, leaving no functioning health service, very little is available. Almost no aid is entering Gaza. I can’t watch. I can’t not watch. I feel hollow.

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Healing wounds

My partner recently injured his hand on a faulty ladder. This took off an area of skin over a proximal finger joint resulting in a dramatic amount of bleeding and an inability to use the finger. Over the days and weeks since we have watched the healing process with fascination, noticing the stages of recovery of both form and function. Normal wound healing has four recognised stages: haemostasis, inflammation, proliferation, and remodelling. For a wound to heal successfully, the four phases must occur in the right sequence and time frame. Many factors can interfere with this process, risking impaired wound healing.

As we watched the re-epitheliation and remodelling of his physical wound it made me think about the unseen wounds many of us have suffered since the start of the pandemic, and the impaired wound healing we have been experiencing. So many people have been harmed not only by the virus itself but also by the lockdowns and the lack of a social safety net, eroded for decades by austerity. I see wounded people often in my work. They are incredibly adaptive and resilient but the body keeps the score, and many chronic diseases and distressing physical symptoms have their roots in emotional and social distress. I cannot speak for these people but I see them. I see their suffering and their strength.

Neither can I speak for all NHS staff, but is is well recognised that the pandemic traumatised healthcare workers. We experienced moral injury long before COVID-19, when we did not have the resources to provide the quality of care we wished to, were let down by a decimated social care system, or were forced to turn people in need away due to factors such as their immigration status. The pandemic brought us challenges that were all too familiar, but, more than that, it highlighted the pervasiveness, severity and proximity of this harm.

INDECISION
36” x 24” Acrylic paint on canvas, 2017. Cheyanne Silver.
From: www.luc.edu/features/stories/artsandculture/burnoutart/
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Patients not passports

I spent this week scrolling through my news feed, watching war crimes committed by Russia in Ukraine. A hospital was just bombed. I sent more money to humanitarian organisations including Doctors of the World. Whilst it is easy to feel powerless in the face of terrible world events, there are ways we can stand in solidarity. And whilst our minds are focused on people fleeing conflict, it is a good time to consider how refugees are treated if they reach the UK and need healthcare. I was therefore pleased to be part of a panel this week, to launch the Southwark Patients not Passports campaign.

It included a screening of NHS Borderlands, an investigative documentary into the human cost of charging migrants for accessing the NHS, made by Bare Life Films. It features Angela who, after fleeing Zimbabwe in fear for her life, sought asylum in the UK where she has lived with her husband for 20 years. Following a vital hysterectomy operation Angela was – without warning – issued a bill for £8,000 by the NHS. Angela is not allowed to work and has no source of income and this bill jeopardizes her life in the UK forever. There are many stories like Angela’s, most untold and undocumented. This film shows how healthcare workers and campaigners are fighting alongside Angela to keep the border out of the NHS.

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Time to Live

Last night I watched Time to Live from BBC2’s Life Stories series. Twelve people who have a terminal diagnosis share what they have learned about themselves and about life, knowing that it is short. They are people of all ages who have managed to find positives in their terminal prognosis and are making the most of the time they have left.

It is a fascinating, beautiful and uplifting, but also heartbreaking film. We can all learn something from these twelve people who live life with an intensity few of us experience, and who appreciate and celebrate the life they have.

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