In the moment – time flies!

Life flies past so quickly, doesn’t it?

I reflect on what I remember:

It’s nearly a year since the Brexit referendum.

It’s five years since London hosted a dazzling Olympic Games.

It’s eleven years since my first wonderful grand-daughter was born.

It’s seventeen years since we celebrated the millennium with fireworks and apprehension about whether all our computers would crash.

It’s forty-two years since I married Daphne, and forty-one since the birth of our first beloved daughter.

It’s forty-eight years since mankind took the giant step of sending a man to land on the moon for the very first time.

It’s sixty years since the Russians launched Sputnik 1, and a new era of exploration began.

The personal; the newsworthy; the significant; the trivial; they’re all there in my memory, and none of them really feel a long time ago – ok, well maybe Sputnik, although the memory is clear enough!

What a rush!

We can, though, slow down our perception of time if we practise living in the moment. We pay mindful attention to what we are experiencing as we experience it, and time slows for us. In particular, we pay attention to our feelings, nurturing the positive, and gently looking to let go of the negative. We have time to appreciate, time to enjoy; time to say “I love you” to those closest to us; time to fully enjoy their presence with us. Our time is both slower and richer.

Cooking ingredients 170530

I sometimes find that cooking helps me reach a state of mindfulness. It’s an activity where you have to focus on what you’re doing, and be alert to what’s happening. You pay attention to the appearance of the ingredients, and to their smell and to their taste. It’s a small step from there to being fully ‘in the moment’ and appreciating with your whole attention who you are and what you are living. I wrote a brief poem about this.

Season to Taste

I taste and season, stir and cover,

Chop potatoes, pepper, beans,

Making a meal, family-making,

Making pleasure, making love.

Not too salty, fine-chopped onion,

Taste and season, stir and cover.

Flavour contrast, savoury and sweet,

Unlikely partners, no meat,

Celery and chili (discreet).

Taste and season, stir and plate,

Food for my family – come and eat!

At first sight

My last couple of posts have been rather serious. Time for a change! Isn’t it strange how life-changing experiences can happen when we least expect them? Jonathan, a PhD student at Imperial College, was hardly a party animal, Academic supervisors aren’t noted for hosting orgies. And yet, by the end of the evening, Jonathan’s world has been turned upside-down.

Party buffet for story 170526

It was a good party. There was appetising food and a choice of wine, cask beer, or any number of soft drinks. The music was cheerful and not too loud; guests could converse without needing to shout at each other. As he queued at the table for a portion of fresh salmon salad, Jonathan idly wondered how his host had persuaded a live band to play at less than full volume. He would stay for an hour, long enough not to appear impolite, and then go back to his flat. His thoughts strayed back to the work he was doing for a PhD.

The band started to play a cover of the Rolling Stones song ‘Satisfaction’. Jonathan glanced down the room, curious to know the age of the musicians. The girl that he saw close to him filled him with sudden wonder and delight. Her eyes were amber. Her long hair was the colour of clover honey. She seemed, astonishingly, to be on her own. Jonathan was a shy man, but he immediately went over and introduced himself.

“Can I fetch you some food?” he offered.

She smiled. “I’ll join you in the queue, I think.” Her accent was Australian. “My name’s Vikki, by the way.”

“Vicky. Short for Victoria, or christened Vicky?”

“Christened? My folks wouldn’t have anything to do with that! But Vikki’s the name on my birth certificate.”

Jonathan turned in response to a tap on his shoulder. The man was tall. He was handsome in a flashy way. He gestured that Jonathan should leave.

“Don’t be so tedious, Guy.”

Vikki looked upset by the interruption.

“I’m sorry. I don’t want to intrude if you’re with Guy.”

“I’m not.”

Guy and Vikki exchanged looks.

“Go away, Guy,” she said. “You know you shouldn’t be anywhere near me.”

Guy didn’t move.

Jonathan hated confrontation; nevertheless, “Vicky doesn’t want you here,” he said; and hoped he looked sufficiently intimidating. Guy’s punch to his head took him completely by surprise, and knocked him flat. As he elbowed himself off the floor, he saw Guy striding to the exit dragging Vikki with him.

Jonathan pushed away the concerned onlookers. He wiped his hand over his face, and felt dismayed by the blood and mucus. Then he ran at Guy, and punched him as hard as he could at the place where he imagined the kidneys would be.

Friends grabbed him, pinned him. Others held onto Guy, who was retching, struggling to breathe.

Jonathan’s host was there.

“Put him outside,” he said, gesturing at Guy.

“If you want to continue,” he said to Jonathan, “you can go outside too. What on earth were you thinking about, Jon?”

“He was thinking of me,” interrupted Vikki. “Thank you, Jon. Guy’s a brute. There’s a restraining order against him, but he won’t leave me alone.”

Vikki led Jonathan into the kitchen, sponged the blood off his face.

“You’ll have a nasty bruise there.”

Jonathan grinned. “Never mind that. Can I see you tomorrow?”

“Oh, Jon! I wish you hadn’t asked that! I’m going home to Oz.”

They looked at each other.

“Holiday, or permanent?”

“Permanent.”

They looked away.

Then Jon turned back to Vikki, and took both her hands in his. Her skin was so soft and smooth.

“You feel it too, don’t you?” he said. He watched her face attentively, seeing pain, hunger, longing.

At last she sighed, nodded, and laid her face against his shoulder.

Next day, Jonathan watched her go through the departure gate, stayed and watched her plane take off. He clutched the piece of paper on which she’d written her name and address.

Who would have thought that love at first sight could hurt so much?

New Poem: ‘I Think’

Joe Solo (for those who don’t know) is a musician and poet with a burning commitment to social justice, and a great deal of compassion. If you have the chance to go to one of his gigs, do go – he’s good!

Joe Solo

Hope Not Hate
I think of the mother
Whose baby has gone
I think of the father
Who’s trying to be strong
I think of the surgeon
Who toiled through the night
And the nurse holding tears back
Til the moment was right
I think of the door
Opened wide to the world
Of the stranger whose words
Calmed a scared little girl
I think of the taxi cab
Waiving the fares
To reunite families
In a city that cares
I think of the kettle
That worked overtime
For emergency services
On the front line
I think of the Vigil
Every race, colour, creed
Of how shrapnel is colourblind
How it’s Red we all bleed
I think of the candles
They lit in the square
Of the queues at the blood bank
And the lives saved in there
I think of one homeless man’s
Ocean of calm
As he cradled a woman
Who…

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In the moment – sleep

Like most people, I have had times when sleep has not come easily. However, matters came to a head when I suffered from an anxiety disorder about eight years ago. One of the symptoms was struggling to sleep well. Part of my therapy taught me how best to approach going to sleep, and I’ve continued to use the techniques. They work! Here they are!

Bedroom 170524

Sleep.

It’s one of the most important things we do.

The brain uses sleep to consolidate memories and to deal with stress. Lack of sleep impairs our judgement. Did you know that even moderate lack of sleep affects driving as much as exceeding the legal blood alcohol level?

Most of the time we enjoy an adequate amount of sleep. However, we can also have periods when we don’t. Perhaps we work long hours at a stressful job, and struggle to unwind at the end of the day? Perhaps there are matters that are troubling us? Perhaps we’ve allowed bad sleep habits to creep into our routine?

Sleep is a natural action. Our minds and bodies know how to do it; we don’t need to think about it. In fact, if we’re having trouble going to sleep and we try to force ourselves to nod off, we’ll probably make matters worse. It’s much more effective to relax and let sleep happen naturally.

Mindfulness, being ‘in the moment’, can help us to overcome difficulties in going to sleep, Here are some thoughts that may help.

It’s easier to be ‘in the moment’ if that moment is pleasurable.

At bedtime, ideally, we don’t want to be too full; a heavy meal late at night, especially with a bit too much to drink, does not help sleeping! Equally, we don’t want to feel hungry; some people find a hot chocolate before bed helps.

Then there’s the place where we sleep. It should be as comfortable as we can reasonably make it. I’m not the most house-proud person in the world, but my bedroom is tidy. The bed is made earlier in the day, well before I want to sleep in it. The bedding is laundered frequently. My favourite photographs and books are close to me on the bookshelves. I’m careful about the temperature of the room. It’s a pleasure when I lie down in bed; everything feels good.

So, you’re ready for bed. As you approach it, remind yourself that sleep is natural; remind yourself that your bed is comfortable, and that it’s a nice place to be. Be conscious of the way the bed feels as you climb into it. Feel the texture of the bedclothes, and enjoy the feeling. It’s comfortable, a pleasure. Lie down. Switch off the light.

If you’re feeling stressed, give yourself permission to stop worrying. Say it out loud if you like. “I give myself permission to stop worrying and relax.” Say it, and believe it. You’re allowed to stop trying to solve problems. You’re allowed to enjoy the comfort of a good night’s sleep. You’re worth it, and you deserve it.

Enjoy lying there. Let yourself be aware of the resilience of the mattress; the texture of the bedclothes; the cosiness of being snug in bed. Wriggle into your usual sleeping position. Feel how good it is. Then relax, consciously.

A good way of doing this is to start by relaxing the muscles of your scalp, and then, progressively, the rest of your body. Relax your scalp, the back of your neck, your forehead, your cheeks, your jaw, your shoulders, and so on, right down to the tips of your toes.

I find it helps if I synchronise my breathing with the relaxation, like this. I think, “Relax the muscles of your scalp,” as I inhale. Then I exhale gently. “Relax the muscles of your neck,” as I inhale again. Then I exhale gently. “Relax the muscles of your forehead,” as I inhale. And so on. It’s been a long time since I’ve finished the sequence, because I’ve slipped peacefully into sleep…

Sleep well, folks!

I’m sharing my personal experience in the hope that it might help people who occasionally have some difficulty getting off to sleep at night. However, if you have persistent difficulty that significantly reduces the time you sleep, you should seek help from a professional. Also, lack of sleep impairs your ability to drive. If your sleep has been significantly disturbed, you should think carefully about whether you’re safe before driving.

 

Emergency

This story is set in an A&E department. It’s based on stories reported in various newspapers in January 2017, although it is, of course, fictional. I am not an NHS worker. I am, however, someone with cause to be grateful for the excellent work of doctors, nurses and paramedics 24/7. I apologise in advance for any inaccuracies in the detail of this story.

hospital-emergency 170520

I was just starting my shift when the paramedics wheeled in my gran; it took me a few seconds to remember that in fact she had died four years earlier. As we transferred the patient to one of our trolleys in Accident and Emergency, she wheezed, “Can I have a fag, love?” and then chuckled hoarsely before wincing.

“You are my gran!” I exclaimed. “You look just like her, and that’s exactly what she would have said!”

We wheeled her into an assessment bay. Doctor Springer, the consultant on our rapid assessment team, glanced at the paramedic’s notes, asked a few questions, quietly told me the tests he wanted doing, initialled my record form and left swiftly.

“He’s a looker, isn’t he?”

I smiled. He certainly was.

“What was your gran’s name, love?”

“Ivy. Sharp scratch now.” The patient jumped.

“Oh, I’m sorry; I didn’t mean to hurt you!”

“No, you didn’t, love. It’s just odd. I’m Ivy, too!”

“I’m afraid I’m going to have to wheel you out of this area into the corridor, Ivy. We’re terribly busy tonight.” On the way, I dropped the blood samples into the pathology lab box on the desk.

“That’s alright, love. You do what you need to. I suppose you couldn’t give me something for the pain in my side?”

I checked my record form. Doctor Springer hadn’t prescribed analgesia; but he hadn’t stated ‘nil by mouth’ either. Would a couple of paracetamol hurt? But there was no record of a pain in the side; Ivy had been admitted with shortness of breath and chest pain. I recorded the pain in her side on the record form.

“I’m afraid we’d better wait until Doctor Springer’s seen your test results. He may want to have another look at you. Sorry, Ivy.”

Just then, Doctor Springer walked quickly past, his face serious, heading towards Resus. He nodded at me to follow him. I gave a little wave to Ivy and chased after the consultant. A middle-aged man had suffered a cardiac arrest. He’d been a ‘walk-in’ patient, and usually they’re less seriously ill; not this time.

We used the defibrillator once. Twice. The third time I held my breath; it was probably his last chance.

“Shocking”

The patient heaved up with the current. His heart monitor began to beep. Back from the brink…I passed Doctor Springer the man’s record form and he initialled it.

We’d only been in Resus for five minutes, but there were already two ambulance trolleys waiting for us. We processed the patients quickly. Both of them were basically okay – a bad asthma attack, and an elderly man who’d fallen in the street.

“Rosie?”

I looked up from the form I was checking.

“Can you chase Majors for bed-space, please? I’d like to move a couple of these trolleys, and when I asked Mark he told me to piss off. You’ve got more clout than I have.” Jonathan was our health care assistant; very useful, but a little lacking in assertiveness.

“I’ve already asked, Jon. That’s probably why Mark was rude. They have two patients due to go to the wards by four o’clock, but that depends on the wards’ patients being discharged.”

“So, fifty-fifty then?”

“Depends on whether they’ve got somewhere to go, Jon. You know that. Go and see if any of the patients would like a cuppa. And remember to check whether they’re ‘nil-by-mouth!'”

Two ambulances arrived together. There’d been a road accident. A rapid assessment team is supposed to eliminate triage. However, when you have simultaneous arrivals, you must have some way of prioritising who the consultant sees first. I grabbed the notes from the ambulance crews, glanced in at the patients. One of them was making a fuss; not surprising with a broken leg. The other was quiet, but had a head injury that could be serious. The head injury goes first.

Doctor Springer examined the patient quickly but thoroughly. “This patient needs a CT scan immediately”. I buzzed for a porter. No response. I stuck my head out of the cubicle; from the corner of my eye, I saw Ivy wave at me but I had to ignore her.

Good! There was a porter.

“Derek! Just in time! This patient must go immediately for a CT scan.”

“I’m supposed to be on reception.”

“I know that. This is urgent. Just do it, please.”

He looked daggers at me, and I can’t say I blamed him. It’s a very physical job, portering, and he was rushed off his feet. Still, the patient’s safety comes above everything else.

“Notes?” he reminded me. I was still clasping them. I slipped them into the wallet on the trolley.

“Ta, Derek.” I smiled at him as nicely as I could.

The patient with a broken leg was soon off to X-ray, and I had a moment or two to catch up. Ivy was waving at me again.

“Hello, Ivy. Did Jon get you a cuppa?”

“It’s this pain in my side, nurse. It’s worse.”

Ivy wasn’t looking too well, but her pulse was steady, and her blood oxygen was okay – adequate, but not great.

“I’ll tell the consultant at your review, when we receive the test results.”

The pace picked up. I literally didn’t have a moment free. Another two trolleys went into the corridor. Ivy had dozed off. Good. That would probably ease her discomfort.

The clock showed five to six as Neil, our manager, approached.

“Rosie. I’m stuck for cover tomorrow; Katy’s rung in sick.”

“But she’s on at six in the morning, isn’t she? I’m on at ten. If I do both, that’s a double stint on the rapid assessment team.”

“I know. I’m afraid there’s no-one else, and we’ve finished our department’s monthly budget for agency staff.”

“But it’s only the nineteenth!”

Neil nodded. “Even so, there’s no budget left, and that means no agency staff unless we have a black alert.”

“I’m not happy about it. It’s bad for patient safety.”

“If you can’t do it, Rosie, then we work without a Band 5 Nurse. I think that would compromise patient safety even more, don’t you?”

Why do I do this job? The bloody government exploits my goodwill.

“I haven’t said I won’t do it. I don’t let my patients down. But it’s your job to get us an adequate budget.”

“Rosie, we have a bigger slice of the hospital’s spend than most departments; it’s just not as big a budget as we’d all like. At least as a member of a rapid assessment team you’re not facing the possibility of seeing your department close.”

I grabbed a pizza on my way home. I’d been meaning to cook something nice, but that would take too long; I needed an early night ready for the six o’clock start.

It was dark when I rolled out of bed at five o’clock. Although I’d set the alarm, I hadn’t needed it and I’d turned it off when I was sure my concerns about the day had woken me beyond hope of another half hour’s sleep. My partner grunted, but didn’t stir.

When I arrived in the department, it was bedlam. Carolyn, the nurse I was relieving, just said, “It’s been hell”, thrust the notes into my hands and ran. Her mascara was streaked right down her cheeks. It must have been a really bad night.

The notes were a mess. Well, not a mess exactly, but obviously written by someone in a tearing hurry. I blessed the person who had designed the forms so that they were mostly tick boxes or numerical results, with a minimum of free text.

There were more trolleys in the corridor. Ivy was still there, asleep. I checked the stats of all the patients on trolleys; some of them had been there even longer than Ivy. Thank goodness there were no ambulances right now, which gave me time to review the notes. I noted that my record of Ivy’s pain in her side now had a question mark beside it in Doctor Springer’s handwriting. Gosh! He’d done two until six this morning after yesterday’s afternoon shift! That must have been tough.

By ten past six, everything was in full flow once again. It had been a cold night after rain, and people seemed to be slipping and sliding all over the place. We had three fractured wrists, a dislocated thumb and two broken ankles in the first hour, not to mention a postman who’d collapsed with chest pains on his round. At least we were able to send the fracture patients to X-ray so they didn’t add to the numbers on trolleys.

As I passed Ivy on her trolley, she looked up at me. “Nurse,” she begged, “can you please let me have something for the pain?” I stopped and looked at her. She seemed much worse. Her pulse rate was very high, and her blood oxygen low. I looked around for the consultant. Where the hell was he? I grabbed Chloe, the junior nurse. “We need the consultant. Fetch him now, whatever he’s doing!”

Ivy sat up, hand pressed to her left side, wailing, and then slumped back. Her pulse had gone. I glanced to make sure the sensor hadn’t detached, then hit the crash button. “Help me get her into Resus!”

Doctor Springer came up at a run. What on earth was he doing still here?

“Get the defibrillator. It’ll be too slow trying to extricate her trolley from this traffic jam.”

We had the defibrillator there within seconds, but it was no good. We’d lost her. Right there in the corridor. No privacy, no dignity, no peace. Poor Ivy. I couldn’t believe it. What had we missed? What had gone wrong?

Doctor Springer looked haunted. “Aneurysm. Damn. I thought it was a possibility. I was going to go back and check but I never had time. Damn, damn, damn. That’s one we shouldn’t have lost.”

Poor Ivy. I don’t usually cry when I’m on duty, but I wept for her.

Doctor Springer laid his hand on my shoulder, but said nothing. We both knew that she might have survived; we both knew that it wasn’t our fault that she’d died; there simply hadn’t been enough staff. And that didn’t make a blind bit of difference to how we felt

Some facts about the NHS

The King’s Fund reports quarterly on the performance of the NHS. This data is from their latest report:

  • The target time for Ambulance Trusts to respond to Red 1 emergency calls is 8′. When this was introduced in June 2012, it was missed 24% of the time. This has now risen to 33% of the time.
  • A&E Departments have a target that no-one should wait more than 4 hours from arrival to admission, or transfer, or discharge (as appropriate). During 2009 – 10 this was missed less than 2% of the time. It’s now being missed 10% of the time.
  • The target for waiting time after diagnosis is that fewer than 8% of patients should wait longer than 18 weeks before the start of treatment. In 2012, this target was being met comfortably; fewer than 6% of patients waited longer than the target time. The latest report notes that the target has now been missed for ten consecutive months, and exceeds 10%.

You can find the data here.

http://qmr.kingsfund.org.uk/2017/22/data

 

#tuesdayuseitinasentence : Hard and black and heavy

Lynn Love is an excellent writer. This short story comes from her blog on WordPress, Word Shamble. The story is beautifully constructed, and packs a serious emotional punch. I find it well worth ‘following’ her blog, both for the pleasure of reading it, and for what I can learn from it as a writer.

Word Shamble

Lady Justice, blind, blindfold, balanceImage : Pixabay

‘It was just an accident. There was no reason.’ He wants to sit down, you can see it in his body language, the uncertain bobbing between standing and the hard backed chair.

It’s ridiculous, of course. There are always reasons. He was rushing home to watch the match on TV; he only had a provisional licence and was driving alone; the road was wet and the brake pads were worn. All small decisions he made that led to this.

There’s a spot of dried blood on his neck from where he’s caught himself shaving and his shirt’s grey from overwashing, crinkled as if it’s just been pulled from the laundry basket.

The sight makes me furious. That he didn’t deem this day important enough to buy a new shirt. That he’s too lazy to iron the old one.

That my son isn’t worth the effort.

Finally he sits. I…

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In the moment – be happy!

Bluebell wood 170508

Life holds many joys; the vigorous growth we’re seeing in gardens and fields; lambs gambolling on the moor; the love of families and friends. Even memories can bring us joy. Every day I look at the photograph of my wedding day – it’s in the bedroom, right in front of me as I drink my first cup of tea. It always lifts my spirits, not just as I remember the day itself, but because the picture reminds me how lucky I am to still be happily married to Daphne after more than forty years.

But life can also feel tough. There may be challenges at work, within the family, within society more broadly. Personally, I am deeply concerned about the political situation in Western democracies, where we seem to be increasingly polarised. We all have times when we feel sad; we all experience anger; we have all felt fear, or apprehension.

Now, here’s an interesting thing. Our brains process our feelings separately from our rational thought. Feelings come from our emotional brain, the amygdala, which is a very primitive part of the brain. When the emotional brain feels we are in a threatening situation it causes adrenalin to flood the body. This quickens the pulse rate dramatically and sharply raises levels of glucose in the blood. This is the “fight or fly” response, preparing us for combat, or for escape.

Once upon a time this was essential for our survival. In Western society that is no longer usually the case. In fact, repeated stimulation of the emotion of fear can lead to anxiety, where even ordinary daily life feels threatening. This can be sufficiently intense to disrupt our lives (been there, done that – it’s horrid).

Our brains process our feelings separately from our rational thought.

Our emotional brain has no way of knowing when it’s making the right response to a situation – it relies on our rational brain to tell it so. If our rational brain is consistently viewing a certain type of situation as a threat, then our emotional brain will believe it. So, for example, if we constantly worry about what’s going on in the world, our rational brain is sending the message, “I’m in a dangerous place. I’d better be on the alert.” Our emotional brain believes what the rational brain tells it, so that at the least sign of threat it goes, “AAAAGGGGHHHH!!! What’s that???”

The good thing is that our emotional brain also believes the rational brain if we consciously think positively about life. When, every night before bed, we write down three things that have gone well during the day, we are sending a powerful message to the emotional brain that life is good. When we count our blessings every morning, we are sending a message to the emotional brain that life is good. When I look at the photograph of my wedding day while drinking my first cup of tea of the day, I’m saying to my emotional brain, “Life is good. I’m happy.”

And when we do that consistently, day after day, the emotional brain gradually turns more to happiness, and less to vigilance. We become happier and more relaxed people.

And, while I don’t expect St Paul had this in mind when he gave the advice originally in his letter to the Philippians (Philippians 4:8), it certainly sums up well a good way of staying positive:

“Finally, brothers and sisters, whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable–if anything is excellent or praiseworthy–think about such things.” (NIV translation)

I hope you found this interesting and helpful. It’s meant to encourage a more positive, and therefore happier approach to life in those who are basically well. If you are constantly apprehensive, depressed, or listless, to the extent that it affects how you live your life, I strongly advise you to seek professional help.