Tuesday, 3 December 2013

Off Balance

Sometimes you can be moseying along, feeling pretty good about how you are coping with life – and then everything goes pear-shaped......

Well, that’s happened to me.  I was making steady progress after my cycling accident when, one night on my way to the loo, I suddenly realised I couldn’t walk straight.  The world seemed to be turning round and round. I couldn’t work out what was up and what was down. My head was spinning.  I had to hang on to the wall for dear life.  The next morning was no better.  Walking downstairs was too terrifying to contemplate, so bum-shuffled instead (which confused the dogs no end.)

And no, before you ask, I hadn’t been on the ale.    

It was vertigo. It’s common after head trauma. The collision dislodges the tiny stones in the inner ear (otoliths) which are responsible for balance.

It’s better now. I’ve had time to reflect on my responses to this, and how they might make sense for different sorts of unexpected problems.  

1.     Panic. Yes, I’m afraid so, panic is the first thing you do. It’s pretty inevitable when something unpleasant and unexpected happens, no matter how calm and capable you like to think you are.  My precarious night-time trip to the bathroom was accompanied by various silent expletives, ‘You cannot be serious’ and ‘What the **** is happening’.  It was not funny, not at all. I was scared. I was knocked off balance - literally and metaphorically.

2.     Find a place of safety. If you can, find somewhere out of harm's way, to ride out the storm.  For me it was lying on my back in bed, moving as little as possible.  I didn’t know what was happening, how long it was going to go on, whether it would get better or worse. But just lying there I had a sense of calm, of acceptance. In Gabrielle Roth’s words, I was ‘finding comfort in the sweet territory of silence’.  

3.     Distract yourself. If you’re stuck somewhere bad and can’t do anything about it, then it’s good to take your mind off it all, distract yourself. Switch from right brain (feelings) to left brain (thought). I decided to try and remember the names of the main characters in The Wire. I got lots of them – McNulty, Bunk, Daniels, Avon and DiAngelo, Bubbles and the brilliant Omar Little. For some reason I couldn’t recall Stringer Bell (psychoanalysts will have their theories, I’m sure).  

4.     Find support.   You need someone who’s there for you, who can calm things down a bit and help you think about what to do next. For me that’ was the easy bit. I just told Sue and she was there like a shot.

5.     Seek help.  You still need someone to help you fix the problem, or at least manage it as best you can. Within 24 hours I was in touch with the wonderful Nova Mullin, balance therapist from our local hospital. She has exactly the right combination of wisdom and confidence, assured me it was going to get better and started me on exercises I could do even with my neck in a brace.  


A s I say, I’m a lot better now. I can do White Crane Spreads Wings again in my tai chi class - though not yet with my eyes closed!




I wonder if this makes sense for you. How did you respond, the last time something unexpectedly horrible happenened?    






my cycling accident

Wednesday, 20 November 2013

Grief and Joy

Here are four of the many wise and thoughtful responses I’ve received to my most recent posts, plus a beautiful poem.  The writers have given their permission for me to share their thoughts with you. I hope you find them as helpful as I do.  


I was thinking, "Don't rush. Grief doesn't have a destination. It's a journey of a lifetime".  I wonder if you have read "Carrying the Elephant" by Michael Rosen?  It's the first of three volumes of poetry for adults, primarily about the death of his son.  He has some powerful imagery about "walking along".  I find this helpful, and the poem always makes me cry.  I think the whole journey of life thing is a bit trite, but I like the idea that we walk along.  I take myself to the lakes and think of those who accompany me on the way, sometimes we hold hands, sometimes pulling or helping each other, sometimes the kids and dogs dash about in front.  There are those who walk with us for a while, join another group then return, and those who just spend a short time with us.  There are those with whom we walk in comfortable silence, and those to whom we cannot stop chattering.  We take in the ever changing view, in all its weathers.  I find life can be hard to make sense of, and I find this idea comforting.



My brother died nearly 15 years ago, and I still miss him.  I found it took a year before I was back to normal functioning. One of the hardest things was not the absolute grief – which was like falling off a cliff into profound sadness, but the brain fog.  Quite simple tasks became almost impossible, and academic work was quite beyond me.  My experience was that with time, and by that I mean over the course of the year, not just a few weeks, although the level of sadness didn’t diminish, the frequency of falling off the cliff did, and each time I fell off, it lasted slightly less long.  So I went from being always at the bottom of the cliff, to being mostly at the top of the cliff, but with episodes of feeling the same searing loss as right at the beginning.  It was like losing half my self.

I’d like to add one more thought that came to me while reading your blog: when one grieves a loved one, the more this person was important to us, the heavier we’ll feel when we lose this person because to some extent, this person inhabits us more; we sometimes feel responsible for pursuing this person’s mission; thus it feels like gaining a lot of weight suddenly and having to learn how to balance our body with this new weight after.


I agree completely when you challenge the foolish notion that there is a set ‘healthy’ period of time to grieve. Simply not true! Loss affects everyone differently; the person, your relationship and manner of their passing also play a large part in determining how you come to terms with what has happened. In many ways, you never recover from what has happened, but you learn to accept it and manage your emotions. I know that my grief is managed when I can let go of those moments I missed or wasted (survivor’s guilt?), and think of that person with a sense of joy that overrides my sorrow. Other times I relive the grief as raw as ever, usually when I think I should have moved on – but this is not something that makes me concerned or ashamed.

I feel that in many ways people are the memories they gain and share with others. These transcend being, and can never be taken away from you. I will feel sadness as well as happiness, and this will probably continue in waves throughout my life. It means that the person was important to me. And I find that to be a comforting thought.



Thinking/wondering about grief and how long it lasts, I think we can be still grieving gently at some level while learning to live on without the person we mourn, so these two experiences co-exist within us. There isn't a 'stop time' when the grief has ebbed away and we see no mark of it on the sand; there isn't a 'start time' when happiness and lightness begins again and we exchange one for the other. Each informs the other, perhaps.

In the poem 'Lovers on Aran' Heaney asks a wonderful question of the Aran land-sea scape: 'Did sea define the land, or land the sea?' and he goes on to say that 'each drew new meaning from the waves' collision'. I wonder if perhaps grief and joy are just like that, defining each other, quite powerfully, each drawing new meaning from the collision that happens within our identify when we are shaken and upended.

And I think of how you've also had to cope with your accident and the whole recovery process, and that 'squishiness of being' that reminds us we are so very vulnerable, and so very precious. And how in your blog you talked about handing over to others to take care of you. I imagine that here, too, in the collision of strength and weakness in our physical being, we might find some definition, some new meaning/s about who we sense ourselves to be, our growing identity.

It's late, it's a dark blue night, the wind is sweeping in from the west; rain is gusting down from the Connemara hills and sparkling against the windows. I send my warmest thoughts, and to Sue and Sasha, every good wish. It sounds so good to have their care and comfort. I get the impression you are forging ahead to where you want to be, so I'm also sending various Irish pishogues, magical spells and mythical beings to speed that up!

Lovers on Aran

The timeless waves, bright, sifting, broken glass,
Came dazzling around, into the rocks,
Came glinting, sifting from the Americas

To possess Aran. Or did Aran rush
to throw wide arms of rock around a tide
That yielded with an ebb, with a soft crash?

Did sea define the land or land the sea?
Each drew new meaning from the waves' collision.
Sea broke on land to full identity.
Seamus Heaney

Monday, 28 October 2013

Reasons to be Cheerful

I had a nasty accident ten days ago.

I was knocked off my bike in town by an unobservant driver, ending up in a dramatic pool of blood in the middle of the road. Broken nose, teardrop fracture to my 7th cervical vertebra, lots of lacerations and bruises, and a fair bit of post-traumatic stress.....

But also many reasons to be cheerful.

1.     It could all have been so much worse. I’m still here. No brain injury (thank you, crash helmet). No spinal cord damage.
2.     The kindness of strangers. I’ve written about this before, and here was living proof of it. Within seconds I was surrounded by passers-by making sure I was alright and got the help I needed. Top of the list of good Samaritans was Tracey Saphier, a nurse on her way home from work, who took charge of the whole scene, making sure I didn’t move, mopping blood out of my eyes, talking to Sue on the phone, checking on ambulance arrival time. Thank you kind people of Liverpool, thank you Tracey. 

3.     Our NHS is great in a crisis. It really is.  Forget the bad press it gets these days.  The ambulance team who got me onto a stretcher and secured my neck; the amazing trauma team in the Royal Liverpool Hospital who checked me out from top to toe in a matter of minutes (while chatting to me about bikes and cycling gear); spinal surgeon Marcus de Matas who took all possible care of my neck fracture; and the staff on Ward 4a who looked after me while I couldn’t move for three days.  I needed their help, and they were there.   

4.      Sue is wonderful in a crisis. She really is. She arrived at the hospital before the ambulance, fed me yoghurt when I couldn’t reach the hospital food, guided me through a psychic meltdown, and now is getting me back on my feet at home. I needed her help, and she was there.  

5.     The love of family and friends. Thank you all for being there, for your kind words and actions, for looking after Sue as well as me.  

6.     My neck brace. My exo-skeleton (non-biologists, google it!) for the next three months. It’s keeping my neck and back safe, and is deeply reassuring.  

7.     Time out. Now I can watch all five seasons of Breaking Bad in one go.  

All of the above (well, maybe not the Breaking Bad bit) are parts of something bigger, something that I haven’t quite worked out but seems profound to me.  For a while there, lying in the road and in hospital, I was in a real mess, completely helpless and utterly dependent on the care of others - something I’m not at all used to. 
And it was OK. In fact more than OK, it was liberating. I didn’t need to try and control my own destiny, it was fine to let go. I could relax.  I felt – no, I knew – that I was in safe hands. 
So, one final reason to be cheerful.

8.     Being alive is wonderful.


Wednesday, 2 October 2013

How long does grief last?

My brother Steve died two months ago. Those of you who’ve been following this blog will know this is a big thing for me, and explains why I haven’t posted for a while.  I’ve been mourning him. Life hasn’t been much fun.  I’ve been trudging through treacle. Sometimes I felt like I was drowning in it. 

But the past couple of weeks are better. An evening in London with Anna and Tom. A long weekend with Sue in Andalucia.  A new grandchild on the horizon. Walking the Bounding Ridge of White Nancy (yes, really – google it) last Saturday. My wellbeing recipes are starting to kick back in. I’m feeling lighter.

So for me, this time round, the worst of my grief lasted six weeks or so.

Which is interesting. The Orthodox Christian tradition is that mourning lasts for 40 days. The soul of the departed is thought to travel around during that time, visiting places of significance in its life. I wonder where Steve’s been visiting: no doubt Dublin, Corbridge, Cambridge and Newport.  I’m sure he’s called in to see us in Liverpool.   

However, as anthropologists tell us, there are many different cultures of mourning. In Victorian Britain, for example, mourning after the death of a sibling was expected to last for 6 months. So maybe I have a while to go yet.

The American Psychiatric Association would have us believe that if grief lasts for more than 2 weeks – that’s not a misprint, not two months or two years but two weeks – then we can be diagnosed with a depressive disorder and offered medical treatment.  So absurd it’s hard to believe, but it’s there in black and white in DSM-5, their current system for classifying mental disorders. 

This is dangerous nonsense.  It may help big pharma to sell more pills, but it stands in the way of realising and accepting our loss. It sanitises sadness. It medicalises this normal part of what it means to be alive, to love.    

A friend’s wife died just over a year ago. He’s beginning to think about going out with other women, but he knows he’s not really ready yet.   Someone told him ‘You should be over your grief by now, you need to see a psychiatrist to sort yourself out’.  He asked me what I thought.

My answer was simple: ‘Absolute rubbish! You’re still grieving. You can’t rush it. Take your time. You’ll know when you’re ready to move on.’

Grief is the price of love.

It drags us down. It drains us of energy. It hurts, physically. As CS Lewis wrote in A Grief Observed, time may be a healer but he’s not a very good anaesthetist. We just have to hang on in there, hide under the duvet and let it wash over us.  Grief lasts as long as it lasts. There’s no timetable, no deadline.  

But then, eventually, one day, it starts to get easier. 

If you are grieving now, I hope that day is not too far away.

Tuesday, 21 May 2013

How light is your heart?

I’m reading Julian Barnes’ beautiful book Levels of Life, about hot air ballooning and the death of his wife.  His link between the two is to do with height. He used the word both physically and metaphorically – rising effortlessly up in the air in a balloon, or crashing down into the depths when grief strikes.

I've been thinking about how we often use physical words to describe our emotions. 

We do talk a lot about height when describing our moods, mainly whether we’re feeling up or feeling down.  Sometimes we think visually, and talk about feeling bright or gloomy.

Another way of looking at our emotional lives is in terms of their weight.  If life is treating us well and there is lots of fun and enjoyment around, we often describe ourselves as ‘light-hearted’. If things are not going so well, we’ve had bad news or are expecting something difficult to happen, then we may talk about doing something or approaching a situation ‘with a heavy heart’. We can be weighed down by the cares of the world. Hopefully, we can sometimes throw off our burdens or share them with other people.  

The word depression contains elements of both height and weight. In physical terms it refers to a hollow, an area that is sunk below its surroundings.  It also refers to a sense of pressure, of being compressed, constrained, pushed down.  

For me, there is a very strong link between my emotional state and my sense of weight. This is nothing to do with my actual weight in kilograms, which could usually do with being a bit lower! 
If life is difficult I feel heavy, tired, sluggish. I find it’s a big, big effort to drag myself around. I’m trudging through treacle 
But when everything is going well I really do feel lighter, not just in my heart but in my whole being. Sometimes I feel weightless, it’s as if I could take off and fly. 

I love this sense of lightness. It is effortless, floating, breezy - like being in one of Julian Barnes’ hot air balloons, or floating on my back in the Mediterranean with the evening sun (another form of lightness) warming me.  I experienced it yesterday evening in my tai chi class, when my arms floated up and down without any effort at all from me. 
Lightness of being.

Yes please. Unlike Milan Kundera, I don’t find it unbearable.
I can see there might be down-sides to lightness. It can suggest not being serious, superficial, unimportant, lacking gravity (another physical term!), as in “he’s a light-weight.” 

But in emotional terms, I think lightness hard to beat.

How light is your heart today?

Sunday, 24 February 2013

Second Acts

I’m working my way through the whole of The Wire on a DVD box set. I know, I know, I’m ten years behind the times. But better late than never, and I’m loving it. 

In Season Two, D’Angelo Barksdale is on a long prison sentence for drug dealing. In a reading group discussion he quotes Scott Fitzgerald’s famous statement ‘There are no second acts in American lives’. D’Angelo reckons this means we only get one chance at living our lives[1]. Whatever role we find ourselves in is the role we are stuck with. We can try to change things, to break out and live differently, but we can’t do it. We are trapped. 

There is certainly no second act for D’Angelo, who is killed a few days later.  Nor for most of the characters in The Wire, whether drug dealers, trade unionists or police. Attempts to make big changes are invariably doomed to failure, death or disaster.   

It’s like a classical Greek drama, where human beings are playthings at the mercy of capricious, unpredictable gods.  We have the illusion of free will, but in reality our lives are predetermined, chosen for us and directed by forces beyond our control. So we’d better just accept our lot and make the best of a bad job.

Hang on a minute....

Well no, actually. No way. Absolutely not.

Great TV, great drama, but I refuse to accept this pessimistic view of the world.

We are persons with the capacity to lead our own lives. We are not passive victims of fate or circumstance. We have choices. We can do things differently.  Transformation is possible. Think Nelson Mandela.

Even if we’ve made a complete pig’s ear of our life up to this point, even if we’ve had a very rough deal until now, it is possible to turn things around.  We can have second (and even third and fourth) acts.

Last week Helen (not her real name) came to see me in my surgery. It was the first time we’d met for more than ten years, as she’d move away from our area for a while.  Back then she was dependent on alcohol and heroin, and had problems with hepatitis. She was heading rapidly downhill. But no longer. Helen’s off all that stuff now. She’s back in control of her life, caring for her teenage daughter and half way through a degree in sociology. 

For lots of people retirement is a great time to start over. Second act, third age - it’s the same thing. Once earning our living is no longer necessary we have a chance to try something we’ve always wanted to do. We can reinvent ourselves.

I wonder what I’ll do next.

What do you think?  Are we stuck with what we’ve got, or can we change things around? Have you had a second act?  Or are you planning one?

Saturday, 26 January 2013

Seeking Sanctuary

Where do you go when life gets too much for you?   

When everything’s getting on top of us, when we just can’t take it all any more, we need to escape to somewhere safe.  A refuge, a bolt-hole, an asylum, a shelter - a sanctuary.

In the Middle Ages a sanctuary was a place – often a church or monastery - where safety was guaranteed for people fleeing from arrest or prosecution. By the law of the medieval church, a fugitive from justice or a debtor was immune from arrest. If you’ve ever watched Derek Jacobi in Cadfael (or read Ellis Peters’ stories) you’ll know how that worked.  
If you were seeking sanctuary in those days, getting your hand on the door knocker was enough. You were safe and your pursuers couldn’t touch you. Next time you’re in Durham, grab hold of the sanctuary knocker on the main door (complete with protective gargoyle to ward off evil spirits) and breath a huge sigh of relief.

We don’t always have to go to such extremes. It is good to have our own personal sanctuaries, for those times when we just need to get away from it all.  You might find yours in the shed at the bottom of the garden, or on your allotment. Or jogging round the park, with your favourite tunes on your iPod. Or soaking in a hot bath with music and candles, and the bathroom door firmly locked.

When I was growing up in Dublin, family life was often stressful. To escape from all the hassle, I created a little library for myself in the outside toilet. I loved sitting there and reading. My brother Nick found a different refuge (usually from us older brothers wanting to beat him up!) in the branches of an old apple tree. Going through major life changes in my late 20s, the main place I felt safe was in my car, driving up and down the M6 between Manchester and Worcester.

Sadly, sanctuaries can become prisons. Lots of people use booze or drugs as a means of escape. They work for a while, giving that warm glow of comfort and forgetting. But too much for too long and they cause more problems than they solve.

If things are really, really bad – if you’re experiencing abuse or violence at home and don’t know how to get away from it - you may seek sanctuary inside your own head[1].  You find ways to watch what’s happening to you as if you’re outside the situation. It’s safer and easier than experiencing the pain or terror directly. But you risk losing touch with the rest of the world. As a GP, a lot of people with problems like this find ten minutes of sanctuary in my consulting room.  

How do you find sanctuary, when life gets too much for you?  

[1] I’ve touched on this before, a year or so ago in a post called What if you don’t feel at home?